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October, 2008:

“Working To Shape What Society’s Expectations Of Us Should Be”: Philip Morris’ Societal Alignment Strategy

Oct 9th, 2008
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Published Online First: 9 October 2008. doi:10.1136/tc.2008.026476
Tobacco Control 2008;17:391-398
Copyright © 2008 by the BMJ Publishing Group Ltd.

RESEARCH PAPERS

J S Yang1, R E Malone2

1 Center for Tobacco Control Research and Education, University of California, San Francisco, California, USA
2 Department of Social and Behavioral Sciences, University of California, San Francisco, California, USA

Correspondence to:
R E Malone, Department of Social and Behavioral Sciences, University of California, San Francisco, 3333 California Street Suite 455, San Francisco, California, USA 94118; ruth.malone@ucsf.edu

Background: A key element of Philip Morris’s (PM’s) corporate social responsibility initiatives is “societal alignment”, defined as “strategies and programs to meet society’s expectations of a responsible tobacco company”. This study explored the genesis and implementation of Philip Morris’ (PM) societal alignment efforts.

Methods: The study retrieved and analysed approximately 375 previously undisclosed PM documents now available electronically. Using an iterative process, the study categorised themes and prepared a case analysis.

Results: Beginning in 1999, PM sought to become “societally aligned” by identifying expectations of a responsible tobacco company through public opinion research and developing and publicising programs to meet those expectations. Societal alignment was undertaken within the US and globally to ensure an environment favourable to PM’s business objectives. Despite PM’s claims to be “changing”, however, societal alignment in practice was highly selective. PM responded to public “expectations” largely by retooling existing positions and programs, while entirely ignoring other expectations that might have interfered with its business goals. It also appears that convincing employees of the value and authenticity of societal alignment was difficult.

Conclusions: As implementation of the Framework Convention on Tobacco Control proceeds, tobacco control advocates should closely monitor development of such “alignment” initiatives and expose the motivations and contradictions they reveal.

Study Reveals Mechanism Behind Nicotine Dependency

Oct 8th, 2008
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The Scripps Research Institute By Gary Kuhlman and Mika Ono Benedyk – October 8, 2007

Many more people try to quit smoking than succeed in giving up this nicotine-delivering habit. Now, a group of scientists at The Scripps Research Institute has identified one neurobiological mechanism that contributes to nicotine dependence, and to the anxiety and craving experienced upon withdrawal. The findings also suggest a new approach to developing drugs that could help smokers quit.

The research was published the week of October 1, 2007, in an advance, online issue of the journal Proceedings of the National Academy of Sciences(PNAS).

The new study reveals that, in rats, chronic nicotine use recruits a major brain stress system, the extrahypothalamic corticotropin releasing factor (CRF) system, which contributes to continued tobacco use by exacerbating anxiety and craving upon withdrawal. The researchers found that administering a compound that blocked the receptors involved in this stress system alleviated withdrawal symptoms.

“We reduced the need to take nicotine by blocking CRF-1 receptors in the brain,” says Olivier George, a research associate in the Scripps Research Koob lab who conducted the study with Sandy Ghozland and other colleagues. “We were surprised by the compound’s dramatic effectiveness. We don’t know yet if the same mechanism is involved in humans with tobacco dependence, but it is very promising.”

Tobacco addiction is the leading avoidable cause of disease and premature death in the United States, responsible for more than 438,000 deaths annually, according to the Centers for Disease Control and Prevention. Nicotine, the main psychoactive ingredient in tobacco, is a tough drug, with smokers continuing to crave it long after they’ve started withdrawal. Most smoking-cessation medication is based on nicotine replacement therapy, using nicotine gum or patches, that substitutes one source of nicotine for another. Roughly 80 percent of smokers who try to quit relapse within a year.

While nicotine can produce mildly pleasurable effects, the Scripps Research scientists believe a more important factor in the difficulty in quitting is the brain’s adaptation to that reward, which produces an intense discomfort upon withdrawal.

“The key in nicotine addiction is that the positive pleasurable effects of nicotine are instantaneous and short lasting, while the negative effects are delayed and long lasting,” George says. “Even if nicotine may transiently induce a relief from a negative emotional state, its long-term consequences are disastrous.”

For years, scientists have wanted to know what changes in the brain occur in the transition from nicotine use to nicotine dependence. In the current study, the researchers set out to see if nicotine dependence is linked to changes in the CRF system in the amygdala, an area of the brain that plays a primary role in the processing and memory of emotional reactions. The CRF system is activated by CRF-1, an essential protein for coping with stressful events.

When the researchers induced nicotine withdrawal in rats, the nicotine-deprived group exhibited severe anxiety-like behavioral symptoms of withdrawal—such as burying and “freezing” (becoming motionless)—compared with controls. In addition, withdrawal whetted the rats’ appetite for even greater quantities of the drug, a result the researchers call the “nicotine deprivation effect.”

“Rats exhibited drug-loading behavior following a cycle of abstinence, attaining an amount of nicotine in roughly six hours that previously took 12 hours,” George says. “This is like the light smoker becoming a chain smoker after trying to quit.”

Measurements showed this behavior was indeed matched by hyperactivity in the CRF system, and that these withdrawal effects lasted a surprisingly long time. In addicted rats, these effects developed in under a week and maintained a hold for at least two months.

“That’s a long time for a rat, considering its life expectancy is two years,” says George. “These results suggest long-lasting neuroadaptations of the CRF system, possibly through gene regulation, that may help explain why many cigarette smokers relapse even after a long abstinence from smoking.”

Importantly, the researchers were able to moderate the effects of nicotine deprivation. When addicted rats were injected with a CRF receptor antagonist, the injected rats showed less anxiety-like behavior during withdrawal and self-administered less nicotine compared with an addicted controls.

The Scripps Research scientists hope their work will lead to new nicotine-free pharmacological treatments, as well as shedding light on questions such as what makes some people more likely than others to become addicted in the first place.

In addition to George and Ghozland, authors of the paper, titled “CRF-CRF1 system activation mediates withdrawal-induced increases in nicotine self-administration in nicotine dependent rats,” are Marc R. Azar, Pietro Cottone, Eric P. Zorrilla, Loren H. Parsons, Heather N. Richardson, and George F. Koob of The Scripps Research Institute; and Laura E. O’Dell of the University of Texas, El Paso.

The research was supported by the Tobacco Related Disease Research Program of the State of California, the National Institutes of Health, the Pearson Center for Alcoholism and Addiction Research at The Scripps Research Institute, and the Tobacco Etiology Research Network of the Robert Wood Johnson Foundation.

Send comments to: mikaono@scripps.edu

Smoking Threatens Millions In China

Oct 5th, 2008
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Al Jazeera and agencies | 5 October 2008

Tens of millions of Chinese will die of lung diseases over the next 25 years unless the government takes action to combat smoking and the indoor burning of fuel, scientists have warned.

The study*, published on Saturday in the British journal, The Lancet, said chronic respiratory illness would kill 53.3 million, while lung cancer would leave another 13.5 million dead.

Half of Chinese men smoke and more than 70 per cent of Chinese households use solid fuels, such as wood, crop residues and coal for heating and cooking, providing a potent source of indoor air pollution, according to the study.

The paper – written by scientists from the Harvard School of Public Health in the US state of Massachusetts – said that smoke from tobacco products and indoor fuel use would be the cause of more than 80 per cent of all deaths from respiratory disease.

However, it suggests that a number of measures could be taken to dramatically reduce the risk, including building proper chimneys, air circular stoves with chimneys ending outside the house and ventilated ground stoves to reduce the toxic chemicals circulating indoors.

“There are proven ways to reduce tobacco smoking and to provide homes with clean-burning energy alternatives. China can save millions of premature deaths from respiratory diseases in the next few decades if it … implements these interventions,” Majid Ezzati, senior author of the study, said.

‘Tobacco epidemic’

Dr Sarah England, the technical officer at World Health Organisation’s Tobacco Free Initiative in China, told Al Jazeera that at least one million people were dying from tobacco related causes every year in China.

“The Chinese experience is particularly severe because there haven’t been enough steps taken yet to curtail the tobacco epidemic,” she said.

She noted that though the government had signed the global convention for tobacco control, the country still dominates sales and production.

“We see that China has a vested interest in tobacco production and marketing, and that is a tough thing for China to come to grips with as it tries simultaneously to curb the horrible health impacts that tobacco is exerting on the Chinese people,” she said.

More than 900 million of the world’s 1.1 billion smokers currently live in low-income and middle-income countries and about one half of the world’s population uses biomass and coal for household energy.

* Harvard University report published in the Lancet on 4 Oct 2008: Effects of smoking and solid-fuel use on COPD, lung cancer, and tuberculosis in China: a time-based, multiple risk factor, modelling study
BY Hsien-Ho Lin, Megan Murray, Ted Cohen, Caroline Colijn, Majid Ezzati

Millions To Die In China From Lung Disease: Report

Oct 4th, 2008
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Reporting by Tan Ee Lyn; Editing by Jerry Norton – Reuters | Sat Oct 4, 2008

HONG KONG (Reuters) – Tens of millions of people will die from respiratory illness and lung cancer over the next 25 years in China if nothing is done to reduce smoking and fuel burning indoors, scientists warned.

In an article published in The Lancet, they predicted 65 million deaths from chronic obstructive pulmonary disease (COPD) and 18 million deaths from lung cancer between 2003 and 2033 from smoking and biomass burning at home.

Those figures would account for 19 and 5 percent respectively of all deaths in China during that period, said the researchers at the Harvard School of Public Health (HSPH).

However, interventions to reduce smoking and household use of biomass — like wood, charcoal, crop residues and dung — for cooking and heating could reduce the number of deaths.

Using mathematical models, they said gradual elimination of smoking and biomass burning would avoid 26 million deaths from COPD and 6.3 million deaths from lung cancer by 2033.

Interventions include building proper chimneys, air circular stoves with chimneys ending outside the house and ventilated ground stoves to cut respirable particulates, carbon dioxide and sulphur dioxide circulating indoors.

“There are proven ways to reduce tobacco smoking and to provide homes with clean-burning energy alternatives. China can save millions of premature deaths from respiratory diseases in the next few decades if it … implements these interventions,” said Majid Ezzati, associate professor of international health at HSPH and senior author of the study.

Respiratory diseases are among the 10 leading causes of deaths in China. About half of Chinese men smoke and in more than 70 percent of homes, Chinese cook and heat their homes with wood, coal and crop residues.

Smoking and pollution from indoor burning of these fuels are major risk factors for COPD and lung cancer and have been linked to tuberculosis.

Globally, more than 900 million of the world’s 1.1 billion smokers currently live in low-income and middle-income countries and about one half of the world’s population uses biomass and coal for household energy.

© Thomson Reuters 2008 All rights reserved.

30-year Smoke Toll Put At 63m

Oct 4th, 2008
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Agence France-Presse – Updated on Oct 04, 2008

Tobacco use and smoke from coal and wood are likely to claim tens of millions of lives in China in the next quarter-century, according to a study published online today by the British journal The Lancet.

Smoke from tobacco, biomass and coal will kill 53.3 million Chinese people from chronic respiratory illnesses and 13.5 million from lung cancer from 2003 to 2033, its authors calculate, using the current rate of exposure as a benchmark.

Half of Chinese men smoke, and more than 70 per cent of Chinese households use solid fuels – such as wood, crop residue and coal – for heating and cooking, providing a potent source of indoor air pollution, the study says.

Smoke from these sources will account for 82 per cent of the likely 65 million deaths in China from respiratory disease from 2003 to 2033, and 75 per cent of the probable 18 million deaths from lung cancer, it projects.

The lead authors of the paper were Hsien-Ho Lin and Majid Ezzati of the Harvard School of Public Health in Massachusetts.

Effects Of Smoking And Solid-fuel Use On Health In China

Oct 4th, 2008
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Hsien-Ho LinMD, Megan MurrayMD, Ted CohenMD, Caroline ColijnPhD and Majid EzzatiPhD – The Lancet DOI:10.1016/S0140-6736(08)61345-8 |

Title: Effects of smoking and solid-fuel use on COPD, lung cancer, and tuberculosis in China: a time-based, multiple risk factor, modelling study

Summary

Background

Chronic obstructive pulmonary disease (COPD), lung cancer, and tuberculosis are three leading causes of death in China, where prevalences of smoking and solid-fuel use are also high. We aimed to predict the effects of risk-factor trends on COPD, lung cancer, and tuberculosis.

Methods

We used representative data sources to estimate past trends in smoking and household solid-fuel use and to construct a range of future scenarios. We obtained the aetiological effects of risk factors on diseases from meta-analyses of epidemiological studies and from large studies in China. We modelled future COPD and lung cancer mortality and tuberculosis incidence, taking into account the accumulation of hazardous effects of risk factors on COPD and lung cancer over time, and dependency of the risk of tuberculosis infection on the prevalence of disease. We quantified the sensitivity of our results to methods and data choices.

Findings

If smoking and solid-fuel use remain at current levels between 2003 and 2033, 65 million deaths from COPD and 18 million deaths from lung cancer are predicted in China; 82% of COPD deaths and 75% of lung cancer deaths will be attributable to the combined effects of smoking and solid-fuel use. Complete gradual cessation of smoking and solid-fuel use by 2033 could avoid 26 million deaths from COPD and 6·3 million deaths from lung cancer; interventions of intermediate magnitude would reduce deaths by 6–31% (COPD) and 8–26% (lung cancer). Complete cessation of smoking and solid-fuel use by 2033 would reduce the projected annual tuberculosis incidence in 2033 by 14–52% if 80% DOTS coverage is sustained, 27–62% if 50% coverage is sustained, or 33–71% if 20% coverage is sustained.

Interpretation

Reducing smoking and solid-fuel use can substantially lower predictions of COPD and lung cancer burden and would contribute to effective tuberculosis control in China.

Funding

International Union Against Tuberculosis and Lung Disease.

Affiliations

a. Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
b. Department of Population and International Health, Harvard School of Public Health, Boston, MA, USA
c. Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA
d. Community Health Society, Mennonite Christian Hospital, Hualien, Taiwan
e. Division of Infectious Disease, Massachusetts General Hospital, Boston, USA
f. Division of Social Medicine and Health Inequalities, Brigham and Women’s Hospital, Boston, USA
g. Department of Engineering Mathematics, University of Bristol, Bristol, UK
h. Initiative for Global Health, Harvard University, Cambridge, MA, USA

Corresponding Author InformationCorrespondence to: Majid Ezzati, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA

No Butts As Anti-smoking Minister Targets Bollywood Star

Oct 3rd, 2008
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S. N. M. Abdi – SCMP – Updated on Oct 03, 2008

The Indian government’s campaign to curb smoking has spilled over into a very public spat between a crusading minister and Bollywood’s reigning superstar.

From yesterday, a new law bans smoking in public places, including bars and restaurants. In his zeal to wean smokers off the habit – which kills more people in India than in any other country – Health Minister Anbumani Ramadoss has targeted chain-smoking actor Shah Rukh Khan.

“The clash between the politician and the film hero throws a spotlight on the landmark Prohibition of Smoking in Public Places Rules, 2008, which empowers state-appointed watchdogs for the first time to slap fines ranging from 200 to 1,000 rupees (HK$32 to HK$160) for lighting up virtually anywhere except parks, roads and homes,” said columnist Rajat Roy.

“Khan is known for his addiction to cigarettes in real life as well as smoking scenes in many a super-hit film. So targeting one of India’s most high-profile smokers makes a lot of sense.”

Mr Ramadoss has ordered a non-governmental organisation in Mumbai to bombard the actor’s palatial house daily with pamphlets highlighting the effects of cigarettes. The minister has also instructed the NGO to flood the actor’s wife and son with letters and e-mails warning them about the threat nicotine poses to his health.

“Shah Rukh must stop smoking both on and off screen because our studies show that popular actors and actresses exercise a big influence on teenagers and youths of both sexes. He is a role model for the young generation, which is increasingly getting addicted to cigarettes. I expect him to kick the habit for the sake of the country,” says Mr Ramadoss who boasts that he is waging a war against smoking.

“While I appreciate the minister’s concern, I do not like anyone telling me what to do and what not to do,” an unfazed Khan retorted.

“I will quit smoking if I decide to. I might give up smoking – and I might not. I’m fully aware of the consequences of inhaling nicotine. But it’s a personal issue between me, my family and my doctor, and I thoroughly disapprove of it being made a public issue.”

The acclaimed actor – who has featured in more than 100 smoking scenes since 1991 and tops a recent list of Bollywood’s “serial offenders” compiled by the World Health Organisation – is even more critical of the minister’s attempts to ban smoking scenes in films and television serials.

“Contrary to claims, films do not glorify murder, rape, robbery or smoking and drinking. These negative aspects are depicted because they are a reality. Films reflect what’s happening around us. So cinema can’t portray only good things as everyday life is a mix of the good and the bad.”

Mr Ramadoss refuses to buy the argument. “India has the highest number of smokers who get addicted between the age of 13 and 15 in South Asia,” he says. “And the biggest culprits are films and superstars. Tragically, more and more youngsters and women are using tobacco because films glorify smoking. Some 15 million Indians go to the movies every day. So one can imagine the magnitude of the incitement.

“Our data shows that 52 per cent of children smoked their first cigarette under the influence of film celebrities.”

Besides Khan, Mr Ramadoss has also attacked former Bollywood superstar Amitabh Bachchan for popularising what he derisively calls “the cancer stick”.

The minister, whose campaign is reportedly backed by India’s teetotal prime minister, Manmohan Singh, and ruling Congress Party president Sonia Gandhi, says that the new legislation and targeting Bollywood’s smoking stars are in the public interest because 1 million Indians die annually from smoking-related diseases.

The latest National Family Health Survey shows that 33 per cent of men across India aged 15 to 49 are smokers. In urban areas, 31 per cent of women in the same age bracket are addicted to cigarettes. The trend is particularly alarming because, in 1995, only 10 per cent of women smoked.

His drive, Mr Ramadoss insists, also makes economic sense: while the tobacco industry is worth 350 billion rupees, the government is forced to spend 360 billion rupees annually on treating and preventing tobacco-related diseases.

As of yesterday, anyone lighting up in government and private buildings, including workplaces, cafes, restaurants, schools, hotels, pubs, discos, stadiums, railway stations, airports, hospitals and bus stands, will be fined.

The new law also bans matches, lighters and ashtrays from public spaces. However, airports, hotels with more than 30 rooms and restaurants seating more than 30 diners, are permitted to have a smoking bay.

“We have excluded roads and parks from the list of no-smoking zones although, strictly speaking, they are public places. Homes, too, are exempted but I expect smokers to seek the permission of their spouse and children before lighting up in their residence,” Mr Ramadoss said.

A survey conducted five days before the clampdown by Mumbai’s Healis Sekhsaria Institute of Public Health showed that 92 per cent of respondents in the four largest cities – Mumbai, New Delhi, Calcutta and Chennai – are in favour of smoke-free public spaces and workplaces, while 99 per cent want smoke-free restaurants.

“The public evidently can’t wait for the implementation of the new law, whose prime objective is to protect non-smokers from second-hand smoke,” said Monika Arora, convenor of the Advocacy Forum for Tobacco Control, an NGO fighting for tougher anti-smoking regulations.

But the tobacco and hotel industries are up in arms against the new law and are apparently planning to sue the government in the Supreme Court. An Indian Tobacco Company spokesman said that the ban on smoking in workplaces could be easily challenged because it includes private offices like a lawyer’s chamber or a painter’s studio.

Similarly, the Indian Hotels Association has objected to the banning of matchboxes and lighters in restaurants.

“I would not be able to organise a candlelit dinner. I cannot even use matchboxes if there is a power cut,” complained one association spokesman.

But Ms Arora says that the hospitality industry had no reason to worry. She cited research from Australia, Canada and the US that shows anti-smoking legislation had no negative impact on sales, revenues or employment in restaurants, bars and hotels in the long run.

Mr Ramadoss has also read the riot act to powerful politicians.

He told a TV channel that Buddhadev Bhattacharya, West Bengal’s chain-smoking chief minister, should not light up in Writer’s Building, the administrative headquarters of the state government. Mr Bhattacharya remains defiant, saying he has no plans to quit smoking.

Kill The Tobacco Industry, Or It Will Keep Killing

Oct 3rd, 2008
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Simon Chapman and Becky Freeman – The Sydney Morning Herald | October 3, 2008

This month in Rio de Janeiro, the global tobacco industry’s annual conference features a special session on what many are seeing as its Armageddon: plain, generic packaging. All packs are identical except for the brand name, printed in standard font. No colours, no logos, no box variations. Nothing but the brand and the health warning.

The British Government has released a consultation paper on the idea. Morgan Stanley advised its clients recently that “homogenous packaging” would “significantly restrict the industry’s ability to promote their products”.
Tobacco Journal International, the industry’s main trade journal, had as its latest cover story a warning:
“Plain packaging can kill your business.”
That’s the whole idea, ladies and gentlemen.

The World Health Organisation’s Framework Convention on Tobacco Control, now ratified by 160 nations, is rapidly accelerating a long overdue regulation of the tobacco industry. Plain packaging has not happened in any nation yet, but the race is on. Here is why it is the most important next step in reducing Australia’s leading cause of death.When you take a doctor’s prescription to a pharmacy for a drug designed to prolong life, relieve pain or symptoms or in some way promote health, radically different things happen than when you buy a packet of cigarettes.

First, the pharmaceutical company making the drug will have spent a small fortune trialling it to see if it does what it is meant to do – such as act as an effective contraceptive or lower blood pressure – and that it does not cause adverse reactions that are so severe as to radically alter the cost-benefit ratio of the drug (for example, chemotherapy for cancer often causes nausea but may prolong life).

Tobacco companies, by contrast, have to meet no standards for their products and can add any legal substance that will, for example, get nicotine to your brain faster or mask the astringent, choking sensation of smoke. While Philip Morris once withdrew its salmonella-contaminated Kraft peanut butter from shops because it might have harmed customers, it is relaxed and comfortable about half of its best customers dying from using its tobacco products in the intended way.

Next, your prescription will be made up by a pharmacist with a minimum four-year university degree, while your cigarettes will be handed to you by someone who may have left school at 15.

You will get a limited supply from the pharmacist and have to go back to your doctor if you want a repeat prescription.
With cigarettes, you can buy as many as you like. If a pharmacist supplied drugs to someone without a prescription, they would be fined, perhaps jailed and almost certainly struck off the register. If a store supplies cigarettes to a child, hell would freeze over before they were caught or any serious action taken.In the pharmacy, prescribed drugs are not on open display but stored in the dispensary. Until now, cigarettes have been on open display, sending the message that they are profoundly ordinary products, no different from sweets, soft drinks and groceries.

Verity Firth, when she was the minister for cancer, prepared a raft of reforms that will have their final reading in State Parliament on Friday. The most important “denormalising” proposal will see all tobacco products stored out of site, as occurs in Canada, Thailand and Iceland.

The final difference between tobacco and prescribed drugs is packaging. When you pick up your next prescription, check out the plain, dull box. It is not designed to express the product’s “personality” or to confer prestige or some other desirable attribute in the user. It simply states the drug’s name, dosage and any contraindications. Tobacco products, by contrast, are the result of ongoing market testing to ensure they are as attractive and beguiling as possible, particularly to what the industry euphemistically calls “starters” or “young adult smokers”.

Research released this week by Professor Melanie Wakefield, from the Cancer Council Victoria, shows how smokers feel about plain packaged cigarettes. When shown regular packaged brands and the dull, generic packs, the 813 smokers rated the dull packs as much less attractive and popular, and those who would smoke them as much less stylish, outgoing and mature than smokers of the original pack. They inferred that cigarettes from the plain packs would be less satisfying and of lower quality.

The federal Health Minister, Nicola Roxon, has repeatedly put prevention front and centre of national health policy. By making Australia lead the world – by taking a step that the history of tobacco control suggests is inevitable – she could start global dominoes tumbling, and save millions of lives. If the tobacco industry thinks plain packaging will kill its business, no stronger recommendation is available.

Simon Chapman is a professor of public health and Becky Freeman is a doctoral student on the future of tobacco control at the University of Sydney.

Source:How does increasingly plainer cigarette packaging influence adult smokers’ perceptions about brand image? An experimental study

Tob Control. Published Online First: 30 September 2008.

Melanie A Wakefield, Daniella Germain, Sarah J Durkin

The Cancer Council Victoria, Australia

http://tobaccocontrol.bmj.com/…
http://tobaccocontrol.bmj.com/…

Editor’s note: The full text PDF is freely available from the link immediately above. If this link does not work, please send your request to shatensteins@sympatico.ca and kindly remember to include the name of the full citation (study title, journal and authors’ names) and your e-mail address in the body of your message.

Source: The Sydney Morning Herald

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