Clear The Air News Tobacco Blog Rotating Header Image

World No Tobacco Day: Smoking robs your wallet, health – Cansa

On May 31 the world celebrates #WorldNoTobaccoDay.

Smoking-Infographic-2

Tobacco use is a threat to any person, regardless of gender, age, and race, cultural or educational background that causes over 18 types of cancer, and accounts for over 20 per cent of cancer deaths worldwide.

This is according to the Cancer Association of South Africa (Cansa) which advocates stopping the use of any and all tobacco products.

According to Cansa, tobacco can be found in many forms, and all tobacco use is harmful.

“People only think of cigarette smoking when you talk about tobacco, but it goes beyond that. They need to be aware that hubbly bubbly and e-cigarettes are just as harmful to your health and the health of those around you.

“It’s not just the smoker who has increased risk of disease, but also people exposed to second-hand smoke,” says Cansa health specialist, Prof Michael Herbst.

According to Dr Oleg Chestnov, World Health Organisation’s (WHO) Assistant Director-General for Non-communicable Diseases (NCDs) and Mental Health, on top of the health implications, tobacco products are getting more expensive and are creating a huge negative impact on the economy.

“The tobacco industry produces and markets products that kill millions of people prematurely, rob households of finances that could have been used for food and education, and impose immense healthcare costs on families, communities and countries,” said Chestnov.

Herbst said: “There is so much more you can do with an average R30 a day, instead of buying a pack of cigarettes.

“Have you thought about that? Giving up smoking one pack a day, will free up close to R1000 a month, which can be used in better ways than harming your health, and the health of those around you. The financial impact is huge.”

He said hookah, or hubbly bubbly use is especially concerning among the youth.

“The tobacco is no less toxic in a hookah pipe and the water in the hookah does not filter out the toxic ingredients in the tobacco smoke. Hookah smokers may actually inhale more tobacco smoke than cigarette smokers do, because of the large volume of smoke they inhale in one smoking session.

“In South Africa, hubbly and their related tobacco products, fall under the definition of ‘tobacco product’ as indicated in the Tobacco Products Control Amendment Act (2007). This means that its use and sale have to comply with the regulations that apply to a tobacco product in the country.

“This includes the prohibition of the sale of hookahs and their products to anyone under the age of eighteen.

“Electronic cigarettes and similar devices are frequently marketed as aids to quit smoking, or as healthier alternatives to tobacco. This has not been proven, and e-cigarettes are not a better alternative to cigarettes.

“They still contain harmful chemicals, and it’s rather recommended to quit smoking by proven treatments. CANSA has a e-Kick Butt programme, which assists with quitting smoking (www.ekickbutt.org.za),” continued Herbst.

Cansa in a statement said it has played a significant role in contributing to tobacco control legislation in South Africa.

The organisation insist every one should be able to breathe tobacco-smoke-free air.

Offenses can be reported here: http://www.cansa.org.za/take-action-against-those-who-break-the-law/

According to Cansa:

Legislation is very clear about where people may smoke and where smoking is prohibited
It’s your right to complain when someone smokes in your presence
It’s also your right to take remedial steps if someone smokes in any area where smoking is prohibited
Adults may not smoke in a car when a passenger under 12 years is present
Smoking is not allowed in premises (including private homes) used for commercial childcare activities, such as crèches, or for schooling or tutoring
No person under 18 may be allowed into a designated smoking area
No smoking in partially enclosed public places such as balconies, covered patios, verandas, walkways, parking areas, etc.
The fine for the owner of a restaurant, pub, bar and workplace that breaks the smoking law is a maximum of R50 000 and for the individual smoker R500
The tobacco industry can no longer use ‘viral’ marketing like parties to target young people
The sale of tobacco products to and by persons under the age of 18 years is prohibited
Cigarette vending machines that sell tobacco products cannot be used to sell other products like crisps, chocolates etc.
For more info visit www.cansa.org.za or contact Cansa toll-free 0800226622 or at info@cansa.org.za as email address. Follow CANSA on Twitter: @CANSA (http://www.twitter.com/@CANSA) and join CANSA on Facebook: CANSAThe Cancer Association of South Africa and follow CANSA on Instagram: @cancerassociationofsouthafrica

The Hole Story: Ventilated Filters Make Smoking More Deadly

The ventilation systems built into cigarette filters in the mid-1960s to reduce tar and make smoking ‘smoother’ and ‘safer’ were responsible for the paradoxical rise in rates of lung adenocarcinoma — even as rates of other lung cancer subtypes dropped along with the number of smokers. These conclusions were in the 2014 US Surgeon General’s report on the health consequences of smoking.

http://www.medscape.com/viewarticle/880383

Now, two new weight-of-evidence reviews have pinpointed 25 “causation analysis evidence blocks” that could support an outright ban of filter ventilation, according to lead author, Peter G. Shields, MD, deputy director of the Comprehensive Cancer Center, the Ohio State University Wexner Medical Center, in Columbus, and colleagues.

The review found that between the 1960s and the 1980s, the health risks associated with smoking jumped almost 2-fold in men and increased 10-fold in female smokers. At the same time, the relative risks for adenocarcinomas rocketed from 4.6 to 19.0 in men and from 1.5 to 8.1 in women — even though the risks for other lung cancer subtypes didn’t increase. “Thus, there was a paradoxical increase for lung adenocarcinomas while squamous cell cancers decreased with decreased smoking rates,” the review authors write.

“The analysis strongly suggests that filter ventilation has contributed to the rise in lung adenocarcinomas among smokers,” they say in a report published online May 22 in the Journal of the National Cancer Institute.

“Based on these weight-of-evidence reviews, the FDA [Food and Drug Administration] should embark on a regulatory process of data evaluation and consider regulation(s) for the use of ventilation in filters, up to and including a ban on their use,” the authors conclude.

“The prime point is to rally the troops to get the FDA to focus on this,” Dr Shields told Medscape Medical News. “To me, this is a policy paper. Physicians can’t be silent.”

This is a policy paper. Physicians can’t be silent. Peter D. Shields

Ventilation holes in filters are now found in nearly every brand of cigarettes, and they make smoking even more deadly, Dr Shields elaborated in an interview.

The tiny filter holes slow down tobacco combustion, giving smokers more puffs per cigarette but also allowing more toxic constituents to form, increasing the mutagenicity of the smoke, the review authors explain. To get the requisite nicotine hit from a cigarette with a ventilated filter, a smoker must also inhale more deeply, drawing smoke farther into the lungs and exposing cells vulnerable to adenocarcinoma.

Increasing amounts of tobacco-specific nitrosamines can also be found in new blended tobaccos that provide a “smoother” smoking experience, albeit with more carcinogens, Dr Shields commented. This makes smoking more dangerous than ever before, and patients need to know this, he emphasized.

“As part of your risk counseling, tell patients who smoke that the cigarettes today are more deadly than the cigarettes from 30 or 40 years ago. We need to take away smokers’ perception that any cigarette is safe. It’s like putting your head in a chimney,” Dr Shields said.

Increased Risk for Adenocarcinoma

In an accompanying editorial, Jonathan M. Samet, MD, and Lilit Aladadyan, MS, MPH, say that ending filter ventilation “could be a ‘no regrets’ action that would benefit public health.”

Dr Samet is professor and Flora L. Thornton Chair for the Department of Preventive Medicine at the Keck School of Medicine at the University of Southern California (USC) in Los Angeles, and Aladadyan is center director for the USC Tobacco Center of Regulatory Science.

The editorialists note the review looked at a “large and somewhat poorly circumscribed body of literature” and that the evidentiary threshold required for the FDA to take action is not supported by any record of precedents.

However, they also say that the review’s conclusion about the contribution of filter ventilation to rising rates of lung adenocarcinoma in smokers “is well justified” and supports “the indictment of filter ventilation as increasing risk for adenocarcinoma.”

Filter ventilation was originally designed to lower smoking machine tar yields in so-called light cigarettes marketed primarily to women as a “healthier” alternative to regular cigarettes. “This was done to fool smokers and the public health community into thinking that they actually were safer,” Dr Shields said in a statement.

In 2009, the Family Smoking Prevention and Tobacco Control Act gave the FDA authority to ban tobacco companies from labeling and marketing cigarettes as “low tar” or “light.”

Dr Shields has served as an expert in class action suits against tobacco companies marketing light cigarettes as a healthier alternative. He’s also heard lawyers for Big Tobacco say peer-reviewed evidence was needed. “From our perspective, there is more than enough data to start the process and it’s time for regulation,” he said. “We believe that such an action would drive down the use and toxicity of conventional cigarettes and drive smokers to either quit or use less harmful products. There are some open questions about unintended consequences for enacting a ban, which provides for an important research agenda.”

Future clinical trials could assess smokers switching to filtered cigarettes without ventilation, using a panel of biomarkers to measure exposure to carcinogens and lung toxicants, markers of oxidative damage and inflammation in lung, blood, or/and urine, the review authors suggest. At present, human exposure biomarker studies do not appear to support a causal relationship, they didn’t measure exposure in the lung or “utilize known biomarkers of harm,” they note.

Smokers’ perceptions, and transition to alternate products, should also be assessed, looking at differences by race and ethnicity, sex, age, and vulnerable populations. The effect of filter ventilation on the risk for other diseases, such as chronic obstructive pulmonary disease, could also be studied, they say.

This study was supported by the National Cancer Institute of the National Institutes of Health and the FDA Center for Tobacco Products. Dr Shields and coauthors Neal L. Benowitz, MD, and Theodore M. Brasky, PhD, disclose they have served as consultants and expert witnesses in litigation against tobacco companies. Coauthor K. Michael Cummings, PhD, MPH, declares a relationship with Pfizer Inc. The study authors and editorialists have disclosed no relevant financial relationships.

Cigarette Filter Ventilation and its Relationship to Increasing Rates of Lung Adenocarcinoma

https://academic.oup.com/jnci/article-abstract/109/12/djx075/3836090/Cigarette-Filter-Ventilation-and-its-Relationship?redirectedFrom=fulltext

The 2014 Surgeon General’s Report on smoking and health concluded that changing cigarette designs have caused an increase in lung adenocarcinomas, implicating cigarette filter ventilation that lowers smoking machine tar yields. The Food and Drug Administration (FDA) now has the authority to regulate cigarette design if doing so would improve public health. To support a potential regulatory action, two weight-of-evidence reviews were applied for causally relating filter ventilation to lung adenocarcinoma. Published scientific literature (3284 citations) and internal tobacco company documents contributed to causation analysis evidence blocks and the identification of research gaps. Filter ventilation was adopted in the mid-1960s and was initially equated with making a cigarette safer. Since then, lung adenocarcinoma rates paradoxically increased relative to other lung cancer subtypes. Filter ventilation 1) alters tobacco combustion, increasing smoke toxicants; 2) allows for elasticity of use so that smokers inhale more smoke to maintain their nicotine intake; and 3) causes a false perception of lower health risk from “lighter” smoke. Seemingly not supportive of a causal relationship is that human exposure biomarker studies indicate no reduction in exposure, but these do not measure exposure in the lung or utilize known biomarkers of harm. Altered puffing and inhalation may make smoke available to lung cells prone to adenocarcinomas. The analysis strongly suggests that filter ventilation has contributed to the rise in lung adenocarcinomas among smokers. Thus, the FDA should consider regulating its use, up to and including a ban. Herein, we propose a research agenda to support such an effort.

Brands Test Limits as UK Introduces Plain Tobacco Packaging

The UK is now the second country in the world and the first in Europe to require cigarettes to be sold in plain, standardized packaging, following the lead of Australia, which implemented the first such measure in December 2012.

http://brandchannel.com/2017/05/22/uk-tobacco-plain-packaging-052217/

In May 2016, new EU legislation dictated how tobacco products are manufactured, produced and sold across Europe. The revised rules, called the Tobacco Products Directive, banned certain products from sale such as flavored cigarettes (except menthol). Retailers were given 12 months, until May 20th, to sell old products and comply with the new laws, or face stiff fines or criminal prosecution.

In tandem with the new EU rules taking effect, the UK government’s plain packaging legislation came into force, introducing standardized packaging of tobacco products to limit the impact of logos, colors, brand images or promotional information on packaging other than brand names and product names that are displayed in a standard colour and typeface.

Standardised packaging design, including; shape, size, material and opening mechanisms. The UK’s Standardised Packaging Regulations aim to unify (and not make stand out) the material, size, shape and opening mechanisms of tobacco packaging; create a drab, off-putting color (a sickly brownish green) of tobacco packaging, as well as standarized font, size and positioning of text.

No glossy finishes to catch the light now; the tobacco packs come with a matt finish. Prices aren’t printed on the packaging, but health care warnings have increased in size with graphic images depicting the adverse health impact of smoking. Text is only in Helvetica font, with no logo or typeface of a brand name or variety name permitted.

Failure to comply with retailer guidelines for selling e-cigarettes and tobacco products may result in a three month custodial sentence, a fine, or both, following a summary conviction.

Health groups have welcomed the measure and are hopeful as new smoker numbers continue to decline in the UK with about 17% of the UK adult population currently smokers. Smoking advocates decry the move as an anti-choice effort by a nanny state that “infantilise” consumers and will make no difference to public health. Smokers’ rights group Forest also told the BBC that the new rules “treat adults like naughty children.”

No matter: they’re stuck with the compulsory standardised packaging with larger, health warnings on two-thirds of the front and back of any packet is “the ugliest colour in the world.”

Hazel Cheeseman, a member of ASH (Action on Smoking and Health), told the BBC that the packaging itself has been shown to be a “form of advertising” that cigarette companies call “their silent salesman. Branding and advertising is one of the things that helps to recruit young people into smoking. So removing the branding features, making the health warnings bigger and more prominent, is intended to protect young people from taking up smoking in the future.”

Two-thirds of smokers start before age 18, according to Cancer Research UK, so the organization supports removing branding from cigarette packs in order to reduce their attractiveness to children. Research has shown that young people are attracted to the color and design of cigarette packs.

Scotland was the first country in the UK to support plain packaging for tobacco products in a change that could lead to 300,000 fewer smokers in the UK over the next year.

Testing the legislation, Marlboro-maker Philip Morris introduced durable tins that look like ordinary cigarette packets. The tins, available at chains including Sainsbury’s, Londis and Budgens, sport Marlboro’s logo and distinctive branding, the required deterrent photos and the warning message, “Smoking kills.” No chance they’d get away with that, the Guardian reports.

“Research shows that packs of 10 appeal to young people and the price conscious,” said Karen Reeves-Evans, of the Tobacco Control Research Group at the University of Bath. “By offering packs of 10 in reusable tins, Philip Morris International is knowingly increasing the lifespan of packs of 10 and promoting its brand, if smokers decant their cigarettes into these small branded tins. The fact that these tins appeared almost immediately prior to the branding and size restrictions coming into force is suspicious.”

Alex Cunningham, Labour MP for Stockton North added, “It’s against the whole spirit of what’s intended with the plain packaging legislation. The tobacco companies will stop at nothing in order to retain their branding and sell a product that everyone knows has such tremendous health risks. It’s an immature trick and I hope people will soon put them into their bins and they’ll find their way to the recycling centre.”

Philip Morris rival JTI Gallaher also issued aluminum tins for its Benson & Hedges, Mayfair and Camel brands in the run-up to the plain packaging laws, described by Ireland’s former health minister James Reilly as “extremely cynical.”

As tobacco brands and activists balk at the changes, Alison Cox, Cancer Research UK’s director of prevention, told the Guardian that “Today marks a momentous victory in the battle for a tobacco free future. Standardised packs will help protect the next generation from an addiction that kills around half of all regular smokers.”

How e-cigarette ads might sway teens to try tobacco products

When non-smoking teens see ads for e-cigarettes, and are curious about the products advertised, perhaps even identifying with a favorite brand, they might also be more susceptible to taking up cigarettes, a new study finds.

http://www.businessinsider.com/r-how-e-cigarette-ads-might-sway-teens-to-try-tobacco-products-2017-5?IR=T

For the study, researchers showed a nationally representative sample of 10,751 U.S. teens advertisements for a wide variety of tobacco products including traditional cigarettes, cigars, chewing tobacco and e-cigarettes. Overall, the teens were more receptive to ads for e-cigarettes than other products and television ads were most likely to prompt brand recall.

“The imagery used by tobacco companies focuses on the aspirations of young people including having fun, being independent, sophisticated, socially accepted, popular, etc.,” said lead study author John Pierce of the University of California, San Diego.

“Those who have an emotive response to these aspirational images are more likely to see use of the product as a way to achieve their aspirations,” Pierce said by email. “It is hypothesized that in adolescents who are committed never smokers, recall of tobacco product advertising will be associated with first movement toward product use within a one-year time frame.”

Big U.S. tobacco companies are all developing e-cigarettes, battery-powered gadgets with a heating element that turns liquid nicotine and flavorings into a cloud of vapor that users inhale.

For the past decade, public health experts have debated whether the devices might help with smoking cessation or at least be a safer alternative to smoking traditional combustible cigarettes, or whether they might lure a new generation into nicotine addiction.

Fewer teens smoke today than a generation ago, but declines in traditional cigarette use have stalled and e-cigarettes have become increasingly popular in recent years. As of 2015, an estimated 16 percent of U.S. high school students used e-cigarettes, compared with about 9 percent for traditional cigarettes, according to the U.S. Centers for Disease Control and Prevention.

While television ads for traditional cigarettes have been illegal in the U.S. for decades, e-cigarette ads are currently allowed on TV, researchers note in Pediatrics.

In the study, Pierce and his colleagues examined how receptive or curious non-smoking teens were about different tobacco products and whether they had a favorite image or advertisement. They also looked at how susceptible the adolescents might be to trying tobacco products based on their ability to recall specific brands they saw in the ads.

The researchers showed each study participant a random selection of five ads each for cigarettes, e-cigarettes smokeless tobacco and cigars based on 959 different promotions that had recently been used to advertise these products.

Overall, 41 percent of the younger teens in the study and half of older adolescents were receptive to at least one tobacco advertisement, the study found.

Across each age group, teens were most receptive to ads for e-cigarettes, followed by traditional cigarettes and smokeless tobacco.

E-cigarette ads shown on television had the highest recall.

Compared to teens in the study who were not at all receptive to the ads, youth who had the highest level of engagement with the promotions were more than six times more likely to be susceptible to trying tobacco products, the study found.

The study isn’t a controlled experiment designed to prove whether or how ads may directly influence tobacco use.

Another limitation is that researchers didn’t have data to show whether or not teens actually used tobacco products after viewing these ads, the authors note.

Even so, the findings suggest that non-cigarette ads for tobacco-related products may be damaging for adolescent health, Rebecca Collins of Rand Corporation in Santa Monica, California, writes in an accompanying editorial.

“This study provides some very provocative data suggesting that the marketing of e-cigarettes, which is not regulated, might be leading to cigarette smoking among teens,” Collins said by email.

Appeals Court Deals Blow To Tobacco Companies

More than a decade after the Florida Supreme Court opened the floodgates for lawsuits against tobacco companies, an Atlanta-based appeals court this week rejected arguments that could have helped shield cigarette makers in legal battles about smoking-related illnesses and deaths.

http://wlrn.org/post/appeals-court-deals-blow-tobacco-companies-0

The full 11th U.S. Circuit Court of Appeals ruled against R.J. Reynolds Tobacco Co. and Philip Morris USA, Inc., which contended that federal law trumps certain claims. The appeals court also rejected the companies’ arguments of due-process violations.

The case largely stems from a 2006 Florida Supreme Court ruling that established findings about a series of issues including the dangers of smoking and misrepresentation by cigarette makers. The ruling helped spawn thousands of lawsuits in state and federal courts, with plaintiffs able to use the findings against tobacco companies — lawsuits that have become known as “Engle progeny” cases.

The appeals-court decision Thursday came in an Engle progeny case tried in federal court in Jacksonville. The case was filed by the family of Faye Graham, who died after smoking for 41 years and developing chronic obstructive pulmonary disease and lung cancer, according to a brief in the case.

A jury ruled against R.J. Reynolds and Philip Morris on issues of strict liability and negligence. It also found Graham partially at fault, with a judge ultimately deciding that R.J. Reynolds should pay $550,000 in damages and Philip Morris should pay $275,000.

In the appeal, the tobacco companies argued, in part, that federal laws regulate cigarettes and, as a result, should prevent claims of strict liability and negligence based on the Engle findings — a legal concept known as federal preemption.

“The strict-liability and negligence claims in this case do not rest on any alleged defect specific to the cigarettes smoked by Mrs. Graham. Instead … they rest on the inherent riskiness of all cigarettes,” attorneys for the tobacco companies argued in a 2014 brief. “The claims here thus seek to enforce a legal duty, grounded in Florida tort law, to refrain from selling ordinary cigarettes. Because such a duty squarely conflicts with federal law, the claims here are preempted.”

But Thursday’s majority ruling, written by appeals-court Judge William Pryor, rejected such contentions, writing that “federal tobacco laws do not preempt state tort claims based on the dangerousness of all the cigarettes manufactured by the tobacco companies.”

“Florida may employ its police power to regulate cigarette sales and to impose tort liability on cigarette manufacturers,” Pryor wrote in the 43-page opinion.

The majority also rejected to the tobacco companies’ arguments that due-process rights had been violated in using the Engle findings in the Graham case.

But appeals-court Judge Gerald Tjoflat wrote an encyclopedic 226-page dissent on the preemption and due-process issues. As an example, in addressing the preemption issue, he wrote that judges “cannot give effect to the Florida Supreme Court’s decisions in a manner that operates as a ban on the sale of cigarettes without elevating state law over federal law.”

“I merely conclude that, having surveyed both federal and state law, it is clear that Congress would have intended to preempt Graham’s strict-liability and negligence claims, rooted as they are in a broadly applicable state law set forth by the Florida Supreme Court that deems all cigarettes defective, unreasonably dangerous, and negligently produced,” Tjoflat wrote.

Doctor honoured for fight against tobacco

Cancer specialist U.S. Vishal Rao of Bengaluru has been honoured with the 2017 Judy Wilkenfeld Award for International Tobacco Control Excellence for his role in combating tobacco use. Dr. Rao was presented the award on Wednesday at an event organised by the Campaign for Tobacco-Free Kids in Washington D.C.

http://www.thehindu.com/todays-paper/tp-national/tp-karnataka/doctor-honoured-for-fight-against-tobacco/article18443143.ece

His efforts led to a ban on gutka, chewing tobacco and e-cigarettes in Karnataka. However, the State government recently overturned the ban on chewing tobacco.

Dr. Rao is a member of the High-power Committee on Tobacco Control instituted by the government of Karnataka. He is the inventor of a Rs. 50 voice box prosthetic for throat cancer patients whose larynx has been removed.

Speaking over telephone from Washington DC, Dr. Rao said, “The committee gave the award in recognition of the steps taken towards implementing the Cigarette and Other Tobacco Products (Prohibition) Act, and how Karnataka led the way. Another was implementation of the ban on gutka and chewing tobacco by the government of Karnataka.”

The Wilkenfeld Award was established in honour of Judy Wilkenfeld, founder of Tobacco-Free Kids’ international program. Dr. Rao is the second Indian to receive the award, the first being Pankaj Chaturvedi of Tata Memorial Hospital in 2013.

What’s keeping Indonesia, China addicted to smoking?

A World Trade Organisation ruling backing Australia’s hard line on cigarette packaging highlights a gulf between Asia and much of the rest of the world

http://www.scmp.com/week-asia/society/article/2094162/whats-keeping-indonesia-china-addicted-smoking

It was during a trip to Egypt in 1995 when Edison Siahaan first felt that something wasn’t quite right with his throat. Four decades had gone by since he started smoking at the age of 15. His voice had been raspy for years. Maybe this was just the dry air tickling the back of his throat.

But it wasn’t dry air and it wasn’t a tickle. It was cancer. Doctors excised a portion of his trachea leaving a hole the size of a nickel at the base of the throat. He lost his bank job because for a year following the surgery he couldn’t speak. Even now, what passes for speech makes him sound like the emperor from Star Wars only with more hissing. Now 79, Siahaan, a kindly old gent with a full head of hair, is tough to look at. “I see kids smoking all the time here,” he says, gesturing back and forth along the length of the street from his front room. “It makes me sick to think they are going to ruin their life. I point at this hole in my throat and say to them: do you want to look like this?”

Asian men already account for the lion’s share of the world’s tobacco related illnesses, yet a World Trade Organisation ruling this week that upheld tough anti-smoking rules introduced in Australia in 2012, showed that if anything, the gap in attitudes between Asia and the rest of the world may be widening.

“Tobacco in China is absolutely devastating,” says Dr Angela Pratt who helps handle external relations at the World Health Organisation’s office for the Western Pacific in Manila.

In China, roughly 300 million people smoke, according to the WHO. Most of these are men. More than half of Chinese adults are smokers and two-thirds of young Chinese men start smoking. While smoking rates are steady, the absolute number of smokers is rising in line with population growth. Chinese smokers account for 44 per cent of all the cigarettes puffed in the world. At current rates 200 million Chinese will die this century from tobacco-related illnesses, Pratt says. “That’s a huge burden. The people afflicted are often the sole income earners,” she says.

This week, the WTO ruled that Australia’s plain packaging rules, which ban branding and distinctive colouring from packs of cigarettes, were a legitimate public health measure. The ruling knocked back a complaint from Indonesia, Cuba, Honduras and the Dominican Republic, who said the rule amounted to an illegal trade barrier. As the former chief of staff to the Australian health minister who introduced the plain packaging measures, Nicola Roxon, Pratt helped develop the policy, bulletproofing it from court challenges from tobacco companies and governments.

“We were proud to be taking on plain packaging,” Pratt recalls. “But we wanted to be sure to be able to defend it.”

Together with graphic warnings and taxes that will push cigarettes up to A$40 (HK$230) per pack by 2020, the measure is credited with accelerating the fall in Australia’s smoking rate. The most recent figures show about 13 per cent of Australian adults smoke and less than five per cent of school children. A dozen countries, from Canada to Chile and Britain to Uruguay are either introducing similar rules or seriously considering them.

At the other extreme is Indonesia. The most recent figures, which date back to 2013, show 240,000 Indonesians die every year from tobacco related illnesses. Two-thirds of Indonesian men and boys, over the age of 15, smoke, according to the Ministry of Health.

Most troubling are the numbers of new young smokers throughout the archipelago, says Dr Widyastuti Soerojo, chair of the tobacco control unit at the Indonesian Public Health Association. She says some 16 million Indonesian youngsters between the ages of 10 and 19 experiment with smoking every year – a rate of about 44,000 every day.

Indonesia is among the few countries that are not signatories to the United Nation’s Framework Convention on Tobacco Control, which among other things aims to curb the appeal of smoking for children.

Indonesia television and billboards feature handsome intrepid men jumping out of planes or into business meetings. Roadside kiosks individually sell clove cigarettes, known as kretek, for as little as 10 US cents each.

Governments in Jakarta and local governments in vote-rich provinces, such as Central Java and East Java, fend off calls for more curbs on smoking saying they provide badly needed jobs to rural families.

But mechanisation and growing taste for machine-made cancer sticks rather than hand-rolled types, belie that argument. Tobacco accounts for about half of one per cent of all jobs in Indonesia, according to the Southeast Asia Tobacco Control Alliance. Campaigners are quick to point out the country’s richest families have tobacco to thank.

The Hartonos, Indonesia’s richest family and worth US$17 billion, own kretek maker Djarum.

Indonesian cigarette sales totaled US$16 billion in 2015. Sampoerna, which is more than 90 per cent owned by Philip Morris, is Indonesia’s most valuable company.

“The government treats tobacco like it’s a normal industry but really this is neocolonialism by tobacco companies,” Dr Soerojo says.

In China, the culprit for health advocates is the China National Tobacco Corporation, which controls more than 98 per cent of the local market. Implementation of the UN tobacco convention falls to the Ministry of Industry, which is also home to the body that owns China Tobacco. “A parallel would be, back when I was with the health ministry, meetings were chaired by a representative of Philip Morris,” Pratt said. “There’s plenty of room for conflict of interest.”

Still, there’s progress. Beijing, Shanghai and Shenzhen, with a combined population of more than 60 million, have banned smoking in public areas. China hiked taxes on cigarettes in 2015. The move resulted in a 20 per cent jump in the retail prices of the cheapest brands. Owing to its massive market, that move alone resulted in a more than 2 per cent drop in world tobacco consumption in 2016.

In Indonesia, smoking is banned in most public spaces but enforcement peters out the further one travels from the centre of Jakarta. Indonesia introduced graphic warnings on packaging in 2012 and hiked excise taxes on cigarettes by 15 per cent in 2016. Even so, additional hikes for this year were scotched. Glimmers of light are on the horizon, says WHO’s Pratt, but plain packaging is still “a long way off”.

For Siahaan, his government’s halting go-slow approach is proof that cigarettes are insidious, and for him, more ruinous than narcotics. “At least with drugs you can get help,” he gasps. “For cigarettes, you see them everywhere.”

Cigarette tax hike takes effect June 20th

The price of cigarettes will increase by NT$20 (US$0.6) per pack starting on June 20th

http://www.taiwannews.com.tw/en/news/3160480

The Ministery of Finance announced Thursday that the price of cigarettes will increase by NT$20 (US$0.6) per pack starting on June 20th, after the Legislature passed the third and final reading of an amendment to the Tobacco and Alcohol Tax.

The amendment raises the cigarette tax from NT$590 per 1,000 cigarettes (per kilogram) to NT$1,590, which translates into a tax per packet of NT$31.8, up from the current NT$11.8.

The increase will generate NT$23.3 billion in additional tax revenue per year, which will be used to fund the long-term care program for seniors, according to the Finance Ministry.

Finance Minister Sheu Yu-jer said earlier this year that he believed the policy would also help curb tobacco consumption and promote public health.

Anti-smoking group seeks to raise legal smoking age to 20

Around one billion people will die from tobacco-related causes by the end of the 21st century if current smoking patterns continue…

http://www.taiwannews.com.tw/en/news/3159764

Taiwan’s anti-smoking group held a press conference on Wednesday calling for higher legal smoking age and completely smoke-free workplaces and indoor public places.

The group has called on the Legislature to revise the nation’s Tobacco Hazards Prevention Act comprehensively to correspond to the requirements of the WHO’s Framework Convention on Tobacco Control (WHO FCTC).

WHO FCTC is the first treaty negotiated under the auspices of the World Health Organization that was developed in response to the globalization of the tobacco epidemic.

Democratic Progressive Party (DPP) legislator Chen Man-Li (陳曼麗) and Kuomintang (KMT) legislator Ko Chih-En (柯志恩) both showed up to the press conference today in support of the group.

Taiwan Heart Foundation’s Chairman Lue Hung-chi (呂鴻基) said today that around one billion people will die from tobacco-related causes by the end of the 21st century if current smoking patterns continue.

Major changes that the group has called for include bans on smoking in all workplaces and indoor public places, increase the size of warnings on tobacco packs to 85% of the surface area and with mandatory plain packaging, bans on sponsorship from tobacco companies, bans on the sale of flavored cigarettes, extend all the smoking-related bans to include e-cigarettes, and raise the legal age for smoking from 18 to 20.