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January, 2017:

Youths More Likely to Combine E-cigarettes with Other Substances

Jan 18th, 2017
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Are youths more likely to combine e-cigarettes with other substances? A new study of Canadian high school students shows a correlation between e-cigarette use and other risky behaviors, including tobacco and marijuana smoking, binge drinking, and mixing alcohol with energy drinks.

http://www.medicalnewsbulletin.com/youths-likely-combine-e-cigarettes-substances/

E-cigarette popularity has increased significantly amongst global youths since 2011. Recent data also shows a spike in e-cigarette use amongst high school students in Canada, with approximately 20% of students reporting having tried an e-cigarette. With vapor emerging as a supposedly healthier alternative to tobacco smoking, researchers and public health workers have voiced concerns regarding unknown long-term effects of e-cigarette vapor on individuals’ health, the risks of renormalizing smoking in popular culture, and the potential for e-cigarettes to become gateway substances. Evidence suggests that high school students may be more likely to combine e-cigarettes with other substances such as marijuana and alcohol, which pose health risks amongst youths.

A recent Journal of Adolescent Health (2016) review of year 3 (2014-2015) of the COMPASS study analyzed data from 39,837 Canadian high school students from Grade 9-12 to investigate the correlation between e-cigarette use and binge drinking, mixing energy drinks with alcohol, and smoking tobacco or marijuana. During the course of the COMPASS study, a student-level questionnaire, or Cq, was given to participants during class time in order to collect information regarding substance use within the last 30 days to 12 months. Any student who indicated that they had consistently used a substance within the last 30 days was classified as a current user (e.g. students who reported smoking cigarettes within 30 days prior to taking the questionnaire were categorized as current smokers).

Researchers retained all data for participants that provided full information on necessary variables for the study, such as age, ethnicity, and consistent responses regarding recent substance use. Using these criteria, 2323 respondents were excluded from this study. The remaining data was further divided into subgroups based on sex, ethnicity, and spending money, and placed within a logistic regression model to examine any potential associations between each student’s demographic and their substance use patterns.

Nearly 10% of participating students reported having used e-cigarettes in the last 30 days. Comparatively, approximately 6% were current smokers, 15.97% were marijuana users, 13.69% consumed energy drinks mixed with alcohol, and 16.20% reported occasional binge drinking. While marijuana use was more common among male participants, occasional binge drinking was found to be more prevalent among females. Evidence also showed a higher likelihood of e-cigarette users to use other substances as well (28.66% of e-cigarette users were current tobacco smokers, 53.15% were current marijuana users, 20.09% were occasional binge drinkers, and 41.08% reported mixing alcohol and energy drinks). Researchers found that while the co-occurrence of binge drinking and marijuana use among current e-cigarette users seemed common, e-cigarette users who exclusively only smoked tobacco (and did not binge drink or smoke marijuana) was determined to be rare.

Both current smokers and male students with more spending money were found to be more likely to use e-cigarettes. Similarly, students who reported other health-risky behaviors, such as binge drinking and marijuana use, were more likely to use e-cigarettes than non-drinkers or non-smokers. This data on current e-cigarette use demonstrates a 35% increase amongst the youth of Ontario and Alberta from the previous year of COMPASS data. Furthermore, substance use appears to act as a strong indicator of future e-cigarette use relative to age, sex, ethnicity, and available funds.

As the results of this study have shown, health-risky behaviors appear to have a strong correlation with increased likelihood of e-cigarette use (although there is a lower prevalence of e-cigarette use as smokers increase in age). These findings are useful in terms of public health program planning, as further research may enable prevention efforts to target younger demographics within the youth population who are at a higher risk for e-cigarette or other substance use.

Vapers beware: 10 things to know about e-cigarettes

Jan 18th, 2017
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With catchy names like Smurf Cake and Unicorn Puke and sweet flavors like bubble gum and strawberry, electronic cigarettes may have special appeal to young people, but that doesn’t mean they are safe.

https://www.universityofcalifornia.edu/news/vapers-beware-ten-things-know-about-e-cigarettes

Evidence is mounting that e-cigarettes are exposing a new generation to nicotine addiction and may be leading users toward a cigarette habit. As a result, the U.S. surgeon general last month issued a report declaring youth e-cigarette use “a major public health concern.”

“All Americans need to know that e-cigarettes are dangerous to youth and young adults,” said Surgeon General Vivek Murthy, in releasing the report. “Any tobacco use, including e-cigarettes, is a health threat, particularly to young people.”

The battery-powered devices heat a liquid typically containing nicotine mixed with the chemicals propylene glycol and glycerin as well as flavorings to deliver an aerosol inhaled by the user. While e-cigarettes deliver nicotine without the tar and smoke of traditional tobacco cigarettes, they still are considered tobacco products.

But their healthy halo has helped propel their popularity: E-cigarettes are now so popular that more American youth vape than smoke cigarettes. In just a decade, e-cigarettes have become a multibillion-dollar business led by multinational tobacco companies with outlets not just online but everywhere from vape shops to convenience stores and retail giants like Wal-Mart.

Ads tout them as a cool, harmless alternative to cigarettes. E-cigarette users, or vapers, have contests to see who can blow the largest cloud of vapor.

But there’s more to e-cigarettes than meets the eye. The surgeon general’s report aligns with increasing scrutiny of e-cigarettes, from new regulations to a growing body of research into health effects.

Here are 10 things to know about e-cigarettes:

E-cigarettes contain nicotine

E-cigarettes contain nicotine, which is addictive and can harm the developing adolescent brain, said UC San Francisco professor of medicine Stanton Glantz.

A lot of the kids who take up vaping are at low risk for smoking, but once they start using e-cigarettes, they are three to four times more likely to start using cigarettes, Glantz said.

“The biggest health concern with e-cigarettes is they are prolonging and expanding the tobacco industry,” Glantz said.

Glantz, director of UCSF’s Center for Tobacco Control Research and Education, said he was initially neutral on e-cigarettes, but now finds them concerning. Among other hazards, e-cigarettes produce ultrafine particles than can trigger inflammatory problems and lead to heart and lung disease.

“The data is just becoming overwhelming,” Glantz said.

E-cigarettes expose people to more than ‘harmless water vapor’

E-cigarettes are billed as producing “harmless water vapor,” but, strictly speaking, the vapor produced when users exhale is actually an aerosol that contains a mixture of nicotine, flavorings and other ingredients that can be toxic.

Stanford University pediatrics professor Bonnie Halpern-Felsher has studied young people’s perceptions of e-cigarettes. In September, she launched a free, downloadable youth tobacco prevention toolkit with an e-cigarette module, funded by the UC Tobacco-Related Disease Research Program (TRDRP) and the California Department of Education.

“Youth are definitely using e-cigarettes because they think they are cool,” Halpern-Felsher said. “Adolescents and young adults don’t know a lot about e-cigarettes. They think it’s just water or water vapor. They don’t understand it’s an aerosol. They don’t understand that e-cigarettes can have nicotine. They don’t understand that flavorants themselves can be harmful.”

The flavors can be toxic

More than 7,000 varieties of flavored e-cigarettes are on the market.

UC Riverside professor of cell biology Prue Talbot screened the cytotoxicity (quality of being toxic to cells) of 36 refill fluids and found that some were highly toxic. The most cytotoxic flavor, Cinnamon Ceylon, contained a chemical called cinnamaldehyde, which gives cinnamon its flavor and whose side effects may include coughing and sore throats. Talbot has been studying more flavors and is building a database to help determine the most dangerous ones.

“Flavors are something that could be potentially regulated,” Talbot said.

Vaping has secondhand and thirdhand effects

Unlike cigarettes, which emit smoke from the lit end, e-cigarettes don’t produce sidestream emissions between puffs, but they still generate secondhand and thirdhand effects when users exhale the mainstream vapor.

In a TRDRP-funded study, Berkeley Lab researcher Hugo Destaillats led a team that found 31 chemicals that include several toxicants at significant levels in e-cigarette vapor. The most toxic chemicals included acrolein, a severe eye and respiratory irritant; and formaldehyde, an irritant and probable carcinogen.

Emissions varied by type of device and voltage.

“The way you heat the liquid drastically determines if you produce a lot of compounds or just a few,” Destaillats said. “As you increase the voltage, toxic byproduct concentrations increase exponentially.”

The batteries can explode

There were 134 reports of e-cigarette batteries overheating, catching fire or exploding between 2009 and January 2016, according to the Food and Drug Administration, which will host a public workshop in April to gather information about e-cigarette battery safety concerns.

E-cigarette batteries “can explode without notice,” Talbot said. “People can be quite severely injured.”

E-liquids are poisonous if swallowed

Calls to poison control centers about e-cigarette exposure in young children have skyrocketed nationally in recent years. In California, the number of calls involving e-cigarettes increased from 19 in 2012 to 243 in 2014, according to the UC-administered California Poison Control System. More than 60 percent of those e-cigarette calls were related to nicotine poisoning in children 5 and under.

E-cigarettes show mixed results in helping smokers quit

While some people have quit smoking with e-cigarettes, on average, adult smokers who use e-cigarettes are about 30 percent less likely to stop smoking cigarettes, Glantz said. Also, e-cigarettes are associated with more, not less, cigarette smoking among adolescents.

“If you are a middle-aged person who has been smoking for 20 years, maybe it is good to switch to e-cigarettes,” Destaillats said. “But if you are a teenager and never have smoked, then it is not a good idea to use e-cigarettes.”

The minimum age has risen

In June, California became the nation’s second state, following Hawaii, to raise the minimum age for tobacco sales to 21, and for the first time added e-cigarettes to the definition of tobacco products. In August, the FDA extended its tobacco oversight to e-cigarettes, banning sales to those under 18.

“It sends a message to youth that e-cigarettes are in the same category of all tobacco products,” Halpern-Felsher said.

E-cigarettes will be taxed

Under Proposition 56, the tobacco tax passed by California voters in November, the state will tax e-cigarettes for the first time, starting April 1. It’s estimated that the price of a typical 30-milliliter bottle of e-liquid could increase to about $30 from $20.

“Anytime you increase the price, people buy less,” Glantz said.

The tax revenue will enhance education efforts by boosting funding for the state Tobacco Control Program. The surgeon general’s report also will make it easier for states to integrate e-cigarettes into tobacco education campaigns and could lead to more regulations, Glantz said.

E-cigarettes may be safer than cigarettes, but unknown risks remain

Expect more information to emerge about e-cigarettes as studies examine long-term effects.

“It’s often assumed that e-cigarettes are safer than cigarettes, but that could be an incorrect assumption,” Talbot said. “We don’t yet know the long-term health effects of e-cigarettes.”

Decades of research have helped scientists determine that cigarette smoke creates more than 7,000 chemicals, at least 69 of which are known to cause cancer and many of which are poisonous.

So, while e-cigarettes deliver fewer cancer-causing chemicals than cigarettes, research has yet to reveal how e-cigarettes fully impact heart and lung health and their cancer-causing potential, Glantz said.

He estimates that e-cigarettes are about one-third to one-half as dangerous as cigarettes.

In other words, they are still plenty dangerous.

“Regular cigarettes are super unhealthy,” Destaillats said. “E-cigarettes are just unhealthy.”

Problems in interpreting the acute effects of e-cigarette use

Jan 18th, 2017
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How Much Of Big Tobacco’s Sales Come From Vape Products?

Jan 17th, 2017
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https://www.benzinga.com/news/17/01/8912943/how-much-of-big-tobaccos-sales-come-from-vape-products

The $49 billion purchase by British American Tobacco PLC (ADR) BTI 1.62% of the remaining stake available in Reynolds American, Inc. RAI 0.83% comes in a tobacco market that’s a lot less hazy than before, with leading manufacturers investing in alternatives to the traditional cigarette.

Tobacco industry sales as a whole may have contracted by 2.5 percent in 2016, Wells Fargo analyst Bonnie Herzog was quoted as saying last week in the Winston-Salem Journal — and Herzog is forecasting a 3.4 percent decline for 2017.

At the same time, Herzog forecasts $400 million in growth in the e-cig and vaporizer sectors in 2017.

Growing Smokeless Revenue

Reynolds has its own electronic cigarette brand, Vuse, and holds about one-third of the American e-cigarette market. The Winston-Salem Journal reported in 2015 that while Reynolds’ e-cigarette revenue isn’t separately reported, but rather included in an “all other” revenue category. That category had $386 million in sales in fiscal 2015, according to Reynolds’ annual report — a 39.9 percent leap from $263 million in 2014.

The e-cigarette venture remains a fraction of Reynolds’ traditional tobacco business, which saw $8.6 billion in net sales in 2015 (24 percent of the U.S. market), according to the Motley Fool. Reynolds acquired Lorillard LLC (previously traded NYSELO for $25 billion in 2015, taking over the Newport cigarette brand in the process.

Reynolds is developing products such as e-cigarettes and nicotine gum under the umbrella of RAI Innovations Co., CEO Susan M. Cameron wrote in a letter to shareholders last year.

Competitor Altria Group Inc (NYSE: MO), which markets the MarkTen e-cigarette, has “single-digit shares” in the e-cigarette sector, according to the Motley Fool.

British American’s equivalent e-cigarette device, Vype, is sold overseas

There’s Nothing Sexy About An E-Cigarette Exploding In Your Face

Jan 17th, 2017
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http://www.forbes.com/sites/robwaters/2017/01/17/theres-not-much-sexy-about-an-e-cigarette-exploding-in-your-face/#2bab2377177e

Rob Waters ,

Contributor

I write about health, science and our crazy healthcare system.

Opinions expressed by Forbes Contributors are their own.

The last time I wrote about electronic cigarettes in this space, the post generated about as many comments as I’ve received from any piece (with the possible exception of the hate mail I got when I wrote about the need to permit federal funding for research looking at gun violence). The commenters called me a liar, an idiot and…well, you get the idea.

In that earlier post, I noted that e-cigarette marketers were peddling their products as cool and sexy. The ads are full of women with bare shoulders or in slinky blue satin who “smoke in style” (as an ad for blu e-cigarettes exclaims), while dangling their devices. Now, the continuing spate of news about e-cigs blowing up in the faces or pockets of users made me wonder what a new set of anti-e-cigarette commercials might look like. (Note to California Dept. of Public Health: there’s an idea for you here.)

E-cigarette devices have burst into flames in people’s pockets, blown up in their mouths or exploded while charging. Videos of them starting a fire from the pocket of a Fresno, California, bus rider or in a Leeds, England, market are now making the rounds on the Internet.

But this is no laughing matter.

Earlier this month, the Food and Drug Administration announced it is investigating the dangers of “battery-operated nicotine-delivery devices” as they clinically, but accurately, refer to e-cigarettes. The agency has documented 134 incidents of e-cigarette batteries overheating, exploding or catching fire.

The FDA will hold a two-day public workshop to discuss safety issues surrounding the batteries used in e-cigarettes on April 19 and April 20, 2017, that scientists and members of the public are invited to attend. Some wonder why it took so long.

Global tobacco control

Jan 16th, 2017
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Philip Morris jolted by Indian proposal to ban foreign tobacco investment

Jan 16th, 2017
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Philip Morris International is fighting to keep a toehold in India’s $11 billion tobacco market, as the government considers further tightening foreign investment rules in the sector, according to documents seen by Reuters.

http://in.reuters.com/article/india-philip-morris-marlboro-cigarette-idINKBN15005S

In previously unreported letters from Philip Morris to the trade minister and an influential government think-tank, the U.S.-based company said the “discriminatory” and “protectionist” proposals would represent a blow to its plans to launch new products and make further investments in India.

The two letters dated May and October last year followed local media reports of a possible change in government policy. While the warnings may be part of the firm’s negotiations, they show the level of concern the proposals are causing.

“The proposed ban will impact our future investments in India and also force a review of our overall operations, including tobacco crop purchases,” Martin G. King, Philip Morris’ Asia president, wrote on Oct. 13 to NITI Aayog, India’s most influential government think-tank that has a say in federal policies, including those related to foreign investments.

India banned foreign investment in cigarette manufacturing in 2010, but it still allowed tobacco companies to invest through technology collaboration and licensing agreements. Investments could also be made by forming a trading company.

Over the past year, the government has been considering whether to stop these, in a bid to safeguard public health interests, according to the documents and a senior government official.

The new proposal was being discussed by the health and trade ministries at least as early as April last year, according to a government memorandum dated June 3. Neither ministry responded to requests for comment.

A Philip Morris spokesman said the company had “nothing further to add” when asked about the company’s view on foreign investment.

The final decision on the rules, based on recommendations from various ministries, will be taken by Prime Minister Narendra Modi’s cabinet.

BLOW TO PLANS

Philip Morris entered India in the late 1960s by acquiring a majority stake in the London-based parent of Godfrey Phillips India Ltd. It gradually reduced its stake in Godfrey over the years, in part due to regulatory changes.

Ahead of the 2010 ban on investments into cigarette manufacturing, Philip Morris formed a new wholesale trading company with Godfrey and an investment firm.

Under the current arrangement, Godfrey manufactures Marlboros while Philip Morris’ trading firm helps promote them.

That part of its operations would not necessarily be impacted by the foreign investment changes being considered, as such changes usually do not apply to previous arrangements.

However, if the new rules were implemented, Philip Morris’ future investment plans in India would be in jeopardy, as any form of new investment or collaboration would be outlawed.

Those plans, the company says, include the possible launch of its heat-not-burn electronic cigarette called iQOS, an alternative product which Philip Morris sees as a key step towards a smokeless future that could also bring health benefits to India.

Godfrey did not respond to a request for comment.

India is a key market for Philip Morris.

Even before the company contemplates introducing alternative products there, demand is strong for conventional cigarettes that still account for most of the company’s $74 billion in global annual revenues.

The number of male cigarette smokers, aged between 15 and 69 years, almost trebled in India to 40 million between 1998 and 2015, according to BMJ Global Health estimates. Another 48 million smoke traditional hand-rolled cigarettes, called beedis.

Marlboro faces stiff competition from premium brands of India’s largest cigarette maker, ITC Ltd, which is part-owned by British American Tobacco (BAT) as well as several state-run firms.

Still, its market share has doubled between 2012 and 2015 to 1 percent, data from Euromonitor International show.

LOBBYING DRIVE

Outlining the firm’s importance to India’s economy, Philip Morris said in its letters that it spent $460 million on tobacco leaf over the previous five years and more than $200,000 on corporate charities each year.

It says it has employed more than 90 people in its India unit.

The company does not give country-by-country figures for revenues or market share.

Philip Morris’ King wrote to the trade minister in May, saying the reported proposals would “dent India’s credibility as a reliable investment destination.” He also said the move would unfairly favour the domestic industry.

“It is discriminatory in its application since it will provide undue leverage to the domestic industry at the expense of international products,” King wrote.

ITC, which has a market share of almost 80 percent, did not comment on the proposed new policy.

King’s letter was redirected by the trade ministry to the federal health ministry for further comment.

The health ministry rejected the company’s arguments, citing India’s obligations under an international tobacco control treaty and domestic laws.

The health ministry said allowing foreign tobacco money was against public health interests and would only lead to expansion and promotion of the sector.

“There should be a comprehensive ban on foreign collaboration in any form,” the health ministry wrote on July 27, adding wholesale trading in tobacco should be banned as well.

Philip Morris wrote again in October to argue its case, this time to NITI Aayog, the think-tank.

It said an investment ban could “raise significant concerns” about India’s compliance with its obligations under international trade and investment treaties.

(Additional reporting by Manoj Kumar; Editing by Mike Collett-White and Paritosh Bansal)

COSH urges the Government to take full account of public opinions Enact Enlargement of Pictorial Health Warnings Promptly

Jan 16th, 2017
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http://smokefree.hk/en/content/web.do?page=news20170116

Hong Kong Council on Smoking and Health (“COSH”) urges the Government and Legislative Council to enact the enlargement of pictorial health warnings promptly in order to reduce the attractiveness of tobacco, motivate more smokers to quit and deter youth from trying the first cigarette. Mr Antonio KWONG, COSH Chairman remarked, “Results from survey conducted by COSH and two rounds of public consultations organized by the Legislative Council showed that majority of citizens and organizations supported the enlargement of pictorial health warnings to 85%. The Government and Legislative Council should take full account of public opinions and enact the proposed tobacco control measure as soon as possible.”

The Government briefed the legislative proposals to strengthen tobacco control on 18 May 2015, including enlarging the size of pictorial health warnings to at least 85% of the two largest surfaces of the packet, increasing the number of forms of health warning from six to twelve and adding the quitline 1833 183. The date of enactment is yet to be scheduled after more than one and a half years.

The Legislative Council collected views of the public and held special meetings on the enlargement of pictorial health warnings twice. Among the hundred submissions received in July 2015 regarding the increase in the size of pictorial health warnings, more than 80% supported. Besides, over 100 submissions were received for the special meeting of Legislative Council Panel on Health Services to be held tomorrow (17 January 2017), in which around 70% agreed the proposed measure.

The School of Public Health of The University of Hong Kong was commissioned by COSH to carry out the Tobacco Control Policy-related Survey 2016. It was found that public support on enhancing the pictorial health warnings was overwhelming, 79.5% of all respondents agreed to display more threatening messages about the health risks of smoking. About 72.5% of all respondents supported to increase the coverage of the health warnings to 85% while about half of the current smokers also supported. Majority of respondents opted for plain packaging* of cigarettes as well. In addition, COSH has collected over 26,500 signatures from citizens and organizations through street counters and online platform supporting the enlargement of pictorial health warnings since May 2015.

In recent years, many countries have successfully introduced more stringent measures to regulate tobacco packaging. Prof Judith MACKAY, Director of Asian Consultancy on Tobacco Control and Senior Policy Advisor of World Health Organization claimed, “Hong Kong ranked the 72nd in the world regarding the implementation of pictorial health warning and behind many developing countries like Laos, Myanmar and Sri Lanka. Hong Kong should enlarge and strengthen the pictorial warnings promptly in order to reduce the use of tobacco.” World Health Organization called for more countries to enlarge pictorial warnings covering more than 85% and implement plain packaging. “Get ready for plain packaging” was designated as the theme of World No Tobacco Day 2016.

Recently, some organizations opposed the proposed enlargement of warnings in the pretext that it would lead to a surge in cigarette smuggling activities. A recent study also claimed that illicit cigarettes composed for around 30% of cigarette consumption in Hong Kong. Prof LAM Tai-hing, Chair Professor of Community Medicine cum Sir Robert Kotewall Professor in Public Health, School of Public Health, The University of Hong Kong said, “the public should express reservation on the results of this tobacco industry-funded study. The data collection methods and calculations of the study were unclear using dubious methods.” The tobacco industry and its allies always express strong opposition against tobacco control measures proposed by the Government under the pretext that it will lead to a surge in cigarette smuggling activities. As recommended by the World Health Organization, the most effective measure against smuggling is tight control and aggressive enforcement.

With the Government’s multi-pronged tobacco control policies over the years, the smoking prevalence in Hong Kong has gradually reduced from 23% in early 80s to 10.5% in 2015. In view of the tobacco epidemic in Hong Kong and the international tobacco control trend, we urge the Government and Legislative Councilors to take account of public opinions and implement the enlargement of pictorial health warnings as soon as possible to safeguard public health. The Government should also actively consider adopting plain packaging within 2 to 3 years and develop long-term and comprehensive tobacco control policies including regulating the emerging tobacco products and e-cigarettes, raising tobacco tax substantially, expanding no-smoking areas, increasing resources on education, publicity, smoking cessation services and enforcement to further reduce the smoking prevalence in Hong Kong and protect people from the harms of smoking and secondhand smoke.

*Remarks: Plain packaging standardizes and simplifies the packaging of tobacco products. The pictorial health warnings on the main sides of cigarette pack are expanded. All forms of tobacco branding should be labeled according to the government prescriptions and with simple and plain format. This means that trademarks, graphics and logos are not allowed on cigarette packs, except for the brand name that is displayed in a standard font size, colour and location on the package. The packaging should not contain other colours and should include only the content and consumer information, such as toxic constituents and health warnings required by law. The quitline number should also be displayed at a prominent position. Australia was the first country to introduce plain packaging in 2012. The measure was also implemented in the United Kingdom, France and Hungary in 2016 and will be implemented in Ireland in 2017.

Bigger graphic health warnings on Hong Kong cigarette packs needed, anti-smoking group says

Jan 16th, 2017
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Survey finds most in favour of move, which advocates say can protect public health and encourage more to quit habit

http://www.scmp.com/news/hong-kong/health-environment/article/2062577/more-graphic-health-warnings-hong-kong-cigarette

An anti-smoking body has pressed the government to speed up legislation on cigarette pack health warnings after a survey revealed almost 80 per cent of people desired sterner messages on smoking risks.

The Council on Smoking and Health made the call ahead of another public hearing held on Tuesday in the Legislative Council to collect views on whether to implement the law.

The legislation will expand the size of health warnings on cigarette packs from the current 50 per cent to 85 per cent of the packaging surface.

The proposal was first submitted by the government in May 2015, and the first hearing was held in July in the same year.

According to a survey commissioned by the council and done between February and September last year, 79.5 per cent of 2,058 respondents – comprising smokers, non-smokers and ex-smokers – want cigarette packs to show clearer and more graphic warnings.

Another 72.5 per cent of them also want to see the graphic warnings enlarged to cover 85 per cent of the packaging surface, a move also supported by almost half of the smokers in the survey.

“The implementation work has dragged on for one and a half years. This measure can protect public health and help more people quit smoking.

“We hope that Legco will not procrastinate on the legislation any further,” council chairman Antonio Kwong Cho-shing said.

He said that Australia recorded a drop of 2.2 percentage points in average smoking rate after introducing plain cigarette packaging in 2012.

Of this amount, 0.55 percentage points, or 108,000 fewer smokers, were due directly to the new measure which only allowed brand names to be displayed in a standard font size, colour and position on the packaging, thereby making them less conspicuous and seemingly less desirable.

Professor Judith Mackay, a veteran tobacco control advocate and senior policy advisor for the World Health Organisation, said a larger graphic warning would have an even bigger visual impact and induce more smokers to quit.

According to a Canadian Cancer Society survey which studied the effectiveness of health warnings on cigarette packs worldwide, Hong Kong ranked 72nd out of 205 places.

“We used to be among the top 12 jurisdictions [in cigarette pack warnings] … now we are lagging very far behind from the international experience,” Mackay said. She has been working on tobacco control advocacy in the city for more than 30 years.

The survey done by the Canadian group looked at various factors, including whether graphic warnings existed on the packaging design, the sizes of the images and when the warnings were introduced.

Mackay attributed the city’s poor ranking partly to outdated warnings, which were first introduced in 2007, and the lack of information on helpline numbers for those seeking to quit the habit.

She said in the long run the government should also further increase tobacco tax to make cigarettes less affordable.

Kwong from the Council on Smoking and Health said it submitted a letter to the financial secretary late last year to suggest increasing tobacco tax to 100 per cent.

Doctors Lobby Group Would Welcome Arthur Sinodinos as Health Minister

Jan 15th, 2017
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