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January 24th, 2013:

US: Two major new studies on smoking and mortality

Two new US studies examining smoking and mortality are published today in the New England Journal of Medicine.

The findings from one of the studies indicated that the relative risk from dying of a smoking related death has grown substantially for women and is now at a level almost identical to that of men. For men, their risk of dying has plateaued and is sustained at the high levels previously witnessed in the 1980’s.

The second study, utilising data from the US National Interview Survey between 1997 and 2004, revealed that people who smoke take at least a decade off their overall life expectancy.

However, the research also found that stopping before the age of 40 eliminated 90% of the overall risk of a smoking associated death.

The conclusions from these American studies are almost identical to that of similar research conducted last year by researchers from Oxford.

Commenting on the finding in women to the BBC, lead researcher of the Oxford Study, Prof Sir Richard Peto, said: “If women smoke like men, they die like men.”

Source: USA Today, 23 January 2013
Link: http://usat.ly/V91a7D
Smoking could be reduced by standardised packaging of tobacco products says study
The introduction of tobacco in standard packaging would see a significant reduction in the number of adult smokers in the UK, a new study has postulated.

The researchers also believe that the number of children trying smoking for the first time would be reduced from 27% to 24%.

The study was conducted by the University of Cambridge and harnessed the expert opinion of academics from the UK, Australasia and North America to try and gauge the potential impact of standardised packaging.

The research is published in BMC Public Health today.

Source: News Medical, 24 January 2013
Link: http://bit.ly/Whxx7E
Spain: Implementation of smoke-free legislation reduces the number of acute myocardial infarctions by 11 percent
A Spanish study has found that the incidence of acute myocardial infarctions in the country’s province of Girona has decreased by 11% since the introduction of smokefree legislation.

A public smoking ban was introduced in 2006.

The study, published in PLoS ONE, found that the decrease was especially prevalent in women and those aged between 65 and 74.

Source: Medical Xpress, 23 January 2013
Link: http://bit.ly/WhzDo0

Experts believe plain packaging of tobacco products would cut smoking

http://www.eurekalert.org/pub_releases/2013-01/uoc-ebp012313.php

Public release date: 23-Jan-2013
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Contact: Genevieve Maul
gm349@admin.cam.ac.uk
44-012-237-65542
University of Cambridge

Study examined likely impact on smoking rates in adults and children

Experts believe that plain packaging of tobacco products would cut smoking, a new study has found. Tobacco control experts from around the world estimate that two years after the introduction of generic packaging the number of adult smokers would be reduced by one percentage point (in the UK – from 21 to 20%*), and the percentage of children trying smoking would be reduced by three percentage points (in the UK – from 27 to 24%*). The Cambridge research was published today in the journal BMC Public Health.

Because Australia, the first country to implement plain packaging, only did so in December of last year there is no quantifiable evidence as of yet. Therefore, scientists have used the next best option, the expertise of internationally-renowned tobacco control specialists from around the world.

For the study, 33 tobacco control experts from the UK (14), Australasia (12) and North America (7) were recruited. Professionals in these regions were targeted because these countries are currently considering (or have recently implemented) plain packaging for tobacco products. They were then interviewed about how plain packaging – packaging without brand imagery or promotional text and using standardised formatting – might impact the rates of smoking in adults and children.

The experts estimated that plain packaging would reduce the number of adult smokers by one percentage point (on average) two years after the introduction of plain packaging.

Professor Theresa Marteau, Director of the University of Cambridge’s Behaviour and Health Research Unit, who led the study, said: “Currently, approximately 10 million** adults in Britain smoke. A one percentage point decline – from 21% of the population to 20% – would equate to 500,000 people who will not suffer the health effects of smoking.”

More impressively, they believe that generic packaging would reduce the percentage of children trying smoking by three percentage points (on average) two years after plain packaging is introduced.

Dr Rachel Pechey, first author of the study from the University of Cambridge’s Behaviour and Health Research Unit, said: “Given that the majority of smokers first try smoking in adolescence, the impact on children is of particular importance. Nicotine dependence develops rapidly after lighting up for the first time, even before the user is smoking once a week.”

The tobacco control experts indicated that plain packaging would reduce the numbers of children trying smoking because they expect younger people to be more affected by less appealing packs, less brand identification, and changes in social norms around smoking. This ties in with previous research that has described three ways in which plain packaging may reduce smoking rates, particularly among youth – by reducing the appeal of packs, by increasing the salience of health warnings and by standardising pack colour.

Pechey added: “Despite the consistency of experts’ predictions that plain packaging would reduce smoking rates, many participants felt that the two-year time frame we used was insufficient and did not allow for the full impact of the packaging. This suggests generic packaging could have a greater impact over a longer term period, as the impact on young people starting smoking feeds through into the adult smoking statistics.”

Professor David Spiegelhalter from the University of Cambridge Centre for Mathematical Sciences added: “Expert elicitation methods can guide policy makers by quantifying uncertainty where no direct evidence exists.”

The UK government recently conducted a public consultation on the possible introduction of a plain packaging policy for tobacco products (from April to August 2012). It is estimated that treating diseases caused by smoking costs the NHS £2.7 billion a year.***

###

For additional information please contact:

Genevieve Maul
Office of Communications
University of Cambridge
Tel: direct, 44-1223-332-300
Mob: 44-7774-017-464

Notes to editors:

1. The paper:

‘Impact of Plain Packaging of Tobacco Products on Smoking in Adults and Children: An elicitation of international experts’ estimates’ was published online by BMC Public Health.

2. External statistics:

* UK smoking prevalence rates used in the study from: Smoking and drinking among adults, 2009: A report on the 2009 General Lifestyle Survey (Adults); Smoking, Drinking and Drug Use among Young People in England in 2010 (Children)

Smoking prevalence rates for North America were: Adults: 17.5%; Children 21.6% (Tobacco Use in Canada: Patterns and Trends, 2011 Edition) and for Australasia: Adults: 18% (Australian Institute of Health and Welfare. 2010 National Drug Strategy Household Survey report); Children: 21.1% (Australian secondary school students’ use of tobacco, alcohol, and over-the-counter and illicit substances in 2008)

**2010 General Lifestyle Survey, ONS; see http://ash.org.uk/files/documents/ASH_106.pdf

*** http://www.ash.org.uk/files/documents/ASH_121.pdf

3. Funding:

The Behaviour and Health Research Unit (BHRU) is funded by the Department of Health Policy Research Programme as the Policy Research Unit in Behaviour and Health (PR-UN-0409-10109). The Department of Health had no role in the study design, data collection, analysis, or interpretation. The final version of the report and ultimate decision to submit for publication was determined by the authors. The research was conducted independently of the funders, and the views expressed in the paper are those of the authors and not necessarily those of the Department of Health.


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Biomarkers of secondhand smoke exposure in automobiles

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21st-Century Hazards of Smoking and Benefits of Cessation in the United States

http://www.nejm.org/doi/full/10.1056/NEJMsa1211128

BACKGROUND

Extrapolation from studies in the 1980s suggests that smoking causes 25% of deaths among women and men 35 to 69 years of age in the United States. Nationally representative measurements of the current risks of smoking and the benefits of cessation at various ages are unavailable.

METHODS

We obtained smoking and smoking-cessation histories from 113,752 women and 88,496 men 25 years of age or older who were interviewed between 1997 and 2004 in the U.S. National Health Interview Survey and related these data to the causes of deaths that occurred by December 31, 2006 (8236 deaths in women and 7479 in men). Hazard ratios for death among current smokers, as compared with those who had never smoked, were adjusted for age, educational level, adiposity, and alcohol consumption.

RESULTS

For participants who were 25 to 79 years of age, the rate of death from any cause among current smokers was about three times that among those who had never smoked (hazard ratio for women, 3.0; 99% confidence interval [CI], 2.7 to 3.3; hazard ratio for men, 2.8; 99% CI, 2.4 to 3.1). Most of the excess mortality among smokers was due to neoplastic, vascular, respiratory, and other diseases that can be caused by smoking. The probability of surviving from 25 to 79 years of age was about twice as great in those who had never smoked as in current smokers (70% vs. 38% among women and 61% vs. 26% among men). Life expectancy was shortened by more than 10 years among the current smokers, as compared with those who had never smoked. Adults who had quit smoking at 25 to 34, 35 to 44, or 45 to 54 years of age gained about 10, 9, and 6 years of life, respectively, as compared with those who continued to smoke.

CONCLUSIONS

Smokers lose at least one decade of life expectancy, as compared with those who have never smoked. Cessation before the age of 40 years reduces the risk of death associated with continued smoking by about 90%.