Issue 194  |  18 April 2012

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Guest Editorial: Enjoyable satisfying nicotine replacement therapy

by Brent Caldwell
School of Medicine and Health Sciences, University of Otago, Wellington

My passion is to develop more effective nicotine replacement therapies that genuinely replace the rewarding aspects of smoking.

If we want to help smokers make the healthy choice between nicotine replacement therapy (NRT) or smoking a cigarette, we need to make the NRT option more competitive.

At the moment, smokers are faced with a choice between NRT (which provides slow delivery of nicotine, little sensory reward, and lots of common side-effects) and cigarette smoking (which provide rewarding airway sensations and a hit of nicotine within six seconds of each puff). It's no wonder that cigarettes win over NRT for the 90 percent of smokers who go back to smoking within 12 months after using NRT. And it is no surprise that the vast majority of smokers who try to quit do so without the assistance of NRT, even though NRT doubles their chance of quitting (from 5 percent to 10 percent).

In order to match the rewarding effects of smoking, nicotine replacement therapies need to get nicotine to the brain as fast as cigarettes do. The only way to achieve that is to deliver nicotine via deep lung nicotine deposition.

Along with my colleagues at the University of Otago, Wellington, I have been developing a nicotine inhaler that is tolerable and achieves deep lung deposition. There are many technical hurdles to overcome, such as making nicotine particles small enough to get to the lungs rather than hitting the back of the throat; minimising the formation of gas-phase nicotine that mainly deposits in the upper airway and is irritating; also the flavouring right. We have completed a small trial of a range of different inhaler formulations, and are about to start a large trial of the best nicotine inhaler, to measure the quit rate that it can achieve.

We hope that the new inhaler will be highly effective, and appealing enough to motivate smokers to want to give it a go. Every time a smoker tries to quit, they need the best help they can get, because if they fail, they might not try to quit again for many years, doing more and more damage to their health. Hopefully our inhaler will help more smokers to quit early on by give them the optimism and encouragement they need.


Asthma Awareness Week 30 April - 6 May

Asthma Awareness Week and Balloon Day are our opportunity to raise awareness of how asthma affects so many New Zealanders and also to raise money to make a difference.

Did you know:

  • one in four kiwi kids and one in six adults have asthma – that 's over 600,000 New Zealanders?
  • our kids lose over 500,000 school days each year due to asthma
  • asthma is the most common cause of hospital admissions for children?

You can help raise money for people with asthma this Balloon Day (Friday 4 May) with 'Dance 4 Asthma'.

What can you do? Hold a disco or dance, have a dancing competition, have a dance everywhere day, come dressed as your favourite pop idol – it's up to you, you can be as creative and outrageous as you like.

The money you raise will help asthma sufferers and their families across New Zealand. We have some of the highest rates of asthma in the world and far too many of our young people spend time in hospital with asthma.

Email to register.

Applications open for Youth Week event grants

The application process is now open to apply for your Youth Week event grants!

The application forms are available on our website for download. If you fit this year's grant criteria, please fill in the downloadable form and return it back to us by mail or by email by Monday 23 April.

There are specific criteria for applying for Youth Week grants this year, please see the form for details. If you have any inquiries regarding your eligibility or the criteria to apply for grants, contact Brittney or phone 04 802 5000. Unfortunately, we cannot accept any late forms, so be sure to get them in before the closing date.

If you are interested in receiving Youth Week resources by mail, such as poster, stickers and booklets, there will be a form available on our website shortly. Fill it in and email it to us, and we will be sure to get the resources to you well in time for Youth Week.

Thank you to Youthline and YMCA, our two new supporters who have come on board with Youth Week this year. We appreciate all your support!

Keep sharing your events with us via email and posting them to our Facebook page. We have heard about a lot of really awesome events so far, so keep them coming!

Quitline's new advertising campaign

Quitline has launched a new advertising campaign entitled "The New You". This fresh campaign takes an inspirational approach, focusing on the benefits of being smokefree and the free support available through Quitline.

The campaign, which includes television advertisements, Adshels, radio advertisements and online advertisements, features six Quitline clients who have successfully quit smoking.

The television advertisements are available in both English and Māori, and can be viewed here.

Video interviews with the people featured in the advertisements can be viewed here.

Preventing child abuse/improving child health

A public inquiry seeks to find what can be done to prevent child abuse and promote child well-being in children.

The Health Select Committee wants to hear about:

  • the things that influence best childhood outcomes from preconception to three years, and also about significant barriers to these
  • improvements that can be made to health, education, social, and other services before children are conceived that will improve infant and child outcomes
  • improvements that can be made to antenatal maternity services so that children at risk of adverse health outcomes are identified early, monitored appropriately, and dealt with
  • improvements that can be made to post-natal services (including how the lead maternity caregiver, Plunket, and primary care services work with each other)
  • improvements that can be made to the "well child" services (especially hard to reach children)
  • improvements that can be made to get the best possible outcomes for children between six weeks and three years, with particular reference to health services but not excluding education, social, housing, justice, and other determinants of health.

Submissions close on 4 May 2012. You can submit online, or send two copies of your submission to the Health Select Committee, Parliament Buildings, Wellington 6160.

More information.

Unlocked 2012: Health on the Inside

This two-day conference aims to build on links between primary health care in the Prison Health Service and the community.

Conference speakers include:

  • Judge Ema Aitken, District Court Judge
  • Dr Janice Wilson, CEO Health Quality and Safety Commission
  • Professor Doug Sellman, Director of National Addiction Centre.

Register before Monday 8 June 2012.

Find out more.

International Indigenous Development Research Conference 2012

27-30 June 2012
Auckland, New Zealand

Registrations are open for the 5th Biennial Ngā Pae o te Māramatanga conference. The conference will highlight indigeneity and the multidisciplinary approach used for indigenous development.

Presentations will address all aspects of the following themes central to the realisation of indigenous development:

  • Optimising Indigenous Economic Wellbeing – addressing issues, needs and opportunities arising in Māori and indigenous communities leading to increased economic independence and self-determination
  • Healthy and Thriving Indigenous Families addressing issues, needs and opportunities arising in indigenous families leading to health, successful and thriving indigenous families
  • Enhancing Indigenous Distinctiveness – understanding the distinctive contributions that indigenous communities – people, knowledge, assets, resources – do and may yet make to the world at large. Yielding opportunities for development that may not be sourced from any other community or population.

Keynote speakers include:

  • Dr Keawe'aimoku Kaholokula, the University of Hawai'i
  • Dr Jelena Porsanger, Smi University College, Norway
  • Aroha Mead, Victoria University of Wellington
  • Professor Charles Royal, Director of Ngā Pae o te Māramatanga and Professor of Indigenous Development in the Faculty of Arts, University of Auckland.

Early bird registration rates close 23 April, so register today!

Click for more information and registrations.

For enquiries, please contact the conference's Event Manager.

Expressions of Interest for Connect For presentations are now open

Expressions of Interest for presenting are now open for the Connect For: improved outcomes for vulnerable young people conference to be held 25-26 June 2012 at the Melbourne Park Function Centre.

The conference brings together government, local government, schools and the community sector.

It is a response to children and young people experiencing barriers to accessing opportunities to learning and development. It is designed for those working in education, youth support, health, housing, justice services and police.

To apply, fill out this form, and email it to by 20 April 2012. Late expressions may not be considered.

World No Tobacco Day 31 May 2012 resource

Fair trade tobacco does not exist. Tobacco farming is associated with health, environmental and human rights violations.

This poster is part of a project to encourage country representatives of the WHO to use the theme "Tobacco Agriculture and Industry Practices that Undermine Human Rights" for World No Tobacco Day 31 May 2013.

View the poster.




Vodafone Fellowship in Youth Health Leadership

A fellowship in youth health leadership is being offered by The Vodafone NZ Foundation in association with SYHPANZ (Society of Youth Health Professionals Aotearoa NZ).

The fellowship is a leadership development grant ($90,000 over 12 months) for mid-career health practitioners or researchers with proven leadership and experience in the youth sector to complete their study, research, or undertake a sabbatical.

Applications close 1 June 2012.

Find out more.

Health Improvement and Innovation Resource Centre resources

The following resource is available via the Health Improvement and Innovation Resource Centre website:

  • Graphic warning labels on plain cigarette packs: Will they make a difference to adolescents?

    Graphic warning labels and plain cigarette packaging are two initiatives developed to increase quit behaviour among smokers. Although little is known about how adolescents interpret graphic warning labels, very few studies have examined how plain cigarette packaging would affect adolescents' perceptions of cigarette smoking and smoking behaviour. Through focus group interviews, this study explored how teens interpret and respond to graphic warning labels and the plain packaging of cigarettes, and assessed the potential that these strategies may offer in deterring smoking initiation.

Recent research

Click the links below each piece for more information.

The pervasive effects of racism: experiences of racial discrimination in New Zealand over time and associations with multiple health domains

Harris R, Cormack D, Tobias M, Yeh LC, Talamaivao N, Minster J, Timutimu R

Self-reported experience of racial discrimination has been linked to a range of health outcomes in various countries and for different ethnic groups. This study builds on previous work in New Zealand to further investigate the prevalence of self-reported experience of racial discrimination by ethnicity, changes over time and associations with multiple health measures.

Continued importance of family factors in youth smoking behaviour

Although it is known that levels of family factors (FF) such as parental monitoring and parent–adolescent connectedness vary during adolescence, it is unknown which factors remain protective, preventing smoking initiation, in youth of differing racial/ethnic groups. Using a longitudinal, nationally representative sample, we examined which FF protect against smoking initiation in white black, and Hispanic youth.

Socioeconomic inequalities in childhood exposure to second-hand smoke before and after smokefree legislation in three UK countries

Second-hand smoke (SHS) exposure is higher among lower socioeconomic status children. Legislation restricting smoking in public places has been associated with reduced childhood SHS exposure and increased smokefree homes. This paper examines socioeconomic patterning in these changes.

Portrayal of smokeless tobacco in YouTube videos

Videos of smokeless tobacco (ST) on YouTube are abundant and easily accessible, yet no studies have examined the content of ST videos. This study assesses the overall portrayal, genre, and messages of ST YouTube videos.

The effect of cigarette smoking on allergic conditions in Maltese children

Maltese children are frequently exposed to tobacco smoke through passive and personal smoking. In this study questionnaire, we enquired about passive smoking to the parents of 3816 five- to eight-year-old children and about passive and personal smoking to 4139 13- to 15-yr-old participating children.

Challenges to Australia's national health policy from trade and investment agreements

This article explores the potential for the Trans-Pacific Partnership Agreement to constrain Australia's national health policy space through two illustrative case studies: tobacco plain packaging and the Pharmaceutical Benefits Scheme.

The combined effect of very low nicotine content cigarettes, used as an adjunct to usual Quitline care (nicotine replacement therapy and behavioural support), on smoking cessation: a randomised controlled trial

The aim of this trial was to determine the combined effect of very low nicotine content cigarettes and usual Quitline care (nicotine replacement therapy and behavioural support) on smoking abstinence, in smokers motivated to quit.

Sex differences in availability of 2*-nicotinic acetylcholine receptors in recently abstinent tobacco smokers

Sex differences exist in the reinforcing effects of nicotine, smoking cessation rates, and response to nicotine therapies. This study examined 2*-nAChR availability in male and female smokers vs non-smokers and to determine associations among 2*-nAChR availability, tobacco smoking characteristics, and female sex steroid hormone levels.

Smokeless weight loss

Smoking and obesity are two leading causes of chronic disease in the developed world. Given that the combined impact of these factors on health can be especially deleterious, it is somewhat ironic that smoking is known to have beneficial effects on body weight; smoking is one of the easiest and most reliable approaches to weight loss, at least for low level smokers.

Effect of passive smoking on the ultra-structure of the nasal mucosa in children

Passive exposure to cigarette smoke has been implicated in a number of respiratory childhood disorders. The aim of the present study was to study the ultra-structural changes in the nasal mucosa of a paediatric population exposed to passive smoking.

Mentholated cigarettes and cardiovascular and pulmonary diseases: a population-based study

Cigarettes labelled as "mentholated" contain substantially higher levels of menthol than regular cigarettes, to produce a characteristic mint flavour and cooling sensation. Potential non-cancer adverse health effects of added menthol to cigarettes are largely unknown. The purpose of this study was to determine if cardiovascular and pulmonary disease risk was different between mentholated cigarette smokers and non-mentholated cigarette smokers.

Exposure to second-hand smoke outside of a bar and a restaurant and tobacco exposure biomarkers in non-smokers

With an increase in indoor smoking bans, many smokers smoke outside establishments and near their entrances, and this has become a public health concern. This study characterised the exposure of non-smokers to second-hand smoke outside a restaurant and bar in Athens, Georgia, where indoor smoking is banned.

Smokefree shorts

Where possible, links to full articles are provided below each story.

New Zealand

No more park puffing

The Far North's parks and reserves have been declared smokefree after one of the shortest debates in council history. The Northland DHB was expected to make a presentation at the next council meeting, but councillors saw no need to wait, voting to adopt the policy immediately.

Northland Age, 5 April 2012

Plan to stub out city's smoking culture

As well as wanting to make Auckland the world's most liveable city, Auckland Council wants it to be one of the healthiest and plans to stub out the city's smoking culture.

Auckland Now, 5 April 2012


Up in smoke: Philip Morris fined for publishing ads

Philip Morris has been fined for publishing full page advertisements in leading magazines including The Herald, Newsweek Pakistan and The Express Tribune, among others, in violation of laws.

The Pakistan court imposed a fine of Rs5,000 as per the tobacco control laws. The industry is not allowed to place advertisements in print media which are more than one square inch, according to section 7 of Prohibition of Smoking and Protection of Non-Smokers Health Ordinance 2002.

The Express Tribune, 11 April 2012

Safer cigarettes? Prove it, says FDA

Under federal regulations being proposed by the Food and Drug Administration (FDA), tobacco companies will be required to provide verifiable scientific evidence proving that their products marketed as being "safer," really are., 6 April 2012

Honduras joins WTO complaint on Australia tobacco packaging

Honduras has joined a complaint against an Australian law requiring all tobacco to be sold in plain packaging, warning of "serious economic consequences" if the measure was enforced. Honduras, like Australia, was in favour of legitimate steps to reduce smoking, but plain packaging was not one of them.

Reuters, 4 April 2012

'Public backs' plain packaging

There is strong public support for forcing cigarettes to be sold in plain packaging in England, an opinion poll found, amid a row over Government plans to ban branding., 15 April 2012

Tobacco executive admits involvement in destruction of research documents

A Montreal lawyer who was a top executive for Imperial Tobacco Ltd in the 1980s and 90s has admitted in a major Canadian tobacco trial that he helped destroy dozens of company research documents, some of which dated back decades and spelled out health risks associated with smoking.

Roger Ackman, who was on Imperial's management committee and ran its legal department until he retired in 1999, had difficulty remembering the precise nature of the documents destroyed or why, exactly, the company embarked on the shredding mission.

The Globe and Mail Update, 2 April 2012

England introduces display ban

As per reports, it has been revealed that England has put a ban on tobacco product displays, which means shopkeepers will have to keep the tobacco products below the counter. The ban will be applicable for large shops and supermarkets. Small outlets are free from the ban until 2015.

Top News, 6 April 2012

British poll: Kids hate being around smoke

A TV and radio campaign in England says smoking by a window or the back door does not protect children from harmful effects of second-hand smoke., 31 March 2012

Why quitting smoking is harder for women

Why is it that women find it harder to quit smoking than men? A US study suggests it could be environmental and social factors, rather than a physical dependence on the nicotine itself.

MSN News: Health Hub, 5 April 2012

World Health Organization aims to fight tobacco smuggling with new regulations

Health officials have provisionally agreed a global deal to combat tobacco smuggling, a trade the World Health Organisation said makes harmful smoking too cheap and robs finance ministries of up to $50 billion a year.

Huffington Post, 4 April 2012


"The Health Promotion Agency will retain all of the functions of the Health Sponsorship Council and Alcohol Advisory Council and provide exciting opportunities to better integrate promotional activities and build strong expertise in this area."

The Chair of the HPA Establishment Board, Dr Lee Mathias, says the focus at the moment is on maintaining business as usual. This applies also to any programmes that will transfer from the Ministry of Health to the new agency. The Board wants to take some time to consider how best to integrate the Health Promotion Agency's work programme and ensure it has the resources it needs.

Ministry of Health/NGO forum, 29 March 2012

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