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April 3rd, 2015:

Bill seeks to raise legal tobacco purchase age to 21

Bills’ opponents critique lost sales revenue from 18 to 20 age group, encroachment on individual rights

A bill introduced by Rep. Teresa Tanzi, D-Narragansett and South Kingstown, proposes to increase the legal age to buy or sell tobacco products in Rhode Island from 18 to 21 years old. After being introduced in February, the legislation entered the hearing stage last week, spurring debate between medical professionals, politicians and other interested parties.

Similar legislation has been passed in municipalities across the country, but the legislation’s passage would make Rhode Island the first state in the nation to raise the legal age for purchasing or selling tobacco to 21.

“There’s very good research that decision-making among 18 to 21 year olds is still not fabulous,” said Patricia Risica, professor of epidemiology.

“The kind of social pressures put on them override what they know to be a bad decision,” Tanzi said.

Increasing the legal age not only decreases the risk of smoking in that age group but also reduces access to cigarettes for underage youth who get their tobacco products from young adults, Risica said.

The municipal government in Needham, Massachusetts passed an ordinance raising the age of buying tobacco to 21, which immediately decreased the percentage of people under 21 who have smoked within the last 30 days by 48 percent, Tanzi said. New York City also enforces the older legal age.

A hearing for the bill was held by the House Committee on Health, Education and Welfare March 25. Opponents cited an overstep in government regulation as one of the bill’s defects. Some pointed out that 18-year-olds are allowed to vote and join the military, and they should have the right to make decisions for themselves, the Providence Journal reported March 26.

Raising the age could also cost the state to lose tax revenue from cigarettes, said Scott Mackay, political analyst for Rhode Island Public Radio, adding that Gov. Gina Raimondo’s recently unveiled budget proposes an additional 25 cents-per-package increase on the state cigarette tax.

“There’s nothing to stop a young person between 18 and 21 to just drive 3 or 4 miles over the border and go to Massachusetts to buy cigarettes,” which would hurt R.I. retail sales, MacKay said. “This would be a much easier choice if Massachusetts did the same thing.”

Small business owners testified against the bill at last week’s hearing, said Karina Wood, public policy director for the American Lung Association, adding that while the association supports the state’s small businesses, “there are many other things that convenience stores and gas stations in Rhode Island can sell and make good money.”

Cigarette sales to the 18 through 20 age group make up 2 percent of convenience store sales, Tanzi said. “It’s a drop in the bucket,” she added.

The money lost would be made up by savings on health care expenditures on tobacco-related illnesses, Tanzi said.

Brain development and growth in self-regulation continue past the age of 18, according to an FDA-initiated study from the Institute of Medicine entitled “Public Health Implications of Raising the Minimum Age of Legal Access to Tobacco Products.”

“High-risk behaviors, including tobacco use, are generally more common in adolescents and young adults than in older adults,” the IOM reported. “Additionally, the tobacco industry, prohibited from marketing to those younger than 18 years of age, has for decades targeted marketing and promotional activities to young adults.”

Ninety percent of adult smokers began before the age of 21, according to an American Lung Association study.

Hong Kong would be wise to tighten regulations on sales of e-cigarettes

Electronic cigarettes have become increasingly popular the world over, so much so that the need for regulation can no longer be ignored. Although the World Health Organisation and the US Food and Drug Administration are pushing for better health protection measures, some governments continue to dodge the issue, citing inconclusive medical research as the excuse. The Hong Kong government has not been doing much on this front either, arguing that e-cigarettes are already covered by existing law. Firstly, the smoking ban in some areas applies equally to e-cigarettes. Secondly, it contains nicotine, meaning it is a pharmaceutical product and must be registered with the Pharmacy and Poisons Board before sale or distribution.

The reality, of course, is somewhat different. When questioned by lawmakers last year, the government conceded that no e-cigarettes have been registered under the law. While it expressed concerns over their illegal sale on the internet and in local stores, and had received 35 complaints between 2012 and 2014, there was only one conviction. Enforcement against smoking e-cigarettes in banned areas is also woefully inadequate, with only two persons fined since 2011.

It is good that the Council on Smoking and Health is taking an unequivocal position on the issue. The recommended total ban, including sales, advertising, distribution, sponsorship and manufacturing, may seem sweeping compared to the existing restrictions imposed on the tobacco industry. But as medical experts have pointed out, there is evidence showing e-cigarettes are just as bad, if not worse, than regular cigarettes. The number of users is also rising, up from 1 per cent of respondents in a survey of Hong Kong people in 2012-13 to 1.8 per cent last year. It is therefore prudent to take a preventive approach lest e-cigarettes flourish into a booming business. The initial response from the health chief appears to be positive, although he was quick to add that the details have to be studied further. Given the government’s clear stance against smoking, it is only right for it to further tighten the regulations.

Source URL (modified on Apr 3rd 2015, 7:22am):

The 16th World Conference on Tobacco or Health

The 16th World Conference on Tobacco or Health: Not exactly “World”


Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida

Two years ago, I was invited to serve on the scientific committee for the 16th World Conference for Tobacco or Health (WCTOH). I was particularly happy to serve, since this was the first time such an important event was planned in the Middle East, where most of my career has been focused.

Over the past decade, several colleagues and I were greatly involved in initiatives aiming at seeding tobacco control research and training of tobacco control professionals from the region, with support from the US National Institute of Health.

The decision to hold the 16th WCTOH in Abu Dhabi (UAE) was only good news for me; a homecoming of years of efforts to seed science and evidence-based tobacco control principles in the Middle East. To build momentum, we started planning events that combine research and capacity building for tobacco control in the region, with conferences held in Abu Dhabi in 2013 and Qatar in 2014. We supported regional researchers to attend these conferences and conducted special research training workshops for junior researchers from the Middle East. This was complemented by a seed-grant program, for pilot studies in tobacco control in different countries in the region. Given the great opportunity presented by WCTOH for those grantees, we organized a special symposium during the WCTOH for our seed grantees to present their research results.

This was really going well all around, and personally I was looking forward to a highlight of my career efforts in the region.

My excitement withered as the conference drew closer, when I started receiving worried messages from researchers in the region about a delay in their visa and travel arrangements. It became clear certain countries, not individuals, were the focus of visa denials. These were Syria, Iraq, Tunisia, and Bangladesh. I had a flashback from a year earlier, as I and my wife preparing for the 2014 waterpipe conference in Abu Dhabi, when her visa was denied while I had no problem. My wife is a tobacco control researcher from the University of Miami, and has years of work in tobacco control in the region. The only difference between us is that I had couple of months before received my new US citizenship, while she was still a permanent residence awaiting her citizenship and had to travel with her Syrian passport. When I brought this issue to the attention of one of the WCTOH organizers and warned about its grave potential for the WCTOH, he kept brushing the issue aside as of no concern.

Eventually, about 60 conference participants were denied entry to UAE, including 3 out of 6 participants in my symposium for young researchers in the region (Syria, Iraq, Tunisia). The conference organizers issued a statement that such denial is to be expected, and that it is actually less than previous similar occasions. However, I expect that in most similar occasions in the past visa denial was based on a case by case consideration not nationality, since I travelled to all of them since 2000 on my “cursed” Syrian passport. Still, I would have accepted this as related to the country’s policy with little that one can do about it. The main problem here is that the policy was well known to the local organizers based on previous experience, such as mine, but it was kept hidden from both the international organizing committee and conference participants. In the words of one of the conference Chairs, the local organizers assured everybody that “bona fide delegates would be allowed to enter the country”.

The largest delegation denied visas came from Bangladesh, one of the most active countries in Asia in tobacco control. It is also the home of second largest migrant working population in UAE, and has a lot to do with the construction and development boom of UAE, mostly under appalling conditions. What is worse is that the local organizers kept all participants from “shady” countries waiting even as the conference started (sometimes spending more than a day in the airport or with friends waiting for news) without telling them to go home based on what they knew of the extreme unlikelihood that they will receive a visa. Even two weeks after the conference, no official apology or responsibility declaration has been issued by any of the bodies related to the organization of WCTOH. This is unheard of from a community like ours that aspires to the highest moral values and respect for human dignity.

Tobacco control has been the cause of my life and career. Having a strong tobacco control community and successful international gatherings is vital for international cooperation and collaboration. If we remain silent about such mishandlings we risk repeating them or becoming accomplices in them. This is why I think such an incident requires a clear response from the organizers, and calls on us as community to create a better process for selecting host countries and organizing future World Conferences. Much more say in such decisions should be given to tobacco control activists from developing countries, who are at most risk of being refused visas, to ensure they have the opportunity for full participation.