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May, 2016:

Medical chiefs want total ban on tobacco sales to anyone born after the year 2000

The proposal is aimed at stopping people taking up smoking, with Norwegian health experts hoping to stamp out the habit by 2035

Medical chiefs are calling for a complete ban on tobacco sales to anyone born after the year 2000.

The controversial proposal, in Norway, is backed by six out of ten people in the wealthy Scandinavian country.

Norwegian Medical Association president Marit Hermansen said: “It is not a basic human right to begin using tobacco.

“We have long had the policy of phasing out smoking by 2035. This is a measure to achieve this goal.

“It shouldn’t be forbidden to smoke, but we want young people to not get started with tobacco.”

But while the majority of Norwegians agree the NMA, Health Minister Bent Hoie told the Aftenposten newspaper that the government currently has no plans to take up any legislation that would lead to a ban of tobacco sales.

In Britain, new rules banning e-cigarette advertising and ordering that all cigarettes are sold in plain packets come into force in May.

But tobacconists have a year’s grace period to sell their old stock.

Then by 2020, packs of ten cigarettes and menthol cigarettes will be banned and rolling tobacco must come in at least 30g packs.

They form part of the EU ’s aim to slash the number of smokers across Europe by 2.4 million and combat an estimated 700,000 premature deaths caused each year by

Tobacco control cost-saving study dubbed ‘outstanding’

Work to cash up potential health savings from stop smoking schemes has won a major European award.

EQUIPT, (European-study on Quantifying Utility of Investment in Protection from Tobacco) aims to calculate the costs and benefits of tobacco control across Europe.

The €2 million Brunel-led project has pocketed an Outstanding European Health Research Award from the European Network for Smoking and Tobacco Prevention.

EQUIPT will offer health providers and policy makers across Europe tailor-made figures on how much they can save from investing in tobacco control such as stop smoking schemes.

“In terms of saving lives through less smoking related diseases, this is very far reaching,” said study leader Dr Subhash Pokhrel. “It can also avoid different countries spending money on similar research.”

Big regional differences across Europe mean one size doesn’t fit all, when it comes to smoking statistics. Evidence strongly suggests hard-hitting, joined-up tobacco control programmes are the best way to stop people starting smoking and get more to stop. But regional European health providers and policy makers don’t have the tailored data to financially justify such prevention programmes.

EQUIPT uses comparative analysis to show European health providers how they can translate figures from similar English regions to predict tobacco control benefits locally.

Above helping regional health providers calculate value for money, “it should give us enough information to see if harmonising efforts on tobacco controls across Europe could be cost effective,” said Dr Pokhrel.

Led by Brunel’s Health Economics Research Group (HERG), EQUIPT is a partnership between Belgium, Croatia, Germany, Hungary, the Netherlands, Spain and the UK.

Hong Kong must adopt plain tobacco packaging, say health advocates

Three-quarters of Hongkongers support restrictions on logos, colours and brand images on cigarette and other tobacco product packs in a bid to further reduce smoking

We’ve all chosen products purely based on packaging – a bag of chips at the supermarket, a novel at the bookstore, a photo of a dish on a menu. Even when dealing with people, we tend to let first impressions guide our future interactions with them.

The power of packaging to directly influence one’s perception of something or someone is so strong that it’s no surprise the World Health Organisation advocates plain packaging for tobacco products, which kill almost six million people every year.

Momentum for plain packaging has steadily gained in the past few years, starting with Australia’s implemention in December 2012, and now the measure looks to be gaining traction worldwide.

“We’re beginning to see the globalisation of plain packaging,” says Benn McGrady, a legal adviser to the WHO’s Framework Convention on Tobacco Control.

Plain packaging of tobacco products restricts or prohibits the use of logos, colours, brand images and promotional information on packaging other than brand and product names displayed in a standard colour and font style.

Earlier this month on May 20, France and Britain each began implementation of plain packaging. Ireland is also preparing to introduce the measure this year; Hungary and Norway are in the process of developing laws to implement plain packaging; Singapore is undertaking a public consultation with a view to introducing plain packaging; and several other countries, including New Zealand, South Africa and Turkey, have either expressed an intent to implement the measure or are in the policy development process.

When will Hong Kong be next? Antonio Kwong, chairman of the Council on Smoking and Health (Cosh), says Cosh has been advocating the government to implement plain packaging since 2012.

About three-quarters of Hongkongers have expressed support for plain packaging, Kwong says, citing results from the 2015 Tobacco Control Policy-related Survey commissioned by Cosh and conducted by Hong Kong University’s School of Public Health to collect public opinion towards current and future tobacco control policies.

“In view of the global successful examples and WHO’s appeal, Cosh recommends the government to actively consider adopting plain packaging in two to three years,” says Kwong.

The WHO is stepping up its drive for plain packaging by making it the theme of this year’s World No Tobacco Day, held annually on May 31 since 1988. WHO has launched a new 86-page guide to plain packaging of tobacco products, which gives governments the latest evidence and guidance on implementing the measure.

“Plain packaging reduces the attractiveness of tobacco products. It kills the glamour, which is appropriate for a product that kills people,” says WHO director-general Dr Margaret Chan. “It restricts tobacco advertising and promotion. It limits misleading packaging and labelling. And it increases the effectiveness of health warnings.”

McGrady says there’s a “strong evidence base” supporting the implementation of plain packaging, including more than 80 peer-reviewed empirical studies, three systematic reviews of the evidence, and an official post-implementation review from Australia.

“As a whole, this body of evidence points in one direction, which says plain packaging is an effective public health intervention,” says McGrady.


Smoking prevalence has been steadily declining in Australia for years, and even if plain packaging hadn’t been introduced the rate was projected to be 17.77 per cent among those aged 14 and older in 2015. However research shows that between December 2012 and September 2015, there was an additional 0.55 percentage point fall in smoking prevalence attributable to the packaging changes – meaning a 17.21 per cent prevalence – McGrady says.

This equates to more than 108,000 fewer smokers in Australia as a consequence of plain packaging – a “very big” number, says McGrady. “Plain packaging has decreased tobacco use in Australia beyond trend; it has increased the speed of the downward trajectory.”

Plain packaging reduces the attractiveness of tobacco products. It kills the glamour, which is appropriate for a product that kills people Margaret Chan, WHO director-general

Tobacco packs act as a prominent form of tobacco advertising and promotion, not only at the point of sale, but also after, says the WHO report. Tobacco products are “badge products”, meaning they have a high degree of social visibility and that consumers identify with the brand image cultivated on product packaging.

“As internal tobacco industry documents recognise, packaging plays an increasingly important role in promoting tobacco products as other restrictions on tobacco advertising and promotion are tightened,” the report says.

In the evidence gathered in the report, studies show that packaging – in particular colour – affects consumers’ perceptions of risk. Early evidence of this can be found in internal tobacco industry documents released to the public through litigation, the report says.

For example, a 1990 tobacco industry document recognised that so-called “lower delivery products” were featured in lighter packs because they have a clean healthy connotation. Other studies tested consumer reactions to ultra-light products packaged in different colour packs. Consumers ranked the perceived tar level of products in different colour packs and commented on factors such as the harshness and strength of the flavour of different colour packs with otherwise identical products inside them.

There’s also evidence that plain packaging influences the intention and increases the urgency of smokers to quit. It also reduces active smoking and the display of tobacco packs in outdoor settings.

Plain packaging also prevents misleading packaging, the report says, such as labels like “light”and “mild”, which suggest products are less harmful to health than regular brand variants when this is not the case. Rather, consumers compensate for the lower tar and nicotine yields in these products, including by smoking more of a cigarette and taking deeper puffs.

With all this compelling evidence, why aren’t more governments rushing to implement plain packaging?

“I think the resistance to tobacco control and plain packaging are driven by the tobacco industry using its deep pockets to oppose implementation of good public health policies. It’s political; it’s nothing to do with evidence or public policy,” says McGrady. “That’s what’s slowing down tobacco control globally.”

Tobacco industry opposition to plain packaging dates back more than 20 years, McGrady says. Most recently the world’s top four tobacco companies challenged Britain’s new plain packaging law, arguing that it unlawfully took away their intellectual property. The High Court struck down the challenge and the law came into effect on May 20.

“It is wrong to view this issue purely in monetised terms,” the ruling said. “There is a significant moral angle embedded in the regulations, which is about saving children from a lifetime of addiction, and children and adults from premature death and related suffering and disease.”

One person dies from a tobacco-caused disease approximately every six seconds according to the WHO. Annual deaths are forecast to rise from 6 million to more than 8 million by 2030.

In Hong Kong, the prevalence of daily cigarette smokers among persons aged 15 and over has decreased steadily from 23.3 per cent in 1982 to 10.5 per cent in 2015 (except for years from 2000 to 2002). Still, a Chinese University study last year found that smoking costs the city HK$11.3 billion each year, in health care expenses and productivity losses related to tobacco.

The WHO recommends implementing plain packaging as part of a comprehensive approach to tobacco control that includes large graphic health warnings and comprehensive bans on tobacco advertising, promotion and sponsorship.

Says Kwong: “Through the implementation of a comprehensive and multipronged strategy, including a policy of long-term tobacco tax increases to reduce affordability, expansion of statutory no-smoking areas, restriction of tobacco promotion and packaging, the banning of tobacco product displays at points of sale, raising the minimum age to buy cigarettes to 21, increasing resources for smoking cessation services, strengthening smoke-free education and promotion, placing responsibility on venue managers for smoking offences in their premises etc, we hope the smoking prevalence will drop to below 5 per cent in the near future.”
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China back-pedals on tough national smoke-free law

Changes to draft legislation would let people light up in restaurants, bars, hotels and airports

China has back-pedalled on a proposed national smoke-free law, with plans now to grant exemptions to restaurants, bars, hotels and airports.

Sources who have read the draft said they were shocked by how much it had been watered down from the version put up for public consultation in November 2014. That earlier draft proposed a ban on smoking at all indoor, and some outdoor, public spaces.

The latest version of the Ordinance on Smoking Control in Public Spaces would allow restaurants, bars, hotels and airports to set aside smoking areas, several sources who have seen the draft said. The changes are a major departure from the 12th five-year plan, which ended last year and called for a complete smoking ban in public spaces.

Bernhard Schwartländer, the World Health Organisation’s representative in China, said the WHO was worried by the changes.

A law that has so many exceptions can’t be enforced. We have learned the best law is one that is 100 per cent smoke free.

“You see again and again in the world such exceptions built in the law and it doesn’t do much to protect the health of the people from second-hand smoke. A law that has so many exceptions can’t be enforced. We have learned the best law is one that is 100 per cent smoke free. That’s is very simple and clear,” Schwartländer said.

With about 315 million smokers, the mainland is the world’s biggest producer and consumer of tobacco products. And roughly 700 million people are routinely exposed to second-hand smoke, according to the WHO.

Tobacco control is difficult on the mainland because the industry is state-owned and lucrative, generating more than 1.09 trillion yuan (HK$1.3 trillion) in profit and tax revenue last year.

A national health official campaigning to restrict tobacco use said some cities already had strict laws banning smoking in all indoor public areas and “we’d rather have no law at all than have a national law that says it is OK to smoke indoors”.

Eighteen mainland cities have passed municipal smoking bans since 2008 and of those Beijing’s is the strongest. The law, introduced in the capital in June last year, complies fully with the WHO’s call for a complete ban on smoking in all indoor workplaces, public transport, indoor public areas and other public places.

A year after it came in, smoking in indoor public areas in Beijing has dropped from 23.1 per cent to 6.7 per cent and smoking in restaurants fallen from 40.3 per cent to 14.8 per cent, according to Fang Laiying, director of the Beijing Health and Family Planning Commission.

But the manager of Hua’s Restaurant in Beijing said allowing smoking areas in restaurants would make his job much easier.

“Some customers are not from Beijing. Some are drunk. It’s very difficult to persuade them not to smoke in the restaurant,” he said.


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World No Tobacco Day, 31 May 2016

Clear the Air says:

The rest of the world is starting to follow the WHO directive, except here, where the clocks are winding back instead of forward.

Hong Kong Health Bureau officials, having learned the Ombudsman is chasing their lack of effort and political will, have now decided they will press for

– Oops not plain packaging-

they will (following 3rd world country India who already did it) press instead for an 85% graphic health warning (replacing outmoded 50% current) on the packet, but the whole idea is to take away the glitzy colors which Big Tobacco uses on its ‘Silent Salesman’ packet, its remaining legal advertising gullible youth attractant fly paper

Whiskers middle class citizen food truck promoting Tsang took in HKD 6.297 bn last year in excise tobacco tax to the concrete pouring fund, and doled out a meagre HKD 160 million for tobacco control whilst HK continues to subvent the costs of smoking related health care as tobacco executives with impunity continue to smuggle (not control their supply chains) their own brands to get more market share =more deaths = defeat tobacco control existing flimsy methods.

Earlier, last month on May 20, France and Britain each began the implementation of plain packaging under new laws. Ireland is also preparing to introduce the measure this year; Hungary and Norway are in the process of developing laws to implement plain packaging; Singapore is undertaking a public consultation with a view to introducing plain packaging; and several other countries, including New Zealand, South Africa and Turkey, have either expressed an intent to implement the measure or are in the policy development process. Canada follows Australia’s lead and has sued Big Tobacco and won, CAD 15 billion for recovery of health care costs – why not here ?

Get ready for plain packaging

Plain packaging of tobacco products can save lives by reducing demand for tobacco products, and is recommended in the WHO Framework Convention on Tobacco Control. “Plain packaging reduces the attractiveness of tobacco products. It kills the glamour, which is appropriate for a product that kills people,” says WHO Director-General Dr Margaret Chan.

Canada to make plain packaging for tobacco products compulsory

Canada, following the lead of Britain and Australia, will make plain packaging of cigarettes compulsory in a bid to cut the rate of smoking, Health Minister Jane Philpott said on Tuesday.

Although Canada already obliges firms to slap large graphic warning labels on cigarette packets, Philpott said more must be done, given that some 5 million of Canada’s 36 million inhabitants still use tobacco products.

The measures would require a uniform, standardized color and font on packages and restrict the use of logos and trademarks.

“I don’t believe tobacco companies should be allowed to build brand loyalty with children for a product that could kill them,” Philpott told reporters.

A final decision on what packaging rules to apply will be announced after a three-month period of public consultations.

Earlier this month, a British court backed the government’s plans for mandatory plain packaging when it struck down a legal challenge from tobacco companies.

In 2011, Australia became the first country to adopt plain packaging legislation.

Major producers of tobacco sold in Canada include Japan Tobacco’s JTI-Macdonald unit, Rothmans Benson & Hedges Inc, which is partly owned by Philip Morris and Imperial Tobacco Canada Ltd, a unit of British American Tobacco.

“With products already hidden from view in stores and 75 percent of the pack covered with health warnings, nobody starts smoking because of the pack,” said Eric Gagnon, a spokesman for Imperial Tobacco.

(Reporting by David Ljunggren; Editing by Alan Crosby)

Canadian Cancer Society praises federal consultation on tobacco plain packaging

The Canadian Cancer Society commends Minister of Health Jane Philpott for launching a formal consultation toward implementing tobacco plain packaging in Canada.

The consultation document, announced today on World No Tobacco Day, provides a detailed outline of how plain packaging may be required in Canadian regulations.

“Plain packaging is highly effective and is supported by extensive research,” says Rob Cunningham, senior policy analyst, Canadian Cancer Society. “If plain packaging were not effective, then tobacco companies would not be so strongly opposed to it. It is precisely because plain packaging will reduce sales that tobacco companies are objecting so loudly.”

“It is encouraging that the government is looking not only to eliminate tobacco-company promotion on packages, but also to standardize the shape of the package and to ban slim cigarettes,” says Cunningham. “Slim and superslim cigarettes target young women and associate smoking with weight loss, sophistication and glamour.”

Smoking is the leading cause of preventable disease and death in Canada, including about 30% of all cancer deaths. Among women alone, the number of lung cancer deaths is double the number of breast cancer deaths. Smoking kills 37,000 Canadians every year. The 2014 Canadian Community Health Survey found that 18% of Canadians (more than 5 million people) are smokers.

“Plain packaging is a key tobacco control measure to advance public health in Canada,” says Cunningham. “Today’s announcement of a formal consultation brings us closer to the day when plain packaging will be in effect to protect youth.”

“Tobacco companies should not be able to use the package as mini-billboards to promote tobacco,” adds Cunningham. “Tobacco is a highly addictive, lethal product and should not be sold in packages made to be more attractive. It is essential to provide protection from tobacco-industry marketing tactics, especially for children.” A growing number of other countries are requiring plain packaging, which will make it easier for Canada to do so. The international trend is very positive.

What are other countries doing?

Plain packaging was required in Australia in 2012, implemented in the UK and France as of May 20, 2016, will be implemented soon in Ireland and is under formal consideration in New Zealand, Norway, Sweden, Finland, Hungary, Slovenia and other countries.

What is plain packaging?

Plain packaging prohibits brand colours, logos and graphics on tobacco packages. Graphic health warnings and pictures still appear, but the rest of the package is a standard colour for all brands, such as the drab brown required in Australia. Package dimensions are standardized, eliminating slim and superslim packs as well as other attractive package formats recently introduced by tobacco companies.

About the Canadian Cancer Society

The Canadian Cancer Society is a national, community-based organization of volunteers whose mission is the eradication of cancer and the enhancement of the quality of life of people living with cancer. When you want to know more about cancer, visit our website at or call our toll-free, bilingual Cancer Information Service at 1-888-939-3333.

Plain cigarette packaging increases motivation to quit, says anti-smoking group

The National Council Against Smoking (NCAS) believes that the stripping of cigarette package branding, directly affects the the sale of the tobacco products.

NCAS Executive Director, Yussuf Saloojee says that a case study in Australia proves that plain packaging is effective in reducing the rate of smoking.

According to Saloojee, Australia introduced the plain packaging laws in 2012 and tobacco usage has fallen to its lowest levels.

Plain packaging increases the motivation of smokers to stop smoking and deters young people from starting.

— Dr Yussuf Saloojee, NCAS Executive Director

Saloojee suggests that current packaging in South Africa entices impressionable youth into believing that smoking is a ‘glamorous’ thing to do.

He says that the cigarette industry spends excessive amounts of money trying to sell their brand and promote the habit to young people.


Mapped: The countries that smoke the most cigarettes

To mark World No-Tobacco Day, we’ve mapped the world according to cigarette consumption.

Those countries shown in darker colours smoke the most; those in lighter ones the least.


As with alcohol consumption, Eastern European countries dominate. Montenegro, where 4,124.53 cigarettes are smoked per adult per year, according to 2014 figures from the World Health Organisation (WHO), is the top of the pile, while Belarus, Macedonia, Russia, Slovenia and Bosnia also make the top 10.

The 20 countries that smoke the most

  1. Montenegro
  2. Belarus
  3. Lebanon
  4. Macedonia
  5. Russia
  6. Slovenia
  7. Belgium
  8. Luxembourg
  9. China
  10. Bosnia and Herzegovina
  11. Czech Republic
  12. Kazakhstan
  13. Azerbaijan
  14. Greece
  15. South Korea
  16. Austria
  17. Jordan
  18. Ukraine
  19. Estonia
  20. Hungary

Lebanon and China are the most tobacco-dependent non-European countries. Few regular visitors to Greece will be surprised to see it at 14th. Other popular summer holiday destinations not far from the smokers’ summit include Croatia, Turkey and Italy.

Britons, conversely, consume far fewer cigarettes – just 827.48 per adult per year – placing it 73rd on the list. The US is slightly higher, at 58th.

Residents of Guinea should be proud of the fact that they smoke the least of all those countries to feature in the WHO’s list. The Pacific nations also fare well, with the Solomon Islands, Kiribati and Vanuatu among the 10 most tobacco-free countries.

There is also a clear relationship between wealth and tobacco consumption. Many of the world’s poorest countries can be found in the lower reaches of the rankings. Those with no data appear in grey on the map above.

The 20 countries that smoke the least

  1. Guinea
  2. Soloman Islands
  3. Kiribati
  4. Rwanda
  5. Samoa
  6. Democratic Republic of the Congo
  7. Vanuatu
  8. Suriname
  9. Malawi
  10. Tonga
  11. Mozambique
  12. Nepal
  13. Afghanistan
  14. Lesotho
  15. Trinidad and Tobago
  16. Burundi
  17. Tanzania
  18. Liberia
  19. Niger
  20. Sao Tome and Principe

Tobacco scenes on screen should carry R-rating, say researchers

There’s something about Audrey Hepburn’s impossibly long cigarette holder that oozes elegance and class.

The use of tobacco on-screen has long been a device used to help craft characters, from the effortlessly cool Danny Zuko in Grease to the womanising executive Don Draper in Mad Men.

But New Zealand researchers are calling for an R rating for TV shows and films containing tobacco imagery, after a study that shows there has been little change in on-screen smoking in the past 10 years.

“While tobacco imagery cannot be banned in any meaningful way, legislation could be introduced requiring programming with tobacco imagery to be R-rated,” the authors concluded.

The research, led by Louise Marsh of the University of Otago, examined tobacco imagery on New Zealand television over a week-long period in October 2014 – 10 years after a similar study in 2004.

There was “virtually no change” in the number of programmes with tobacco imagery, but there was a small reduction in the number of scenes with imagery, said Marsh, who works in the university’s department of preventive and social medicine.

Marsh argued the lack of change did not reflect the decline in smoking in New Zealand, and might encourage normalisation of smoking.

But longstanding film reviewer Graeme Tuckett said an R-rating would achieve nothing. “The whole idea of ratings has almost become redundant, because so many people watch things online.”

Films had typically reflected reality, and smoking was rarely portrayed as “cool” any more, he said.

“In the 30s, 40s and 50s, cigarette companies definitely paid for extensive product placement in film and TV to make smoking look really cool.

“It’s been a long time since I’ve seen a modern-day heroic character smoking.

“[Smoking] is one of those things that’s naturally on its way out, and trying to legislate it could be counter-productive.”

While the overall depiction has remained steady, the number of scenes featuring tobacco and under-18s had tripled, Marsh said.

One positive she could see was that the level of anti-smoking advertisements, such as those for Quitline, had almost tripled.

An Otago University professor supported the proposed R-rating, arguing that TV remained a powerful influence for normalisation.

“Having tobacco and smoking images on [TV] increases the risk that smoking will remain a ‘normal’ activity,” associate professor of public health George Thompson said.

“The removal or countering of smoking and tobacco images in the media is a major neglected area for tobacco control, and a tobacco and smoking R rating appears to be a practical and effective way of intervening for health.”