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December, 2016:

Hong Kong to press ahead with cigarette packaging reform

Plan includes increasing warning size and number of graphic images

Hong Kong will press ahead with cigarette packaging reform to increase warnings that “smoking kills”, despite opposition from the tobacco industry, a leading health official said on Saturday.

Cigarette packaging has remained the same since 2007 and it was time for the government to overhaul packaging, Undersecretary for Food and Health Sophia Chan Siu-chee said.

“We feel that at this point in time it is important for us to increase the warning size and also the number of designs from six to 12,” Chan said in a radio interview.

The size of warnings on cigarette packs would increase to cover 85 per cent of the pack, from the current 50 per cent, and the number of graphic designs would double from six to 12.

Chan said Hong Kong’s measures to deter smokers were much fairer to the industry and the public than in some other countries, which had legislated unbranded plain packaging or given increased prominence to shocking pictures.

“We think [our proposal] is a balancing act, to increase the warning size to 85 per cent and increase the number of designs” she said. “We haven’t gone to plain packaging yet. We felt that this is something we can do to protect people from smoking.”

Department of Health data from 2012 showed the number of Hong Kong residents who smoke had dropped to a low of 10.2 per cent of the population.

Acting SFH on tobacco control

Hong Kong (HKSAR) – Following is the transcript of remarks made by the Acting Secretary for Food and Health, Professor Sophia Chan, after attending a radio programme today (December 24):

Reporter: The tobacco industry is not very happy with the Government’s proposal to make warning signs bigger on cigarette packages. Would the Government consider budging on its proposal? And also, under what circumstances will the Government consider imposing further measures to try to bring down the number of smokers in Hong Kong?

Acting Secretary for Food and Health: First of all, we have discussed this issue of increasing the size of the pictorial warning on cigarette packets since May 2015. There were deputations in the Legislative Council in July 2015 in which over 100 organisations attended. Most of them supported the Government’s initiative of increasing the packet warning size. The World Health Organization has suggested the larger the size of the pictorial warning on cigarette packets, the better or the more effective it is to decrease the number of people smoking. Therefore, from the statistics and evidence from different countries, we know that this is an effective tobacco control measure. So on the one hand, our packet (warning) size is now 50% and we have six different designs of pictorial warning. It hasn’t been changed since 2007, so it is almost ten years now. Therefore, we feel that at this point in time it is important for us to increase the packet warning size and also the number of designs from six to 12. The other issue is that there are also, obviously, countries that have gone even one step further, that is to go to plain packaging, i.e. 100% of the cigarette packet is already standardised and also (carries) a very big size of pictorial warning. Therefore, we think (our proposal) is already a balancing act, i.e. to increase the warning size to 85% and increase the number of designs. We haven’t gone to plain packaging yet. We felt that this is something that we can protect people from smoking. And also, it is shown that it is effective according to the evidence we collected from other countries.

Reporter: How about further measures?

Acting Secretary for Food and Health: For further measures, we always take a progressive and multi-pronged approach. We have just defined non-smoking area in the bus exchanges outside the eight tunnel portals in Hong Kong. Obviously there are other suggestions as to whether we would ban smoking at all bus stops or even on the streets. We will consider all these comments or suggestions, looking into the current tobacco control measures in Hong Kong, our smoking prevalence, our targets and also the related legislation.

Cigarette makers using devious ways to advertise to children, bypassing anti-tobacco law

Cigarette makers have resorted to devious ways to advertise, bypassing a law that bans promotion of tobacco products.

Advocates say the firms are now enticing children as young as seven years old to smoke, thus frustrating the full implementation of the Tobacco Control Act.

International Institute for Legislative Affairs chief executive Emma Wanyonyi said the industry is openly advertising cigarettes through conspicuous shop displays at the eye-level of young children.

“The industry is not only advertising their products, but also displaying products to children due to lack of enforcement,” she said.

Wanyonyi said even though one local company has started printing the graphic warnings as demanded by the Tobacco Control Regulations, 2014, the industry is already in court challenging those regulations.

The regulations seek to operationalise the 2007 Tobacco Control Act.

The sale of single stick cigarettes is also widespread, close to schools, although it is illegal, she said.

Wanyonyi challenged the Agriculture ministry to come to the rescue of farmers, who are still dependent on tobacco for them to have alternative crops.

“Tobacco growing depletes soil but researches that have been done show that there are alternative crops that can be grown,” she said.

Tobacco is the biggest known preventable cause of cancer and other non-communicable diseases.

Kenya Tobacco Control Alliance member Achieng Otieno said tobacco industries are so powerful as they have in the recent past compromised a section of MPS.

“The fact that the industry is well resourced has been a challenge in the implementation of the new law,” he said, adding that it has taken the country nine years to come up with new regulations.

Ochieng said even though they have written to EACC concerning bribery allegations by industry to MPS with the view of influencing some of the policies, EACC is yet to respond to them, one year later.

The World Health Organisation says last year, Kenyans smoked eight million cigarette sticks, compared to 6.5 million in 2013.

Tobacco industry in the country is vehemently opposed to new regulations regulating the manufacture, sale and advertising of tobacco products.

The regulations demand that pictures of dead babies, throat cancer and rotten teeth should appear on cigarette packets next month.

They include pictures of punctured throats and cancerous lung.

The regulations require both pictorial and text health warnings printed on the packets.

Also known as plain packaging, the move aims at dissuading current and potential smokers by giving them information on the harmful effects of nicotine and tar.

Dutch plan new law to ban shops displaying cigarettes and tobacco

Junior health minister Martin van Rijn is working on draft legislation which would force shopkeepers and petrol stations to keep cigarettes out of sight of consumers, broadcaster NOS said on Friday. The tobacco industry had promised to come up with measures but is taking too long to do so, Van Rijn said in a briefing to parliament.

The tobacconists’ association NSO has pledged to stop advertising tobacco products outside shops by 2020 but did not think a total ban on displays inside was an option.

Petrol station owners too had said they would bring in a partial ban on the display of packets of cigarettes within two years. ‘Smoking is extremely bad for you and we have to do all we can to stop youngsters taking up the habit,’ Van Rijn said.

Legal age to purchase tobacco in Orange County to go from 18 to 21

Beginning the middle of the new year, you will have to be at least 21 years of age in order to purchase any tobacco products in Orange County. The county legislature on Thursday voted unanimously to raise the legal age, citing health risks associated with the habit of smoking or other tobacco uses.

The bill is sponsored by James DiSalvo. “If we can save a few lives with this legislation, then it is worth it,” DiSalvo said

Legislator Michael Anagnostakis, chairman of the Health and Mental Health Committee, said the Centers for Disease Control has data about raising the purchase age.

“They did the study and said if this kind of a law was implemented across the whole United States of America, you would 225,000 less deaths every single year going forward and it would account for savings of upwards of $10 billion in the healthcare system,” Anagnostakis said.

Legislator Matthew Turnbull termed smoking “a horrible addiction.”

Lawmaker Kevin Hines recounted a conversation with his son.

“I have a 21-year-old son who smokes and he told me, ‘make sure you pass this law.’ He knew that he got hooked on it and he’s fighting it.”

Legislator Melissa Bonacic sees teenage behavior on a regular basis.

“Being a high school teacher myself I see sometimes teenagers make a lot of great decisions but are also at the age where they make a lot of poor decisions as well,” Bonacic said. “And I think there are a lot of factors out there, whether it is in the media, on TV or in the movies, that promotes smoking because it is cool, we know today that smoking is not cool.”

Legislator Chris Eachus said the next step in the process to keep tobacco out of the hands of children is to establish local laws to move tobacco advertising out of the line of sight of young people.

County Executive Steven Neuhaus supports the measure and is expected to sign it.

E-cigarettes ‘ticking time bombs’ for unsuspecting users

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As you get ready to travel for the holidays, you could be sitting next to a ticking time bomb. That’s the warning from one senator after an e-cigarette exploded in a man’s pocket on a bus.

AAA tells 10News that more than 103 million Americans — the most on record —are expected to travel for the holidays.

E-cigarettes are exploding on planes, buses and in stores. New York senator Charles Schumer is putting the heat on the feds to consider recalling exploding batteries and devices.

“It’s terrifying to see people hurting themselves and blowing up. There are a lot of videos out there,” said Adam Wooddy, owner of Satyr Vapor in Fresno, California.

That’s for sure. This viral video shows a Fresno bus driver warning a passenger about using his e-cigarette. The man puts it away; seconds later sparks and flames fly from his pants pocket. Investigators say the e-cig’s battery is likely the source of the blast.

The e-cig fires are happening at 30,000 feet, too. Last week, American Airlines Flight 1129 from Dallas to Indianapolis had to divert to Little Rock, Arkansas, after an e-cig caught fire in a passenger’s carry-on bag.

“I hope this sets an example for people to not take e-cigarettes on board,” said passenger Susan Karimi.

The FAA has banned the devices in checked baggage, but they can still be carried onboard. They cannot be charged while on board.

A New York liquor store worker is still recovering from serious burns after smoke and fire shot from his pocket at coworkers a few weeks ago.

“This e-cigarette didn’t just explode, it exploded a number of times,” said victim Otis Gooding’s attorney, Sanford Rubenstein. “Clearly, government authorities need to intervene, with regard to the sales of these e-cigarettes, so that what happened to this victim won’t happen to anybody else.”

The Federal Drug Administration ties e-cigarettes to 66 explosions last year into early 2016. Many are linked to the lithium ion battery. Overcharging, manufacturing defects and punctures can cause it to overheat, sometimes triggering a fiery reaction.

“These batteries are fragile. They have a wrap on the outside that needs to stay intact. If that battery gets torn and starts to touch metal, something like loose change in your pocket or something like that, it can definitely short out the battery,” said Wooddy.

Senator Schumer wants the Consumer Product Safety Commission and FDA to uncover exactly why the devices are exploding, be it a design problem, battery problem or operator error.

“E-cigarettes have become ticking time bombs, and we’re here today to disarm them before they injure more unsuspecting people,” said Schumer.

Experts suggest e-cig users should buy American, since 90 percent of the products come from China with fewer regulations, and buy a reputable domestic brand. Users are urged to read the instructions; don’t hold down the button too long, use the correct charger and don’t charge it too long to help prevent the device from going up in flames.

The Tobacco Vapor Electronic Cigarette Association points out that millions of people use the devices with only a few accidents. TVECA does support responsible regulation saying, “When you don’t have oversight, companies who want to make a quick buck buy batteries and equipment that aren’t up to snuff.”

Polycyclic Aromatic Hydrocarbons Overview

General Information

Polycyclic aromatic hydrocarbons (PAHs) are a class of more than 100 chemicals generally produced during the incomplete burning of organic materials, including coal, oil, gas, wood, garbage, and tobacco. PAHs are composed of up to six benzene rings fused together such that any two adjacent benzene rings share two carbon bonds. Examples include phenanthrenes, naphthalene, and pyrene. Important PAH sources include motor vehicle exhaust, residential and industrial heating sources, coal, crude oil and natural gas processing, waste incineration, and tobacco smoke. The emitted PAHs can form or bind to particles in the air, and particle size depends in part on the source of the PAHs. The smaller or fine particulates (e.g., PM2.5 or smaller) have higher concentrations of PAHs than the larger or coarse particulates (Bostrom et al., 2002; Rehwagen et al., 2005). Ambient air PAH concentrations show seasonal variation (IPCS, 1998; Rehwagen et al., 2005). Smoking, grilling, broiling, or other high temperature processing leads to PAH formation in meat and in other foods, as well. Uncooked foods and vegetables generally contain low levels of PAHs but can be contaminated by airborne particle deposition or growth in contaminated soil. With the exception of naphthalene, the PAHs described here are not produced commercially in the U.S.

Human exposure usually occurs to PAH mixtures rather than to individual chemicals, and PAH mixture composition varies with the combustion source and temperature (ATSDR, 1995). For persons without occupational exposure, important sources of PAHs include ambient air pollution (especially motor vehicle exhaust), smoke from wood or fossil fuels, tobacco smoke, and foods. PAH exposure can occur in workplaces where petroleum products are burned or coked, such as coke production, coal gasification and gas refining, iron or steel production, roofing tar and asphalt application, waste incineration, and aluminum smelting. Coal tar ointments containing PAHs are used to treat several inflammatory skin conditions.

PAHs are lipid soluble and can be absorbed through the skin, respiratory tract, and gastrointestinal tract. PAH metabolism is complex and occurs primarily in the liver, and to a lesser extent, in other tissues. PAH elimination occurs via urine and feces, and urinary metabolites are eliminated within a few days (Ramesh et al., 2004). PAHs and their urinary hydroxylated metabolites measured in at CDC are shown in the table. The metabolic pathways and enzyme-inducing effects of specific PAHs, such as benz[a]pyrene, have been actively studied to elucidate cancer potential and causal mechanisms (Ramesh et al., 2004). Although immunologic, kidney and brain toxicity have been seen in animals after high doses were administered, it is unclear if similar effects may occur in humans. Lung, bladder, and skin cancers have been reported in occupational settings following high PAH exposures (Bosetti et al., 2007; Bostrom et al., 2002; Lloyd, 1971). Exposure to fine particulates has been associated with fetal growth retardation, respiratory disorders, and cardiovascular disease, but it is unknown whether PAHs contained within fine particulates are etiologic (ATSDR, 1995; Choi, 2006).

IARC classifies naphthalene as a possible human carcinogen. NTP determined that naphthalene is reasonably anticipated to be a human carcinogen. Many other PAHs are considered to be probable or possible human carcinogens. IARC and NTP have classified specific PAH-containing chemical mixtures (e.g., soot, coke oven emissions, coal tars and coal tar pitches) as human carcinogens. OSHA has developed criteria on the allowable levels of these chemicals in the workplace.

Information about external exposure (i.e., environmental levels) and health effects is available in reviews (Bosetti et al., 2007; Bostrom et al., 2002; Brandt and Watson 2003) and from ATSDR at


Biomonitoring Information

Measurement of urinary metabolites reflects recent exposure to PAHs. Some of the parent PAHs can produce more than one measurable urinary metabolite, as shown in the Table. The hydroxylated metabolites of PAHs are excreted in human urine both as free hydroxylated metabolites and as hydroxylated metabolites conjugated to glucuronic acid and sulfate. Urine metabolite profiles can vary depending on the PAH source(s), but also have been found to vary between individuals experiencing similar exposures within the same workplace (Grimmer et al., 1997; Jacob and Seidel 2002).

Finding a measurable amount of one or more metabolites in the urine does not imply that the levels of the PAH metabolites or the parent PAH cause an adverse health effect. Biomonitoring studies of urinary PAHs provide physicians and public health officials with reference values so that they can determine whether or not people have been exposed to higher levels of PAHs than are found in the general population. Biomonitoring data can also help scientists plan and conduct research on exposure and health effects.

CAS No. 129-00-0

General Information

Pyrene has been used as a starting material for producing optical brighteners and dyes. Notable pyrene sources include domestic heating sources, particularly wood burning; gasoline fuel exhaust; coal tar and asphalt; and cigarette smoke. Pyrene is commonly found in PAH mixtures, and its urinary metabolite, 1-hydroxypyrene, has been used widely as an indicator of exposure to PAH chemicals, particularly in occupational exposure studies. IARC determined that pyrene was not classifiable as to its human carcinogenicity.

Biomonitoring Information

Urinary levels of 1-hydroxypyrene reflect recent exposure. The overall geometric mean of 1-hydroxypyrene levels in the NHANES 2003–2004 subsample was similar to that of general populations in other industrialized countries (Becker et al., 2003; Chuang et al., 1999; Goen et al., 1995; Heudorf and Angerer 2001a, 2001b; Yang et al., 2003). Higher levels have been noted in residents of industrialized and high traffic urban areas compared with rural or suburban settings, and the mean urinary 1-hydroxypyrene levels from the former group were somewhat higher than in the NHANES 2003–2004 subsample (Kanoh et al., 1993; Kuo et al., 2004; Yang et al., 2003). Variation also has been noted in the mean 1-hydroxypyrene urine levels between different industrialized countries (for example, South Korea or China, compared to the U.S.), which is attributable to such factors as ambient air pollution and residential heating and cooking sources (Huang et al., 2004; Kuo et al., 2004; Roggi et al., 1997; Siwinska et al., 1999; Yang et al., 2003). In general, smokers have about 2 to 4-fold higher urinary 1-hydroxypyrene levels than non-smokers (Goen et al., 1995; Heudorf and Angerer 2001b; Jacob et al., 1999). Environmental tobacco smoke may contribute to higher urinary 1-hydroxypyrene levels in exposed children (Chuang et al., 1999; Siwinska et al., 1999; Tsai et al., 2003).

Numerous studies of workers with occupational exposure to excessive vehicular exhaust have found increased urinary 1-hydroxypyrene levels compared to non-exposed individuals (Kuusimaki et al., 2004; Merlo et al., 1998; Tsai et al., 2004). The highest urinary levels of 1-hydroxypyrene measured in occupational studies have been found in aluminum smelter and coke oven workers exposed to heated tar and coal tar products (Alexandrie et al., 2000; Goen et al., 1995; Jacob and Seidel, 2002; Lu et al., 2002; Serdar et al., 2003). Results in these workers have ranged from about 100 to more than 1000 times greater than non-exposed levels and the geometric mean values found in the Fourth Report. Tobacco smoking also was associated with levels about double those in nonsmoking workers (Campo et al., 2006; Merlo et al., 1998; Mukherjee et al., 2004).

Finding a measurable amount of urinary 1-hydroxypyrene does not imply that the level of 1-hydroxypyrene causes an adverse health effect. Biomonitoring studies on levels of 1-hydroxypyrene provide physicians and public health officials with reference values so that they can determine whether people have been exposed to higher levels of pyrene than are found in the general population. Biomonitoring data can also help scientists plan and conduct research on exposure and health effects.


Alexandrie AK, Warholm M, Carstensen U, Axmon A, Hagmar L, Levin JO, et al. CYP1A1 and GSTM1 polymorphisms affect urinary 1-hydroxypyrene levels after PAH exposure. Carcinogenesis 2000;21(4):669-676.

Becker K, Schulz C, Kaus S, Seiwert M, Seifert B. German environmental survey 1998 (GerES III): environmental pollutants in the urine of the German population. Int J Hyg Environ Health 2003; 206:15-24.

Campo L, Buratti M, Fustinoni S, Cirla PE, Martinotti I, Longhi O, et al. Evaluation of exposure to PAHs in asphalt workers by environmental and biological monitoring. Ann NY Acad Sci 2006;1076:405-420.

Chuang JC, Callahan PJ, Lyu CW, Wilson NK. Polycyclic aromatic hydrocarbon exposures of children in low-income families. J Expo Anal Environ Epidemiol 1999;9(2):85-98.

Goen T, Gundel J, Schaller KH, Angerer J. The elimination of 1-hydroxypyrene in the urine of the general population and workers with different occupational exposures to PAH. Sci Total Environ 1995;163(1-3):195-201.

Heudorf U, Angerer J. Internal exposure to PAHs of children and adults living in homes with parquet flooring containing high levels of PAHs in the parquet glue. Int Arch Occup Environ Health 2001a;74(2):91-101.

Heudorf U, Angerer J. Urinary monohydroxylated phenanthrenes and hydroxypyrene–the effects of smoking habits and changes induced by smoking on monooxygenase-mediated metabolism. Int Arch Occup Environ Health. 2001b 74(3):177-83.

Huang W, Grainger J, Patterson DG, Turner WE, Caudill SP, Needham LL, et al. Comparison of 1-hydroxypyrene exposure in the US population with that in occupational exposure studies. Int Arch Occup Environ Health 2004;77:491-498.

Jacob J, Grimmer G, Dettbarn G. Profile of urinary phenanthrene metabolites in smokers and non-smokers. Biomarkers 1999;4(5):319-327.

Jacob J, Seidel A. Biomonitoring of polycyclic aromatic hydrocarbons in human urine. J Chromatogr B 2002;778(1-2):31-47.

Kanoh T, Fukuda M, Onozuka H, Kinouchi T, Ohnishi Y. Urinary 1-hydroxypyrene as a marker of exposure to polycyclic aromatic hydrocarbons in environment. Environ Res 1993;62(2):230-241.

Kuo CT, Chen HW, Chen JL. Determination of 1-hydroxypyrene in children urine using column-switching liquid chromatography and fluorescence detection. J Chromatogr B 2004;805(2):187-193.

Kuusimaki L, Peltonen Y, Mutanen P, Peltonen K, Savela K. Urinary hydroxy-metabolites of naphthalene, phenanthrene and pyrene as markers of exposure to diesel exhaust. Int Arch Occup Environ Health 2004;77(1):23-30.

Lu PL, Chen ML, Mao IF. Urinary 1-hydroxypyrene levels in workers exposed to coke oven emissions at various locations in a coke oven plant. Arch Environ Health 2002;57(3):255-261.

Merlo F, Andreassen A, Weston A, Pan CF, Haugen A, Valerio F, et al. Urinary excretion of 1-hydroxypyrene as a marker for exposure to urban air levels of polycyclic aromatic hydrocarbons. Cancer Epidemiol Biomarkers Prev 1998;7(2):147-55.

Mukherjee S, Palmer LJ, Kim JY, Aeschliman DB, Houk RS, Woodin MA, et al. Smoking status and occupational exposure affects oxidative DNA injury in boilermakers exposed to metal fume and residual oil fly ash. Cancer Epidemiol Biomarkers Prev 2004;13(3):454-460.

Roggi C, Minoia C, Sciarra GF, Apostoli P, Maccarini L, Magnaghi S, et al. Urinary 1-hydroxypyrene as a marker of exposure to pyrene: an epidemiological survey on a general population group. Sci Total Environ 1997;199(3):247-254.

Serdar B, Waidyanatha S, Zheng Y, Rappaport SM. Simultaneous determination of urinary 1- and 2-naphthols, 3- and 9-phenanthrols, and 1-pyrenol in coke oven workers. Biomarkers 2003;8(2):93-109.

Siwinska E, Mielzynska D, Bubak A, Smolik E. The effect of coal stoves and environmental tobacco smoke on the level of urinary 1-hydroxypyrene. Mutat Res 1999;445(2):147-153.

Tsai HT, Wu MT, Hauser R, Rodrigues E, Ho CK, Liu CL, et al. Exposure to environmental tobacco smoke and urinary 1-hydroxypyrene levels in preschool children. Kaohsiung J Med Sci 2003;19(3):97-104.

Tsai PJ, Shih TS, Chen HL, Lee WJ, Lai CH, Liou SH. Urinary 1-hydroxypyrene as an indicator for assessing the exposures of booth attendants of a highway toll station to polycyclic aromatic hydrocarbons. Environ Sci Technol 2004;38(1):56-61.

Yang M, Kim S, Lee E, Cheong HK, Chang SS, Kang D, et al. Sources of polycyclic aromatic hydrocarbon exposure in non-occupationally exposed Koreans. Environ Mol Mutagen 2003;42(4):250-257.

Philippines: Department of Health backs Ecigs restrictions supported by WHO

Philippines are going towards one of the toughest tobacco control on Southeast Asia. The government back e-cigarette restrictions decided at the CoP7 and include vaping in smoking bans.

The presence of Alicia Bala, Civil Service Commission (CSC) Chairperson, rather than Department of Health (DOH) Secretary Paulyn Jean Ubial at the head of the Philippine delegation in New Delhi to lead the negotiations with the Worldwide Health Organization (WHO) has been deemed beyond of their expertise.

The delegation clarified that the CSC lead initiatives on tobacco control within governmental agencies. Indeed, in 2009 and 2010, CSC tobacco control initiatives have been to issue an absolute ban on smoking in all government offices and to impose to all government officials and employees not to interact with the tobacco industry unless to supervise, regulate or control tobacco production.

Department of Health agrees with WHOs position on potential risks to the health

During the last CoP7, the Framework Convention on Tobacco Control (FCTC) encouraged parties to “to prohibit or restrict the manufacture, importation, distribution, presentation, sale and use of ENDS,” in response to what the WHO describes as a “tobacco epidemic.” The global organization discourages the use of ENDS until it is deemed “safe and effective, and of accepted quality by a competent national regulatory body.”

As a signatory of the WHO’s treating since 2005, Philippines, the Southeast Asia’s second-most populous country, has committed to prioritise public health over other interests in relation to the manufacture, sale, and use of tobacco products.

To clarify the position of the Government with respect to the ecigarette, the Department of Health (DOH) declared it agrees with WHOs position on potential risks to the health of users, as these have not yet been clearly determined.

The determination of a president to have Philippines smoke-free

After his election on June 30, 2016, Rodrigo Dutertre’s government proposed increasing taxes on cigarettes and other tobacco products. To confirm president Dutertre’s determination to enforce nationally an anti-smoking law that he experimented as a mayor for 22 years of a 1.5 million citizen city, Davao, the government spokesman Ernesto Abella declared “Certainly in Davao, the sentiment and business establishments support a smoke-free Davao. The president sees it as something that’s not ideal for health… and this is part of the public well-being”. DOH Secretary, Paulyn Jean Ubial, told Reuters she was supportive with the president to curb smoking in public places, including parks, bus stations, and even in public vehicles.

During his term as a mayor in Davao, Reuters reports that he once personally forced a man to stub out his cigarette and eat it after he refused to stop smoking in a restaurant. His nickname, “The Punisher”, was inherited from his governance ruled by harsh laws like a ban on late-night drinking and karaoke, and a 10 p.m. curfew for school children in addition to his smoke-free policy in Davao.

Tobacco industry, a powerful lobby

A Sin Tax Law signed by former president Benigno Aquino III in 2012 strengthened the lobby of cigarette manufacturers and kept the tax structure on alcohol and cigarettes complicated and weak. The system was believed to encourage corruption among state agents and to constitute a loss of earnings for the DOH to manage issues arising from abuse in the use of alcohol and cigarettes.

Cigarette packs to carry graphic health warnings

Starting Friday, graphic warnings about the harmful effects of smoking will be attached to cigarette packs sold in South Korea.

According to the Ministry of Health and Welfare, all cigarette packs sold here, including those sold at duty-free shops, must carry one of 10 designated full-color and disturbing photos with warnings on the adverse effects of smoking.

Some of the photos depict the body parts of smokers suffering from fatal diseases such as lung cancer, oral cancer, heart attack and strokes. Text warnings include those about the dangers of secondhand smoke, smoking while pregnant, as well as possible side effects such as sexual dysfunction, skin aging and premature death.

The graphic health warnings must be placed on the upper part of both sides of cigarette packets. The photos are required to cover more than 30 percent of both sides of each packet, the ministry said.

The ministry also plans to resume anti-smoking TV ads, introducing real cases of victims of smoking. It had stopped doing so 14 years ago.

It will take one month before the cigarette packs with the warnings will appear in the market due to production and distribution procedures. However, some of the cigarette packs with graphic warnings will be released at retail stores starting Friday for promotion purposes near crowded downtown areas such as Gwanghwanmun, Yeouido and Gangnam, the ministry added.

Anti-smoking campaigns that use such visual images were first introduced in Canada in 2001. Such practices are currently adopted by 101 countries around the world.

“After reviewing figures from 18 countries which adopted the graphic health warning labels, it was found that the smoking rate fell by 13.8 percent in Brazil, while the average for these countries was around 4 percent, after these labels were attached,” said the ministry official.

In June, the National Assembly approved a bill that makes it obligatory for tobacco-makers to display graphic warnings on cigarette packs to promote people’s health.

Under the law, the graphics will be replaced every 24 months and a notice about the next 10 photos will be announced six months ahead of the replacement. Violators of the law will face up to a year in jail or up to 10 million won ($12,000) in fines, or revocation of the company’s business license.

The smoking rate among South Koreans, aged 19 or older, dropped to 39.3 percent last year from 43.1 percent in 2014. It marked the first time that South Korea’s smoking rate fell below 40 percent.

The decrease came after sharp hikes in tobacco prices here. The government raised tobacco prices by 2,000 won per pack in January as part of an anti-smoking campaign.

The ministry announced last year that it aims to lower the smoking rate among South Korean men to 29 percent by 2020.

By Kim Da-sol (

Kentucky leads nation in adult smoking

Once again, Kentucky ranks first for its adult smoking rates, barely inching ahead of West Virginia to take back the first place spot, according to the federal Centers for Disease Control and Prevention.

Kentucky’s adult smoking rate in 2015, the latest period available, is 25.9 percent; West Virginia, which ranks second, is at 25.7 percent. That means that more than one-fourth of the adults in both of these states smoke. Arkansas closely follows at 24.9 percent.

States with the lowest smoking rates are Utah at 9.1 percent and California at 11.7 percent.

“Tobacco use is the leading cause of preventable disease and death in the U.S., accounting for more than 480,000 deaths every year, or one of every five deaths,” says the CDC.

Nationwide, smoking rates have declined almost 28 percent since 2005, to 15.1 percent in 2015 from 20.9 percent in 2005, says the CDC report based on the 2015 National Health Interview Survey. Kentucky’s smoking rates declined 10 percent in the same time frame, from 28.7 percent to 25.9 percent respectively, according to the Behavioral Risk Factor Surveillance System, a constant national poll conducted by the CDC.

The report also notes that smoking is more prevalent among men, Native Americans, the poor, the less educated, Midwesterners and Southerners, people who on are Medicaid or are uninsured, and those who have a disability, are gay or bisexual, or have mental-health issues.

The CDC says we know how to reduce smoking: “Proven population-based interventions, including tobacco price increases, comprehensive smoke-free laws, anti-tobacco mass media campaigns and barrier-free access to tobacco cessation counseling and medications, are critical to reducing cigarette smoking and smoking related disease and death among U.S. adults; particularly among subpopulations with the highest smoking prevalence,” said the report.

Kentucky has room for improvement in all of these areas.

Kentucky ranks in the bottom 10 states (43rd) for its cigarette tax, at 60 cents per pack, and spends only 4.4 percent of what the CDC recommends for smoking cessation efforts ($2.5 million a year). The state’s high smoking rate also comes with a hefty price tag, as the Campaign for Tobacco-Free Kids estimates Kentucky smoking-related health costs at $1.92 billion a year. The group ranks Kentucky 37th in protecting children from tobacco, and says 17 percent of its high-school students smoke.

And though Kentucky has tried to pass one in the past, Kentucky does not have a comprehensive statewide smoke-free law and isn’t likely to get one any time soon because Republican Gov. Matt Bevin does not support such a law, saying this should be a local decision. State Health Commissioner Hiram Polk said in October that he’s looking for away to get Bevin to alter his policy: “We’ve got to find some kind of landmark we can use there that would be acceptable to the governor and get through the legislature.”

About one-third of Kentuckians are protected by local comprehensive smoke-free workplace laws, according to the Kentucky Center for Smoke-free Policy.

In contrast, Utah, which has the lowest smoking rate (9.1 percent), does have a comprehensive statewide smoke-free law, has a cigarette tax of $1.70 per pack and spends $7.1 million on tobacco cessation initiatives, which is almost 37 percent of the CDC’s recommended spending. And Utah spends less on health cost caused by smoking at $542 million.

Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Media at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.