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October 26th, 2016:

Macau tobacco law must pass by Aug 2017: health boss

Lei Chin Ion, the director of Macau’s Health Bureau, said on Wednesday his department wants to see the government’s draft of the revised tobacco control bill complete all necessary scrutiny and approval prior to the city’s current legislative term ending in August 2017. If the deadline is missed, the current proposed legislation would fall and the process – which began in July 2015 – would have to start afresh.

Mr Lei added that his department had yet to decide if it supported the idea of allowing the continuation of smoking lounges on the main floors of the city’s casinos. The draft bill originally submitted had envisaged a total ban on all smoking inside the city’s casinos. Investment analysts have noted that casino markets that entirely ban in-casino smoking usually experience a fall in casino gross gaming revenue (GGR), as players are forced to exit the casino in order to indulge their habit.

But a working committee of the city’s Legislative Assembly tasked with scrutinising the bill had in May suggested that with use of the right technical know-how and other safeguards for the health of non-smokers, the retention of smoking lounges might be feasible. Macau has already been buffeted by two years of sustained declines in casino GGR that investment analysts have associated with China’s ongoing anti-corruption campaign. Only in the past three months have there been signs that the market’s casino GGR might be stabilising, a number of senior industry executives have said.

“We are still collecting opinions regarding whether to have smoking lounges inside casinos, and are now studying this subject,” the Health Bureau’s Mr Lei told reporters on Wednesday following a closed-doors meeting of the working committee. Mr Lei doesn’t sit on the body, but as head of the Health Bureau had been invited by lawmakers to attend that day’s committee session.

Bill deadline

“What we strive to do is to see this bill approved before the current legislative term ends [in August] in 2017,” Mr Lei added.

The Health Bureau director declined to comment on the likely date the provisions of the bill would come into force, assuming it is passed before August next year. Aside from the contested issue of casino smoking lounges, the measure proposes more restrictive terms for sales of tobacco products and a ban in Macau on the sale of electronic cigarettes.

Prior to the two-month summer recess of the Legislative Assembly – a break that ended on October 15 – a majority of the relevant working committee had shown support for the retention of smoking lounges on casino main floors, the committee’s president Chan Chak Mo told reporters on May 26.

The working committee’s support for smoking lounges is on condition that second-hand smoke can be kept away from casino staff, and from guests that don’t smoke, Mr Chan said at the time.

Smoking on casino main floors in Macau is currently only allowed in airport-style enclosed smoking lounges that do not contain any gaming tables or slot machines. Casino operators have been required to get approval for such facilities. Having a cigarette while gambling is at present still allowed in Macau casino VIP rooms.

Speaking to reporters after meeting the government on Wednesday, committee president Mr Chan noted that the majority of his working committee had not changed its stance regarding the retention of smoking lounges inside casinos. He further noted that his committee is to discuss the subject with government officials in the next meeting. That meeting is yet to be scheduled.

“There is a deadline to it [the government’s study of the retention of smoking lounges],” Mr Chan noted on Wednesday.

“Because this year is the final year of our legislative term [the fifth term of the Legislative Assembly], this means if this bill cannot be approved before August 15, 2017, it will have to be scrapped,” the legislator stated.

Florida Jury Awards Nearly $29 Million in Damages in Smoker’s Death

On October 25, a Florida jury awarded $20 million in punitive damages against R.J. Reynolds Tobacco Co. in a trial over a chain smoker’s lung disease death. The jury added to the $8.8 million in compensatory damages awarded a day earlier.

Jurors awarded widower Alan Konzelman about $10 million more than he had sought, Law360 reports. He was awarded $8.8 million in compensatory damages for his pain and suffering over his wife’s death. He had asked for $5 million plus about $300,000 for his wife’s medical expenses. He had asked for $14 million in punitive damages and received $20 million.In closing arguments last week, Konzelman’s attorney told jurors how the sailor’s wife of 29 years died of chronic obstructive pulmonary disease (COPD). The attorney explained that Konzelman loved his wife “deeply” and spent every possible moment with her. “They had an amazing and adventurous life . . .They sailed, they got married, they had fun together . . . And they had a right to grow older together.”

An attorney for R.J. Reynolds argued that Elaine Konzelman knew smoking was dangerous and her husband and four children had long been urging her to quit. The attorney said she kept smoking despite warnings on cigarette packs and public health campaigns, according to Law360.

This case is one of thousands arising from the landmark Engle class action against tobacco companies. Dr. Howard Engle, a lifelong smoker, was one of the plaintiffs in the class action lawsuit. They said they had been turned into nicotine addicts by a tobacco industry that did not warn them of the health risks of the habit. The Florida Supreme Court decertified the class in 2006 and overturned a $145 billion verdict, but it allowed up to 700,000 people who could have won judgments to rely on the jury’s findings to file lawsuits of their own. Among the conclusions, the jury found that smoking causes certain diseases and that tobacco companies hid smoking’s dangers.

In a case decided in December 2015, an attorney said changes in practices made by tobacco companies were not voluntary, but were the result of a series of government lawsuits and a 2009 act of Congress that put the tobacco industry under the regulatory power of the Food and Drug Administration (FDA). But the changes came too late for Elaine Konzelman and many like her. The attorney in the 2015 case said “there is no evidence whatsoever that the tobacco companies have done anything to mitigate what they’ve done in the past. . . If they have changed, they probably don’t put down in writing every thought that they have anymore.”

Study finds perception of e-cigarette harm growing among US adults

The proportion of American adults who perceive e-cigarettes to be equally or more harmful than traditional cigarettes has tripled over the last few years, highlighting the need for more accurate public health messaging, according to a study led by tobacco researchers in the School of Public Health at Georgia State University.

“Although the impact of long-term use of e-cigarettes on health is still unknown,” the study stated, “the available scientific evidence indicates that e-cigarettes are less harmful than combustible cigarettes, and that smokers switching to e-cigarettes could benefit from a decrease in health risks related to smoking combustible cigarettes.”

Researchers looked at data from the Tobacco Products and Risk Perception surveys from 2012 through 2015 to examine changes in how adults in the United States perceived the relative harm and addictiveness of e-cigarettes. The surveys were conducted nationally in 2012, 2014 and 2015 by the Tobacco Center of Regulatory Science (TCORS) at the School of Public Health. Nearly 16,000 adults completed the surveys.

The study results are published in the American Journal of Preventive Medicine in an article titled “Changing Perceptions of Harm of E-Cigarettes among U.S. Adults, 2012-2015.” The study’s lead author is Dr. Ban Majeed, a postdoctoral research associate with TCORS in the School of Public Health.

According to the survey, 35 percent of adult smokers perceived e-cigarettes to be equally or more harmful than combustible cigarettes in 2015—a sizeable increase over the nearly 12 percent who reported that perception in 2012. Also, the proportion of adult smokers who thought e-cigarettes were addictive more than doubled from 25 percent in 2012 to nearly 57 percent in 2015. Similar trends were seen in non-smoking adults.

“The findings underscore the urgent need to convey accurate information to the public, especially adult smokers, about the available scientific evidence of the harm of e-cigarettes compared to combustible cigarettes,” the study stated.

“Our public health messages should accurately convey to cigarette smokers that switching completely to e-cigarettes would reduce their risks even if e-cigarettes are addictive and not risk-free,” said one of the study’s authors, Dr. Michael Eriksen, dean of Georgia State’s School of Public Health and a globally recognized expert in tobacco control.


When e-cigarettes first made their appearance on the market, they were greeted with enthusiasm and relief by smokers and non-smokers alike. Anyone who expressed skepticism or a desire to learn more about the potential health hazards of this miracle product was met with harsh resistance. New information out of Harvard University has emerged, however, which incontrovertibly links e-cigarettes to lung disease. Apparently, the heavy focus on removing the combustion element of smoking overshadowed the other health hazards posed by the use of this device.

The discovered danger lies in the chemical flavourings used in e-cigarettes – more specifically, Diacetyl, a flavorings chemical that, according to Harvard, can lead to severe respiratory disease. The chemical is found in more than 75 percent of flavoured electronic cigarettes, alongside two other related and potentially harmful compounds used to produce flavours that appeal to a variety of young people, like cotton candy.

This is quite disturbing, particularly given the fact that there are currently more than 7,000 varieties of flavoured e-cigarettes and e-juices (the nicotine containing liquid used for refillable devices) available on the market.

The Harvard press release emphasized that the U.S. Food and Drug Administration (FDA) has not tested e-cigarettes for safety and their potential health effects, and, what’s worse, they are not currently regulated.

We are dealing with chemicals that the Occupational Safety and Health Administration and the flavouring industry itself have warned workers about because of their association with the respiratory disease bronchiolitis obliterans, also known as “popcorn lung.”

“Recognition of the hazards associated with inhaling flavoring chemicals started with ‘popcorn lung’ over a decade ago. However, diacetyl and other related flavoring chemicals are used in many other flavors beyond butter-flavored popcorn, including fruit flavors, alcohol flavors, and, we learned in our study, candy-flavored e-cigarettes.” – Lead author Joseph Allen, assistant professor of exposure assessment sciences.

The study tested more than 50 types of flavoured e-cigarettes. Each e-cigarette was then placed into a closed off chamber attached to a lab-built device which drew air through the e-cigarette for eight seconds at a time. The air stream was then analyzed by researchers and they found at least one of three harmful chemicals detected in 47 of the 51 flavours tested.

“Since most of the health concerns about e-cigarettes have focused on nicotine, there is still much we do not know about e-cigarettes. In addition to containing varying levels of the addictive substance nicotine, they also contain other cancer-causing chemicals, such as formaldehyde, and as our study shows, flavoring chemicals that can cause lung damage,” said study co-author David Christiani, Elkan Blout Professor of Environmental Genetics.”

As more research on e-cigarettes becomes available, it becomes increasingly clear that there are associated dangers which must be acknowledged. At this point, I think we can safely describe them as an uncontrolled experiment on consumers. And the Harvard study above isn’t the only one making noise; a study done by The German Cancer Research Center found that e-cigarettes and their emissions are not safe and that they contain cancer causing substances like volatile organic compounds, acetone, formaldehyde, acetaldehyde, benzopyrene, and silicate, along with various other metal particles.

What Else Can You Do To Quit Smoking?

Aside from developing a true desire to quit smoking, which is the necessary and usually most difficult first step in making any significant lifestyle change, there are a number of steps one can take to quit. GreenMedInfo has put together a great list of options, including the research and evidence that goes with their efficacy.

COP7: Group urges measures to hold big tobacco liable

In early November, up to 179 countries will convene for the seventh session of the Conference of the Parties of the global tobacco treaty to take some of the most powerful steps in tobacco control since the World Health Organization treaty’s adoption.

At the conference, countries will advance a provision to hold the tobacco industry civilly and criminally liable for its abuses. In the wake of revelations this year about British American Tobacco (BAT)’s widespread bribery, governments will also advance policies to exclude the industry from public health policymaking at the international and national levels.

Litigation against Big Tobacco has compelled the industry to pay for the healthcare costs it has caused to countries around the world. The successful litigation against the tobacco industry in the U.S., via the Master Settlement Agreement (MSA), secured the recovery of $206 billion in health care costs and transformed public health by banning advertising to kids and exposing industry lies.

A recent 17-year court case in Canada has similarly awarded smokers $15.6 billion CAD, in what is believed to be the largest class-action lawsuit in Canada to date.

“Litigation is one of the most powerful strategies in forcing the tobacco industry to pay for the staggering costs it incurs on society,” said Cloe Franko, senior international organizer with the Challenge Big Tobacco campaign at Corporate Accountability International.

“The outcomes of this year’s Conference of the Parties are poised to mark a turning point for public health.”

The tools parties will promote at this year’s conference will especially help low – and middle-income countries, where the majority of the world’s smokers now live, but whose GDPs are often dwarfed by Big Tobacco’s revenues—making going head-to-head with the industry in the courts a dubious prospect.

“Nigeria and other developing nations targeted by Big Tobacco for marketing of their lethal products now have the opportunity to support the adoption of mechanisms to hold the industry accountable for the harms caused by tobacco,” said Philip Jakpor, NATT Nigeria Spokesperson.

“Standing for the adoption of provisions that advance criminal liability on Big Tobacco is the right step for delegates from the African region owing to widespread bribery allegations levelled against British America Tobacco (BAT), which has in no small measure slowed the implementation of life-saving legislations.”

In addition to advancing tools to hold the tobacco industry civilly and criminally liable, parties will also close loopholes the tobacco industry has exploited to participate in treaty meetings.

The policy stems from a broader treaty directive called Article 5.3 that prevents industry interference in the halls of government.

The global tobacco treaty, known formally as the World Health Organization Framework Convention on Tobacco Control (FCTC) entered into force in 2005.

To date, 179 countries and the European Union have become Parties to the treaty. It contains the world’s most effective tobacco control and corporate accountability measures—estimated to save more than 200 million lives by 2050 if fully implemented.