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May, 2017:

Study: China Struggles to Kick World-Leading Cigarette Habit

Most smokers in China, the world’s largest tobacco consumer, have no intention of kicking the habit and remain unaware of some of its most damaging health effects, Chinese health officials and outside researchers said Wednesday.

http://www.voanews.com/a/china-smoking/3879050.html

An estimated 316 million people smoke in China, almost a quarter of the population, and concerns are growing about the long-term effects on public health and the economy.

The vast majority of smokers are men, of whom 59 percent told surveyors that they have no plans to quit, according to a decade-long study by the Chinese Center for Disease Control and Prevention and Canadian researchers with the International Tobacco Control project.

Such numbers have prompted efforts to restrict the formerly ubiquitous practice. Major cities including Beijing and Shanghai having recently moved to ban public smoking, with Shanghai’s prohibition going into effect in March. In 2015, the central government approved a modest nationwide cigarette tax increase.

But Chinese and international health officials argue that more is needed, including a nationwide public smoking ban, higher cigarette taxes and more aggressive health warnings. Such actions are “critically important,” Yuan Jiang, director of tobacco control for the Chinese Center for Disease Control, said in a statement released with Wednesday’s study.

A public smoking ban appeared imminent last year. The government health ministry said in December that it would happen by the end of 2016, but that has yet to materialize.

“They have to figure out what’s important as a health policy,” said Geoffrey Fong of Canada’s University of Waterloo, one of the authors of Wednesday’s study. “Every third man that you pass on the street in China will die of cigarettes. …When you have cheap cigarettes, people will smoke them.”

In line with global trends, smoking rates among Chinese have fallen slowly over the past 25 years, by about 1 percent annually among men and 2.6 percent among women, according to a separate study published in April in the medical journal The Lancet.

Yet because of China’s population growth — 1.37 billion people at last count — the actual number of smokers has continued to increase. Rising prosperity means cigarettes have become more affordable, while low taxes keep the cost of some brands at less than $1 a pack.

Sixty percent of Chinese smokers were unaware that cigarettes can lead to strokes and almost 40 percent weren’t aware that smoking causes heart disease, according to the study, which was released on World No Tobacco Day, when the World Health Organization and others highlight health risks associated with tobacco use.

Judith Mackay, an anti-tobacco advocate based in Hong Kong, said China has made strides with the public smoking bans in some cities and a similar ban covering schools and universities, but that’s not enough.

“This is the first time there has been a report looking at the overall picture of where China stands,” said Mackay, senior adviser at Vital Strategies, a global health organization. “The reality is, it’s falling behind.”

Mackay blamed behind the scenes lobbying by China’s state-owned tobacco monopoly for impeding efforts to toughen tobacco policies. The State Tobacco Monopoly Administration did not immediately respond to a request for comment.

Government agencies and research institutes in China, Canada and the United States funded the study.

Support World No Tobacco Day – say “no” to tobacco

To support the World No Tobacco Day 2017, the Department of Health (DH) today (May 31) held a sharing session to remind the public again of the hazards of smoking and to urge smokers to quit smoking as early as possible.

http://www.info.gov.hk/gia/general/201705/31/P2017053100249.htm

Speaking at the sharing session, the Director of Health, Dr Constance Chan, said that the World Health Organization (WHO) has marked May 31 as World No Tobacco Day annually. The theme for World No Tobacco Day 2017 is “Tobacco – a threat to development”, with the aim of demonstrating the threats posed by tobacco to the world’s sustainable development, including public health and the economy. Dr Chan strongly urged members of the public to say “no” to tobacco and to continue supporting the Government’s efforts in tobacco control.

“With the collaborative efforts of the Government and various sectors over the years, the work on tobacco control in Hong Kong has attained pleasing results, with a drop in overall smoking prevalence from 23.3 per cent in the 1980s to 10.5 per cent in 2015. Nonetheless, casualties and economic loss directly and indirectly caused by tobacco remain tremendous. Local studies revealed that tobacco-related fatalities reach nearly 7 000 people annually and the economic loss resulting from tobacco-related health problems is estimated to be about 5.5 billion every year,” Dr Chan said.

“Smoking is a causative agent of many cancers as well as cardiovascular and respiratory diseases. Smoking causes harm not only to the smoker but also to their family members and friends due to the secondhand smoke induced, which increases their risk of cancer and many other chronic diseases as well as the chance of children developing respiratory symptoms,” Dr Chan added.

Sharing the research findings on local smoking-related mortality and morbidity conducted by the University of Hong Kong (HKU), the Chair Professor of the School of Public Health of the HKU, Professor Lam Tai-hing, pointed out that at least one out of every two elderly smokers died of tobacco-related diseases. He said that the Government must continue to adopt various tobacco control measures to encourage smokers to quit the habit.

The Head of the Tobacco Control Office of the DH, Dr Lee Pui-man, introduced in the sharing session 12 new pictorial health warnings on cigarette packets, which better inform the public about the specific hazards of tobacco use to smokers and their families. Experience and evidence from the WHO and around the globe also demonstrate that pictorial health warnings are an effective intervention, and increasing the size of pictorial health warnings on cigarette packets is now an international trend.

“The graphics and designs of health warnings should be updated regularly so as to maintain their salience and enhance the impact. The Government updates pictorial health warnings coupled with multiple tobacco control measures to discourage members of the public from smoking and encourage smokers to quit,” Dr Lee said.

Smokers who intend to quit smoking can call the DH’s Integrated Smoking Cessation Hotline on 1833 183, where registered nurses provide professional counselling services on smoking cessation and will also refer service users to suitable social service agencies for follow-up when necessary. To enhance smoking cessation services to smokers, the DH will launch a pilot public-private partnership programme this year to trial a new mode of smoking cessation service supported by family physicians.

In addition, the DH will collaborate with a renowned medical institution, Mayo Clinic, in the United States to organise an online training programme on tobacco dependence treatment, which will be rolled out within this year. Family physicians joining the programme will acquire skills and knowledge on smoking cessation via e-learning, and their capacity in providing smoking cessation services will be further enhanced through training and assessment. The programme aims to ensure that they can provide quitters with effective evidence-based treatment.

In addition, two patient representatives shared their experience of smoking at the sharing session, ranging from smoking-related diseases to successfully quitting the habit. They urged other smokers to quit smoking as early as possible and to seek help on smoking cessation if necessary.

Ends/Wednesday, May 31, 2017
Issued at HKT 15:18

Stop Smoking: It’s Deadly and Bad for the Economy

Higher taxes on tobacco products reduce tobacco consumption and improve public health, while also increasing government revenues that can be used to fund priority investments and programs that benefit the entire population.

http://www.worldbank.org/en/news/infographic/2017/05/31/stop-smoking-its-deadly-and-bad-for-the-economy

WBG_NoTobaccoDay_Infographic_052417-Final

World No Tobacco Day, 31 May 2017

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Big investors warn against tobacco investment on World No Tobacco Day, but smoking in Europe is still stubbornly high

Today marks the passing of the 30th World No Tobacco Day, designed to encourage smokers to abstain for a day in the hope that they might quit.

http://www.cityam.com/265672/big-investors-warn-against-tobacco-investment-world-no

Yet it seems the annual event is doing little to help people kick the habit, despite support from big investors such as Axa and Calpers who are using the day to encourage a reduction in tobacco investment.

According to a survey of EU citizens, published by the European Commission to coincide with World No Tobacco Day, there has been no decrease in the number of daily smokers since 2014 – and even an increase among 15- to 24-year-olds.

“The increase in youth smoking rates illustrates the urgency for member states to enforce the provisions of the Tobacco Products Directive, which forbid attractive cigarettes aimed at enticing young people,” said EU commissioner for health and food safety Vytenis Andriukaitis.

The directive, which came into force in May this year, forbids tobacco manufacturers from marketing products as flavoured and requires them to cover 65 per cent of the packaging in health warnings.

Yet the overall smoking rate in the EU has remained at 26 per cent since 2014 and has risen from 25 per cent to 29 per cent in people aged 15 to 24.

Smoking in the UK sits fairly well below the European average, with 17 per cent of the population taking a daily puff.

Greece, Bulgaria, France and Croatia all rank highly, with smoking rates in each country above 35 per cent. Yet in Sweden, only seven per cent of people will regularly smoke a tobacco product.

Axa, Calpers, Scor and AMP Capital are putting their weight behind the push to quit, sponsoring the world’s first global investor statement on the subject.

It aims to “make visible the strong support within the financial community” for the World Health Organisation’s (WHO) framework on tobacco control and encourage stakeholders to act against tobacco investment, Axa said.

Axa and AMP Capital divested from tobacco last year, while Calpers did so 17 years ago and has since widened its ban to include externally managed funds.

The substance kills more than seven million people each year according to WHO, which has coordinated World Tobacco Day since the first event in 1988, and costs households and taxpayers more than $1.4trn (£1.1trn) in healthcare expenditure and lost productivity.

Still No Tobacco Standardised Packaging Regulations

Imperial Tobacco New Zealand wants to know why the Government still hasn’t released Regulations to implement standardised packaging of tobacco.

http://www.scoop.co.nz/stories/PO1705/S00500/still-no-tobacco-standardised-packaging-regulations.htm

Parliament passed the Bill for tobacco products for standardised packaging in September 2016, but Regulations that set out exactly how and when the measure will be implemented still haven’t been released.

Head of Corporate and Legal Affairs for Imperial Tobacco New Zealand, Louise Evans McDonald, says Imperial and tobacco retailers are becoming increasingly frustrated with the delay.

“While we have made our objection to standardised packaging known, we will obviously need to comply with the new law. That is going to be extremely difficult to do if the Government won’t tell us exactly what the new law is.

“Retailers have joined us in calling for at least 12 months lead time until implementation – but that has clearly fallen on deaf ears. The legislation says that we must have standardised packaging in March next year, which is now less than 10 months away.

“We need to see the Regulations immediately so that we can source and prepare packaging materials ready to meet the deadline. If we don’t know what those materials must contain because we don’t have Regulations, then exactly what is the Government going to expect of us and, importantly, of retailers?”

ENDS

Timeline of key dates:

31 May 2016 – Exposure draft of regulations for consultation
30 June 2016 – Bill’s second reading
8 September 2016 – Bill’s third reading
14 September 2016 – Bill received Royal assent

Russian showpieces to be tobacco-free events

This year’s FIFA Confederations Cup and next year’s FIFA World Cup™ will be tobacco-free events. FIFA and the Local Organising Committee (LOC) confirmed this on Wednesday 31 May, as World No Tobacco Day is celebrated across the world in conjunction with the World Health Organisation (WHO).

http://www.fifa.com/confederationscup/news/y=2017/m=5/news=russian-showpieces-to-be-tobacco-free-events-2890503.html

This decision is based on FIFA´s long-standing commitment to counter the use of tobacco and its negative impacts, which started in 1986 when FIFA announced it would no longer accept advertising from the tobacco industry.

“FIFA has banned smoking at FIFA World Cups since 2002 in order to respect and protect people’s Human Rights as a part of FIFA´s social responsibility commitment,” said Federico Addiechi, FIFA’s Head of Sustainability & Diversity. “FIFA´s Tobacco-Free Policy for FIFA Tournaments ensures that those who choose to, may only use tobacco products in designated areas, if in existence, to ensure that it does not harm others. The policy protects the right of the majority of the population, who are non-smokers, to breathe clean air that is not contaminated by carcinogens and other harmful substances in tobacco smoke and e-cigarettes.”

“All our actions in preparing for the tournament are taken in strict compliance with the Sustainability Strategy,” said Milana Verkhunova, Director of Sustainable Development at the Russia 2018 LOC. “One of the objectives in this area is to create a tobacco-free environment at all World Cup stadiums and FIFA Fan Fests.

“Creating a tobacco-free environment at all World Cup stadiums and FIFA Fan Fests is a very important objective of the 2018 FIFA World Cup Sustainability Strategy”, said Milana Verkhunova, Director of Sustainability Department at the Russia 2018 LOC. “In order to fulfill this task, we actively interact with the World Health Organization, the Ministry of Health, the expert community, host cities, stadium operators, the World Cup ambassadors and fans, as well as with the Russian Football Union. We hope that by joint efforts we will be able to contribute to the reduction of tobacco consumption in Russia.”

Here, FIFA.com highlights the key dates in FIFA’s work towards smoke-free sporting events.

1986: FIFA announces it will no longer accept advertising from tobacco-industry sponsors.
1999: At the FIFA Women’s World Cup™ in the USA, FIFA supports an anti-smoking campaign launched by the U.S. Department of Health and Human Services (HHS).
2002: FIFA supports a smoke-free campaign launched by WHO and the HHS. World football’s governing body is consequently bestowed with the WHO Director General’s Award for an anti-smoking campaign.
2002: Korea/Japan becomes the first smoke-free FIFA World Cup, meaning it has no links whatsoever to tobacco. Every FIFA World Cup since has followed suit.
2010: FIFA, the LOC and other stakeholders develop and adopt the ‘Stadium Code of Conduct’, which describes the applicable measures and policies for stadium visitors and staff, including prohibition of smoking in the stands and around the pitch.
2011: FIFA provides input to the European Healthy Stadia Network for policy position and enforcement guidelines for UEFA, concerning a smoke-free UEFA EURO 2012.
2013/2014: The FIFA Confederations Cup and World Cup in Brazil take place as tobacco-free events.
2015: World No Tobacco Day celebrated as ‘World Smoke Free Day’ at the FIFA U-20 World Cup New Zealand 2015
2017/2018: The FIFA Confederations Cup and the FIFA World Cup in Russia will both be tobacco-free events.

Study reveals high environmental cost of tobacco

Smoking kills 7 million people a year, and it scars the planet through deforestation, pollution and littering.

http://edition.cnn.com/2017/05/31/health/tobacco-environment-who-report/

Details of the environmental cost of tobacco are revealed in a study released Wednesday by the World Health Organization, adding to the well-known costs to global health, which translate to a yearly loss of $1.4 trillion in health-care expenses and lost productivity.

From crop to pack, tobacco commands an intensive use of resources and forces the release of harmful chemicals in the soil and waterways, as well as significant amounts of greenhouse gases. Its leftovers linger, as tobacco litter is the biggest component of litter worldwide.

“Tobacco not only produces lung cancer in people, but it is a cancer to the lungs of the Earth,” said Dr. Armando Peruga, who previously coordinated the WHO Tobacco Free Initiative and now works as a consultant. He reviewed the new report for the WHO.

world-of-tobacco

Commercial tobacco farming is a worldwide industry that involves 124 countries and occupies 4.3 million hectares of agricultural land. About 90% of it takes place in low-income countries, with China, Brazil and India as the largest producers.

Because tobacco is often a monocrop — grown without being rotated with other crops — the plants and the soil are weak in natural defenses and require larger amounts of chemicals for growth and protection from pests.

“Tobacco also takes away a lot of nutrients from the soil and requires massive amounts of fertilizer, a process that leads to degradation of the land and desertification, with negative consequences for biodiversity and wildlife,” Peruga said.

The use of chemicals directly impacts the health of farmers, 60% to 70% of whom are women. This is especially prominent in low- and middle-income countries, where some compounds that are banned in high-income countries are still used.

300 cigarettes = one tree

Farming also uses a surprisingly large amount of wood, rendering tobacco a driver of deforestation, one of the leading causes of climate change.

About 11.4 million metric tonnes of wood are utilized annually for curing: the drying of the tobacco leaf, which is achieved through various methods, including wood fires.

That’s the equivalent of one tree for every 300 cigarettes, or 1.5 cartons.

This adds to the impact of plantations on forest land, which the study describes as a significant cause for concern, citing “evidence of substantial, and largely irreversible, losses of trees and other plant species cause by tobacco farming.”

Deadly gases

In 2012, 967 million daily smokers consumed approximately 6.25 trillion cigarettes worldwide, the WHO estimates.

“That means about 6,000 metric tonnes of formaldehyde and 47,000 metric tonnes of nicotine are released into the environment,” Peruga said.

Tobacco smoke contains about 4,000 chemicals, at least 250 of which are known to be harmful. It also contains climate-warming carbon dioxide, methane and nitrous oxides. “The combination of greenhouse gases from combustion is equivalent to about 1.5 million vehicles driven annually,” Peruga said.

Secondhand smoke is particularly deadly: It contains twice as much nicotine and 147 times more ammonia than so-called mainstream smoke, leading to close to 1 million deaths annually, 28% of them children.

Some of these pollutants remain in the environment (and our homes) as “third-hand smoke,” accumulating in dust and surfaces indoors, and in landfills. Some, like nicotine, even resist treatment, polluting waterways and potentially contaminating water used for consumption, the study notes.

Non-biodegradable litter

Tobacco litter is the most common type of litter by count worldwide.

“We calculate that two-thirds of every cigarette ends up as litter,” Peruga said.

The litter is laced with chemicals including arsenic and heavy metals, which can end up in the water supply. Cigarette butts are not biodegradable, and tossing one on the ground is still considered a socially acceptable form of littering in many countries.

The WHO estimates that between 340 million and 680 million kilograms of tobacco waste are thrown away every year, and cigarette butts account for 30% to 40% of all items collected in coastal and urban clean-ups.

“In addition to that, there are 2 million tons of paper, foil, ink and glue used for the packaging,” Peruga said.

A way forward?

Even though smoking is declining globally, it is increasing in some regions, such as the eastern Mediterranean and Africa. China is a world leader both in production (44%) and consumption, with 10 times more cigarettes smoked than in any other nation.

Every stage of the production of a cigarette has negative effects on the environment and the people who are involved in manufacturing tobacco products, even before the health of smokers and non-smokers is affected.

Although governments worldwide already collect $270 billion in tobacco taxes a year, the WHO suggests that increasing tax and prices is an effective way of reducing consumption and help development priorities in each country, adding that by collecting 80 cents more per pack, the global tax revenue could be doubled.

“Tobacco threatens us all,” WHO Director-General Margaret Chan said in a note. “It exacerbates poverty, reduces economic productivity, contributes to poor household food choices, and pollutes indoor air.”

Hong Kong must adopt plain tobacco packaging, say health advocates

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

http://www.scmp.com/lifestyle/health-beauty/article/1959203/hong-kong-must-adopt-plain-tobacco-packaging-say-health

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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