June, 2015:
ASH: President Obama, U.S. Trade Representative Ambassador have opportunity to curb tobacco epidemic forever
http://www.news-medical.net/news/20150625/ASH-President-Obama-US-Trade-Representative-Ambassador-have-opportunity-to-curb-tobacco-epidemic-forever.aspx
President Obama and U.S. Trade Representative Ambassador Froman have the opportunity to curb the tobacco epidemic forever. The Senate voted to pass the Trade Promotion Authority Bill (TPA or Fast-Track) which creates an expedited process to get trade bills through Congress, paving the way for Obama’s signature.
Now that Fast-Track has passed, the President and Ambassador Froman will turn their attention to the Trans-Pacific Partnership Agreement (TPP), an emerging trade and investment agreement being negotiated by the United States, Australia, Brunei, Canada, Chile, Japan, Malaysia, Mexico, New Zealand, Peru, Singapore, and Vietnam. The agreement, once completed, will be the largest regional trading block in the world and will serve as the model for 21st century trade agreements. How tobacco is treated now will set the precedent for how tobacco will be treated in TTIP (The Trans-Atlantic Trade and Investment Partnership), an even larger agreement, and in future trade agreements worldwide.
As the only consumer good that kills half of its consumers when used exactly as intended, tobacco has become a major issue in the TPP negotiations, with public health and other groups banding together to call for unique treatment of tobacco products. “The purpose of international trade agreements is the free movement of goods, and tobacco is no good,” stated Prakit Vathesatogkit of Thailand during the global tobacco treaty negotiations in Moscow this past October.
The outcomes of the TPP negotiations will have a huge impact on tobacco control and global health. The tobacco industry has long used litigation, and trade agreements in particular, as a tool to block public health and tobacco control laws. For example, Philip Morris International created “legal chill” by threatening to sue Togo, one of the 10 poorest countries on earth, if Togo implemented graphic health warning labels on cigarette packs. Additionally, Australia and Uruguay are currently being sued over their tobacco packaging laws.
In 2011, two U.S. tobacco companies sued the FDA over an advisory report that simply considered a ban of menthol cigarettes. The tobacco industry is very comfortable using litigation as a tool, and if tobacco is included in the TPP, tobacco companies will use the TPP to their full advantage to prevent governments from enacting policies that protect the health of their citizens.
The TPP represents a crucial moment for tobacco control. President Obama and USTR Ambassador Froman should insist that tobacco be granted a full “carve out” from the TPP and from all other trade agreements. A “carve out” means that tobacco products will be excluded from the right and benefits of the trade agreement, providing governments with protection to regulate tobacco inside their borders without fear of being sued by the tobacco industry.
Furthermore, all of the TPP countries (except the U.S.) have ratified the WHO Framework Convention on Tobacco Control (FCTC), a legally binding international treaty, and have an obligation to implement its measures. Mary Assunta, Senior Policy Advisor of the Southeast Asia Tobacco Control Alliance (SEATCA) says, “[FCTC] Article 5.3 Guidelines, Recommendation 7.1 says the tobacco industry must not be given any incentives to run its business. Hence the TPPA, a new agreement, should reflect this clause.” The U.S. has not ratified the FCTC, but as a signatory, the U.S. should strive to reach the tobacco control best practices set out in the FCTC.
Unlike other consumer products included in trade agreements that can become harmful when abused or overused, there is no “safe” use or amount of tobacco. Tobacco is the only consumer product that kills when used exactly as intended. The tobacco industry seeks to increase consumption of tobacco, while ASH and its public health allies seek a higher level of global health. There is no “happy medium” to be found between the tobacco industry and the public health community.
The World Health Organization (WHO) estimates that 1 billion people will die from tobacco this century unless drastic actions are taken. One of those critical actions to take is carving tobacco products out of trade agreements. It is impossible to predict how many lives hang in the balance of the trade debate, but it is certainly millions worldwide. ASH encourages President Obama and Ambassador Froman to utilize TPP has a tool in the global fight against tobacco.
ASH Executive Director Laurent Huber says “The TPP is a moment in history for Obama – he is making a choice about how to treat tobacco that will echo for decades to come.
Hopefully that choice is to protect health over profit and carve tobacco out of the TPP.”
Minister claims duty free tobacco cut ‘results’
http://www.trbusiness.com/regional-news/asia-pacific/nz-minister-says-lower-tobacco-limit-yields-results/77413
The New Zealand Government’s Customs Minister Nicky Wagner claims that the country’s customs service has destroyed more than 2.5 tonnes of ‘abandoned tobacco’ and collected NZ$1.35m ($933,324) in additional duty and taxes since it reduced the duty free tobacco allowance last November.
In a statement, Wagner said: “People seem to be learning about the change. The amount of tobacco abandoned at airports by those not wanting to pay duty is dropping from the 100 kilograms Customs was initially collecting every week.”
“The change was well signalled in advance and advertising to highlight the change continues. Customs’ passenger surveys show most people are aware of and accept the change in regulations.
“Customs recorded over 7,600 individual transactions for people choosing to pay duty, with the total collected in the six months adding to over NZ$1.35m ($933,324).”
Associate Health Minister Peseta Sam Lotu-Iiga also welcomed the reduction in the amount of tobacco being brought into New Zealand through its airports.
“The fact that people appear to be aware of the changes to our duty free tobacco limits and accept them is confirmation that our Government’s policies are making a real difference. We are determined to reduce the harm tobacco causes and the cost to our health system.
“The new duty-free tobacco limits, together with tax increases on tobacco sold in New Zealand, are pricing tobacco out of reach of many users. This is reflected in the numbers of smokers giving up tobacco,” he said.
New Zealand changed its regulations on 1 November, 2014 where passengers have had to declare any tobacco over the 50 cigarettes or 50 grams, and either dispose of the excess or pay duty on it. Tobacco sent by mail or cargo also no longer qualifies for a gift allowance.
Holyoke, Mass. Increase Tobacco Age, Passes Smoking Ban
http://halfwheel.com/holyoke-mass-increase-tobacco-age-passes-smoking-ban
It was not a good day for smokers in Holyoke, Mass. today, as the city’s board of health raised the minimum age to purchase tobacco and nicotine delivery products from 18 to 21 and also passed a ban on the use of those products, though a press release did not provide specifics as to the locations where lighting up will be forbidden and an email to the board was awaiting a reply.
The law does make an important distinction that pertains to those under 21-years-old, as only the purchase becomes illegal, while usage will not be a punishable offense.
Both changes were passed unanimously.
Holyoke has a population of just over 40,000 residents and is located about 10 miles north of Springfield.
Why e-cigarettes are dividing the public health community
http://www.bmj.com/content/350/bmj.h3317
Jonathan Gornall, journalist, Suffolk, UK
The tobacco industry used to be seen as the enemy of public health, but the move into e-cigarettes and harm reduction has seen some experts shift their views. Are they right or does industry have more cynical motives? Jonathan Gornall reports
Even the man from British American Tobacco (BAT) struggles to keep the sense of wonder out of his voice as he recounts the strange event that took place earlier this year in San Jose, California. The occasion was the 2015 annual meeting of the American Association for the Advancement of Science. Sharing the floor at the San Jose Convention Centre were two unlikely bedfellows: Deborah Arnott, chief executive of the UK charity Action on Smoking and Health, and Kevin Bridgman, chief medical officer of BAT’s electronic cigarette (e-cigarette) company, Nicoventures.
“Imagine that happening 10 years ago,” says Will Hill, public relations manager for BAT. “We’re now starting to share podiums with people like ASH at e-cigarette conferences.”
It’s a proposition that fills some in the public health community with dismay.
The subject of the symposium was “E-cigarettes: killing me softly or our greatest public health opportunity?” and Arnott and Bridgman—a former GP who is now working for Nicoventures offshoot Nicovations—were singing from the same hymn sheet.
Arnott’s talk highlighted her concern that “some groups” were calling for an outright ban on e-cigarettes, despite a lack of evidence of harm, “especially in comparison to smoking.”
She wanted to focus on “counteracting moralistic dogma and separating fact from fiction.”1
Bridgman’s message was that “regulators should resist the urge to apply highly restrictive measures that would have the perverse effect of prolonging cigarette smoking.”2
For some, such an apparent convergence of views is a sign that the industry’s enthusiastic—and, critics maintain, cynical—embrace of the controversial concept of “harm reduction.
BMJ investigation examines bitter dispute over e-cigarettes in the public health community
http://www.eurekalert.org/pub_releases/2015-06/b-bie062215.php
An investigation published by The BMJ today reveals how the controversial concept of “harm reduction”, embraced enthusiastically by the tobacco industry, has sharply divided the public health community.
On one side of the increasingly bitter dispute are those who believe it is time to work with the industry in support of products such as e-cigarettes.
Those in the other camp, however, not only contest the claimed public health benefits of the new products but also fear harm reduction is a cynical and superficial smokescreen for an industry that has every intention of maintaining global sales of smoked tobacco for as long as possible.
As cigarettes continue to kill six million people each year, journalist Jonathan Gornall asks who is right?
Simon Capewell, professor of public health and policy at Liverpool University’s Institute of Psychology, Health and Society, and others argue that e-cigarettes help to glamorise and renormalise smoking. Worse, he says, they are being used by the industry “as a trojan horse to get inside ministries of health. They are saying ‘This is all about harm minimisation, we’re part of the solution, we’re no longer the problem.'”
However, Deborah Arnott, chief executive of the UK charity Action on Smoking and Health (ASH), dismisses such fears, saying there is no evidence so far that e-cigarettes are a gateway into smoking for young people. “The risk is that smokers who could potentially use these an alternative to smoking are being discouraged, and that’s not a good thing,” she argues.
Gornall describes how, in 2014, the tension “boiled over into a pitched battle of words” in the run up to the World Health Organization’s Framework Convention on Tobacco Control.
Some 56 specialists in nicotine science and public health policy wrote to Margaret Chan, director general of WHO, urging her to support harm reduction and insisting it was “part of the solution, not part of the problem.” But 129 opposing experts swiftly responded, warning WHO and other public bodies not to “buy into the tobacco industry’s well-documented strategy of presenting itself as a partner.”
One of the organisers of the Chan letter was Gerry Stimson, a former director at Imperial College London and a member of the group producing NICE guidance on tobacco harm reduction.
Stimson has made no secret of his relations with the tobacco industry and told The BMJ that e-cigarettes and other nicotine delivery systems had “huge potential … to help shift people away from smoking.” But “the quandary for many public health experts … is that the solution might well lie with the much reviled tobacco industry.”
Karl Fagerstrom, a Swedish clinical psychologist who has also accepted industry money, said he considered products such as e-cigarettes could have a role in reducing the harm caused by smoking and accused some in public health of losing sight of the true objective.
Another signatory to the Chan letter was John Britton, an epidemiologist who heads the UK Centre for Tobacco and Alcohol Studies, and also sat on the NICE guideline group. “I’m no apologist for or friend of the tobacco industry,” he told The BMJ, but if an alternative means of delivering nicotine comes along “it’s inconceivable that tobacco companies will not get involved and seek to exploit it, and that’s a risk that has to be managed.”
For Martin McKee, professor of European public health at the London School of Hygiene and Tropical Medicine, there is no doubt that tobacco companies are entering the e-cigarette market “solely so they can say they are part of the solution.” But there was, he said, still no evidence that e-cigarettes were effective in helping people to quit smoking.
British American Tobacco (BAT) is now poised to market Voke, the first licensed medicinal nicotine product from a tobacco company.
ASH has welcomed the decision, saying Voke “… will allow smokers to choose a product which meets the high standards of medicines regulation and could be provided on prescription to help them stop smoking.”
But regardless of their true value in the battle against tobacco harm, and the ferocious row they have triggered in the public health community, are all such products anything other than a sideshow, designed to make the tobacco industry look good as cigarettes continue to kill half the people who use them, asks Gornall?
He notes that while BAT says it is “committed to developing and promoting a range of next generation tobacco and nicotine products,” its 2014 annual report clearly states that tobacco remains “at the core of our business and will continue to provide us with opportunities for growth.”
Free trade agreements ‘preferential’ and dangerous, says Productivity Commission
http://www.theage.com.au/business/the-economy/free-trade-agreements-preferential-and-dangerous-says-productivity-commission-20150624-ghw7rk.html
The Productivity Commission has launched a scathing attack on Australia’s latest series of free trade agreements, saying they grant legal rights to foreign investors not available to Australians, expose the government to potentially large unfunded liabilities and add extra costs on businesses attempting to comply with them.
The assessment comes after trade minister Andrew Robb successfully concluded agreements with Japan, Korea and China, and on the cusp of final negotiations to seal a so-called Trans Pacific Partnership with eleven Pacific-facing nations including the United States, Japan, New Zealand and Singapore.
On Wednesday, the US Senate voted to give President Barack Obama special negotiating powers that will remove one of the last impediments to the partnership.
The Productivity Commission has devoted a special chapter of its Trade and Assistance Review released on Wednesday to the agreements, which it described as “preferential” rather than “free” trade agreements.
It claims that by favouring some countries over others and excluding firms sourcing substantial inputs from other countries from special treatment, they “add to the complexity of international trade and investment, are costly and time-consuming to negotiate and add to the compliance costs of firms and administrative costs of governments.”
According to the Commission, the Japan and Korean agreements were concluded without a rigorous and independent assessment of whether costs would exceed benefits. There was also no mechanism in place to monitor the outcomes of the agreements after they come into force, it said.
“Without such a detailed assessment it is not possible to form a view as to whether the aspirational goals typically ascribed to the formation of preferential agreements are commensurate with real-world impacts,” the Productivity Commission said in its trade review.
Leaks about the text of the Trans Pacific Partnership suggested it will “include obligations on pharmaceutical price determination arrangements in Australia and other TPP members of an uncertain character and intent”.
“The history of intellectual property arrangements being addressed in preferential trade deals is not good.”
Also, investor-state dispute settlement clauses included in the Korean and Chinese agreements and planned for the Trans Pacific Partnership “depart from national treatment principles by affording substantive appeal rights to foreigners not available to domestic firms,” the Commission warned, saying this could create the risk of “regulatory chill” where Australian governments will be cautious about enacting new laws for fear they are challenged in foreign tribunals.
The safeguards and carve-outs for environmental and health legislation included were of “uncertain effect, lack transparency and have inadequate parliamentary scrutiny”, exposing the government to “potentially large unfunded contingent liabilities dependent on decisions by international arbitration tribunals”, the Commission found.
The cost to Australia of defending an action brought against it by Philip Morris Asia under an investor-state dispute settlement clause over its plain tobacco packaging legislation were “unknown, unfunded and likely to be substantial.”
Kids and Tobacco Use: Some Surprising Findings
http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm450882.htm
The number of kids smoking cigarettes is down—but the number using other tobacco products is way up. That’s the word from the 2014 National Youth Tobacco Survey (NYTS), co-conducted by the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA).
“This is the only nationally representative survey of middle and high school students that focuses exclusively on tobacco use,” says Benjamin J. Apelberg, Ph.D., branch chief of epidemiology at FDA’s Center for Tobacco Products.
Survey results provided a national snapshot of what tobacco products today’s middle and high school youth are using, as well as emerging trends over time.
The key findings include:
In 2014, one in four high school students and one in 13 middle school students reported being tobacco users (using one or more tobacco products in the previous 30 days).
Of the then-current 4.6 million youth tobacco users, 2.4 million reported using e-cigarettes.
Between 2011 and 2014, the percentage of students reporting current use of cigarettes decreased from 15.8% to 9.2%.
Between 2011 and 2014, hookah use among high school students doubled and e-cigarette use increased even more dramatically.
In 2014, nearly 2.2 million students reported using two or more tobacco products.
Since the survey started collecting data on e-cigarettes in 2011, in 2014 their current use for the first time surpassed current use of every other tobacco product, including conventional cigarettes.
“One thing the study confirms for us is that the tobacco product landscape has changed dramatically,” Apelberg says. “Middle and high school kids are using novel products like e-cigarettes and hookahs in unprecedented numbers, and many are using more than one kind of tobacco product.”
It’s something of a good news/bad news picture, says FDA epidemiologist Catherine Corey. “While we’re glad to see cigarette smoking decreasing in middle and high school youth, the increase in the
Nicotine Can Affect the Developing Brain
Nicotine is dangerous and highly addictive for kids at any age, whether it comes from an e-cigarette, hookah, cigarette or cigar. Because the brain is still developing, adolescence appears to be a particularly vulnerable time. Research has clearly demonstrated that exposure to nicotine at a young age increases the chance that kids will become addicted. In addition to nicotine exposure, tobacco use can be harmful due to the numerous other chemicals present in tobacco products that can cause disease.
“Youth should not use tobacco in any form,” Apelberg says.
At this time, FDA has regulatory authority over cigarettes, cigarette tobacco, roll-your-own tobacco and smokeless tobacco. The agency is in the process of finalizing a rule that would extend its authority to regulate additional products that meet the legal definition of a tobacco product, such as electronic cigarettes, cigars and hookahs. FDA is also proposing a minimum age of 18 for buying tobacco.
“These latest findings serve to strengthen existing scientific evidence that novel tobacco products like e-cigarettes and hookah have great appeal to youth, and that comprehensive youth prevention efforts that focus on reducing all forms of tobacco use are needed,” says Corey.
Results of the survey were published in the Morbidity and Mortality Weekly Report in April, 2015.
How You Can Help
FDA’s tobacco compliance and enforcement efforts range from training and education to monitoring compliance with the law and initiating advisory and enforcement actions. In addition, the agency inspects tobacco retailers to ensure, among other things, that retailers are checking IDs and not selling regulated tobacco products to anyone under the age of 18.
Consumers can help FDA by reporting potential violations of the agency’s rules for tobacco products, either online or by phone at 1-877-CTP-1373.
This article appears on FDA’s Consumer Updates page, which features the latest on all FDA-regulated products.
Hong Kong smokers, non-smokers sceptical about effect of larger cigarette pack warnings
SCMP
Smokers and non-smokers both agree that larger graphic health warnings on cigarette packs will not be strong enough to deter people from the habit.
The comments came as the Hong Kong Council on Smoking and Health conducted a signature campaign today seeking public support for the government’s proposal to strengthen tobacco control measures.
The Food and Health Bureau is proposing to enlarge the size of pictorial warnings on cigarette packs from the current 50 per cent of its total size to at least 85 per cent, as set out in a document presented to the Legislative Council in mid-May. It also wants to increase the number of images used on packs from six to 12.
The government is also proposing to prohibit e-cigarettes and ban smoking in eight bus interchange facilities within tunnel portal areas across the city.
Smoking sustains me spiritually. I can think well only with cigarettes
Construction worker Mr Chan
Smokers, however, do not find the measure strong enough to put them off smoking. “It is useless … Smoking sustains me spiritually. I can think well only with cigarettes,” said Mr Chan, a 67-year-old construction worker who has been smoking for 50 years.
Even some non-smokers do not find it useful. “It doesn’t work unless all cigarettes are banned from the market,” said Ms Au-yeung, who said she was afraid of the smell of smoke and backed a smoking ban at interchange facilities near tunnels.
“Many people are fully aware they should not smoke, but they still need to buy cigarettes,” she said.
However, Alan Cheung, a 60-year-old non-smoker, said the new measures would be effective. “[Enlarged images are] good. People can see straight away that they should not smoke,” he said.
The council set up booths in Causeway Bay to display dummy cigarette packs with the proposed new design – bigger images, the warning that “tobacco kills up to half its users” and the number of the government hotline for those wanting to quit.
The signatures in support of the government measures will be submitted to the Legco health panel for a special meeting on July 6 when members will discuss the proposed control measures.
Council chairman Antonio Kwong Cho-shing said the enlarged size of the health warnings would be more effective in deterring people from smoking. “The images will be clearer and the cigarette packs will look less appealing, especially to young people,” he said.
He said larger images had proved effective in other countries. The smoking rate in Australia, which first expanded the size of health warnings to 85 per cent or more on cigarette packs in 2012, dropped from 15.1 per cent in 2010 to 12.8 per cent in 2013.