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July, 2009:

FDA: Electronic cigarettes contain toxic chemicals

By MATTHEW PERRONE (AP)

WASHINGTON — Federal health officials said Wednesday they have found cancer-causing ingredients in electronic cigarettes, despite manufacturers’ claims the products are safer than tobacco cigarettes.

The Food and Drug Administration said testing of products from two leading electronic cigarette makers turned up several toxic chemicals, including a key ingredient in antifreeze.

“Little is known about these products, including how much nicotine is there and what other chemicals may be there,” said FDA’s Deputy Commissioner Dr. Joshua Sharfstein.

FDA scientists said they tested 19 varieties of cigarettes, half of which contained forms of nitrosamine, a carcinogen known to cause cancer in humans. Many products which claimed to contain no nicotine actually had low levels of the stimulant.

Agency officials said the “quality control processes used to manufacture these products are inconsistent or nonexistent.”

Brands tested by the agency included Smoking Everywhere, marketed by a Florida-based company and NJoy Cigarettes, based in Scottsdale, Ariz. The Electronic Cigarette Association, which represents the companies, had no immediate comment Wednesday afternoon.

Public health advocates have complained the products are aimed at young people and can serve as a “gateway” to tobacco smoking. Many come in flavors, including chocolate, bubblegum and mint.

“Tobacco industry research has demonstrated that fruit and candy flavors increase the social acceptance of cigarettes and curiosity to try the product,” said Dr. Jonathan Winickoff, chair of the American Academy of Pediatrics Tobacco Consortium.

Because electronic cigarettes are not covered by federal tobacco laws, they are also often easier for young people to buy.

Electronic cigarettes produce a nicotine mist absorbed directly into the lungs. Most can easily pass as a tobacco cigarette with slim white bodies and glowing amber tips. They even emit what look like puffs of white smoke.

Manufacturers have touted the products as a healthier alternative to smoking because there is no burning involved, and they don’t contain the same hazardous cocktail of cancer-causing chemicals.

Regulators said they have halted 50 shipments of electronic cigarettes at the border since last summer. The FDA said it is authorized to seize the products because — for legal purposes — they are a medical device used to deliver nicotine.

However, the FDA’s enforcement attempts have been challenged in federal court by manufacturers. The products are made primarily in China.

FDA officials declined to comment on whether they would take action against the two manufacturers whose products were tested.

The agency did say it’s “planning additional activities” to address safety issues with the products, which may include recalls or criminal sanctions.

In an effort to move beyond cigarettes, tobacco companies have introduced a number of smokeless products to keep smokers as buyers of other items. They are trying to convert smokers to products such as moist snuff, chewing tobacco and snus — teabag-like pouches that users stick between their cheek and gum.

R.J. Reynolds spokesman David Howard said the company is focused on being the “total tobacco company,” pointing to its products like dissolvable tobacco, rather than technology like e-cigarettes.

Neither Reynolds nor Altria Group Inc.’s Philip Morris USA currently market electronic cigarettes.

Earlier this year, the FDA gained the authority to regulate tobacco products for the first time. However, the agency already could regulate electronic cigarettes because they do not actually contain tobacco.

AP Business Writer Michael Felberbaum in Richmond, Va., contributed to this report.

Copyright © 2009 The Associated Press. All rights reserved.

More councils introduce smoke-free outdoor areas

http://www.smh.com.au/national/more-councils-introduce-smokefree-outdoor-areas-20090721-ds4f.html

http://www.smh.com.au/

Louise Hall Health Reporter

THE number of councils in NSW that have introduced smoke-free outdoor areas has more than doubled in the past two years, a Heart Foundation survey has found.

The figures, published today, show 58 of 152 NSW councils had banned smoking in areas such as playgrounds, swimming pools and alfresco-dining areas by May, up from 28 councils in 2007.

The implementation of smoke-free outdoor areas has been higher in metropolitan municipalities, with 65 per cent of 43 councils introducing the bans, compared with 28 per cent of 109 regional councils.

Warringah, Wollongong City, Camden, Hurstville and Port Stephens are the latest councils to approve a smoke-free policy in council-owned outdoor areas.

The Heart Foundation says there is emerging evidence that secondhand smoke in outdoor areas where people tend to congregate,including alfresco-dining areas, sports stadiums and concert venues, can present a health risk to the public and staff.

A recent study of cigarette smoke levels in a variety of outdoor locations showed that a person sitting near a smoker in an outdoor area could be exposed to levels of cigarette smoke similar to those experienced by someone sitting in an indoor pub or club.

There is also evidence to suggest that smoke-free areas support smokers who are trying to quit as well as reduce their overall cigarette consumption.

The chief executive of the Heart Foundation, Tony Thirlwell, said there had been some resistance to the idea in some councils, but complacency was the largest factor in more NSW councils failing to follow suit.

“In the councils which have implemented the policy, there’s largely been a particular councillor that’s felt strongly about the issue and been an advocate for it,” he said.

Of the 58 councils with smoke-free policies, 95 per cent cover playgrounds, making this the most common smoke-free area. Sporting fields (78 per cent), pools (26 per cent), beaches (17 per cent) and alfresco-dining areas (16 per cent) were included to various degrees.

“While there are fines for breaching the policy, we’re not into policing, such as getting council rangers to hunt out smokers,” MrThirlwell said.

“But we do hope it raises awareness in the community, so that people walk away from others if they want to smoke.”

World Expo hands back sponsorship from tobacco firm

Will Clem in Shanghai, SCMP

The Shanghai World Expo 2010 has handed back 200 million yuan (HK$227 million) in sponsorship funds from a tobacco company, state media reports.

If confirmed, the move would be a major coup for anti-smoking activists on the mainland, who have been pressuring authorities to live up to their commitments to international health treaties.

The Southern Metropolis News reported yesterday that the Expo organising committee had decided to return the Shanghai Tobacco Group’s contribution to the China national pavilion to promote a “healthy World Expo”.

The paper quoted anonymous sources in the Expo bureau as saying the decision had been reached in a document ruling out gifts from firms linked to the tobacco industry.

When the Shanghai Tobacco Group made the donation in May, it was the largest single contribution the national pavilion had received since fund-raising began in 2007.

No one at the Expo organising bureau could be reached for comment, and no announcement that the sponsorship money had been returned was on the fair’s website.

However, the company is no longer listed among the fair’s 13 global partners, 12 senior partners or 14 project sponsors on either the Chinese or English versions of the site.

Campaigners submitted a petition to the Expo organisers arguing that the sponsorship was in breach of the World Health Organisation’s Framework Convention on Tobacco Control, the South China Morning Post reported last week.

China ratified the convention in 2005. The 20 signatories included medical experts, prominent anti-smoking activists and health officials.

Jiang Yuan , a tobacco- control official at the Ministry of Health, said she had not heard confirmation that the campaign was successful, but welcomed the news.

“This would be a huge step forward,” she said.

“The Shanghai government has the chance to set a positive example to the rest of the country, to show that a change in attitude is needed.

“This is not just about the Shanghai World Expo. There are many other public events that have received money from tobacco companies, and I am certain the Shanghai government’s decision will have an impact.”

She said she believed that the initial decision by organisers to accept the money had been made “without fully understanding the issues and the implications”.

“The Expo is an international event, and so it should keep with international standards,” she said. “After this, there will be more room for understanding.”

With 350 million smokers, the mainland is the largest tobacco market, accounting for one-third of the world’s smokers.

About a million mainlanders die each year from smoking-related illnesses, Ministry of Health figures show.

The anti-smoking lobby is still in its relative infancy, but has begun making inroads – despite state-run cigarette manufacturers’ political influence.

The mainland has already banned direct tobacco advertising and plans to implement a total ban on promotions in 2011.

Big Tobacco retains its clout

Dan Morain, San Francisco Chronicle

The tobacco industry has had a rough patch lately. The industry lost big in the courts in May. First, the California Supreme Court reinstated a major consumer lawsuit aimed at cigarette-makers’ decadeslong advertising campaign. The case focuses on industry deceits including claims implying that “light” cigarettes were less harmful than regular cigarettes.

A few days later, the U.S. Court of Appeals in Washington, D.C., affirmed a 2006 lower court decision that the tobacco industry violated the Racketeer Influenced and Corrupt Organizations Act, citing past industry claims that nicotine was not addictive, that tobacco did not cause cancer and that secondhand smoke was not harmful. Then in June, President Obama signed legislation placing the U.S. Food and Drug Administration in charge of tobacco regulation.

But the industry is nothing if not cunning. No sooner did it seemingly lose than it started flexing its muscle in California.

On the very day when the House approved legislation authorizing FDA regulation, the industry sent an e-mail to Sacramento legislators inviting them to a “cigar mixer.” The industry long has been among the big moneyed interests that keep Sacramento lubricated with money.

In case tobacco-friendly legislators need cover, the industry embarked on a campaign to gin up opposition to a proposed tobacco tax increase. You could walk into liquor stores in parts of the state this summer, and see evidence of tobacco’s fight to block a higher tobacco tax. The proposed $1.50-per-pack state tax (up from 87 cents), offered by Sen. Alex Padilla, D-Pacoima (Los Angeles County), and Senate President Pro Tem Darrell Steinberg, D-Sacramento, would raise more than $1 billion a year, and help avert drastic cuts in state-funded health care and public education. “Help stop this new cigarette tax,” say the flyers, strategically placed at counter level. The index card-size notes, designed to be torn off by customers, urge that people call their legislators immediately. The call will be toll free, courtesy of Philip Morris, USA, the world’s largest cigarette manufacturer. The effort had its impact. No matter that California’s tobacco tax is lower than taxes imposed by more than 30 other states. The proposed tobacco tax increase stalled in the Legislature, and Gov. Arnold Schwarzenegger vowed to block any tax increase.

Foes of Padilla’s SB600 range from chambers of commerce to anti-tax groups, many of which have received tobacco industry money in the past.

When the U.S. Court of Appeals affirmed the lower court conclusion that cigarette executives defrauded the public by claiming nicotine wasn’t addictive and “light” cigarettes were less deadly than regular cigarettes, the judges were direct: “Defendants knew of their falsity at the time and made the statements with intent to deceive. Thus, we are not dealing with accidental falsehoods or sincere attempts to persuade; defendants’ liability rests on deceits perpetrated with knowledge of their falsity.”

Now that the FDA is about to start regulating tobacco, the public could be lulled into thinking that the industry has been brought to heel. Based on what is happening in California, that view would be naive.

Dan Morain is communications director for Consumer Attorneys of California.

http://sfgate.com/cgi-bin/article.cgi?f=/c/a/2009/07/21/ED6K18S3TE.DTL

Huge Team to Enforce Smoking Ban Everybody Wants

Clear the Air, Jim says:

the population of Turkey is 72 million

the population of Hong Kong is 7 million

Turkey will employ 4,500 Tobacco Control Officers (TCOs)

Hong Kong has 85 TCOs and a further 14 soon to cover three shifts over Hong Kong Island, Kowloon, NT and the Islands of the territory.

Is Hong Kong Government serious about enforcing its anti smoking laws ? what do you think ? what is the use of enacting laws without adequate enforcement capability (bark, no bite) ?

http://act.tobaccochina.net/englishnew/content.aspx?id=39804

Huge Team to Enforce Smoking Ban Everybody Wants

Source from: Tobacco Reporter  07/20/2009

http://act.tobaccochina.net/englishnew/images/speacer.gif Turkey’s government is setting up a 4,500-strong team to help enforce a tobacco smoking ban that on Sunday will be extended to include bars, restaurants and coffee houses, according to a story by Suzan Fraser for Associated Press.

A Health Ministry official was quoted as saying the force would carry out surprise checks on bars, restaurants and coffee houses where men traditionally pass time lighting up, drinking tea or coffee and playing backgammon and card games.

The news of the special force is in one way surprising. In most countries where such bans have been imposed, smokers have proved to be remarkably law abiding.

Also, a survey conducted by the Association of Public Health Experts and reported earlier this week was said to have shown that 89.9 per cent of all employers and employees of establishments that will become smoke-free, and 85.9 per cent of their customers, are in favour of the ban. Enditem

Tobacco ban spells end for smoky little Turkish cafes

TURKEY, Daren Butler, SCMP

Smokers in Turkey tempted to flout a new ban in cafes, restaurants and bars will be spared execution, as allegedly meted out in 17th-century Istanbul – but their prime minister has likened cigarettes to terrorism.

That’s a measure of how strongly Recep Tayib Erdogan feels about tobacco. Ottomann Sultan Murad IV is said to have roamed the streets ordering the execution of those who defied a smoking ban aimed at curbing coffeehouse sedition.

One of the world’s oldest prohibitions of smoking, Sultan Murad’s failed and, as tobacco’s popularity grew in Turkey, the saying “smoke like a Turk” took root in languages across Europe.

Mr Erdogan is the driving force behind the next phase of a widely popular ban that took effect yesterday. It aims to curb the habit in a country where 22 million people, including about half the adult male population, smoke.

But at a time of economic crisis, the prohibition – adding restaurants, cafes and bars to the places where smoking is not allowed – is viewed by a minority as a potential assault on their culture.

Mr Erdogan, who long since banned smoking in cabinet meetings, also faces opposition from owners of thousands of bars and cafes across the Muslim country, who see the ban as a threat to their business.

Some in the bar industry point out that the smoking ban coincides with the introduction of restrictions on alcohol advertising this month, but experts reject suggestions it is a stalking-horse for tighter controls on the sale of alcohol.

“Let’s keep alcohol and cigarettes separate. They are different things,” law professor Hayrettin Okcesiz of Akdeniz University said. “If there is a ban on alcohol, everyone should have the right to protest, but we shouldn’t see this is as step towards an alcohol ban.”

Among opponents are those who work in nargile, or water-pipe cafes, an ancient tradition that has enjoyed a revival in the past decade among locals and tourists. “This is the Ottoman culture that comes from our ancestors,” said cafe owner Ali Yogurtcu, 54. “We will protest if they try to ban this, but I don’t think they will try to destroy it.”

A meagre fine under Turkey’s ban – 69 lira (HK$350) against a ceiling of €500 (HK$5,475) in neighbouring Greece – masks fierce determination on the part of Mr Erdogan. His personal dislike of the habit may give the ban the momentum it needs to succeed in the world’s seventh-biggest cigarette market.

When the anti-smoking campaign was launched in 2007, he famously declared the struggle against cigarette use to be “as important as the struggle against terrorism”, words that resonate strongly in a country that has witnessed a bloody 25-year Kurdish guerilla insurgency.

In Turkey, 100,000 people are estimated by the Health Ministry to die annually from smoking-related illnesses – about 0.45 per cent of smokers. Globally, about 5.4 million die annually of smoking-related illnesses.

Surveys indicate about 90 per cent popular support for the smoking ban, which started last year in workplaces and shopping centres. The authorities say that has already lowered cigarette consumption slightly.

Support has been helped by a growing interest in healthy lifestyles as people enjoy greater prosperity (SEHK: 0803, announcements, news) and expect better standards of living. But there have been problems.

A group of convicts rioted at a prison in the southeastern province of Siirt, climbing on to the roof, lighting fires and throwing stones to protest at the ban on smoking in jail.

Smoking has also continued in some cafes in shopping centres, where retailers have complained about its impact on trade as the economy slumped nearly 14 per cent in the first quarter of the year.

These fuel doubts about whether the ban will be implemented in the thousands of smoky, male-dominated tea houses in towns and villages across Turkey where many men spend much of their free time, gossiping or playing backgammon.

Tea-house owners say more than 80 per cent of their patrons smoke.

Others say Mr Erdogan’s anti-smoking fervour reflects efforts to change society in a country where his Islamist-rooted Justice and Development Party (AKP) is accused by secularists of promoting a more conservative vision since it came to power in 2002.

“I think we have been heading towards a camouflaged alcohol ban,” said Tahir Berrakkarasu, who heads the Beyder association that represents cafes, bars and restaurants in Istanbul’s bustling Beyoglu district.

“Why is this happening? It means that alcohol isn’t wanted in this country,” he said, referring to what he says is a six-year government campaign targeting bars with a stream of taxes and bureaucratic obstacles.

The advertising restrictions on alcohol that take effect this month ban linking alcohol to food and cultural values: drink producers say they will severely curb their marketing ability.

Even though the authorities say implementing the smoking ban will be a challenge, they point out that Turks are receptive to change, citing the success of a 13-year-old ban on smoking in buses and the country’s adoption of the Latin alphabet in place of Ottoman Turkish script in 1928.

“We can see that the people who live in this land can adapt very quickly to change,” said Ubeyd Korbey, who chairs an anti-smoking association and played a role in drafting the ban. “And we now have a very decisive prime minister.”

Reuters

Enforcement Policy Forthe Regulation Of Smoking In Smoke Free Premises, Places And Vehicles

http://www.redcar-cleveland.gov.uk/main.nsf/5889bbc32b5b15ef8025729f00346179/$file/smoke%20free%20enforcement%20policy.pdf

Legal Responsibility of Bars and Nightclubs Owner

SCMP

Hong Kong is a world leader in environmental foot-dragging. From our toxic air to our mildly poisonous seas, we struggle to move our environmental-protection laws towards international standards. And that’s before you even talk about the environmental damage that is deliberately caused, such as the endless pouring of concrete into our country parks.

But there is one area in which Hong Kong seems to have been successful. In one short week we have managed to reduce substantially the number of plastic bags handed out in the city. I imagine that there are one or two people who aren’t in favour of reducing this environmental scourge, but that’s perhaps because none of these critics have accidentally inhaled one while swimming at Shek O.

In any case, our ingenious method of controlling the distribution of plastic bags is that if you want one at the supermarket you now have to pay for it. Some sources have estimated that this has resulted in an 85 per cent reduction in their use. I would guess that the average cost of my shopping at Wellcome or ParknShop is about HK$200 per visit. If I need three plastic bags to hold everything, I am looking at 0.75 per cent added to my bill. It has only been a bit more than a week, but I can guarantee that I have never and I will never pay that extra 0.75 per cent for the convenience of not having to stuff my briefcase full of mangoes or risk derision from my colleagues by carrying around a canvas bag.

And for one last comparison, look at the impact of the smoking ban. Under the rules, a smoker lighting up in the wrong place can potentially be fined HK$5,000. It’s no longer legal to smoke in bars and nightclubs and places like that, but it’s not the owner who gets fined, it’s the smokers themselves. Strangely, the owners don’t seem to have any legal responsibility at all.

A quick stroll through Lan Kwai Fong in the evening will reveal that there are plenty of smokers ready to risk the HK$5,000 fine to have the luxury of slowly poisoning themselves to death in a public area. But these same smokers can also be seen sporting environmentally friendly shopping bags when buying their air fresheners and anti-stain toothpaste.

When investing, we are all ready to give away the certainty of a small amount of money in favour of the possibility of some larger amount. But even the biggest risk-taker, who is prepared to lose hundreds of thousands of dollars on investment ideas or who will happily accept the near certainty of death from smoking, isn’t going to forgo that  50 cents at the supermarket.

Contact Alan Alanson at alan@alanalanson.com

Turkey smoke ban extends to bars

BBC News

Turkey has extended an existing ban on smoking in public places to all bars, cafes and restaurants.

The ban has come into force despite opposition from some bar and cafe owners who fear losing business.

It comes after the government banned smoking from most enclosed public spaces in May last year in an effort to improve the nation’s health.

Turkey has more than 20 million smokers but polls suggest 95% of people support the ban.

“We are working to protect our future, to save our youth,” said Health Minister Recep Akdag.

Anyone caught lighting up in a designated smoke-free area faces a fine of 69 liras ($45:£28) while bar owners who fail to enforce the ban could be fined from 560 liras for a first offence (US$ 366) up to 5,600 liras (US$ 3,660).

Local authorities have hired thousands of extra staff to track down smokers and impose the fines.

Many people in Istanbul said they thought the ban was a good move.

“We were being destroyed in the places where you were allowed to smoke inside,” said Istanbul cafe patron Hanife Demirm.

“I was choosing the non-smoking places automatically, but after the ban is extended I will not need to be selective. I’ll be very comfortable in every place that I go,” he told the AP news agency.

‘Unnecessary stress’

But the BBC’s David O’Byrne in Istanbul says many Turkish people see the ban as an erosion of their democratic rights and have called for bars to be able to apply for a smoking licence.

Some cafe owners have also said they were concerned the ban would drive away customers.

“They will simply leave and never come back, or we would get in trouble for letting them smoke,” said Istanbul cafe owner Selahattin Nar.

“Then both we and they would be filled with unnecessary stresses. In the end they will not be able to relax and we will have to shut down.”

But Mr Akdag said there was no reason for cafe and bar owners to be worried about a drop in trade.

“The public supports a smoke-free environment and the only ones to suffer will be the cigarette producers and sellers,” he said.

A no smoking rule has been in place for the past 15 months in government offices, workplaces, shopping malls, schools and hospitals.

All forms of public transport, including trains, taxis and ferries, are also affected but there are exemptions for special zones in psychiatric hospitals and prisons.

Story from BBC NEWS:
http://news.bbc.co.uk/go/pr/fr/-/2/hi/europe/8157747.stm

Published: 2009/07/18 23:42:21 GMT

© BBC MMIX

__________________________

CTA, Jim: we need many more Tobacco Control Inspectors and the onus placed on licensees to enforce the smoking ban here in Hong Kong

the officers could be empowered to issue littering tickets also

IN MY VIEW: Effectiveness of Nicotine Replacement Therapy Needs to Be Re-Examined

http://tobaccoanalysis.blogspot.com/

In light of yesterday’s revelation (post #1; post #2) concerning the failure of the blinding in nicotine replacement therapy (NRT) trials, and also in light of the way in which financial conflicts of interest with pharmaceutical companies have resulted in bias in the reporting of the results of these studies, I think it is time for a re-examination of the effectiveness of NRT and its role as part of a national smoking cessation promotion strategy.

The current recommendation that NRT or other pharmaceutical agents be used with every smoker who wishes to quit is plagued by a number of serious problems:

1. The panel making this recommendation was heavily conflicted. Its chair and seven members had financial conflicts of interest with pharmaceutical companies that manufacture smoking cessation drugs.

2. The presentation of information to physicians on drug treatment for smoking cessation has been found to bebiased, presumably because of these financial conflicts of interest.

3. The conclusions of a number of the individual studies of NRT therapy appear to be biased, also presumably on account of financial conflicts of interest. See also this post.

4. Reporting of the financial conflicts of interest in smoking cessation drug studies has been inadequate, making it even more difficult to uncover the role of bias in the reporting and review of this literature.

5. The use of NRT therapy during pregnancy has been specifically challenged.

6. Population-based studies indicate that cold turkey cessation, not the use of NRT, is the most effective method for smoking cessation.

7. A number of recent studies indicate that spontaneous quit attempts, usually conducted without the assistance of NRT, are more effective than planned quit attempts which commonly use NRT.

8. Smoking cessation treatment providers have an odd dislike of electronic cigarettes, suggesting that financial conflicts of interest are playing a major role in skewing the thinking on the issue of national smoking cessation strategy.

9. Blinding failure in NRT clinical trials is a serious concern and has not yet been adequately addressed. As a result, the conclusions of the existing literature have been thrown into doubt. See the following posts for more on this issue: post 1; post 2; post 3.

Blinding failure is a serious concern because when subjects enter into a clinical trial with the thought/hope that they are going to receive nicotine replacement and then they realize they are getting a dud, they may well become very disappointed and discouraged right away. Relapse is very likely under such circumstances. This immediately lowers the continuous abstinence rates in the placebo group. There may be some recovery but it is unlikely that this initial effect can be overcome.

10. Failure to compare NRT to cold turkey quitting: In order to credibly claim that NRT is effective, one needs to compare NRT not to placebo, but to cold turkey quitting.

The Rest of the Story

In light of these 10 problems, I believe that it is time for a serious re-examination of both the effectiveness of nicotine replacement therapy and the role of NRT as part of a national strategy for the promotion of smoking cessation.

Most importantly, this re-examination needs to be conducted by unconflicted researchers who do not have financial interests in pharmaceutical companies which stand to benefit from the recommended use of nicotine replacement products.

Unfortunately, the tobacco control field has become so intertwined with pharmaceutical company money — even its national and international conferences are now sponsored by Big Pharma — that I see little possibility for such an unconflicted re-examination of this issue to take place.