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February, 2008:

Smoking May Kill a Million Indians Every Year By 2010

Agence France-Presse in Chicago – Updated on Feb 15, 2008 – SCMPIndia is in the midst of a smoking epidemic which will kill about a million people annually – or nearly one out of every 10 deaths – during the 2010s, researchers said.

And some 70 per cent of those people will die before they reach the age of 70, according to the study published in the New England Journal of Medicine.

“I am alarmed by the results of this study,” India’s Health Minister Anbumani Ramadoss said. “The government of India is trying to take all steps to control tobacco use – in particular by informing the many poor and illiterate of smoking risks.”

The first nationally representative study of smoking habits and associated mortality rates found that some 120 million Indians smoke, although they generally pick up the habit later in life.

Some 37 per cent of men and about 5 per cent of women aged 30 to 69 smoke either cigarettes or leaf-wrapped bidis, which are unfiltered and contain about a quarter as much tobacco as a cigarette.

The study projected that by next decade that deaths linked to smoking will rise to one in five among males and one in 20 among females aged 30 to 69.

Men who smoked cigarettes lost an average of ten years of life, while smoking bidis cut an average of six years off the life expectancy of men and eight years off of the lives of women.

Even light smokers saw their mortality risk jump: smoking between one and seven cigarettes a day nearly doubled the mortality risk while smoking the equivalent number of bidis raised mortality risks by a third.

“It is truly remarkable that one single factor, namely smoking, which is entirely preventable, accounts for nearly one in ten of all deaths in India,” said Nobel Laureate Amartya Sen.

“The study brings out forcefully the need for immediate public action in this much neglected field.”

Indian, Canadian and British researchers led a team of 900 field workers who surveyed all adult deaths during 2001-2003 in a nationally representative sample of 1.1 million homes in all parts of India.

Researchers compared the smoking histories of 74,000 adults who had died with 78,000 living and adjusted their findings based on education levels, alcohol use and whether they lived in rural or urban areas.

They found about 61 per cent of men who smoked died between the ages of 30 and 69 compared with only 41 per cent of non-smokers.

Some 62 per cent of women who smoked died in middle age, compared with only 38 of non-smokers.

“The extreme risks from smoking that we found surprised us, as smokers in India start at a later age than those in Europe or America and smoke less,” said lead author Prabhat Jha of the University of Toronto’s Centre for Global Health Research.

“And, smoking kills not only from diseases like cancer and lung diseases but also from tuberculosis and heart attacks.”

Quitting smoking has been shown to greatly reduce the mortality risk. But it is uncommon in India, where only about 2 per cent of adults have quit, and they often did so only after they fell ill.

Casino Smoke Ruling

Casino Smoke Ruling / Just Pass The Ban

Published: Friday, February 15, 2008 – Press of Atlantic City

Well, this always seemed inevitable to us.

Why it hasn’t seemed inevitable to the casino industry – and why the industry hasn’t been more afraid of cases like this – is well … hazy.

A state workers’ compensation judge has ruled that a casino dealer’s 10 years of secondhand-smoke exposure materially contributed to her lung cancer. The dealer, Kam Wong, never smoked herself, nor did anyone in her household smoke. The insurance company for the former Claridge Casino Hotel is now responsible for any future medical treatment related to Wong’s work in the casino.

And this won’t be the last such case.

Yes, casino revenue in Atlantic City is down, and many in the industry blame the city’s partial smoking ban, which restricts smoking to 25 percent of the casino floor. The state’s public-smoking ban, which exempted casino floors, prohibits smoking in casino hotels’ other public areas. But at least one poll has concluded that more New Jersey residents would patronize casinos if they went completely smoke-free.

Besides, the debate is, in essence, over.

Revel Entertainment Group’s Atlantic City casino will be completely smoke-free when it opens. Last year, James Perry, then head of Trump Entertainment Resorts, said: “Generally speaking, we believe over the next three-year period, smoking will be banned in almost all casinos throughout the United States or certainly on the Eastern Seaboard. Long-term, we have to be prepared to operate these casinos in a smoke-free environment.”

And now, the court cases have come rolling in. The science about the dangers of secondhand smoke has been clear for sometime; more court cases will soon follow – and, almost certainly, in lawsuits posing far more liability for the industry than this one workers’ compensation case.

Atlantic City’s partial ban is not really being enforced anyway. The casinos’ plans for dividing up their casino floors into smoking/no-smoking areas or building nongaming smoking rooms will be neither cheap to build nor particularly effective.

It’s over. A bill in the state Senate to ban smoking on casino floors – just as it is banned in virtually every other workplace in the state – has been reintroduced. It was approved in the Senate last year but languished in the Assembly. It’s time for the casinos to drop their opposition and for state lawmakers to end the casino smoking exemption.

That would make Atlantic City’s partial ban moot. The casinos could drop plans for the expensive retrofitting of their casino floors. And the industry won’t look quite so culpable the next time a nonsmoking casino dealer with lung cancer goes before a judge or jury seeking damages.

Treaty On Illegal Tobacco Trade

WHO wants treaty on illegal tobacco trade by 2010

15/02/2008 AFP

GENEVA (AFP) — The World Health Organisation announced Friday that it planned to adopt a new international treaty on the illegal tobacco trade by 2010.

“We have finally assessed that we want a protocol on the illicit trade of tobacco,” Ian Walton-George, the world health body’s top negotiator on the issue, told a press conference at Geneva. The WHO has been meeting this week at its headquarters in the Swiss city to debate a new protocol on the illicit tobacco trade to tie in to its wider Framework Convention on Tobacco Control (FCTC).

“2010 is the date for finalising negotiations and adopting the text of the protocol,” said Haik Nikogosian, who heads the WHO’s anti-tobacco secretariat. The illicit tobacco trade is estimated to make up approximately 10 percent of global tobacco sales and costs governments between 40 and 50 billion dollars (27-34 billion euros) every year.

In African countries such as Nigeria, its share is estimated to be even higher at between 10 and 16 percent, lobby group Corporate Accountability International (CAI) said earlier this week. “Controlling this trade, controlling the prices is crucial to prevent young people to use tobacco,” Deborah Arnott, European head of the Framework Convention Alliance pressure group, said Friday.

Campaigners alleged ahead of the WHO meeting that tobacco giants Philip Morris, British American Tobacco and Japan Tobacco actively collude with cigarette smugglers to gain a foothold in lucrative developing markets.

“Transnationals benefit in a number of ways from the illicit trade in tobacco,” said Kathyrn Mulvey, CAI’s director of international policy.

This includes establishing a brand presence in new markets, and getting more people addicted to cigarettes — particularly children because smuggled tobacco is so cheap, she told journalists on Wednesday.

“Documents do show industry complicity in this deadly business,” Mulvey added.

The WHO said last week that tobacco use could kill more than one billion people around the world this century unless governments and civil society act to reverse the epidemic.

The existing FCTC agreement, signed in February 2005, aims to rein in the estimated five million annual deaths caused by smoking, which the WHO says will double by 2020 if nothing is done.

Illicit Trade In Tobacco Products

This note records the Chairperson’s personal view of the overall content of the discussions that have taken place during the first session of the Intergovernmental Negotiating Body on a protocol on the illicit trade in tobacco products. In accordance with decision FCTC/COP2(12) of the Conference of the Parties to the WHO Framework Convention on Tobacco Control, the template for a protocol on illicit trade in tobacco products prepared by the expert group (convened in accordance with decision FCTC/COP1(16)) formed the basis for these discussions. This note is not, and is not intended to be, a record of the discussions. Rather, it is an aide-memoire for the Chairperson and an attempt to capture the general tenor of the views exchanged during the first session of the Intergovernmental Negotiating Body. In accordance with decision FCTC/COP2(12), a chairperson’s text will be drafted and submitted to the Intergovernmental Negotiating Body for consideration at its second session.

See the full document on Drafting and negotiation of a protocol on illicit trade in tobacco products here.

WHO Study Group on Tobacco Product Regulation

WHO Study Group on Tobacco Product Regulation (TobReg) report on the scientific basis of tobacco product regulation

WHO Study Group on Tobacco Product Regulation – get the PDF document here.

The Tobacco Free Initiative announces the release of a WHO Study Group on Tobacco Product Regulation (TobReg) report on the scientific basis of tobacco product regulation. This report presents policy recommendations on the contents and design features of tobacco products, their relationship to dependence potential and consumer appeal; candy-flavoured tobacco products; biomarkers of tobacco exposure and resulting health effects; and, maximum limits for tobacco smoke toxicants. The Study Group hopes that these recommendations will be useful to WHO Member States, and national policymakers and regulators. The English printed version is now available, and the other UN language versions will be available soon.

10 Facts On Tobacco And Second-Hand Smoke

World Health Organisation

Fact 1
Tobacco is the leading preventable cause of death in the world. It causes 1 in 10 deaths among adults worldwide. In 2005, tobacco caused 5.4 million deaths, or an average of one death every 6 seconds. The death toll is projected to reach more than 8 million by 2030 if current trends continue.

Fact 2
Tobacco kills up to half of its regular users. On average 29% of people around the world are smoking tobacco. Smoking is more common among men – 47.5% of all men smoke compared to 10.3% of women.

Fact 3
More than 80% of the world’s more than one billion smokers live in low- and middle-income countries. Unless urgent action is taken, by 2030, more than 80% of tobacco related deaths will occur in the developing world

Fact 4
Tobacco caused 100 million deaths in the 20th century. If current trends continue, there could be up to one billion deaths in the 21st century.

Fact 5
The smoke produced by burning tobacco products is known as second-hand tobacco smoke or environmental tobacco smoke. Tobacco smoke in enclosed spaces is breathed by everyone, exposing both smokers and non-smokers to its harmful effects. This is commonly referred to as involuntary smoking or passive smoking.

Fact 6
Second-hand tobacco smoke is dangerous to health. There are about 4000 known chemicals in tobacco smoke. Second-hand smoke also causes heart disease and many serious respiratory and cardiovascular diseases in adults which can lead to death.

Fact 7
An estimated 700 million children, or almost half of the world’s children, breathe air polluted by tobacco smoke, particularly at home. Second-hand smoke causes many serious diseases in children and worsens conditions such as asthma.

Fact 8
The International Labour Organization estimates that at least 200 000 workers die every year due to exposure to smoke at work. The United States Environmental Protection Agency estimates that second-hand smoke is responsible for about 3000 lung cancer deaths annually among non-smokers in the country.

Fact 9
Exposure to second-hand smoke also imposes economic costs on individuals, businesses and society as a whole, in the form of direct and indirect medical costs and productivity losses.

Fact 10
There is no safe level of exposure to second-hand tobacco smoke. Neither ventilation nor filtration, even in combination, can reduce the exposure indoors to levels that are considered acceptable. Only 100% smoke-free environments provide effective protection.

UN Treaties Are National Issues

SCMP

On behalf of the World Health Organisation, I would like to answer the questions that Jake van der Kamp asks in his Monitor column (“Smoking out the real victim of heavy tobacco taxation”, February 6) about the WHO Framework Convention on Tobacco Control (FCTC), to which Hong Kong is now a party. Van der Kamp asks: “Did Legco approve it, did Exco sanction it, did the chief executive sign it into law?” This is not the way of any of UN conventions.

The signatories are national governments; thus in Hong Kong’s case, since 1997, China. In keeping with this, and specifically with regard to the FCTC, on October 11, 2005, the government of China informed the UN secretary general of the following: “In accordance with the provision of article 153 of the Basic Law of the Hong Kong Special Administrative Region of the People’s Republic of China and article 138 of the Basic Law of the Macau Special Administrative Region of the People’s Republic of China, the government of the People’s Republic of China decides that the WHO Framework Convention on Tobacco Control . . . shall apply to the Hong Kong Special Administrative Region and the Macau Special Administrative Region of the People’s Republic of China.”

As with all UN treaties, Hong Kong’s reporting mechanism is also through China.

Dr Judith Mackay, senior policy adviser, World Health Organisation

Facts About Light And Mild Cigarettes

There is no such thing as a ‘safe’ cigarette:

  • Many smokers believe that smoking “light,” “mild,” “low-tar,” or “ultra-light” cigarettes reduces the risk of smoking-related health problems
  • In fact, there is no such thing as a ‘safe’ cigarette or ‘safe’ level of consumption

Read about all the facts about light and mild cigarettes here.

Study of Smoking and Death in India

A Nationally Representative Case–Control Study of Smoking and Death in India

Background: The nationwide effects of smoking on mortality in India have not been assessed reliably.

Methods: In a nationally representative sample of 1.1 million homes, we compared the prevalence of smoking among 33,000 deceased women and 41,000 deceased men (case subjects) with the prevalence of smoking among 35,000 living women and 43,000 living men (unmatched control subjects). Mortality risk ratios comparing smokers with nonsmokers were adjusted for age, educational level, and use of alcohol.

Results: About 5% of female control subjects and 37% of male control subjects between the ages of 30 and 69 years were smokers. In this age group, smoking was associated with an increased risk of death from any medical cause among both women (risk ratio, 2.0; 99% confidence interval [CI], 1.8 to 2.3) and men (risk ratio, 1.7; 99% CI, 1.6 to 1.8). Daily smoking of even a small amount of tobacco was associated with increased mortality. Excess deaths among smokers, as compared with nonsmokers, were chiefly from tuberculosis among both women (risk ratio, 3.0; 99% CI, 2.4 to 3.9) and men (risk ratio, 2.3; 99% CI, 2.1 to 2.6) and from respiratory, vascular, or neoplastic disease. Smoking was associated with a reduction in median survival of 8 years for women (99% CI, 5 to 11) and 6 years for men (99% CI, 5 to 7). If these associations are mainly causal, smoking in persons between the ages of 30 and 69 years is responsible for about 1 in 20 deaths of women and 1 in 5 deaths of men. In 2010, smoking will cause about 930,000 adult deaths in India; of the dead, about 70% (90,000 women and 580,000 men) will be between the ages of 30 and 69 years. Because of population growth, the absolute number of deaths in this age group is rising by about 3% per year.

Conclusions: Smoking causes a large and growing number of premature deaths in India.

See the complete study of Smoking and Death in India here.

Smoking Deferral Exemptions

The following letter was sent by James Middleton of Clear The Air to Tobacco Control on the 12th of Feb 2008.

Dear Tobacco Control,

The Department of Health grants smoking deferral exemptions to any liquor licensed premises that states on its application form for deferral that its main income is derived from the sale of intoxicating liquor and not from its food sales. The Department Of Health does not even request a certified set of accounts to prove this point.

It seems pointless for restaurants to apply for a General Restaurant (full) license and abide by the rigid size requirements for the kitchen etc when their main sales are supposedly from liquor and they could pack more people in to sell drinks rather than having tables for food. It is obvious that many restaurants would apparently earn possibly more from its food sales than drinks. Tobacco Control should not rely on these declarations and should by inspection , ascertain what the main usage of the premises is : ie they are a genuine sit down restaurant or they are a bar with occasional full meals.

As we see it, any premises that has a General Restaurant license rather than a Light Refreshment license is involved in the sale mainly of meals, rather than being a bar, then can be exempted . Furthermore any premises that has its exemption overturned should be prosecuted under the Crimes Ordinance for making a false declaration in order to obtain the initial exemption (ie that their premises conformed to all requirements listed in the application procedure) and such prosecutions will probably see a flood of sham bars that are actually restaurants rescinding their exemptions.

Kind regards

James Middleton

CleartheAir