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April, 2012:

China’s tobacco excise tax should be almost tripled, WHO says

15/03/2012 11:10:00Simeon Bennett

China should almost triple its excise taxes on tobacco products to
dissuade young people in the nation with the most smokers from taking up
the deadly habit, the World Health Organization said.
The excise tax on tobacco products should be at least 70 percent of the
retail price, the Geneva-based agency said in an e-mailed statement
today. The most-sold brand of cigarettes in China currently has an
excise tax of 26 percent, the WHO said.
China is home to a third of the world’s smokers and more than 1 million
people in the most populous nation die each year from tobacco-related
diseases, according to the statement. Half of China’s 350 million
smokers spend 5 yuan (79 cents) or less for a packet of 20 cigarettes,
the WHO said.
“Increasing prices through taxation has proven to be one of the most
effective ways to discourage people from smoking, particularly young
people,” Michael O’Leary, the WHO’s representative to China, said in the
statement. “Numerous studies, globally and in China, show that a small
increase in the price of tobacco through increased taxation will
significantly reduce the number of smokers and generate considerable
extra revenue for the government,” the WHO said.
Miao Wei, China’s industry minister, said March 11 that the price of
cigarettes in the country is “quite high.” The ability of higher prices
to discourage smoking was yet to be proven, Miao said.

With assistance from Daryl Loo in Beijing. – Bloomberg

South Australia mounts lawsuit against tobacco companies

South Australia is pushing for tobacco companies to compensate governments for the health costs. Source: Supplied

SOUTH Australia is spearheading a push to recoup billions of dollars spent on caring for sick smokers.

Health Minister John Hill put the proposal to a Ministerial Council meeting in Canberra on Friday and said he had received a positive response.

Mr Hill said Australia was well placed to force tobacco companies to compensate governments for the health costs associated with smoking over many decades.

A similar class action in the US led to the major firms agreeing to the 1997 US Master Settlement Agreement, in which tobacco companies agreed to pay up to $200 billion compensation to states over 30 years.

“I raised it with the other Ministers and we agreed that we would ask the Commonwealth to investigate a similar scheme here,” Mr Hill said.

“It costs taxpayers millions of dollars a year to look after smokers and it is a cost that is completely preventable, and I think we should be able to make a case in Australia, similar to the case in the US, where tobacco companies were forced to pay compensation to the states.”

The class action suggestion was raised in December last year by visiting US anti-tobacco campaigner Matthew Myers, who participated in negotiations which led to the US agreement. Mr Myers told the Federal Government a similar class action would have great prospects of success, given Australia’s common law principles which are based on English laws rather than those of the US.

Five Canadian provinces have recently filed similar law suits, a move which Mr Hill believed Australian authorities should follow.

“There seems to be a firm belief that if they can do this in America and Canada there is no reason why it could not happen in Australia,” Mr Hill said.

New Smokefreemovies ad: Tobacco bought its way into movies. It’s time to get it out again.

See the actual ad

Smoke Free Movies has launched a series of print advertisements in Variety, The Hollywood Reporter and other publications. This advertisement first ran on April 25, 2012 in The Hollywood Reporter and Variety.

Tobacco bought its way into movies. It’s time to get it out again.

[Image: Detail of 1948 Chesterfield cigarette advertisement]


What’s changed for audiences? In 2011, they saw Brad Pitt, Johnny Depp, Daniel Craig, Bryan Cranston and Phillip Seymour Hoffman using Marlboro, Kool, Camel and Copenhagen brands in five different PG-13 and R-rated films from one major studio.


First, cross-promotion

During Hollywood’s “Golden Age,” more than two-thirds of America’s top adult box office stars advertised tobacco brands.

What did film studios get in return for brokering these deals? Valuable national ad campaigns plugging their contract stars and latest films, paid for by the tobacco industry.

What did the tobacco companies get out of it? Stars smoking on screen reinforced every cent the companies spent on their brand advertising.

Then product placement

In the early 1950s, tobacco promotion shifted to TV. By the time tobacco ads were barred from radio and TV in 1970, Hollywood no longer kept brands off screen. So, through at least the early 1990s, tobacco companies again bought their way into movies through product placement deals involving hundreds of films.

Exposure led to a 1998 legal agreement with state Attorney Generals that barred paid brand placement by domestic tobacco companies. Yet smoking in mainstream movies continued to climb, peaking as late as 2005.

Movies still sell smoking

In 2011, kid-rated films delivered twice as many tobacco exposures as in 2010. Whoever decides it, top stars continue to be associated with tobacco brands on screen (above).

Bottom line? Movies continue to recruit large numbers of new young smokers who replace the adult smokers killed by tobacco.

The R-rating solution

In March 2012, the U.S. Surgeon General reviewed the scientific evidence and history of commercial links between the tobacco and film industries. She then joined other leading health authorities in concluding that the adoption of the R-rating for all future films with tobacco imagery, excepting films that depict tobacco’s real health consequences or portray actual historical people who smoked, would contribute to a reduction in youth smoking.

The tobacco industry has exploited movies for at least seven out of the last nine decades. The R-rating will ensure that the movies young people see most often are, in the future, tobacco-free.


“Tobacco company advertising and promotional activities cause adolescent and young adult smoking initiation and are compounded by depictions of smoking in the movies.” — U.S. Surgeon General, March 2012


American Academy of Pediatrics

American Heart Association


American Lung Association

American Medical Association

Americans for Nonsmokers’ Rights

American Public Health Association

Campaign for Tobacco-Free Kids

Smoke Free Movies

Review tobacco’s history on screen and evidence-based policy recommendations in Preventing Tobacco Use Among Youth and Young Adults: A Report of the Surgeon General (2012), Chapter 5: The tobacco industry’s influences on the use of tobacco among youth.

Ad sample courtesy of Stanford Research into the Impact of Tobacco Advertising (SRITA)

Tobacco chief admitted smoking is harmful in an internal memo

Lamented future ‘smokeless society’

By SUE MONTGOMERY, The GazetteApril 20, 2012

In the suit against Rothmans Benson &

Photograph by: PIERRE OBENDRAUF GAZETTE FILE , The Gazette

The former president of Imperial Tobacco Limited admitted in a confidential internal document that it is an unrefuted and accepted fact that smoking is a serious health issue – but a few months later told a federal legislative committee that there is not proof that tobacco causes disease.

In a 1987 memo, Jean-Louis Mercier, along with Wilmat Tennyson, Imperial’s marketing man at the time, conceded that the tobacco industry had lost the battle “on four critical fronts”: health, social cost, social acceptance and secondhand smoke. The memo concluded the industry should shift the blame to the federal government.

Testifying Thursday at the trial in which Quebec smokers are claiming C$27 billion in damages from Canada’s big three tobacco companies, Mercier repeated that the government, not the tobacco companies, was at fault.

“Personally, I said that if it’s true that it kills 32,000 people a year, I don’t understand why we sell cigarettes,” Mercier said in a large courtroom filled with lawyers on the top floor of Montreal’s courthouse. “Why does the government permit it?

“It should have taken the leadership.”

Mercier also noted that the government, which has made billions of dollars over the years from tobacco sales tax, should have put some of that money into researching how the negative effects of smoking could be reduced.

The tobacco industry lost the health debate, the memo says, because it was “clearly constrained by the basic flaw that it could not argue smoking is good for you.”

It was also hamstrung by the fear of liability and handcuffed by its own lawyers.

“Smoking is a serious health hazard; it is an accepted fact and there is no longer any possibility of refutation,” the memo says.

But according to the transcripts from the legislative committee on Bill C-204 to regulate smoking in the federal workplace and common carriers, Mercier, just months after writing his internal memo, denied smoking caused disease.

“Our views are that, in the context of the current scientific knowledge, these diseases are most likely caused by the interaction of many factors,” he told the committee. “The role, if any, that tobacco or smoking plays in the initiation and the development of these diseases is still very uncertain.”

The transcripts weren’t presented in court, but The Gazette obtained a copy.

The memo also says that the industry, through inaction and apathy, has been “shouldering the entire burden of guilt” and should shift the onus onto government.

“If it is too late to change public perception, the target of the wrath can be changed and this can be done relatively easily and quickly,” the memo says. “The blood is not on the hands of manufacturers engaged in a legitimate endeavour.”

The memo ends in a deflated tone, noting that neither the public nor government has any confidence in the tobacco industry.

“We will continue to stumble along, a sunset industry, heading for a smokeless society.”

The trial, which began in March and is expected to last at least two years, involves about two million Quebec smokers and is the largest claim in Canadian history.

The plaintiffs allege the cigarette industry made and sold a product it knew was dangerous.

The companies – Rothmans Benson & Hedges, JTI Mac-Donald and Imperial – deny the allegations.

To see if you can join the suit, go to


© Copyright (c) The Montreal Gazette

No treatment for smokers or the obese: Doctors back measures to deny procedures for those with unhealthier lifestyles

29 April, 2012

Treatment ban: Some doctors have called for non-emergency treatments to be banned for those who are obese

More than half of doctors across the UK have backed controversial measures to withhold treatment to smokers and the obese.

According to a new survey around 54 per cent of those who took part said the NHS should have the right to deny non-emergency treatments to those who fail to lose weight or kick their smoking habits.

Members of the networking website were asked ‘Should the NHS be allowed to refuse non-emergency treatments to patients unless they lose weight or stop smoking?’

And although the poll was optional 593 of the 1,096 doctors who participated answered yes.

It is believed that some procedures are less likely to work on those with unhealthier lifestyles and medics say they should not use their already limited resources for such work.

In some parts of England smokers and the obese are already being rejected IVF treatment as well as hip and knee replacements by private clinics but patient groups have reacted angrily to calls for the NHS to follow suit, saying it denies them their basic human rights.

Speaking to The Observer Dr. Tim Ringrose,‘s chief executive, said the shift in attitudes is a result of the need to make huge cut backs.

Unhealthy: Smokers should not be entitled to the same medical care because of their habit, according to some doctors

He said: ‘This might appear to be only a slim majority of doctors in favor of limiting treatment to some patients who fail to look after themselves, but it represents a tectonic shift for a profession that has always sought to provide free healthcare from the cradle to the grave.’

Dr. Clare Gerada, chair of the Royal College of General Practitioners, also told the paper: ‘Clearly, giving up smoking is a good thing, but blackmailing people by telling them that they have to give up isn’t what doctors should be doing.’

Pulse magazine has already reported that around 25 of 91 Primary Care Trusts in England have imposed some treatment bans since April last year.

A move to help save the £20bn, expected by the Government, before 2015.

But treatment bans of any kind were slammed by Dr Mark Porter, chairman of the British Medical Association’s consultants committee, who added: ‘There are occasions where a doctor may advise an obese person to lose weight before surgery can safely go ahead.

‘But treatment bans are wholly unacceptable.

Read more:

Asian WhiteCoats program
read and be educated
then apply the same to what EPD is doing with its ‘trashcoat experts’

China bans high-tar cigarettes

27 Apr 2012. China will ban the sale and import of cigarettes containing more than 11 milligrams of tar from 1 January 2013, according to the State Tobacco Monopoly Administration (STMA).
The move comes as the government seeks to reduce the health-care costs associated with smoking. Cancer and other chronic diseases spurred by smoking may lead to slower growth in the world’s second-biggest economy if unabated, Health Minister Chen Zhu said in an interview earlier this months, reports Today online.´

China set the limit for tar per cigarette at 17 milligrams in 2001 and gradually cut it to 12 milligrams by 2011 to make smoking “less harmful.” (pi)

Graphic health warnings help quitters stay away from smoking

The graphic health warnings on cigarette packets not only help smokers quit, it also helps those who have quit to stay away from smoking.

This has been indicated in a survey of former smokers carried out in Australia, Canada, the US and the UK.

While noticing that cigarettes might pose a risk for ex-smokers to start again, warnings on labels can be used to actively resist the urge, according to the survey carried out by scientists from the Cancer Council Victoria, Australia; University of South Carolina, US and the University of Waterloo, Canada.

Giving up: Health warnings on the side of cigarette packets have been found to help quitters stay away from smoking

Giving up: Health warnings on the side of cigarette packets have been found to help quitters stay away from smoking

The survey involved 1936 recent ex-smokers.

‘Our results provide the first prospective evidence that warning labels can have a protective benefit for recent ex-smokers over a period of at least one year after quitting,’ one of the scientists said.


The paper was published in the journal Tobacco Control.

It may be that ex-smokers actively use warning labels to remind them of their reasons for quitting.

Thus, ex-smokers should be encouraged to use pack warnings to counter urges to resume smoking.

Novel warnings may be more likely to facilitate this, scientists suggested.

Warnings: The packaging helps raise awareness of smoking-related diseases

Health warning labels on cigarette packets have consistently been shown to provide information, raise awareness of smoking- related risks, promote quit-line use, reduce cigarette packet appeal, strengthen intentions to quit and increase cessation behaviours such as reducing cigarette consumption and making quit attempts.

People who have never smoked report that warning labels discourage them from taking up the habit.

Among adolescents, warning labels reduce intentions to smoke and lead to their not taking up the habit.

However, the impact of warning labels on exsmokers was not well understood so far.

The survey was part of the International Tobacco Control 4-Country policy evaluation project which commenced in 2002 to monitor the impact of tobacco control policies.

Another study by scientists from the University of Michigan has warned that global smoking prevalence would fall by about 1.7 percentage points by 2030 unless governments initiate concerted action.

But if measures suggested by the World Health Organization such as tobacco use monitoring, protection from second-hand smoke, warnings about the dangers of tobacco, ban on tobacco advertising, promotion and sponsorship, and tax hikes are adopted, global prevalence would fall from around 24 per cent in 2010 to a little over 13 per cent by 2030

Read more:

Tobacco ads ‘target young children’

Thursday, 26 April 2012

A new study has claimed tobacco companies are targeting youngsters with colourful and eye catching packaging
A new study has claimed tobacco companies are targeting youngsters with colourful and eye catching packaging

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Tobacco companies have targeted children by using “colourful and slick” cigarette packaging, a charity has alleged.Video footage released by Cancer Research UK shows children as young as six years old discussing what attracts them to cigarette packets, with one explaining: “It makes you feel like you’re in a wonderland of happiness.”

A new report by the charity claims tobacco companies have identified young people and women as target groups for packaging design purposes.

Other reactions by the group of six to 11-year-old children, filmed to launch the charity’s The answer is plain campaign, were “The pictures actually look quite nice. Ice cubes and mint;” “It reminds me of a Ferrari;” “Is that the royal sign?” and “Yeah. Pink, Pink, Pink.”

The charity said the children were shown cereal boxes and asked for their responses before being shown cigarette boxes and again asked for their “unprompted and unscripted” thoughts. It has launched a petition calling for all branding on tobacco packaging to be removed.

Cancer Research’s UK director of tobacco control, Jean King, said: “This footage provides us with a chilling insight into how powerful branding and marketing can be. Children are drawn to the colourful and slick designs without having a full understanding of how deadly the product is inside the pack.”

The report reviews tobacco industry documents from over the last half-century, with several internal documents describing how packaging had been developed to appeal to new smokers, notably teenagers, through its size, colour and design, the charity said.

It claims that some cigarette brands are packaged to appeal specifically to women or men, with those targeting women often designed to be long and slender and using pale or pastel colours “indicating femininity, style, sophistication and attractiveness”.

Eight focus groups for the charity of around 50 15-year-olds showed clear differences between boys and girls when asked to pick their favourite packs. Girls liked the female-oriented Silk Cut and Vogue Superslims which “suggested femininity and pleasure, such as perfume, make-up and chocolate”, the charity said, while boys preferred the Marlboro Bright Leaf, Lambert & Butler and Benson & Hedges slide packs which “suggested maturity, popularity and confidence”.

The report coincides with a Department of Health public consultation on the future of tobacco packaging.

Read more:

Government urged to ban smoking in outdoor areas

Government urged to ban smoking in outdoor areas

Updated April 26, 2012 13:15:21

Four of Victoria’s leading health groups have stepped up pressure on the Baillieu Government over smoking in outdoor areas.

Quit Victoria, the Australian Medical Association, the Heart Foundation and the Cancer Council want a ban on smoking in outdoor dining and drinking areas.

The groups have also recommend a ban on smoking in children’s playgrounds, at public transport stops and even between the flags on patrolled beaches.

Quit Victoria’s Fiona Sharkie says Victoria is lagging behind other states on this issue.

“Victoria remains the only state that doesn’t have a ban on smoking in outdoor drinking and dining areas and we feel that we need to rectify that as soon as possible, given that Victoria has been such a leader in tobacco control,” she said.

Ms Sharkie says even some smokers support the changes.

“What we do find is that smokers are generally pretty supportive of bans, particularly if they’re bans in areas where children and families congregate,” she said.

Health Minister David Davis says the outdoor bans are under consideration.

“It’s certainly is one of a number of measures that are being considered and are being looked at very closely,” he said.

“There’s been consultation on that and other measures with a wide range of organisations.”

First posted April 26, 2012 08:16:46

Clear the Air says: In Hong Kong the following set of questions  was raised inLegco in 2007 – guess what has happened since 2007! Well,  nothing. Why not ?

The new Secretary for Health can do one simple thing and does not even have to go toLegco to achieve it  – that is to add an additional  single paragraph to every liquor licence in Hong Kong :  the current licences state –

7.        The licensee shall not permit any person to occupy or use any portion of the premises for any immoral or illegal purpose.

Smoking in a licensed premises and workplace is an illegal activity and the licensee is bound to prevent it in the same way they are obliged to obey the other licensing conditions.  By not doing this the licensee breaks the conditions of the premises’ liquor licence. The onus must be placed on the licensee to prevent smoking in his/her premises as is the case everywhere overseas.

Accordingly we would urge the new Secretary for Health to direct the  Liquor Licensing Board to be proactive and to add  :

iii) 持牌人須確保處所內無人吸煙或攜帶燃着的香煙、雪茄或煙斗。(新增)

iii) The licensee shall ensure no smoking or carrying a lit cigarette, cigar or pipe in any area of the licensed premises. (New)

to ALL issued Liquor Licenses  as a matter of course and to advise the licensees of their duty to abide by all the conditions of their liquor licences and the pitfalls of not doing so.  The amendment should cover all parts of the liquor licensed premises, including patio areas , Outside Seating Accommodation whether more than 50% enclosed or not and within 15 meters of said premises to prevent smokers congregating at entrances and those who currently sit and smoke half in and half out of premises.   The law is to prevent damage to the health of staff in the workplace and should cover all parts of the licensed area whether covered , indoor or otherwise.

If people cannot go out and smoke in entertainment areas, many will quit. This means also an urgent increase in the staffing of the Tobacco Control Office who have insufficient staff for preventative  patrols and who can act only days later on telephone or email complaints.  53 officers per each of two shifts to cover the whole of HK, Kowloon, NT and the Islands is ludicrous and a deliberate ploy of the incumbent administration to produce a potholed legislation then fail to allocate enough staff to enforce it.

Then even worse, the massive sums taken in from tobacco taxation are not used for anti -smoking measures , whether cessation or advertising , but just enter the General Fund to be used to build more concrete white elephants.

Time for change.

From: Astor Chan []
Tuesday, July 24, 2007 12:39 PM

Dear Mr. Middleton,

Thanks for your email. We have raised a Legco question regarding this issue. Attached plsfind the question and answer.


Astor Chan

Research Officer (Health Policy)

Legco Secretariat

Democratic Party

Following is a question by the Hon Andrew Cheng and a written reply by the Secretary for Food and Health, Dr York Chow, in the Legislative Council today (July 4):


Regarding smoking in outdoor public places, will the Government inform this Council:

(a) whether it knows if smoking outside designated no smoking areas (e.g. outside restaurants) has become prevalent since the implementation of the Smoking (Public Health) (Amendment) Ordinance 2006, the locations where the situation is particularly serious, as well as the impact on the health and smoking habits of members of the public (especially the problem of smoking among children); if it knows, of the details; if not, whether it will consider conducting a survey to understand the situation;

(b) of the number of prosecutions instituted by the Government against smoking in designated no smoking areas of outdoor public places since January 1 this year; whether there are difficulties in implementing the smoking ban in such places; if so, of the details and locations where the implementation of such a ban is particularly difficult, as well as the measures taken by the Government to resolve the difficulties; and

(c) whether it will consider amending the legislation to designate areas within 15 metres from the entrance to indoor designated no smoking areas (e.g. shopping arcades) as no smoking areas; if it will not, of the reasons for that, as well as how it protects the public from exposure to heavy second-hand smoke before they enter the premises concerned?


Madam President,

My reply to each part of the question is as follows:

(a) The purpose of designating no-smoking areas is to minimise the effect of secondhand smoke on the public.  In so doing, we have balanced the interests of all parties, including both smokers and non-smokers.  With the vast expansion of statutory no-smoking areas since January 1 this year, the exposure of the public to secondhand smoke has already been greatly reduced.  At present, our priority is to implement the smoking ban in statutory no-smoking areas.  As for changes in the number of smokers and their smoking frequency and habits, the impact of secondhand smoke outside the statutory no-smoking areas, as well as public reaction towards the overall tobacco control efforts after the implementation of the amended Smoking (Public Health) Ordinance, we will conduct survey and study at a later stage to assess the effect of the new legislation.

(b) Statutory no-smoking areas designated under the Smoking (Public Health) Ordinance are set out in Part 1 of Schedule 2 to the Ordinance.  Since January 1 this year, the Tobacco Control Office has arranged to issue 70 summonses for smoking offences committed in outdoor no-smoking areas, including 69 cases that took place in public pleasure grounds under the management of the Leisure and Cultural Services Department and one case that took place in a public hospital.  Generally speaking, most people have complied with the smoking ban since the expansion of no-smoking areas. The Administration has encountered no particular difficulty in its enforcement of the smoking ban in outdoor areas.

(c) The amended Ordinance has vastly expanded the statutory no-smoking areas and the new legislation has only been in force for six months.  It would take time for the public to get accustomed to the new requirements and the Administration to review the effect of the new law.  At the present stage, we have no plans to further expand the statutory no-smoking areas.  As stated in part (a) of my reply, we will conduct survey and study after the new law has been in force for some time.  We should also note that no matter by how much the no-smoking areas were expanded, clear and conspicuous demarcations between smoking areas and no-smoking areas would still be needed.  Before putting in place any smoking ban, we must consider how to ensure effective enforcement and easy compliance by the public.

The long-term objective of tobacco control is to reduce the number of smokers, in particular young smokers.  Smoking cessation services are now made available by the Department of Health (DH) and the Hospital Authority.  In the past five months, the number of people calling DH’s smoking cessation hotline has increased twofold as compared with the same period last year.  Many family doctors and pharmacists working in the community have also joined in the provision of smoking cessation services.  We will continue to work with all sectors of the community to encourage smokers to quit smoking and hope that the trend of cessation will continue.

———- Forwarded message ———-
From: James Middleton <>
Date: 19-May-2007 11:16
To: Legco <>,
Cc: Judith Mackay <>, Professor Hedley <>, COSH <>, “Dr. Wan” <>,



the Honorable Cheng Kar Foo

Ms Monna Lai

Dear Sir,

please find attached a late 2006 report on second hand smoke.

Currently there are designated smoking areas in parks and smoking is allowed in outdoor areas of restaurants and bars open to all ages that are not 50% enclosed.

Whilst being contrary to existing Hong Kong laws as addressed previously, this causes Outdoor Tobacco Smoke that is a proven danger to persons nearby or downwind of the smoke, especially chidren and susceptible adults. It also gives the impression to our youth that smoking in public is  acceptable behaviour and can encourage our youth to smoke and become addicts.
Please give consideration to amending the exemptions which currently allow designated smoking areas outdoors, especially in parks and restaurants which are open to all ages. Furthermore please give consideration to banning smoking within 15 meters of doorways, lifts,  escalators and building entrances. Our children and the 86% of our population that does not smoke in Hong Kong should not have to walk through the cancerous and irritating obnoxious smoke of the minority in order to enter and leave buildings.

Yours faithfully,

James Middleton

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Stanford Report, May 2, 2007

Exposure to secondhand tobacco smoke in outdoor settings a risk, study shows


L.A. Cicero  

Wayne Ott and Neil Klepeis were members of a team of Stanford researchers who conducted the first in-depth study on how smoking affects air quality at sidewalk cafés, park benches and other outdoor locations.

Tens of thousands of Americans die each year from secondhand tobacco smoke, according to a 2006 report by the U.S. Surgeon General. While the health risks associated with indoor secondhand smoke are well documented, little research has been done on exposure to toxic tobacco fumes outdoors.

Now, Stanford University researchers have conducted the first in-depth study on how smoking affects air quality at sidewalk cafés, park benches and other outdoor locations. Writing in the May issue of the Journal of the Air and Waste Management Association (JAWMA), the Stanford team concluded that a non-smoker sitting a few feet downwind from a smoldering cigarette is likely to be exposed to substantial levels of contaminated air for brief periods of time.

“Some folks have expressed the opinion that exposure to outdoor tobacco smoke is insignificant, because it dissipates quickly into the air,” said Neil Klepeis, assistant professor (consulting) of civil and environmental engineering at Stanford and lead author of the study. “But our findings show that a person sitting or standing next to a smoker outdoors can breathe in wisps of smoke that are many times more concentrated than normal background air pollution levels.”

Klepeis pointed to the 2006 Surgeon General’s report, which found that even brief exposures to secondhand smoke may have adverse effects on the heart and respiratory systems and increase the severity of asthma attacks, especially in children.

“We were surprised to discover that being within a few feet of a smoker outdoors may expose you to air pollution levels that are comparable, on average, to indoor levels that we measured in previous studies of homes and taverns,” said Wayne Ott, professor (consulting) of civil and environmental engineering at Stanford and co-author of the JAWMA study. “For example, if you’re at a sidewalk café, and you sit within 18 inches of a person who smokes two cigarettes over the course of an hour, your exposure to secondhand smoke could be the same as if you sat one hour inside a tavern with smokers. Based on our findings, a child in close proximity to adult smokers at a backyard party also could receive substantial exposure to secondhand smoke.”

Unlike indoor tobacco smoke, which can persist for hours, the researchers found that outdoor smoke disappears rapidly when a cigarette is extinguished. “Our data also show that if you move about six feet away from an outdoor smoker, your exposure levels are much lower,” Klepeis added.

The public has become increasingly concerned about the effects of outdoor smoking, Ott noted. More than 700 state and local governments have passed laws restricting outdoor smoking at playgrounds, building entrances and other public areas, according to the American Nonsmokers’ Rights Foundation. Some of the strictest ordinances are in California. The city of Santa Monica, for example, recently banned smoking at parks, beaches, automatic teller machines, theater lines, open-air restaurants and other outdoor locations.

“Throughout the country, cities and counties are looking at various laws against outdoor smoking, and some of the proposals are pretty drastic,” Ott said. “The problem is that until now, there have been virtually no scientific data to justify such restrictions. In fact, our paper is the first study on outdoor smoking to be published in a peer-reviewed scientific journal.”

Particulate matter

In the study, the researchers used portable electronic monitors to make precise measurements of toxic airborne particles emitted from cigarettes at 10 sites near the Stanford campus. “We wanted to quantify the potential level of exposure to outdoor tobacco smoke that could occur in everyday settings,” Klepeis said. “To do this, we used five different, state-of-the-art instruments to measure secondhand smoke at parks, open-air cafés, sidewalks and outdoor pubs where smokers were present.”

Each instrument was calibrated to measure an airborne pollutant known as particulate matter-2.5 (PM2.5), which consists of thousands of microscopic particles that are less than 2.5 micrometers in width—about 30 times narrower than a human hair.

“PM2.5 is a toxic pollutant produced by cigarettes, wood-burning stoves, diesel engines and other forms of combustion,” Ott explained. “It contains benzo(a)pyrene, a carcinogen, and many other toxic chemicals that can penetrate deep inside the lungs.”

According to the Environmental Protection Agency, exposure to PM2.5 can lead to serious health problems, including asthma attacks, chronic bronchitis, irregular heartbeat, nonfatal heart attacks and even premature death in people with heart or lung disease. The current EPA ambient air standard for PM2.5 is 35 micrograms per cubic meter of air averaged over 24 hours. Levels that exceed 35 micrograms are considered unhealthy. “However, since tobacco smoke contains many toxic components, including carcinogens, it may be even less healthy than typical ambient air pollution,” Klepeis noted.

Test results

To measure PM2.5 levels in secondhand smoke, the researchers placed the instruments near actual smokers in different open-air environments. “We also performed controlled experiments with burning cigarettes, which allowed us to make precise measurements of PM2.5 levels at different distances,” Klepeis said.

The results were clear: The closer you are to an outdoor smoker, the higher your risk of exposure.

“A typical cigarette lasts about 10 minutes,” Klepeis said. “We found that if you’re within two feet downwind of a smoker, you may be exposed to pollutant concentrations that exceed 500 micrograms of PM2.5 over that 10-minute period. If you’re exposed multiple times to multiple cigarettes over several hours in an outdoor pub, it would be possible to get a daily average of 35 micrograms or more, which exceeds the current EPA outdoor standard.”

Outdoor tobacco smoke consists of brief plumes that sometimes exceed 1,000 micrograms, Klepeis added. “On the other hand, clean air typically contains less than 20 micrograms of PM2.5,” he said. “Therefore, a person near an outdoor smoker might inhale a breath with 50 times more toxic material than in the surrounding unpolluted air.”

However, the researchers found that air quality improved as they moved away from the smoker. “These results show what common sense would suggest—when you’re within a few feet downwind of a smoker, you get exposed,” Ott explained. “But likewise, when you go a little distance or stay upwind, the exposure goes way down. If there’s just one smoker, and you can sit six feet away, you would have little problem. At the same time, if there are a lot of smokers nearby, you may be exposed to very high levels of secondhand smoke. So this thing that critics have been dismissing as trivial is not.”

Added Klepeis: “If people realize that being near outdoor smokers can result in potentially large exposures to toxic air pollution, they may decide they do not wish to be exposed in a variety of outdoor settings. This realization may lead to an increased number of smoking bans in public locations.”

The study also was co-authored by Paul Switzer, professor of statistics and of geological and environmental sciences at Stanford. The research was supported by grants from the State of California and the Flight Attendant Medical Research Institute in Miami.

Related Information

© Stanford University. All Rights Reserved. Stanford, CA 94305. (650) 723-2300.

Smoke-free Parks

  • As of January 1, 2003, children and their families will have a 25-foot safe zone around playgrounds and toddler sandbox areas by state law. Kids should be able to play without being directly exposed to the harmful effects of secondhand smoke. It’s common sense to protect children where they play and socialize.
  • The reasons for protecting people, especially children, from secondhand smoke are convincing and overwhelming. Scientific evidence proves that exposure to secondhand smoke poses a serious health risk and there is no safe level of exposure. It is not only dangerous – it can also be deadly – especially for children and adults with asthma or other chronic illnesses.
  • Studies have shown that adult smoking behavior significantly influences youth smoking behavior. When Children see adults smoking in a family friendly place, they see the behavior as acceptable.
  • A critical component in addressing youth smoking is to create an environment in which tobacco use is not considered the norm in adult society. Every day in California, nearly 300 children begin smoking. Of those, 200 will go on to become addicted smokers. Half of those children will die prematurely of smoking-related diseases.
  • Cigarette butts are hazardous to children, animals and the environment. Smokers regularly discard their cigarette butts and empty packages on the ground. Small children are at risk of swallowing, choking, or burning themselves with discarded butts.
  • Cigarette butts are the most common litter in our parks and the clean up is time consuming and costly to taxpayers

Banning outdoor smoking is scientifically justifiable

Simon Chapman has argued that smoking should not be in outdoor public venues such as hospital patios, beaches, and outdoor sporting areas, and this might also encompass building entrances, waiting lines for cinema tickets, and outdoorcafés. However, failure to ban smoking in such venues may expose non-smokers to levels of environmental tobacco smoke (ETS) as high or higher than received in indoor spaces where smoking is unrestricted.

The reality of atmospheric dispersion of ETS in outdoor settings is this: individual cigarettes are point sources of air pollution and, therefore, smoking in groups becomes an area source. Outdoor air pollutants from individual point sources are subject to plume rise if the temperature of the smoke plume is hotter that the surrounding air. However, if the plume has a small cross-section, as far a cigarette, it will rapidly cool and lose its upward momentum, and then will subside as the combustions particles and gases are heavier than air. Thus, in the case of no wind, the cigarette plume will rise to a certain height and then descend. In a case where a group of smokers are sitting in an outdoor café, on a hospital patio, or in stadium seats, their smoke will tend to saturate the local area with ETS.

Where there is wind, the amount of thermally induced plume rise will be inversely proportional to the wind velocity–doubling the wind velocity will halve the plume rise. In this case, the cigarette plume will resemble a cone tilted at an angle to the vertical. The width of the cone and its angle with the ground will depend upon the wind velocity: a higher wind will create a more horizontal cone, a smaller cone angle, and a higher concentration of ETS for downwind non-smokers. If there are multiple cigarette sources, the downwind concentrations will consist of multiple intersections cones–that is, overlapping plumes. As the wind direction changes, ETS pollution will be spread in various directions, fumigating downwind non-smokers. ETS contains a large quantity of respirable particles, which can cause breathing difficulties for those with chronic respiratory diseases, or trigger an asthmatic attack in those with disabling asthma. For the remainder of non-smokers, ETS causes eye, nose, and throat irritation, just like any other noxious outdoor fumes, such as bus exhaust. If smoking is freely permitted in these venues, hospital orderlies, sports spectators, outdoor café aficionados, and beach goers might have to be restricted to the ranks of the non-asthmatic.

Have you ever had dinner in an outdoor café in Pairs, Athens, Las Palmas, or Salt Lake spoiled by smokers at adjacent tables? Have you ever had to move your blanket on a public beach because someone suddenly started smoking upwind, replacing clean salt air with irritating smoke? Smoking has no social value other than to create unnecessary work for physicians, and windfall profits for morticians. Even if outdoor environmental tobacco smoke were no more hazardous than dog excrement stuck to the bottom of a shoe, in many places laws require dog owners to avoid fouling public areas. Is this too much to ask of smokers?


Repace Associates Inc,
Secondhand Smoke Consultants
101 Felicia Lane
Bowie, MD 20720, USA;
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“Failure to ban smoking in outdoor public venues may expose non-smokers to levels of environmental tobacco smoke (ETS) as high or higher than received in indoor spaces where smoking is unrestricte

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