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July, 2008:

Linking Second-Hand Smoke And Lung Cancer

Medical News Today – July 4, 2008

It is a widely accepted notion that second-hand smoke (SHS) is linked to lung cancer. However, medical professionals and researchers have not reached consensus on the extent of the increase in cancer risk due to SHS. In an article published in The Lancet Oncology, Dr Ahmad Besaratinia and Dr Gerd Pfeifer, Beckman (Research Institute of the City of Hope National Medical Center, Duarte, CA, USA) suggest that a better approach to establishing risk level may be to screen for biological markers that are targeted to SHS and associated with lung cancer.

SHS is a mixture of two types of smoke that result from tobacco consumption: mainstream and sidestream smoke. Mainstream smoke is created when a person puffs a cigarette (or other tobacco product) and draws smoke from the burning cone and hot zone of the product. Mainstream smoke can either move through the filter or out of the mouthpiece (depending on the apparatus used). The second type of smoke, called sidestream smoke, comes from the smoldering coal of a tobacco and is generated between puffs. Researchers have found that mainstream and sidestream smoke have similar chemical compositions and carcinogenic compound, but sidestream smoke has different quantities of these chemicals due to a lower burning temperature. Mainstream smoke is often partially filtered and scrubbed by the lungs and comprises less than 15% of SHS (sidestream smoke comprises 85% of SHS). Smokers intake more carcinogens than individuals exposed to SHS because smokers are actively inhaling high doses of mainstream-smoke carcinogens.

“However,” note the authors, “the finding that sidestream smoke-condensate is more potent than mainstream smoke-condensate in inducing mouse skin tumours suggests that SHS imposed on non-smokers might be even more carcinogenic than mainstream smoke inhaled by active smokers.”

Many of the carcinogenic compounds found in smoke are able to create additional substances that lead to DNA lesions called DNA adducts. In fact, these genotoxic carcinogens often create mutations at certain locations, which are like unique signatures genes that are related to cancer. Two laboratory techniques – DNA-lesion footprinting (locates the site of DNA damage) and mutagenicity analysis (finds changes in DNA sequences) – are used together to find these carcinogen signatures. Though these techniques have already been used to find DNA lesions that are linked to smoke-derived carcinogens such as polycyclic aromatic hydrocarbons, the researchers suggest that they be implemented in cancer-relevant genes that are frequently mutated in smoke-related lung cancer.

Besaratinia and Pfeifer also note that more research is needed that can determine how the type, frequency, and distribution of DNA adducts in cancer-related genes are different for non-smokers exposed to SHS and smokers exposed to mainstream smoke. This type of comparative analysis would provide analysts with information to determine if the different risks of lung cancer development are just due to the different doses of smoke exposure seen by smokers and those affected SHS.

Further, the authors place importance on discovering if SHS can lead to lung cancer through an epigenetic pathway. That is, without changing the order of DNA molecules (the primary DNA sequence), environmental factors may cause the gene to express itself differently. They write that, “Future investigations using in-vitro systems, animal models, and biospecimens from chronically exposed individuals will be needed to determine whether SHS induces lung cancer through an epigenetic pathway.”

To conclude, Besaratinia and Pfeifer mention that environmental carcinogens contained in food, drink, and air, make it extremely difficult for models to specifically focus on the association between SHS and lung cancer in humans. In addition, SHS is not consistent in its composition and concentration, providing further barriers to research. They write: “Although the causal link between SHS exposure and lung-cancer development is well established, the estimated risk for lung cancer development consequent to SHS exposure remains somewhat debatable. Elucidation of the mechanisms of SHS action that are relevant to carcinogenesis can help identify unique biological markers that can be used for assessing lung cancer risk in relation to SHS exposure.”

Pub Chain Stubs Out Smoking Ban Effects

Edinburgh Evening News – July 4, 2008 – Michael Blackley

Strong food sales within its pubs since the smoking ban has helped profits at Lothians-based Belhaven surge by 16 per cent.

The Dunbar-based firm, which owns Edinburgh pubs including the Albanach and the World’s End on the Royal Mile, Pivo on Calton Road and Drouthy Neebor’s on West Preston Street, saw revenues rise six per cent to £126.1 million in the year to May 4.

Operating profits climbed to £27.5m, compared to £23.3m last year.

It attributed the success to repositioning specialist pubs to appeal to a wider customer base through an increased focus on food and value for money.

Greene King, the pub company that owns Belhaven, said the performance of its Scottish operations was particularly encouraging.

Following publication of its full-year results today, Greene King chief executive Rooney Anand said: “Although all our divisions have performed well in difficult circumstances, I am particularly encouraged by Belhaven’s result.

“Scotland’s smoking ban came over a year before England’s. In the second year of the ban, the Belhaven team have developed the business significantly towards food and families, and delivered operating profit growth of 18 per cent.”

During the last year, the number of Belhaven pubs trading increased from 299 to 321, 95 of which are managed and the rest leased or tenanted.

The company said that like-for-like rents and beer supply income from the leased and tenanted pubs were both positive.

And its managed pubs enjoyed “an excellent year” with strong profit growth. Mr Anand said: “Growth came from the successful repositioning of a number of specialist pubs to appeal to a broader consumer base, increased focus on food and value for money, and an impressive improvement in the rate of conversion of sales to operating profit.

“Food business development has been a key theme throughout the estate. Overall, Belhaven’s food revenue has increased by more than 50 per cent over the last two years.”

The Belhaven Brewery also performed well, with beer volume sales increasing despite the overall on-trade market being down six per cent.

Volume sales of Belhaven Best increased by 4.6 per cent, giving it a “substantial” increase in market share.

Greene King also acquired Loch Fyne Restaurants for £64.2m last August. It said the 41-outlet chain, which has a branch at Western Harbour, has now been successfully integrated into the group and is trading well.

Overall Greene King pre-tax profits increased by two per cent to £142m, while revenues rose five per cent to £960m.

Mr Anand said: “The year saw an unprecedented set of challenges for the industry but I am pleased to report exceptional performance across the business.”

Legco Passes Bill Setting Smoking Fine At HK$1,500

Loretta Fong – Updated on Jul 03, 2008 – SCMP

A bill to impose a fixed-penalty fine on people caught illegally lighting up under the Smoking (Public Health) Ordinance was passed by the Legislative Council yesterday.

Smokers caught in no-smoking areas will be given a fixed fine of HK$1,500, to be settled within 21 days. If the offenders fail to settle the fine in time, they will receive a letter requiring payment within another 10 days. But if they still fail to do so, a court order will be issued.

The bill also gave officers of the Leisure and Cultural Services Department, the Housing Department and the Food and Environmental Hygiene Department the power to issue the tickets to complement the efforts of the Tobacco Control Office. Three thousand officers from the three departments will join 85 tobacco control officers in enforcing the law.

Under the smoking ban, which came into force in January last year, offenders are summonsed to court, where they can be fined up to HK$5,000, but are usually fined about HK$700.

Tobacco Control Office inspectors are empowered only to collect evidence on offences and to issue summonses, but are not empowered to make arrests. Under the new legislation officers will have the power to issue fixed-penalty tickets.

Democratic legislator Andrew Cheng Kar-foo was disappointed that his proposed amendment allowing offenders to spend the fine on a quitting course was rejected.

The proposed amendment was dismissed by Legislative Council president Rita Fan Hsu Lai-tai on Monday. She ruled that it was irrelevant to the Fixed Penalty (Smoking Offences) Bill.

Li Kwok-ying, of the Democratic Alliance for the Betterment and Progress of Hong Kong, said Mr Cheng’s proposal would complicate matters.

He added the government should provide more training to officers to help them enforce the system.

Some officers were worried the workload might be too high and also that they might have difficulties when dealing with offenders.

The chairman of the Council on Smoking and Health, Homer Tso Wei-kwok, believed the fixed-penalty system would help reduce time in court and probably be a deterrent.

The government is considering offering Tobacco Control Office officers civil service contracts to ease manpower concerns. It also plans to strengthen the anti-smoking drive by utilising NGOs.

Secretary for Food and Health York Chow Yat-ngok said a date for the legislation to be introduced had not been set.

Fixed Fine For Smoking Violators

Bonnie Chen – HK Standard – Thursday, July 03, 2008

Smokers who light up in non-smoking areas will face a fixed penalty of HK$1,500, according to a bill passed in the Legislative Council yesterday.

But Secretary for Health, Welfare and Food York Chow Yat-ngok said there is no timetable to enforce the fixed penalty as publicity remains to be done and the Health Department needs 10 months to set up an information system.

“The HK$1,500 fixed penalty can cut out a lot of court procedures,” Chow said.

Currently, violators face a maximum fine of HK$5,000. But the highest penalty meted out so far is only HK$1,500 and the lowest HK$50.

In addition to the Office of Tobacco Control, Chow said police and officers of the Leisure and Cultural Services Department, Food and Environmental Hygiene Department and Housing Department will be authorized to hand out the tickets.

Violators have to pay the fine within 21 days.

The Office of Tobacco Control currently has 80 inspectors and will hire more. To retain staff, Chow added its inspectors will be given status as permanent government staff.

“We will eventually have over 3,000 law enforcement officers altogether,” Chow said.

Meanwhile, Democratic Party legislator Andrew Cheng Kar-foo cited a survey the party did last month which showed 80 percent of 700 respondents agreed to allow those caught to choose between paying the fine and using the money to pay for treatment to quit smoking.

Cheng was disappointed when Legco president Rita Fan Hsu Lai-tai rejected discussion on his suggestion as it was outside the scope of the bill.

Lawmaker Li Kwok-ying of the Democratic Alliance for the Betterment and Progress of Hong Kong said Cheng’s suggestion will make the law enforcement procedures more complicated.

Li added it will also lead to more conflicts between the officer and violators.

From the start of the year to last month, the Office of Tobacco Control gave away 9,851 tickets.

British Pubs Closing Fast

British pubs closing fast as smoking ban stubs out profits

Tim Bryan – SCMP – Updated on Jul 02, 2008

It seems like an age ago, but yesterday marked only the first year of the smoking ban. Life seems to have changed little, except in the pub.

Pubs are closing at their fastest rate ever, four a day in Britain and one every other day in London, says the British Beer and Pub Association, which highlights a perfect storm of rising beer and energy prices, the smoking ban and the credit crunch. The association said 78 of London’s 3,879 urban pubs closed in the last six months of 2007 – one in 50.

Tony Jerome, of beer pressure group Camra, said pubs were being crippled by the smoking ban and beer duty, the highest in Europe, and the supermarkets.

“Supermarkets can sell alcohol cheaper than water,” he said. “They make beer and wine a loss leader to bring people through their doors and spread the cost over other goods. Pubs can’t do that. The smoking ban then makes smokers think twice about a pint.”

The ban has had many health benefits, with a study showing it had helped more than 400,000 smokers quit, the largest fall on record, the Health Behaviour Research Unit said.

London now has the highest proportion of smokers in Britain, at 29 per cent, says Time Out – 2 percentage points higher than the norm in Britain. Why, no one really knows, though Meriel Jeater, curator at the Museum of London, which is showcasing the changing attitude to smoking in London, has a theory.

She told Time Out that inexpensive, mass-market cigarettes were first made in London, fed by cheap tobacco streaming out of the docks in the 1880s. Londoners until then had preferred the pipe, with cigarettes seen as an effeminate European import.

Why 2 million Londoners still smoke is another matter, although their more bohemian and liberal attitude might provide a clue, plus the fact cheap smuggled cigarettes are sold in market stalls.

Ms Jeater said: “It occurred to me there must be lots of memories about smoking, which people would forget after the ban, so I created a record of smoking in London.”

The foyer display hosts smoking paraphernalia, from matches to advertisements, including an election poster from the 1920s of would-be prime minister Stanley Baldwin smoking a pipe, under the banner “Smoke Baldwin’s security mixture – vote Conservative.”

Most memories don’t stretch so far, though I can recall smoking on the Underground (it was banned after the King’s Cross Tube station fire, sparked by a cigarette igniting trash under an escalator, killing 31 people in 1987).

I still recall people smoking on the top deck of the bus, and it was only about four years ago that trains dropped smoking carriages.

Three years ago you could smoke in a corridor at work – a horrific thought, in hindsight, subjecting non-smoking colleagues, and your boss, to a pall of smoke as they walked by. Staff smoke outside now, by the bike shed, ironically where most smokers started at school.

Though many miss the days when friends could sit and drink together without half of them camped outside, there has been 99 per cent compliance with the ban in London, the highest rate in Britain.

Many boozers have adapted, building covered outdoor smoking areas or gardens. Those suffering were the “landlocked pubs”, said Mr Camra – those without any outside space, or scope for shelters.

Legco Chief Rejects Idea Of Flexibility In Smokers’ Fines

May Chan – Jul 02, 2008 – SCMP

Legislative Council president Rita Fan Hsu Lai-tai has rejected a proposed amendment to the anti-smoking law that would allow people caught puffing illegally to spend the amount of the penalty on a course to help them kick the habit.

The amendment, proposed by democratic legislator Andrew Cheng Kar-foo, was to have been raised for discussion in Legco today.

But Mrs Fan dismissed the amendment as irrelevant to the Fixed Penalty (Smoking Offences) Bill, which proposes a fine of HK$1,500 for smoking in places where it is banned.

The rejection was in accordance with Legislative Council procedures, which stated that an amendment “must be relevant to the subject matter of the bill”, she wrote in a letter on Monday.

Mrs Fan also pointed out that the proposed fixed-penalty bill did not provide or allow other options to relieve the offenders of their legal responsibility to pay the fine.

So it was not necessary to further discuss Mr Cheng’s proposal, including its implications for government spending, she said in the letter.

Mr Cheng accused Mrs Fan of being inflexible and ignoring the will of the wider public.

The Democratic Party conducted a telephone survey of 779 people last week, 22 per cent of whom are smokers. Of the respondents, 79.7 per cent supported the notion that, with the passage of the HK$1,500 fixed penalty for smoking, fined smokers should be given the choice to spend the money on smoking cessation services, which they agreed should not cost more than HK$1,500.

A similar percentage said the government should spend the revenue from the smoking penalty on setting up a fund to subsidise smoking cessation services.

Mr Cheng said he would seek to push the government to set up such a fund.

“I am most regretful over the council’s rejection of my proposal,” he said. “I don’t understand why the smokers’ money can’t be spent on smokers, to help them quit. It is a shame that my proposal is not even being given the chance to be debated and voted in the council, despite its popularity among the public.”

He went on to say that there had been a regression in democracy since the handover.

According to Mr Cheng, 31 proposed amendments had been turned down since 1997, on the grounds of being “out of the scope” of the discussion topic. That accounted for 53 per cent of the 58 amendments proposed to Legco from 1997 to 2008.

“Legco should not be rigid in following rules, and should consider options that are practical and responsive to the practical needs of the public,” Mr Cheng said.

The Food and Health Bureau had earlier written to Legco outlining the financial implications of Mr Cheng’s proposal. It could cost, they said, HK$18.7 million a year to provide extra clinics and subsidised services, as well as HK$7.9 million for an information system and HK$960,000 in yearly administrative costs.

Spotlight on the Framework Convention on Tobacco Control

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Public Smoking Becomes Illegal Throughout Germany

AFP – July 1, 2008

BERLIN (AFP) – Lighting up in bars and restaurants become illegal across Germany’s 16 states on Tuesday, spelling the end of the country’s status as one of Europe’s last smokers’ havens.

North-Rhine Westphalia and Thuringia became the last two regions to implement public smoking bans on July 1, all other states having done so piecemeal since late 2007.

In Berlin, where a ban took effect on January 1, smokers were granted a six-month period of grace that expired on Tuesday and those who breach the ban now face fines of 1,000 euros (1,575 US dollars).

In the eastern state of Saxony, fines can run up to 5,000 euros but in the northern port of Hamburg and Thuringia, in eastern Germany, the highest fine authorities can issue is 500 euros.

The wealthy southern state of Bavaria is considered to have the country’s toughest public smoking ban because it prohibits restaurants from opening separate smoking sections — a practice allowed in other states.

The new anti-tobacco laws have met with strong popular resistance and are being challenged in courts around the country, where nearly one in three adults smoke.

In Saxony, Schleswig-Holstein and Rhineland-Palatinate, judges have lifted the ban in single-room bars, provided the owners serve the drinks themselves.

The German Constitutional Court last month began hearing three legal challenges to the new laws, including one from barkeepers and nightclub owners who contend that it interferes with their right to practise their profession.

The German cancer association, which claims 3,300 people die from passive smoking in Germany annually, said Tuesday that the extension of the ban to all states meant “people can breathe a sigh of relief.”

But the country’s biggest anti-tobacco lobby, Pro Rauchfrei, has said efforts to stamp out public smoking are doomed because the absence of a single federal ban and the number of exemptions allowed by the courts have created too much confusion.