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December 9th, 2016:

Parliament adopts Standardised packaging to save lives and prevent suffering

Dec 9th, 2016
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Members of Parliament voted in favour of standardised packaging of tobacco products despite intense lobbying by the tobacco industry to sway politicians against the measure.

http://www.smokefreepartnership.eu/partner-news/item/parliament-adopts-standardised-packaging-to-save-lives-and-prevent-suffering

The snowball that was set in motion in Australia in 2012 rolled through Norway today. An overwhelming majority of Parliament endorsed recommendations formulated on 1 December 2016 by the parliamentary Standing Committee on Health and Care Services. The measure will be introduced at the same time as the EU Tobacco Products Directive measures on packaging and labelling.

Tobacco advertising is deadly. It seeks to addict people to a product that kills almost half of its long-term users. Today, Norway becomes one of the first countries in the world to introduce standardised cigarette packs and the first country to standardise smokeless tobacco boxes. Smokeless tobacco use increased dramatically among young people in Norway during the last decade. The new measure will contribute to ensure that children and young people never start with tobacco and thus avoid tobacco-related suffering and death.

Anne Lise Ryel, Secretary General of the Norwegian Cancer Society said: “Norwegian politicians have taken a historic step forward to reduce the consequences of tobacco advertising. Advertising works, especially with children. Norway was the first country in the world to introduce bans on all traditional forms of advertising of tobacco products. Ever since, cigarette packs have become mini billboards for tobacco industry marketing. With this morning’s event, the tobacco industry loses its last vehicle to lure children into addiction, disease and possibly death. This is truly a ground-breaking public health reform, and a landmark day for the cancer cause”.

The Norwegian Cancer Society congratulated Minister of Health and Care Services Bent Høie for his leadership in support of the measure in the face of persistent pressure and campaigning from the tobacco industry.

UK public health experts move to quash e-cigarette fears in wake of US report

Dec 9th, 2016
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https://www.onmedica.com/newsarticle.aspx?id=be447bf6-8e2a-430a-9ba1-7783e5078bd8

UK public health experts have moved to quash fears about the potential dangers of e-cigarettes in the wake of the US Surgeon General’s report* setting out the urgent need to curb the rising popularity of vaping among young people in the US.

Clinicians should not be put off from helping smokers to quit or cut their risk of harm by switching to vaping, they insist.

In his report,* published earlier this week, Dr Vivek Murthy pointed to the evidence on the impact of nicotine on the developing brain, and its ability to trigger lifelong addiction, as well as the potentially harmful additives found in some e-cigarettes.

Use of e-cigarettes among high school students in the US had soared by 900% in the past five years, surpassing all other forms of conventional tobacco use, he said.
“We must protect our nation’s young people from a lifetime of nicotine addiction and associated problems by immediately addressing e-cigarettes as an urgent public health problem. Now is the time to take action,” he urged.

But Professor Kevin Fenton, national director of health and wellbeing at Public Health England, said that while he understood the concern about the rapid uptake of e-cigarettes in the US, attempts to regulate these products in the US had been difficult, and the situation in the UK was very different.

“We have comprehensive regulations in place, including a ban on selling e-cigarettes to under-18s and tough restrictions on advertising, as well as minimum standards for safety, maximum nicotine levels and health warnings on packs,” he said.

“Our review of the evidence found e-cigarette use carries a fraction of the risk of smoking, a conclusion reiterated by the Royal College of Physicians earlier this year. No new evidence has been published to contradict this, however we are closely monitoring any emerging evidence,” he added.

Professor Peter Hajek, Director of the Tobacco Dependence Research Unit at Queen Mary University of London (QMUL), reiterated the findings of the Royal College of Physicians report, which identified vaping “as a great public health opportunity,” rather than a threat.

“The new US report’s conclusions do not tally with what the actual data show. It is simply not true that e-cigarettes are a tobacco product or that vaping lures children to smoking or that it creates dependence in non-smokers,” he insisted.

“The prevalence of smoking among young people is at an all-time low and regular use of nicotine containing e-cigarettes among never-smokers is extremely rare. Ongoing vigilance is needed, but so far, e-cigarettes have acted as a gateway away from smoking, for adults and adolescents alike,” he continued.

The report also ignores the huge benefits of vaping for adult smokers in helping them switch from “deadly smoking,” he added.

“The worst part of the report is its policy recommendations. They may be well meant, but no consideration is given to their likely unintended consequences. Limiting smokers’ access to the much less risky option of vaping is likely to contribute to keeping smokers smoking and smoking-related disease and death going at the current rate,” he said.

Linda Bauld, Professor of Health Policy at the University of Stirling and Co-Chair of the Smoking in Pregnancy Challenge Group, said the evidence presented in the report on the potential harms of vaping during pregnancy had been fundamentally misunderstood, and was based on studies in rats and mice, not people.

“While we need more research on e-cigarettes, pregnant women who find it difficult to stop smoking should not be discouraged from using them. This is the position and current advice in the UK endorsed by a range of organisations,” she pointed out.

The Surgeon General’s report might make clinicians more hesitant about discussing e-cigarettes with pregnant women who smoke. “That would be harmful to maternal and child health and must be avoided,” she insisted.

Hong Kong leads mainland in war to cut smoking

Dec 9th, 2016
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http://www.ejinsight.com/20161209-hong-kong-leads-mainland-in-war-to-cut-smoking/

When a person goes to buy a packet of cigarettes in Hong Kong, he or she faces two obstacles. One is the price — Double Happiness at HK$43 and Marlboro at HK$57 — the result of a tobacco tax up to 68 per cent of the price.

The other is the hideous image on the packet of the worst consequences of smoking.

A survey by the Economic Intelligence Unit earlier this year ranked Hong Kong as the eighth most expensive city in the world for a packet of branded cigarettes, at US$7.48.

Top was London with US$14.30, followed by New York with US$13.67 and Singapore with US$9.15.

These two measures, along with the creation of smoke-free areas in public and work places, have been effective in cutting the number of smokers.

According to government figures, the percentage of daily cigarette smokers aged 15 and above in Hong Kong in 2015 was 10.5 percent, down from 10.7 percent in 2012 and 23.3 per cent in the early 1980s.

The mainland, the world’s largest tobacco market with 316 million smokers in 2015, has only recently started to learn the lessons of Hong Kong.

Since 2010, the number of smokers has increased by 15 million and cigarette production risen by 35 per cent.

The health warnings are written, not visual, and appear modestly at the bottom of the packet. They would not frighten any first-time user.

In 2015, China increased the tobacco tax to 40 per cent. Consumption tax from tobacco in 2015 was 536 billion yuan, an increase of 60 billion from a year earlier. The recommendation of the World Health Organisation (WHO) is that the tax should be 70 per cent of the retail price.

“There is certainly room for future tobacco tax increase,” said Jian Shi, director of the information office of the Taxation Research Institute at the State Administration of Taxation in Beijing.

“In some western countries, the tobacco tax rate has reached 70-80 per cent. The room for the increase needs to be considered based on the development goal of the industry and the condition of national revenue.”

Health professionals argue that increasing the tobacco tax is the quickest and most effective way to cut smoking — by both preventing young people from starting and encouraging smokers to quit.

According to WHO figures, each increase of 10 per cent in the price will cause 3.7 per cent of adults and 9.3 per cent of teenagers to stop smoking.

Antonio Kwong Cho-shing, chairman of the Hong Kong Council on Smoking and Public Health, said that selective or modest hikes would not make much of an impression on smoker numbers in Hong Kong.

“Only a 100 per cent increase in tobacco tax would induce people to quit smoking,” he said. If the government accepted this proposal, an average pack would cost HK$119.

The Department of Health has proposed an enlargement of the health warning.

It said on Nov. 23 that the area of the graphic health warning shall be of a size that covers at least 85 percent of the two largest surfaces of the packet or the retail container and that the number of forms of health warning should be increased from six to 12.

The situation in the mainland is years behind. The biggest obstacle is that the State Tobacco Monopoly Administration (STMA), the world’s biggest manufacturer of cigarettes, is also the industry regulator.

This is despite years of lobbying by China’s health professionals, the WHO and the norms practised around the world. They argue that the two must be separate institutions.

According to WHO figures, 1.2 million die each year in China from smoking-related diseases; this number will double by 2025.

Jian Shi put it succinctly. “The major difficulty lies in that the related departments have quite different views on this matter, and it is difficult for them to reach agreement on this matter. That will cause obstruction to policy making and implementation.”

The STMA opposes graphic health warnings and higher taxes because they would hurt its sales and profits. Yet, simply due to global population expansion, there will be more smokers in 2040 than there are today, so it is difficult to believe that this concern is genuine.

The health lobby has had some success, in the modest increase in tobacco tax and restrictions on smoking in indoor public areas and workplaces and some outdoor areas introduced in Beijing in June 2015. Other mainland cities have taken similar measures at different times.

On Dec. 6, the Beijing Commission of Health and Family Planning said that more than 2,700 people had been fined for violating these restrictions, with total fines of 142,500 yuan, as of Nov. 30 this year.

Professor Dr Judith Mackay, based in Hong Kong and Asia’s leading anti-tobacco campaigner, said that the price of cigarettes in China is still extremely low.

“The latest small tobacco tax increase, while laudable, will not have a serious, sustained effect on reducing smoking. It is time to review the whole tobacco tax structure in China, significantly increase the price of cigarettes and thus protect the health of the Chinese people.

“In Australia, there is a regular increase of 12.5 per cent tobacco excise tax every year. The cost of a packet could soon rise to A$40 (HK$230). Hong Kong and China should both consider long-term tobacco tax planning in this way, so that tobacco control proceeds in an orderly form, and immense energy and time is not wasted year by year in campaigning for a tax increase. Otherwise, thousands will die.”

Beer-loving Czechs approve smoking ban in pubs, restaurants

Dec 9th, 2016
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The Czech lower house of parliament on Friday approved a ban on smoking in restaurants, bars and pubs, overcoming years of wrangling and bringing the country in line with most others in the European Union.

http://uk.reuters.com/article/us-czech-smoking-idUKKBN13Y1KT

“This brings the Czech Republic (in line with) civilized countries that care for the health of their citizens,” Prime Minister Bohuslav Sobotka said.

Parliament’s upper house must sign off on the legislation but the lower house vote showed there was enough support to override any potential veto. The law is to take effect on May 31, 2017, the annual World No Tobacco Day.

Seventeen of the 28 EU member states have comprehensive smoking-free laws in place. The ban enjoys support from three in four Czechs, polls show, but is sensitive all the same as Czechs are fervent pub-goers and beer drinkers are often smokers. Moreover, Czechs drink the most beer per capita in the world.

About 28 percent of Czechs are smokers, somewhat above the EU average of 24 percent. About 18,000 Czechs die annually from smoking-related illnesses, the Health Ministry says.

But there has been a clear trend toward less smoking in public places, especially in bigger cities, and many restaurants have voluntarily gone no-smoking in recent years.

In the last decade, several attempts to introduce sweeping anti-smoking legislation failed, most recently in May.

Opponents of a ban have argued it would force bars out of business, especially in villages where they remain a main gathering point for locals, and say it should be up to each restaurant owner to decide.

To push the latest legislation through, the Health Ministry accepted a compromise offering a peek into Czech pub life – it agreed to drop a clause requiring restaurants to serve at least one non-alcoholic drink cheaper than beer, addressing the fact that Czech beer is cheaper than water in some places.