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FROM THE DIRECTOR'S DESK
Last year the presentation to the Select Committee by the Smokefree Coalition and ASH prompted Hone Harawira MP to call for tobacco to be banned. Who knows what will come out of this year's submission! What I did note from the Budget Policy Statement was a commitment to continue to progress the government's overarching policy goals of "Economic Transformation, Families - young and old, and, National Identity." It is the last of these I wish to address. Just before the end of 2006, the Ministry of Health released its research into the Smoke-free Environments Amendment Act 2003. You can access the report online here. A University of Otago media release regarding the report is available on the Scoop site here. It was fascinating to see 90 percent of New Zealanders agreed that non-smokers have the right to live and work in a smokefree environment. For this to occur many smokers had to support smokefree environments, and this was indeed the case. In light of these results, our smokefree environments can now rightly be seen as part of our national identity. In that case, a strong argument can be advanced for there to be a budget priority aimed at building on the successes so far. So what can be done? Well, something I have learned over the course of my first year in this job is many smokers would like to quit. However, breaking an addiction is not easy and part of a comprehensive tobacco control strategy should be to provide motivation for smokers to give up. One of the things that achieves this is price, particularly when the increase in the price of cigarettes comes courtesy of a government tax increase. We know from Ministry of Health reports that price increases do lead to a drop in consumption.1 We also suspect that the same price increase leads some smokers to switch to roll-your-owns which remain relatively more affordable than tailor-made cigarettes, and this issue must also be addressed. Price also plays a part in discouraging smoking initiation. It does so in two respects. Firstly, cigarettes must compete with all other consumer goods for a person's discretionary dollar. The more expensive a packet of cigarettes is the more likely it is that other spending choices will trump the decision to buy that packet. Secondly, the more expensive cigarettes are the less likely it is that a smoker will offer a cigarette to another person. The case for a tax increase is therefore well made. Politicians, however, seem reluctant to bite the bullet for fear of being accused of being "nanny state". So why not link any tax increase to greater support for effective tobacco control efforts, particularly cessation services? After all, the petrol tax is now well tied to roading. I have a number of golfing buddies who still smoke and grumble about the tax take. However they all tell me they would not mind it so much if the taxes went towards supplying nicotine patches. Tax is not the only issue in a tobacco control strategy. We should acknowledge and celebrate the advances made recently and over the years (the decision to move to graphic health warnings, for example). However, tax is part of a comprehensive tobacco control policy designed to bring about a prevalence drop. And it has been ignored for far too long. Have a good fortnight. Mark Peck Director _________________ 1. Ministry of Health. Tobacco Tax - the New Zealand Experience. (2000) Ministry of Health: Wellington. IN THIS ISSUE:
KIWI SMOKERS FIRST TO TEST QUICK-FIX LOZENGEWorld-first trials of a lozenge designed to deliver nicotine hits up to twice as fast as current quit smoking treatments will begin in New Zealand in February. Ninety volunteers in Auckland will try the lozenge, plus a mouth spray and an oral pouch developed by Swedish researchers. Experts hope the new products will get nicotine to the brain within 15 minutes, significantly reducing cravings for those who want to quit cigarettes. "There are no magic cures for stopping smoking, unfortunately," says Hayden McRobbie, research fellow at Auckland University's Clinical Trials Research Unit, which will run the trial. "But medications definitely help by making stopping smoking easier. They essentially double your chances of quitting." The new products, developed by Swedish company NicoNovum, are due in New Zealand soon. McRobbie says they contain no more nicotine than treatments already available. "But we think they might release nicotine a little bit faster." McRobbie says nothing can compete with cigarettes, "which deliver nicotine to the brain within 10 to 20 seconds." The Auckland trials will look specifically at how effective the three new products are at relieving tobacco withdrawal symptoms. At the end of the trial, smokers will be offered help to quit using currently available methods. McRobbie says statistically, people who go cold turkey have a 3 to 5 percent chance of being non-smokers a year later. Success rates rise to 20 to 30 percent among those who use nicotine replacement therapies and professional support. "That's how hard it is to quit smoking, and that's how high the relapse rates are. I do think perhaps we need to make a little bit more available to smokers... one size doesn't fit all." Current smoking cessation guidelines allow smokers to buy eight weeks of nicotine replacement therapy for a maximum of $15. Revised guidelines, to go to Ministry of Health for approval in April, are expected to recommend extended treatment periods. Quitline executive director Helen Glasgow says smoking cessation research is a growing field. "My hope is there will be more successful quit aids becoming available. Over the next five to 10 years, I would expect there are going to be methods that give a better outcome for people dealing with the effects of quitting, than there are at the moment. "According to the World Health Organization, about a third of the global population aged 15 and over smokes. About 75 percent of smokers in developed countries are unhappy about their smoking behaviour and would like to change." Stuff, 7 January 2007 NON SMOKERS USED TO BE A RARITYBy Gordon Parry
When I was young a non-smoker was a rarity. Every restaurant table had its ashtray, offering a cigarette was a polite thing to do and popular presents for Christmas were silver cigarette cases or Ronson lighters. There were even smoking rituals. You opened your little case, proffered it, took your own cigarette and tapped it two or three times on the case or packet, then lit up. If you could blow smoke rings you were admired. Smoking began early. Small boys somehow got hold of packets of Guinea Gold (fourpence for 10) and lit up at the end of the garden. At school a furtive fag behind the bike shed was an indication of sophisticated daring, and swapping cigarette cards was a routine activity. Film stars smoked, politicians smoked, doctors smoked. Smoking was a normal activity. Advertising was smart. "Not a cough in a carload" was one slogan I remember, though I'm not sure if that was for Camels or Chesterfield. De Reszke always featured people in evening dress, Senior Service and Capstan showed sailors. Craven A (where on earth did that name come from?) concentrated on the bright red of its packet, and if that didn't tempt you maybe Three Castles, Ardarth or Players would. It's fascinating to think that people used to smoke in bed; while driving a nail or a golf ball; during "half-time" at the pictures; before going into church; while waiting to bat at cricket - anywhere, any time the cigarette was a companion. In Britain one used to be allowed to smoke in the cinema, though not in the theatre. Old Walter Raleigh had a lot to answer for. It wasn't until I gave up smoking 30 or 40 years ago that I realised clothes used to stink of tobacco. How wives who didn't smoke put up with it I don't know. It was standard practice after guests left to open all the windows and doors to get rid of the tobacco smell, just as the host's first job was to empty the ashtrays. Attitudes have changed to a remarkable degree. We are wiser than we used to be, more health-conscious, more aware that it is smart never to begin smoking because the habit is hard to break. Remember what Mark Twain had to say: "To cease smoking is the easiest thing I ever did; I ought to know because I've done it a thousand times." * Gordon Parry is a Dunedin writer and broadcaster. Otago Daily Times, 9 January 2007 THREE RETAILERS CAUGHT IN CPO STINGDistrict health board officers are disappointed at how easy it is to buy cigarettes in the Wairoa district. Three retailers, two in Mahia and one in Wairoa, sold cigarettes to a 14-year-old volunteer during a controlled purchase operation (CPO) carried out recently in Hawke's Bay. Hawke's Bay DHB's smokefree promoter Gevana Dean said Wairoa had one of the highest smoking rates in the district and by selling to underage customers these retailers were contributing to the high youth smoking rates. She said a recent ASH survey showed the Hawke's Bay district had the second highest Year 10 youth smoking rate in the country. "We need retailers to help reduce the uptake of smoking by young Hawke's Bay people." The Ministry of Health has been provided with details about the retailers who sold cigarettes to the 14-year-old and will decide whether to prosecute. Retailers can be fined up to $2000 for selling cigarettes to minors and repeat offenders could be ordered not to sell tobacco products. Wairoa Star, 9 January 2007 THE QUITLINE UPDATE DECEMBER 2006A total of 1,239 people registered with the Quitline last December to make a quit attempt. Nearly 22 percent of these callers were Māori, and Pacific peoples made up 4.4 percent of registered callers. Registered caller numbers traditionally drop in December, and there was no Quit or Health Sponsorship Council advertising on television to promote calls. Registered caller numbers are expected to increase substantially this month. The next series of Video Diaries, where viewers can watch a smoker quitting in a series of television commercials, is due to start on 28 January and will run until the end of March. The commercials are scheduled to run on Māori Television as well as the main networks.
Numbers of callers registered with the Quitline by month QUITLINES FOUND EFFECTIVE AND INEXPENSIVEAn article published in the American Journal of Preventive Medicine finds that tobacco quitlines provide cessation treatment at a remarkably modest cost, according to study author Paula Keller of the University of Wisconsin School of Medicine and Public Health. The article analyses a survey conducted by the North American Quit Line Consortium which found quitlines had a median per capita cost of US 14 cents and a median cost per adult smoker of US 85 cents. "Compared to other medical treatments and the total economic cost of smoking per year, quitlines are really a bargain," Keller says. Previous research has demonstrated the effectiveness of quitlines. Because they are convenient (no transportation, available during weekdays and weekends), confidential and free, individuals who smoke are four times more likely to use them than to seek face-to-face counselling. Quitlines also have been shown to improve rates of quitting by 20 to 35 percent. Science Daily, 11 January 2007 TASMANIA SOON TO BAN SMOKING IN CARSProposed new laws to ban smoking in cars with child passengers will go before the Tasmanian State Cabinet early this year. The move follows an independent report prepared for the Government by Public Health Director Roscoe Taylor last June, which highlighted the impact of adults smoking in cars carrying children. The move will cement Tasmania's position as a leading advocate of measures to reduce the harmful impact of smoking on the population. South Australia is the only state to have already acted on the issue, with new laws from 1 January banning smoking in cars carrying children and allowing police to issue $75 on-the-spot fines. It has been shown that children breathe in 20 times the level of dangerous toxins when in a car with a smoking adult, compared to being in a home where smoking is allowed. The potential harmful effects caused by such intense exposure to passive smoking include asthma, cot death, ear disease, lung cancer and even death. Dr Taylor said exposing children to very high levels of airborne particles, even if the windows are open, can be very harmful to their long-term health. As well as banning smoking in cars with children, his 2006 report also recommended that sales assistants under 18 not be allowed to sell cigarettes, that cigarettes not be so publicly displayed and that fines or penalties be introduced for people under 18 caught smoking. The Mercury, 3 January 2007 SURGERY ON SMOKERS IS 'WASTED' - LEADING DOCTORSmokers should be denied surgery on Britain's National Health Service (NHS) unless they stop, a leading doctor has said. In a debate published in the British Medical Journal, Professor Matthew Peters, the head of thoracic medicine at the Concord Repatriation General Hospital, Sydney, Australia, claims that five non-smokers could be operated on for the cost of four smokers, and that their outcomes would be better. About a thousand patients a day are admitted to NHS hospitals in England for smoking-related diseases, at a cost of £1.7 billion a year. But Professor Leonard Glantz, of Boston University School of Public Health, in Massachusetts, said in the journal: "It is shameful for doctors to be willing to treat everybody but smokers in a society that is supposed to be pluralistic and tolerant." ASH UK said that smokers needed to be encouraged to quit, not punished for their addiction. The Times Online, 5 January 2007 CINEMAS JUST WON'T QUITCigarettes and smoking were glamorised in most hit films last year, according to new research. Health campaigners have called for Hollywood to stop the practice, which is now worse than it was in 1950s films. More than 160 of the top films last year were analysed by researchers from Breathe California, a US anti-smoking group. They found that 60 percent of the films depicted smoking, with more than 15 cigarette-related scenes an hour. This compares with only 10 scenes an hour for films of the 1950s. Harvey Weinstein, a Hollywood producer, said his films would carry smoking warnings in future. Health campaigners are concerned because children are nearly three times as likely to try tobacco if they regularly watch actors smoke. Smoking featured in more than one in five of youth-rated films last year. Almost all films with a PG15 certificate contained scenes of smoking, with people exposed to the sight of a cigarette every two minutes on average. Kori Titus, the director of Breathe California, said: "Any tobacco depiction in kid-rated films is too much. Such depictions are a major factor in kids trying tobacco, which we know will lead to health problems and shortened lifespan." Professor Stanton Glantz of the University of California said: "A kid going to the movies is going to think smoking is as common as it was in the 1950s. Smoking in films is a more powerful stimulus than cigarette advertising." Independent on Sunday, 7 January 2007 SECOND-HAND SMOKE LINKED TO CINWhile Taiwanese women smoke much less than Western women (3 to 4 percent vs 28 percent), a large proportion of Taiwanese men do smoke (55 to 62 percent). As a result, many women in Taiwan may be exposed to second-hand smoke in their homes or offices. Recent Taiwanese research conducted by Hsiu-Ting Tsai et al has suggested that exposure to second-hand smoke is a major risk factor for growth of abnormal tissue in the lining of the cervix, a condition known as cervical intraepithelial neoplasm (CIN). Active cigarette smoking has been a known risk factor for CIN, but the community-based case-control study attempted to estimate the relationship between second-hand smoke and CIN which has so far not been conclusively determined. Potential study subjects were selected through pap smear screening in Kaohsiung County, Taiwan. A total of 171 subjects with either their first case of inflammation (benign epithelial lesion) or CIN1 (pre-cancerous cells) by biopsy confirmation were assigned to a case group; 513 normal subjects with negative findings by pap smears or biopsies were assigned to a control group. The results were that non-smoking women exposed to more than 20 pack-years of cigarette smoke had a significantly greater risk of developing CIN1 or CIN2 (moderate dysplasia) than unexposed non-smokers. The greater the severity of disease found in the groups (normal, inflammation, CIN1, to >= CIN2), the more likely it was for the women to be exposed to second-hand smoke. The research concluded that in addition to active cigarette smoking, exposure to second-hand smoke is a major risk factor for CIN among Taiwanese women. Summarised from Gynecologic Oncology 2006 PUBLIC HEALTH ASSOCIATION CONFERENCE 2007Te Torino: Re-imagining health
Public health workers and practitioners from around the country are invited to attend the 2007 conference, to be held in Auckland on 4 to 6 July. This is the only conference held in New Zealand that focuses specifically on public health. Conference themes are urban design, food matters and voices. Topics will include kaupapa Māori, systems and structures, workforce, inequalities, determinants of health, and globalisation. The 2007 conference will have something for everyone - including people who work in strategic management roles, researchers and academics, service providers, advocacy organisations, government and non-government organisations, District Health Boards, public health services, and community workers. Papers are now being called for, and the closing date for abstracts is 31 January 2007. Abstracts can be submitted on the website - www.pha.org.nz. Submitters will be notified by 31 March if their papers are accepted. Further information about the conference will be available on the website early in the New Year. In the meantime, put 4-6 July in your calendar! COMBINED AUAHI KORE TRAINING AND KAI TŌTIKA ME WHAKAPAKARI TINANA UPDATE HUI
Date: 14-16 March 2007. The hui will consist of combined sessions relevant to both sectors and also workshops relative to Auahi Kore and Kai Tōtika me Whakapakari Tinana. Please note, only those who have successfully completed the Te Hotu Manawa Māori Kai Tōtika me Whakapakari Tinana training will be able to attend those related workshops. Accommodation and meals will be available at the marae. Click
here to view the full programme for the hui.
PACIFIC ISLANDS HEARTBEAT SMOKING CESSATION SERVICE
Free training for health professionals Cessation practitioner training (three-day training) This training is designed for health professionals and community health workers looking for the knowledge and skill to assist patients in the cessation process. The course provides an understanding of brief intervention skills and principles for providers offer smoking cessation services. These skills and principles are evidence-based, with a strong emphasis on what is culturally relevant and appropriate for Pacific cultures. Workshop content includes: Guidelines: Background Overview; The Pacific Community and their issues; Stages of Change Model; Nicotine addiction; Introduction to Motivational Intervention; Communication Skill and Pacific Culture; Environmental Tobacco Smoking(ETS); Pharmacotherapy; Subsidized Nicotine Replacement Therapy (NRT) and Quit Cards Registration; Brief facilitation skills - Principles; Introduction to Relapse Prevention - Brief and intensive; Case studies - Application of Knowledge and skills, NRT Prescription etc; Relevant Strategies and Support for Pacific Smokers. Training date and venue: Dunedin Time: 9:00 am - 4:00pm Morning and afternoon tea will be provided. For more information contact Anthony Leaupepe, Pacific Islands Heartbeat Smoking Cessation Training Facilitator, Central Region and South Island (04 472 2790 | anthonyl@nhf.org.nz). BLAST FROM THE PAST
Retrieved from: 20th Century Tobacco Ad Collection Collected by Richard Pollay, catalogued by Roswell Park Cancer Institute http://roswell.tobaccodocuments.org/pollay/dirdet.cfm.
QUOTABLE QUOTES"Most people don't want to try heroin; they're afraid. But they wouldn't mind trying a cigarette. You're much more likely to be killed by a cigarette." Irish anti-smoking campaigner, Luke Clancy "...addiction to nicotine is freedom-eroding for smokers. That is, there is evidence from developed countries that the great majority of smokers regret having started smoking." George Thomson, Nick Wilson, Philippa Howden-Chapman "That so many smokers are unhappy to continue smoking illustrates not only how addictive cigarettes are, but also how adept the tobacco industry has become at making it hard for smokers to quit." Quit Victoria (Australia) Executive Director Todd Harper "Students are tremendously loyal. If you catch them, they'll stick with you like glue." Phillip Morris Memo, 1950 MEDIA THEMESNorthern Ireland: The smokefree countdown begins The countdown to the introduction of a smoking ban in Northern Ireland has started. To get people ready a campaign - Space to Breathe - developed by the Health Promotion Agency on behalf of the Department of Health, will include TV and radio advertisements, public information leaflet and website - www.spacetobreathe.org.uk. The Government and the anti-smoking lobby hope the new legislation will lead to a substantial drop in the 3,000 smoking related deaths each year in Northern Ireland. Similar bans already in place in Ireland and Scotland have already resulted in an improvement to the health of workers in the hospitality industry. Dr Brian Gaffney, chief executive of the Health Promotion Agency, said 74 percent of adults in the North were now non-smokers and of those who did smoke 77 percent wanted to quit, and that the new legislation had received overwhelming support from the public and would save lives. "Around 3,000 lives are lost each year in Northern Ireland as a result of tobacco related illnesses, most of which are preventable," he said. Ireland Online, 7 January 2007 Body Parts 1, Tobacco 0 Some people may think it a bit soon to name the most disturbing ad of 2007. Those are people who haven't seen the latest anti-smoking spot from The American Legacy Foundation. As a gritty musical track plays, we see pictures of trash cans on the street around New York. They are filled to overflowing and waiting for the next garbage pick-up. One of the things they are filled with: body parts - a foot or an arm - sticking out of the cans. Intercut with this are reaction shots of people walking by and looking horrified. The text reads, "Every month, tobacco kills more people than there are trash cans in NYC." Top that. Or maybe it would be better if you didn't. Brandweek, 8 January 2007 |
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While most people have spent early January dodging the wind and the rain I have been working my way through the Budget Policy Statement 2007 and the Half Year Economic and Fiscal Update 2006. I'm preparing submissions to present to Parliament's Finance and Expenditure Select Committee in February.
At 10 o'clock in the morning they move outside, pull out their cigarettes and light up. Sometimes they are alone, more often they enjoy the company of two or three others, but always they look just a trifle self-conscious. Smoking is no longer fashionable, and because offices are smokefree those who still puff are forced to indulge outdoors.
The Public Health Association Conference is a 'must attend' for anyone who works in, or has an interest in, public health.
Mai i te kore, ki te pō, ki te ao mārama Te Hotu Manawa Māori announces the first combined National Auahi Kore Training and Kai Tōtika me Whakapakari Tinana Update Hui.
Players go places (1984)