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| Issue 76 | 10 October 2007 |
Having trouble viewing this newsletter? Try the online version. FROM THE DIRECTOR'S DESK
This is a question which deserves a considered reply. To be fair she does chronicle the tragic story of smoking in her family, the withdrawal and the death and concludes from the evidence that rather than follow in the cantankerous footsteps of her forebears she would continue to smoke. But nowhere in her dissertation do I get the impression that she smokes for pleasure. Indeed it appears that her experience is that "for five brief minutes it all goes away." What goes away? The drudgery of daily life, the difficulty of coping with change, the inevitability of the advancement of age, or is it the need to satisfy the craving for another nicotine fix? Let's not kid ourselves that there are many happy smokers. UK research published in January 2007 concludes; "...we found no evidence to support the conclusion that smoking is associated with heightened pleasure or with better quality of life. In fact, there is evidence to support the opposite."1 This study was done in response to comments made by Dr John Reid who in June 2004, while he was the UK Secretary of State for Health (the same thing as the New Zealand Minister of Health), claimed that people in lower socio-economic categories "have very few pleasures in life and one of them they regard as smoking." He went on to say, "What enjoyment does a 21-year-old single mother of three living in a council sink estate get? The only enjoyment sometimes they have is to have a cigarette." Despite the extraordinary nature of this statement from a person holding high office, it is difficult to reply using a solid evidence-base. Existing studies of the relationship between smoking and pleasure focused on smokers' self-reports of their motives for smoking. The UK study is among the first, if not the first, to provide evidence to debunk the myth John Reid expressed and with which I suspect Sue Heap concurs. I don't find playing the blame game very useful in this debate. I have no doubt that Sue Heap has accurately portrayed the incredible difficulty faced by those who are addicted to any substance to break that addiction. One of the presenters at the recent Oceania Tobacco Control Conference Shu Hong Zhu2 presented evidence to show that it takes a mean average of 14 attempts for a person to finally quit smoking. So let us accept that quitting is tough. Now let's look at her question, "How are smokers supposed to cope?" Exactly! For the harm they do cigarettes are by an accident of history very lightly regulated. Half of all continuing smokers will die from smoking – an average of fourteen years early.3 At present cigarettes are treated pretty much like chocolate and chewing gum. They can be bought at any convenience store, dairy, supermarket or service station. No other drug is treated as leniently and indeed if they were introduced today, cigarettes would rapidly be classified as a class "A" drug with the pushers imprisoned. The case for heavy regulation of cigarettes is strong. While we are to see pictorial health warnings from February next year this is but a first step to getting cigarettes out of sight, out of mind. Then there is price. Twice in Sue Heap's article she refers to price as a determinate of smoking. Her introduction to smoking was using the "kiddie pack" (Pall Mall 10s) and she switched to using roll-your-owns when the price went up. Ministry of Health research figures show a very strong correlation between increasing the price for cigarettes and a drop in tobacco consumption.4 Of as much, if not more importance, price may well deter many who are smoking curious from ever starting. Next, her question "How much change can a man take?" I suppose that comes down to the time when the addicted person says, "I am sick and tired of being sick and tired!" I speak with some personal experience here. I know how hard it is to beat an addiction but it can be done. It has to start with the breaking of denial. For an addicted person that is very much a personal journey. There is a lot of help around for people who want to quit smoking – you don't have to do it on your own. The Quitline provides a high quality service and it, and others offering quit smoking help, can provide subsidised nicotine replacement therapy. There are also a number of cigarette alternatives available and new pharmaceuticals are becoming available all the time. Research shows the sooner one stops smoking, the greater the health gain.5 Within two hours of "quitting" nicotine is out of your system and carbon monoxide has cleared the system within twenty-four hours. After a year of not smoking your chances of a sudden death from heart attack are nearly half that of a smoker's.6 Finally, I have one question for Sue Heap and others who might champion the pleasures of smoking. Is smoking something you want your children or grand children to do? That is the challenge that is posed in the talk about a tobacco free New Zealand, starting of course with becoming smokefree. And to be completely clear, don't knock on the door of prohibition. It does not work. Why would anyone want to provide the underworld with another commodity of misery with which to line their pockets? I see it this way. New Zealand has been nuclear free since 1973 and we are proud of it. Our smokefree environments legislation has been hugely successful and I see a smokefree New Zealand in time becoming as entrenched as our nuclear free stance. But the journey has to start somewhere. Have a good fortnight. Mark Peck Director _______________________________________________ 1. Lang, I. et al, "Was John Reid right? Smoking, class, and pleasure: A population-based cohort study in England", Public Health (2007) 121, 518-524 IN THIS ISSUE:
AWARD RECOGNISES NEW ZEALAND AS TOBACCO CONTROL LEADER
Associate Health Minister Damien O'Connor said he is delighted that New Zealand has received further international recognition for its leading role in combating smoking. "This award is a testament to the high regard in which New Zealand is held internationally in this arena," Mr O'Connor said. "New Zealand has played a leading role in establishing international agreement on the guidelines, which were adopted unanimously at the Conference of Parties in Bangkok in July." The FCTC is a World Health Organization initiative in response to the global epidemic of tobacco addiction. It is the first binding international treaty that provides an agreed approach to tobacco control at a global level in order to protect public health and reduce deaths from tobacco related illness. The guidelines give national and local governments clear direction to establish smokefree environments. The Convention addresses all aspects of tobacco control including economic and trade issues. New Zealand has been actively involved with the Convention from its inception. "New Zealand has some individuals who are exceptionally committed to tobacco control, and the Labour-led Government has a proven track record of action and investment in the battle to combat smoking," Mr O'Connor said. New Zealand initiatives include:
Scoop, 14 September 2007 IN-HOME QUIT SUPPORT AND ADVICE FOR ASIAN SMOKERSA free quit smoking programme targeting Asian households in parts of Auckland has resulted in a 100 percent reduction in smoky homes and almost half the participants stopping smoking. Ninety-three Asian people in 87 households took part in the Asian Smokefree Communities programme, and every home and all but two cars were smokefree by the end, compared to 16 homes and almost two-thirds of cars which were not smokefree before the intervention. The self-reported quit rate was 72 percent at one month, almost 54 percent at three months and 41 percent at six months. Language and cultural differences mean Asian people do not always find mainstream smoking cessation services accessible or effective. The Waitemata-based programme provides Asian New Zealanders and Asian immigrants with nicotine replacement therapy, counseling, telephone support, home visits and culturally appropriate resource information. The programme has been successful, with 92 percent of clients surveyed saying they would recommend the service. It is also a finalist in the 2007 Health Innovation Awards. Harbour Health PHO media release, 11 September 2007 SMOKING DEATHS A WORLDWIDE SCANDALA top World Health Organization official has urged the world to get tough with tobacco companies, saying smoking deaths are an international scandal. "The deaths and misery caused by smoking continue to be one of the greatest scandals of our time," said Shigeru Omi, WHO Regional Director of the Western Pacific. WHO Director General, Margaret Chan, said the WHO urges countries to implement the Framework Convention – to fight smoking with higher taxation, a total advertising ban and more education. Bay of Plenty Times, 25 September 2007 PACIFIC ISLANDS HEARTBEAT SMOKING CESSATION SERVICE
This training is designed for health professionals (nurses and community health workers) to enhance their knowledge and skills in providing brief advice and cessation support to patients/smokers in the cessation process. The course has a strong emphasis on what is culturally relevant and appropriate for Pacific people. Participants and providers who complete the training can get registered with the Quit Group as Quit Card providers to access subsidised Nicotine Replacement Therapy (NRT) for clients who smoke and wanting to quit. The workshop will be held at the Napier Public Library Seminar Room in Napier, 16-18 October, starting at 9 am. For more information contact Anthony Leaupepe, Training Facilitator, 04 472 2780 ext 2, or e-mail: anthonyl@nhf.org.nz. THROUGH THE SMOKE
Freaking News is a Photoshop pictures site which holds contests for the wackiest doctored photos fuelled by actual news stories. Members get cash for participating and winning the daily contests. People who don't want to participate in the contests can still view the funny pictures. Click here to see 16 images to do with smoking harm. When you get to the bottom of page 1, there is a link to a second page.
SMOKEFREE SHORTS
New ZealandNiue to discuss bill to restrict tobacco use Niue's Associate Minister of Health says a new tobacco control bill will be tabled in parliament this week. The bill bans smoking in all public places, workspaces, government departments and tourist places. It also contains a provision for village councils to ban smoking in their villages and ban the sale of tobacco. Radio New Zealand International, 1 October 2007 InternationalWould you stub out your cigarette for a snus?
Industry leaders Philip Morris USA and R.J. Reynolds Tobacco have begun test marketing Swedish-style "snus" products using the names of their leading cigarette brands Marlboro and Camel. Snus, the Swedish word for snuff, is made up of finely shredded tobacco leaves encased in a tea bag-like pouch about the size of a piece of gum. CNBC (USA), 2 October 2007 We need more tobacco like a hole in the head Add to the list of "innovations" the world does not need: smokeless, chewless and spitless tobacco. Snus (rhymes with moose) is currently being test-marketed by Imperial Tobacco in Edmonton. It's sold in about 230 retail outlets in the city, under the brand name du Maurier. Look for it in the fridge, near the Red Bull. Globe and Mail (Canada), 4 October 2007 Smoking ban at home could come in future Parents could be banned from smoking in their homes to protect their children's health, following the success of the smoking ban in public places, legal experts have claimed. But such a ban may not happen for many years, because society is not yet ready for such a draconian step, they admit. Western Mail (Wales), 17 September 2007 City rejects apartment smoking ban The first California city to outlaw smoking in public places has backed away from a plan that would have banned apartment tenants from lighting up in their own homes. Instead, the Calabasas City Council has tentatively recommended tenants be prohibited from smoking on outdoor patios and balconies and that a specific number of units be reserved for those who do smoke. Contra Costa Times, 5 October 2007 Study: Law prompts drop in heart attacks A study credits New York's 2003 Clean Indoor Air Act with an 8 percent drop in heart attacks because of reduced exposure to second-hand smoke. The report, issued by the state Health Department, found that hospitals admitted 3,813 fewer patients for heart attacks in 2004 than would be expected in New York without the indoor smoking ban. Associated Press, 28 September 2007 Muslim groups kick off Ramadan with anti smoking initiative A prominent national Islamic civil rights and advocacy group and two organisations representing American Muslim physicians today encouraged US Muslims to use the discipline acquired during the upcoming Ramadan fast to quit smoking. Yahoo News!, 12 September 2007 Delegates to Edmonton tobacco conference told provinces should sue more Delegates at the National Conference on Tobacco or Health are urging provinces to sue tobacco companies and recover billions in lost health-care dollars. During a session focussing on litigation as a major strategy for tobacco control, law students debated new ways to use the courts against tobacco companies. The Canadian Press, 4 October 2007 One in 10 hospitality workers suffers violence from smokers flouting ban Since the smoking ban came into force in June, more than 10 percent of hospitality workers have suffered threats or actual violence after asking customers to stop smoking. A survey of more than 5,000 hospitality workers, published by hospitality recruitment website Caterer.com, reveals shocking testimonials from workers who report being hit, spat at, strangled and sexually abused. Medical News Today, 4 October 2007 More Hollywood studios say 'No smoking'
That portrayal and scene could still fly these days at DreamWorks, which made the movie. But if Universal Pictures were to produce the movie today, Murphy might consider having his character switch to chewing gum. The New York Times, 1 October 2007 It's tobacco, not taxes, that hurt the poor For sheer brass, for pure towering chutzpah, it's hard to top the tobacco companies' claims that tobacco taxes are unfair to poor people. That's the argument the tobacco companies' public relations wizards are making against the tobacco tax increases currently being debated in Oregon and in Washington, D.C. It's an argument worthy of an industry whose sales pitches are aimed at obscuring the fact that its product kills its customers. The Register Guard, 3 October 2007 Teens in part-time jobs and school more likely to start smoking High school students who take part-time jobs for pocket money may be more likely to start smoking than teens who don't join the after-school and weekend workforce, a study suggests. The study of Grade 10 and 11 students in Baltimore shows that those who took jobs, often in retail outlets and fast-food or other restaurants, had a greater propensity to begin lighting up – and that trend was strongest among teens who worked the most hours per week. The Canadian Press, 27 September 2007 Nicotine may accelerate atherosclerosis, may be as dangerous as tar By comparing reduced-nicotine cigarettes with regular cigarettes, US researchers have discovered that the extent of cigarette-smoke induced atherosclerosis in mice correlated with the levels of nicotine -- the higher the nicotine, the more disease. NewsWise.com, 11 September 2007 First puff can turn kids into smokers: study Just a single drag on a cigarette may drag a teen into smoking addiction, a new study suggests. Researchers say almost a third of kids interviewed who tried smoking said their first cigarette brought them a feeling of relaxation – and two-thirds of those kids went on to become smokers. HealthDay News, 1 October 2007 Tobacco firm denies pro-smoking videos An Australian tobacco company has denied funding pro-smoking clips posted on popular internet sites to encourage young people to light up. Leading Sydney anti-smoking campaigner Professor Simon Chapman said sites such as YouTube, Facebook and MySpace were running riot with pro-smoking messages which appeared to have the "fingerprints of tobacco companies all over them." The Australian, 28 September 2007 Tobacco ads paying off in Oregon The millions of dollars that big tobacco companies are spending on advertisements aimed at convincing Oregonians to vote against a proposed cigarette tax hike appear to be paying off. Activists on both sides of the issue say the onslaught of TV and radio ads has gotten Oregonians to think twice about Measure 50, which would increase cigarette taxes to pay for health insurance for about 100,000 Oregon children currently without coverage. CNNMoney.com, 2 October 2007 Minimum age for purchasing tobacco rises to 18 in Britain
Nearly ten percent of Britain's 11 to 15-year-olds smoke and the government hopes that raising the minimum age will not only reduce their access to cigarettes but also help retailers more easily identify under-age smokers. The government also hopes that bringing the laws on the purchase of tobacco into line with those on buying alcohol will highlight the health risks associated with cigarettes. AFP, 4 October 2007 Smoking spurs snoring Your chances of getting a peaceful night's sleep are better if you don't smoke, or spend time around anyone who does. That's because smoking – both active and passive – makes it more likely you'll snore the night away, according to a study in the October issue of the American Journal of Respiratory and Critical Care Medicine. PakTribune, (Pakistan) 3 October 2007 Smokers should be treated like drug addicts say doctors Smokers should be treated the same as heroin addicts and offered tobacco substitutes that deliver the same hit of nicotine without the harm, doctors say. The number of people smoking is declining by only 0.4 percent a year and a new approach is needed to protect those who continue to smoke from the lethal effects of their addiction. The Independent (UK), 6 October 2007 QUOTABLE QUOTES"Although anti-smoking groups have the right to express their views (especially given the health risks of smoking), their arguments can often sound quite moralizing and overbearing, especially to those who know the risks of smoking and freely choose to smoke." Chris Seck, Editor, The Stanford Review, 28 September 2007 "[Your article mentions] quitters overburdening their hearts and living in permanent mourning for lost pleasures. Do tobacco companies feel a burden on their hearts or mourn the 5,000 people that die early from using their products? They simply add chemicals to reduce the harshness, and enhance the flavour and addictiveness of each cigarette." Imogen Held, ASH NZ, Letter to the Editor, Otago Daily Times, 2 October 2007 "It is true too that snus users have higher rates of pancreatic cancer. And that snus contains far more addictive nicotine than cigarettes do. In other words, stuffing steam-cured tobacco bags in your mouth is "healthier" than chewing on fermented tobacco (traditional American snuff) or sticking a flaming stick of tobacco in your mouth and inhaling. That's a lot like saying being hit by a car hurts less than being hit by a big rig or a train." Andre Picard, Globe and Mail (Canada), 4 October 2007 |
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In an article entitled "Smokers grieving for lost pleasures" (
New Zealand, Ireland and Finland
have been jointly awarded the Global Smokefree Partnership's Extraordinary Award in Edinburgh, in recognition of their "exceptional and outstanding commitment" in the development of guidelines for Article 8 (Protection from exposure to tobacco smoke) of the Framework Convention on Tobacco Control (FCTC).
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Are smokers ready to put down their cigarettes and get their nicotine fix from a tiny pouch of tobacco placed between their upper cheek and gum?
In the movie musical Dreamgirls, James "Thunder" Early, Eddie Murphy's soul-singing, chain-smoking character, was so infuriated by a fumbled food order that he mashed his cigarette into a chicken sandwich that was supposed to have no mayonnaise.
The legal minimum age to buy cigarettes in Britain has risen from 16 to 18 as the government tries to slash the number of young smokers.