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September, 2016:

The Tobacco 21 Movement and Electronic Nicotine Delivery System Use Among Youth

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Big Tobacco Pours Millions Into California Cigarette Tax Fight

Reynolds American Inc., Altria Group Inc. and other tobacco companies are steering millions of dollars to defeating a $2 cigarette-tax increase in California, a high-stakes effort and the third such fight in a decade in the most populous U.S. state.

The tobacco industry’s outlay of $55.9 million so far means that it has outspent supporters 3-to-1 in donations to defeat the measure, which starting in April would boost the levy to $2.87 a pack. The initiative would generate from $1 billion to $1.4 billion in revenue in fiscal 2018 for cancer treatment and smoking prevention.

“When one side is spending much more than the other, it’s hard for voters to get a clear picture,” said Daniel G. Newman, president of MapLight, a Berkeley, California-based nonpartisan research organization that tracks money in politics. “Imagine two messages side by side — one blaring from a gigantic movie screen and on the other side from a small cellphone. For voters, that amplification is going to make a difference.”

California, the first U.S. state to eliminate smoking in bars and restaurants and legalize medical marijuana, is an important battleground for the tobacco industry because policies approved there tend to be adopted by other municipalities. Blocking the tax in the state of 39 million people could deter anti-tobacco advocates in more conservative states from pursuing similar changes. That’s led cigarette markers including Richmond, Virginia-based Altria and Winston-Salem, North Carolina-based Reynolds to steer more cash toward fighting tax proposals in California than in any other state.

As the harmful health effects of smoking have come to light, the industry has for years employed an army of lobbyists and spent hundreds of millions of dollars on its battle with state and federal regulators and public-health advocates over curbing the practice and marketing the product, especially to kids. The firms reached a $200 billion settlement with 46 states in 1998 over the costs to treat ailing cigarette smokers.

Tobacco plain-packaging given tick by MPs

Legislation requiring tobacco products to have plain packaging has passed its final hurdle in Parliament.

The bill was first introduced in 2013 before legal action by tobacco companies in Australia put the legislation on hold.

However, that challenge failed last year.

Under standardised packaging all cigarettes and other tobacco products would be in brown or green coloured packaging, similar to what is required in Australia.

Mandatory health warnings would also cover at least three quarters of the packet, and tobacco company marketing imagery removed.

Brand names would be allowed, but there would be restrictions about how and where they could be printed.

Associate Health Minister Sam Lotu-Iiga said the passing of the legislation sent a clear message the government was serious about ending the unnecessary deaths from tobacco use.

“The bland packs will maximise the impact of health warnings and cut out any false impression that smoking is cool or glamorous,” he said.

“Standardised packaging, along with the existing suite of tobacco control measures and quit-smoking services, is a logical next step towards the Smokefree 2025 goal.”

Regulations needed for the law to come into force are currently under development following a public consultation that closed at the end of July.

New Zealand First and the ACT Party were the only parties to oppose the bill.

Plain packaging for tobacco confirmed

Plain packaging for tobacco is on the way after legislation passed its final hurdle tonight.

Associate Health Minister Peseta Sam Lotu-Iiga took a large cigarette packet prop into Parliament’s debating chamber to show what plain packaging could look like.

“This is what will make a difference,” he said.

“When cigarette packs come out of a smoker’s pocket or are left lying around on the table where others can see, there will be nothing but a drab, ugly background colour and large, prominent, graphic pictorial warnings.”

Lotu-Iiga said no other product was so widely used and posed such a direct level of risk to users. Smoking led to between 4500 and 500 premature deaths in New Zealand each year, he said.

“This bill takes away the last means of promoting tobacco as a desirable product. It stops the promotion of smoking as cool, fun, glamorous.

“About 13 people die prematurely every day from smoking-related illnesses…this is a bill to protect children and young people from being tempted from trying cigarettes.”

The legislation passed 108 to 13 votes, with opposition from New Zealand First and the Act Party.

New Zealand First health spokeswoman Barbara Stewart said all parties would be in agreement as to the damage that smoking could cause.

However, New Zealand First had concerns about a lack of evidence that plain packaging was effective, and possible unintended consequences such as an increase in black market sales.

“We have to remind people that $1.6 billion in excise tax is going into the government coffers every year…there is a clear ulterior motive here, and it is not public health, as it should be.

“We remain unconvinced that plain or standardised packaging is effective at reducing tobacco consumption.”

Plain packaging is part of measures designed to make New Zealand smoke-free by 2025, a key goal of the Maori Party.

Maori Party co-leader Marama Fox referenced her confrontation with Imperial Tobacco spokesman Dr Axel Gietz on TV3`s The Nation in June.

Fox stormed out of the TV interview after accusing Gietz of “peddling death and destruction and misery”.

Tonight, she said last night she was visited by a person whose wife had recently died after being a smoker for 40 years.

“He came to bring me his wishes to tackle tobacco control in this country. He said she tried everything…e cigarettes, patches, cold turkey.

“She could not kick the habit, and eventually she died trying. Today I want to remember her.”

Plain packaging for tobacco is likely to be in place early next year.

The government in May released draft regulations and a consultation document which aims to standardise the look of cigarette packs.

New Zealand had been keeping an eye on the outcome of legal challenges against Australia’s plain packaging, one from tobacco firm Philip Morris and another from tobacco-producing countries via the World Trade Organisation (WTO).

Australia won the case against Philip Morris in December.

The WTO challenge is ongoing, but the Government received advice late last year that the Government was on a “firm footing” to progress plain packaging because several other countries, including the UK and Ireland, had introduced it.

These countries did not face a challenge under the WTO.

A pack of 20 cigarettes in New Zealand will increase from about $20 now to around $30 in 2020 after hefty excise increases were announced as part of May’s Budget.

The tax on tobacco will rise by 10 per cent on January 1 each year for the next four years.

That is expected to bring in an extra $425 million in tax over that period.

It will affect the about 15 per cent of adult New Zealanders who smoke each day – about 550,000 people.

That rate increases to 35 per cent for Maori, and 22 per cent for Pacific people.

Lotu-Iiga last month released a consultation document that includes a proposal to legalise the sale of e-cigarettes in New Zealand.

Nicotine patches and gum can be bought, but nicotine e-cigarette liquid must be bought from overseas.

Other countries, like the UK, allow the e-cigarettes or vaporisers to be sold in supermarkets and dairies.

The products would not be allowed to be used in smoke-free areas, and safety measures including child-proof containers will be considered.

Total 73 Macau smoking lounges await approval: govt

Applications for a total of 73 smoking lounges across Macau’s casino market were pending government approval as of early July this year, said Health Bureau director Lei Chin Ion in a written reply to a question from Macau legislator Ella Lei Cheng I.

The official statement, publicised on Wednesday, did not specify which casinos had applied for the smoking lounges. It did state that a total of 86 smoking lounges were designated as government-approved facilities in the city’s casino market as of early July, but didn’t list where they were. Of that number, 83 were located on main or ‘mass’ gaming floors; while the remaining three smoking lounges were situated in “areas restricted to certain gamblers”.

In October 2014 the Macau government banned smoking on casino mass floors. An exception was made for tobacco use in enclosed smoking lounges – facilities without gaming – located on some casino mass-market floors in the city. Having a cigarette while gambling is at present still allowed in VIP rooms.

The main floor ban had brought an “apparent improvement” in the air quality inside casinos, Mr Lei remarked in his answer to Ms Lei, a legislator affiliated to an influential local labour grouping called the Macau Federation of Trade Unions. Some local casino workers have complained that smoking lounges do not sufficiently protect them from secondhand smoke.

As of the first half of this year, a total of 277 people have been fined for smoking in unauthorised areas inside the city’s casinos, Mr Lei stated. His department has also received 561 complaints in the period regarding alleged smoking rules violation inside casinos, of which 90 percent of the cases were transferred to the city’s casino regulator Gaming Inspection and Coordination Bureau for further follow up.

The government is now pushing for a full smoking ban inside casinos as part of a scheduled revision of the city’s tobacco control law. But the majority on the Macau Legislative Assembly working committee asked to scrutinise the revised tobacco control bill currently supports the retention of smoking lounges on casinos. The working committee is currently on its summer break: it will only continue reviewing the bill after October 15 at the earliest, once the Legislative Assembly’s two-month recess ends.

A number of investment analysts have said that were smoking to be banned outright from the city’s casinos, it could have a negative affect on gaming revenue generated from smokers; as they would spend less time at a gaming table or a gaming machine if required to step outside to pursue their tobacco habit.

Increasing tobacco tax: Another smart move by Jokowi?

Cheap cigarette prices in Indonesia are driving a health crisis of increasing numbers of smokers and spiralling associated death rates. But with huge numbers of people employed in the tobacco industry, raising prices to reduce this risk is a dangerous move by Jokowi’s government.

By Fawnia

Since rumours about rises in cigarette prices made it to the news a week ago, there has been endless debate, discussions, and surveys. The differences of opinion, which revolve around the effectiveness of the policy and the reasons behind it, show substantial divisions in public opinion.

The price hike is heavily influenced by a recent study from the Centre for Health Economics and Policy Studies at the University of Indonesia. It says that according to a survey of 1,000 people across 22 Indonesian provinces, 82% of the respondents said they approved the idea of a rise. Meanwhile, 72% of smokers agreed they would quit smoking if the price of cigarettes went above Rp 50,000 ($3.80)

At the same time, the results showed that 67% of adult males in Indonesia, or around 70 million people, were smokers and that this number has been increasing sharply since 1995. Compare this to public health figures that explain 217,400 deaths every year are caused by non-communicable diseases and the problem becomes apparent. Of these deaths; smoking cigarettes is the highest risk factor. If you accept that the increase in the number of smokers goes hand in hand with increases in cigarette production, it is also worrying to know that Indonesia will produce 125.3 billion more pre-rolled cigarettes over the next ten years.

Twice the price, twice the risk? Current cigarette prices in Indonesia range from just Rp 12,000 ($0.9) to Rp 20,000 ($1.5), and this low price makes it easy for teenagers as young as 12 years old to smoke. A survey completed by the World

Health Organization in 2014 supported this suggestion, showing around a third of boys between the ages of 13-15 in Indonesia were regularly smoking. That figure will almost certainly have risen.

Despite this pressing evidence the proposal to raise cigarette prices to Rp 50,000 has triggered a range of responses. One member of the House of Representatives believes that although the rise would discourage smoking, the government should be concerned about the fate of people working for tobacco companies. On a similar note, East Java Governor Soekarwo has said the increase would be a significant challenge to employment in the province.

Soekarwo explained his region depends heavily on tobacco industry employment for 6.1 million people, while taxes from smoking products make up the majority of East Java’s locally generated recurring revenue. Indeed, as the tobacco industry is one of the largest sectors in Indonesia, the decision to double the price cannot be made hastily.

At the same time, steps would also need to be taken to rule out an increase in the circulation of illegal products as a result of a price hike. Rumours of the new pricing are already a big concern for Indonesian tobacco farmers, and according to industry insiders, wholesalers are taking advantage by bidding for their stocks at a low price.

This situation has spurred peaceful demonstrations in Central Java by members of the Association of Indonesian Tobacco Farmers (APTI). They are worried for their livelihood and demand the government reduces tobacco imports and cancels the change in pricing. According to another industry group, the jobs of more than 1.5 million workers are at stake.

The significant increase has yet to be finalised, and Finance Minister Sri Mulyani Indrawati says there is no decision yet regarding the new ruling on prices or taxes. Will the government succumb to the public’s angry protest, or will it be a ground-breaking measure that reduces the number of smokers in Indonesia? In the balance of the health of the economy versus the health of the people; there is an enormous amount at stake.

15.6 million Vietnamese spend $1.4bn on smoking: survey

About 15.6 million adults in Vietnam consumed tobacco last year, the Ministry of Health announced Tuesday, citing findings of a global survey.

Vietnamese smokers spent VND31 trillion (US$1.39 billion) on cigarettes, or VND2.7 million ($121) per person per year, according to the Global Adult Tobacco Survey (GATS) 2015.

The GATS, a World Health Organization-backed initiative, was conducted last year in Vietnam by the Hanoi Medical University and the General Statistics Office.

The survey found that besides traditional cigarettes, there is an increase in using e-cigarettes, sisha, and chewing tobacco among adults in the country, the health ministry confirmed at a conference to announce its results in Hanoi.

The percentage of adults smoking e-cigarettes has risen to 0.4 percent in men and 0.1 percent in women. About 0.1 percent of adults also consume sisha, while 1.4 percent of the population use chewing tobacco, according to the survey.

The good news is that only 45.3 percent of men aged 15 and above smoked in 2015, compared to 47.4 percent a year earlier.

The smoking rate among men in urban areas also decreased from 45 percent in 2010 to 38.7 percent last year.

The survey also said that raising tobacco taxes proved to be an effective solution in reducing smoking.

The Ministry of Health’s spokesperson said that many countries had banned e-cigarettes due to the density of nicotine stored in the devices, which is more harmful than traditional cigarettes.

The Global Adult Tobacco Survey (GATS) is a nationally representative household survey launched in February 2007 as a new component of the ongoing Global Tobacco Surveillance System (GTSS), the WHO said on its website.

The GATS enables countries to collect data on adult tobacco use and key tobacco control measures.

Topics covered in GATS include the prevalence of tobacco use, knowledge, attitudes as well as perceptions, economics, and more.

Anti-tobacco law to be upgraded with harsher punishments, fines

One decade after a law to control tobacco use went into effect, the government is finally pledging to give teeth to the legislation. Violators could face increased fines and even prison time, health officials warn.

Dr Thuzar Chit Tin, director of the Ministry of Health and Sport, said the 2006 Control of Smoking and Consumption of Tobacco Products Law is in the process of being updated, with fines raised to reflect the current economy and act as a bigger disincentive.

Under the existing law, advertising tobacco products, distributing cigars, cigarettes or other tobacco products free of charge, sponsoring sports and other exhibitions, or publicising tobacco by any means is subject to a fine ranging from K20,000 to K50,000 for the first offence, rising to a maximum of K200,000 or two years in prison for subsequent offences. Penalties also apply to anyone who tries to obstruct or assault officials trying to prevent smoking in a no-smoking zone.

“Amendments will be made to the law to upgrade the punishments” and bring them into conformity with current conditions, said Dr Thuzar Chit Tin on September 1.

Myanmar launched a tobacco-free program in 1980, after introducing its first anti-smoking legislation in 1959 with an act that banned smoking in theatres.

Though the consumption of cigarettes and tobacco products decreased in 2007 after the control of smoking law came into effect, usage subsequently increased, apparently in part because of lax enforcement, particularly with regard to the ban on selling cigarettes within 100 feet (30.5 metres) of a school, or selling single cigarettes. Tobacco companies were among the first to quickly enter the country after the government began relaxing import restrictions.

According to a 2014 survey, the rate of tobacco use in Myanmar is 26.1 percent of the population, including 43.8pc of men and 8.4pc of women. About 80pc of smokers use tobacco every day. About 7pc of students smoke, and 17pc use cigars or other forms of tobacco.

The rate of betel use is higher, with 43pc of the population consuming betel, including 62pc of men and 24.1pc of women.

One of the problems in countering consumption, Dr Thuzar Chit Tin said, is that tobacco, betel and pickled tea leaves are considered traditional leisure activities, and their use seems to be rising. “We need to educate the public about the dangers of smoking,” she said.

However, she said, the tobacco industry is very powerful and influential compared to the resources available to the government. “The tobacco industry influences policymakers and the media. They have the financial resources to ensure that what the industry says gets better media coverage than the information we provide.”

She added that the updated law could also apply some of the tax derived from tobacco products to the health sector and to public education drives intended to reduce smoking.

In 2010 the government doubled the tax on cigarettes to 100 percent, while taxes on other tobacco products, including cheroots, were raised to 50pc in 2012. Additionally, shops are required to charge a 5pc sales tax. But according to the Internal Revenue Department, most cigarette producers do not pay the tax because of a lack of enforcement.

But measures to scale up the warning labels on tobacco products have gained traction. In 2014, the Myanmar Cigarette and Tobacco Products Consumption Controlling Central Committee added picture and text health on packaging and branding tobacco products. In June, the Ministry of Health announced that warning labels must appear on all brands of tobacco products in Myanmar from September.

The ministry released a notification in February calling for the implementation of the 2006 law. But the six-month period that was to have elapsed before enforcement began has been extended a further six months following appeals from the industry. The law is now expected to come fully into force in March 2017.

Translation by Thiri Min Htun

St. Louis County could raise minimum age to buy tobacco

ST. LOUIS, MO (KTVI)-Soon it may be harder for those under 21 to purchase tobacco products and e-cigarettes. The St. Louis County council could pass a bill at tonight’s meeting that raises the age to buy tobacco products from 18 to 21.

Opposition from the e-cigarette industry says vaping products should not be included with the tobacco. But a council member says the FDA ruled e-cigarettes can be regulated along with tobacco products.

If the bill is passed tonight, it would take effect at the end of the year.

Health costs of smoking may be higher than tobacco profit

Quitting smoking is hard as cigarettes contain nicotine, an addictive substance in tobacco that fuels cravings. After smoking, the brain becomes dependent on the nicotine and has thus rewired itself.

Because of this physical dependency, if a person stops smoking for a period of time, they will start experiencing symptoms of withdrawal. This is the brain and body adjusting to no longer having nicotine in the system.

But quitting smoking in a country like Indonesia, where 67 percent of men smoke, poses a different kind of challenge altogether.

After smokers overcome their withdrawal symptoms, such as anger and anxiety, they still have to face the last stage of overcoming nicotine addiction, which is reinforcement.

“The reinforcement challenges in Indonesia are very strong. People who have quit smoking will start smoking again once they see their neighbors smoking and smell the smoke. They might also see cigarette ads and start smoking again,” Widyastuti Soerojo of the Public Health Scholars Association (IAKMI) told The Jakarta Post.

This has led to an extremely low quit ratio for smokers in Indonesia. According to data from the World Health Organization (WHO), the quitting ratio for men in Indonesia is only 9 percent, while it is 23.2 percent in women.

Lioni Hendrawaty, a 30-year-old NGO worker, is an example of someone who finds that the temptation to smoke again after quitting is too much to resist.

She has been a smoker for 14 years. Throughout that time, she had tried repeatedly to quit smoking.

She said that she noticed her breathes getting shorter and so she was afraid that her habit would eventually kill her.

Lioni was diagnosed in 2014 with hypothyroid, a common disorder in which the thyroid gland does not produce enough thyroid hormone. “Since I was diagnosed, every time I smoke, my heart beats faster. It’s uncomfortable,” she told the Post.

Consequently, she was told by her doctor to stop smoking as her smoking habit would only exacerbate her illness.

But it turns out that being ill is not enough for someone like Lioni to stop smoking.

“Actually I had succeeded in reducing my cigarette consumption to once a day. At the most, I smoke three cigarettes in one day,” she said.

Therefore, it is important to make smoking not normal and not cool as the stakes are too high for Indonesia.

Though the government often argues that the tobacco industry brings much-needed revenue to the country, with it targeting to collect Rp 148.86 trillion from tobacco excise this year, the economic loss from tobacco consumption is actually much greater.

In 2013, the total loss due to tobacco consumption hit Rp 378.75 trillion, according to the Health Ministry, resulting from lost productivity due to illness, disability and premature death in youth and medical expenses.

Indonesia’s economy is also expected to lose Rp 59,580 trillion (US$4.5 trillion) by 2030 from tobacco-related diseases.

The University of Indonesia’s demographic institute associate director, Abdillah Ahsan, said Indonesians are having the hardest time to quit smoking because smoking is already considered normal in the country.

Smokers who want to quit will be constantly seduced by everyone who smokes around them as well as by pervasive cigarette advertisements.

“Access to cigarettes is very easy. If I live in a housing complex, I will find a small stall selling cigarettes just a few houses from me. It’s also easy for children to buy cigarettes. If they step out of their schools, they will find a warung. Above the warung will be a banner advertising cigarettes,” Abdillah said.

Furthermore, public officials are often shown to be smoking in public spaces, such as lawmakers around the parliament building.