 |
| Issue 113 | 15 April 2009 |
Having trouble viewing this newsletter? Try the online version. FROM THE DIRECTOR'S DESK
Three things come to mind today. Firstly, you will find a reminder to complete the Tobacco Control Update reader survey in this issue. There have only been a few responses so far. The last time we did an evaluation changes were made to the style and presentation of the Update so your views and comments are certainly useful to us as we try to improve the e-publication. Secondly, I have been watching the Face the Facts campaign with much interest. It is an excellent reminder of the need for a holistic approach to tobacco control. The messages are a good prompt to stop smoking and just might act as a foil to someone starting to smoke. The ads are short and punchy and leave the viewer in no doubt about the dangers of smoking. And finally, I am particularly glad to see that Dr Judith McKay has been awarded the British Medical Journal's first Lifetime Achievement Award. She was up against some pretty strong competition so it was good to see a tobacco control champion recognised in this way. So, I think it might be good to give her the last word this time. Here is an excerpt from her acceptance speech which gives the flavour of the challenges she faced and why she is so deserving of this honour.
Congratulations to Judith and all the best for the coming fortnight. Mark Peck Director IN THIS ISSUE:
Mumbai – 14th World Conference on Tobacco or HealthIn this and the next two Updates, Carleine Receveur, Project Manager for the Totally Smokefree Hawke's Bay District Health Board will present a series of articles on her experiences and the knowledge gained from attending the 14th World Conference on Tobacco or Health (WCTOH) held 8-12 March 2009 in Mumbai. This first article provides a general overview of the conference mission and includes some sobering global statistics. Back in 1967 – New York – Robert F Kennedy addressed the first WCTOH. Now every three years people from around the globe come together to share, network and progress the work around tobacco control.
The aim of the five-day conference was to build and strengthen tobacco control action by advancing tobacco control polices and providing a global perspective on tobacco control issues. Mumbai, the host city, was described in the conference programme as a mega city that is a microcosm and replica of India. It is the home of Bollywood, the world's largest film industry – a crowded, polluted city of over 14 million people including Asia's largest slums. Seeing the movie Slumdog Millionaire was an informative introduction to Mumbai so I wasn't surprised at seeing a group of young boys playing cricket on the outskirts of their slum from the comfort of my seat on the aeroplane tracking down the runway. It also provided an insight into the local laundry system. India was very proud to host the conference and claimed that it probably was the biggest gathering of health experts ever held in India. The last world conference held in a developing country was in 1997 in China. India is the second largest producer and consumer of tobacco in the world. It has the widest spectrum of smoking and smokeless tobacco including smoked, chewed, applied, sniffed and gargled. Children are the most vulnerable victims of tobacco. Every two seconds, one more Indian child will have his or her first tobacco experience.
Globally the burden of tobacco is huge. Tobacco is the single greatest preventable cause of death in the world today, killing up to half the people who use it. More than one billion people worldwide currently smoke tobacco – about one quarter of adults – and tobacco use currently kills more than 5 million people worldwide each year. Tobacco use continues to grow in developing countries due to steady population growth along with aggressive tobacco industry marketing efforts. If the current trends continue, tobacco will kill more than 8 million per year by 2030. By the end of this century, tobacco may kill a billion people. It is estimated that more than three quarters of these deaths will be in low- middle income countries. In her video address at the opening ceremony, Dr Margaret Chan, Director General of the World Health Organization, called for immediate action on the need to share best practices, expertise and experiences about this global health concern. Even though the scientific community has informed the world for over 50 years of the dangers of smoking and more than 20 years of the hazards of second-hand smoke, few countries have implemented effective and recognised strategies to control the tobacco epidemic. It was identified that developing countries are even less likely to have implemented robust tobacco control measures and that these countries were specially targeted by the tobacco industry. Women and young adults in these countries were also at the greatest risk as they become the next unprotected victims of cunning and ruthless tobacco marketing. Next issue: A whirlwind tour through some positive global tobacco control action. 'Light' and 'mild' cigarettes equally deadly
The Asthma and Respiratory Foundation is warning that all tobacco is deadly – no matter how it is packaged. "Smoking tobacco with descriptors such as 'light' and 'mild' is not better for health and these products are not safer to smoke compared with smoking regular tobacco," says Executive Director Jane Patterson. "Smoking tobacco is harmful regardless of how it is labelled or what the packet looks like." All cigarettes are deadly, no matter how they are packaged or described is the latest message from the Face the Facts campaign, developed by the Health Sponsorship Council and the Ministry of Health. In 2005, 44 percent of the manufactured cigarette brands listed for sale contained at least one descriptor, such as 'light' or 'mild'. Jane Patterson says the tobacco industry has promoted light and mild cigarettes as 'safer' or as an alternative to quitting, when all along it has known that these products are not better for health, or safer to smoke, than regular tobacco. "Recent New Zealand research shows that the tar and nicotine content of light cigarettes is comparable to regular cigarettes, and that light cigarettes may deliver more carbon monoxide than regular cigarettes.1 "As well, smokers are likely to compensate for smoking 'light' cigarettes, by inhaling more deeply, holding smoke in the lungs for longer, covering manufactured cigarette ventilation holes with the fingers or mouth, or smoking more frequently.2 Smokefree Coalition Director Mark Peck says a survey of 2709 smokers reported that 36 percent smoked light or mild cigarettes.3 "This included 27 percent of Māori and 40 percent of females surveyed. Those who reported smoking light and mild were asked why they smoked these types: 23 percent provided some health-related reason for their choice, and a further 5 percent thought that 'light' or 'mild' cigarettes were "less addictive" and/or "made it easier to quit". He says because the descriptors 'light' and 'mild' mislead consumers about the health risks of smoking, the Commerce Commission in New Zealand recently warned the tobacco industry to remove them from tobacco products. "Extensive research is carried out by tobacco companies to ensure that cigarette packaging appeals to selected target groups, including young adults and women. We can now expect to see tobacco packs that use pack design and colour to communicate the impression of lower tar or milder cigarettes. "Don't be fooled – all cigarettes are deadly, including so-called 'light' and 'mild' products." More information about Face the Facts can be found at: www.facethefacts.org.nz. Asthma and Respiratory Foundation media release, 12 April 2009 ____________________________ 1. Norton, K.J., Wilkins, K., O'Connor, R., Wilson, N., Edwards, R., & Peace, J. (2008). Properties of
'light'
cigarettes sold in New Zealand. New Zealand Medical Journal, 212, 107-110. High levels of smoker regret by ethnicity and socioeconomic status: national survey data
Some previous international work has studied levels of regret among smokers. In Australia, Canada, the UK, and the US, the proportion of smokers who agreed, or agreed strongly, with the statement "If you had to do it over again, you would not have started smoking", was very high (range: 89.2% to 91.3%). This study also reported significantly lower regret by higher level of education, but no significant differences by ethnicity or income. New Zealand is a good country to further explore smoker regret by sociodemographic variables given the ethnic diversity of the population and detailed small area data on deprivation levels. We have asked this same question on regret (as mentioned above) in a survey of New Zealand smokers. The survey involved a national sample of 1376 New Zealand adult (18+ years) smokers and was conducted between March 2007 and February 2008. Further detail on the survey methods is available elsewhere. The results, weighted to reflect the national population of smokers in New Zealand, showed that most smokers (83.3%; 95%CI=80.2% to 86.4%) showed regret about starting smoking. There were no significant differences in the level of regret by ethnicity (Europeans 82.8%, Māori 84.7%, Pacific peoples 89.2% and Asian peoples 75.5%). Similarly, there were no significant differences by small area deprivation quintile (range: 81.1% to 85.8%, using NZDep2006). Nevertheless, those reporting "smoking-induced deprivation" (subjects who reported spending money on cigarettes in the last six months which would have been better spent on household essentials like food) were significantly more likely to report regret (89.1% versus 81.4%, odds ratio=1.87; 95% confidence interval=1.04 to 3.37). These results are fairly similar to those reported for youth smokers in New Zealand for a very similar question. The NZ Tobacco Use Survey found that 72.3% of youth smokers aged 15-19 years regretted starting smoking (82.2% for Māori and 68.7% for non-Māori). These high levels of regret are consistent with the previous work in developed countries and further highlight that regret is widely shared among different groups of smokers. Such high levels of regret help to justify government action to substantially expand existing tobacco control interventions and smoking cessation support (which New Zealand still uses at below full potential). They also support arguments for governments to explore more innovative regulatory options to advance tobacco control, such as re-designing the tobacco market in order to accelerate reductions in smoking prevalence. Competing interests: The first two authors have previously undertaken work for government and non-government agencies involved in tobacco control. Nick Wilson, Richard Edwards, Deepa Weerasekera TOBACCO CONTROL UPDATE SURVEYAs announced in the last Tobacco Control Update, we're asking readers to tell us what they think of our fortnightly e-publication. We're keen to make sure the Update continues to be a relevant source of information for those interested in tobacco control, so your feedback is important. We'd be delighted to hear from you, whether you have praise or criticism, but we know how busy people are and that things are easily forgotten. So please head over now to the survey to give us your thoughts. It's mostly tick boxes and multiple choice, so it shouldn't take too long, but there's also plenty of room for any comments you may have. As an incentive, all who fill out the form and include their contact details will go into a draw to win a $100 Whitcoulls voucher. If you don't want to go into the draw, we're also happy for you to fill out the form anonymously. The survey form is available at www.surveymonkey.com/s.aspx?sm=WAC3oVu2VvS3Z42BeG4Log_3d_3d, or you can follow the link from our homepage. Quit Group registrations to February 2009A total of 5,293 clients registered with Quit services in February. This includes 3,062 Quitline callers, 1,920 web clients and 311 Txt2Quit clients. Approximately 23.2 percent of clients were Māori (1,229), 83.6 percent were New Zealand European/Other (4,424) and 5.8 percent identified themselves as Pacific peoples (305). The highest proportion was in the 20-24 age bracket (14.2 percent), followed by the 25-29 age group (14.1 percent).
Numbers of callers registered with the Quitline to February 2009 THROUGH THE SMOKEDistressing anti-smoking ads Anti-smoking television advertisements have hit the news in several countries lately, because they are said to be too real and/or too distressing.
Find out more and watch the ad at the BBC News website. In New South Wales, however, an even more 'distressing' ad produced by the New York City Department of Health has been rejected for use because it has sparked outrage in the United States over whether it crossed ethical lines by filming a four-year-old actor in what appears to be a very real state of anguish.
The ad's makers say it goes for the heartstrings of parents, but its detractors say it hits below the belt, and a large number of complaints have been received by people who do not believe the child is acting. The MSNBC website carries a video of the ad as part of a five minute NBC current affairs story. While being interviewed about the ad, the Chairman of the Deutsch Advertising Agency, Donny Deutsch, says, "Maybe sometimes advertising agencies do make a kid cry, but if saves 20,000 lives for five seconds of a kid crying, I'll take the trade." What do you think? SMOKEFREE SHORTS
New ZealandContest against tobacco
Marlborough Cancer Society's new Health Promotion Co-ordinator, Corinne Payne, who is a former oncology nurse, has organised a competition for primary, intermediate and secondary school students. Primary students are invited to design a kite with a smokefree or fresh air theme; intermediate pupils are encouraged to design a poster, write a letter or newspaper article discouraging fellow students from starting smoking; and secondary students are challenged to design a radio campaign advertisement aimed at 10 to 19-year-olds. Marlborough Express, 8 April 2009 Smokefree policy linked to violence Mentally-ill patients forced to quit smoking at the Henry Rongomau Bennett Centre are more likely to become violent, says a former mental health worker. Paula Jessep, Waikato District Health Board's Senior Consumer Adviser at the centre from mid-2003 to late 2005, said she believed the new smokefree policy would lead to increased aggression among acutely-ill patients, more unexplained absences, and fewer smokers in the community seeking help. Waikato Times, 2 April 2009 Smokefree award for park Seven years after selling their last packet of cigarettes over the counter, Bowentown Beach Holiday Park has been recognised by the Asthma Foundation and awarded a Smokefree Retailers award. Owners Dave and Kay Roche have also since made efforts to keep their park smokefree. Bay of Plenty Times, 2 April 2009 International
Home life and popular culture pose smoking risk to children
In one study, researchers assessed the exposure of children to second-hand smoke at home. They found that 34.4 percent of children live with one or more adult smokers. Among poor children, 49.4 percent live with a smoker, and 21.2 percent live with multiple smokers. Modern Medicine, 6 April 2009 US court dismisses smoking appeal The US Supreme Court has dismissed an appeal by cigarette maker Philip Morris over a $NZ136.5m award to the widow of a long-time Oregon smoker. The court upheld a 1999 ruling by the Oregon Supreme Court in favour of Mayola Williams. The judgement has grown to more than $NZ249m with interest. BBC News, 31 March 2009 Stop smoking lines in the US flooded as tobacco tax rises Calling your state stop-smoking hot line for help kicking the addiction? Expect a wait: smokers are flooding the lines in a panic over an increase in the tobacco tax. Denver-based National Jewish Health received triple the usual number of calls for a March day, on 30 March, to quit lines it runs in six states: Colorado, Idaho, Iowa, Montana, New Mexico and Ohio. The Washington Post, 31 March 2009 One company's unusual smoking ban
Company officials say that CEO Chung Joon-yang wants Posco, which employs 16,000 people, to be smokefree by the end of year. The company's union and the Health Ministry have welcomed the campaign. But Noh Hee-bum, a spokesman at the Constitutional Court, says the move could violate South Korea's Constitution, which guarantees the people's right to seek happiness. WWLP, 7 April 2009 Blood tests reveal tobacco smoke residues in non-smoking New Yorkers More than half of non-smoking New Yorkers have elevated levels of cotinine in their blood – meaning that they were recently exposed to toxic second-hand smoke in concentrations high enough to leave residues in the body. Cotinine, a by-product of nicotine breakdown, is not harmful itself but signals exposure to environmental tobacco smoke. EurekAlert!, 8 April 2009 Smoking in the classroom With its nose-burning, clothes-stinking and teeth-yellowing tendencies, the smoking addiction is obvious fodder for health and hygiene curriculums. The applications for math classes would be intriguing: Suppose it takes a waitress at a casino 45 minutes to second-hand smoke one cigarette emanating from five customers who are smoking continually the entire time. How long would it take her to second-hand smoke three cigarettes if there are eight customers, four of whom smoke continually and the other four smoke only half the time? Yankton Press, 2 April 2009 A smoking experience that's unmatched
"I had lunch, a cup of coffee and a smoke the other day at the offices of the American Legacy Foundation in downtown Washington. I puffed away for a good 15 minutes, savouring the irony. "Here I was, surrounded by zealous anti-smokers – Legacy is among the nation's most influential and well-funded tobacco-fighting organisations – yet I had been invited over to partake in all the nicotine I could handle. "Of course there was a catch: What I puffed on wasn't a Marlboro or any other combustible cancer stick. I didn't need an ashtray. The "smoke" was more accurately fog – small, vaporous clouds. I was trying out a controversial new nicotine-delivery device that somewhat resembles a cigarette but is actually a plastic tube with a glowing LED at its tip." The Washington Post, 7 April 2009 Recession might be good for your health It took a moment to make the connection, but Jake Sawyers says the recession has been good for him, or at least for his health. "I smoke when I drink, and I drink when I go out and I've been doing less of that," said the 36-year-old Maryland resident who was buying a pack of cigarettes at a neighbourhood convenience store. "I am also exercising more. Maybe I have more energy because I'm not drinking and smoking as much." CLTV, 1 April 2009
Give It Up, Smoker It might be a little difficult to recognise. It's that raspy, croaking noise, sort of like an emphysemic chainsaw making out with a bucket of powdered glue. Hear it now? Yes, it's the gravelly howl of the nation's livid smokers, AKA "the last persecuted group in America" (well, except for the obese and Catholics, Mormons, dwarves, Hummer owners, gun lovers, vegans, atheists, lawyers, Wall Street execs, lesbians, Mexicans, working moms, single moms, obese single Mexican lesbian moms and a few dozen others, but never mind that now) whose God-given civil rights are now being trampled by our increasingly oppressive, fascist government. San Francisco Chronicle, 8 April 2009 MILESTONESLook who has had a birthday recently... Heather Muir! QUOTABLE QUOTES"You will never get rich being an anti-smoking advocate, but you might just get a little satisfaction with the thought that you helped some people quit (or not start), and made their lives a little better." Robert Moffitt, "A ban on candy (cigarettes) is dandy, but prohibition?" "Many young ladies, perhaps because they are unable to consume enough servings of fruit, believe that by smoking peach [cigarettes], they are getting the same amount of nutrition as they would from a real peach." Lin Ching-Li, Director of the John Tung Foundation's Tobacco Control Division |
| Subscription info |
|
The Tobacco Control
Update is produced by the Smokefree Coalition If you are
considering using any material from the Tobacco
Control Update, |
The conference was a melting pot of people from various streams of the sector including academics and researchers, policy makers and strategists, representatives from governments and NGOs, cessation practitioners, health professionals, youth ambassadors, through to action and advocacy groups. The global tobacco control community is a collection of passionate people.
Despite the overwhelming issues India faces the spirit of the conference was one of hope and progress. The words of Mahatma Gandhi – an influential figure in what was then Bombay, across India and indeed the world – greeted delegates at the entrance of the conference.
This article first appeared in the 3 April edition of The New Zealand
Medical Journal, and has been reproduced with permission. A PDF version
which includes footnotes, will be available via the
In
Britain an ad aimed at convincing parents to give up smoking upset children and broke several rules, the Advertising Standards Authority says.
It ruled that the "I'm not scared" ad, which attracted 51 complaints overall, should not be shown before 7.30pm. In it a girl says she is not afraid of spiders, clowns or bullies, but does fear her mother – a smoker – dying. 
The little boy is shown standing alone in a train station while separated from his mother. His look of puzzlement turns into abject fear as tears roll down his face. A voice-over then says, "This is how your child feels after losing you for a minute. Just imagine if they lost you for life."
Where
possible, links are provided below the stories. Please click these to read the
story in full.
Health lobby heavyweights the Heart Foundation, Barnardos and Plunket are backing a Cancer Society campaign to alert young people to the dangers of smoking tobacco, and now the society wants to enlist backup from the kids themselves.
Smoking remains a serious health risk for children, who are exposed to second-hand smoke at home or influenced to take it up themselves by its depiction in popular movies, according to two studies published in the April issue of the journal Pediatrics.
South Korean steelmaker Posco has sent its employees a tough no smoking message and may require them to take blood tests to check if they have
stopped smoking.
Opinion piece by Richard Leiby of The Washington Post