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November, 2012:
Canada’s tobacco warnings move up to 4th in world ranking
http://www.cbc.ca/news/health/story/2012/11/13/cigarette-warning-labels-cancer-society.html
Canadian Cancer Society’s international cigarette warning report
Conference of the Parties (COP) to the WHO Framework Convention on Tobacco Control
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Canada’s world ranking for cigarette package warnings has risen to fourth in 2012 from 15th in 2010 after new Canadian warnings covering 75 per cent of cigarette packages were implemented, an international report finds.
The Canadian Cancer Society publishes a report every two years ranking cigarette health warnings. The latest report was released Wednesday at the World Health Organization’s Framework Convention on Tobacco Control conference in Seoul, South Korea.
Last year, Health Canada announced it would renew health-related labels on tobacco products, including cigarettes. Canada’s warning labels now cover 75 per cent of the front and 75 per cent of the back of cigarette packages.
Rob Cunningham, senior policy analyst for the Canadian Cancer Society, commended Health Minister Leona Aglukkaq for the new warnings, but also urged the federal government to follow Australia’s lead in implementing plain packaging.
Australia, which received the top ranking, has the largest warnings, covering 82.5 per cent of the package front and back of packages (75 per cent front, 90 per cent back), the group said. Australia also prohibits tobacco company colours, logo and design elements on the branded part of the package.
Australia prohibits tobacco company colours on cigarette packaging. (Australian government/Reuters)
“Plain packaging would curb the industry’s use of the package as a promotional vehicle, would increase the effectiveness of package warnings, would curb package deception, and would decrease tobacco use,” the report’s authors said.
Cigarette makers challenged the Australian rules on the grounds that they violate intellectual property rights and devalued their trademarks. The country’s highest court upheld the law in August.
Tobacco donor ban closer
http://www.themercury.com.au/article/2012/11/13/365972_print.html
Tobacco donor ban closer
MATT SMITH | November 13, 2012 01.50pm
STATE legislation banning political donations from tobacco companies has moved one step closer.
An amendment to the Electoral Act, which would render the Tasmanian Liberals unable to accept political donations from tobacco companies, passed the Lower House of Parliament this morning.
The amendment – branded “unconstitutional” by the Liberals — will now move to the Upper House.
Greens health spokesman Paul O’Halloran said the move meant Attorney-General Brian Wightman had delivered on a majority vote of the chamber more than a year ago in support of a Greens’ motion calling for legislative reform.
“If political representatives want to encourage smokers to end their tobacco addiction then it’s only appropriate for political parties show leadership by ending end their addiction to tobacco company donations,” Mr O’Halloran said.
“The community expects their elected representatives to walk the talk, particularly when Tasmania has the highest smoking rate across Australia.
“A ban on big tobacco donations is just one aspect of our political donations reform package, and we will continue to pursue for further necessary reform.
“We are confident the Legislative Council will support this progressive reform that will benefit Tasmanian health and ease the burden on the health system.”
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At conference, UN health chief urges more to be done in global anti-tobacco efforts
http://www.un.org/apps/news/story.asp?NewsID=43464&Cr=tobacco&Cr1=#
12 November 2012 – Highlighting the impact that the adoption of a new anti-tobacco treaty may have, the United Nations top health official today spoke out on gains and challenges in global efforts to reduce tobacco consumption and exposure to smoke throughout the world – and encouraged further action in these areas.
“I can think of no other undertaking that can make such a huge contribution to better health in every corner of the world. And that includes the health of young children and unborn babies,” the Executive Director of the UN World Health Organization (WHO), Dr. Margaret Chan, said at the Fifth Session of the Conference of the Parties (COP) to the WHO Framework Convention on Tobacco Control (WHO FCTC), taking place in Seoul, the capital of the Republic of Korea.
“This has always been one of the anti-tobacco campaign’s most compelling arguments. Tobacco use is the epidemiological equivalent of a drive-by shooting – it hurts the innocent bystanders as well as those held captive by an addiction that damages their health,” she added.
Tobacco use is responsible for five million, or 12 per cent, of all deaths of adults above the age of 30 globally each year – equivalent to one death every six seconds – noted a WHO mortality report released in March this year.
According to WHO, the Framework Convention on Tobacco Control – an evidence-based treaty that reaffirms the right of all people to the highest standard of health – represents a milestone for the promotion of public health and provides new legal dimensions for international health cooperation. It is the first international treaty negotiated under the health agency’s auspices, and was developed in response to the globalization of the tobacco epidemic.
The number of Parties to the Convention has grown steadily over the years, from the 40 parties that brought the treaty into force in 2005, to 113 at the first session of COP in 2006, and 176 as of today. The COP, the central organ and governing body of the WHO FCTC, is set to review it and further promote its implementation at its session, which began today and ends on Saturday.
“The tobacco industry behaves like a corrosive substance that can eat through, or seep through, any crack or fissure in the armour of our defences. Our response must be to seal all these cracks and fissures, one by one, with science and evidence, supported by instruments for applying this knowledge and backed by the rule of law,” Dr. Chan said.
“This is what you are doing,” she continued. “This is what makes the work of this conference so monumentally important. With the guidelines and recommendations you put forward, and now with the first protocol before you for approval, you are hemming in the enemy, cutting off its options, giving it less space to manoeuvre.”
Amongst a range of items on its agenda, the Fifth Session of COP is also expected to adopt a protocol to eliminate the illicit trade in tobacco products – once adopted, it will be the first protocol to the WHO FCTC and an international treaty in itself.
“The protocol gives the world an orderly rules-based instrument for countering and eventually eliminating a sophisticated international criminal activity that costs a lot, also for health,” Dr. Chan said. “Illicit trade is bad for health because it circumvents measures, like taxes and price increases, that are known to reduce demand. In other words, illicit trade seriously compromises effective implementation of the treaty.”
Citing past experience, the WHO chief noted that the tobacco industry will challenge “the best science, promote arguments that have nothing to do with the facts, and fund front groups to give these arguments a cloak of legitimacy,” as well as engage in other activities, such as lobbying lawmakers and funding plaintiffs to challenge legislation.
Dr. Chan added that in a “recent and most disturbing trend,” efforts to resolve differences between governments and the tobacco industry have moved to the courtroom. In this regard, she lauded recent legal rulings in Australia and Norway which upheld the legality of tough control measures – and noted the support for other countries facing similar interference.
“Of course, industry will have its day and its say in the media. Australia’s law is not a good one, they say. It will be a bonanza for the black market and benefit no one but organized crime, including groups that support terrorists. Let them rattle their sabres,” Dr. Chan said.
“Australia’s law mandating plain packaging, a world first, is based on rigorous research. It peels the glamour off a package full of harm and replaces it with the truth. It will have vast benefits for health,” she added. “I want to thank civil society for doing so much to counter industry’s claims with the facts, to expose their duplicity to the public eye.”
http://www.un.org/apps/news/story.asp?NewsID=43464&Cr=tobacco&Cr1=#
Tobacco Use is the Equivalent of a Drive-by Shooting: UN Official
http://www.valuewalk.com/2012/11/tobacco-use-is-the-equivalent-of-a-drive-by-shooting-un-official/
Tobacco Use is the Equivalent of a Drive-by Shooting: UN Official
November 12, 2012By DebbieBaratzinShare0
On Monday, at a health conference, a top United Nations health official discussed the effect of a new anti-tobacco treaty and the global challenges to cut tobacco use and exposure to smoke.
Speaking at the Fifth Session of the Conference of the Parties (COP) to the WHO Framework Convention on Tobacco Control (WHO FCTC) in Seoul, Korea, Executive Director of the UN World Health Organization (WHO), Dr. Margaret Chan, said via UN.org, “I can think of no other undertaking that can make such a huge contribution to better health in every corner of the world. And that includes the health of young children and unborn babies.
“This has always been one of the anti-tobacco campaign’s most compelling arguments. Tobacco use is the epidemiological equivalent of a drive-by shooting – it hurts the innocent bystanders, as well as those held captive by an addiction that damages their health,” added Chan.
Annually, tobacco use contributes to five million (12 percent) of adult deaths for those older than 30 worldwide. This equates to one death every six seconds, according to a March WHO mortality report.
Fortunately, tobacco use among minors appears to be on the decline.
WHO has said that the Framework Convention on Tobacco Control, a treaty that declared a person’s right to the highest standard of health, is a milestone for public health and gives new legal dimensions for international health cooperation. It represents the inaugural treaty negotiated under the agency, and comes from a response to the global tobacco epidemic.
Through the years, the number of Parties in the Convention has grown from 40 in 2005, and 113 in 2006 at COP’s first session, to the current number of 176. The COP, which is the WHO FCTC governing party, will further review the treaty and try to advance its implementation at the session; it runs from Monday to Saturday.
Additional remarks from Chan included:
“The tobacco industry behaves like a corrosive substance that can eat through, or seep through, any crack or fissure in the armour of our defenses. Our response must be to seal all these cracks and fissures, one by one, with science and evidence, supported by instruments for applying this knowledge and backed by the rule of law”
This is what you are doing. This is what makes the work of this conference so monumentally important. With the guidelines and recommendations you put forward, and now with the first protocol before you for approval, you are hemming in the enemy, cutting off its options, giving it less space to maneuver.”
The Fifth Session of COP has a variety of items on its agenda, including the adoption of a protocol to get rid of the illicit tobacco products trade
New international protocol adopted to combat illicit trade in tobacco products
http://www.who.int/mediacentre/news/releases/2012/illicit_tobacco_20121112/en/index.html#
News release
12 November 2012 | Seoul, Republic of Korea –The delegates of more than 140 Parties to the WHO Framework Convention on Tobacco Control (WHO FCTC) adopted a new international treaty Monday, setting the rules for combating illegal trade through control of the supply chain and international cooperation. The Protocol to Eliminate Illicit Trade in Tobacco Products commits countries to establishing, as a central measure, a global tracking and tracing system to reduce the illicit trade of tobacco products.
Illicit trade in tobacco products
“The elimination of all forms of illicit trade in tobacco products, including smuggling and illegal manufacturing, is an essential component of tobacco control,” says Ambassador Ricardo Varela, President of the Conference of the Parties (COP) to the WHO FCTC. “In adopting this new Protocol today by consensus, countries have reiterated their historic commitment towards protecting the health of their citizens, particularly the young and vulnerable.”
A global problem
Illicit trade in tobacco products is a global problem. It undermines health objectives, imposes additional strain on health systems and weakens tax and other measures designed to strengthen tobacco control. It leads to substantial revenue losses to governments around the world but generates vast financial profits for illegal traders. These are often used to fund transnational criminal activity.
Defining unlawful conduct
“Eradicating illicit trade in tobacco products constitutes a clear win-win situation for governments and their people,” says Dr. Haik Nikogosian, Head of the Secretariat of the WHO FCTC. “The new Protocol establishes what actions constitute unlawful conduct and sets out related enforcement and international cooperation measures, such as licensing, information-sharing and mutual legal assistance that will help counteract and eventually eliminate illicit trade.”
After today’s adoption by the Conference of the Parties, the procedural steps for the Protocol on Illicit Trade in Tobacco Products to enter into force are:
- protocol open for signature by the Parties for one year, starting 10 January 2013;
- ratification process, according to national law; and
- entry into force (90 days after 40 ratifications).
Reaching consensus
The Protocol to Eliminate Illicit Trade in Tobacco Products was drafted and negotiated by an Intergovernmental Negotiating Body, mandated to undertake this work by the COP at its second session in 2007.
After four years of negotiations, the Intergovernmental Negotiating Body held its fifth and final session from 29 March to 4 April 2012 in Geneva, where the Parties reached consensus on the draft Protocol.
The COP is the central organ and governing body of the Convention and is currently meeting for the fifth time since the treaty entered into force in 2005. The number of Parties to the Convention has grown steadily over the years, from the 40 parties that brought the treaty into force in 2005, to 113 at the first session of the Conference of the Parties in 2006, and 176 as of today.
The WHO FCTC was adopted by the World Health Assembly on 21 May 2003 and entered into force on 27 February 2005. It has since become one of the most rapidly and widely embraced treaties in United Nations history.
For more information please contact:
Christian Lindmeier
Media & Communications Officer
Convention Secretariat
WHO Framework Convention on Tobacco Control
Telephone: +41 22 791 3282
Mobile: +41 79 217 3439
Mobile (in Seoul during COP5): +82 (0)10 4970 8634
E-mail: lindmeierch@who.int
Tobacco control: WHO Director-General addresses history-making conference
Dr Margaret Chan
Director-General of the World Health Organization
Address to the Fifth Session of the Conference of the Parties to the WHO Framework Convention on Tobacco Control
Seoul, Republic of Korea
12 November 2012
http://www.who.int/dg/speeches/2012/tobacco_control_20121112/en/index.html
Excellencies, distinguished delegates, ladies and gentlemen,
I am delighted to address this fifth session of the Conference of the Parties to the WHO Framework Convention on Tobacco Control. Our shared goal is to see this treaty fully implemented, to see its powers fully used to reduce tobacco consumption and exposure to tobacco smoke, everywhere in the world.
As this session opens, support for the Convention has grown to 176 Parties, representing nearly 90% of the world’s population. This shows the scale of the impact you can have.
Since the treaty came into force seven years ago, the work of this conference has given more than ten articles of the Convention teeth and traction by creating supplementary instruments.
You have done so in a spirit of solidarity, fully mindful of the transnational nature of the tobacco threat, and fully aware of the need to build implementation capacity among Parties with meager resources. Success depends on a capacity to implement, everywhere.
In crafting guidelines and recommendations, this body reaches well beyond the domains of medicine and public health. You gather evidence and support from multiple sectors, like trade, finance, agriculture, education, labour, the environment, law enforcement, and the judicial system.
The work of this conference is a model of multisectoral collaboration but also of an interagency response, as you will be discussing during this session.
The Convention is a powerful instrument for prevention, but also for international cooperation. This importance has been recognized in recent political declarations on noncommunicable diseases and on the social determinants of health.
You are inspired by the preventive power of what you are doing. I can think of no other undertaking that can make such a huge contribution to better health in every corner of the world. And that includes the health of young children and unborn babies.
This has always been one of the anti-tobacco campaign’s most compelling arguments. Tobacco use is the epidemiological equivalent of a drive-by shooting. It hurts the innocent bystanders as well as those held captive by an addiction that damages their health.
You are united by a shared spirit of determination but also out of necessity, given the nature of the opposition, of the forces that are equally determined to undermine, circumvent, and interfere.
The tobacco industry behaves like a corrosive substance that can eat through, or seep through, any crack or fissure in the armour of our defences. Our response must be to seal all these cracks and fissures, one by one, with science and evidence, supported by instruments for applying this knowledge and backed by the rule of law.
This is what you are doing. This is what makes the work of this conference so monumentally important. With the guidelines and recommendations you put forward, and now with the first protocol before you for approval, you are hemming in the enemy, cutting off its options, giving it less space to manoeuvre.
As we know from experience, the tobacco industry will challenge the best science, promote arguments that have nothing to do with the facts, and fund front groups to give these arguments a cloak of legitimacy. This industry will lobby lawmakers, woo the press and, now, fund plaintiffs to challenge legislation.
In a recent and most disturbing trend, the showdown between governments, seeking to safeguard the health of their citizens, and industry, seeking to maintain its profits, has moved to the courtroom.
I know you will want to join me in congratulating Australia and Norway for recent rulings that upheld the legality of their tough control measures. We are united in our support for other countries facing similar interference.
Of course, industry will have its day and its say in the media. Australia’s law is not a good one, they say. It will be a bonanza for the black market and benefit no one but organized crime, including groups that support terrorists. Let them rattle their sabres.
Australia’s law mandating plain packaging, a world first, is based on rigorous research. It peels the glamour off a package full of harm and replaces it with the truth. It will have vast benefits for health.
I want to thank civil society for doing so much to counter industry’s claims with the facts, to expose their duplicity to the public eye.
As recent examples, you have documented industry’s role in promoting illicit trade in tobacco products, despite all the public denials. You have documented industry’s role in supporting front groups that purport to speak for tobacco farmers. In reality, industry practices keep these farmers trapped at the bottom end of the supply chain.
Such reports extend the public resonance of items that will be discussed during this session.
Ladies and gentlemen,
You have 25 items on your agenda.
You will consider a report on progress in implementation of the treaty. The report indicates which articles and provisions are most readily implemented and where countries are facing difficulties and need more support. The report also demonstrates, for everyone to see, that the treaty is having an impact.
Research is also on our side. Evidence of the substantial health benefits of measures set out in the treaty continues to mount.
You will look at options and experiences for using price and tax measures to reduce demand, and consider the complex issues surrounding efforts to help tobacco farmers switch to economically sustainable alternatives.
You have before you state-of-the art reports on recommended responses to smokeless tobacco products and electronic nicotine delivery systems. Again, industry is seeping through the cracks.
You will also be considering the Convention’s first draft protocol, aimed at eliminating illicit trade in tobacco products, which awaits your approval. After four years of negotiations, this is a game-changing treaty, and a potentially history-making session.
WHO and its Member States gave birth to the Convention. The Convention took on a life of its own and now gives birth to another treaty. This is how we build ambitions in public health. This is how we hem in the enemy.
The protocol gives the world an orderly rules-based instrument for countering and eventually eliminating a sophisticated international criminal activity that costs a lot, also for health.
Illicit trade is bad for health because it circumvents measures, like taxes and price increases, that are known to reduce demand. In other words, illicit trade seriously compromises effective implementation of the treaty.
As the chair of the Intergovernmental Negotiating Body noted, the fact that consensus on the text was achieved is due to “the commitment and energy of everyone involved, and a willingness to seek solutions and take hard decisions on difficult issues.”
With this spirit, in this historical battle against a ruthless industry that quite literally cannot afford to lose, I sincerely believe the good guys will win in the end.
Thank you.
Tobacco Taxes A Win–Win Measure for Fiscal Space and Health
Download PDF : ADB 2012 Tobacco Taxes a Win-Win Measure
Let us now praise famous men and women
(Published 13 November 2012)
Cite this as: BMJ 2012;345:e7605
- Tony Delamothe, deputy editor, BMJ
Richard Doll and the BMJ (and BMA) go back a long way together
Notoriously forgetful, science has made an exception for Richard Doll. The 100th anniversary of his birth was marked by a reception at Green-Templeton College, Oxford. Three days of presentations followed at the Richard Doll Building, which houses part of Oxford’s Medical Sciences Division. According to Richard Peto, the driving force behind the celebrations, every major epidemiological study of smoking was represented at the meeting.
Both the Lancet and BMJ published articles to coincide with the anniversary. The Lancet’s Million Women Study reported that among UK women smoking causes two thirds of all deaths of smokers in their 50s, 60s, and 70s; smokers lose at least 10 years of life.1 The BMJ’s Life Span Study found that Japanese men and women who smoke from early adulthood also lose about 10 years of life, settling the question of whether the Japanese people were truly “different” when it came to the effects of smoking.2 A coauthor of both papers, Peto summed up the message of the Lancet study as, “If women smoke like men they die like men,” and that of the BMJ study as, “If the Japanese smoke like Brits they die like Brits.”
He also warned the meeting against expecting many surprises from the 60 year follow up of the British Doctors Study, which is heading into print soon. By now almost all the smokers are dead, Peto said. And anyway, he preferred the Million Women Study, whose enormous numbers allow the calculation of effect sizes with much greater confidence.
So with so few mysteries left to solve about the lethal effects of smoking, is it time to wrap the whole epidemiological project up, I asked Peto. His answer was that if you wanted to convince the policy makers in countries such as India and China, they needed data on their own populations. By themselves the results of the British Doctors Study are not enough.
Still, it would be understandable if readers (and staff) of this journal felt a little nostalgic over this study. As described in Conrad Keating’s biography of Doll, Smoking Kills: The Revolutionary Life of Sir Richard Doll,3 its genesis lay in a case-control study of cancers of the lung, stomach, colon, and rectum reported by Doll and Austin Bradford Hill in the BMJ in 1950.4
The logical next step was a prospective study, and with the assistance of the BMA Doll and Hill sent 59 600 British doctors a questionnaire about their smoking habits. An open letter from Hill, chivvying them to respond, followed in the BMJ, 61 years ago this month.5
The British Doctors Study was the first major prospective study of smoking and death anywhere in the world. And when British doctors read its findings in the BMJ, beginning in the mid-1950s, they became the first group in the world to reduce their smoking. Although some of them undoubtedly influenced their patients to follow suit, it was the Royal College of Physicians’ Smoking and Health (1962) that marked the beginning of the concerted fightback against tobacco in the United Kingdom.6
Despite being intensely political when young, Doll did not lobby politically for the changes that his epidemiological work indicated, according to Keating. Instead he saw his role as being “a neutral dispassionate scientist describing the relationship and leaving the public and physicians to draw their inevitable conclusions.”
The role of dispassionate scientist is not one that would appeal to Judith Mackay, who spoke to the Oxford meeting on the topic “From tobacco research to policy.” Mackay, who won the BMJ Group’s first ever lifetime achievement award in 2009, has been a scourge of the tobacco industry for almost 30 years.7
For Mackay the battle is ultimately political and will happen “in the corridors of power, not on wards.” She regrets that some people believe that putting research findings in the public domain is somehow “unprofessional” and that few medical schools’ curriculums teach health advocacy (that is, how to communicate research findings to influence policy). The tobacco industry is not shy to lobby, noted Mackay, although over the past few years it has taken to the courts to try to block antitobacco legislation. The latest Tobacco Atlas (coauthored by Mackay) lists 18 countries where legal challenges have been mounted recently (www.tobaccoatlas.org).
But there have been many successes. Despite several legal challenges, Australia switches to plain cigarette packaging on 1 December. In the UK the prevalence of smoking has fallen from 82% in 1948—the highest in the world—to closer to 20% now. New Zealand is working to become smoke free by 2025; Mackay predicts that her own Hong Kong will beat them to it. Nevertheless, a billion people may die from smoking related diseases this century, compared with “only” 100 million last century, such has been the explosion in smoking.
The heirs of Doll, who made their way to the Oxford meeting from the countries that will bear the brunt of the 21st century smoking epidemic, will need to team up with a Mackay when they get home. Robust scientific evidence on its own is not enough.
Notes
Cite this as: BMJ 2012;345:e7605
References
- Pirie K, Peto R, Reeves GK, Green J, Beral V, for the Million Women Study Collaborators. The 21st century hazards of smoking and benefits of stopping: a prospective study of one million women in the UK. Lancet2012, doi:10.1016/S0140-6736(12)61720-6.
- Sakata R, McGale P, Grant EJ, Ozasa K, Peto R, Darby SC. Impact of smoking on mortality and life expectancy in Japanese smokers: a prospective cohort study. BMJ2012;345;e7093.
- Keating C. Smoking kills: the revolutionary life of Sir Richard Doll. Signal, 2009.
- Doll R, Hill AB. Smoking and carcinoma of the lung: preliminary report. BMJ1950:ii:739-48.
- Hill AB. Do you smoke? BMJ1951;ii:1157.
- Delamothe T. Deaths from smoking: the avoidable holocaust. BMJ2012;344:e2029.
- Hawkes N. Promoting hand washing, stroke prevention, and tobacco control are recognised at BMJ Group award ceremony. BMJ2009;338:b1428.
ADB: High tobacco prices save lives
http://www.bangkokpost.com/news/asia/321050/doubled-cigarette-prices-reduce-deaths
Smoking-related deaths in Thailand and four other Asian countries where tobacco use is amongst the highest in the world would drop by 20% if cigarette prices were doubled by increased taxation, according to an Asian Development Bank study released on Tuesday.
Photo by Jetjaras na Ranong
The Manila-based bank claimed that even a 50% price hike would save 27 million people from dying from smoking-related diseases and cause nearly 67 million current smokers to quit, or youths not to take up the habit, in China, India, the Philippines, Thailand and Vietnam.
“An even higher price increase of 100% yields greater benefits, saving nearly 55 million lives in the five countries or about 20% of the projected deaths,” the study said.
An estimated 402 million people are smokers in China, India, the Philippines, Thailand and Vietnam, while 130 million more are projected to be future smokers.
“In the absence of intervention, smoking will eventually kill about 267 million current and future cigarette smokers who are alive today in the five countries,” it said.
A 50% increase in cigarette prices would also generate more than US$24 billion (936 billion baht) in additional tax revenues annually, the study said.