Philippines: Survey finds more than half of Metro Manila citizens inhale second-hand smoke every day

The Center for Health Development - Metro Manila (CHD-MM) and World Lung Foundation (WLF) have published the first results of a survey that shows 52% of Metro Manila citizens are exposed to second-hand smoke every day in workplaces, restaurants and other public spaces. The comprehensive survey of smoking knowledge, attitudes and behavior also revealed that 74% are exposed at least once per week. According to the research, 71% of non-smokers strongly agree that being around smoke upsets them, yet only 8% told smokers to stop smoking around them in the last week. In addition to being upset, people say they know second-hand smoke harms non-smokers. 87% of people said they think smoking causes heart disease in non-smokers, 93% believe it causes lung cancer and 96% believe smoking causes lung disease in children who breathe it. 

"We have to encourage Metro Manilans to complain about their exposure to second-hand smoke to smokers nearby," said CHD-MM Director Irma Asuncion, MD. She added, "We are very pleased to be working with World Lung Foundation on this survey and on other measures that can deliver a clear message that second-hand smoke is deadly."

According to the research, a large majority of smokers and non-smokers in Metro Manila want smoke-free schools (78%), hospitals (77%) and public transportation (69%), according to the survey. Approximately 60% of non-smokers have expressed interest in smoke-free workplaces and more than half of all people surveyed think it should be forbidden to smoke in all public places. 

"The amount of second-hand smoke exposure citizens of Metro Manila face is alarming and there is a clear majority that wants more smoke-free places," said Peter Baldini, Chief Executive Officer, World Lung Foundation. "We commend Center for Health Development - Metro Manila for helping to bring this message to the public and to policy makers." 1,000 adults, ages 18 to 55, were sampled and interviewed with respondents across all soci-economic classes and from all 17 local government units. Door-to-door interviews were conducted between January 29 and February 26, 2009. The research was commissioned by CHD-MM and WLF, and was executed by IPSOS Philippines, Inc. Additional results will be released as the data continues to be analyzed.

Source: Medical News Today, 17 June 2009
Link: http://tiny.cc/Xf5pa

Spain: Imperial, Philip Morris hike tobacco prices

Imperial Tobacco and Philip Morris have both raised the price of their cigarettes in Spain by about 0.35 euro a pack, according to figures published in Spain's state bulletin. Imperial's best-selling Spanish brand Fortuna will now cost 3 euros per pack, while Philip Morris's Marlboro brand will rise to 3.45 euros. The Spanish government has announced tax increases on tobacco and fuel to help pay for massive government spending programmes and counteract sliding revenues. The government said the tax hike would imply only an additional 0.20 euro per pack of cigarettes.

Source: Reuters, 16 June 2009
Link: http://tiny.cc/PLRJd

Ireland: Men more successful at quitting smoking

A report carried out on behalf of the Department of Health shows men are more likely to give up smoking than women. The National Survey of Lifestyle, Attitudes and Nutrition 2007 also found smoking is more common among younger adults. It is the third time this survey, known as the Slán report, has been carried out in Ireland since 1998. It showed smoking rates had decreased from 33% to 27% in 2002, but then crept back up to 29% by 2007.

Men are more likely to smoke than women but are also more successful at quitting. Women are also more likely to fear negative consequences of quitting such as gaining weight. 9% of smokers said they were actively trying to give up, 17% were planning to quit, 33% were thinking about it and 41% were not thinking about it at all. The survey also shows those who smoked were between two and three times more likely to report psychological distress or be assessed as having an anxiety disorder.

Source: RTE News, 16 June 2009
Link: http://tiny.cc/QEl83

New Zealand: Hand-rolled cigarette smoking patterns compared with factory-made cigarette smoking in men

Abstract

Background: Roll-your-own (RYO) cigarettes have increased in popularity, yet their comparative potential toxicity is uncertain. This study compares smoking of RYO and factory-made (FM) cigarettes on smoking pattern and immediate potential toxicity.

Methods: At a research clinic, 26 RYO and 22 FM volunteer male cigarette smokers,(addicted and overnight-tobacco-abstinent) each smoked 4 filter cigarettes, one half-hourly over 2 hours, either RYO or FM according to usual habit, using the Cress Micro flowmeter. First cigarette smoked was their own brand. Subsequent cigarettes, all Holiday regular brand, were RYOs (0.5 g tobacco with filter) or FM with filter. Cravings on 100 mm visual analogue scale, and exhaled carbon monoxide (CO) were measured before and after each cigarette smoked.

Results: Smokers reported similar daily cigarette consumption (RYO 19.0, FM 17.4, p=0.45), and similar time after waking to first cigarette. (RYO 6.1, FM 8.6 minutes, p=0.113). First cigarette's RYO tobacco (0.45 g) weighed less than for FM (0.7g, p<0.001); less tobacco was burnt (RYO 0.36 g, FM 0.55 g, p<0.001) but smoking patterns were no different. RYO smokers smoked subsequent cigarettes more intensively; inhaled 28% more smoke per cigarette (RYO 952 mL, FM 743 mL, p= 0.025); took 25% more puffs (RYO 16.9, FM 13.6, p= 0.035); puffed longer (RYO 28 seconds, FM 22 seconds, p=0.012), taking similar puffs (RYO 57 mL, FM 59 mL). Over four cigarettes, RYOs boosted alveolar CO (RYO 13.8 ppm, FM 13.8 ppm), and reduced cravings (53%, 52%) no differently from RYOs.

Conclusions: In these smokers, RYO smoking was associated with increased smoke exposure per cigarette, and similar CO breath levels, and even with filters is apparently no less and possibly more dangerous than FM smoking. Specific package warnings should warn of RYO smoking's true risk. RYOs are currently taxed much less than FM cigarettes in most countries; similar harm merits similar excise per cigarette.

Source: Laugesen, M. et al. BMC Public Health, 18 June 2009
Link: http://tiny.cc/KztIS

PQ: Cost of smoking related illness

Lord Laird (Crossbench): To ask Her Majesty's Government how much it cost to provide health services to those with smoking-related conditions in 2006-07.

Lord Darzi of Denham (Parliamentary Under-Secretary, Department of Health; Labour): In 1998 the Government's White Paper, Smoking Kills, estimated that the cost to the National Health Service of treating illness and disease caused by smoking was £1.7 billion every year. In October 2008, Action on Smoking and Health published a report called Beyond Smoking Kills, which estimated that the costs of smoking to the NHS had risen to £2.7 billion a year. The latest research published in the journal Tobacco Control in June 2009, by researchers from the University of Oxford Department of Public Health, estimates the costs of smoking to the NHS at £5.2 billion.

Source: Hansard - (Citation: HC Deb, 18 June 2009, c231W)
Link: http://tiny.cc/hRfpN

Hardline smoking ban just isn't fit for purpose

Opinion piece by Clare Allan in The Guardian

Psychiatric units in England are experiencing considerable difficulties implementing the smoking ban that came into force last July. A report published last month by the Mental Health Foundation (MHF) says 85% of respondents to a survey it conducted said the ban had not been implemented "wholly effectively". Widespread practical problems reported included a rise in "secret smoking" - with associated safety concerns - and occasions where staff feel obliged to "turn a blind eye", especially when a patient is very unwell, thus placing them both in a position of breaking the law.

Two years ago, I wrote a piece expressing my concerns about the forthcoming ban. It seemed to me that the issue was a great deal more complex, both practically and morally, than a simple equation of "smoking is bad, therefore we must ban smoking".

I certainly wasn't advocating a return to the days when I was first admitted and patients smoked anywhere and everywhere, except for a small no-smoking room, kept locked in an attempt to preserve its unsullied air - which also meant that nobody could go in there. But I felt that the status quo at the time I wrote the piece - with smoking banned everywhere except that same room, now crammed like a rush-hour tube train, with patients lighting one fag off the butt of the last - was far from ideal, but was probably the least bad of the realistic options.

I wasn't alone in my concerns. A survey conducted in 2006 and published by the King's Fund health thinktank revealed that fewer than 10% of staff on mental health wards were in favour of a ban. There was considerable anxiety about the pressure it would place on already-stretched staff, the possible impact on patient behaviour, and the right of staff to stop patients - especially involuntary patients - from smoking at all.

Policy-makers responded with a mixture of "guidance" and bullheadedness. "The 'smoking den' culture that has afflicted mental health wards for decades is over," said national director for mental health Louis Appleby, in a letter to this paper more than a year before the ban was even due to be brought in.

Some trusts have introduced the ban effectively, and their experience is informative. One trust quoted in the MHF report had introduced the ban in conjunction with "healthy lifestyle initiatives". It said that "every ward has stretch and movement to start the day, a gym, and staff trained to diploma level in physical healthcare".

If stopping smoking is to be seen as a positive choice, rather than the loss of yet another freedom, such initiatives would seem to be crucial, as would a healthy, nutrition-rich diet. I have never been on a ward that offered either.

My local mental health unit, which was purpose-built only a few years ago, does not have a gym at all. Nor, crucially, do wards have direct access to a safe outside space. While smoking is not banned in the grounds, patients not able to go out on their own are dependent on staff to accompany them, putting extra demands on nurses and preventing them using their time in other ways.

Again, this contrasts with the facilities available to "wholly successful" trusts. "The ground floor ward [has] a smoking hut in their specific garden. For the first floor wards, they have access to a specific garden area with a smoking hut and a balcony which can be used."

If every ward could be provided with such facilities, most people would embrace the ban as a huge step forward. But that is not the reality most staff and patients face. As in so many other areas of government policy, the law-makers appear to be curiously detached from the situation on the ground. And, as so often, it is frontline staff who are obliged to stretch themselves across the gap.

The fact is that psychiatric wards contain people who are ill - some too ill to leave the ward and certainly too ill to appreciate the benefits of not smoking. In the interests of common humanity, staff are turning a blind eye and breaking the law. They shouldn't have to.

Source: The Guardian, 01 July 2009
Link: http://tiny.cc/neHue

China: Raising tobacco tax to curb smoking

China has raised taxes on tobacco by six to 11 percent in an effort to pad state coffers and curb smoking in the world's largest cigarette market, according to the government and state press. Tobacco wholesalers have also been hit with a five percent levy according to new tax rates that went into effect on May 1 but were announced over the weekend, the State Administration of Taxation said in a notice on its website.

"Efforts to increase the tobacco tax and lift tobacco prices have proven the most effective in reducing smoking among smokers of all income levels," the China Daily quoted the Chinese Association of Tobacco Control as saying Monday. "It will prevent young people from smoking and encourage more smokers to quit the harmful habit." Tax on more expensive brands of cigarettes went up from 45 percent to 56 percent per carton, while the tax on cheaper tobacco saw an increase to 36 percent from 30 percent, the administration said.

China is the largest producer and consumer of cigarettes in the world with up to a million people dying of smoking-related diseases each year, the China Daily said. This figure could rise to up to three million by 2050, it added. The Asian giant has a total of 350 million smokers and a growing army of young people are picking up the habit, it added. Half of all male Chinese smoke, it said.

The tax administration said the new levies would "moderately improve" revenues, while the China Daily said the move would add up to 30 billion yuan (4.4 billion dollars) annually to state coffers. China's government has said it expects a record deficit this year due to efforts to fund a 585-billion-dollar stimulus package to offset the global financial crisis. State revenue, meanwhile, declined 6.7 percent year-on-year in the first five months of 2009, the report said.

Source: Yahoo News, 22 June 2009
Link: http://tiny.cc/SJ3ak

PQ: Tobacco Sales

Stephen Ladyman (South Thanet, Labour): To ask the Secretary of State for Health if he will consult the National Federation of Retail Newsagents on the provisions contained in Part 3 of the Health Bill [Lords].

Gillian Merron (Parliamentary Under-Secretary, Foreign & Commonwealth Office; Lincoln, Labour): The Department's policy has always been to consult interested stakeholders. This includes consultation on tobacco policy and legislation. The National Federation of Retail Newsagents provided a consultation response to the 'Consultation on the future of tobacco control' which was reflected in the report on that consultation, which considered the legislation on prohibiting tobacco displays. The National Federation of Retail Newsagents met Baroness Thornton during the passage of the Health Bill through the House of Lords and are setting a date to meet departmental officials during the passage of the Bill through the House of Commons.

Source: Hansard, Citation: HC Deb, 15 June 2009, c120W
Link: http://tiny.cc/JKY6B

Understanding the nurse's role in smoking cessation

Abstract

Guidelines from the National Institute for Health and Clinical Excellence (NICE) recommend that every nurse should consult their patients about giving up smoking. This is an important public health role but in order to fulfil it, nurses need to have an understanding of the motivations and barriers that underpin smoking cessation. Furthermore, nurses need to know the options available to support the patient. This review provides an overview of the stages and motivations behind smokers' intentions. It aims to increase the knowledge of nurses and provide them with a greater understanding of the issues which smokers face. This review identified smoking cessation as a continuum. Nurses play an important role in raising the issue of smoking cessation with patients and they can offer a balanced perspective on the challenges they might face. They can then sign-post patients to the most appropriate smoking cessation options.

Source: Carlebach S, Hamilton S. British Journal of Nursing, Vol. 18, Iss. 11, 11 Jun 2009
Link: http://tiny.cc/4WASg

Smokers on parade at festival

Council bosses and Manchester International Festival organisers are at loggerheads after it emerged smokers and boy racers could take centre stage of the launch parade. Procession, which kick-starts next month's festival, is the brainchild of Turner Prize winning artist Jeremy Deller. He was commissioned to showcase the city, its history, traditions and characters. The carnival-style parade, which is partly paid for by taxpayer-funded AGMA (the Association of Greater Manchester Authorities), will feature smokers and boy racers - issues the council has campaigned against.

Council bosses are now calling for the smoking element to be withdrawn if the parade is to go ahead. Coun Pat Karney, NHS Director of Smoke Free Greater Manchester, said: "I find this shocking and unbelievably irresponsible. There will be thousands of children and young people watching this parade. How we can use public money to promote smoking in this way is beyond belief. It is at odds with the policies of Manchester City Council and the NHS in Greater Manchester. Maybe the artist would like to parade 14 coffins through the streets which is the sum total of people who die from smoking-related illness every day in Greater Manchester."

It is understood Manchester's communities and neighbourhoods committee unanimously passed a resolution condemning the smoking element as `an appalling waste of taxpayers' money'. Promoters are thought to have advertised in tobacconists and on the internet for smokers to join the parade. The event is described by London-born Deller as a `free and uniquely Mancunian procession'. It will last one hour and travel down Deansgate, from Liverpool Road to Manchester Cathedral, on July 5 - the opening weekend of the two-and-a-half week arts extravaganza which is expected to cost around £9.6m.

Deller has said he believes he knows Manchester through its music and has visited the area to recruit scouts, mill workers, and the goths and emos that congregate outside Urbis to join his parade. He said it would pay homage to `northern social surrealism'. Festival director Alex Poots defended Deller's work. He said: "MIF is an artist-led festival and sometimes artists do raise challenging questions. Jeremy Deller is an internationally-acclaimed artist making significant work with groups across Greater Manchester. The idea behind Procession is to bring in to focus different areas of the local community, including some groups that aren't usually represented in civic parades. It's also about public space; who uses it and how. Smoking outdoors isn't illegal and Procession does not promote smoking - but it does encompass a fantastically wide range of groups and communities, all selected by the artist."

Source: Manchester Evening News, 18 June 2009
Link: http://tiny.cc/VxJcn

Swedish Match sells S.African ops to Philip Morris

Swedish Match has agreed to sell its South African operations to Philip Morris International for 1.75 billion rand ($224.7 million). The Swedish tobacco products maker said in a statement the deal would be complete in the second half of 2009 and was subject to approval by South Africa's competition authority.

"This agreement with Philip Morris International is in line with Swedish Match's strategy to focus on smokefree tobacco, cigars and lights products," said Swedish Match Chief Executive Lars Dahlgren.

"SMSA (Swedish Match South Africa) will continue to be a strong player in South Africa and we believe that PMI will benefit significantly from its deeply-entrenched and highly-recognized brands and its dedicated people." A company spokesman said Swedish Match estimated the capital gain on the sale of the business at abuot 500 million Swedish crowns to 600 million Swedish crowns ($65.89 million to $79.07 million). The firm said SMSA will continue to distribute lighters, matches and cigars for Swedish Match. ($1=7.788 Rand) ($1=7.588 Swedish Crown)

Source: Reuters, 02 July 2009
Link: http://tiny.cc/WBTOs