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March, 2011:

Tobacco Taxation in Vietnam

Download PDF : Vietnam_tobacco_taxes_report_en

Economics Studies


An excerpt from a currently unpublished study conducted by the San Francisco Department of the Environment

More than 360 billion cigarettes were consumed in the U.S. in 2007. Cigarette consumption results in the littering of cigarette butts and other tobacco-related packaging. Tobacco product litter, particularly cigarette butts, has been shown to be toxic, slow to decompose, costly to manage, and growing in volume—a trend that appears to be exacerbated by the increased prevalence of indoor smoking bans. Growing concern over cigarette butt litter has prompted states and municipalities to undertake a variety of policy initiatives. In this report we estimate the costs of tobacco product litter (“TPL”) to the City of San Francisco. We focus mainly on direct costs, but the indirect costs associated with environmental impact and tourism—while not the basis for the fee discussed herein–are also discussed. The overall objective is to calculate a cost-per-pack (of cigarettes) that offsets the costs of TPL incurred by the City. TPL is estimated to cost the City $7,487,916 after applying data from the City’s 2009 Streets Litter Audit. Based on a per annum pack consumption of 30.6 million, the City would need to charge a “maximum permissible fee” of $0.22 per pack to recover the costs of TPL.

Toxicity studies

SDSU public health researcher and CBAG Member Richard Gersberg evaluated the effects left-over cigarette butts have on marine life and found that the chemicals from just one filtered cigarette butt had the ability to kill half the fish living in a 1-liter container of water.  Cigarette filters are made of cellulose-acetate, which is not biodegradable.

Standardized test fish (top smelt in salt water, flat-head minnows in fresh water) were used in this study, performed according to standards recommended by the California Department of Toxic Substances Control and was approved by the SDSU Institutional Review Board.

Gersberg’s study used three types of cigarette butts: smoked filtered cigarettes without tobacco; smoked filtered cigarettes with tobacco and clean un-smoked filtered cigarettes. In all cases, about half of the fish were killed with a very low concentration of cigarette butts.  The most important finding in this research is that it seems to be the filter, or rather whats in the left-over filter that is most dangerous to our water,Gersberg said.  The results of this study are now being prepared for publication in a peer-reviewed scientific journal.

In response to these findings, CBAG held a press conference on May 1, 2009, in the Aztec Center to recommend that cigarette butts be considered and regulated as toxic wastes.

Each year, billions of cigarette butts end up on our beaches, and in our oceans, lakes and rivers,said Tom Novotny, chair of CBAG and professor of public health at SDSU. Based on this new research, we believe that cigarettes should be considered toxic waste and new requirements need to be established for how they are disposed.

Six-year review of cigarette ingestion in children–gastric lavage versus medical observation

Kubo K, Chishiro T.


“During 2006, the Japan Poison Information Center received 2583 inquiries about ingestion of cigarette, which is the most frequent household products ingested by children in Japan. During 2001-2006, two hundred and seventy-six children under seven years of age ingesting cigarettes and its related substances presented to the emergency department in Japan Red Cross Hospital Wakayama Center. The peak age was one year and younger, so-called “ingestion age”. Patients were frequently detected chewing cigarettes and the situation of cases varied individually. It was impossible to estimate the amount of ingested cigarette based on the medical interview. Eighty-three percent of the patients were asymptomatic. Treatment strategy has been changed into a noninvasive one. Gastric lavage has not been performed by emergency physicians since 2001, and by pediatricians since 2006. After the medical observation for two hours following ingestion, all the children except one (who was hospitalized because of his family’s request) were discharged from the emergency department. Independent of doing gastric lavage, all the 276 children had good prognosis. We concluded that ingestion of cigarette in children is generally benign. No gastric lavage, but medical observation for two hours following ingestion in emergency department is our recommendation of management.”

The dangers of nicotine ingestion in dogs

Nicole C. Hackendahl, DVM, and Colin W. Sereda, DVM

A toxicology brief from the American Society for the Prevention of Cruelty to Animals on a dog that ingested cigarette butts:

Tobacco Documents Research

Dr. Libby Smith, historian with the UCSF Center for Tobacco Control Research and Education, Vivian Wang (Research Assistant), and Kristin Lum (MS1), have been looking into the previously secret tobacco industry documents housed at the UCSF Library to find out what has been done by the industry regarding cigarette butt litter.  Vivian and Kristin have found that the industry has tried unsuccessfully for years to develop marketable biodegradable filters (for example, made from food starch); these efforts have essentially been abandoned by the industry.

Dr. Smith has found that the industry has sought to understand why smokers discard their butts so carelessly.  She suggests that such research has revealed significant levels of discomfort about smoking addiction among smokers such that they seek to rid themselves of the evidence of their addiction (the butt) as soon as possible.  The industry also appears to understand the potential public relations problems it has with environmental concerns regarding cigarette butt waste.  For example, Phillip Morris became one of the major supporters of the “Keep America Beautiful Campaign” (a non-profit organization [KAB]), which encourages individual responsibility for proper butt disposal and other wastes.

However, some analysts point out that Philip Morris’ interest lies primarily in shifting the responsibility for butt waste to the consumer; KAB’s efforts focus on public education and increasing availability of butt receptacles, including hand held (cigarette brand-logo labeled) ashtrays.

In 2007, KAB did receive a $3 million grant from Philip Morris USA for its butt litter campaigns, but this type of largesse serves mainly to enhance Philip Morris’ corporate social image. There is no evidence to show the positive effects of their campaigns.  Those hand held ashtrays end up being dumped somewhere.

Policy Research

CBAG members Tom Novotny, Kristin Lum, Vivian Wang, Libby Smith, and Richard Barnes have just published a paper in the International Journal of Environmental Research and Public Health entitled Filtered Cigarettes and the Case for an Environmental Policy on Cigarette Waste.  This peer-reviewed article lays out the policy options available to law-makers, advocates, and the general republic to reduce the impact of cigarette butts as toxic hazardous waste.  Additional research is called for in this article, including:

  • The health consequences of banning the sale of filtered cigarettes
  • The behavioral outcomes of banning the sale of filtered cigarettes
  • The efficacy of outdoor smoking bans in reducing cigarette butt waste
  • The economic costs of butt waste cleanup for cities, counties, and states
  • Knowledge, attitudes, and practices of smokers regarding cigarette butt waste disposal
  • The environmental impact of butt waste on marine life, other animals, and humans

Smoke-free Interventions and Research

A number of beaches have gone smoke free.  Click here for a current listing by the American Non-Smokers Rights Foundation.

Analysis of Metals Leached from Smoked Cigarette Litter

Moerman, J. W. & Potts, G. E.

Littered cigarette butts are potential point sources for environmental contamination. In areas with substantial amounts of cigarette litter, serious environmental hazards may exist as captured components are leached from the filters and smoked tobacco. Although the compounds in cigarettes and mainstream smoke have been extensively researched, few studies have attempted to identify and quantify the components leached from cigarette butts or assess the leaching behavior of these components.

The aim of this study is three-fold: 1) to determine the concentration of Al, Ba, Cd, Cr, Cu, Fe, Mn, Ni, Pb, Sr, Ti, and Zn leached from cigarette butts in aqueous solution; 2) to assess the relationship between pH of the leaching solution and metal concentration leached; and 3) to assess the relationship between soaking time and metal concentration leached. Smoked cigarette material was added to aqueous solutions of pH 4.0, 5.0, and 6.0 ± 0.1. This procedure was also repeated using unsmoked cigarettes to establish background concentrations. The leachates were analyzed via inductively-coupled plasma optical emission spectroscopy (ICP-OES) 1 day, 7 days, and 34 days after sample addition.

All metals were detected in the leachates derived from smoked material 1 day after sample addition, with the exception of Cd.  The metals were released at varying rates. The concentration of some metals leached increased over the study period, establishing that cigarette litter is a point source for metal contamination for at least a month and possibly longer.  The concentration of other metals remained constant after one day of soaking, possibly indicating a rapid release of those species from the litter. No clear relationship between pH and metal concentration leached emerged from this study, suggesting that differences in pH within the range typical of precipitation have no appreciable impact on metal concentration leached from cigarette material.

Smokers are at risk from radioactive element in tobacco

South China Morning Post — 27 March 2011

There has been public concern that the contamination of the environment by the Fukushima nuclear power plants may extend to eastern and southern China, including Hong Kong.

While the radiation hazard created by the earthquake damage in Japan is an emergency, it is important we take a consistent and comprehensive approach to the prevention of cancer due to radiation.

It has been reported since the 1960s that tobacco smoke contains the radioactive element polonium-210 ({+2}{+1}{+0}Po), and this isotope emits high-energy alpha radiation which causes cancer.

It has been documented that the tobacco industry has unsuccessfully tried to remove {+2}{+1}{+0}Po from tobacco products over more than 40 years.

A detailed review of the scientific literature on {+2}{+1}{+0}Po in tobacco was published in the American Journal of Public Health in 2008, titled “Waking a Sleeping Giant: The Tobacco Industry’s Response to the Polonium-210 Issue”.

This review points out that smokers of 1.5 packs of cigarettes a day are exposed to as much radiation as they would receive from 300 chest X-rays a year.

The presence of {+2}{+1}{+0}Po in tobacco plants is the result of farmers enhancing the tobacco flavour by repeatedly applying phosphate-rich fertiliser produced from phosphate rock.

The rock contains natural radium isotopes which decay to {+2}{+1}{+0}Po.

This polonium isotope is known to be completely volatile at the temperature of a burning cigarette.

Alpha particle radiation is emitted from {+2}{+1}{+0}Po and carried by fine particles in tobacco smoke. While there are many cancer causing chemicals in tobacco smoke, the accumulation of this radioactive material in the lungs of smokers is also capable of damaging the tissues in the respiratory system in a way which leads to lung cancer.

It is vitally important that all avoidable exposure to radioactive and other agents responsible for cancer is prevented. We can begin by ensuring that:

  • Smokers are helped to quit by providing effectively funded, staffed and distributed smoking cessation services;
  • Children are not enticed to smoke by tobacco companies; and
  • Everyone is protected from breathing second-hand tobacco smoke.

Lai Hak-kan, honorary assistant professor, school of public health, University of Hong Kong

Big tobacco splutters over plain package law

THE AGE . COM  AUSTRALIA  — 27 March 2011

TOBACCO giant Philip Morris has launched a website calling on smokers to unite and flex their political muscle over tough federal government regulations.

The online campaign comes as the tobacco industry ramps up opposition to a government plan for cigarettes to be sold in plain packaging from next year.

Philip Morris’s new website –

– claims smokers are under constant attack from a ”nanny state” determined to raise taxes and ban smoking in public spaces, such as beaches and city malls.

Advertisement: Story continues below

”If you’re tired of being singled out as a smoker, it’s time to speak up because the more that smokers like you have a say, the more the government will have to listen,” the website, authorised by Philip Morris, says.

The site encourages disaffected smokers to contact their local member of Parliament and provides a forum to share grievances.

The web address is on cards inserted inside tobacco products manufactured by Philip Morris.

The new strategy follows a recent media blitz by the Alliance of Australian Retailers, which is extensively funded by Philip Morris, British American Tobacco and Imperial Tobacco.

The campaign claimed there was no evidence to support the introduction of plain packaging for cigarettes, which would harm newsagents, service stations and convenience stores.

Quit Victoria executive director Fiona Sharkie accused the tobacco industry of hiding behind websites and third-party organisations that purport to be independent.

Govt commits to smokefree NZ by 2025

ONE News — March 14, 2011

The government has committed to a goal of New Zealand becoming smokefree by 2025.

Associate Health Minister Tariana Turia today released the government’s response to the recommendations of the Maori Affairs Committee Report into the effects of tobacco use among Maori.

As well as a committment to making New Zealand smokefree by 2025, the government will look into law changes around the promotion, packaging and display of tobacco products.

It will also investigate regulating the use of additives and nicotine levels in tobacco products.

Turia said it was a landmark moment in New Zealand.

“It is about us asserting our own identity as a nation and defining for ourselves the role tobacco is allowed to play in the life of this country – this is not something we are just going to leave in the hands of the tobacco industry,” she said.

“There is still so much to be done, but I’m more confident than ever that we can reach the goal of New Zealand being a nation free of tobacco.”

The government will also look at raising the fine for retailers who sell tobacco to children.

However it has not agreed to make the tobacco industry pay for smoking cessation programmes, nor require those selling tobacco to be 18 years or older.

The Smokefree Coalition has said it is delighted with the government’s response.

The inquiry into the tobacco industry and the effects of tobacco use among Maori ran throughout 2010 and received 260 submissions.

Brisbane Customs and Border Protection Seize Shipping Container from Hong Kong Containing Illegally Imported Tobacco

Brisbane, Queensland, Australia (News4us.comMarch 09, 2011

Brisbane Customs and Border Protection Seize Shipping Container from Hong Kong Containing Illegally Imported Tobacco

Minister for Home Affairs Brendan O’Connor today revealed more than 2.5 million illegally imported counterfeit cigarettes have been seized by Customs and Border Protection in Brisbane.

“This is a large seizure that represents an attempt to evade government revenue of almost $1.2 million,” Mr O’Connor said.

“While cigarettes and tobacco are not illegal items in Australia, it is against the law to fail to declare what is being brought into Australia and duty evasion is also illegal,” he said.

Counterfeit products can also be subject to civil action from the registered trademark owners.

“Customs and Border Protection is constantly assessing imports to Australia at our sea ports, as well as airports and postal centres, to catch people who seek to break Australia’s laws.”

In February, Customs officers at the Brisbane Container Examination Facility identified risks associated with a shipping container from Hong Kong that was marked by the importer as holding bubble wrap and lunch boxes.

Customs officers conducted an initial container x-ray and due to the scan showing inconsistencies, the goods were unpacked and a physical examination uncovered 2.5 million cigarettes.

Investigations are continuing into this matter.

Under the Customs Act the maximum penalties for smuggling and evading duties is five times the amount of duty evaded or $110,000, whichever is greater. Customs and Border Protection can also lay charges under the Criminal Code Act that can attract penalties of up to ten years jail.

“This seizure is a credit to hardworking Customs and Border Protection personnel and the state-of-the-art Container Examination Facility,” Mr O’Connor said.

Tobacco smuggling and counterfeit cigarette production are problems worldwide.

Over the past four years, Customs and Border Protection has seized 977 tonnes of tobacco and 286 million cigarette sticks in sea cargo. This has prevented potential revenue evasion of approximately $397 million.

Customs and Border Protection continues to work with international partners, law enforcement agencies and industry to combat illegal importation of tobacco and counterfeit cigarette production.

Promoting tobacco cessation via the workplace: opportunities for improvement

Introduction Little research exists on the prevalence of
evidence-based tobacco cessation practices in
workplaces, employer promotion of state-sponsored
quitlines and predictors of these practices.
Methods Cross-sectional analysis of the 2008 Healthy
Worksite Survey, a telephone survey administered to
Washington employers with 50 or more employees
(n¼693). The objectives were to describe workplaces’
implementation of evidence-based tobacco cessation
practices and identify key predictors of implementation in
order to highlight opportunities for interventions.
Results Among these employers, 38.6% promoted
quitting tobacco, and 33.8% offered insurance coverage
for cessation medications and counselling, 27.5%
referred no-smoking violators to cessation services, and
5.7% included the state-sponsored quitline in health
promotion messages. Larger workplaces and workplaces
with a wellness staff, committee or coordinator had
greater insurance coverage for tobacco cessation,
communications promoting tobacco cessation, and
promotion of the state-sponsored quitline (p<0.01).
Workplaces with a wellness staff, committee or
coordinator referred more violators of no-smoking
policies to cessation services (p<0.01).
Conclusions In Washington State workplaces do little
to promote tobacco cessation by their employees. The
lack of tobacco cessation promoting practices at small
businesses, restaurants and bars, and businesses
without wellness personnel indicates an opportunity for
finding and reaching current smokers at businesses with
limited resources. By adopting inexpensive prevention
efforts, such as promoting the state-sponsored tobacco
cessation quitline, employers can help employees quit
smoking and, thereby, assist in improving employee
health and lower medical costs.

ABSTRACTIntroduction Little research exists on the prevalence ofevidence-based tobacco cessation practices inworkplaces, employer promotion of state-sponsoredquitlines and predictors of these practices.Methods Cross-sectional analysis of the 2008 HealthyWorksite Survey, a telephone survey administered toWashington employers with 50 or more employees(n¼693). The objectives were to describe workplaces’implementation of evidence-based tobacco cessationpractices and identify key predictors of implementation inorder to highlight opportunities for interventions.Results Among these employers, 38.6% promotedquitting tobacco, and 33.8% offered insurance coveragefor cessation medications and counselling, 27.5%referred no-smoking violators to cessation services, and5.7% included the state-sponsored quitline in healthpromotion messages. Larger workplaces and workplaceswith a wellness staff, committee or coordinator hadgreater insurance coverage for tobacco cessation,communications promoting tobacco cessation, andpromotion of the state-sponsored quitline (p<0.01).Workplaces with a wellness staff, committee orcoordinator referred more violators of no-smokingpolicies to cessation services (p<0.01).Conclusions In Washington State workplaces do littleto promote tobacco cessation by their employees. Thelack of tobacco cessation promoting practices at smallbusinesses, restaurants and bars, and businesseswithout wellness personnel indicates an opportunity forfinding and reaching current smokers at businesses withlimited resources. By adopting inexpensive preventionefforts, such as promoting the state-sponsored tobaccocessation quitline, employers can help employees quitsmoking and, thereby, assist in improving employeehealth and lower medical costs.

3 March 2011

Download PDF : Cessation Workplace, USA. TC 11 07

Why the tobacco industry is bad for public health (beyond the obvious reasons)

2 March 2011

This post summarises recent examples of how the tobacco industry seeks to block policies promoting public health.

1. Flexing its legal muscle

In the US, tobacco companies are reportedly taking the Food and Drug Administration to court trying to block release of a report, produced by an FDA advisory panel, which may recommend a total ban on menthol-flavoured cigarettes. The R.J. Reynolds Tobacco Company and Lorillard have filed suit against the government agency charging “conflicts of interest and bias” among panel members.


2. Creating false diversions

Thanks to Simon Chapman, Professor of Public Health at the University of Sydney, for this analysis of the industry’s latest attempt to divert our attention.

Simon Chapman writes:

The tobacco industry knows on which side its bread is buttered, and over the years, its regular squealing about tax rises have told us all that tax increases cause painful falls in tobacco consumption – precisely the point!

Cigarette prices have an elasticity of around -0.4, meaning that a 10% in retail price rises cause a 4% fall in overall consumption, caused by both quitting and reducing use.

Low income groups like children and the poor have even higher responsiveness to price rises, with elasticities of up to -1.2 (12% fall for 10% price rise).

The 2010 Rudd government excise rise was one of the biggest on record and roundly applauded by public health groups. The tobacco industry has shifted its main attack on tax rises from being a concerned friend to the poor (“prices rises hurt the poor .. so keep the price low!”) to the idea that they generate significant black markets.

This week, an industry-commissioned Deloitte report has trumped another industry-commissioned 2010 PriceWaterhouseCoopers report on the size of the illegal tobacco market in Australia.  In 2010, PWC estimated this at 12.3% of all tobacco then consumed in Australia: that’s right, get your heads around this one: 1 in 8 cigarettes and roll-your-owns are purchased illegally, they want us to believe!

Globally, an upper limit of 8.5% of tobacco sold is estimated to be black market, with most of this occurring in nations with high corruption indexes like much of Africa and former Soviet states. Our local tobacco industry is saying that Australia is near the top of that league. Who would have thought!

Now Deloitte has gone one better.  To quote the release:

A Deloitte report into illegal tobacco in Australia revealed taxpayers are losing out on almost $1.1 billion in excise revenue as the illegal tobacco market grows rapidly. The report estimated that 2.68 million kilograms of illegal tobacco products were sold in Australia during 2010, equivalent to 15.9% of the total legal tobacco market. Organised crime gangs importing loose leaf tobacco, counterfeit and contraband cigarettes are now the fourth largest tobacco player in Australia just behind Imperial Tobacco which holds 17% of the legal market. British American Tobacco spokesperson, Scott McIntyre said the annual report highlighted the worrying upward trend in black market tobacco which pays no excise duty to the Government, is unregulated and often carries no health warnings.

Contrast these findings of the 2007 National Drug Household Survey, which found that only 0.2% of the population (around 33,000 people) used black market tobacco more than half the time. The tobacco industry continues to blow self-serving smoke.

Try and picture this: unlike the Federal police who are charged with busting those who sell illegal tobacco and have in the past made arrests that have seen fines running into the millions, masses of ordinary smokers are apparently somehow able to do a better job in finding out where these all these illegal outlets are.

Look at all the legal cigarette packs that you see in thousands of legal outlets .. divide that by 6 and imagine that that is approx the number of outlets that these industry sponsored reports would have us believe are out there.

• PS from Croakey: See how The Daily Telegraph fell for the industry spin – hook, line and sinker…


3. FOI-ing the living daylights out of health departments (freedom of information)

Documents tabled recently in Senate Estimates hearings reveal how FOI requests from tobacco companies are costing the Federal Department of Health and Ageing a small fortune (drop me a note if you’d like a copy of these, and see this previous Croakey post for more background).

The documents, which have been circulated by Senator Rachel Siewert, show that the Department has spent months negotiating with British American Tobacco Australia and Philip Morris Limited about their FOI requests around the Government’s plans for plain packaging of cigarettes.

In a recent media statement, Senator Siewert said six people are being employed at taxpayer expense specifically to deal with these tobacco company requests.

The Senate Estimates Hearings documents showed that in one case, negotiations between DoHA and a tobacco company resulted in the Department’s initial estimate of an FOI charge of $1.47 million being reduced to $367,106 as the scope of the request was narrowed.

In another case, the Department spent six months negotiating with a tobacco company to narrow the scope of its FOI requests from more than 5,800 files to 280 files. “In that case, the initial charges estimate was $637,673.50. Negotiations on the scope of the request brought that down to $100,426.17 before agreement was reached on a request with estimated charges of $25,566.49.”

The Department noted that the FOI regulations do not provide for full cost recovery and that the charges levied to FOI applicants do not reflect the real cost of completing the work: “The regulations state that staff time, regardless of the level of the officer, is chargeable at $15 per hour for search and retrieval, and $20 per hour for decision-making time. In addition, none of the costs involved in the process of negotiation, which included assessing the requests and preparing three charges estimates, are covered by the ultimate estimate of the charges for which the applicants will be liable.”

All of which is to say that Australian taxpayers are subsidising tobacco industry efforts to block public health measures.


4. Paying for political clout

Health groups are waiting to see whether the Federal Coalition will line up behind the Government’s plain packaging legislation, or whether they will support the interests of their tobacco donors (Cancer Council Australia has morebackground on plain packaging).

Perhaps Senator Eric Abetz’s questions in the Senate last year give some indication of the Coalition’s likely position.

Abetz asked the Minister for Innovation, Industry, Science and Research, upon notice, on 16 November 2010:

(1) What are the intellectual property (IP) implications of plain packaging of tobacco products?

(2) Is it correct that plain packaging may not be consistent with Australia’s IP treaty obligations?

(3) Is it correct that IP Australia has advised the Government that plain packaging would make it easier for counterfeit products to be produced and supplied on the market.

(4) Has the Minister been advised that plain packaging of tobacco products may be seen by trademark owners as a restriction on the ability to use their marks; if so: (a) where did that advice come from; (b) what was that advice; and (c) what are the implications

Senator Carr replied on 8 February, 2011:

The answer to the honourable senator’s question is as follows:

(1) Plain packaging will involve regulating the use of trademarks on tobacco products. This measure will not remove any existing trade mark registrations, nor affect the registrability of future trademarks.

(2) No. The relevant treaty, the Trade-Related Aspects of Intellectual Property (TRIPs) Agreement, allows for regulating the use of trade marks when it is justified and reasonable to do so.

(3) Yes. IP Australia advised the Government that plain packaging might increase the potential for the counterfeiting of tobacco products. However, IP Australia did not estimate the level of any likely rise.

(4) Yes.

(a) The advice came from IP Australia.

(b) The advice was that the use of trademarks can be restricted by Government when it is justified and reasonable to do so, for instance to address a public health issue.

(c) The implications are that the Government will be able to restrict the way a trade mark can be used when it is justified and reasonable to do so.

According to public health sources, it should only be a matter of weeks until the draft legislation is available for public consultation, with the bill’s introduction in the lower house expected in June or July.

By July, a Greener shade of Senate is likely to support the bill (the Greens have already indicated support), but health groups are expecting the House of Reps to be a challenge.

Some believe that the fate of the legislation may hinge on the views of the independents Tony Windsor and Rob Oakeshott.

Perhaps someone should give them the stats on the toll that tobacco takes in their electorates. Or perhaps this has already been done…

If the independents don’t support the legislation, it will make their professed concerned for rural health sound rather hollow.


5. PR spin

On this comprehensive Radio National Background Briefing report, you can hear how the industry is spinning its opposition to plain packaging, as well as analysis from journalist-turned-PR Peter Wilkinson and former industry lobbyist and current Crikey contributor Richard Farmer.

The program also canvasses former Coalition Government Minister Dr Brendan Nelson’s support for generic packaging. When interviewed for the program, Nelson (now Ambassador to the EU) declined to reiterate his opposition to political parties taking tobacco money.

He did, however, say that the tobacco industry’s most frustrating tactic is the use of third-party endorsers (as we’ve seen recently from the industry-funded Alliance of Australian Retailers and its inept efforts in this area, aspreviously described at Croakey)

We will soon know how well that cap – “third party endorser” – fits the Federal Opposition … it’s not a pretty look for any politician or political party these days. It will be interesting to see if the doctors in the Coalition will be prepared to wear it.

A cancer epidemic among the poor

South China Morning Post — 2 March 2011

Cancer is an enormous – and growing – global public health problem. And, of the 7.6 million cancer deaths every year, 4.8 million occur in the developing world. A disease formerly considered more pervasive in affluent countries now places its heaviest burden on poor and disadvantaged populations.

In some African countries, fewer than 15 per cent of cancer patients survive for five years following diagnosis of cervical and breast cancer, diseases that are highly curable elsewhere in the world. These are shocking statistics.

The increase in cancer’s impact on the poor reflects factors such as demographic growth, population ageing, the spread of unhealthy lifestyles (including tobacco use), and lack of control of cancer-associated infections.

If no action is taken, the number of cancer deaths in the developing world is forecast to grow to 5.9 million in 2015 and 9.1 million in 2030, while cancer deaths in wealthy countries are expected to rise by 40 per cent over the next 20 years.

Throughout the developing world, most health care systems are designed to cope with episodes of infectious disease. But most lack the funds, equipment and qualified personnel needed to provide basic care for cancer patients. They also have little capacity for prevention, public education, or early diagnosis and treatment.

Many of these patients do not have to die. We know that around one-third of cancers can be prevented. This figure could be increased markedly if more emphasis were placed on identifying additional environmental and lifestyle-associated factors that increase cancer risks. In addition, a diagnosis no longer has to be a death sentence, because one-third of cancers can be cured if detected early and treated properly.

The World Health Organisation and the International Atomic Energy Agency, which helps to build countries’ capacity for radiation medicine, are working closely together to improve cancer control in developing countries.

Preventive measures such as public health initiatives to curb smoking can be remarkably effective. Vaccines against hepatitis B and human papillomaviruses, if made available at affordable prices, could contribute significantly to the prevention of liver and cervical cancers, respectively.

We are seeing promising results in individual countries, but our efforts are just a drop in a vast ocean of need. In order to respond to the growing cancer epidemic, we need nothing less than concerted global action similar to the successful mobilisation against HIV/Aids.

Cancer should be seen as a vital part of the global health agenda. World leaders should be made aware of the scale of the cancer crisis facing developing countries.

The UN General Assembly’s Summit on Non-Communicable Diseases in September provides an opportunity to focus the world’s attention on cancer in developing countries. Let us make cancer control one of the good news stories of 2011.

Margaret Chan is director general of the World Health Organisation. Yukiya Amano is director general of the International Atomic Energy Agency. Copyright: Project Syndicate

Prof .   J u d i t h   L o n g s t a f f   M a c k a y

MBChB, FRCP (Edin), FRCP (Lon)

Senior Advisor

t:  +852.2719.1995    f:  +852.2719.5741

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Plain Tobacco Packaging: A Systematic Review

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