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April, 2008:

Smoking Ban To Cover All Schools

Apr 10, 2008 – SCMP

The country’s health departments are planning a complete smoking ban in schools from next month. The Beijing News quoted the Ministry of Health as saying nursery, primary and middle schools would not be allowed to have smoking rooms. The ministry said the ban would be introduced as part of activities to mark World No Tobacco Day on May 31.

Tobacco Tax Hike Justified

OUR VIEW: Tobacco tax hike justified

April 08, 2008 6:00 AM – South Coast Today

Raising the tobacco tax makes sense.

The best benefit has nothing to do with money: It could reduce the number of young people who take up smoking, giving them years of better health and saving them the agony of quitting later in life. Existing smokers might redouble their efforts to quit, too.

But even from a purely financial perspective, the take hike is justified. Though smokers still have a right to smoke, their exercise of that right costs the public money — a lot of money.

A 2000 study by the Massachusetts Department of Public Health estimated the annual health care costs for smoking-related conditions at US$2.8 billion. An additional — and shocking — US$7.3 million is spent caring for babies who acquire smoking-related problems in the womb.

Not only does smoking cause cancer, which is expensive to treat, but some smokers develop devastating long-term health problems like heart disease and pulmonary obstruction.

If just a small fraction of those smokers is uninsured, the public will pay a hefty sum to treat them. So as Massachusetts looks for ways to cover the cost of income-based subsidies in its mandatory health insurance program, tobacco users represent a fair place to lay some of the burden.

Over the years, the state has taken a leading role on the tobacco issue, funding smoking cessation programs and raising the tobacco tax higher than other states. Massachusetts had the highest cigarette tax in the nation as recently as 2002, when it was doubled to $1.51 per pack. Since then, other states have followed suit, and the Bay State now has the 15th-highest tobacco tax.

The ranking isn’t as important as the amount of revenue it generates as a proportion of smoking-related costs. At the rate health care costs are rising, the tobacco tax — though not intended to be a direct reflection of tobacco-related spending — certainly has not kept pace.

Cigarette makers and convenience store operators, who have an obvious financial interest in keeping the tax low, warn that smokers will take their business elsewhere, namely to neighboring states or the Internet. But those who are inclined to do so are probably already doing it, since New Hampshire charges tax of just $1.08 per pack. And Massachusetts is getting more sophisticated about collecting taxes on cigarettes shipped into the state as the result of online sales. It collected $2.4 million in the six-month period that ended in January, and Gov. Deval Patrick has proposed using new technology that he says could raise the amount to $12 million a year.

So the idea that business will go out of state no longer does much to change the equation.

Massachusetts’ landmark health care law serves the public good, and it needs funding. The tobacco tax can help serve that need. If the gradual result is fewer smokers, fewer health problems and less need for the very funding that started the trend, so much the better.

Early Life Second-Hand Smoke Exposure

Early life second-hand smoke exposure and serious infectious morbidity during the first 8 years: evidence from Hong Kong’s ‘‘Children of 1997’’ birth cohort


Background: Second-hand smoke (SHS) exposure is a modifiable cause of ill health. Despite the smoking ban in public places introduced in Hong Kong in 2007, infants and children continue to be exposed within the home.

Aims: To determine the critical windows of SHS exposure and the duration of its impact on serious infectious morbidity in the first 8 years of life.

Methods: The Hong Kong ‘‘Children of 1997’’ birth cohort is a prospective, population-based study of 8327 children comprising 88% of all births in April and May 1997, of whom 7402 (89%) were followed up until their eighth birthday in 2005. We used multivariable Cox regression to assess the relation between postnatal SHS exposure and risk of first admission to public hospitals (together accounting for .95% total bed-days overall) for respiratory, other and all infections from birth to 8 years of age, for all individuals and for vulnerable subgroups.

Results: Overall, household SHS exposure within 3 metres in early life was associated with a higher risk of admission for infectious illness up until 8 years of age (hazard ratio 1.14, 95% CI 1.00 to 1.31), after adjustment for sex, birthweight, gestational age, feeding method, maternal age, highest parental education and proxies of preferred service sector. The association was strongest in the first 6 months of life (HR 1.45, 95% CI 1.15 to 1.83). In vulnerable subgroups such as premature babies, the association held through to 8 years of age (HR 2.00, 95% CI 1.08 to 3.72). Infants exposed to SHS in the first 3 months of life were most vulnerable to infectious causes of hospitalisation.

Conclusion: Household SHS exposure in early infancy increases severe infectious morbidity requiring hospital admission. Reducing SHS exposure in infants and particularly in more vulnerable infants will lower the beddays burden due to infectious causes.

View the full study on Early life second-hand smoke exposure.

Tobacco Profits Going Up in Smoke?

Tobacco Profits Going Up in Smoke? (PM, CG, RAI)

07 April, 2008 12:06:00 Thom Buschman – Investerms

Tobacco companies may face an uphill battle against regulators after new legislation was proposed that would give the U.S. Food and Drug Administration (FDA) authority of tobacco products. The House Energy and Commerce Committee voted 38-12 in favor of the proposal that is now ready to be passed on to the U.S. Senate before becoming effective. Shareholders of tobacco companies are divided as the legislation may benefit some while hurting others.

The new legislation is expected to impose significant restrictions on marketing as well as require larger warning labels. These are developments that are more likely to hurt smaller tobacco companies rather than the nationally-recognized and established brand names. This means that big companies like Philip Morris International (NYSE: PM), which recently spun off from Altria Group (NYSE: MO), stand to benefit at the expense of other smaller players like Carolina Group (NYSE: CG) and Reynolds American (NYSE: RAI).

This may sound great for larger companies, but there is a big downside. The FDA will also likely require manufacturers and importers of tobacco to pay user fees to fund the new regulatory responsibilities under the bill. These fees are expected to net $90 million this year, but increase to $755 million by 2018. These fees would be assessed based on market share, which means that the lion’s share of the fees will be levied on companies like Philip Morris.

The best options for shareholders may be those tobacco companies with greater international exposure. Companies like Imperial Tobacco Group (NYSE: ITY) with particular strengths in the United Kingdom, Germany, The Netherlands, Belgium, the Republic of Ireland, France, Spain, Greece, Poland, Ukraine, Russia, Australia, Taiwan and sub-Saharan Africa are of particular interest. Strong international brands may become more important than strong domestic brands if the measures pass.

In the end, tobacco companies are likely to suffer from these new measures. Reduced marketing will put pressure on top-line growth by limiting their ability to attract new customers. Meanwhile, the fees associated with the new regulation will put pressure on margins and negatively impact the bottom-line. Combined, this is bad news for tobacco companies if the bill is passed in its current state.

Empower The FDA To Regulate Tobacco

Michael Schwalbe – The News and Observer

RALEIGH – Invent a drug to help people stop smoking and you’ll need approval from the U.S. Food and Drug Administration before you can bring it to market. The approval process requires clinical testing, disclosure of ingredients and expert review of the data concerning safety and effectiveness.

All drugs that can have powerful effects on the body are similarly regulated. The curious exception is nicotine delivered in tobacco products. Fortunately, this deadly loophole might soon be closed.

That nicotine is a powerful drug is not in doubt. The 1988 Surgeon General’s report reviewed the scientific research on nicotine and concluded that it is as addictive as cocaine or heroin. Tobacco companies hated to see the word “addiction” applied to tobacco, but they were not surprised by the findings.

As we know from whistleblowers and from documents pried loose by litigation, the tobacco companies have long understood that they sell a psychoactive drug. In public they call tobacco use a habit. In private the companies acknowledge their dependence on nicotine’s addictiveness to stay in business.

Worse, the companies have manipulated nicotine levels to foster addiction. This was Judge Gladys Kessler’s conclusion in 2006 at the end of the five-year Department of Justice trial that found the industry guilty of racketeering and of lying about the health hazards of smoking.

Last year, researchers at the Harvard School of Public Health found that nicotine yields from smoking had increased each year between 1998 and 2005, by a total of about 11 percent. This was true for all brands tested.

Critics of the industry surmised that nicotine levels were adjusted upward to keep smokers addicted after the 1998 Master Settlement Agreement led to price increases that prompted more people to try quitting.

Legislation pending in Congress may soon curtail the industry’s ability to hook new users. The Family Smoking Prevention and Tobacco Control Act would give the FDA power to regulate tobacco products much as it now regulates other potentially hazardous consumables.

UNDER THIS LEGISLATION, THE FDA could require that nicotine levels in tobacco products be reduced to levels that do not cause addiction.

The legislation would also tighten controls on tobacco advertising seen by children. In addition, it would ban candy flavorings, require disclosure of ingredients to the FDA, forbid the industry from implying that “low-tar,” “light” or “mild” cigarettes are safer and require enlarged health warnings on tobacco products.

This legislation isn’t perfect. It won’t allow the FDA to reduce nicotine levels to zero. It doesn’t require disclosing ingredients directly to consumers. And it permits menthol flavoring.

Some critics of the legislation have argued that it might encourage tobacco use by allowing the industry to claim that its products are FDA approved. But after recent hearings by the House Energy and Commerce Subcommittee, language is being added to the bill to prohibit the industry from making such claims.

DESPITE ITS FLAWS this legislation could save millions of lives. So who could be opposed? Tobacco companies, naturally. But in this case there is a twist to the story.

The largest cigarette maker in the U.S., Philip Morris, supports the bill, while R.J. Reynolds and the smaller tobacco companies oppose it.

Philip Morris’ support reflects its beliefs that regulation would not threaten its dominant share of the market and that regulation would put a heavier burden on its competitors. Philip Morris also uses menthol flavoring not banned by the legislation, while R.J. Reynolds uses the kid-catching candy flavorings the legislation forbids.

Both of North Carolina’s senators, Richard Burr and Elizabeth Dole, recipients of a combined $132,700 in contributions from Reynolds over the last five years ($21,500 for Dole, $111,200 for Burr), oppose the bill. In doing so, they may serve the interests of one segment of the tobacco industry, but they fail to represent the views of most North Carolinians.

National polls show that two-thirds of Americans favor FDA regulation of tobacco. A 2007 survey by the Mellman Group found that 62 percent of adults in North Carolina’s 1st Congressional District felt the same way. That’s in tobacco country.

Every year in North Carolina about 14,000 teenagers start smoking and about 12,000 adults die prematurely because of smoking. As a result, we pay $2.46 billion in excess health care costs and $3.3 billion in costs due to lost productivity. Giving the FDA authority to regulate tobacco would help reduce these costs.

Some of North Carolina’s elected leaders agree (U.S. Rep. David Price co-sponsored the bill). Others are still in thrall to corporate interests that put profits ahead of public health. Urging our representatives in Congress to support FDA regulation of tobacco products is a way to tell them that it’s time for change, even in tobacco country.

(Michael Schwalbe is a professor of sociology at N.C. State University. He is writing a book about people whose lives have been changed by tobacco-related disease.)

Smokers Urged To Cough Up The Truth

Life Insurance: Smokers urged to cough up the truth – April 4, 2008

Life insurance companies are increasingly checking if claimants are truly non-smokers, and turning down claims for those failing to prove they are smoke-free.

Analysis from shows non-smokers enjoy much lower life insurance premiums – proving a solid incentive for smokers to lie on forms to reduce the cost of cover.

A 25-year female smoker faces life insurance premiums of £11.20 a month, while a non-smoker can pay from £7.50 a month.

Meanwhile a non-smoking 40-year-old male will pay £49.26 per month for critical illness cover (CIC) and a 40-year-old smoking male £93.78.

However, smokers are being warned if they die of a smoking related illness and their insurer thinks they are a non-smoked there will be no pay-out.

Ian Durrell of Onlyinsurance said: “Smokers who declare they have given up but continue to smoke, no matter how infrequently, will be paying for nothing should they die from a smoking related condition.

“The policy simply won’t pay out and their beneficiaries will be the losers.”

To be classed as a non-smoker, for life insurance you need to be fag free for 12 months – over which time you would be £2,016 a year better off through not buying cigarettes.

“Smokers will pay twice the price for critical illness cover than a non-smoker – it’s a no win situation for the smoker, their nicotine addiction is tightening both their heart and purse strings,” concluded Mr Durrell.

Tequila To Be Downed Without Cigarette In Hand

In Mexico City, tequila to be downed without cigarette in hand

Apr 4, 2008, 0:45 GMT – M & G

Mexico City – Mexico City citizens who enjoy smoking while visiting the city’s 35,000 public establishments had to stub out their cigarettes Thursday.

People who defy the law multiple times face fines of up to 150 dollars, and determined repeaters could even be thrown in jail for 36 hours. Owners of restaurants and hotels also face fines, and office buildings, hospitals and universities which continue to allow smoking in public spaces also face harsh sanctions.

Restaurants where smokers are caught twice in one year will be closed, according to the law.

The anti-smoking law reflects a growing trend across the North American continent and, more recently, Europe, spurred on by health- conscious governments trying to stem the human and material costs of tobacco’s health consequences.

Polluted Mexico City Bans Smoking

By Anahi Rama – Reuters – Thu Apr 3, 2008 8:21pm EDT

MEXICO CITY, April 3 (Reuters) – Mexico City on Thursday banned cigarette smoking in all public places, from bars to office buildings, to reduce the amount of carcinogens inhaled by residents of the smog-filled capital.

The city, home to some 18 million people in the metropolitan area, is the latest large city around the world to pass a smoking ban to improve public health and protect nonsmokers from secondary smoke.

But not all Mexicans are happy about the prospect of smoke-free cantinas where tequila and cigarettes are traditionally enjoyed hand-in-hand.

“Right now I’m fine, but later tonight — after a couple of drinks — I’m going to really want one,” said 26-year-old Rodrigo Nunez, a smoker and government office worker playing a game of pool in a bar in the fashionable Condesa neighborhood on his lunch break.

The law to ban smoking in all enclosed areas, from sidewalk cafes to public transportation to elevators and schools, was passed by the city assembly in November.

Smokers who violate the ban can be fined between $50 and $300, with higher penalties for bar and restaurant owners who allow smoking.

The fines will not be applied until next week, giving restaurant and bar owners time to post large no-smoking signs to let people know about the change.

Major U.S. cities like New York and Los Angeles as well as countries across Europe have enforced similar bans. The Dutch government is even planning a cigarette smoking ban in Amsterdam that would apply to coffee shops where patrons can legally smoke marijuana.

But in Mexico, where businessmen still often smoke in meetings and most restaurants lack nonsmoking sections, the habit will be hard to break.

“The young people will accept it because they will realize that it’s a step forward … it’s the old people who will be upset,” resident Jose Manuel Ogando said.

The World Bank Report 2008

New York City Department of Health and Mental Hygiene

2nd April, 2008

Influencing Tax Policies for Tobacco Control

Make Tobacco Firms Pay Up

Updated on Apr 01, 2008 – SCMP

I could not agree more with Martin Brinkley (“Stopping causes of illness better policy than imposing ‘health tax'”, March 28) Tobacco is the only legal consumer product which kills its users and innocent bystanders when used as directed by its makers.

Cigarette smoking is the single most preventable cause of premature death in the world.

A University of Hong Kong study placed a value on the loss of productivity and life in Hong Kong due to smoking at 25 times the revenue received from tobacco taxation. Tobacco tax was last increased in Hong Kong in 1999. The World Health Organisation says increasing excise tax is the most effective method of reducing smoking levels worldwide; a 10 per cent increase in tobacco tax will reduce youth smoking by 7 per cent and overall smoking by approximately 4 per cent. Each year 1,324 people die of passive smoking here. The government has the taxation capability. If we prevent our youth smoking through tax increases there will be no need to treat the lethal devastating effects. In his RTHK interview the financial secretary said that if he increased tobacco tax, smuggling would increase thus casting doubt on the abilities of the Customs and Excise Department to handle this problem. This is a poor excuse for his failure to act. The government has a duty of care to the health of its residents and has yet again missed the opportunity to save lives.

If you relieve the major financial and manpower burden of treating smoking related illnesses, does this not make more sense than taxing non-smokers to pay for this treatment? The government should sue the big tobacco firms to recover the costs of treating smoking illnesses.

James Middleton, Clear the Air