ASH Daily News for 5 November 2019



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UK

  • Audio: How a Guardian story led to a landmark case against big tobacco

International

  • Austria: Smoking ban takes effect in bars and restaurants
  • Italy: Drug currently used to treat type 2 diabetes could help smokers quit by reducing nicotine cravings
  • USA: Study predicts that national vaping tax may result in higher smoking rates
  • USA Study: Preventing smoking — evidence from urban emergency department patients

UK

Audio: How a Guardian story led to a landmark case against big tobacco

In June 2018, Sarah Boseley wrote about child labour in the tobacco fields of Malawi. Human rights lawyer Martyn Day read her story and decided to seek compensation, on behalf of labourers, from British American Tobacco. They recently returned to Malawi to check on the progress of the case. The case, potentially one of the biggest that human rights lawyers have ever brought, could transform the lives of children in poor countries who are forced to work to survive not only in tobacco but also in other industries such as the garment trade.

In this podcast, Boseley discusses her reporting with Rachel Humphreys, while Day explains how they plan to seek compensation.

Source: The Guardian, 5 November 2019

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International

Austria: Smoking ban takes effect in bars and restaurants

A ban on smoking in Austrian bars and restaurants took effect on Friday 1 November, making it one of the last European countries to enact a ban in indoor public places after years of protracted debate and protests.

Parliamentarians approved the ban in July in a bid to rid Austria of its status as the “ashtray of Europe”. Only members from the Freedom Party (FPOe) opposed the measure. A quarter of the country’s 8.8 million inhabitants smoke, exceeding the European average of 18%, but calls for bans dated back more than a decade.

The FPOe had stymied a previous attempt to ban smoking in pubs and restaurants when it entered the government in December 2017. That prompted a backlash from large sections of the public and the Austrian medical association, which organised a petition in favour of the ban signed by almost 900,000 people, or around 14% of voters. In May the FPOe left government, paving the way for the proposal to be voted again in parliament.

Smoking had been legal in bars and restaurants larger than 540 square feet if it was done in a separate area — although this rule was not always implemented. No separate area was necessary in smaller establishments if the owner was happy to allow smoking on the premises. Some restaurants and cafes had already banned smoking of their own accord.

Source: France 24, 1 November 2019

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Italy: Drug currently used to treat type 2 diabetes could help smokers quit by reducing nicotine cravings

A new study has found that a drug commonly used to treat type 2 diabetes could also be helpful for smokers who want to quit. Researchers from the University of Camerino, Italy, found pioglitazone — sold under the brand name Actos — weakened the effects of nicotine withdrawal on rats and mice. The drug targets nuclear receptors found in areas of the brain involved in drug addiction.

The rats were split into a drug group, which were given a 5.2mg dose of nicotine for seven days, and a control group. On the eighth day, nicotine patches were removed, and the rats were placed into transparent cylinders for 16 hours for observation. Withdrawal symptoms included teeth-chattering, writhing, shaking and yawning. The same effects were seen in mice.

Six days after the removal of the patches, some of the rats were given pioglitazone at 15 and 30 mg/kg doses. Co-author Dr Esi Domi said they saw a marked reduction in the severity of symptoms in the group given the drug and added it “significantly attenuated anxiety-like behaviour”.

Pioglitazone may help diabetic smokers quit by lessening the physical and emotional withdrawal symptoms while reducing insulin resistance. The drug was originally designed to alter the genetic make-up of cells to regulate the amount of glucose in muscle tissue and the liver.

Source: Mail Online, 4 November 2019

See also:
The Journal of Neuroscience. Activation of PPARγ attenuates the expression of physical and affective nicotine withdrawal symptoms through mechanisms involving amygdala and hippocampus neurotransmission. November 2019

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USA: Study predicts that national vaping tax may result in higher smoking rates

According to a new study, e-cigarette taxes may increase the purchase and use of cigarettes. E-cigarette taxes started on 1st October in Connecticut, Ohio, Washington and Wisconsin, and e-cigarette taxes are scheduled to be enacted on 1st January 2020 in Maine and Nevada.

“Our results suggest that while cigarette taxes reduce cigarette use, and e-cigarette taxes reduce e-cigarette use, they also have important interactions on each other. E-cigarettes and cigarettes are economic substitutes. So, if you raise the tax on one product, you will increase use of the other product.” said Michael Pesko, co-author of the paper and economist at Georgia State University.

For the study, researchers used data on tobacco use from 3.1 million records from the Behavioral Risk Factor Surveillance System and National Health Interview Surveys between 2011 and 2017. The authors examined the effect of e-cigarette taxes adopted by eight states and several counties during this period to predict the likely impact of a federal e-cigarette tax or future state-level e-cigarette taxes.

“Despite the recent news about vaping deaths,” Pesko said, “e-cigarettes are thought to be only 5% as harmful as cigarettes […] Adopting a national e-cigarette tax proportional to the cigarette tax could harm public health by pushing people to use a more dangerous product—cigarettes.”

“Some people would argue that harshly regulating e-cigarettes is justified if e-cigarettes are a gateway to cigarette use, but the evidence does not back up that theory as youth cigarette use has been rapidly declining while e-cigarette use has been rising,” he said.

An earlier study co-authored by Pesko also warned that e-cigarette taxes could raise smoking among pregnant women by about 6%.

Source: Medical XPress, 4 November 2019

See also:
National Bureau of Economic Research. The Effect of E-Cigarette Taxes on Pre-Pregnancy and Prenatal Smoking, and Birth Outcomes. 2019

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USA Study: Preventing smoking — evidence from urban emergency department patients

A new study from the Prevention Research Center of the Pacific Institute for Research and Evaluation offers a more in-depth understanding of smoking among patients in an urban emergency department. Patients in urban emergency departments smoke cigarettes and use other substances at higher rates than the general population.The data are from a survey with 1037 patients in California.

Smoking prevalence was higher among men than women (35.5% vs. 18.9%), and both smoking rates were more than double those of the general population. Having a spouse/partner who smoked was related to smoking behaviour among both sexes. Among women, being unemployed was associated with current and moderate/heavier smoking, and past-year intimate partner violence was related to current smoking, light and moderate/heavier smoking. Among men, food insufficiency was related to current and light smoking.

There were no racial/ethnic differences in the likelihood of current smoking among men, but Hispanic/Latino and African American men were less likely to be heavier smokers than white men. Among women, Hispanics/Latinas were less likely to be current smokers, and Hispanics/Latinas and African Americans were less likely to be light smokers compared to white women.

These findings indicate that, among urban emergency department patients, those who are faced with socioeconomic stressors, such as unemployment and food insufficiency, may be particularly vulnerable to smoking-related health disparities. Lead author Dr. Carol Cunradi said that “clinicians should consider factors such as polysubstance use and socioeconomic stressors as they screen underserved patients who smoke and formulate cessation treatment plans.”

Source: Medical XPress, 4 November 2019

See also:
Tobacco Use Insights. Gender Differences in Smoking Among an Urban Emergency Department Sample. 2019

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