Smokers with financial stress are more likely to want to quit but less likely to try or succeed: findings from the International Tobacco Control (ITC) Four Country Survey

Abstract

Objective: To examine the association of financial stress with interest in quitting smoking, making a quit attempt and quit success.

Design and participants: The analysis used data from 4984 smokers who participated in waves 4 and 5 (2005-07) of the International Tobacco Control (ITC) Four Country Survey, a prospective study of a cohort of smokers in the United States, Canada, the United Kingdom and Australia.

Measurement: The outcomes were interest in quitting at wave 4, making a quit attempt and quit success at wave 5. The main predictor was financial stress at wave 4: '. . . because of a shortage of money, were you unable to pay any important bills on time, such as electricity, telephone or rent bills?'. Additional socio-demographic and smoking-related covariates were also examined.

Findings: Smokers with financial stress were more likely than others to have an interest in quitting at baseline [odds ratio (OR): 1.63; 95% confidence interval (CI): 1.22-2.19], but were less likely to have made a quit attempt at follow-up (OR: 0.74; 95% CI: 0.57-0.96). Among those who made a quit attempt, financial stress was associated with a lower probability of abstinence at follow-up (OR: 0.53; 95% CI: 0.33-0.87).

Conclusions: Cessation treatment efforts should consider assessing routinely the financial stress of their clients and providing additional counseling and resources for smokers who experience financial stress. Social policies that provide a safety net for people who might otherwise face severe financial problems, such as not being able to pay for rent or food, may have a favorable impact on cessation rates.

Source: Siahpush, M. et al., Addiction, 12 May 2009
Link: http://tinyurl.com/nfpnaz

Scotland: Fines for adults who buy cigarettes for children

Adults who buy cigarettes for under age youngsters could be fined under tough new laws to stub out the habit among children. Scottish ministers have revealed that they are considering bringing in new penalties for those caught buying tobacco for under-18s.

Public Health Minister Shona Robison told Holyrood’s health and sport committee that she would consider extending its new anti-tobacco legislation.

Committee member Michael Matheson said: “It’s an offence for someone to actually purchase alcohol and pass it on to someone who is under the age of 18, but there’s not a similar approach to tobacco.”

Ms Robison told him: “I’m happy to consider amending the Bill to include this provision.”

Source: Scottish Daily Express, 11 June 2009
Link: http://tinyurl.com/mw6jcn

PQ: Health Bill

Dr. Stephen Ladyman (South Thanet, Labour): To ask the Secretary of State for Health what recent discussions he has had with the Secretary of State for Business, Enterprise and Regulatory Reform on the provisions contained in Part 3 of the Health Bill [Lords] and the likely cost of their implementation.

Gillian Merron (Parliamentary Under-Secretary, Foreign & Commonwealth Office; Lincoln, Labour): All relevant provisions in Part 3 of the Health Bill were cleared through the usual processes across Government, including with the Secretary of State for Business, Enterprise and Regulatory Reform. The Department continues to work closely with the Department for Business, Enterprise and Regulatory Reform on the Bill’s provisions, in particular to ensure regulations are developed that will enable cost-effective solutions to be used to remove tobacco displays. Relevant provisions are supported by full impact assessments.

Hansard Source 09/06/2009 Column 383W

Dr Ladyman: To ask the Secretary of State for Health which organisations he plans to consult on the provisions contained in Part 3 of the Health Bill [Lords].

Gillian Merron: We intend to work closely with a wide range of interested stakeholders, as appropriate, on the detailed implementation of the provisions in Part 3 of the Health Bill. We are already working with various organisations to develop draft regulations concerning the tobacco provisions. The consultation on the draft regulations will be open to all interested stakeholders and members of the public.
The organisations we will consult include, but are not limited to: the Association of Convenience Stores, the British Retail Consortium, the National Federation of Retail Newsagents, the Local Authorities Coordinators of Regulatory Services, the National Association of Cigarette Machine Operators, the UK Travel Retail Forum, the Association of Independent Tobacco Specialists, the Imported Tobacco Products Advisory Council, the Local Government Association, the Airport Operators Association as well as a number of individual businesses.

Hansard Source 09/06/2009 Column 383W

Dr. Ladyman: To ask the Secretary of State for Health when he plans to publish in draft form the draft regulations provided for under the provisions of the Health Bill [Lords].

Mike O'Brien (Minister of State, Department for Energy and Climate Change; North Warwickshire, Labour): The timetable for preparing and publishing draft regulations which support, where relevant, implementation of the provisions in the Bill will vary and depends on a range of different factors concerning each provision. We aim to publish draft regulations on the tobacco provisions as soon as possible, subject to the passage of the Health Bill through Parliament. This would give businesses adequate lead-in time before regulations commence.

Hansard Source 09/06/2009 Column 837W

Stephen Ladyman: To ask the Secretary of State for Health if he will place in the Library a copy of (a) his recent letter regarding the potential costs of compliance with Part 3 of the Health Bill [Lords] sent to retailers and (b) his Department's analysis upon which such estimates were based; and what plans he has to issue further guidance to retailers on the means by which compliance may be achieved prior to the enactment of legislation.

Gillian Merron: The letter relating to the tobacco provisions of the Health Bill sent from Baroness Thornton to the National Federation of Retailers and Newsagents dated 6 May 2009 has been placed in the Library. The letter contains information on the potential costs of removing tobacco displays, including cost estimates provided to the Department from a Canadian company with experience of providing solutions to remove tobacco displays in Canada. Further detail of the analysis of estimate costs of removing tobacco displays, and other measures contained in the Health Bill, can be found in the impact assessment produced by the Department, copies of which are available from the Vote Office in the House of Commons or from the Department's website.

The Department is committed to working with retail organisations such as the Association of Convenience Stores, the British Retail Consortium and the National Federation of Retail Newsagents, along with the Local Authorities Coordinators of Regulatory Services, to develop and distribute guidance to business with regard to regulations on tobacco displays.

Hansard Source - 09/06/2009 Column 836W

Source: Hansard

Pakistan: Landmark decisions for tobacco control

The government has reduced the tobacco industry to the size of a pygmy in Pakistan by announcing immediate rollback of the controversial Statutory Regulatory Order (SRO) on Designated Smoking Areas (DSAs) and making the printing of pictorial health warnings on cigarette packs and outers mandatory with effect from January 1, 2010. The government also prohibited the tobacco companies from offering free giveaways, cash rebates or discounts as a marketing incentive. It also announced to make Pakistan Railways smoke-free from July 1, 2009.

Minister for Health Mir Aijaz Hussain Jakhrani made these surprise announcements at a seminar organised in connection with World No-Tobacco Day 2009 (WNTD). By doing so, the government not only added a golden chapter to the history of tobacco control efforts in Pakistan but also regained its lost glory in the international health community, which felt the pinch of the country's pro-tobacco industry posture just as much as anti-tobacco campaigners at home.

Pakistan shocked health experts at home and abroad on September 6, 2008 when it issued the controversial SRO containing guidelines for the establishment of designated smoking areas (DSAs). No other decision of the Ministry of Health has triggered as much media criticism as the said SRO. Even though the Ministry took a long time to realize that a fault denied is twice committed, it still deserves commendation for finally demonstrating-through solid actions-its resolve to undo mistakes of the past by prioritising the health and well-being of the people of Pakistan.

In fact, the government went a step ahead by recognising the importance of this year's theme of World No-Tobacco Day and making it mandatory, with effect from January 1, 2010, to print pictorial health warnings on cigarette packs and outers. "We realize that in view of our low literacy rate, people need to be warned of the health risks of smoking through graphic representations," Jakhrani stated. He also said that heavy penalties would be awarded to tobacco companies that offer any kind of marketing incentives to promote sales. "With effect from July 1, 2009, no tobacco company will be allowed to offer goods, cash rebates, or discounts as a marketing incentive," he stated.

Jakhrani also announced that all railway trains will be smoke-free from July 1, 2009. "We have worked out an action plan with the Ministry of Railways towards this end," he informed. After Pakistan International Airlines, Pakistan Railways will be the second public transport organisation to become smoke-free. He also promised to work on enforcement of the Prohibition of Smoking Ordinance by prohibiting smoking in all public places including government and public offices, restaurants, airports and railway stations, etc.

Source: The International News, 01 June 2009
Link: http://tiny.cc/aSdvU

Name change for Henri Wintermans Cigars

Henri Wintermans Cigars has announced that it will be adopting the name of its parent company and trading as the Scandinavian Tobacco Group United Kingdom Limited, taking affect from 12th June 2009. 

One of Europe's principal cigar companies and No.3 worldwide, the Scandinavian Tobacco Group purchased Henri Wintermans in 1996, to market its wide portfolio of leading brands, most notably Café Crème and Founders Blend.

Huw Williams, Managing Director, comments: "The decision to change our corporate identity has been taken as part of Scandinavian Tobacco Group's global strategy to trade as one clearly defined entity in all key markets."

Source: Talking Retail, 04 June 2009
Link: http://tinyurl.com/lsbxou

Lebanon: A smoker's paradise

Want to indulge in a guilt-free tobacco experience? Then head to Lebanon, a smoker's paradise where you can work, dine and have your hair styled in a cloud of smoke. The anti-smoking lobby is barely a blip on the radar and the government cares little about the issue.

So the price of Cuban Havanas is among the world's cheapest, cigarettes are free of punitive pricing and health warnings are barely visible on the side of packs - far from the bold warnings and pictures the World Health Organisation (WHO) promoted on World No Tobacco Day. Even teenagers can afford the average one dollar per pack, compared to an average seven dollars (five euros) in France or nearly nine dollars in Britain.

George Saade, a cardiologist and head of the tobacco control unit at the ministry of health, noted: "The Lebanese government is doing nothing as far as tobacco control is concerned," partly attributing lax enforcement to a rocky political situation. He said his unit, located in two small offices at the ministry, barely has a 20,000-dollar annual budget, a drop in the bucket compared to the millions available to the tobacco industry.

"Tobacco companies are very powerful in this country and they are involved in many things that would raise concerns of conflict of interest elsewhere," Saade said. "They sponsor concerts, television shows and sports events where free cigarettes are sometimes distributed. You even see them at ski resorts," he added. "Where there are youths, there are tobacco companies."

Ironically, some of the local companies that market cigarettes are also the agents for cancer-fighting drugs. Most worrisome is a growing trend of narghile, or water pipe, smokers, especially among teenagers who wrongly believe it is less harmful to their health than cigarettes, experts say. "We are facing every day new evidence about narghile smoking, which is spreading among all age groups but more specifically among youths," said Rima Nakkash, an American University of Beirut professor who is doing research on the issue.

She said according to a 2005 survey carried out by WHO, 60 percent of youths in Lebanon aged between 13 and 15 smoke cigarettes, narghile or cigars, the highest number in the region. Overall, an estimated 42 percent of males and 30 percent of females smoke in Lebanon, a country of 4.5 million inhabitants, health experts say.

"The tobacco industry has recognized the Middle East as one region of the world which has the least restrictive regulations compared to other countries, even in Asia," Zaatari said. "So sometimes they use countries like Lebanon as dumping grounds for products they are unable to bring into other countries. And they are particularly interested in young people because once you're hooked, you're hooked for life," he added.

Zaatari also noted that although Lebanon signed WHO's Framework Convention on Tobacco Control in 2005 it has failed to ratify the document and has shown little interest in enforcement. For example a survey conducted at 40 restaurants nationwide in coordination with the Harvard School of Public Health showed that air quality in such establishments was, on average, hazardous by WHO standards. "The thing with Lebanon is we are behind 20 or 30 years as far as tobacco control but we can learn from the experience of other countries," Nakkash said. "We can learn how they failed and succeeded. It's not like we are drawing up a nuclear strategy."

Source: Middle East Online, 30 May 2009
Link: http://tinyurl.com/kj2ljy

Imperial Tobacco enhances customer relationship management

Imperial Tobacco is upgrading its customer relationship management (CRM*) platform to improve visibility and efficiency of its retail relationships. The multinational tobacco firm has been working on the replacement of its legacy version of Oracles Siebel software since September last year and expects to complete the project by the end of this year.

Ahead of the CRM software upgrade, Imperial Tobacco has also rolled out a new generation of Fujitsu pen tablet PCs following a nine-week trial with other vendors including Dell.

With the devices, sales staff can access information from the CRM platform while on the move. The version loaded on the tablet PCs is the legacy system, so the company expects to fully benefit from the hardware functionality once the software is upgraded.

"We expect our sales reps to be able to capture information on clients a lot faster once the upgrade is complete," said Mohammed Jassat, UK salesforce systems co-ordinator at Imperial Tobacco.

* Customer relationship management (CRM) consists of the processes a company uses to track and organize its contacts with its current and prospective customers. CRM software is used to support these processes; information about customers and customer interactions can be entered, stored and accessed by employees in different company departments. Typical CRM goals are to improve services provided to customers, and to use customer contact information for targeted marketing. (Wikipedia)

Source: Yahoo News, 11 June 2009
Link: http://tinyurl.com/ntec9r

WHO says shocking images deter cigarette smokers

Cigarette packages should show graphic images of yellow teeth, blackened gums, protruding neck tumours and bleeding brains to alert smokers to their disease risks, according to the World Health Organisation. More than 20 countries, including Britain, Iran, Peru and Malaysia, already use visual warnings on their tobacco products, the head of the WHO's Tobacco Free Initiative said.

"Although some people question the need for such pictures, the evidence is absolutely clear that they convince people to quit," said Douglas Bettcher, Director of the World Health Organisation’s Tobacco Free Initiative. Bettcher pointed to a warning that read "smoking causes brain strokes" and showed blood oozing from a brain. He has called for such images to be printed on all tobacco product packages and on tags to water pipes that are popular in the Middle East. Bettcher added that the "disgust, fear, sadness or worry" from the warnings can discourage smoking.

The WHO, which requires all its staff to be non-smokers or to agree to try to quit, has been campaigning for more than two decades to discourage smoking and fight efforts by big companies such as Philip Morris International, Imperial Tobacco, Japan Tobacco and British American Tobacco to attract new customers. Bettcher said the tobacco industry opposed visual warnings, viewing them as a threat to profits.

Tobacco is the world's leading preventable cause of death, killing more than 5 million people a year, the WHO says, Around 80 percent of smokers live in developing countries, where smoking rates have risen sharply in recent years alongside a ramping-up of tobacco marketing and production in poorer states, Bettcher said.

In addition to package warnings, the WHO supports bans on tobacco marketing and sponsorship, prohibitions of smoking in public buildings, and high taxes on tobacco products. The recent emergence of designer cigarette pack-holders and other accessories to cover up health warnings showed the warnings were having an impact, Rob Cunningham of the Canadian Cancer Society said. "That is a good indication, because smokers are noticing enough that they feel that they must not look at them," Cunningham said.

For images from the WHO's World No Tobacco Day campaign, see: www.who.int/tobacco/wntd

Source: Yahoo News, 29 May 2009
Link: http://tinyurl.com/mg44hj