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January, 2008:

Proposed Guidelines for the Implementation of Article 8

Jan 3rd, 2008
by AdminCTA.
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China (Hong Kong) has ratified the FCTC treaty, yet its requirements are not being enforced in Hong Kong.

The rationale for protection from exposure to tobacco smoke is clearly stated in Article 8.1 of the FCTC, in which Parties accept the overwhelming scientific consensus that second-hand smoke kills:

Parties recognize that scientific evidence has unequivocally established that exposure to tobacco smoke causes death, disease and disability.

In the time since the Convention was negotiated, the scientific consensus that exposure to tobacco smoke causes death, disease and disability has grown ever stronger, with the publication of important new expert reports, including those by the UK Scientific Committee on Tobacco or Health, 1 the US Surgeon General, 2 the French National Assembly, 3 the California Environmental Protection Agency,4 and others. These authorities further confirm that exposure to tobacco smoke causes a variety of illnesses, including fatal illnesses, in adults and children.

During this time, civil society has played a central role in educating opinion leaders, stakeholders and the general public in many countries about the hazards of exposure to tobacco smoke and the benefits of smoke-free legislation. Advocacy organizations, academic experts and institutions, medical associations and health professionals have all contributed to an ongoing transformation in the world’s understanding of this global problem. As the proposed guidelines acknowledge, civil society has a central role to play in building support for smoke-free measures, and must be an active partner in developing, implementing and enforcing legislation (Proposed guidelines, para 10).

Most importantly, since the negotiation of the FCTC, many national jurisdictions, including several States Parties, have adopted laws that provide almost universal protection against tobacco smoke in all indoor public places and indoor workplaces. The number of subnational jurisdictions with such laws has also grown quickly. Evidence surrounding the implementation of these laws shows a remarkably similar pattern. Smoke-free laws are effective. They are practical, workable, and economically beneficial. They are popular, enjoying exceptionally high levels of public support.

Read more on the Joint Briefing Paper: Proposed Guidelines for the Implementation of Article 8 of the WHO Framework Convention on Tobacco Control

Radioactive compounds

Jan 3rd, 2008
by Editor.
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The radioactive compounds found in highest concentration in cigarette smoke are polonium-210 and potassium-40. Other radioactive compounds present include radium-226, radium-228 and thorium-228. Radioactive compounds are well established as carcinogens.(12)


From: James Middleton [mailto:dynamco@netvigator.com]
Sent: Thursday, January 03, 2008 14:49
To: ‘dynamco@netvigator.com‘
Subject: – constituents of tobacco smoke are already classified as Toxic Air Contaminants by HK EPD

Hong Kong  EPD Report classifies many of the compounds present in tobacco smoke as TOXIC AIR POLLUTANTS

“Toxic Air Pollutants Monitoring Operation
The Air Science Group has installed in July 1997 additional monitoring facilities at the Tsuen Wan and Central/Western stations to measure regularly the levels of Toxic Air Pollutants (TAPs) in Hong Kong.

The TAPs being monitored can be broadly classified as volatile organic compounds (e.g.

benzene, perchloroethylene and

1,3-butadiene),

dioxins and furans (e.g.2,3,7,8-TCDF and 2,3,7,8-TCDD), carbonyl compounds (e.g.

formaldehyde),

polycyclic aromatic hydrocarbons (e.g. benzo(a)pyrene), and

hexavalent chromium.

Five distinct methods were used to analyse the collected samples for target TAPs (please refer to Table B4 for details).
All these methods have stringent QA/QC criteria to ensure the data quality. Sampling media used include stainless steel canisters, Sep-Pak cartridges, polyurethane foams and bicarbonate impregnated filters. TAP samples are analysed by the Government Laboratory.”

http://www.epd-asg.gov.hk/english/report/files/aqr06e.pdf ”

Table B4 Sampling and Analysis Methods Used in Measuring Toxic Air Pollutants (on Page B6)

5.1 Constituents of tobacco smoke

Unless otherwise noted, information in this section comes from reference 1.http://www.quit.org.au/quit/FandI/fandi/c05s1.htm

Tobacco smoke is estimated to contain over four thousand compounds, many of which are pharmacologically active, toxic, mutagenic and carcinogenic. There are 43 known carcinogens in tobacco smoke.(2)

The following major components of tobacco smoke have been identified as most likely to cause disease:

Tar

‘Tar’ describes the particulate matter inhaled when the smoker draws on a lighted cigarette. Each particle is composed of a large variety of organic and inorganic chemicals consisting primarily of nitrogen, oxygen, hydrogen, carbon dioxide, carbon monoxide, and a wide range of volatile and semivolatile organic chemicals.(3) In its condensate form, tar is the sticky brown substance which can stain smokers’ fingers and teeth yellow brown. It also stains the lung tissue.

Among the carcinogens or tumour initiators present in cigarette smoke are two major classes of tumour initiators, polycyclic aromatic hydrocarbons (see above EPD TAC) and tobacco-specificnitrosamines. Benzo[a]pyrene, (see above EPD TAC) well established as a carcinogen, is a prominent polycyclic aromatic hydrocarbon found in tar.

Nicotine

Nicotine appears to be the most important acute-acting pharmacological agent in tobacco smoke, and is the drug in tobacco which causes addiction among smokers.(4) Its immediate physiological effects include increased heart rate and blood pressure, constriction of cutaneous blood vessels, and muscular, hormonal and metabolic effects.(4) With prolonged exposure, it may contribute, in combination with carbon monoxide, to increased platelet stickiness and aggregation and damage to the lining of the blood vessels, suggesting a potential role in causing coronary disease. It is also implicated in the causation of reproductive and gastrointestinal disorders.(4) Although nicotine does not appear to possess direct carcinogenic activity itself, it enables the formation of tobacco-specific nitrosamines, which are potent carcinogens.(4)

Nicotine is among the most toxic of all poisons and acts with great speed. The average lethal dose for an adult human is estimated to be between 30 to 60 milligrams (mg). Once relatively common due to its use in insecticides in the 1920s and 1930s, nicotine poisoning is less usual these days.(5) Dosages of nicotine obtained through tobacco smoking are far too low to cause acute poisoning, although there is a serious risk for children who ingest cigarettes (see also Chapter 3, Section 6). Before building up a tolerance to nicotine, the smoker may experience mild effects of nicotine toxicity.

Except where it occurs in tobacco products, nicotine is scheduled as a poison and its availability is controlled by the State Poisons Acts. Products containing nicotine for therapeutic (drug) use are categorised as Schedule 3 and 4 poisons. Included in these Schedules are nicotine chewing gum and transdermal nicotine patches, aids in breaking nicotine addiction. The gum is available in two dosages, in 2 mg and 4 mg of nicotine per gum piece. The 2 mg gum is available without prescription from pharmacists, and classified as a Schedule 3 product. The 4 mg gum, nicotine patches and other products containing nicotine and intended as aids in tobacco withdrawal, are categorised as Schedule 4 products and available on prescription from a medical practitioner. Advertising of Schedule 3 and 4 products is restricted to professional or trade journals, or in publications intended for circulation in the medical, dental, veterinary or pharmaceutical professions or the wholesale drug industry.

All other forms of nicotine (tobacco products excepted) come under Schedules 6 or 7, which apply to highly toxic agricultural, domestic and industrial poisons.(6,7)

It is ironic that except in the case of tobacco products, which are expressly manufactured for self-administration by humans at great loss of life, products containing nicotine are highly regulated.See Chapter 11 for further discussion about nicotine.

Carbon monoxide

Carbon monoxide (CO) is an odourless, tasteless gas, giving no warning of its presence in most circumstances.(8) In large amounts it is rapidly fatal.

CO is formed when a cigarette is lit. It has a number of toxic effects on the body, the most important of which is its impairment of oxygen transportation in the blood. As CO has a chemical affinity for haemoglobin over 200 times greater than that of oxygen, it binds preferentially with the haemoglobin, thereby reducing the amount of oxygenated blood circulated to body organs and tissues.(8)

CO is strongly linked with the development of coronary heart disease. It is thought that this might occur through interference with myocardial oxygenation, increasing platelet stickiness, or promotion of atherosclerosis. Although CO is not in itself a carcinogen, it may contribute to cancers and other diseases of the respiratory tract because of its inhibiting effect on the respiratory tract’s mucus clearance mechanism. Instead of being cleared away, toxic substances contained in cigarette smoke remain in the airways, causing inflammation and damage, impairing lung function, and increasing the likelihood of lung disease.(9) CO may also have a short term effect on vision(10,11) (see also Chapter 3, Section 6).

The factors that influence the CO yield of a given brand of cigarettes depend on the manufacturing process (for example porosity of the paper and filter ventilation) and therefore may vary independently of tar yield. The absorption of CO is more dependent on depth of inhalation than is the absorption of nicotine, and, if a change to lower tar products results in a compensatory increase in depth of inhalation (see Section 5.3 below), smoker exposure to CO may remain unchanged or actually increase compared to dosages from the higher tar brands.

Nitrogen oxides

Cigarette smoke contains oxides of nitrogen in relatively high levels. This gas is known to cause lung damage in experimental animals similar to that noted in smokers, and may be responsible for initiating lung damage leading to emphysema.

Hydrogen cyanide and other ciliatoxic agents

Hydrogen cyanide has a direct, deleterious effect on the cilia, part of the natural lung clearance mechanism in humans. Interference with this cleaning system can result in an accumulation of toxic agents in the lungs, thereby increasing the likelihood of developing disease.(3) Other toxic agents in cigarette smoke which directly affect the cilia include acrolein, ammonia, nitrogen dioxide and formaldehyde. (see above EPD TAC) (9)

Metals

Thirty metals have been detected in tobacco smoke, including nickel, arsenic, cadmium,(12)chromium and lead (see above EPD TAC) .(2) Arsenic and arsenic compounds and chromium and some chromium compounds are causally associated with cancer in humans, while nickel and cadmium and their compounds are probably carcinogenic to humans. Arsenic levels in tobacco have been elevated in the past due to the use of arsenical pesticides. Cadmium levels may be related to the presence of cadmium in phosphate fertilisers.(12)

Radioactive compounds

The radioactive compounds found in highest concentration in cigarette smoke are polonium-210 and potassium-40. Other radioactive compounds present include radium-226, radium-228 and thorium-228. Radioactive compounds are well established as carcinogens.(12)

Cigarette Consumption Up Despite Smoking Ban in Hong Kong

Jan 2nd, 2008
by AdminCTA.
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Smokers puff 12m more each month after ban

Cigarette consumption up despite limit on smoking areas

Scarlett Chiang and Mary Ann Benitez – SCMP Jan 02, 2008

A year after the smoking ban was introduced in most public places, more than 12 million more cigarettes a month are being smoked in the city.

According to the Customs and Excise Department, the city consumed an average of about 289.67 million cigarettes per month last year, or about 14.5 million packs, while the average monthly consumption in 2006 was 277.65 million. Census figures for the end of 2006 showed the city had about 840,000 smokers.

Medical sector legislator Kwok Ka-ki said the increase showed the smoking ban was not motivating people to quit smoking. “I think the smoking ban can prevent second-hand smoke in public places,” he said, “but to motivate people to quit, the government still has a long way to go.”

Anti-smoking campaigner James Middleton of Clear the Air said the partial smoking ban had “no chance of success as long as [people] can continue to smoke in bars and restaurants that are granted these pathetic deferral exemptions”.

Mr Middleton said it was “business as usual for the tobacco companies and smokers alike”.

But the Tobacco Control Office insisted the ban was working.

Smoking is not allowed in indoor workplaces, restaurants, sports stadiums, parks and playgrounds or on beaches. But six types of establishments, including bars, nightclubs and mahjong parlours, have been given exemptions until June 30, 2009.

Anthony Hedley, chair professor of the department of community medicine at the University of Hong Kong, said the city’s growing population could account for the rising figures but added that so long as the prices of cigarettes stayed low, consumption would remain high.

“The price of cigarette and tobacco duty has not increased for seven years,” he said.

“The low price is the biggest driver of consumption. I am convinced this is because of long-term negotiations between the government and tobacco companies.”

The Tobacco Control Office has issued 3,360 summonses, including 998 at amusement game centres, 565 at food premises, 336 at markets, 315 at shops, 259 in shopping malls, 236 in parks, 139 on backstairs and 512 at other indoor public places.

As of November 30, about 1,300 people had been convicted, paying fines from HK$50 to HK$1,500.

Christine Wong Wang, head of the Tobacco Control Office, said: “The majority of the public, including some smokers, have shown appreciation of the statutory smoking ban, and voluntary compliance remains by and large the established norm.”

Federation of Restaurants and Related Trades vice-chairman Lock Kwok-on said restaurant business was hurt in the first six months of the ban but had steadied as customers became accustomed to it and more considerate in the second half of the year.

Many customers now were willing to step outside to smoke when told of the ban.

Dr Wong said the main aim of the ban was to protect people from second-hand smoke, but it may also have motivated more smokers to quit.

A smoking cessation hotline (1833183) set up by the Department of Health to counsel smokers had handled at least 5,800 calls since January last year – about 70 per cent higher than the previous year, she said.

But Dr Kwok said the department’s promotions were not enough to counter increased tobacco marketing towards teenagers since the introduction of the ban.

“A tobacco company will offer free delivery if you buy only two packages,” he said.

“Who needs delivery services to buy two packages of cigarettes? It must be targeting teenagers who cannot get them in a shop.”

It’s Time To Build On Smoking Ban’s Success

Jan 2nd, 2008
by AdminCTA.
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LEADER Jan 02, 2008 SCMP

The year-old public smoking ban has, without doubt, saved lives by reducing people’s exposure to second-hand smoke. But as a society, we have not made much headway in encouraging smokers to quit or discouraging others from taking up the deadly habit. The ban, therefore, has only been a partial victory for public health in Hong Kong.

As we report today, tobacco imports for local consumption rose slightly last year compared with the 12 months before the ban was introduced in January last year. Customs seizures of smuggled cigarettes also shot up. Much work lies ahead if we are to reduce the number of smokers in the city and the cost to public health services. Still, what the anti-smoking ban has already achieved deserves recognition and celebration. It has overcome the resistance and scepticism of the food services industry. Many restaurateurs who originally complained about a drop in business from smoking customers now acknowledge that business has returned to normal; many say their establishments now attract non-smoking customers who tended to avoid them in the past. Their experience will, it is hoped, convince operators of massage and mahjong parlours, nightclubs and bars to comply with the law when their exemption from the ban expires on June 30 next year.

But the ban’s most important result is no doubt the number of lives that have been saved from diseases caused by the inhalation of other people’s smoke. Though the ban is only a year old, that number should be significant.

According to the US surgeon general, there is no safe level of exposure to second-hand smoke, which increases the risk of a heart attack by 30 per cent for non-smokers. This is on top of other smoke-related diseases they may develop from exposure.

Two new authoritative overseas studies, cited by the Hong Kong Council on Smoking and Health, find that the number of heart attack admissions to hospitals dropped considerably just one year after a public smoking ban was imposed. Nine hospitals in Scotland experienced a 17 per cent drop in heart attack admissions a year after a ban was introduced in March 2006. New York State hospitals had, in general, an 8 per cent decline in admissions in 2004 after an anti-smoking law was introduced the year before. There is no reason to doubt something comparable has been achieved in Hong Kong with our own smoking ban.

But we need to do more. Food and Health Bureau officials should move quickly to streamline the ban’s enforcement by replacing the current summons system with a fixed penalty. This has widespread support among lawmakers, and its prompt passage by the Legislative Council is virtually guaranteed. What’s more, it will save the courts time and resources in having to handle summonses for smoking violations.

An unfortunate side effect of the indoor smoking ban is that it has pushed more smokers to light up in the streets. This has caused many people to complain frequently about having noxious fumes blown in their faces. In many overseas cities, people are banned from smoking outside main entrances to buildings and other public facilities. A similar ban should be considered in Hong Kong. Some established office buildings have already set aside smoking corners to stop smokers from causing a nuisance at entrances.

As a liberal society, we cannot outlaw smoking, but we should certainly do our best to ban the noxious practice where we can and frown upon it when we can’t.

Australia: the healthiest country by 2020 – The case for prevention: tobacco

Jan 1st, 2008
by Editor.
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