ASH Daily News for 18 June 2008

Widespread support for smoking ban

Most people continue to support the UK-wide smoking ban, reveals a report published today by the Office for National Statistics (ONS). Eighty per cent of respondents taking part in the 2007 Omnibus Survey said they agreed with the legislation banning smoking in enclosed public places. Sixty one per cent strongly agreed and 19 per cent agreed. A further 14 per cent disagreed with 6 per cent disagreeing strongly.

Almost three quarters of people tend to visit the pub as often as they did before the smoking ban (73 per cent) with 16 per cent reporting that they now go more often. The remaining 11 per cent said they went less often than before the smoking ban. Those in employment were also less likely to experience smoking in the workplace. Ninety-three per cent said that smoking was banned in the building where they worked. In particular 31 per cent reported that no smoking was allowed on the premises or the grounds where they worked.

There has also been a drop in the number of people allowing smoking in their home. Approximately two-thirds (67 per cent) said that smoking was not allowed at all in their home compared to 61 per cent in 2006. Awareness of the effects of second-hand smoking was widespread. Respondents thought that a child’s risk of getting chest infections (91 per cent) and asthma (85 per cent) were increased by living with a smoker. Seventy-nine per cent of smokers said they did not smoke at all when they were in a room with a child and 13 per cent said they would smoke fewer cigarettes in the presence of a child. Nearly all (94 per cent) of respondents agreed there should be smoking restrictions in place where there are, or are likely to be, children under the age of 16.

The awareness of the effect of second-hand smoke on adults increased in 2007 compared to previous years. More than 80 per cent thought that second-hand smoking would increase a non-smoking adult’s risk of lung cancer, bronchitis and asthma. Today's report presents the results of the 12th survey of smoking behaviour and attitudes, carried out by ONS for the NHS Information Centre for health and social care.

Source: Office for National Statistics News Release, 18 June 2008
Link: http://tiny.cc/eDcez

Smoking and poverty blamed as cancer kills 20 per cent more in the North

People living in the North of England have a 20 per cent higher chance of dying from cancer than those living elsewhere, according to new evidence underlining stark divides in the nation's health. Deaths due to various forms of cancer are significantly higher in the North, a major report concludes today, with higher rates of smoking, unhealthy lifestyles and poverty likely to be at the root of the problem. There were, on average, 380 cases of cancer — and 182.3 deaths — for every 100,000 people in England, the latest figures show.

But the mortality rate was much higher in the North, rising to 215.9 deaths per 100,000 in Merseyside and parts of Cheshire, while a large swath of the country, from Manchester to the Scottish border, also reported above-average death rates. Overall, deaths from cancer were lowest in the South of England and the Midlands, figures from 30 regions showed. The figures are from the first report of the National Cancer Intelligence Network (NCIN), a new body commissioned last year to collate information on 20 different forms of cancer.

The incidence of many forms of the disease was found to be higher in the South of England, suggesting that it is diagnosed early as a result of patients attending screening tests or picking up warning signs more regularly. Ministers have recently extended a target to reduce the “postcode lottery” of health inequalities in England by 10 per cent within two years, as measured by infant mortality and life expectancy at birth. But while the UK overall is enjoying longer life expectancy and lower cancer mortality, the North of England still suffers poorer health than the South “in almost all cases”, the Government's Health Profile of England, concluded last year.

Experts believe this North-South divide is due to a number of factors, especially higher smoking rates in the North, which are linked to increased risks of smoking-related cancers. For example, 68 per 100,000 men in the North of England died from lung cancer in 2005, compared with the England average of 51. The Surrey, West Sussex and Hampshire area had the lowest rate of deaths from lung cancer, with about 36 men in every 100,000 dying from the disease.

When differences in regional populations were taken into account, the risk of dying from any form of cancer was a fifth greater in the North than elsewhere. While lung cancer remains the biggest killer among cancers in men across England, the most commonly diagnosed cancer in each of the 30 regions was prostate cancer. An average of 97 men in every 100,000 were found to be suffering from it in 2005 compared with 60 for lung cancer, but there were no clear geographic patterns in the incidence of prostate cancer.

In women, breast cancer was the most commonly diagnosed cancer, with the South having the highest rates. But the highest mortality rates in women varied across the country, with lung cancer deaths more common in the North and breast cancer in the South. Mike Richards, the Government's national cancer director, said that certain differences could be caused by varying levels of prosperity. “In the north of the country, even though breast cancer rates of women are high, more women die of lung cancer. That's a reflection of higher levels of smoking in more deprived areas,” he said.

“It goes in an opposite direction with breast cancer. Affluent women often tend to delay childbirth, and having children older may slightly increase the risk of the disease. Furthermore, an increasing proportion of breast cancer is being detected through screening. There is some evidence that women in more affluent areas are more likely to attend screenings.”

David Forman, of the University of Leeds, an information and analysis leader for the NCIN, said: “These figures show us that some of the past trends aren't changing - cancer death rates remain higher in the North than the rest of England. “Smoking is responsible for nearly nine in ten cases of lung cancer. More people in the North smoke, and this explains why lung cancer rates are so much higher.

“There are also higher levels of deprivation in the North, which could contribute to cancer risk through other means — we know that deprivation is linked to later diagnosis, which can affect mortality.” The emergence of prostate cancer as the most common cancer in men, could be due to a general decline in smoking rates and more men asking their doctor for a prostate specific antigen test to spot the early signs, Professor Forman added.

Source: The Times, 18 June 2008
Link: http://tiny.cc/tUYGQ

US medical association refuses to challenge controversial menthol exemption in tobacco bill

The country's largest organization of doctors yesterday refused to challenge a controversial tobacco bill that would ban many flavor additives in cigarettes sold in the United States but exempt menthol flavoring. Under a bill before Congress that gives control of tobacco products to the Food and Drug Administration, flavor additives such as mint, clove and vanilla, which appeal to young people, would be banned, but menthol flavoring would be allowed.

Menthol is preferred by more than 75 percent of black smokers, according to government estimates. Fewer than 25 percent of whites smoke it. The menthol exemption has been challenged by many prominent health figures including seven former health secretaries who sent a letter to lawmakers voicing opposition to the menthol exemption. "If we're banning things such as clove and peppermint, then we should ban menthol," said Dr. Louis Sullivan, health secretary from 1989 to 1993 under President George H.W. Bush. "If it doesn't happen, this bill will be discriminatory against African-Americans."

But in this case, the AMA voted Tuesday to refer the decision on menthol to its board, effectively silencing doctors who wanted the organization to speak out against the exemption. The reason is that the menthol exemption helped congressional leaders reach a bipartisan compromise on legislation that would put cigarettes under government regulation. Supporters say it would give the FDA authority to reduce harmful ingredients in cigarettes, require new health warnings and bar misleading labels such as "light" and "mild."

Dr. Ron Davis, a preventive medicine specialist who is wrapping up his one-year term as president, said removing the menthol exemption from the bill might derail the legislation. And while other flavor additives are aimed at luring young smokers, menthol is different, he said. Banning it would merely drive mature black smokers to other brands, said Davis.

Menthol cigarettes such as Kool were marketed during the 1960s in advertising campaigns targeting urban blacks, according to the National African American Tobacco Prevention Network. That group withdrew its support from the tobacco control bill last month over the menthol exemption and found allies in the former health secretaries. The exemption harms the black community, said Robert McCaffree of the American College of Chest Physicians. He noted that cigarette maker Philip Morris USA supports the bill and the exemption.

William S. Robinson, executive director of the African American Tobacco Prevention Network, said the group believes a superior tobacco control bill could be crafted without the support of Philip Morris, which makes several menthol brands. "We understand from an industry perspective why menthol is off the table," Robinson said. "We think part of it is because menthol represents almost 30 percent of the $70 billion U.S. cigarette market."

Philip Morris spokesman Bill Phelps said the bill would give the FDA authority to remove ingredients that are determined harmful to health. "Based on our scientific judgment, menthol does not increase the inherent hazards of smoking," Phelps said.

Source: International Herald Tribune, 17 June 2008
Link: http://tiny.cc/MZvNp

Ireland: Smoking on rise again

Smokers are on the increase in Ireland despite the introduction of the ban on lighting up in public places nearly three years ago. The number of smokers reportedly fell from 33 per cent in 1998 to 27 per cent in 2002, but jumped alarmingly to 29 per cent last year, according to a survey published by Ireland’s Department of Health.

Anti-smoking lobbyists ASH Ireland have called for a 50 cent increase in the cost of cigarettes, the removal of all smoking advertising from shops and huge investment in educating young people on the risks of tobacco. ASH Ireland’s Professor Luke Clancy said he was concerned the study showed 56 per cent of women, aged 18-29, and from the two lowest socio-economic brackets, were smoking.

The Survey of Lifestyle, Attitudes and Nutrition (SLÁN) found half of the population described their health as “excellent” or “very good” with only three per cent describing it as “poor”. However, a sharp decrease was recorded in the numbers who reported “risky drinking” or having six or more standard drinks at least once a week. This figure dropped from 45 per cent in 2002 to 28 per cent last year.

Source: The Irish World, 18 June 2008
Link: http://tiny.cc/DA4kr

French smokers abandon bars, clubs and restaurants for private parties

Smokers in France are uniting to beat a ban on lighting up in public by organising open-house parties where they can puff on their Gauloises until the early hours. The parties, held in flats and houses but also in clandestine clubs, often draw dozens of people for a drink, a chat, a dance and a cigarette. Some are paying, others are free, but all welcome the smokers who are deserting bars, bistrots and night clubs.

The movement has flourished since the introduction of a smoking ban in all public places on January 1, and has been compared to the speakeasies that secretly served alcohol during the Prohibition in the US in the 1920s. Internet networks have sprung up to link the partygoers and inform them of planned festivities. One such network was created on Facebook by a 30-year-old Gauloises-smoking DJ who gives his name only as Shandor. “We set up the group because of the smoking ban,” he told The Times. “It was clear to us that it was going to be very complicated to go to a nightclub now. “A whole evening without a cigarette is very hard — especially when you're drinking — so you're better off at a party.”

The group — Pour le Grand Retour de la Fête en Appart' en 2008 (“For the Great Comeback of Parties in Flats in 2008”) — originally included a few dozen people. Now it has 1,182 members. “It's taken off so much that we've had to create a second, secret group,” said Shandor. “You can't really have 1,000 people in a small flat.” His network is free and informal, with members giving the address and date of their parties on the web. But others are more structured. Open Appart', for instance, was set up by a graphic designer who holds monthly gatherings for well-connected Parisians in a 50 square metre flat in the centre of the city.

“I got an invitation on the internet from a friend of a friend,” said Antoinette, 60, a teacher. “It's friendlier than cafés, you can smoke and it's not so expensive.” In another initiative, a chef in south Paris has set up an unofficial restaurant at his home where diners — attracted by word of mouth — can eat and “have a fag without having to go outside”, according to Le Parisien newspaper.

Vincent Grégoire, artistic director at Nelly Rodi, the trend-forecasting agency, said that a dozen or so secret establishments had been formed in Paris since the smoking ban. “They're halfway between public and private — where you only get in if you're invited by an existing member,” he said. “Sometimes you need a password and you have to pay a membership fee. This all existed before but it has really taken off after the smoking ban. People want to authorise for themselves everything that they're not supposed to do.”

France introduced a ban on smoking in the workplace on February 1 last year and extended the measures to its 200,000 bars, cafés and nightclubs 11 months later. They report a drop in custom of between 10 and 20 per cent as a result.

Source: The Times, 18 June 2008
Link: http://tiny.cc/xY9sW