Issue 85  | 5 March 2008

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FROM THE DIRECTOR'S DESK

Last week the Smokefree Coalition held a stakeholders' meeting to finalise its strategic plan. Discussion and debate at the meeting clarified a lot of issues which will be important to the work of denormalising tobacco.

It was clear that the vision work which started in June last year needed completion. Agreeing this vision and identifying the steps to achieving it will now be the focus of a meeting to be held in April. This meeting will be convened from the original participants but expanded to include others who were unable to attend the last korero.

Another area of work concerns the need to discover new champions for our cause. The Cancer Society has done this sort of thing admirably with their work on display bans. This is something in which the coalition is also well versed.

There is no doubt the public is more likely to listen to the views of medical professionals and the credible societies as they come to terms with the notion that cigarettes are not just another consumer product.

It is important to ensure this message is understood. Recently we witnessed the evacuation of most of the town of Patea (South Taranaki) because of authorities' concern about the possible health consequences to the township from a fire in the old freezing works where asbestos was present. It is right to be concerned about the health effects of asbestos but I suspect the annual death burden from smoking (5000) exceeds the annual death burden from asbestosis.

The irony here is that quite a number of the residents of the township, probably up to about half the population given the socio-economic status of the town, were smoking at the time they were evacuated. While they were being saved from asbestosis they were continuing their countdown to disease and death from smoking!

This is why the health warnings are so important. For the first time the truth about the effects of smoking are graphically represented on cigarette packets for all to see. This, however, is just one of the steps needed to denormalise tobacco.

Much, much more needs to be done in product and market reform to make the environment for the tobacco industry hostile. This can happen, and it will happen as we get our message across through the responsible voices of tobacco control.

Have a good fortnight.

Mark Peck

Director
Smokefree Coalition

IN THIS ISSUE:

  • Graphic tobacco warnings pack a punch
  • Cigarette tin promotion scurrilous!
  • Looking ahead into 2008
  • Findings from 2006 Year 10 in-depth survey now available
  • Three fact sheets recently published by The Quit Group
  • New Graduate Diploma in Addictions with smokefree papers
  • Pacific Islands Heartbeat Smoking Cessation Service
  • Through the smoke
  • Smokefree shorts
  • Quotable quotes

GRAPHIC TOBACCO WARNINGS PACK A PUNCH

Regulations effective from 27 February will see graphic pictorial health warnings appear on all tobacco sold in New Zealand. The large graphic images on the front and back of cigarette packs feature images of rotting gums and teeth, mouth cancer and gangrenous feet.

There will be 14 different images introduced. The first seven warnings will appear on cigarette packets in both English and Te Reo Māori in year one, with the remaining seven to be introduced the following year and thereafter they will be rotated annually.

Tobacco control groups are supportive of the new labelling, but caution that there is still a long way to go in battling the deadly tobacco epidemic.

Action on Smoking and Health (ASH) Director, Ben Youdan says, "This is a step in the right direction. Bigger, bolder warnings do get results. Thirty-one percent of former smokers who have been exposed to graphic warnings have said the labels influenced them to quit.

"There is much more that needs to be done and people needn't see this as the final piece in smoking prevention."

Shane Bradbrook, Director of Te Reo Mārama, is pleased that warnings will be carried in both English and Te Reo Māori. "Previous warnings translated the main campaign phrases, but now packs will have specific details too."

Mark Peck, Director of the Smokefree Coalition says, "From the international evidence that I've seen large warnings on the front and back of cigarette packets are very effective ways to alter smoking behaviour, they have the most impact."

The Cancer Society has praised the Government for introducing new graphic health warnings which they say will improve smokers' awareness of the negative health effects of smoking.

"Graphic health warnings are an important step forward and provide a far more effective method of communicating health messages than text alone," says Belinda Hughes, Tobacco Control Advisor for the Cancer Society.

The Cancer Society would also like to see the new graphic health warnings made larger and for the Government to consider requiring plain packaging for the rest of the pack.

"There really is no justification for allowing tobacco companies to continue to use marketing devices like packaging to promote smoking," says Ms Hughes.

The move to pictorial warnings follows the lead of several countries around the world, including Australia, Brazil, Thailand and Canada who have already implemented pictorial health warnings.

Helen Glasgow, Executive Director, The Quit Group expects an increase in the number of quit attempts as a direct result of the graphic warnings on tobacco products.

"Calls to quit smoking services in Australia increased by 30 percent when graphic warnings came into force and if overseas experience is anything to go by, then graphic warnings will certainly encourage New Zealanders to try to quit."

The international treaty, Framework Convention on Tobacco Control (FCTC) which the New Zealand Government ratified in January 2004, laid the groundwork for the introduction of these sets of warnings.

Article 11 of the Framework requires the size of health warnings to be not less than 30 percent (and ideally to be 50 percent or more) of the principal display areas of tobacco packaging. The previous text warnings covered slightly less than 30 percent.

The new regulations will see 30 percent of the front and 90 percent of the back of cigarette packets covered by health warnings. Once the new labelling requirements come into force, retailers will have to sell existing cigarettes containing the old warnings by 31 August.

Media Release, 27 February 2008
Action on Smoking and Health (ASH) NZ, The Smokefree Coalition,
The Cancer Society of New Zealand, Te Reo Mārama and The Quit Group

Smokefree Coalition Director Mark Peck tells Newstalk ZB's Larry Williams further measures could be taken to eliminate smoking, in addition to the graphic new images on packs. A recording can be accessed at http://www.newstalkzb.co.nz/audio2/27163151.wma.

CIGARETTE TIN PROMOTION SCURRILOUS!

The Smokefree Coalition is calling an alcohol promotion involving a cigarette tin give-away scurrilous, underhanded and reprehensible.

Director Mark Peck says the promotion, which offers the free cigarette tin with every pack of a certain RTD (ready-to-drink) purchased, is clearly designed to appeal to young people and to circumvent new graphic health warnings which must now appear on tobacco packaging.

"The cigarette tin is said to be worth $15.00, or around half the cost of a six-pack of this bourbon and cola mix. It's an expensive giveaway, and I smell the yellowed fingers of the tobacco industry behind it.

"The industry has an established history of cleverly evading controls on their advertising and labelling. This promotion is obviously timed to coincide with the new health warnings on packs and provide a way of covering them.

"Young people are the most frequent purchasers of cheap, ready-to-drink spirit mixes, and they are an extremely important market. Big Tobacco needs to recruit them to replace older smokers who are quitting or dying off."

A poster advertising the promotion was noticed by a member of the public who brought it to the attention of the Smokefree Coalition, concerned it breached advertising standards.

Mr Peck believes the promotion is an example of the tobacco industry using another industry to do its dirty work.

"They will stop at nothing to ensure a future market for their lethal products, and we are surprised the liquor industry is allowing itself to be used in this way.

"The new graphic images are there to help young people see what the consequences of smoking can be. To dupe them into this slow form of suicide with a giveaway that encourages them to see smoking as cool is too despicable for words."

The Smokefree Coalition wants the promotion withdrawn and is calling on all liquor retailers to refuse to take part.

Smokefree Coalition media release, 2 March 2008

LOOKING AHEAD INTO 2008

In this fourth instalment in our series of articles on the 2008 plans of tobacco control organisations, ASH Director Ben Youdan summarises his organisation's priorities for this year, as does the Quit Group.

ASH remains one of the most active forces in tobacco control in Aotearoa/New Zealand and, although recent announcements have revealed New Zealand performs extremely well in a global context in regards to tobacco control policy, we must not rest on our laurels.

It is a credit to tobacco control in this country that we have one of the highest strike rates for most of the Framework Convention Tobacco Control (FCTC) articles.

Public places are smokefree, tobacco advertising is almost entirely banned (with the notable exception of cigarette displays!), cigarettes must now feature large picture warnings and there is huge investment into cessation.

However, there should be grave concern at our rate of smoking decline (amongst the slowest in the OECD!). We need seriously to be looking at the end game scenarios for smoking.

Issues such as the role of alternate nicotine products (including snus and the e-cigarette), market regulation and the role of the industry in eliminating cigarettes need to be considered and ASH will be working on how these strategies can be used effectively.

In the immediate future the success of achieving an end result in the campaign to ban retail displays is a priority. Another priority for ASH this year will be to rejuvenate its web presence in 2008.

With an election on the horizon engaging political support for strong tobacco control from all parties will be vital for future progress. Finally, after eight years of no progress, we would love to secure a tobacco tax increase!

The Quit Group is providing more choice and aiming for a higher quality service to quitters this year.

Smokers wanting to call the Quitline will have the option of calling the freephone Quitline, ordering NRT online, or joining the online community and using the blogs and forums. The new youth texting service (Txt2Quit) will also be up and running in the next few months.

The freephone Quitline has been expanded and new telephone systems introduced to minimise wait times. New workforce scheduling software also means Quitline Advisors will be in the right place at the right time.

Demand for the Quit Cards service is growing rapidly with the recent Government announcement that access to the NRT subsidy has been expanded to include all health professionals licensed to prescribe. This means GPs, nurse prescribers and some other groups will not have to train in smoking cessation to be eligible to give their patients Quit Cards for low cost patches and gum.

Media campaign production continues, with two new series of Video Diaries scheduled and others in production. Health Warning campaign commercials will be on television from June to support the introduction of graphic warnings on tobacco products. The Quit Group's work with youth is being supported by the Health Sponsorship Council which will promote Txt2Quit through its Not our Future campaign.

FINDINGS FROM 2006 YEAR 10 IN-DEPTH SURVEY NOW AVAILABLE

This report is now available on the Health Sponsorship Council website and presents the top-line findings from the 2006 Year 10 In-depth Survey, part of the NZ Youth Tobacco Monitor.

The survey explores 14 and 15-year-olds' behaviours, and risk and protective factors associated with smoking uptake.

Results are presented by gender, ethnicity, and socio-economic status sub-groups, and by smoking status where appropriate.

Topics include:

  • Current tobacco smoking behaviour
  • Attitudes and beliefs related to smoking
  • Smoking cessation experience ('current smokers' only)
  • Exposure to others' smoking
  • Smoking-related health promotion messages
  • Youth culture
  • Connectedness – parents and school
  • Awareness of, and attitudes towards, the tobacco industry.

The HSC hopes the report will be of use to both its provider and research partners in tobacco control, and it is proud of the range of information collected and reported on from this survey. Additional mini-reports with a focus on specific topics within the survey are expected soon.

Any further queries should be directed to ingrid@hsc.org.nz  or phone 04 472 5777.

To view the full report  click here (PDF, 366Kb). To find the report via the research publications page, click here.

THREE FACT SHEETS RECENTLY PUBLISHED BY THE QUIT GROUP

Three new fact sheets have been published by the Quit Group of New Zealand.

  1. Quitting behaviours of older smokers
  2. How do Quitline callers compare with the NZ smoker population?
  3. Quitline callers and DHBs 2006.

PDFs are available here.

Other reports and publications by The Quit Group are available here.

The Quit Group is committed to providing evidence-based programmes and advice.

NEW GRADUATE DIPLOMA IN ADDICTIONS WITH SMOKEFREE PAPERS

One of the newest courses at AUT University's North Shore Campus is welcoming staff from overseas and closer to home.

The Graduate Diploma in Addictions, new for 2008, equips students with the knowledge and skills required to work effectively in the addictions field. Areas of specialisation include problem gambling; tobacco control; drug, alcohol and substance abuse; health promotion; and early intervention and treatment.

The course will be delivered in close collaboration with agencies such as ASH, the Problem Gambling Foundation and various addiction experts such as Dr Helen Warren, who for the past 12 years has co-ordinated and taught alcohol and drug studies programmes at the University of Auckland and UNITEC. Dr Warren has worked as a clinician in mental health and alcohol and drug services for 27 years. Associate Professor Paul McDonald, from the University of Waterloo, Canada will visit AUT to teach the diploma's tobacco control papers.

Two smoking specific papers are being offered in 2008.

The first is Tobacco Control which is being offered in March on the 10th, 14th, 17th, 20th and 27th. Students will discuss tobacco control policy and legislation and consider the demographics and prevalence of tobacco use in New Zealand and internationally. Students will also examines the relationship between tobacco use and health inequalities and describe a comprehensive range of population based tobacco control strategies.

In the second semester we will be offering the Smoking cessation paper where students will learn to identify bio-psychosocial factors which contribute to nicotine addiction and develop treatment intervention skills which will assist people to quit smoking. This will be taught by Trish Fraser who started working in tobacco control and smoking cessation in Queenstown in 1991.

For further information please contact: Course Information Centre, 0800 AUT UNI (0800 288 864), email: courseinfo@aut.ac.nz.

PACIFIC ISLANDS HEARTBEAT SMOKING CESSATION SERVICE

Cessation Practitioner Training CPT
(three modules over three days)

This training is intended for health professionals (such as nurses and community health workers) to enhance their knowledge and skills in providing brief advice to patients/smokers and supporting them by making appropriate referrals to services that can help them in the quit process if they are not registered.

Participants and providers who complete this training may register with the Quit Group as Quit Cards providers to access the subsidised Nicotine Replacement Therapy (NRT) for clients who smoke and want to quit.

The course has a deliberate emphasis on what is culturally relevant and appropriate for Pacific people.

The workshop will be held Kenepuru Hospital, Training Room 2, Raiha Street, Porirua, 17-19 March, 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

Cigarette Holder for Nudists

Sourced from Modern Mechanix blog. We're really not sure what we could add by way of comment...

SMOKEFREE SHORTS

Where possible, links are provided below the stories. Please click these to read the story in full.

Milestones

Look who has had a birthday recently!

Michele Grigg.

New Zealand

Gruesome pictures go on tobacco

Graphic images on cigarette packets are the latest in a string of rules aimed at curbing cigarette smoking to improve health. From 27 February, pictures of gangrenous toes, diseased lungs and rotting teeth and gums must be displayed on packets. Retailers have till August 28 to phase out text-only warnings.

But figures from 1996 and 2006 censuses show there are more Māori, Pacific Island and Asian New Zealanders smoking than ever – despite tens of millions of dollars being spent annually to combat it.

The Dominion Post, 28 February 2008

Gory photos help break woman's 14-year addiction

Images of mouth tumours and diseased lungs helped Rachel Stewart break her 14-year smoking addiction. Ms Stewart, of Morrinsville, said the grim health warnings on tobacco packaging convinced her to stub out her addiction.

Regulations requiring the gory health warnings to appear on all tobacco packaging sold in New Zealand come into force from 27 February.

"I had a cousin buy me some duty-free cigarettes and they had those graphic images all over them. It definitely made me think each time I opened up a new pack. It reminded me what I was doing to myself and it was embarrassing," Ms Stewart said.

Waikato Times, 28 February 2008

Fake aims to kill the urge to puff

A device used overseas as a replacement for smoking has been trialled for use in New Zealand to try to encourage more people to quit smoking.

The University of Auckland's clinical trials research unit asked 48 smokers to try a new product called the e-cigarette, made by Ruyan in Hong Kong.

Designed to mimic cigarettes, it is available in more than 40 countries, but not in New Zealand yet. It can be bought online for about $250.

It is often used overseas as a smoking replacement, but researchers here are investigating its possible use as a new form of nicotine replacement.

New Zealand Herald, 27 February 2008

Teens addicted after one smoke

Smoking just one cigarette will leave one in four New Zealand children with symptoms of addiction, a ground-breaking research report has found.

And teenage girls are at greatest risk, according to the New Zealand-based survey of almost 100,000 14- and 15-year-olds.

Of respondents who smoked at least one cigarette, 50 percent went on to become smokers. After smoking 10 cigarettes, more than 80 percent of children became regular smokers.

After 100 cigarettes, 95 percent went on to become regular smokers.

New Zealand Herald, 21 February 2008

More smokers despite tighter laws

Dramatic changes to smoking laws in 2004 have had no effect on reducing the number of people who smoke.

Ministry of Health figures show the number of people smoking is higher than three years ago – 23.5 percent of the population compared with 23 percent – despite the ban on smoking in pubs and clubs, introduced in 2004.

New Zealand Herald, 27 February 2008

International

When it comes to hooking kids, cigarillos are the new cigarettes

Physicians for a Smoke-Free Canada say lax laws over cigarillos have led to a hidden new problem of youth smoking. "Our re-analysis of Health Canada data shows that for many adolescents, cigarillos are the new cigarettes and that today's candy-flavoured cigarillo is a starter product for nicotine addiction," said PSC President Dr. Atul Kapur.

"The current approach to tobacco use exempts cigarillos from most of the regulations that apply to cigarettes and excludes cigarillo use from standard measurements of smoking," he explained. "Kids are falling through these cracks into the waiting hands of tobacco merchants, and we are not even properly counting them as casualties."

Physicians for a Smoke-free Canada media release, 19 February 2008

Smokers waste a year of working life

The average smoker wastes a year of their working life taking cigarette breaks.

By taking an average of three fifteen-minute fag breaks a day, a smoker can cost an employer up to 195 working hours each year.

And research shows that the smoking ban has made the situation worse because smokers now take longer as they have to move further away from buildings before lighting up – spending more time away from their desks.

Swindon Advertiser, 28 February 2008

£10 licence to smoke proposed in the UK

Smokers could be forced to pay £10 for a permit to buy tobacco if a government health advisory body gets its way. No one would be able to buy cigarettes without the permit, under the idea proposed by Health England.

Its chairman, Professor Julian Le Grand, told BBC Radio 5 Live the scheme would make a big difference to the number of people giving up smoking.

But smokers' rights group Forest described the idea as outrageous, given how much tax smokers already pay.

BBC News, 15 February 2008

Cigarette sales drop 4 percent following smoking ban in UK

A drop in cigarette sales prompted by England's smoking ban gathered pace at the end of last year, latest figures show.

Smokers in Britain bought 47 billion cigarettes in the past 12 months - a year-on-year dip of nearly four per cent, according to market analysts Nielsen.

The drop became more acute in the last three months of 2007 with a year-on-year drop of 6.7 percent. This compared to a sales decline of just 0.1 per cent year-on-year during the six months before the ban came into force in England, according to Nielsen data for The Grocer.

The Daily Mail, 25 February 2008

Michigan survey shows most prefer smokefree eateries

Hundreds of Michigan area residents have weighed in and the results overwhelmingly show they want others to put their cigarettes out.

When given a choice whether residents would prefer a smoke-free restaurant to a restaurant that allowed smoking, respondents gave smoke-free restaurants the nod with 66 percent of the vote while 21 percent said they would prefer a restaurant that allowed smoking and another 13 percent said they didn't care.

The Daily News, 28 February 2008

Chinese urged to report smokers

Health officials in the Chinese city of Chongqing are urging people to report their family members to the authorities if they violate a smoking ban. The initiative is part of a campaign in two districts of the city to tackle the effects of passive smoking.

Those who are accused of smoking will have their names posted on a warning list on community notice boards.

As well as the campaign within families, a workplace smoking ban is also being tried in public buildings.

BBC News, 21 February 2008

Trauma during youth linked to increased risk of smoking

Childhood abuse or physical violence in young adulthood greatly raises the odds of someone starting to smoke by their early 20s, a large study suggests.

Smokers often find their habit relaxing, "and this may be how they cope with the trauma," says study leader Bernard Fuemmeler, a paediatric psychologist at Duke University Medical Center (US).

"Survivors of traumatic experiences will say they just want to get back to normal. But for some it's like having a broken leg – you can't just go on and pretend it never happened," he says. "You need to get help or there will be bad effects."

USA Today, 19 February 2008

Bar owner rethinks stance on smoking ban as he battles lung cancer

Ken Roush owns a blue-collar bar on East 14th Street. (Des Moines, US). Kenny D's is the kind of place that closes at 2 am and opens again four hours later. The customers are ironworkers and Firestone employees just off their shift. Roush figures 80 percent of them smoke.

He bought the bar about 10 years ago, long before he found out he had lung cancer. At the beginning, he was there all the time, working, greeting customers, breathing second-hand smoke. Since he got the bad news last fall, he's been a ghost.

Roush is 61. He started smoking regularly when he was 14.

Des Moines Register, 16 February 2008

The global tobacco threat

Three years ago, an international treaty took effect that was designed to help developing countries resist aggressive marketing by big tobacco companies.

The idea was that if a large number of countries committed themselves to the same tobacco control policies – including bans on all advertising and promotion – they would be better able to resist pressure from multinational tobacco companies and their own domestic tobacco sellers.

New York Times, 19 February 2008

RJR's Camel gets a facelift

R.J. Reynolds' iconic Camel brand this week will get its first major package redo in 90 years. The new look sports the classic camel pyramid icon on a clean and contemporary looking white background. Graphics also flag Camel's 1913 heritage and include blue and green highlights.

The Reynolds American unit based in Winston-Salem, N.C., is not advertising in consumer publications during 2008. So Camel's marketing support will consist of  direct marketing with coupon offers to a consumer database and sampling at adult events.

Brandweek, 19 February 2008

Study suggests link between smoking and Alzheimer's

For decades, cigarettes have been associated with a number of less-than-desirable features such as coughing, wheezing, hoarse voice and blackened teeth, not to mention fatal illnesses such as lung cancer and emphysema.

In addition, a new study conducted by Frank M. LaFerla, associate director of the Institute for Brain, Aging and Dementia at the University of California, shows that nicotine may contribute to Alzheimer's disease, despite previous research suggesting that nicotine may prevent the crippling disease.

New University, 25 February 2008

Smoker on subway wounded by police

He was insisting on smoking while riding on a subway, but police tolerated that about as much as they tolerated having a gun pointed at them.

The incident, on the Broad Street Line in North Philadelphia, began when two plainclothes officers riding a northbound subway spotted a man smoking a cigarette between cars.

Philly.com, 21 February 2008

Schools to get smoking clinics

Stop-smoking clinics will be run in Scottish schools as part of a new drive to help city pupils kick their addiction.

Under plans being proposed by NHS Lothian, hour-long sessions will become a regular part of many teenagers' school weeks.

The health board plans to employ a second stop smoking adviser to work with young people to ensure it can cover all of Edinburgh's 23 high schools.

Youngsters aged 12 to 15 will be able to refer themselves in confidence to the clinic, and receive support and guidance on ways of giving up. The sessions will run during lunch breaks or after school.

Evening News, 19 February 2008

QUOTABLE QUOTES

"If the viability of small business in New Zealand depends on the sale of products that cause cancer, emphysema and heart attacks, this reflects a sorry state."

Dr Roland Meyer, Clinical Director, Respiratory Services, Christchurch Hospital,
Tobacco displays help produce horrendous toll, The Press, 20 February 2008

"When we give a box of cigars to a friend, we say: 'You can smoke them, or you can give them to a friend who smokes.' But the best thing to do is give them to your enemy."

Fidel Castro
as Reported by Reuters, 19 February 2008

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