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January 5th, 2017:

Salford study reveals toxicity of different ‘vaping’ flavours on lung tissue

http://www.news-medical.net/news/20170105/Salford-study-reveals-toxicity-of-different-vaping-flavours-on-lung-tissue.aspx

Electronic cigarette users are more at risk of lung damage if they use flavourings such as menthol and butterscotch, according to a new study by scientists at the University of Salford.

Scientists say that ‘vaping’ flavours contain toxins, including harmful substances that are not inhaled by users of standard tobacco cigarettes.

And they claim the huge variety of non-standard vaping liquids is exposing people, particularly younger smokers, to unknown risks.

Studies have shown that vaping liquids contain aldehydes, compounds which can cause damage to lungs, but the Salford study is the first to test flavoured liquids – inhaled as ‘smoke’ – on normal lung tissue.

All proved toxic

“We are talking about flavours which are normally ingested in food where tissue is much different from tissue in the lungs,” explains Dr Patricia Ragazzon of the Biomedical Research Centre at the University of Salford.

“When inhaled, some of the flavours we tested proved to be substantially toxic, with prolonged exposure killing bronchial cells completely.”

The experts, who publish their findings in the journal Scientific Progress, studied 20 liquid refills in nine flavours – cherry, strawberry, ice-mint, menthol, tobacco, blueberry, vanilla, bubble-gum and butterscotch – bought from shops, chemists and over the internet.

In laboratory tests on cell lines of human bronchial tissue, both embryonic and adult cells were exposed to vapour at a range of concentrations over 24, 48 and 72 hours. All proved toxic to the cells varying from less toxic (fruit flavours) to moderately to highly toxic (menthol, bubblegum, coffee, butterscotch and tobacco).

“We showed that cells can recover after 48 hours but not once they were exposed for 72 hours or more, which has serious implications for regular smokers,” said Dr Ragazzon.

Unregulated products

Moreover whilst adult cells were less impacted, the majority of samples proved moderately to highly toxic to the embryonic cells.

Of additional concern, she notes, is the huge variation of flavours and their component ingredients: “The composition of refills is highly irregular – some are natural flavours, some are single compounds, some are synthetic flavours, – there are so many varied products on the market, it’s difficult to gauge their harmfulness,” added Dr Ragazzon.

“Our work supports the opinion that e-cigarettes and especially the ingredients of the e-liquid, which can change in structure after the process of heating, have not been thoroughly characterised or evaluated for safety.”

Hong Kong Customs mounts operation to combat illicit cigarettes

http://www.customs.gov.hk/en/publication_press/press/index_id_1782.html

Hong Kong Customs mounted an operation to combat illicit cigarettes on January 3 and 4. Three cases were detected at Man Kam To Control Point, Kwai Chung and Tai Po. A total of about 3.7 million suspected illicit cigarettes with an estimated market value of about $10 million and a duty potential of about $7.1 million were seized.

On January 3, Customs officers intercepted a private car suspected of distributing illicit cigarettes in Tai Po. About 58 000 suspected illicit cigarettes were found in the vehicle. A 37-year-old male driver was arrested. On January 4, Customs officers intercepted an incoming lorry declared as containing assorted cargoes at Man Kam To Control Point. Upon inspection, about 2.9 million suspected illicit cigarettes were found in 173 carton boxes. A 41-year-old male driver was arrested. Later on the same day, Customs officers intercepted a lorry in Kwai Chung and found about 800 000 suspected illicit cigarettes in 59 carton boxes. A 33-year old man was arrested. Three vehicles involved in the cases were seized.

Smuggling is a serious offence. Under the Import and Export Ordinance, any person found guilty of importing or exporting unmanifested cargo is liable to a maximum fine of $2 million and imprisonment for seven years.

Under the Dutiable Commodities Ordinance, anyone involved in dealing with, possession of, selling or buying illicit cigarettes commits an offence. The maximum penalty upon conviction is a fine of $1 million and imprisonment for two years.

​Members of the public may report any suspected illicit cigarette activities to the Customs 24-hour hotline 2545 6182.

Hong Kong Customs mounted an operation to combat illicit cigarettes on January 3 and 4. Three cases were detected at Man Kam To Control Point, Kwai Chung and Tai Po. A total of about 3.7 million suspected illicit cigarettes with an estimated market value of about $10 million and a duty potential of about $7.1 million were seized. Photo shows some of the suspected illicit cigarettes seized.

Hong Kong Customs mounted an operation to combat illicit cigarettes on January 3 and 4. Three cases were detected at Man Kam To Control Point, Kwai Chung and Tai Po. A total of about 3.7 million suspected illicit cigarettes with an estimated market value of about $10 million and a duty potential of about $7.1 million were seized. Photo shows some of the suspected illicit cigarettes seized.

Doctors urge Theresa May to publish anti-smoking strategy

In a letter to the PM, medical professionals say plan is essential to cut smoking rates, which are highest among poorest in society

https://www.theguardian.com/society/2017/jan/04/doctors-theresa-may-publish-anti-smoking-strategy-tobacco-control

More than 1,000 doctors, healthcare professionals and public health experts, including heads of royal colleges and public health institutions, are calling on the prime minister to publish the latest tobacco control plan without delay.

In a letter to Theresa May, the senior doctors say the plan is essential to drive down smoking rates, which are highest and most damaging to health among the least well-off. The plan was due to be published last summer.

Reminding May of her commitment to “fighting against the burning injustice that if you’re born poor, you will die on average nine years earlier than others”, they point out that half of that difference in life expectancy is caused by smoking.

The letter, which is being published in the British Medical Journal, is being sent to May by Dr Andrew Furber, president of the Association of Directors of Public Health, and Prof John Middleton, president of the Faculty of Public Health.

Furber warned that progress against smoking, which has been good in recent years, could slip. “Directors of public health in local authorities are charged with the responsibility of reducing smoking prevalence. But to succeed needs leadership at national as well as local level,” he said.

“The government must renew the tobacco strategy without further delay. Otherwise we risk losing the momentum gained from recent welcome changes such as standardised packing.”

Middleton said: “Smoking rates have declined over the years, in large part because of concerted government action. However rates are still highest amongst the poorest and if the prime minister truly wants to increase the life expectancy of the poorest in society her government needs to renew its tobacco control strategy, which expired over a year ago.”

The first tobacco strategy in the UK was the Blair government’s white paper, Smoking Kills, published in 1998. Other plans followed, including Andrew Lansley’s in 2011, then health secretary in the coalition government, which included a commitment to consult on standardised cigarette packaging.

Some anti-smoking measures have been a response to EU legislation, such as advertising and promotion bans. However, says Deborah Arnott, chief executive of Action on Smoking and Health, tobacco control strategies have reduced smoking rates in England faster than in some other European countries, particularly among children.

In 1998, 24% of 15-year-olds were smoking, but by 2014 that proportion had dropped to 8%. “France and Germany had European legislation but their rates have not gone down as fast,” she said.

There is also evidence that smoking rates can rise again if the pressure is eased. New York City’s successful Tobacco-Free Living initiative, which lowered smoking rates from 21% in 2002 to 14% by 2010, suffered funding cuts to mass media campaigns from 2009. By 2011, smoking rates rose, reaching 16.1% in 2013, but fell again after more investment in 2014.

Experts hope the new UK tobacco control plan, which has been delayed in part because of the Brexit vote and its fallout, will plot the course for driving smoking rates down to 5% by 2035, which a report from Cancer Research UK said was feasible.

“What we want is a smoke-free future,” said Dr Nicholas Hopkinson, a consultant chest physician at the Royal Brompton hospital and reader in respiratory medicine at Imperial College, who coordinated the letter.

Support for mass media campaigns is needed, he says, as well as the continuation of policies on the cigarette pricing and tobacco smuggling. Spending on media campaigns in England has dropped in the past five years from just under £25m in 2009-10 to £5.3m in 2015, although evidence shows they help people quit.

“It is absolutely clear these interventions work. It is just keeping up the momentum and making sure there is a high priority to this,” he said. “There are 9 million smokers in the UK, and smoking is increasingly associated with inequality – it is quite a bit higher in the poorer parts of society.”

Among the signatories are the heads of several medical colleges. One of them, Prof Neena Modi, president of the Royal College of Paediatrics and Child Health, said: “Most smokers become addicted as children and once addicted find it extremely difficult to quit. Since the government introduced a strategy to tackle smoking in 1998, smoking rates among 15-year-olds have fallen by two-thirds.

“We must not put that achievement at risk. The last tobacco strategy expired over a year ago, so we want to see the new plan published and enacted as a matter of urgency.”

Starting with e-cigs triples odds of starting cigarettes among college students; the evidence just keeps piling up

Tory Spindle and colleagues at VCU recently published a study, “Electronic cigarette use and uptake of cigarette smoking: A longitudinal examination of U.S. college students,” that followed 3757 students at Virginia Commonwealth University for a year to examine the relationship between e-cigarette use among never cigarette smokers at the beginning and whether they were smoking conventional cigarettes a year later. They found, controlling for a wide range of demographic and behavioral variables, that e-cigarette users at baseline were about 3.4 times as likely to be smoking cigarettes a year later as young adults who were not using e-cigarettes.

This effect is consistent with a similar study of young adult males in Switzerland as well as all the studies of adolescents.

Here are the highlights and the abstract:

HIGHLIGHTS

• E-cig and cigarette use has not been studied in college students longitudinally.
• Ever and current e-cig use increased non-smokers chances of trying cigarettes.
• Historically internalizing/externalizing factors predict cigarette uptake strongly.
• Most internalizing/externalizing factors examined did not predict e-cig uptake.
• Males and marijuana users were more likely to initiate e-cig use.

ABSTRACT

Introduction:

Electronic cigarette (e-cigarette) use prevalence is increasing among U.S. adolescents and adults but recent longitudinal data for college/university students are scarce.

Furthermore, the extent that e-cigarette use is associated with the onset of cigarette smoking and the factors that lead to the uptake of ecigarettes in college students has not been explored.

Methods:

3757 participants from a Mid-Atlantic university (women: 66%; White: 45%; Black: 21%; Asian: 19%; Hispanic/Latino: 6%) were surveyed in 2014 and again in 2015.

Results:

Among participants reporting never smoking at time 1, those who had ever tried e-cigarettes or were currently using e-cigarettes (at least one use in past 30 days) were more likely to have ever tried cigarettes by time 2 relative to individuals who had not used e-cigarettes. Ever use of e-cigarettes (but not current use) also increased participants’ likelihood of being current cigarette smokers at time 2. Among initial never users of e-cigarettes or cigarettes, males and ever marijuana users had an increased probability of trying e-cigarettes by time 2. Furthermore, less perseverance (an index of impulsivity) and ever use of other tobacco products increased initial never users’ chances of trying both cigarettes and e-cigarettes by time 2.

Conclusions:

Given that never-smoking participants who had tried e-cigarettes were more likely to initiate cigarette use later, limiting young adults’ access to these products may be beneficial. As the long-term health implications of e-cigarette use become clearer, predictors of e-cigarette use could help identify future populations likely to use and abuse these products.

Here is the full citation: Spindle, et al. Electronic cigarette use and uptake of cigarette smoking: A longitudinal examination of U.S. college students. Addictive Behaviors 2017; 67:66-72. http://dx.doi.org/10.1016/j.addbeh.2016.12.009

 

EXPLODING E-CIGARETTE BATTERIES

http://atlanticcity.legalexaminer.com/uncategorized/exploding-e-cigarette-batteries/

The U.S. Food and Drug Administration is probing the dangers of exploding batteries in e-cigarettes, following dozens of reports of devices that have combusted, overheated or caught fire. The agency announced a two-day public meeting for April. The Associated Press reported last month that 66 explosions were identified by the FDA in 2015 and early 2016.

Electronic cigarettes are battery-powered devices made to mimic traditional cigarettes. They are often shaped like cigarettes or pipes, and work by heating a nicotine mixture called “e-liquid,” “e-juice,” or “vape juice.” E-cigarettes are now a $7 billion global industry made up of roughly 500 brands. However, due to a rash of e-cigarette explosions caused by volatile lithium-ion batteries, many consumers are now filing lawsuits against e-cigarette companies, seeking relief for physical, emotional and financial injuries. Dozens of lawsuits allege serious injuries caused by exploding batteries.

The most common injuries suffered by vapers are lung-related but e-cigarettes are exploding with greater and greater frequency and many vapers have suffered burns, scars, and even amputated fingers. Four New Jersey residents, including two teenagers, who suffered third-degree burns when their e-cigarette batteries ignited are suing the shops that sold the “defective” devices. In October 2015, a California jury awarded Jennifer Ries US$1.9 million after Ms. Ries suffered second degree burns from an exploding e-cig battery.

The manufacturers of the lithium ion batteries that power the vaping devices are also the targets of the litigation although the attorneys acknowledged it would be tougher to hold them accountable. The batteries are made in China.

The safety of E-cigarettes has not been extensively studied and there’s no scientific consensus on whether they help reduce rates of cigarette smoking. Last year the FDA announced it would begin to regulate the fast-growing industry, requiring makers of e-cigarettes to submit their devices and ingredients for review for the first time.

Working Together Around The World To Kick The Big Tobacco Habit

http://healthaffairs.org/blog/2017/01/05/working-together-around-the-world-to-kick-the-big-tobacco-habit/

Ten years ago, the world was a different place when it came to tobacco. Fewer than twenty developing countries in the world had even one strong tobacco control policy in place. The tobacco industry was beginning an aggressive ramping up of nefarious activities to grow their market share in vulnerable developing countries. And although advocates for tobacco control measures had a major public health victory in passing the Framework Convention on Tobacco Control, the world’s first public health treaty, little financial or technical help was available to support countries that wanted to put life-saving, proven tobacco control policies in place.

Early in 2007, the tobacco control landscape was changed dramatically when Michael R. Bloomberg, then in his second term as mayor of the City of New York, donated $125 million through his foundation, Bloomberg Philanthropies, for a two-year commitment to reducing global tobacco use. Now ten years and a total of $600 million later, Bloomberg recently committed another $360 million over six years to this life-saving work, bringing his total financial commitment to nearly $1 billion.

In the ten years since Bloomberg’s first commitment, Bloomberg Philanthropies has been pleased to partner with more than 110 countries and five international partner organizations to tirelessly fight to end the global tobacco epidemic. The decade-long fight has shown that progress is indeed possible. In that time, nearly 100 countries worldwide with a total of more than four billion people have passed at least one strong tobacco control law—and fifty-nine of these countries with nearly 3.5 billion people have received Bloomberg support.

Urgent Need

The need for these tobacco control policies is urgent: tobacco is among the leading public health scourges. Noncommunicable diseases (NCDs) are persistent killers, representing 80 percent of deaths in middle- and lower-income countries. Tobacco contributes to six of the ten leading causes of death globally, including heart attack; stroke; chronic lower respiratory disease; lower respiratory infections; lung, bronchial, and throat cancers; and diabetes.

NCDs are preventable, but together they receive a mere 1 percent of global health funding. As the WHO works to achieve the United Nations’ goal of reducing premature NCD deaths by one-third, Big Tobacco spends heavily to fight against effective regulation of its products.

Here’s one way tobacco companies do it: litigation. In 2010, Philip Morris International filed a challenge to prevent Uruguay from enforcing its tobacco laws—which mandate large, graphic health warning labels on cigarette packs and restrict what is known as “brand usage to a single presentation.” In other words, this means no longer allowing tobacco companies to market a cigarette with various representations such a “light,” “red,” “blue,” and so forth. On July 8, 2016, after a six-year lawsuit, the International Centre for the Settlement of Investment Disputes, a World Bank arbitration panel, determined that Philip Morris’s suit had no merit. Uruguay’s laws were designed according to evidence demonstrating that strong warning labels spur smokers to quit, and they stop nonsmokers—especially youth—from starting. In 2014 youth smoking in Uruguay was at 8 percent, down from 23 percent in 2006, according to the Uruguay Ministry of Public Health.

Uruguay won, as did the rest of the world. Many groups rallied around Uruguay in its fight, including the Campaign for Tobacco-Free Kids, the CDC Foundation, Johns Hopkins Bloomberg School of Public Health, the International Union Against Tuberculosis and Lung Disease, the WHO, Vital Strategies, and others.

The Bloomberg partner network has worked closely with country-level advocates and governments in low- and middle-income countries, where nearly 80 percent of the world’s smokers live and where smoking is ingrained in the culture. Of the 110 countries that have received support from the Bloomberg network, fifty-nine countries—with nearly 3.5 billion people—have passed a strong tobacco control law, saving an estimated 30 million lives. Just in the past two years, Bloomberg Philanthropies and our partners collaborated with the city governments of Beijing and Shanghai, China, to provide technical support aimed at achieving new smoke-free laws. Together, smoke-free laws in those cities now protect more than 30 million residents.

WHO Creates MPOWER

To further support countries and public health officials in their battle against the tobacco epidemic, WHO created the technical package called MPOWER. The acronym stands for a group of policies proven to reduce tobacco use: Monitor tobacco use; Protect people from second-hand smoke; Offer help to quit; Warn about dangers of tobacco use; Enforce advertising bans; and Raise tobacco taxes. MPOWER has, since 2007, spurred action to improve tobacco-control policies through strategies completely in line with the guidelines of the Framework Convention on Tobacco Control.

Bloomberg Philanthropies has provided support for the country-level implementation of MPOWER, for instance, by supporting thirty-four countries representing nearly four billion people to conduct household surveys to track tobacco use—the M in MPOWER. Similarly, the Bloomberg Initiative to Reduce Tobacco Use has supported, through our partners, 168 hard-hitting mass-media campaigns in thirty-one countries. The campaigns were created and adapted for global use—the W in MPOWER.

In Turkey—a country that has made a strong commitment to reducing tobacco use—the establishment of tobacco pack warnings, smoke-free zones, tobacco taxes, and tobacco advertising bans have had a huge impact. From 2008 to 2012, the number of smokers in Turkey declined by 1.2 million. Exposure to second-hand smoke in restaurants there declined from 55.9 percent in 2008 to 12.9 percent in 2012. And Turkey is on track to save 5.2 million lives by 2030.

To continue the momentum, we must build on MPOWER and the work of the global partnership, boldly communicate the importance of tobacco control to keep it on the global public health agenda, deepen support for tobacco taxes in vulnerable countries, ensure long-term funding for tobacco control as well as NCDs, and hold Big Tobacco accountable for its actions and the impact of its products. By remaining focused on programs proven to reduce use of tobacco and expanding successful programs, we can reach the Bloomberg Philanthropies initiative’s ambitious goal of saving 100 million lives by 2050.

State’s High Court Rules NYC Tobacco Laws Apply to E-Cigarettes

http://www.ny1.com/nyc/all-boroughs/news/2017/01/5/state-supreme-court-upholds-city-s-e-cigarette-ban.html

Vapers will have to follow the same laws as smokers following a ruling by the State Supreme Court.

The court dismissed a lawsuit filed by a smoker’s rights group to overturn the city’s ban on electronic cigarettes in the same places where traditional cigarettes are banned.

The devices do not use tobacco, but instead use a liquid containing nicotine and other ingredients that users inhale as vapor.

Supporters of e-cigarettes say the devices help more smokers away from tobacco, and that the ban will make their lives more difficult.

But anti-smoking activists say e-cigarettes can actually lead young people toward using tobacco.

The price of Africa’s puff

It is still one of the biggest businesses in Africa despite all the efforts from the government trying to stamp it out. The tobacco industry makes over $700 billion a year and seems to survive advertising bans and restrictions. Part of this business is African children who work for a dollar a day. The article below first appeared in Forbes Africa and is republished with its permission. Subscribe today by contacting Shanna Jacobsen Shanna.Jacobsen@abn360.com

http://www.cnbcafrica.com/news/special-report/2017/01/05/africa-cigarettes-and-smoking/

It’s 5am in the northern hills of Malawi where its tobacco is grown. Chifundo Ndilowe is awake and ready for the day. Dressed in grey shorts and a blue NBA vest, still filthy from yesterday’s long day on the farm, Ndilowe has hours of hard labour ahead. He is just 15 years old and has been planting and picking tobacco since he was 10.

“I came here in 2011 because rural life is hard. We were battling at home and I had to start contributing for us to survive. I stopped going to school to work. It is very tough working under these conditions because it is hot and we easily get tired and I am often sick,” he says.

Ndilowe moved 567 kilometres from Mulanje to Mpherembe, 300 kilometres north of Malawi’s capital, Lilongwe, to work in a tobacco farm five years ago. It means long hours, missing school and breaking the law for little pay. He earns a little more than $140 and $280 a year depending on the harvest. That’s less than $1 a day.

“We work for the year and only get paid after harvest. During the year, we get 20 kilograms of maize for 12 days because we don’t grow crops for consumption. They also give us salt and then we have to figure out the rest ourselves. I get to eat once a day and I take whatever is there,” he says.

Ndilowe is just one of an estimated 800,000 youngsters in the tobacco fields; voices that are seldom heard. One of an army of children who sweat for millions of cigarettes lit all over Africa.

A study on child labour in the tobacco industry in two areas of Malawi, Suza in the Kasungu district and Katalima in the Dowa district, found 57% of all children were being used as child labour in the tobacco fields.

George Kube, an adult tobacco worker, works with Ndilowe and two other children.

“There is no money for the children to go to school and if they don’t work to help we wouldn’t survive. We farm on two acres of land and the produce is auctioned to tobacco companies. You have to be very strong if you are going to do this job because sometimes we have to cut down trees and look for water,” says Kube.

A study, published by the British Medical Association, says contract farmers, like Kube and Ndilowe, cultivating tobacco in Malawi, live below national poverty lines, while independent farmers operate at a loss.

“Even when labour is excluded from the calculation of income less costs, farmers’ gross margins place most households in the bottom income [groups] of the overall population. Tobacco farmers appear to contract principally as a means to obtain credit, which is consistently reported to be difficult to obtain,” says the study.

Tobacco farmers may struggle to make a living but tobacco manufacturers thrive. The world tobacco industry is worth billions of dollars. Cigarette retail values in 2014 were worth US$744 billion and over 5.6 trillion cigarettes were sold to more than one billion smokers according to the Campaign for Tobacco-Free Kids. But, very few farmers make money from it.

The market is controlled by a few international companies; China National Tobacco Corporation, Philip Morris International, British American Tobacco, Japan Tobacco International and Imperial Brands. They buy tobacco from cheap emerging markets, like Malawi, for profit.

For years, governments around the world have been trying to clamp down on smoking because of its health implications, through stringent laws and higher taxes, yet tobacco use is increasing in some countries, says Zambian economist Grieve Chelwa.

“African incomes have been rising over the last couple of years and we know that tobacco consumption responds to rising incomes. Further, tobacco companies have put in place strategies (subtle advertising) to take advantage of rising incomes.”

And they flourish.

In 2016, British American Tobacco (BAT) announced its revenue went up 8.1% at constant rates of exchange, cigarette volume from subsidiaries was 497 billion, up by 2.2%, cigarette market share in key markets increased by 40 basis points and its brands performed exceptionally well with cigarette volume up 9.8% year ending September 30.

BAT plans to merge with its US partner R.J. Reynolds Tobacco Company, the company behind the famous camel cigarette brand, in a deal valued at $47 billion. It hopes to create a stronger global presence and move into new ventures like e-cigarettes.

In its third quarter, Philip Morris International reported net revenues of $19.9 billion, up by 2.6%, net revenues, excluding excise taxes, of $7 billion, up by 0.8%, operating income of $3 billion, up by 0.6%, and operating company’s income of $3.1 billion, up by 1.2%. In Africa, companies thrive because of weak regulation.

The World Health Organization (WHO) has a 75% benchmark of tax on the retail price, yet the African average is way below. Nigeria taxes cigarettes at only 20% of the retail price. Chelwa says ideally increasing taxes to reduce tobacco use should work anywhere because of the law of demand, increasing price reduces demand.

“But, the important point is the increases have to be real-inflation adjusted increments,” he says.

In Africa, high tobacco taxes are rare. WHO says only 33 countries, with 10% of the world’s population, have introduced taxes on tobacco products of more than 75%.

Tobacco tax revenues are on average 269 times higher than spending on tobacco control.

Tobacco companies are also good at finding new markets, with new smokers and weak regulations. According to an article published by The Lancet, a UK medical journal, tobacco use is declining in higher income countries, but nearly 80% of the world’s smokers live in low and middle income countries.

“Tobacco control regulations are not strong across most of the continent. Countries have ratified the Framework Convention on Tobacco Control (FCTC) but that’s all they have done. And sadly the tobacco industry is an important player in the setting of tobacco control policy in most African countries,” says Chelwa.

For years, tobacco companies argue they market merely to convince smokers to switch brands, but evidence published by the National Center for Biotechnology Information shows advertising drives smoking.

According to a WHO study, smoking has increased in 27 countries over the past 15 years. Seventeen of these are in Africa. In Cameroon, smokers more than doubled from 7% in 2000 to 22% last year. Congo-Brazzaville has seen the biggest spike. Nearly half of Congolese men smoke. Last year, 22% of its people admitted to smoking regularly, up from 6% in 2000.

“Only 42 countries, representing 19% of the world’s population, meet the best practice for pictorial warnings, which includes the warnings in the local language and cover an average of at least half of the front and back of cigarette packs,” says WHO.

In South Africa, cigarette advertising is banned. There are also restrictions on point of sale product display, vending machines and sponsorship of events, activities, individuals, organizations or governments. Now, Health Minister Aaron Motsoaledi has pledged to take it further by strengthening the Tobacco Products Control Act.

Motsoaledi says there should be no branding, no logos and no colors on cigarettes to discourage smoking. If the law is introduced, all cigarettes will be in a brown package with graphics that show the damage they can cause.

This is worrying for the tobacco industry. Christo van Staden heads the only primary tobacco processing factory in South Africa, Limpopo Tobacco Processors, that processes 12 million kilograms of tobacco. He says the effects could be catastrophic.

“The biggest impact [of tougher regulations] is the increase in illicit cigarettes which is a huge dent in the business of BAT and in the whole market. About 20 to 30 percent of cigarettes in Gauteng are illicit and they are paid way below the price,” he says.

As we meet, in Rustenburg, a two-hour drive from Johannesburg, Van Staden’s farmers have lost 30 hectors of tobacco to a passing storm. On this day, the sun blazes down from a cloudless azure sky. A sprinkler keeps the glossy lawns and flowers alive. Inside the factory, it is dark and you can hear a pin drop. The silence is almost tangible. There is no bustle and machines that usually crackle stand still. It is not tobacco season. All employees are upstairs in the offices working. Dressed in khaki shorts and shirt, Van Staden says tobacco farming is hard.

“For every hector, you need two people to work there and pick it by hand, it is very expensive. One hector costs about R130,000 ($9,500) to plant and the farmer needs to make at least 20 to 25 percent profit. Last year was a very tough year. There were very tough conditions and an average farmer did not make any profit at all.”

“Now they are supporting the local market but if they don’t get any benefit out of that, they have to compete with everyone else in plain packaging, then there is no reason for them to buy South African tobacco, they will literally walk out of here overnight and source their product from Brazil, India and China where they can buy a lot cheaper.

We are not ready for that. We would close these doors,” he says.

For Van Staden, closing doors means 10,000 farmers lose their income. He thinks there should be more education about the dangers of tobacco and efforts to keep youngsters away from smoking.

“I am a non-smoker and will not advise anyone to smoke. Most of my staff members don’t smoke. Unfortunately, people smoke everyday but see the warning on the packets and turn a blind eye. Because it’s such an unhealthy product, the governments around the world will try and eradicate it but I don’t think it will happen in the next 20 years. There are laws in this country that allow people to smoke and to close down the primary sector is not going to stop smoking overnight,” adds Van Staden.

South Africa will follow the UK, Ireland, Australia and France in banning branded packaging.

In Uganda, 4,800 kilometres from South Africa, it’s even tougher. If you light up in bars, restaurants or hotels, you will be fined $60 or jailed for up to two months.

Smokers must be at least 50 meters away from public spaces, such as schools, hospitals and taxi ranks.

Uganda’s new laws also ban the sale of electronic cigarettes, flavoured tobacco for water pipes, the sale of single cigarettes and tightened rules on labelling, advertising and selling tobacco to under-21s.

“We are strongly opposed to plain packing as we feel that there hasn’t been enough consultation and research on it. Our concern is the serious adverse consequences that it will have on the economy, jobs and investment; as well as potentially making counterfeit easier. It trounces fundamental intellectual property rights and freedoms guaranteed by the constitution,” says Joe Heshu, Acting Head of External Affairs at BAT.

According to Heshu, counterfeit cigarettes are a bigger issue. In 2015, South Africa’s Treasury lost R5.1 billion ($373 million) due to illicit trade. The trade accounts for about 24% of the market.

South Africa has been increasing tobacco taxes since 1994 and the big impact has been the reduction in consumption and prevalence, but Chelwa agrees there has been a minimal impact of the taxes on illicit trade.

“Illicit trade often has to do with tax administration and not taxes. Even if taxes were a cent, you’d still have illicit trade showing that it is not a tax level or tax rate issue but a tax administration issue,” he says.

On jobs, Chelwa argues “there are very few tobacco manufacturing jobs, very few given how mechanized manufacturing of cigarettes is.”

The big worry he says is in the field.

“Governments have to consciously find ways of transitioning tobacco farmers into growing other types of crops. This will require a lot of work,” says Chelwa.

Asked if he thinks cigarettes are killers, Heshu argues his company has launched e-cigarettes, which are supposedly less harmful products, in the UK, France, Germany, Italy and Poland.

“We are committed to the research and development of Next Generation Products (NGPs) and globally have invested over half a billion pounds during the past five years.

There is a growing body of evidence that NGPs do pose significantly fewer risks than cigarettes.”

For now, tobacco companies continue to thrive. Only 29 countries, representing 12% of the world’s population, have completely banned all forms of tobacco advertising, promotion and sponsorship, according to WHO.

Some of Malawi’s tobacco, grown by the likes of Ndilowe and Kube, is shipped 2,000 kilometers south of Mpherembe. In South Africa, 19% of the population, over the age of 15, smokes according to the World Bank. That’s almost one in five people and it is dangerous.

Tobacco is responsible for six million deaths each year. Of those, 600,000 die from the effects of second-hand smoke. This number is expected to increase to eight million by 2030 if current trends continue, says WHO.

Alexandra chain smoker, Mpho Ndlovu, knows this, yet he goes through three packs of cigarettes a day.

“I have been smoking since I was 15. It started as just playing with friends at school because we knew we weren’t allowed to. It was a way of being cool. I got hooked and have been smoking for 40 years,” says Ndlovu.

What started as a game became a habit and then an addiction.

“Smoking helps me when I’m nervous and I just enjoy it. I have tried to stop many times but have failed. I know this might one day kill me but, at this point, there is nothing I can do.”

Ndlovu spends R110.50 ($8) per day on cigarettes. That’s R766.50 ($56) per week and R3,066 ($225) per month and R36,792 ($2,700) per year and R183,960 ($13,500) in five years. If he continues smoking the same number of cigarettes per day for another 40 years, at this current price, he will spend around $100,000 on cigarettes. If invested, he could buy a house.

Ndlovu spends close to half of his R7,000 ($500) salary he makes working as a driver for a logistics company in Sandton.

“By the last week of the month, I would be out of money and sometimes I have to ask people if I can borrow or take some on credit from the spaza shop,” he says.

“When I smoke, especially on weekends, I drink as well. So the money I earn is never enough. My children get angry because they think I should be using the money on them. I don’t know how to stop.”

Ndlovu buys his cigarettes from Ntando Debeza, a hundred metres from his home.

Debeza’s spaza shop sells cigarettes, pipe tobacco, snuff, chewing tobacco, hookah and shisha.

“I make about R6,000 ($440) a month from this small shop. Most of the money comes from tobacco sales but I also sell other day-to-day products like bread and milk.

People come to buy and sometimes on credit and I collect money at the end of the month,” says Debeza.

This means Ndlovu’s debt grows. But, that’s not all. Smoking does not only affect the smoker. High levels of nicotine exposure from handling tobacco leaves may cause nicotine poisoning called Green Tobacco Sickness, with symptoms including nausea and vomiting.

Back in Mpherembe in Malawi, Kube says he is aware of the dangers of working in a tobacco field without protective clothing, and mostly its effects on minors. “I know children can get sick but what can we do? We need a lot of hands on the farm because this isn’t an easy crop to plant and prepare. It needs three times more people than corn but we don’t make enough money at all,” says Kube.

He is one of the few rural farmers who know this. And it gets worse. A 2009 survey in China revealed that only 38% of smokers knew that smoking causes coronary heart disease and only 27% knew that it can cause strokes.

“Among smokers who are aware of the dangers of tobacco, most want to quit. Counselling and medication can more than double the chance that a smoker who tries to quit will succeed. National comprehensive cessation services with full or partial cost coverage are available to assist tobacco users to quit in only 24 countries, representing 15% of the world’s population,” says WHO.

Cape Town-based entrepreneur Gareth Carter saw this crisis as an opportunity. He founded WeDoRecover, a company that helps patients who suffer from psychiatric and addiction problems.

“Finding the right addiction programme to meet someone’s specific needs is a complex process. The crisis and chaos synonymous with active addiction are overwhelming and the multitude of choices in the marketplace adds to the confusion,” says Carter.

According to Carter, people who smoke are more likely to drink alcohol and vice versa. He says alcoholics frequently present with a co-morbid nicotine addiction.

“As many as 80 percent of people addicted to alcohol and other drugs are frequent smokers, but the bulk will die of smoking-related disease rather than alcohol and drug-related disease…”

The damage doesn’t stop there. Carter adds that major depressive episodes among adults are highest in those addicted to nicotine and lowest in those who have quit or never started smoking.

“With nearly 80 percent of the world’s one billion smokers living in low- and middle-income countries, this is a very real public health care problem for us in Africa.

Making nicotine addiction prevention and treatment readily accessible to the youth counteracts a wide range of potential mental, physical and mood-disorder problems with far-reaching ramifications to families, communities and our economy,” he says.

Carter thinks if tobacco was “invented” today it would be classed with other illegal drugs. That’s not the case. The lucrative industry in Africa puffs on unfettered.

British American Tobacco drops its nicotine inhaler Voke to prioritise vapour and tobacco heating products

British American Tobacco (BAT) today announced it would drop its medical nicotine inhaler Voke to focus more directly on products like e-cigarettes aimed at consumers.

http://www.cityam.com/256448/british-american-tobacco-drops-its-nicotine-inhaler-voke

BAT said it will give up its manufacturing, intellectual property and know-how assets to Kind Consumer, from which it licensed the product, in return for deferred, contingent payments.

No financial details were disclosed.

Kind will take back ownership for the commercialisation of Voke, which was the first device of its kind to be approved as a medical prescription to people trying to quit smoking.

Like e-cigarettes, Voke uses liquid nicotine, but it does not use a battery to heat it into a vapour.

Manufacturing issues have delayed the commercial launch of the inhaler, which was supposed to hit the market in 2016.

Kind chief executive Paul Triniman said the company will be looking for a new global partner or several regional partners to speed up distribution this year.

Kingsley Wheaton, managing director of next generation products at BAT, said Kind’s focus and single-mindedness will bring about a quicker commercialisation of the product.

BAT on the other hand will focus on its Vype e-cigarette and glo tobacco heating products, which are broadly considered to be safer than traditional cigarettes.

BAT, the world’s second-largest international tobacco company, is also in talks of a $47bn (£37bn) takeover of US cigarette maker Reynolds American.

Local Anti Tobacco Advocate Busts E-cigarette Myths

http://www.caledonianrecord.com/features/health/local-anti-tobacco-advocate-busts-e-cigarette-myths/article_65ee5497-ed23-5131-b69d-a503312368c3.html

According to a recently released report by the US Surgeon General, research has confirmed that there has been a significant increase in electronic cigarette (e-cigarette) use in recent years. Just last year alone, in 2015, the increase of electronic cigarette use has more than doubled particularly among our youth (ages 11 – 14), adolescents (ages 15 – 17) and in our young adults (ages 18 – 25) with more than 3 million youth in middle and high school using electronic cigarettes within the past 30 days. A cash cow for the tobacco industry, these numbers are increasing daily. More than 85 percent of electronic cigarette users ages 12 – 17 use flavored e-liquids, which come in a large variety of flavors, and are especially appealing to youth. And the flavors are the leading reason for youth use, according to the Surgeon General’s report.

Tobacco companies have been ramping up their marketing strategies to attract and cause young people to start using electronic cigarettes. In the United States, $3.5 billion dollars in sales is big business for the industry. Electronic cigarette manufacturers spent $125 million dollars in advertising their products with retail stores becoming the most frequent source of youth exposure to the tobacco industry’s advertising approaches. The tobacco industry has gone back to its old tactics that are much the same as the ones used to promote the conventional tobacco products.

Unlike the marketing campaigns of yesteryear, advertising approaches and themes today have a significant advantage with the use of internet and social media creating a more effective and wider outreach to attract youth and young adults, causing them to start using tobacco products at a much earlier age. In 2014, more than 7 out of 10 middle and high school students stated that they have been exposed to tobacco advertising. Research has shown that youth who use tobacco products like electronic cigarettes or chew, are most likely to go on to use other tobacco products like the traditional tobacco cigarette. In 2015, nearly 6 out of 10 high school cigarette smokers were also using electronic cigarettes.

The tobacco industry has claimed that electronic cigarettes are safer than the traditional tobacco cigarette. The tobacco industry has also claimed that the chemicals in e-liquids are not harmful to the user. The tobacco industry has suggested that electronic cigarettes can and may be used as a cessation tool to quit smoking. On the contrary, the newly released US Surgeon General’s report has confirmed these claims to be myths. The US Surgeon General’s report has busted these myths by saying;

The use of products containing nicotine poses dangers to youth, pregnant women, and fetuses. The use of products containing nicotine in any form among youth, including electronic cigarettes, is unsafe.

The liquid usually has nicotine, which comes from tobacco, flavoring; and other additives. Many electronic cigarettes contain nicotine, which is highly addictive. The nicotine in electronic cigarettes and other tobacco products can prime young brains for addiction to other drugs, such as cocaine and methamphetamine. Electronic aerosol is not harmless. The aerosol or vapor created by electronic cigarettes can contain ingredients harmful and potentially harmful to the public’s health.

There have been no conclusive study results or evidence to confirm that electronic cigarettes are a possible cessation tool for those who want to quit smoking. On the contrary, there is sufficient evidence to substantiate that the use of electronic cigarettes promotes users to use both electronic cigarettes along with smoking the conventional tobacco cigarette and that can potentially place the user at risk for exposure to higher levels of nicotine in the body that may ultimately lead to acute toxicity and possible death from over-exposure to nicotine.

The US Surgeon General’s full report titled: E-Cigarette Use Among Youth and Young Adults, can be found on the Surgeon General’s official website: https://e-cigarettes.surgeongeneral.gov.