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January, 2014:

Sky: Smoking In Cars With Children Ban Bid

by Ashish Joshi, Sky correspondent:

Smoking in cars when children are present could soon become illegal.

Peers are set to vote on the issue and Labour wants to see the creation of a specific offence claiming the move will help save to lives.

A ban is already in place in parts of the world including some states in America, Australia, Canada and a few countries in Europe.

Shadow health secretary Andy Burnham says it is time Britain followed suit.

He said: “When it comes to improving the health of children, we are duty bound to consider any measure that might make a difference.

“Adults are free to make their own choices but that often does not apply to children and that’s why society has an obligation to protect them from preventable harm.

“Evidence from other countries shows that stopping smoking in the confined space of a car carrying children can prevent damage to their health and has strong public support.”

But pro-smoking groups think a ban is disproportionate.

They insist most adult smokers choose not to smoke when they are in a car with children.

They are also angry at what they see as a stealth ban, after smoking in enclosed public spaces was made illegal.

They fear the prohibition will eventually be extended into people’s homes.

Simon Clark, director of Forest, said: “I think this legislation is very heavy-handed, totally unnecessary and according to surveys 84% of adults wouldn’t dream of lighting a cigarette in a car, in a small enclosed space with a child present.

“So adults already know how to behave, they don’t need the state interfering in their lives like this. If there are still some people who smoke in a car with children, then lets educate them, but lets not legislate.

“It’s almost going to be impossible to enforce anyway and the danger is that the police will have to ban smoking in all cars.

“We could have a situation were a lone driver, in his own car will be committing an offence by lighting a cigarette and what’s the next logical step after that? Are we going to ban smoking in the home as well if children are present.”

According to supporters of the ban there is overwhelming public support.

Labour cites a YouGov poll from 2011 that found 78% of adults in Great Britain agreeing that smoking should be banned in cars carrying children younger than 18 years of age, while 44% agreed that smoking should be banned in all cars.

And to support its case further it quotes a Mumnsnet survey that found 86% of respondents supported a ban (including 83% of smokers).

Some smokers think leaving a window open will protect their younger passengers from the harmful effects of second-hand smoke, but that argument has been dismissed by experts.

Professor Robert West , from UCL, has extensively studied the potential dangers of second hand tobacco smoke: “We know that the smoke is toxic, we know that the smoke has carcinogens in it.

“If you imagine someone lighting up a cigarette in a club lets say, you would know about it within seconds the other side of the room. In a car it is a much more confined space.

“If you can smell smoke you are being exposed to carcinogens, so you don’t have to be a rocket scientist to know that even if you are trying to smoke out the window the child in the back is going to be exposed to carcinogens.”

29 Jan 2014

BBC: Nigeria’s Lagos state passes smoking ban

from the BBC news:

MPs in Lagos state, Nigeria’s economic hub, have passed a bill banning smoking in public places, including restaurants and on public transport.

Those who ignore the ban could face a $62 (£38) fine or up to three months in jail or both.

The bill also makes it an offence to smoke in front of a child – offenders will be fined $94 or be sentenced to a one-month jail term or both.

Lagos has already banned drivers from smoking to promote road safety.

Smoking is popular in Lagos in beer gardens and nightclubs. (AFP)


London Evening Standard: E-cigarettes to be banned for under-18s in Government crackdown on smoking

from the London Evening Standard:

Under-18s are to be blocked from buying electronic cigarettes under new legislation being planned by the Government.

Adults will also be prevented from buying cigarettes for anyone under 18 as part of a package of tough new laws designed to clamp down on teenage smoking.

E-cigarettes are currently enjoying a sales boom, with the number of UK users now estimated to have reached 1.3million.

The law, which will be introduced this week as an amendment to the Children and Families Bill, will also ban ‘proxy purchasing’ – knowingly buying tobacco on behalf of someone under 18.

Adults caught breaking the law, which ministers hope will come into force by the autumn, could be given a £50 fixed penalty notice or fined up to £2,500.

Public Health Minister and Conservative MP Jane Ellison said: “Two thirds of smokers say they smoked regularly before they were 18, showing that this is an addiction largely taken up in childhood.

“We must do all we can to help children lead a healthy life. That’s why this measure is designed to help protect children from the dangers of being bought cigarettes by irresponsible adults – something that I hope concerned parents and responsible retailers will welcome.”b,

While many people view the tobacco-free devices as a better alternative to traditional cigarettes, health experts remain deeply concerned about the long-term effects they could have on users’ health.

E-cigarettes provide a hit of nicotine – a highly addictive drug – and some fear they reinforce the behaviour of smoking, making it harder to give up in the long term.

England’s chief medical officer, Professor Dame Sally Davies, said: “We do not yet know the harm that e-cigarettes can cause to adults let alone to children, but we do know they are not risk free.

“E-cigarettes can produce toxic chemicals and the amount of nicotine and other chemical constituents and contaminants, including vaporised flavourings, varies between products meaning they could be extremely damaging to young people’s health.”

Currently there is no restriction on people under the age of 18 buying e-cigarettes, and they are hugely popular among teenagers in Briton.

But it is feared that children are turning to the smokeless devices – designed to help users quit – before moving on to traditional cigarettes.

Many secondary schools across the UK have resorted to banning e-cigarettes over fears they are encouraging pupils to take up smoking.

Smoking rates have fallen to their lowest ever, in the wake of the ban on smoking in public and a series of shocking public health campaigns highlighting the dangers of cigarettes.

But more than 1,000 people end up in hospital every day as a result of smoking, and experts have warned that the growth in e-cigarettes could reverse some of the good work that has been done in tackling the dangerous habit.

The latest move comes as Department of Health figures reveal that 41% of 15-year-olds who smoke say they usually buy their cigarettes from other people rather than buying them from a shop.

And 95% of 11- to 15-year-olds who smoke have managed to get someone else to buy cigarettes for them in a shop at least once in the past year.

The proxy purchase of alcohol is already illegal, and retailers have been calling for the creation of a proxy purchasing offence for tobacco for many years.

Smoking is one of the biggest causes of death and illness in the UK. Every year around 100,000 people die from smoking, and it is linked to a string of other potentially fatal illnesses including heart disease and strokes.

Deborah Arnott, chief executive of health charity Action on Smoking and Health (ASH) said: “ASH supports the government decision to make it illegal to sell e-cigarettes to under-18s.

“Although our research shows the only children using e-cigarettes are already smokers, and even then the numbers are small, this is a rapidly growing market and these products are being heavily promoted.”

She said of proxy purchasing of tobacco: “We know that buying cigarettes from adults is a major source of supply for under-age smokers, so in principle making buying cigarettes for children illegal is a good idea. We’d also like to see a retail licensing system put in place so that cigarettes could only legally be sold in shops not in car boot sales and markets.”

26 Jan 2014

UCSF researcher: FDA puts economic theory over empirical evidence in its cost-benefit analysis; undermines sensible public heath regulation

from Dr. Stanton Glantz of the UCSF:

As part of the process of issuing regulations, the FDA (or any other agency) conducts a cost-benefit analysis of the proposed regulation to make sure it is worth doing.  The FDA’s ill-fated regulation on graphic warning labels was no exception.  The Agency’s cost-benefit analysis did find a very small net benefit, but that small showing was not enough to convince the courts that the warning label rule was legal in the face of a constitutional challenge.

Last month Jidong Huang, Frank Chaloupka, and Geoff Fong published an excellent paper showing that the FDA gross underestimated the benefits that graphic warning labels would have on cigarette consumption and made the point that this severe underestimation undermined the FDA’s ability to defend the warning labels in court as necessary.

Today we published a paper in American Journal of Public Health that shows how the FDA grossly overestimated the costs of reducing smoking by counting, as a substantial cost, the lost pleasure people would experience if they were not smoking.

To do this, the FDA counted the lost “consumer surplus,” a concept based on classical economics in which the value of something is completely captured by how much money people would pay for it.  Because nicotine is highly addictive people will pay a lot of money for cigarettes, so, according to the FDA’s logic, will be deprived of a lot of value if they stop (or don’t start) smoking.

While this idea may seem reasonable to some economists, it completely flies in the face of a huge amount of empirical evidence, evidence that the FDA simply ignored.

By so radically underestimating benefits and overstating costs, the FDA’s own analysis (supported, I am told, by the Office of Management of Budget), is making it particularly difficult to justify any regulation designed to protect public health.

Here is the abstract from our paper, “When Health Policy and Empirical Evidence Collide: The Case of Cigarette Package Warning Labels and Economic Consumer Surplus“:

In its graphic warning label regulations on cigarette packages, the Food and Drug Administration severely discounts the benefits of reduced smoking because of the lost “pleasure” smokers experience when they stop smoking; this is quantified as lost “consumer surplus.” Consumer surplus is  grounded in rational choice theory. However, empirical evidence from psychological cognitive science and behavioral economics demonstrates that the assumptions of rational choice are inconsistent with complex multidimensional decisions, particularly smoking. Rational choice does not account for the roles of emotions, misperceptions, optimistic bias, regret, and cognitive inefficiency that are germane to smoking, particularly because most smokers begin smoking in their youth. Continued application of a consumer surplus discount will undermine sensible policies to reduce tobacco use and other policies to promote public health.

We raised many of these issues in our public comment on the original warning label rule; clearly the FDA chose to ignore these issues then.

Last January I had some email correspondence with the FDA economist who prepared the cost-benefit analysis in the final rule in which I asked him to provide citations to the empirical evidence that supported what the agency did.  He could not point to any.

Given the FDA (and OMB most likely) refusal to consider the empirical evidence that its approach is wrong, I expect to see a similarly self-defeating cost-benefit analysis when the much-delayed deeming rule on e-cigarettes is finally released.

12 Dec 2013

SCMP Letters: Tax rise could help young smokers quit

Letter from Heidi Lau, executive director of LEAP, to the SCMP:

The government should consider further increasing tobacco tax to help prevent young people picking up the habit of smoking and motivate more young smokers to quit.

It was reported that 30 per cent of the young smokers who used the Youth Quitline hotline service of the University of Hong Kong cited saving money as the reason for quitting (“University of Hong Kong introduces WhatsApp service to help young smokers quit”, January 7).

The percentage could certainly have been higher if the tobacco tax had been raised to make cigarettes even more unaffordable for young people.

Tobacco, along with alcohol and cannabis, has long been considered a “gateway drug”.

As an organisation that provides preventive drug education to prevent substance abuse, Life Education Activity Programme (LEAP) is convinced that increasing tobacco tax could be an effective way to reduce children’s access to this gateway drug – hence helping to prevent childhood use of cigarettes and the subsequent use of more potent drugs.

Raising tobacco tax further will also help the government to demonstrate its strong determination to build a smoke-free society.

10 Jan 2014

UAE Anti-tobacco Law in effect: Rules and fines…

The much anticipated Anti-tobacco Federal Law has come into place on January 21. A number of rules must be taken into consideration, as violators may be met with hefty fines.

On July 21, 2013 the Ministry of Health announced the executive regulations of the Anti-tobacco Federal Law, which was approved by His Highness Sheikh Mohammed bin Rashid Al Maktoum, Vice-President and Prime Minister of the UAE and Ruler of Dubai, in the Cabinet’s Resolution No 24.

During the course of the next 6 months, the public was able to take the required measures to comply with the new law. As shopkeepers, distributers and the hospitality sector have geared up for the day of implementation, the individual smoker too should be well aware of the new rules from today onward in order to avoid being fined.

Emirates 24l7 has listed below the implications of the new Law.

A couple of rules have been implemented to protect the younger generation from the harm that can be caused through smoking and passive smoking. By far the most-talked about rule is the restriction of smoking in the car in the presence of a child below 12 years.

The violator will be fined with a Dh500 penalty, and Dubai Police is tasked with the enforcement of this rule. So, from today, good behaviour on the road goes beyond being a good driver.

Further, the young generation will not be able to purchase any tobacco products, as the sale of these products to any person under the age of 18 is a violation. Similarly, shisha products may not be provided to persons under the age of 18. Those flouting these rules may be fined with penalties between Dh500-10,000.

Shopkeepers and café owners will have to abide by an additional set of rules. Shisha shops and shops selling tobacco products may no longer be available near schools and mosques. A minimum distance of 15 metres should be maintained from kindergartens, schools, universities and colleges, a minimum of 100 metres from places of worship. A minimum of 150 metres from residential areas is the rule for shisha cafes.

Further, tobacco products cannot be displayed near items marketed for children, or sportswear, health, food and electronic products.

Advertising of tobacco products is no longer permitted. The law bans any content that advertises tobacco products, such as newspaper advertisements, TV commercials and animations.

It also bans importing tobacco products that are not line with technical standards set by the UAE, and any violations regarding such imports can lead to a one year prison sentence and a fine ranging from Dh100,000 to Dh1 million, in addition to the confiscation of products.

The law also provides specifications on the packaging of tobacco products. All products must now display a large warning label on the front to raise awareness on the dangers of tobacco, and not to mislead them. Violators will be fined Dh100,000 to Dh1 million, and the fines can be doubled if the offence is repeated.

Shisha cafes are subjected to specific rules when it comes to their opening hours. The regulations specify that these cafes must comply to working hours from 10am to midnight. Shishas may not be served to customers younger than 18 years, and the cafes will be forbidden from delivering shishas to apartments.

Finally, growing or producing tobacco for commercial purposes will also be forbidden, and current manufacturing plants have been given a grace period of 10 years to sort out their situation, while tobacco farms have been given a two-year grace period.

Tobacco industry manipulation of data on and press coverage of the illicit tobacco trade in the UK

Download (PDF, 1.05MB)

Association between tobacco plain packaging and Quitline calls: a population-based, interrupted time-series analysis



To investigate whether the introduction of tobacco plain packaging in Australia from 1 October 2012 was associated with a change in the number of calls to the smoking cessation helpline, Quitline, and to compare this with the impact of the introduction of graphic health warnings from 1 March 2006.


Whole-of-population interrupted time-series analysis in New South Wales and the Australian Capital Territory between 1 March 2005 and October 2006 for the comparator, graphic health warnings, and October 2011 and April 2013 for the intervention of interest, tobacco plain packaging.


Weekly number of calls to the Quitline, after adjusting for seasonal trends, anti-tobacco advertising, cigarette costliness and the number of smokers in the community.


There was a 78% increase in the number of calls to the Quitline associated with the introduction of plain packaging (baseline, 363/week; peak, 651/week [95% CI, 523-780/week; P < 0.001]). This peak occurred 4 weeks after the initial appearance of plain packaging and has been prolonged. The 2006 introduction of graphic health warnings had the same relative increase in calls (84%; baseline, 910/week; peak, 1673/week [95% CI, 1383-1963/week; P < 0.001]) but the impact of plain packaging has continued for longer.


There has been a sustained increase in calls to the Quitline after the introduction of tobacco plain packaging. This increase is not attributable to anti-tobacco advertising activity, cigarette price increases nor other identifiable causes. This is an important incremental step in comprehensive tobacco control.

Avoidance of cigarette pack health warnings among regular cigarette smokers



Previous research with adults and adolescents indicates that plain cigarette packs increase visual attention to health warnings among non-smokers and non-regular smokers, but not among regular smokers. This may be because regular smokers: (1) are familiar with the health warnings, (2) preferentially attend to branding, or (3) actively avoid health warnings. We sought to distinguish between these explanations using eye-tracking technology.


A convenience sample of 30 adult dependent smokers participated in an eye-tracking study. Participants viewed branded, plain and blank packs of cigarettes with familiar and unfamiliar health warnings. The number of fixations to health warnings and branding on the different pack types were recorded.


Analysis of variance indicated that regular smokers were biased towards fixating the branding rather than the health warning on all three pack types. This bias was smaller, but still evident, for blank packs, where smokers preferentially attended the blank region over the health warnings. Time-course analysis showed that for branded and plain packs, attention was preferentially directed to the branding location for the entire 10s of the stimulus presentation, while for blank packs this occurred for the last 8s of the stimulus presentation. Familiarity with health warnings had no effect on eye gaze location.


Smokers actively avoid cigarette pack health warnings, and this remains the case even in the absence of salient branding information. Smokers may have learned to divert their attention away from cigarette pack health warnings. These findings have implications for cigarette packaging and health warning policy.

Big Island Now: Hawaii Ban on Under-21 Tobacco Sales Begins in July

by Dave Smith, posted on Big Island Now:

Saying he was doing it for the benefit of the community, and especially children, Mayor Billy Kenoi on Thursday put his signature on a law banning the sale of tobacco products to those under 21.

Those attending the signing included County Councilman Dru Mamo Kanuha, who introduced the bill, and students from Kealakehe High School who advocated for the measure.

Wearing T-shirts stating “One Good Reason” with an arrow pointing up at their face, more than 40 students from Kealakehe and Konawaena high schools had attended County Council meetings where the measure was deliberated and eventually passed unanimously.

“I signed this bill for the benefit of our community, and most importantly, our kids,” Kenoi said.

“Mahalo to Councilman Kanuha for hearing their voices and having the courage to follow through. With all of the known harmful effects of tobacco use, this measure is in the best interest of public health and safety.”

According to the Coalition for a Tobacco-Free Hawaii, nearly 1,200 Hawaii residents die each year from diseases related to tobacco use – 90% of whom became daily tobacco users before the age of 18.

“We are deeply grateful to Councilmember Kanuha and his staff for creating a bill that was easy for the other councilmembers to support,” said Sally Ancheta, East Hawai‘i Coalition coordinator for CTFH. “We thank Mayor Kenoi for taking the initiative to protect our youth and supporting the many voices that came to testify.”

“My commitment is to help our young people live longer and healthier lives than the generation who came before them, and to improve the overall health of our island,” Kanuha said.

The law goes into effect July 1, 2014.

20 Dec 2013