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June, 2017:

Advancing the endgame for the tobacco pandemic

Advancing the endgame for the tobacco pandemic: Hāpai Te Hauora backs new research to achieve Smokefree 2025.

https://www.nzdoctor.co.nz/un-doctored/2017/june-2017/29/Advancing-the-endgame-for-the-tobacco-pandemic.aspx

Hāpai Te Hauora supports new research on tobacco control published by the University of Otago in the British Medical Journal this month. “This is significant for the tobacco control sector” says Zoe Hawke, General Manager of the National Tobacco Control Advocacy Service for Hāpai Te Hauora.

“We have new strategies to advance Smokefree 2025 in Aotearoa and now we have an evidence base to support these strategies. Novel interventions can be difficult to advocate for without a track record to link outcomes to. The evidence presented in this study will go a long way to mitigating those difficulties. It also sends a clear message to decision-makers about the critical crossroads we’re at, and what we need to do if we’re serious about achieving Smokefree 2025.”

The study, titled “Impact of five tobacco endgame strategies on future smoking prevalence, population health and health system costs: two modelling studies to inform the tobacco endgame” was a trans-Tasman collaboration between the University of Otago and the University of Melbourne. It was specifically focussed on the New Zealand Smokefree 2025 goal and identified major health gains and cost savings could be achieved by utilising:

1. 10% annual tobacco tax increases

2. a tobacco- free generation: a ban on the provision of tobacco to those born from a set year onwards

3. a substantial outlet reduction strategy

4. a sinking lid on tobacco supply

5. a combination of 1,2 & 3

These strategies are new and the study modelled their potential impacts using New Zealand-specific data to achieve their findings. The authors propose that the data are used as modelling-level evidence for countries looking to achieve health gains, cost savings and reduce inequities related to tobacco consumption. They suggest that the findings will be validated and improved upon as the interventions are adopted.

Hawke says supply reduction is the key to achieving Smokefree 2025, but it won’t be easy. “If we think we’ve seen battles with the tobacco lobby, we’ve seen nothing yet. Reducing supply is the final hurdle to removing this harmful product from our communities and you can guarantee it will be fiercely fought by the industry.”

Proposal to tax heat sticks the same as cigarettes

A proposal to tax heat-not-burn tobacco products at the same rate as combustible cigarettes is before the National Assembly, the Korea Herald reported.

http://www.tobaccojournal.com/Proposal_to_tax_heat_sticks_the_same_as_cigarettes.54292.0.html

Legislation to revise three laws governing taxation of tobacco products reportedly has been introduced by Rep Kim Kwang-lim, a member of the Liberty Korea Party. All tobacco products are harmful and should be taxed at the same rate, according to the legislation. Heat-not-burn products are taxed at about half the KRW 3,323 (EUR 2.59) rate for combustible cigarettes, the Herald said.

San Francisco Menthol Ban Puts Millions in Tobacco Sales in Jeopardy

New law may cut tobacco category by 35%, city research says

http://www.cspdailynews.com/category-news/tobacco/articles/san-francisco-menthol-ban-puts-millions-tobacco-sales-jeopardy

Although California may be known for earthquakes, San Francisco could rock the c-store channel to its core, with its board of supervisors banning the sale of menthol cigarettes—a move that could slash the tobacco category in the city as much as 35% when the law goes into effect next year, according to one state estimate.

Through a press contact at the board of supervisors, CSP Daily News confirmed that the board’s unanimous approval of the menthol ban June 20 has led to its passage into law, with an implementation date set for April 2018.

The measure’s passing comes soon after Ted Egan, chief economist for San Francisco’s controller’s office, issued a report detailing the ban’s potential economic effects. In the report dated June 13, Egan said the ban—which affects all tobacco flavors, including menthol—could cost the city $50.5 million in annual sales, with an average smoker consuming 212 packs annually at a cost of $8.50 per pack.

While the ban’s goal of reducing tobacco use may be the result, the report also suggests that smokers may simply switch to other types of tobacco or buy flavored products in other cities or online.

Based on city records, the ban would affect 726 retailers.

“Most of these retailers are small convenience stores or gasoline stations that sell fewer than 20 packs of cigarettes per day,” the report said. “We have no information on how many sell flavored cigarettes that would be subject to the ban.”

The report, however, cited the California Department of Public Health as estimating 35% of cigarettes sold are menthol-flavored.

The legislation itself amends San Francisco health codes to prohibit local tobacco retailers from selling flavored tobacco products, including menthol cigarettes, flavored chewing tobacco and flavored liquids containing nicotine designed to be used with electronic cigarettes. It does not criminalize the possession or use of flavored tobacco, only its sale by retailers within the city.

In its original form, the law was supposed to take effect in January 2018, but according to the San Francisco Examiner, Supervisor Malia Cohen, who introduced the bill, pushed enforcement back by four months to April 2018 to address business concerns. According to the Examiner, Cohen said she would support increases in funding for small stores so they could transition their business models to reflect the city’s Healthy Food Retail program.

Since the measure’s initial proposal in April, San Francisco-area retailers and tobacco association representatives have expressed vigorous opposition to the measure, saying it would endanger the viability of their businesses.

Here’s a quick update on California counties and cities that have banned or are considering bans on menthol as part of a larger pushback on flavored-tobacco products:

  • Menthol Bans. Municipalities with some form of flavor ban that includes menthol cigarettes: Yolo and Santa Clara counties in California, and Los Gatos, Calif., according to the Antioch Herald. San Francisco’s flavor ban, which includes menthol-flavored tobacco products, will take effect in April 2018.
  • Flavor Bans. Several cities have some form of flavored-tobacco ban involving menthol. For instance, the city of El Cerrito, Calif., banned the sale of flavored tobacco to youth under 21, according to the Antioch Herald. Other cities with various types of restrictions of menthol include Berkley, Hayward and Sonoma, Calif., said the East Bay Times.
  • Considering Flavor Bans. Contra Costa County in California will consider outlawing the sale of flavored tobacco to youth at either its July 11 or July 18 meeting, according to the Antioch Herald. Meanwhile, the city of San Leandro postponed a decision until September on a more encompassing tobacco ordinance that included a flavor ban, the East Bay Times said.

At a public rally in April, Orlando lawmakers stood in solidarity with legislators in San Francisco to ban menthol cigarettes, but according to the San Francisco Examiner, Orlando is still considering its own proposal on the matter.

One of the latest cities to consider an ordinance is Minneapolis, with councilmen introducing legislation June 16 that would include menthol in its current tobacco-flavor ban.

House summons Imee Marcos to tobacco fund hearing

If she fails to attend the July 25 hearing, then the Ilocos Norte governor will be arrested by the House, where her accuser Rodolfo Fariñas is majority leader

http://www.rappler.com/nation/174196-house-subpoena-imee-marcos-ilocos-norte-tobacco-funds-probe

MANILA, Philippines – The House of Representatives has issued a subpoena for Ilocos Norte Governor Imee Marcos to appear at the July 25 hearing on the alleged misuse of P66.45 million worth of provincial tobacco funds.

The subpoena was signed by Speaker Pantaleon Alvarez, House committee on good government and public accountability committee chairperson Johnny Pimentel, and House Secretary-General Cesar Pareja on Tuesday, June 27. A copy of the document was given to reporters on Wednesday, June 28.

Capture

Marcos is allowed to bring a lawyer to assist her in answering the lawmakers’ questions. Should she refuse to be assisted by a legal counsel, the governor must issue a waiver.

She must also give the House a copy of a written statement she plans to read as testimony two days ahead of the hearing. Marcos may also request for a conference with any member of the House good government and public accountability panel.

If Marcos fails to show up on July 25, the committee will cite her in contempt and move to detain her in the House. Her detention room is already being prepared.

The House is investigating the province’s tobacco funds after Ilocos Norte 1st District Representative Rodolfo Fariñas, the House Majority Leader and former Ilocos Norte governor, uncovered various documents indicating the money was used to purchase 40 mini-cabs, 5 secondhand buses, and 70 Foton mini trucks.

Under Republic Act Number 7171, 15% of tobacco excise taxes shall be allotted for a special support fund for tobacco farmers in the identified provinces, mostly in the Ilocos region. The money, however, should only be used for cooperative, livelihood, agro-industrial, and infrastructure projects.

Marcos has ignored previous invitations to appear in the hearings, only sending a letter to the committee maintaining the purchases were aboveboard and benefitted farmers.

Rappler, however, discovered documents showing Ilocos Norte’s tobacco funds go to Marcos’ pet projects.

The House is preparing her detention room after she said her brother, former senator Ferdinand “Bongbong” Marcos Jr, had advised her against testifying before lawmakers.

Six Ilocos Norte officials have been detained for giving “dismissive” answers during the hearings. The Court of Appeals had ordered their provisional release, but this was ignored by the House leadership.

This prompted the Ilocos Norte Provincial Board to declare Fariñas persona non grata. Fariñas, in turn, plans to sue the officials for voting in favor of the resolution against him. – Rappler.com

Alex Calls Out Government on Another Tobacco Control Plan Delay

The Government are making no progress on creating and publishing the Tobacco Control Plan and every delay is putting more lives at risk, argued Stockton North MP Alex Cunningham today.

Last week Alex used the parliamentary tool of submitting a written question to the Secretary of State for Health regarding the long-awaited tobacco control plan, and today received a response from a Health Minister simply saying that the Government are “developing the Tobacco Control Plan which will be published shortly”.

The Member of Parliament for Stockton North argued that this is just another delay in a long succession regarding the plan, which was announced in December 2015 to be published the following year. Since 2016, a number of MPs have added their voices alongside Alex to continue probing the Government on when they will release the plan.

The Tobacco Control Plan, when eventually published, will set out what must be done to identify and develop new measures for reducing smoking and smoking harm.

Speaking on the matter, Alex said:

“I know that the previous Government wasn’t known for its efficiency, but a near 18-month delay on the publication of an extremely important plan is beyond inefficient now.

“There are a significant number of organisations, charities, health workers, and patients that are waiting for this plan. We can’t sit around and allow more people to die from cancer and other smoking-related diseases whilst the Government ponders around making dodgy DUP deals to stay in Downing Street, and key parts of our health strategy are being pushed to the sidelines.”

Is Vaping As Harmful As Smoking Cigarettes? Here’s What You Need To Know

Vaping seems to have taken the mantle of becoming the healthier alternative to smoking, along with the fact that they were designed with the motive to help smokers eventually quit.

http://www.indiatimes.com/health/healthyliving/is-vaping-as-harmful-as-smoking-cigarettes-here-s-what-you-need-to-know-324703.html

In fact, the trend has caught on so rampantly that it’s set to outsell traditional cigarettes by the end of 2023!

With the FDA regulating these products since 2016, it comes as no surprise that vaping is due to become the norm, surpassing traditional smoking in time to come.

In a report on the use of e-cigarettes in Canada, a report previously stated that “Among those whose primary reason for use is to help to quit tobacco, a similar proportion no longer smoke (24%), and this may be considered the success rate for this method of smoking cessation.”

How is vaping different from smoking?

To differentiate itself from tobacco products, vaping is the process of smoking nicotine without inhaling the other harmful substances in tobacco—out of which there 70 known carcinogens. Some products contain little to no nicotine in them. Canada for instance still does not approve of nicotine-containing e-cigarettes.

These battery-powered devices heat the liquid that contains nicotine and/or other flavours, which in turn is inhaled as the vapour.

There is no smoke without fire, however

Since the key objective of switching to e-cigarettes is to cut down the number of cigarettes you smoke, researchers have been assessing the ‘relative harm’ vaping can cause to your tissues.

A study conducted by Jessica Wang-Rodriguez, a head and neck cancer specialist at the University of California at San Diego and her team found that cells lining human organs sustained up to twice the DNA damage seen in unexposed cells. They were also five to 10 times more likely to wither and die than unexposed cells even if the vapour contained no nicotine, the addictive ingredient in conventional and most electronic cigarettes, as reported in New Scientist.

“Without the nicotine, the damage is slightly less, but still statistically significant compared with control cells,” says Wang-Rodriguez, who led the research.

The toxins from the flavouring are another cause of concern

“E-cigarette vapour is known to contain a range of toxins which include impurities in the e-cigarette liquids and toxins generated when solutions are heated to generate vapour,” says John Britton, a toxicologist at the University of Nottingham, UK. “Some are carcinogenic, so it’s likely some long-term users of e-cigarettes will experience adverse effects on their health, and the authors fo the study conducted by Rodriguez and company are correct to point out that these products should not be considered risk-free,” he says. But if smokers can’t give up completely, e-cigarettes are safer than smoking, he says, as reported in New Scientist.

They caused considerable damage to your key blood vessels; similar to normal cigarettes

A study conducted by researchers at the European Society of Cardiology Congress in Rome states that vaping has an impact similar to the what normal cigarettes have on the stiffening of you heart’s aorta, as reported the Independent, UK.

The lead researcher, Professor Charalambos Viachopoulos of the University of Athens said, “We measured aortic stiffness. If the aorta is stiff you multiply your risk of dying, either from heart diseases or from other causes. “There could be long-term heart dangers. They are far more dangerous than people realise.”

The problem lies with the rising number of teens taking to smoking E-cigarettes

A 2014 high school survey conducted in the US found that 17 percent of 12th graders reported the use of e-cigarettes compared to 14 percent who smoked traditional cigarettes. The lower price points at which they are promoted, their perception of being safer than traditional cigarettes, the various flavours they come in and the fact they’re in trend make it a very attractive option for the youth.

Adolescents and young adults who try e-cigarettes are more than three times as likely to take up smoking traditional cigarettes as their peers who haven’t tried the devices, states a recent research review published in Reuters Health.

E-cigarette use, or vaping, was as least as strong a risk factor for smoking traditional cigarettes as having a parent or sibling who smokes or having a risk-taking and thrill-seeking personality, the researchers found.

“E-cigarette use among teens and young adults could increase the future burden of tobacco by creating a new generation of adult smokers who might have otherwise not begun smoking,” said lead study author Samir Soneji of the Dartmouth Institute for Health Policy and Clinical Practice in New Hampshire.

“To the extent that e-cigarette use mimics the behaviour of smoking a cigarette—handling the e-cigarette, the action of puffing, and the inhalation of smoke—it sets the adolescent up for easily transitioning to smoking,” added Soneji. “Like transitioning from driving a Tesla to driving a Chevy.”

Dr Brian Primack, a researcher at the University of Pittsburgh stated that “Young people report that there is a lot of pressure among e-cigarette only users to smoke a ‘real’ cigarette,” Primack said by email. “It may be somewhat analogous to the fact that teens who use flavoured alcohol are often pressured socially to step up their game to harder forms of alcohol.”

Although e-cigarettes claim to be less harmful than conventional cigarettes it could make sense to pay heed to the lack of conclusive long-term evidence

Cigarette smokers are well aware of the perils of smoking normal cigarettes. The New England Journal of Medicine states that smoking tobacco reduces your life span by at least 10 years. But studies on smoking e-cigarettes remain largely inconclusive.

A review of studies published in the journal Tobacco Control reveals that the long-term effects of the vaporised form are not known yet. For instance, it is not known if the chemical propylene glycol, which is mixed with the other chemicals in e-cigarettes known to irritate the respiratory tract, could result in lung problems after decades of vaping, says Dr Michael Siegel, a tobacco researcher and professor of community health sciences at the Boston University School of Public Health in Live Science.

Besides, “because e-cigarettes have been on the market for only about 10 years, there have been no long-term studies of people who have used them for 30 to 40 years. Therefore, the full extent of e-cigs’ effects on heart and lung health, as well as their cancer-causing potential, over time is not known,” says Stanton Glantz a professor of medicine and the director of the Center for Tobacco Control Research and Education at the University of California, San Francisco to Live Science.

 

Vaping teens more likely to take up regular cigarettes

Adolescents and young adults who try e-cigarettes are more than three times as likely to take up smoking traditional cigarettes as their peers who haven’t tried the devices, a research review suggests.

https://uk.reuters.com/article/us-health-teens-vaping-idUKKBN19H292

E-cigarette use, or vaping, was as least as strong a risk factor for smoking traditional cigarettes as having a parent or sibling who smokes or having a risk-taking and thrill-seeking personality, researchers found.

“E-cigarette use among teens and young adults could increase the future burden of tobacco by creating a new generation of adult smokers who might have otherwise not begun smoking,” said lead study author Samir Soneji of the Dartmouth Institute for Health Policy and Clinical Practice in New Hampshire.

Big tobacco companies, including Altria Group Inc, Lorillard Tobacco Co and Reynolds American Inc, are all developing e-cigarettes. The battery-powered devices feature a glowing tip and a heating element that turns liquid nicotine and other flavorings into a cloud of vapor that users inhale.

Soneji and colleagues analyzed data from nine smaller studies with a total of 17,389 participants ages 14 to 30.

They didn’t examine why many teens and young adults transitioned from vaping to smoking traditional cigarettes, but both options contain nicotine, an addictive drug, Soneji said by email.

The habit of vaping may also make the transition to smoking seem more natural, and teens in particular may gravitate toward friends who smoke once they try vaping, Soneji said.

“To the extent that e-cigarette use mimics the behavior of smoking a cigarette – handling the e-cigarette, the action of puffing, and the inhalation of smoke – it sets the adolescent up for easily transitioning to smoking,” Soneji said. “Like transitioning from driving a Tesla to driving a Chevy.”

Seven studies looked at smoking initiation among more than 8,000 youngsters who had never smoked before. Data pooled from these studies showed that roughly 30 percent of e-cigarette users became smokers, compared with only about 8 percent of people who hadn’t tried vaping. That translates into 3.6 times higher odds of smoking for people who have tried e-cigarettes, researchers report in JAMA Pediatrics.

One limitation of the study is that it included some results from earlier studies with a high drop-out rate, and it’s not clear whether people who left these studies were different from participants who remained in ways that would make them more or less likely to smoke, the authors note. Researchers also lacked data on the type of e-cigarettes used, and they only looked at U.S. studies.

Even so, by pooling data from several smaller studies, the results offer stronger evidence that vaping can encourage young people to progress to smoking, said William Shadel, a researcher at RAND Corporation in Pittsburgh who wasn’t involved in the current study.

“The results are particularly compelling because the studies took into account other variables that put kids at risk of cigarette smoking, like alcohol use and peer cigarette smoking,” Shadel said by email. “These results should help to strengthen arguments for regulatory action that limits young people’s access to e-cigarettes.”

Enticing flavors of liquid nicotine used in e-cigarettes, like strawberry or chocolate, may make vaping appealing to some young people who might not like the taste of traditional cigarettes, said Dr. Brian Primack, a researcher at the University of Pittsburgh who wasn’t involved in the study. Peer pressure may then encourage them to graduate to smoking.

“Young people report that there is a lot of pressure among e-cigarette only users to smoke a ‘real’ cigarette,” Primack said by email. “It may be somewhat analogous to the fact that teens who use flavored alcohol are often pressured socially to step up their game to harder forms of alcohol.”

There’s one clear way for young people to avoid this.

“The biggest thing that people can do is never start using them in the first place,” Primack said.

More than 100 pets were poisoned by e-cigarettes in Britain last year

Vaping might be a lot better for pet owners than smoking cigarettes – but the gadgets pose a risk to pets, a new report found.

http://metro.co.uk/2017/06/26/more-than-100-pets-were-poisoned-by-e-cigarettes-in-britain-last-year-6734735/

Vets say that a ‘large increase’ in the number of pets being poisoned by e-cigarettes, according to figures from the Veterinary Poisons Information Service (VPIS).

Last year, 113 pets were poisoned by e-cigarettes in the UK.

The VPIS says, ‘A typical ‘natural’ cigarette could yield, at most, 30mg of nicotine (most have less).

‘E-cigarettes and their refills contain large doses of nicotine (up to 36mg per ml). How well absorbed or how ‘available’ this is for oral or mucosal absorption is not known, but it is reasonable to take any exposure seriously.

‘Ingestion of refill bottles/vials may present a particular hazard as the nicotine may leak over a period of time or may suddenly be released after a variable period in the gut.’

 

Himachal govt bars its officials from participating in tobacco industry’s activities

The circular has been issued recently in view of the fact that different government departments end up taking sponsorship from tobacco industries, knowingly or unknowingly.

http://www.hindustantimes.com/india-news/himachal-govt-bars-its-officials-from-participating-in-tobacco-industry-s-activities/story-4YLg9v87SRBtgk0Rw5411I.html

Himachal Pradesh government has issued a circular barring its officials from participating in any activity related to tobacco industry.

“All the heads of departments in Himachal Pradesh are instructed not to participate in any event organised by tobacco industry and also not to accept any kind of direct or indirect sponsorship or funding from corporate engaged in tobacco business,” the circular read.

The circular has been issued recently in view of the fact that different government departments end up taking sponsorship from tobacco industries, knowingly or unknowingly.

“Sponsorship from tobacco companies will weaken our tirade against tobacco, in which, Himachal is doing really well,” director health safety and regulation department Raman Kumar Sharma said.

Sharma said there are some events organised by tobacco companies where doctors are invited as technical experts. “Head of departments should refrain from participating in such events. It is equal to endorsing their products,” he added.

The directions have been issued in view of the implementation of The Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply, and Distribution) or COTPA Act, 2003.

“Under the act, the direct and indirect advertisement of tobacco product is prohibited. But some tobacco giants sponsor government programme, which is a kind of endorsement of their activities,” health activist Ramesh Badrel said.

Investing in tobacco firms not banned, LIC tells Bombay HC

Mumbai city news: LIC was replying to a public interest litigation objecting to public sector insurance companies investing in firms manufacturing tobacco products

http://www.hindustantimes.com/mumbai-news/investing-in-tobacco-firms-not-banned-lic-tells-bombay-hc/story-ceFSeRSF8q5YNeiRTPRfKL.html

Investing in tobacco companies indirectly is neither prohibited nor banned by any authority, the Life Insurance Corporation of India (LIC) said in an affidavit filed in the Bombay high court.

LIC was replying to a public interest litigation objecting to public sector insurance companies investing in firms manufacturing tobacco products.

“Secondary investment in tobacco companies is neither prohibited nor banned by any authority,” says the affidavit filed by Vikas Chaturvedi, assistant secretary (investment operations) of LIC. “LIC is a corporate body and must function on business principles as far as possible. Ninety-five per cent of its surplus goes to policy vendors,” added the affidavit.

It added that the investment was in accordance with the provisions of the LIC Act, the Insurance Act and guidelines laid down by the Insurance Regulatory and Development Authority, and other prevailing rules and regulations. “LIC looked at several companies with a good track record for investment options,” said the affidavit, adding, “ITC is one such company.”

The affidavit was filed in response to a PIL by anti-tobacco activist Sumitra Pednekar and doctors attached to Tata Memorial Hospital. Meanwhile, the court allowed Karnataka state branch of Indian Medical Association to assist it by listing the ill-effects of tobacco.