Patterns and Behaviors of snus consumption in Sweden..

August 28, 2009 - Snus is a traditional product with a long history of use in Sweden dating back hundreds of years ago.

In this British American Tobacco (BAT) study telephone surveys of snus users (defined in this survey as those who normally use at least one snus portion per day) randomly selected from telephone directories in all regions of Sweden were conducted in 2007 and 2008. In total, 2,914 respondents answered questions on snus usage, including the types of products used and the quantity and frequency of use.

In Sweden the number of men using smokeless wet snuff (‘snus’) tobacco has fallen from 22 to 19 percent, while snus use among women has remained stable over the last five years at about 3 to 4 percent. (Sweden - Regular tobacco (including SNUS) use falling..)

Snus use is reportedly far more common in the male population in Sweden compared with the female population (male to female ratio: ~ 8:1) (Statistics Sweden [English] Living Conditions, 2007). This was reflected in the lower number of females (n = 359) compared with males (n = 2,555) who completed our questionnaire (male to female ratio: ~ 7:1).

The majority of users of both pouched (96%) and loose snus (99%) placed the portion between the gum and upper lip. Although most snus users maintained the portion at the site of application, a significant number, 36.5% of pouched users and 18.9% of loose users, move the portion around the mouth during use. Very similar patterns of behavior were observed for both male and female users. You would think if the tobacco is moved around in the users mouth the flow of saliva with the user having the urge to spit therefore no longer spitless.

Approximately 50% of the pouched snus users and approximately 70% of the loose snus users were aged between 30 and 54 years. The distribution shows that the percentage of loose snus users between 18 and 29 years old was lower compared with the
pouch users (11.5% compared with 23.6%, respectively).

PAPER: Patterns and behaviors of snus consumption in Sweden, Helena Digard, Graham Errington, Audrey Richter and Kevin McAdam, British American Tobacco, Nicotine & Tobacco Research Advance Access published online on August 17, 2009, ABSTRACT.., Full Text...

The survey addressed various topics, from average consumption per day and residence time in mouth to dependence and use of snus as a cessation aid.

The male population was relatively evenly distributed between use of ‘loose snus’ (42%) and ‘portion snus’ (54%). The female population predominantly used ‘portion snus’ (93%). Few used both loose and portioned snus.

Male consumption of ‘portion snus’ was 11.8 grams per day on average while the female group consumed 8.5 grams per day on average. Male users of ‘portion snus’ consumed 12 pouches a day on average compared to 10 pouches a day for female ‘portion snus’ users. ‘Loose snus’ consumption was 29.5 grams per day on average.

22% of male snus users took their first snus within five minutes of waking, and 57% of males took their first snus within thirty minutes of waking. The data were similar for females.

The normal time that respondents kept either a loose portion or a pouch in their mouths was slightly in excess of 1 hr. Female pouched snus respondents tended to use snus for shorter times with a mean time in mouth of 47 min. The shortest normal time of use was just over 20 min for female respondents and just over 30 min for male respondents. Examination of the data for the longest time normally kept in mouth shows some extreme values, with male pouched snus users reporting times in mouth of up to 15 hr, and 7 hr for female pouched snus users.

This study showed lower rates of smoking among Swedish snus users, than those reported for American moist snuff.
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New Zealand - Tairawhiti Board wants tobacco sold only on prescription..

August 28, 2009 - Tairawhiti District Health (TDH) Board will lobby the health minister to get tobacco classified so it can be sold only on prescription.

The Tairawhiti District Health (TDH) covers the Gisborne District serving a population of 45,000. Gisborne (Māori: Tūranga-nui-a-Kiwa) is the name of the largest settlement within the Gisborne Region of northeastern New Zealand. District Health Boards (DHBs) in New Zealand are organisations established by the New Zealand Public Health and Disability Act 2000, responsible for ensuring the provision of health and disability services to populations within a defined geographical area. They have existed since 1 January 2001 when the Act came into force.[1] There are 21 DHBs, 15 in the North Island and 6 in the South Island. DHBs receive public funding from the Ministry of Health on behalf of the Crown, based on a formula which takes into account the total number, age, socioeconomic status and ethnic mix of their population. Gisborne is the first city in the world to see the sun rise. Tairawhiti is the customary Maori name used to describe the coast upon which the sun shines across the water.

TDH is responsible for funding, providing and ensuring the provision of health services for those in need of personal health and disability services. This work is done in the community and from Gisborne Hospital, Ormond Rd, Gisborne.

TDH's role is three fold, namely Owner/Governance, Funder, and Provider of public health and disability services in the district. Our mission statement “Working together, to elevate the wellbeing of Tairawhiti."

A high level of smoking in the ²Gisborne-East Coast region led to huge public health bills and many diseases, and an active stance needed to be taken, said board member Brian Wilson. The board has supported Mr Wilson's recommendation to appeal to Health Minister Tony Ryall to have tobacco and nicotine sold only as a prescription drug. "Nicotine is often described as a toxic addictive drug. It seems incredible then, that it is not classified as such," said Mr Wilson in a report to the board. (Mr Wilson's paper was unanimously supported.)

"My suggestion is that discussions take place around the possibility of it becoming a prescription medicine. It would not be available for young people but could be supplied to adults that were already addicted to tobacco on prescription."

The board will contact the other 20 district health boards, and local MPs (Members of Parliament), to push the message and gather support. The message would be conveyed directly to the minister, Mr Wilson said. "At least then we can test if this thing can get any legs and if we can actually do something about it."

Huge resources had already been invested in trying to limit the number of people smoking, Mr Wilson said. "However, there is still a steady number of young people who take up the habit, resulting in a continuing burden on the health system to care for people with tobacco-related diseases.

"The feeble attempts to limit access by having the products in locked cabinets, restricted to certain age groups and controlling the display of it, have had only a small effect. "What is needed is a bolder approach that will seriously make a difference."

Preventing young people from starting smoking would be the main focus, he said.

Reference: DHB calls for tobacco to be prescription only 3news.co.nz, 8/26.2009.

²Cigarette smoking rate (for Gisborne and Hawke's Bay combined - refer to technical details before use) The proportion (%) of the population in the area aged 15 and over who currently smoke cigarettes.
Sex..... 2001 2002 2003 2004 2005
Male.... 27.7 25.8 31.7 26.2 35.5
Female.29.8 25.1 31.0 30.7 35.3
Total... 28.9 25.5 31.3 28.6 35.4

Image - City of Gisborne Coat-of-Arms - click to enlarge..

New Zealand related news briefs: New Zealand - health researchers calling on government to ban importation of tobacco..; New Zealand - 1st trial ever of e-cigarettes..; New Zealand - BAT reducing prices discouraging people from quitting..; New Zealand - stop smoking campaigns NOT working..; BAT awarded worst corporation in New Zealand..; New Zealand - government may NOT support tobacco display bans..; New Zealand More Evidence Needed to Ban Tobacco and Cigarette Displays..; More evidence - tobacco displays increase the risk of teens smoking..; Horror photos go on New Zealand cigarette packs..; Country to Eliminate Smoking - The South Pacific nation of Niue; Ireland to ban tobacco displays..; Smokefree NZ within 10 years..; By law, oral snuff cannot (but nasal snuff is allowed) be sold in New Zealand and can be imported only for personal use..
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"Smoking Everywhere", an electronic cigarettes retailer sued..

August 28, 2009 - Smoking Everywhere, a major retailer of electronic cigarettes, has been sued in a multi-count civil action. This civil law suit seeks “civil penalties of up to $25,000 for each willful violate[ion] of the Unlawful Trade Practices Act,” as well as full refunds to customers.

Several other sellers of electronic cigarettes have avoided suits by entering into voluntary settlements, says public interest law professor John Banzhaf of Action on Smoking and Health (ASH), the organization which wrote to state attorneys general asking them to bring this type of legal action against the sellers.

According to the complaint, Smoking Everywhere “did not submit their electronic cigarettes to FDA for pre-approval because Defendants believed that they found a regulatory loophole that allowed them to sell electronic cigarettes without FDA approval, so long as the devices were not sold as smoking cessation devices.”

But the FDA “has already declared that electronic cigarettes are subject to FDA approval as a drug or medical device, much like nicotine patches, gum and inhalers — and therefore they are illegal until they are cleared,” and has stated that electronic cigarettes are “unapproved new drugs and/or misbranded drugs or devices,” and appear “to be a combination drug-device product that requires pre-approval, registration and listing with FDA.”

Banzhaf notes that there is legal precedent for classifying products as drugs or drug devices even if the sellers make no claims whatsoever as to their use.

The complaint charges that Smoking Everywhere has engaged in the “deceptive sale and promotion of electronic cigarettes” which “causes immediate harm to public health, safety, and welfare.” It says defendants made claims which were deceptive because “Defendants did not possess such evidence because such evidence does not exist.” These claims included that e-cigarettes “are safer than traditional cigarettes.”

The complaint also charges that Defendant wrongfully claims that its product contain “no harmful carcinogenic ingredients” and are “free of [cigarette-type] tar.”

Defendants were also charged with failing to warn customers that “nicotine can cause dangerous increases in heart rate and blood pressure and should not be used by individuals with hypertension or heart disease.”

Smoking Everywhere was also cited for “target[ing] adolescents and youths who are likely not already addicted to nicotine” and for “knowingly and unconscionable targeting ‘kids” by, among other things, telling listeners to the Howard Stern radio show that “for kids out there, you still look cool ’cause it still looks like a cigarette.”

The complaint alleges that “as a result of Defendants’ unconscionable promotion of electronic cigarettes to young people, Defendants’ product likely will function as a gateway to tobacco abuse and nicotine addiction in young people.”

Previously, ASH, in a legal letter sent to PayPal, advised the company that providing payment for electronic cigarettes “appears to be aiding and abetting the sale of these illegal products by providing payment vehicles to Internet sites which are selling them, and doing so in interstate commerce and in possible violation of consumer protection laws in the individual states.”

PayPal was also warned that: “As the FDA and others have noted, electronic cigarettes pose a wide variety of potential dangers to users, and perhaps also to those around them, both of whom inhale a mixture of nicotine (a dangerous drug) and propylene glycol (which is used in antifreeze and may cause respiratory tract irritation

In response, PayPal is no longer facilitating the sale of this product. Facebook has reportedly decided that “we do not allow ads for electronic cigarettes and will not allow the creation of any further Facebook Ads for this product.”





PROFESSOR JOHN F. BANZHAF III
Professor of Public Interest Law and Executive Director
Action on Smoking and Health (ASH)
America’s First Antismoking Organization
2013 H Street, NW, Washington, DC 20006, USA
(202) 659-4310 // (703) 527-8418 // ash.org

Reference: Electronic Cigarette Seller Sued - Fines and Penalties Sought, pr-inside.com, 8/25/2009.
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Sharjah Emirate, UAE - earn monetary rewards for quiting smoking..

August 28, 2009 - The Sharjah (the third largest emirate (nation or territory ruled by an emir)of the United Arab Emirates (UAE)) Islamic Affairs Department has launched an anti-smoking campaign for Ramadan that will reward those who quit the habit with Dh10,000 (US$2,723; ₤1,667; AUS$3,410). (emir - a prince, chieftain, or governor) UAE are a federation of seven individual states, all ruled by emirs.

Twalib Ebrahim Al Merri, head of the Department of Islamic Affairs of the Government of Sharjah: "We want to use Ramadan to see the end of it for most smokers, because if you can [refrain from smoking] through out the day, then you can [refrain] throughout your life," , said.

The department's campaign is aimed at helping smokers quit this Ramadan and more than 100 smokers have already registered. The campaign was initially launched last year to facilitate the government's efforts to encourage people to quit smoking.

"In June 2008, the Sharjah Executive Council passed a decree banning people from smoking in public areas, such as in restaurants and shopping centers, and the decision was a thoughtful and researched effort to restrict the damaging health effects of smoking on the people of Sharjah," he said.

Contestants can participate in the campaign by calling the toll free number 8001441, where the participants will then be asked to take a medical test.

"Officials from the department will then keep a close watch over [participants] to make sure they quit smoking," Hussain Al Amiri, head of the Awareness Section at the Department of Islamic Affairs, said.

"At the end of the month they would be subject to another medical test to prove that they did not smoke for the whole month, and those who pass the test will then be entered into the draw," he said.

Al Amiri said the first prize winner will receive Dh10,000, while the second and third winners will be rewarded with Dh5,000. Others up to the tenth winner would carry home prizes like mobile phones and other electronics.

He pointed out that after Ramadan the department would continue to monitor those who have tried to quit smoking, and should they fail, they will be given counseling and any other assistance to prevent them from taking up the habit again.

Reference: Sharjah offers Dh10,000 reward to quit smoking by Mariam M. Al Serkal, Staff Reporter, Gulfnews.com, 8/26/2009.

Some related news briefs:
Dubai, UAE customs blocks e-cigarette shipment..;
UAE - graphic warnings on cigarette packs..;
UAE new tobacco ban proposed..;
UAE - Quadruple Cigarette Price - Prevent Kids from Smoking...

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NYC Area - more counterfeit Marlboro cigarettes seized..

August 28, 2009 - Late Wednesday, August 26th approximately 300 cartons of counterfeit Marlboro ® cigarettes were seized from three Mastic smoke shops to prevent their sale to consumers. Suffolk County Police carried out the search and seizure pursuant to an order by U.S. District Court Judge Leonard Wexler following a lawsuit Philip Morris USA (PM USA) filed Tuesday against three Mastic, N.Y., retail stores on the Poospatuck reservation. The Mastic retailers were among a group of nine stores in New York and New Jersey that PM USA sued for selling counterfeit versions of the company's Marlboro® brand cigarettes.

"The sale of counterfeit cigarettes undermines the value of our trademarks, and Philip Morris USA is committed to taking steps necessary to protect its brands and the legitimate cigarette trade," said Joe Murillo, vice president and associate general counsel, Altria Client Services, speaking on behalf of PM USA.

PM USA conducts periodic marketplace purchases of cigarettes and found each of the defendants selling counterfeit cigarettes during August 2009. As a result, PM USA filed suit in the Eastern District of New York against the following defendants from Mastic:

* Smoking Arrow Smoke Shop,159 Poospatuck Lane
* Belle Belle Smoke Shop,174 Poospatuck Lane
* Flying Arrows Smoke Shop, 130 Poospatuck Lane

This lawsuit is the latest in a series of actions PM USA has taken to address counterfeit activity involving its brands. On May 6, PM USA filed suit against Mastic-based Tammy's Smoke Shop for selling counterfeit versions of Marlboro® cigarettes, followed by suits filed on May 18 against seven retailers in New York and New Jersey who also sold counterfeit cigarettes. All told, PM USA has sued 17 retailers in New York and New Jersey in 2009 for the sale of counterfeit versions of Marlboro® brand cigarettes.(PM USA found more counterfeit Marlboro cigarettes in the NYC area..)

In the lawsuit filed Tuesday,Auugust 25th PM USA asked Judge Wexler to grant an order authorizing law enforcement officers, working with PM USA representatives, to search the defendants' inventories of Marlboro® and Marlboro Lights® brand cigarettes and to seize any counterfeit cigarettes found along with any records regarding the manufacture or sale of Marlboro® and Marlboro Lights® brand cigarettes. As part of its argument, PM USA presented facts supporting a potential connection between the distribution of counterfeit products to the various Mastic stores.

The average retail price for Marlboro® brand cigarettes has grown to $9.56 in New York City, of which $5.26 is excise taxes*. The counterfeit cigarettes purchased from the retailers did not bear the appropriate tax stamp. As a result, the applicable excise taxes were not paid.

"With its high taxes on cigarettes and the non-enforcement of tax collection on reservation sales to non-tribal members, the New York metropolitan area continues to be an attractive market for contraband cigarette activity," Murillo said. "Resolving these issues would go a long way toward reducing illegal activity." (NYC - wins round in fight against Indian Tobacco Vendors..)

According to U.S. Customs and Border Protection (CBP), cigarettes were ranked ninth among the most valuable seized counterfeit products in fiscal year 2008 -- the first time cigarettes made CBP's top 10 seizures list since 2005.

PM USA takes a number of actions to protect its valuable trademarks, promote the lawful sale of its brands and to safeguard the integrity of the distribution system. Since 2002, PM USA has filed lawsuits against 185 retailers selling counterfeit cigarettes in New York and New Jersey. In addition to litigation, PM USA works closely with law enforcement authorities in a variety of ways to support their efforts to address contraband cigarette activity. These efforts include providing counterfeit cigarette training for law enforcement professionals and verifying the authenticity of its products at the request of law enforcement.

Related news briefs: PM USA found more counterfeit Marlboro cigarettes in the NYC area..; Philip Morris USA sues over counterfeit Marlboros...

Reference: Philip Morris USA Lawsuit Prompts Seizure of Counterfeit Cigarettes PM USA sues Mastic retailers for selling fake products, Philip Morris USA, 8/27/2009.

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El Cajon - no-smoking ordinance but NOT Enforced..

August 27, 2009 - El Cajon, a city in San Deigo, California with a population of approximately 95,000. The purpose of this Ordinance was to limit public exposure to secondhand smoke in public areas within the City of El Cajon. Smoking is prohibited in and within 20 feet of the following City owned Recreation Facilities: Bostonia Center, Fletcher Hills Center, Hillside Center, Kennedy Center, Renette Center and Wells Center.

For some residents, the law that prohibits smoking in public — in parks, restaurants, bars, places of employment, and common areas of hotels and apartment buildings — is ineffective and unenforceable.

Since March 2008, when the law’s grace period ended, not one citation has been issued for smoking in public.

“I’ve seen people light up right in front of cops, and the cops don’t even ask them to put it out. Look at this guy,” says John, a 15-year resident of El Cajon who doesn’t want to give his real name. “He doesn’t care because no one is going to enforce it.”

The reason isn’t that the law has stopped everyone from lighting up — far from it — but that the law is “self-enforcing,” meaning it is up to employers, property owners, and other citizens to ask smokers to extinguish cigarettes if they pose a “positive danger to health and a cause of material annoyance, inconvenience, discomfort, and a health hazard.” If the smoker refuses to put out the cigarette, the complainant can either find a police officer or file a civil action against the smoker.

For John, asking people to put out their cigarettes is as good as telling them to slow down and drive the speed limit. And filing a civil action is even more outlandish. “Usually when I approach someone smoking, they tell me that they have a right to smoke where they want and there is nothing I can do about it. Their response is always some type of ‘I don’t give a damn’ attitude. If it’s a law, it needs to be enforced by the police and the City, not the people it’s supposed to protect.”

Within four years, the City had enacted the toughest anti-smoking regulations in the county. The first, a 2004 law, aims to end underage smoking. Tobacco merchants pay a fee, currently $675 per year, to fund compliance checks and administrative hearings, held when alleged violators challenge fines. The second law, the smoking ban, went into effect in September 2007.

Smoking is prohibited in and within 20 feet of any tot lot, any playground and any recreational area whether publicly or privately owned. No person shall be in possession of a burning tobacco or tobacco related product, including but not limited to cigars and cigarettes, in any public places; any places of employment; and multi-unit residence common area; or any enclosed and unenclosed places of hotels, businesses, restaurants, and bars and other public accommodation. No person shall smoke in an area in which smoking is otherwise permitted by this chapter or other law within a reasonable distance from any entrance, opening, crack, or vent into an enclosed, area in which smoking is prohibited by this chapter, other law or by the owner, lessee or licensee of that enclosed area.

Reference: El Cajon's Smoking Ordinance, ElcajonFire.com, March 14, 2008 - date smoking ban became effective..; I Blow Smoke on Your Law by Dorian Hargrove, San Diego Weekly Reader, 8/26/2009.

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NYC - wins round in fight against Indian Tobacco Vendors..

August 27, 2009 - A federal judge ruled on Tuesday, August 25th that a group of tobacco vendors on an Indian reservation on Long Island cannot sell tax-free cigarettes to the general public until a court rules in a closely watched legal battle between the reservation and New York City.

A temporary injunction issued by Judge Carol B. Amon of Federal District Court in Brooklyn gave the city at least a temporary victory in its efforts to collect hundreds of millions of dollars in tax revenue.

Under Judge Amon’s ruling, a group of cigarette businesses on the Poospatuck Indian Reservation near Mastic can sell tax-free cigarettes only to tribe members, for personal use, until a verdict is reached in a federal lawsuit the city filed in September. The judge stayed the ruling for 30 days to give the vendors time to appeal.

“The judge’s ruling is completely wrong,” said Harry Wallace, a lawyer and the chief of the Unkechaug Indian Nation, which is on the Poospatuck reservation, adding that it ignored the Indian nation’s sovereignty.

The city says the reservation businesses are illegally selling large amounts of cheap cigarettes to people outside of the tribes, including bootleggers who bring cartons upon cartons into the city for resale. City officials estimated that the sales deprived the city of $420 million from 2004 to 2008.

The loss of tax income to tribal tobacco businesses has taken on greater urgency for many officials amid state and municipal budget cuts. A state court ruled in July that the Cayuga Indian Nation could not be prosecuted for failing to collect cigarette taxes, and the application of that decision is at issue in Mr. Bloomberg’s federal suit, which could have nationwide implications.

Collecting tax on non-Indians seems to be working in Florida: Florida - non-Indian customers pay tax on tobacco at reservation shops...

Related news brief: NYC sues reservation smoke shops over bootlegging..

Reference: New York Wins Round in Fight Against Indian Tobacco Vendors by SARAH WHEATON, The New York Time, 8/26/2009.
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India - Tobacco Atlas - Indian women among worst smokers in world..

August 27, 2009 - According to the latest Tobacco Atlas, 3rd Edition, Indian women are among the worst in the world ranking third in the top 20 female smoking populations. Only the US with 2.3 crore female smokers and China with 1.3 crore women smokers are worse off than India in this chart. (A crore is a unit in the Indian numbering system equal to ten million.)

However, as far as percentage of women smoking is concerned, it is below 20% for India. Among India's immediate neighbors, only Pakistan figures in this infamous list, but right at the bottom at 20th with around 30 lakh female smokers. (A lakh is a unit in the Indian numbering system equal to one hundred thousand.)

Take a look - premature aging - women become older looking before their time. Female smokers in India die an average eight years earlier than their non-smoking peers.

According to the Atlas, about 250 million women in the world are daily smokers -- 22% being from high resource countries and 9% from low and middle resource countries. Realizing the potential of this growing market, the Atlas said the tobacco industry has been marketing cigarettes to women using seductive but false images of vitality, emancipation, slimness, sophistication and sexual allure.

Reacting to the report, Dr P C Gupta, director of Healis Sekhsaria Institute of Public Health, told TOI that this finding had very serious implications for India. "Even though the percentage prevalence of women smoking in India isn't that high, the number is huge. In addition to all the harm that tobacco causes to men, women are additionally exposed in a special way because of their reproductive function." Gupta added that tobacco consumption reduced birth weight of the foetus, decreased their gestational age leading to premature babies, increased the risk of still births and heightened chances of anaemia among adult pregnant women.

The Atlas said tobacco killed some six million people each year -- more than a third of whom will die from cancer -- and drained $500 billion annually from global economies. As 25% of smokers die and many more become ill during their most productive years, income loss devastates families and communities. In 2010, 72% of those who die from tobacco related illnesses would be in low- and middle-income countries. By 2030, 83% of these deaths will occur in low and middle-income countries.

Reference: India third on global 'female smoking list' Kounteya Sinha, The Times of India, 8/27/2009.

Click on image to enlarge, the Indian emblem..
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Lexington County, South Carolina has a workplace smoking ban..

August 27, 2009 - After one of the longest and most divisive smoking-ban fights in South Carolina, Lexington County Council passed by the slimmest of margins (5-4) a smoking ban effective January 1, 2010 for all businesses in unincorporated Lexington County. Opponents of a workplace smoking ban said Tuesday, August 25th plan to target for defeat the five council members who voted for the ban. Most are conservative organizations against the ban draw support from former presidential candidate Ron Paul and television commentator Glenn Beck.

South Carolina has the shameful distinction of having the nation's lowest state cigarette tax, at 7 cents a pack, where it's been since 1977 (32 years). The national average for states is $1.27 a pack. Map of US - Cigarette tax for each state..

The ban will allow smoking only on outdoor decks at bars and restaurants in the unincorporated parts of the county. But the county plans to enforce the ordinance only when it receives complaints from the public, council chairman Debbie Summers said.

On March 31, 2008, the South Carolina Supreme Court unanimously ruled that local governments have the right to enact and enforce smokefree laws. At least 26 other local governments in South Carolina have adopted a ban since May 2006, when Sullivan’s Island led the move to outlaw smoking in workplaces. (Cities/Counties South Carolina Smoking Bans, Latest Could Be Rock Hill)

Reference: Finally, Lexington County smoking ban OK'dby Clif LeBlanc, thestate.com, 8/26/2009.

Related news briefs: South Carolina - governor disappears, maybe its time to slip through a cigarette tax..; South Carolina - next legislative session starts June 16th..; South Carolina - lawmakers may disappoint again on cigarette tax increase..; SC tobacco tax increase - doubt exists maybe NOT this year..; South Carolina - can we expect a tobacco tax increase this year??; South Carolina a magnet for cigarette black market..; South Carolina - legislators eager to pass cigarette tax increase - the odds are against them??; South Carolina to spend NO money on tobacco prevention..; South Carolina (SC) will NOT devote any resources to anti-smoking programs..; In 2008 will the politicians do what's right for the State of South Carolina??; South Carolina - Tobacco Tax Increase Killed - State House Fails to Override Governor's Veto.. and Tobacco Tax Increase – What’s Wrong with South Carolina??

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Los Angeles - jury recommends Philip Morris USA pay $13.8 million in punitive damages..

August 27, 2009 - LOS ANGELES -- A jury on Monday, August 24th, recommended that cigarette maker Philip Morris USA should pay $13.8 million in punitive damages to the daughter of a longtime smoker who died of lung cancer, according to a report by the Associated Press. The panel voted 9 to 3 in favor of Bullock's daughter Jodie Bullock, who is now the plaintiff in the case. Betty Bullock died of lung cancer in February 2003.

She had sued Philip Morris in April 2001, accusing the company of fraud and product liability. A jury in 2002 recommended Philip Morris pay a record $28 billion in punitive damages to Bullock, but a judge later reduced the award to $28 million.

In 2008, the 2nd District Court of Appeal reversed the jury's decision and remanded the case for a new trial over the punitive damages. Philip Morris said the $28 million remained excessive; however, the original jury recommended the tobacco company pay Bullock $750,000 in damages and $100,000 for pain and suffering, a verdict that still stands.

In a statement, Richmond, Va.-based Altria Group Inc., which owns Philip Morris, said any amount given to Bullock's daughter is unwarranted. "After hearing weeks of improper arguments and evidence that violated state and federal law on punitive damages, the jury still managed to reject plaintiff's patently unreasonable request," said Murray Garnick, Altria Client Services senior vice president, speaking on behalf of Philip Morris. "Even so, we believe that any punitive damages award is unwarranted based on the facts in this case and that this award is unconstitutionally excessive."

Defense attorney Frank P. Kelly said outside of court that Philip Morris has not decided yet whether to appeal the decision.

Betty Bullock, 64, of Newport Beach, Calif., started smoking Marlboros when she was 17 and later turned to Benson & Hedges, both Philip Morris products.

Attorneys for Philip Morris argued Betty Bullock could have stopped smoking at anytime, and the harmful effects of cigarettes were known to smokers.

Jurors said the figure they reached was a compromise, with some arguing that Philip Morris should not pay anything, while others believed the cigarette maker should pay billions of dollars in damages.

Matt Reed, 37, of Burbank was one of the three dissenting jurors, who believed Philip Morris should pay a higher amount than the verdict. "Some of us looked at it as an opportunity to deter this behavior," Reed said. "I don't find $13.8 million to be much of a deterrent." Other jurors felt Betty Bullock should have been more responsible, but using a formula decided on an amount for the years she suffered from lung cancer. "I saw it as a personal choice," said Poulet Minasian, 25, of Los Angeles. "There was a big gap in the amount [during deliberations], but the $13.8 million made sense."

Reference: Jury Awards $13.8 Million in Damages to Smoker's Daughter PM USA says award is "unwarranted," "unconstitutionally excessive"Convenience Store/Petroleum (CSP) Daily News, 8/27/2009.
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Altria Group - - webcast, Barclays Capital Consumer Conference..

August 27, 2009 - The Altria Group will host a webcast of its business presentation at the Barclays Capital Back-To-School Consumer Conference in Boston, Massachusetts, starting at about 10.30 hours Eastern Time on September 9, 2009..

The webcast, which will be in a listen-only mode, will feature a presentation by chairman and CEO, Michael E. Szymanczyk.

Pre-event registration is necessary at www.altria.com, at which site an archived copy of the webcast will be available until 17:00 hours October 9, 2009.

Reference: Altria to Host Webcast from the Barclays Capital Back-To-School Consumer Conference, New Release, Altria.com, 8/26/2009.
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Australia - health blueprint to be unveiled by the Rudd Government...

August 26, 2009 - Prime Minister Kevin Rudd handpicked the National Preventative Health Task Force last year. The mention of the task force was to provide evidence-based advice to governments and health providers on preventative health programs and strategies, focusing on the burden of chronic disease currently caused by obesity, tobacco and the excessive consumption of alcohol.

On July 5, 2009 we reported - that the federal government was currently analyzing a series of recommendations provided by the task force.

A report from the task force found the social costs of tobacco, alcohol and illicit drug abuse had risen to $56.1 billion.

Last night, a spokeswoman for Health Minister Nicola Roxon declined to comment on the secret report. The task force proposals, in a report to the federal government, also include:

- cash incentives or vouchers to encourage people in poorer communities to eat healthy food;

- a "health compact" between the government and the food industry for cuts in the levels of salt, sugar and fat and to improve the nutritional value in everyday foods;

- a $5 increase in the price of an average packet of 30 cigarettes; the aim is to cut the numbers of people smoking from 2.9 million, within a decade. (The price of cigarettes would rise by A$5 to A$20 for a pack of 30 cigarettes.)

- an end to cigarette promotions inside shops;

- stricter controls on licensing hours and alcohol advertising;

Australia: the healthiest country by 2020 prepared by the National Preventative Health Task Force 2008..


Measures on alcohol are designed to cut alcohol abuse levels by 30 per cent within 10 years, News Limited says.

The taskforce's report did not set out targets or a time frame for cuts to fat, salt and sugar in foods.

A total ban on alcohol sponsorship associated with sport and an end to alcohol advertising on the internet and in youth magazines. An alcohol sponsorship ban could cost sports up to $300 million a year collectively in lost revenue.

The task force recommended a "health compact" between government and the $70 billion food sector aimed at improving the nutritional value of everyday supermarket items.

The government will face pressure to avoid big tax hikes on alcohol and tobacco that would hit the working poor.

References: Experts call for coupons to encourage healthy eating by Steve Lewis, The Daily Telegraph, 8/27/2009; Plan proposes booze, cigarette tax hikes, Australian News, 8/27/2009.

A few related news briefs: Australia - illicit tobacco, do what's right increase the tobacco tax..; Australia - illegal cigarettes readily available..; Australia - More on federal tobacco tax increase..; Australia - federal government is currently analyzing recommendations for reducing smoking..; Australia - will the federal tax on cigarettes increase..; Australia - increase tobacco tax 50% - 74% of smokers would try to quit..; Australia - providing cigarette ingredients to smokers won't help them quit..; Australia - National Youth Tobacco Free Day Friday - March 27, 2009..; Australia - wants to move up date for fire-safe cigarettes..; Australia NO cigarette price increase since 2001...
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Western Australia - major tobacco companies were worried about tobacco controls..

August 26, 2009 - Confidential tobacco company documents have revealed international tobacco companies were worried action in Western Australia would spread to other states. New research has revealed international tobacco companies feared tobacco controls in Western Australia (WA, W.A.) and closely monitored the state for more than 50 years. In 1998, a legal battle forced four of America's biggest tobacco companies to release millions of confidential documents.

Curtin University in Perth has spent the past two years sifting through more than 50 years of documents. The documents show the companies were deeply concerned about tobacco controls in Western Australia, including the banning of tobacco advertising, education programs and health warnings on cigarette packets.

Professor Mike Daube says the companies were getting regular reports on what was happening in the state. Daube: "They were desperately worried about Western Australia as a national leader. They were worried that action in Western Australia might encourage other states to act." Professor Daube says he has one memo written by a head of tobacco giant Philip Morris. "He says, 'This doesn't sound good at all, they are taking the lead!! This will spread elsewhere'," he said.

Professor Daube is also a member of the Preventative Health Task Force set up by the Federal Government and president of the Australian Council on Smoking and Health.

He says Western Australia remains a leader in tobacco controls, and it is likely the companies still fear the impact of smoking regulations in the state and the flow-on effects to the rest of Australia.

Monograph: “We are still not yet out of the woods in W.A.”: Western Australia and the international tobacco industry..





- Make Smoking History Campaign..




Reference: Tobacco giants 'feared Western Australia's lead', ABC News, 8/26/2009.

Click on image to enlarge, Healthway seeks to promote and support healthy lifestyles to reduce the burden of preventable disease in Western Australia.
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Viet Nam - to ban smoking and increase tax..,

August 26, 2009 - In Viet Nam (Vietnam), tobacco-related illnesses are the leading cause of death. 40,000 people die each year from smoking. That’s more than a hundred people per day and three times higher than deaths from traffic injuries. This country has one of the highest male smoking rates in the world: more than half the adult men in this country smoke. (WHO Representative Office in Vietnam - Background)

Back in March 2008 Andre Calantzopoulos, now chief operating officer of Philip Morris International, noted that among large cigarette markets where the company has little or no presence were China, Vietnam, India and Bangladesh. Philip Morris has begun operations in Vietnam - fighting for a share of the huge and lucrative cigarette market.

---> Vietnam will ban smoking in all indoor public places next year and raise tariffs on tobacco products to reduce consumption, the government said. Starting from January 1, 2010 smoking in schools, hospitals, libraries, cinemas, factories, offices and on public transport will be prohibited, a government statement seen on Tuesday, August 24th. The ban will extend to all indoor public spaces by the end of 2010, the statement said, adding the government also plans to apply "high tariff levels" on tobacco products next year to cut consumption.

Tobacco products are subject to a tax rate of 45 percent at present. The government statement did not provide details of the planned tax hike.

Annual consumption of tobacco products in this Southeast Asian country was estimated at about $500 million in 2007, state media reported.

Viet Nam ratified the WHO Framework Convention on Tobacco Control (FCTC) in December 2004.

Viet Nam is a member of the Southeast Asia Tobacco Control Alliance (Seatca).


Reference: Vietnam to curb smoking, raise tobacco tax, Reporting by Nguyen Nhat Lam; Editing by Nick Macfie, Reuters, 8/24/2009.
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Tobacco Atlas - 3rd edition launched at the Livestrong Global Cancer Summit, Dublin, Ireland..

August 26, 2009 - The Tobacco Atlas, 3rd Edition, Co-authors: Dr. Omar Shafey, Dr. Michael Eriksen, Dr. Hana Ross, Dr. Judith Mackay

The Tobacco Atlas, Third Edition, published by the American Cancer Society and World Lung Foundation, estimates that tobacco use kills some six million people each year- more than a third of whom will die from cancer- and drains US$500 billion annually from global economies. Unveiled at the LIVESTRONG Global Cancer Summit, the Atlas graphically displays how tobacco is devastating both global health and economies, especially in middle- and low-resource countries, and tracks progress and outcomes in tobacco control. The Tobacco Atlas Online, 3rd Edition.. Lance Armstrong's comment after meeting Dr. Judith Mackay...

The Most Preventable Cause of Cancer

According to The Tobacco Atlas, 2.1 million cancer deaths per year will be attributable to tobacco by 2015. By 2030, 83% of these deaths will occur in low and middle-income countries. Unique among cancer-causing agents, the danger of tobacco is completely preventable through proven public policies. Major measures include tobacco taxes, advertising bans, smokefree public places, and effective health warnings on packages. These cost-effective policies are among those included in the Framework Convention on Tobacco Control (FCTC), a global treaty endorsed by more than 160 countries, and recommended by the World Health Organization’s (WHO) M-P-O-W-E-R (W=Warn) policy package.

A $500 Billion Hole in Global Economy

The global economy lost a staggering US$500 billion due to tobacco use. These economic costs come as a result of lost productivity, misused resources, missed opportunities for taxation, and premature death.

* Because 25 percent of smokers die and many more become ill during their most productive years, income loss devastates families and communities.
* Cigarettes are the world's most widely smuggled legal consumer product. In 2006, about 600 billion smuggled cigarettes made it to the market, representing an enormous missed tax opportunity for governments, as well as a missed opportunity to prevent many people from starting to smoke and encourage others to quit.
* Tobacco replaces potential food production on almost 4 million hectares of the world's agricultural land, equal to all of the world's orange groves or banana plantations.
* In developing countries, smokers spend disproportionate sums of money relative to their incomes that could otherwise be spent on food, healthcare, and other necessities.

Burden Shift to the World's Poorest Countries

The Tobacco Atlas crystallizes an undeniable trend: the tobacco industry has shifted its marketing and sales efforts to countries that have less effective public health policies and fewer tobacco control resources in place:

* In 2010, 72 percent of those who die from tobacco related illnesses will be in low- and middle-income countries.
* Since 1960 global tobacco production has increased three-fold in low- and middle-resource countries while halving in high-resource countries.
* In Bangladesh alone, if the average household bought food with the money normally spent on tobacco, more than 10 million people would no longer suffer from malnutrition and 350 children under age five could be saved each day.

Reference: 2009 edition of the Tobacco Atlas catalogues catastrophic toll of tobacco worldwide, ScienceBlog.com, 8/25/2009.

Related news brief: Third Edition Tobacco Atlas.. - PLEASE NOTE: Actually at this time (March 16, 2009) The Tobacco Atlas, 3rd Edition, was in revision. The files presented were in draft form only.

Click on images to enlarge;

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FDA Moves Forward on Implementation of Tobacco Law..

August 25, 2009 - The U.S. Food and Drug Administration (FDA) today announced an action regarding the implementation of the Family Smoking Prevention and Tobacco Control Act. The Agency has officially established the Tobacco Products Scientific Advisory Committee (TPSAC).

The Tobacco Products Scientific Advisory Committee is tasked with providing advice, information, and recommendations to the Commissioner of Food and Drugs on health and other issues relating to tobacco products. The committee will be asked to consider a variety of topics including:

o identifying the effects of the alteration of the nicotine yields from tobacco products;
o reporting on the impact of the use of menthol in cigarettes on the public health; and
o advising on an application for modified risk (use of descriptors such as “light”) tobacco product.

The TPSAC will consist of 12 members, including the Chair to be selected by the Commissioner of Food and Drugs, from among experts knowledgeable in the fields of medicine, medical ethics, science, or technology involving the manufacture, evaluation or use of tobacco products. There will be nine voting and three non-voting members. Of the nine voting members, seven will be health care professionals practicing in the area of oncology, pulmonology, cardiology, toxicology, pharmacology, addiction, or any other relevant specialty. One member will be an officer or employee of a state or local government or the federal government, and the final member will be a representative of the general public.

The three non-voting members will be identified with industry interests. These members will include one representative of the tobacco manufacturing industry, one representative of the tobacco growers, and one representative of the small business manufacturing industry.

Three related Federal Register documents are on display today and being published tomorrow; one announces the establishment of the new advisory committee, one requests nominations for voting members to serve on the committee, and one requests nominations for non-voting members.

For further information please access the following link and then scroll to Food and Drug Administration.

Reference: FDA Moves Forward on Implementation of Tobacco Law, FDA, U.S. Food and Drug Administration, 8/25.2009; FDA Establishes Tobacco Products Scientific Advisory Committee and Requests Nominations for Members by David B. Clissold & Ricardo Carvajal, FDA Law Blog, 8/26/2009.

Tobacco Center related news briefs:
Dr. Lawrence Deyton to head FDA's Tobacco Center..;
U.S.- creating the FDA's Center for Tobacco Products..
U.S. FDA posts job for new tobacco czar..;
President Obama signs bill for FDA to regulate tobacco...

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Poland - son suing Philip Morris Polska and Zakłady Przemysłu Tytoniowego over death of his mother...

August 25, 2009 - A Katowice, Poland resident has put the tobacco industry on alert with the filing of a lawsuit this month against Philip Morris Polska and Zakłady Przemysłu Tytoniowego (Tobacco Industry Works) in the central city of Radom).

Stanisław Lubicz-Sienicki is seeking zł. 10 million ($2.56 million) in damages from tobacco firms for the death of his mother, who died of lung cancer this summer and smoked Marlboro and Popularne (a polish brand made in Radom) brands of cigarettes, according to press reports.

Despite the slew of cases that have beleaguered Philip Morris and other producers in the United States, the lawsuit here caught Polish tobacco producers by surprise. But lawyers and tobacco makers downplayed the impact of the suit and said Lubicz-Sienicki and, perhaps others, face a steep uphill battle here.

"Frankly, we are surprised that there is such a case in Poland because the fact that smoking is damaging is universally known in our country," said Robert Wyszyński, a legal adviser with Phillip Morris Polska. "Despite the fact that it is universally known, Mr. Lubicz filed a claim."

U.S. courts, which have been more receptive to plaintiff's claims, allow for class-action lawsuits, whereby a person can significantly broaden claims against tobacco makers. Not so in Polish courts, where the burden of proof in this case is more rigorous, according to industry members.

"The Polish system simply does not permit class action, so the wave of suits that came in the U.S. can't come here," said Jan Wierzbicki, director of corporate affairs at cigarette maker Reemstma Polska. Moreover, the burden of proof establishing a link between cause and effect is much more rigorous here, he said. "In our system you have to prove a clear cause-and-effect relationship," Wierzbicki said. In practice, that means a general link between smoking and cancer is not enough. "The basic concept is that you know what you are doing when you smoke," said Stanisław Dwernicki managing partner at law firm Gide Loyrette Nouel Polska.

Moreover, considering knowledge of the health hazards and warnings on cigarette packs and advertisements, producers can argue consumers are aware, responsible agents for their own actions. "Producers say, 'I have informed you, I have informed all of Poland, so I am in compliance with all the laws. In that case, I don't have any (responsibility) for results that the client should die of cancer,' " Dwernicki said.

Philip Morris is mum on the lawsuit. "We did not receive officially the contents of the suit filed in court by Mr. Lubicz," Wyszyński said. "We don't want to comment until we are able to get to know the arguments used by Mr. Lubicz."

In filing the suit, Lubicz-Sienicki has requested that the court waive its normal fees, which can run to 5-8% of the amount of damages sought. Lubicz-Sienicki said he is seeking a waiver because he does not want to benefit directly from the case, but would send settlement money to charity. "The man has based his waiver request on the fact that he wants to create a foundation that will help people that have suffered because of smoking," said Andrzej Almert, spokesman for the district court in Krakow, where the case is being considered.

Regardless of the outcome of the fee-waiver motion, the case itself is likely to move forward slowly. The court calendar in Krakow is booked for the next three months, Almert said. In addition, given the complicated medical and scientific nature of the case, the court will seek expert opinions before deciding the case. "For sure it won't end quickly," he said.

Regardless of delays, the Lubicz-Sienicki lawsuit has put the tobacco industry on notice.

Reference: Katowice man taking tobacco makers to task, The Warsaw Business Journal, 8/23/2009.

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Thailand - hosting major tobacco promotion event in November 2009..

August 25. 2009 - The credibility of Thailand's anti-smoking policy is being questioned after it was revealed the country is hosting a major tobacco promotional event in November. Anti-smoking activists are strongly opposing the staging of Tabinfo Asia 2009, which will be held from Nov 11 to 13 at Impact Muang Thong Thani.

They say it makes a mockery of the nation's anti-smoking stand. They said the event was a fresh effort by multinational tobacco companies to expand their business in the region, which is seen as the world's most lucrative market for tobacco consumption. "The tobacco industry is acting like cigarettes are normal and that the Tabinfo Asia 2009 event is just an ordinary trade expo," said Prakit Vathesatogkit, secretary of the Action on Smoking and Health Foundation (ASH Thailand). Dr Prakit said staging the promotion was in contravention of Article 5.3 of the World Health Organisation (WHO) Framework Convention of Tobacco Control in protecting public policy from tobacco industry influence.

"Smoking kills over 5 million people each year. "We cannot just keep silent on this matter. We have to expose that the tobacco industry is challenging Thailand to host an event aimed at harming global health."

A network of anti-tobacco advocates in Thailand would hold activities to condemn an event which they say is aimed at directly and indirectly influencing the country's policy on tobacco control.

He urged government agencies - particularly the Thailand Tobacco Monopoly - to follow the WHO pact. Thailand adopted the treaty, which requires restrictions on all forms of tobacco advertising, trade, sponsorship and promotion, in addition to protection from exposure to tobacco smoke, effective taxation policy, pictorial health warnings on packaging and an end to duty-free sales of tobacco products.

The Public Health Ministry had to look into possible violation of the Thai Tobacco Act at the event as the law prohibited the presence of cigarette packs in retail establishments.

US-based Tobacco Reporter magazine, the organiser, said the reason for holding the event was "to learn how the Thailand Tobacco Monopoly manages to survive under heavy legal restrictions". The organiser also emphasised that Tabinfo Asia 2009 was just another congress focusing on a business meeting with no public admittance. But Dr Prakit said the event aimed to draw more than 3,000 delegates and tobacco traders to brainstorm ways to market their tobacco products in Asia, particularly aimed at young smokers, via new media such as Twitter.

Hatai Chitanondh, president of the Thai Health Promotion Institute: "It is the tobacco industry's new threat [to society], especially to developing countries which are not equipped to fight against huge sums of money and various tricky strategies." said

Public Health Minister Witthaya Kaewparadai said he had assigned the Disease Control Department to look into legal details regarding exhibitors.

Reference: Policy denounced as 'smoke and mirrors' by APIRADEE TREERUTKUARKUL, Bangkok Post, 8/25/2009.

Some Thailand news briefs:
Thailand Tobacco Monoploly - union concerned about privatization..;
Thailand - monks sickly from tobacco smoking and/or smoke exposure..;
Philippines - Thai cigarette import rules..;
Thailand - cigarette and liquor prices are expected to rise once new measures for calculating excise taxes take effect..;
Congratulations.. Thailand Joins Developed World With Total Ban On Smoking..;
Discouraging Tobacco Use - Horrific Images on the Packaging..
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Israel - may initiate a bill to bar smoking in vehicles with kids.. Do it for YURI..

August 25, 2009 - A member of the Knesset (legislative branch of the Israeli government, MK) is considering initiating a bill to bar smoking in vehicles with children as passengers.

Israel Beiteinu (Israel is Our Home - a political party in Israel) MK Robert Ilatov, whose colleague MK Yuri Shtern proposed such legislation three weeks before his death from brain cancer in 2007, told The "Jerusalem Post" on Monday, August 24th after learning of the Johns Hopkins study that found vehicles are the most dangerous space for second-hand smoke levels. that such a bill would be a fitting memorial to Shtern. He asked to read the study, which was published on Tuesday, August 25th in the journal Tobacco Control.

There's an abundance of evidence that children are more susceptible to the negative effects of second-hand smoke (SHS, ETS, environmental tobacco smoke, involuntary smoking, sidestream smoke, passive smoking).

Health Ministry associate director-general Dr. Boaz Lev said he personally was very much opposed to smoking in cars containing minors, but that he had not discussed the proposal with Deputy Health Minister Ya'acov Litzman (United Torah Judaism), who decides policy.

Meanwhile, Jerusalem tobacco control lawyer Amos Hausner, who is chairman of the Israel Council for the Prevention of Smoking, said that smoking in vehicles should not be allowed altogether, since it risks the lives of the driver and his passengers, both due to the increased chance of road accidents and the damage to health from the toxic substances released in cigarette smoking in such a small space.

Hausner noted that there is a law - too seldom enforced - barring the holding of cellular phones while driving, because this greatly increases the risk of crashes. Two years ago, he recalled, the transport authorities sponsored a month of radio public service ads calling on the public not to smoke in cars for this reason.

While laws around the world bar smoking in public indoor places, only a few countries and several [a few] American states have barred smoking in cars occupied by children. But in the US alone, involuntary exposure to secondhand smoke accounts for thousands of respiratory, cardiovascular and cancer deaths every year, the authors note. Vehicles are increasingly being shared for car pools, thus more people are being exposed to smoke. (U.S. - Children Remain Especially Vulnerable to Secondhand Smoke..)

Meanwhile, the Guardian newspaper reported on Monday, August 24th that children - as young as five years old - in Malawi who are forced to work as tobacco pickers are exposed to nicotine poisoning equivalent to smoking 50 cigarettes a day. They suffer from severe health problems from absorbing daily up to 54 milligrams of nicotine through their skin. (Malawi - kids working in tobacco production..

Reference: MK considers bill to bar smoking in vehicles with kids by JUDY SIEGEL-ITZKOVICH, The Jerusalem Post, 8/25/2009.

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More evidence - vehicles most dangerous space for second-hand smoke inhalation..

August 25, 2009 - Every parent wants their children to lead healthy and happy lives. There's an abundance of evidence that children are more susceptible to the negative effects of second-hand smoke (SHS, ETS, environmental tobacco smoke, involuntary smoking, sidestream smoke, passive smoking). As pointed out by Action on Smoking and Health (ASH) Australia in a February 2009 paper the evidence of second-hand smoke harm to children in enclose spaces is extensive and irrefutable. A Harvard School of Public Health report indicated that secondhand smoke in cars (auto, automobile, vehicle) can be up to 10 times more of a health risk than secondhand smoke in a home.

Vehicles have been found to be the most dangerous space for second-hand smoke levels. Kids exposed to smoke are at higher risk since they breathe in more air by weight than adults. Both the respiratory rate and heart rate are higher in children below the age of 13 than in adults. The younger the child, the greater the potential for exposure. Since the lungs of children are still developing, exposure to second-hand smoke can lead to ear infections, asthma, bronchopneumonia and other illnesses.

A Johns Hopkins School of Public Health study now provides further evidence on SHS exposure levels supporting smoke-free vehicles when passengers are present. The study, compared nicotine levels in the cars of 17 smokers and five nonsmokers whose commute to and from work took 30 minutes or longer. The researchers placed airborne nicotine samplers in the cars, one near the front passenger seat headrest and another in the back seat behind the driver. The researchers then analyzed the samples and found a twofold increase in concentrations of nicotine for every cigarette smoked. The authors estimate that nicotine concentrations are twice as high in smokers' cars as in other public and private places studied, and 40 percent to 50 percent higher than in restaurants and bars that allow smoking. "While partially opening windows reduced exposure to secondhand smoke it did not eliminate exposure within motor vehicles," co-author Patrick Breysse said. "It is important to remember that there is no known safe level of exposure to secondhand smoke."

People in the study also completed a questionnaire that included questions on their knowledge and attitudes about the health risks of secondhand smoke and relevant regulations and legislation. Both smokers and nonsmokers said smoking in a car posed a health risk to passengers. Among smokers, 53 percent said not being able to smoke in the car would help them to quit, and 93 percent said cars should be smoke-free voluntarily. Only 7 percent of smokers said there should be laws outlawing smoking in cars.

Breysse stated: "Results of this research and other studies can be used to develop education campaigns aimed at eliminating secondhand smoke exposure in motor vehicles. In addition, these results can be used to support legislative efforts aimed at banning smoking in vehicles, particularly when children are present."

PAPER: Secondhand tobacco smoke concentrations in motor vehicles, Miranda R Jones, Ana Navas-Acien, Jie Yuan, Patrick N Breysse, Johns Hopkins Bloomberg School of Public Health, Published Online First: 25 August 2009. ABSTRACT...

Dr. Norman H. Edelman, chief medical officer of the American Lung Association, said "all those people who smoke in cars and think they are protecting the passengers by using AC [air conditioning] or opening the window are wrong and potentially impairing their passengers' health." Matthew L. Myers, president of the Campaign for Tobacco-Free Kids, called the new study "a rude wake-up call -- cars literally become toxic gas chambers." Myers also believes that laws banning smoking in cars are needed. "It is appropriate and necessary to ban smoking in cars where children are passengers," he said. "Children are not volunteers in cars. This is a more intense, more dangerous exposure to kids than in any other location."

Reference: Smokers' Cars Loaded With Nicotine Levels twice those found in places that permit smoking, study suggests by Steven Reinberg - HealthDay Reporter, Alegent Health, 8/24/2009.

Some related news briefs:
New South Wales politician smoking comment totally inaccurate..;
World Asthma Awareness Day..;
Further evidence - STOP smoking in the presence of your children..;
Ireland - ban smoking in cars when kids are present..;
Ontario law banning smoking in cars with children takes effect ..;
Maine - illegal to smoke in cars while children present..;
Ban on smoking in cars when children are present..;

Click on image to enlarge..
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India - university smoking ban - need for enforcement..

August 25, 2009 - World Lung Foundation-South Asia, spearheads the Delhi University (DU) Smoke Free Initiative. The list of 14 “smoking dens” in DU was released on Monday, August 24th along with an announcement that the initiative would now be extended to all 83 colleges in the university. The “Delhi School of Economics (DSE) was at least 10 per cent worse than the next den, which is the Law Faculty canteen.”

The DU Vice-Chancellor Deepak Pental said, “Deputy Commissioners of Police of all districts must ensure strict implementation of the law banning sale of tobacco products within 100 yards of college campuses. We are also exploring the possibility of appointing nodal officers of the project as enforcement officers for their respective college or department.”

Tobacco use is the smoking gun in 900,000 deaths annually in India, and the numbers are on the rise as the nation grapples with its epidemic-scale cigarette addiction, reports the BBC. At least 1 million Indians will die annually from smoking-related illnesses in the next decade unless the nation takes action soon, warns a new study in the New England Journal of Medicine.

India a nation of nearly 1.2 billion people has roughly 120 million Indian smokers, cigarettes and hand-rolled bidi will soon account for 20% of all male deaths and 5% of all female deaths between the ages of 30 and 69. An estimated 102 billion cigarettes are sold every year.

In an effort to clamp down on a this tobacco epidemic, the government put in action on October 2, 2008 a smoking ban that carries a fine of 200 rupees (£2.40) – more than the average person’s daily wage. The health minister who championed the ban, Anbumani Ramadoss, has said that those wishing to keep up the habit will “have to smoke in the streets”. This smoking ban was the government's second try in four years. (India introduces public smoking ban by Andrew Buncombe in Delhi, The Independent.co.uk, 10/2/2008.

Reference: Smoking: DSE worst on list, Deepu Sebastian Edmond, ExpressIndia.com, 8/25/2009.

India - related news briefs: Mumbai, India - NGO activists want closure of hookah bars..; India - gutkha and bidi companies NOT pictorial warnings..; India - cigarette packs with pictorial warnings are here..; ndia - NO graphic pictorial warnings yet..; India - Still no pictorial warnings on cigarette packs..; India - pictorial warning on cigarettes and tobacco products effective May 31, 2009..; India - pictorial warning on cigarettes and tobacco products will be implemented from May 31 - no doubts about it..; India - will pictorial or graphic health warnings be implemented from May 30, 2009..; India - placing pictorial warnings on tobacco products delayed again..

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England - smoking a shisha pipe just as bad as smoking tobacco..

August 24, 2009 - Shisha (hookahs, argileh, nargile, hubble-bubble, water pipe, hooka, goza, meassel, sheesha)is an Arabic water-pipe in which fruit-scented tobacco is burnt using coal, passed through an ornate water vessel and inhaled through a hose.

The Department of Health and the Tobacco Control Collaborating Centre has found that smoking a shisha pipe is as bad for people as smoking tobacco,

People who smoke shisha, or herbal tobacco, can suffer from high carbon monoxide levels, its research revealed. It found one session of smoking shisha resulted in carbon monoxide levels at least four to five times higher than the amount produced by one cigarette. High levels of carbon monoxide can lead to brain damage and unconsciousness.

The Department of Health said it was difficult to know exactly how much carbon monoxide one cigarette produced, due to the differences in smokers' inhalations.

CO LEVELS - PARTS PER MILLION
Normal level: 3 ppm
Light smoker: 10-20 ppm
Heavy smoker 30-40 ppm
Faulty boiler/fire levels: Upwards of 100 ppm
Severe symptoms: 100 ppm
Lethal levels: More than 300 ppm

But measuring carbon monoxide in exhaled breath showed a normal non-smoker's level to be three parts CO per million parts of air (ppm) (less than 1% of blood not working properly), a light smoker to have 10-20 ppm (2-4% of blood not working properly), and a heavy smoker 30-40 ppm (5-7%).

The study found shisha smokers had 40-70 ppm of CO in their breath - affecting 8-12% of their blood. Dr Hilary Wareing, director of the Tobacco Control Collaborating Centre, told the BBC's Asian Network she was shocked by the results of the research.
"Our mouths opened at the level of harm - none of the tests we did showed anything other than shisha is hazardous to health."

Paul Hooper, regional manager at the Department of Health, said the findings made the dangers of shisha a "major issue". He said many people regard shisha "as not even smoking".

Shisha bars, which are typically decked out with low stools and soft cushions to create an inviting atmosphere, have become popular in cities across the United Kingdom (UK), particularly in London, Manchester and Birmingham.

At the worst, shisha was 400 to 450 times more dangerous than having a cigarette Dr Hilary Wareing Tobacco Control Collaboration Centre.

An activity largely associated with Middle Eastern customers and a young crowd, there is a growing trend of themed shisha parties. Many people who go to "shisha evenings" think it is a safer alternative to smoking cigarettes. "You never see it in the news - 'that is terrible, don't do it' - there's no shock tactics like (there is with) cigarettes," said one young woman. "If my mum sees me smoking shisha, she isn't going to take it as seriously as if I was smoking cigarettes," said a British Pakistani man.

It was this misconception - and finding dangerous levels of carbon monoxide in a pregnant woman who had stopped smoking tobacco, but continued to smoke shisha - which prompted the research.

Researchers have found that hookah smokers inhale more often and for longer periods than typical cigarette smokers. Scientists estimate that by puffing longer and in greater volume, a waterpipe smoker inhales the equivalent of 100 cigarettes or more during a single waterpipe session. (Dangers of hookah (waterpipe) smoking - Harvard Mental Health Letter..)

Edgware Road is home to a large number of shisha cafes or hookah bars. Shisha smokers in a cafe in Edgware Road, London, said the findings would make them think twice about smoking. "You know you can die from cigarettes, but you don't know you can die from shisha," said one.

Akram, a 27-year-old who runs a restaurant and shisha bar in Birmingham, has his own views. "There is a health risk but it's all down to consumption and all the evidence I've seen is that smoking shisha is nothing like smoking even one cigarette," he said. He said he did not actually inhale shisha smoke.

It is not just the level of carbon monoxide that is causing concern. Qasim Choudhory, a youth worker at the NHS Stop Smoking Service in Leicester, said sharing a shisha pipe could pass around infections. "There's a heightened risk of getting TB, herpes and infections like that," she said. "Now you know swine flu is on the top of the agenda right now - there's no kind of direct correlation, but at time when we're up on our hygiene, it's not the best type of activity to be taking part in."

Dr Wareing said more research on exactly how dangerous shisha was needed to be conducted to enable people to make an informed choice. Paul Hooper said the department was working hard at "how best to get the message - that it is dangerous - across to the consumer". "But how do you label the tobacco and the shisha pipe? It's not as simple as labeling a packet of cigarettes," he added.

The "Trouble with Hubble Bubble" broadcast on the BBC's Asian Network can be heard by clicking on the title and then click on the word LISTEN on page displayed.

Reference:
Shisha 'as harmful as cigarettes' by Perminder Khatkar, BBC Asian Network, 8/24/2009.

A few related news briefs: Mumbai, India - NGO activists want closure of hookah bars..; England - Shisha bars still open if comply with the smokefree legislation..; Hookah is worse than smoking cigarettes..; Sheesha (Shisha, Hookah, Narghile, Waterpipe) As Harmful as Cigarettes, says Expert..; Dangers of hookah (waterpipe) smoking - Harvard Mental Health Letter..; Hookah smoking popular among college crowd...

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Hong Kong - tobacco smokers may be prone to developing life-threatening complications from swine flu,..

August 24, 2009 - Smokers may be prone to developing life-threatening complications from swine flu, according to patient data from Hong Kong, where tobacco use was noted in almost half of severe cases.

Twelve of 27 swine flu patients who developed pneumonia and other serious illnesses were either current or former smokers and some had no other known risk factors, Thomas Tsang, acting controller of Hong Kong’s Centre for Health Protection, told a medical meeting in Beijing yesterday, August 23rd. “The proportion of smokers among the serious cases is pretty high,” Tsang said in an interview. “So far this is just one observation that stands out and we need to investigate it.”

Tsang’s findings may shed more light on a mystery that doctors are grappling with: why the new flu remains mild for a majority of people and is severe enough to kill in others. Worldwide, about 1,800 people infected with H1N1 have died since the virus was discovered in April.

In Hong Kong, about 1 in 200 people who tested positive for swine flu developed severe disease, with some needing weeks of intensive-care treatment. About 13 percent of adults in the city smoke, Tsang said at a meeting on influenza over the weekend organized by the Lancet medical journal, China’s health ministry and the World Health Organization.

As drugmakers race to make vaccines to fight the pandemic, health officials are trying to identify vulnerable groups in order to prioritize who should get immunized first.

In Hong Kong, three-quarters of H1N1 patients with serious disease had medical factors that made them more susceptible, Tsang said. Chronic lung conditions such as asthma and emphysema, as well as diabetes, cardiovascular disease, morbid obesity and pregnancy, can put people at risk. Smoking might be linked with one or more of these factors, according to Tsang. “Smokers tend to have poorer lung function and smoking is also associated with some other chronic diseases,” Tsang said. “It could be those factors that explain the association rather than smoking per se.”

Smoking is the biggest preventable cause of death and claims 4.9 million lives a year globally, according to the WHO. The habit is also the leading cause of illness and premature deaths in Hong Kong, according to a statement on the city- state’s Tobacco Control Office Web site. An estimated 5,500 deaths a year result from smoking, the agency said.

Nicotine, the addiction-causing chemical in tobacco, interferes with the immune response to seasonal flu, said John Mackenzie, a Melbourne-based virologist who studied the interaction in mouse models more than 30 years ago. “Smoking is interesting,” Mackenzie said in an interview in Beijing yesterday. “It initially enhances the immune system, but then it depresses it. If you smoke, you become much more susceptible to straight viral pneumonia.”

By impeding the body’s defense mechanisms, smoking may enable the virus to replicate undetected for longer and invade more of the respiratory tract, said Frederick Hayden, professor of clinical virology at the University of Virginia School of Medicine in Charlottesville, in an interview yesterday. “There are some epidemiologic observations to show that smokers have a more serious illness from seasonal influenza,” he said. “Some of these factors have been recognized in the past, and I think we’re seeing them reaffirmed. I’d be surprised if it didn’t eventually turn out to be a risk factor.”

The pandemic strain may have a greater predilection than seasonal flu for infecting the lungs, where it can cause viral pneumonia, said Stephen Toovey, a senior research fellow at London’s Royal Free and University College Medical School. It’s possible bad luck and a person’s genetics may also play a role, Toovey said in an interview in Beijing. Taking a deep breath or yawning immediately after an infected person nearby coughs or sneezes could enable large amounts of airborne viral particles to reach the lower branches of the airway, he said. “It could be that if you do get enough virus by whatever route into the lower respiratory tract, you are more likely to have severe disease than you would with, say, a seasonal virus,” Toovey said.

Toovey: researchers are studying whether certain genetic flaws hamper the so-called early innate immune response, giving the virus an advantage over the body’s defenses.

Reference: Smokers Risk Swine Flu Complications Like Pneumonia, Data Show by Jason Gale (j.gale@bloomberg.net), Bloomberg.com, 8/24/2009.

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