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April, 2009:

Smoking In Public Places Banned From June 2010

Petar Kostadinov, – Thu, Apr 09 2009

Parliament has approved Cabinet’s proposal for a ban on smoking in public places and workplaces in Bulgaria as of June 1 2010.

Cabinet’s amendments to the Public Health Act were put forward by the Cabinet on November 20 2008, world non-smoking day.

Bulgaria has always topped the ranking of countries with the highest number of smokers, but, as experts have warned for decades, passive smoking is much more of a serious problem. Several years ago, the Government forced owners of coffee shops and restaurants to have sections reserved for smokers and non-smokers, but this has failed to lead to an improvement because smokers and non-smokers often find themselves sharing tables just a metre away from each another. Parents of young children, in particular, have often complained that a fog of cigarette smoke prevents them from taking children into the interior of restaurants.

A survey released in October among 2200 high school students in Sofia found that 60 per cent smoked. The survey, carried out by MBMD polling agency at the request of the Sofia city hall, found that most students started smoking at the age of 16.

On October 27 2008, Croatia enforced a ban on smoking in public institutions and workplaces with a six-month grace period for restaurants and bars to comply. Breaking the law will carry huge fines, up to 21 000 euro for proprietors of venues where the ban is broken. Individuals who light up where smoking is forbidden will also face hefty fines.

On November 8 2008, the Greek parliament approved a ban on smoking in public places, including all restaurants, bars and public transport, from January 1 2010. Greece provided for a 300 euro fine for lighting up in an area where smoking is forbidden.

In Bulgaria’s case the amount of the fine has not yet been stipulated.

Nicotine May Have More Profound Impact Than Previously Thought

Science Daily –  April 8, 2009

Researchers have found that the alpha-7 receptor, a site known to bind with nicotine, interacts with 55 different proteins. Nicotine may affect bodily processes — and perhaps the actions of other commonly used drugs — more broadly than was previously thought.

Nicotine isn’t just addictive. It may also interfere with dozens of cellular interactions in the body, new Brown University research suggests.

Conversely, the data could also help scientists develop better treatments for various diseases. Pharmaceutical companies rely on basic research to identify new cellular interactions that can, in turn, serve as targets for potential new drugs.

“It opens several new lines of investigation,” said lead author Edward Hawrot, professor of molecular science, molecular pharmacology, physiology and biotechnology at Brown University.

Hawrot’s research is highlighted in a paper published April 3 in the Journal of Proteome Research. He and a team that included graduate students William Brucker and Joao Paulo set out to provide a more basic understanding of how nicotine affects the process of cell communication through the mammalian nervous system.

The Brown University researchers looked specifically at the alpha-7 nicotinic acetylcholine receptor in mouse brain tissue. A very similar receptor exists in humans. The alpha-7 receptor is the most enigmatic of the so-called “nicotinic” receptors, so named because nicotine binds to them when it is introduced into the body. Most receptors are on the surface of cells and are sensitive to small signaling molecules such as the neurotransmitter acetylcholine, which is the naturally occurring signal the body uses to activate alpha-7 receptors.

Their discovery: 55 proteins were found to interact with the alpha-7 nicotinic receptor. Scientists had not previously known of those connections.

“This is called a “nicotinic” receptor and we think of it as interacting with nicotine, but it likely has multiple functions in the brain,” Hawrot said. “And in various, specific regions of the brain this same alpha-7 receptor may interact with different proteins inside neurons to do different things.”

One in particular — the G alpha protein — was among the most unexpected proteins to be identified in the study, as it is usually associated with a completely different class of receptors (the eponymous G-protein coupled receptors (GPCRs).

This finding is significant because G alpha proteins are involved in many different biochemical and signaling processes throughout the brain and the rest of the body. body.

An example of the importance of G alpha proteins: 40 percent of all currently used therapeutic drugs target a member of the large GPCR family of receptors.

The new finding suggests that the alpha-7 receptors have a much broader role in the body than previously suspected and that the newly identified associated proteins could also be affected when nicotine binds to the alpha-7 receptor.

Nicotine may affect bodily processes — and perhaps the actions of other commonly used drugs — more broadly than was previously thought.

This advance could lead to the development of new treatments to combat smoking addiction. At the same time, the finding could also have future implications for diseases such as schizophrenia, Hawrot said.

Recent genetic studies have suggested that some cases of schizophrenia are associated with deletions where a block of genes, including the gene for the alpha-7 receptor, is missing. Hawrot said the connection, while not conclusive, offers hope for new strategies in the development of treatments for those suffering from the disorder.

To conduct their study, Hawrot’s lab looked at mice genetically engineered by other researchers to lack the alpha-7 nicotinic acetylcholine receptor. Those mice were compared with normal mice, so the difference in receptor-associated proteins could be highlighted.

Grants from the National Institutes of Health and the Rhode Island Research Alliance helped support the study.


ST. LOUIS POST-DISPATCH: Stop Smoking To Avoid New Tax

St. Louis Post-Dispatch, The Atlanta Journal-Constitution – April 06, 2009

Smokers began paying dramatically higher prices Wednesday. The federal cigarette tax jumped by 62 cents a pack Wednesday to $1.01. Levies on other tobacco products also rose.

Obviously, smokers are upset. But this is an excellent opportunity to do what most tobacco users consistently say they want to do: quit smoking.

About seven in 10 smokers say they want to stop smoking, and with good reason. People who do significantly reduce their risk of dying prematurely.

They also reduce the risk of harming others around them —- especially children —- with their smoke. Children raised with a smoker have much higher rates of asthma, as well as more frequent and more severe respiratory infections.

Because money raised by the higher cigarette tax will fund health care for poor children, many smokers say they’re being forced to subsidize services for others. But the truth is that the rest of us subsidize them. We’ve been doing it for years.

Even with higher federal taxes, smokers don’t come close to covering the costs they impose on society. Cigarettes would have to sell for $10.28 a pack to recoup all that money.

In the United States, the direct medical cost of tobacco-related illness —- what we pay for doctors, hospitals, surgery and extras like oxygen —- is nearly $97 billion a year.

The cost to Medicare is about $19 billion, while Medicaid programs shell out about $31 billion.

No other preventable cause of illness and death —- not drinking, obesity or even illegal drug use —- comes close to the toll inflicted by tobacco. It kills nearly 440,000 Americans every year and sickens millions more.

Nobody likes to pay higher taxes. But they will provide a new incentive for many smokers —- and especially many young smokers —- to quit.

Besides, there’s one sure-fire way to stop paying higher cigarette taxes: Stop smoking.

Australia: Tough Anti-tobacco Laws From July 1

April 5, 2009

People in NSW caught smoking in cars in front of children will soon face fines of A$250 under tough new tobacco laws.

NSW minister assisting the minister for health on cancer Jodi McKay says the laws, which also regulate the way cigarettes are displayed in shops, will come into effect on July 1.

Ms McKay said the new laws would prevent children from being exposed to tobacco use.

“Smoking continues to be the greatest single cause of premature death in NSW and we are demonstrating leadership in protecting children and young people from the harmful effects of tobacco,” she said in a statement on Sunday.

“We refuse to be complacent about tobacco control, particularly the use of tobacco products around children.

Under the laws, NSW Police can issue motorists with an A$250 on-the-spot fine if they are caught smoking in front of passengers aged under 16.

The new laws also mean retailers must keep all tobacco products out of sight, vending machines will be restricted to licensed premises and tobacco companies will be banned from sponsoring sporting events.

Retailers who sell cigarettes to children or breach other regulations may be stopped from selling tobacco products.

NSW Cancer Council chief executive Andrew Penman said the changes meant the state was among world leaders in tobacco control.

“This is a strong package of reforms that will have an immediate benefit for the community, especially children,” Dr Penman said.

Shops with more than 50 employees will have six months to implement the display ban, while retailers who employ less than 50 people have a year to comply.

Tobacconists who generate 80 per cent of turnover from tobacco-related sales have 12 months to register as a specialist business to have a further three years to comply with the ban.

Ms McKay said retailers would have time to get used to the new laws, with draft regulations detailing the changes released on Monday as part of a month-long public consultation process.

NSW Health will work with retailers to help them phase out cigarette displays.

This story was found at:

January Warning Over Strokes

Hong Kong  Stardard – 3 April 09

A highly fatal type of stroke appears to occur more frequently during the coldest months of winter and when atmospheric pressure rises, doctors have observed.

In an article published in the Hong Kong Medical Journal, researchers said such strokes, called aneurysmal subarachnoid haemorrhage, peak in January.

”It is the most fatal type of brain hemorrhage, with a mortality rate of 50 percent,” said George Wong, associate professor at the Prince of Wales Hospital’s neurosurgery division.

Those who do not survive usually die on the day of the stroke.

Wong and his colleagues studied records of 135 patients who suffered this form of stroke from October 2002 to October 2006, and found that most of the strokes occurred in winter.

”The incidence is higher in winter, which correlates with changes in atmospheric pressure,” he said.

Wong’s team will try to find out the actual processes that changes in atmospheric pressure trigger in the human brain, but he said it may have to do with blood pressure change.

”It [such a stroke] is more common in patients with hypertension and smokers,” he said.

”The two messages we want to bring out are for people to be more aware of weather conditions and for people to control their blood pressure and, of course, quit smoking.”


‘No Sign’ Illicit Sales Up Since Smoke Duty Rise

Eva Wu, SCMP – Apr 03, 2009

There had been no sign of an increase in the sale of smuggled cigarettes since the tobacco duty was raised in this year’s budget, Secretary for Financial Services and the Treasury Chan Ka-keung told the Legislative Council yesterday.

Professor Chan defended the government against criticism from lawmakers that it had failed to fight the sale of smuggled cigarettes effectively after increasing the tax on tobacco products by 50 per cent.

“The Customs and Excise Department has closely monitored the selling of smuggled cigarettes after the introduction of the tobacco-duty increase in the budget,” Professor Chan said.

“There is temporarily no sign of deteriorating sales of smuggled cigarettes in the market,” he said. “If necessary, the department will increase its manpower to fight against illegal activities.”

But lawmakers disagreed with the government and urged it to step up enforcement against the illegal cigarette trade, which they said had got worse since the duty increase.

Legislator Leung Yiu-chung, of the Neighbourhood and Workers’ Service Centre, said he had received complaints that residents of public-housing estates had recently received leaflets promoting the sale of smuggled cigarettes.

League of Social Democrats lawmaker Albert Chan Wai-yip said the illegal trade was “totally out of control”.

A motion to repeal the cigarette-tax increase, moved by Mr Chan, was voted down by the legislature yesterday.

In his second budget, unveiled in late February, Financial Secretary John Tsang Chun-wah increased the tobacco duty by 50 per cent with immediate effect.

Meanwhile, League chairman Wong Yuk-man yesterday blasted Chief Executive Donald Tsang Yam-kuen, the finance secretary and the government as “bu gai” – “you are wrong” in Putonghua.

The pronunciation of the words is similar to puk kai in Cantonese – meaning “drop dead in the street” – but puk kai was ruled by the Legco president on Wednesday to be unparliamentary language that could no longer be used in the chamber.

Mr Wong delivered his speech in Putonghua and argued that he did not use foul language, despite the similar pronunciation of the two expressions.

British Medical Journal Group Awards: BMJ Lifetime Achievement Award

Announced and presented in London, UK; 2 April 2009


Prof. Judith Mackay’s acceptance speech

Public health:

I am just overwhelmed by this great honour. I have the greatest respect for all my shortlisted colleagues in a wide variety of disciplines, but I have been extremely touched by the outpouring of support from China to Scotland, from Vanuatu to Venezuela, of individuals, academics, organisations and governments who voted for public health, prevention, global health issues and tobacco control, especially as public health has often been the poor relation to curative medicine.

Early days and now:

When I started working in tobacco control in Asia a quarter of a century ago, it was a lonely job, with no career structure and no pay. Few, if any, countries had even a single person working full-time on tobacco control. I also faced the formidable opposition of the trans-national tobacco companies, who identified Asia as their future.

I received tremendous start-up assistance and advice from colleagues from western countries where initial steps in tobacco control had already been taken, and also from WHO and international health organisations.

There has now been a sea-change in attitudes, activities and grant funding, enabling hundreds of job opportunities in tobacco control, which were simply not there beforehand.


Public Health is not as dull as it might first appear:

Public health is usually thought of as rather staid, even boring, compared with the excitement of working in Intensive Care Units in hospitals.

But in the course of my working career, I have:

  1. been held at gunpoint by Presidential guards in Mongolia
  2. kept speaking through martial law in Thailand, a typhoon in Hong Kong, and a huge explosion outside the lecture hall in Cambodia that resulted in the ceiling starting to come down around me
  3. been vilified by the tobacco industry, likened to Hitler, threatened with lawsuits and received death threats from smokers’ rights groups

Treasured award: I have always said that my most treasured award was being named by the tobacco industry as one of the three most dangerous people in the world. But, given my roots and connections with the UK, my medical training in Edinburgh, my Fellowships of the Colleges of Physicians of Edinburgh and London, my membership of the BMA over decades, and being Vice-Chair of the Editorial Advisory Board of the BMJ “Tobacco Control” since its inception, I think this trophy now trumps that of the tobacco industry.

Family members, and eminent colleagues with whom I have worked for decades, have joined me this evening. And, like Edinburgh’s Sir John Crofton, my mentor since 1963, who could not be here tonight, I have no intention of stopping. I have a suspicion that, like him, I will be working in my 90s!

Thank you all so much.
Judith Mackay

World Lung Foundation/Bloomberg Initiative