An advocacy group says Wisconsin falls short when it comes to protecting residents from the harms of tobacco. Wisconsin got an A for smoke-free air — protecting people in public and at work, but Dona Wininsky with the American Lung Association-Wisconsin chapter says the Badger State only got a B for its cigarette tax. She says Wisconsin’s tax is higher than the national average. The tax increases the overall price, which is a great deterrent for using the product.

The group’s State of Tobacco Control 2012 report grades the state based on existing policies. As for tobacco control and funding, the state got an F. The report also gives Wisconsin an F for its coverage of cessation treatments and services. Wininsky says the state’s Quitline is underfunded. The CDC’s recommendation is $10.50 per smoker to adequately help them quit; instead, the Quitline is currently funded at 73 cents per smoker. Wininsky says she doesn’t have huge expectations to be funded at the high levels recommended by the CDC, but says she would at least like to see the program restored to where it had been before the cuts in the recent budget.
Wininsky says, at 20.7 percent, the high school smoking rates are still “uncomfortably” high, but she says the good news is the percentage of youth smokers is down from previous years. According to the American Lung Association, 443,000 people die from tobacco-related illnesses and secondhand smoke exposure each year. Tobacco causes an estimated 7,240 Wisconsin deaths annually and costs the state’s economy $3.7 billion in healthcare costs and lost productivity. Compared to the rest of the nation, Wisconsin falls somewhere in the middle.
Wininsky says up until last year, Wisconsin was getting an F in smokefree air, too. So, going from F to A is a leap forward. Also, the cigarette tax has been increased a couple of times, which helps deter people from smoking in the first place.

Get ready for a barrage of ads that will come at you with a singularly mind-blowing message: Smoking is bad for you. Not just bad for you. Really bad for you. It’s a fact that should be obvious to any sentient being, yet within the next year or so, not one but two federal agencies, the Centers for Disease Control and the Food and Drug Administration, will be newly pounding the nation’s airwaves with anti-smoking ads — as if it were a sure thing that you needed them.

To be a smoker in 2012 is not only to ignore the biological reality that the habit will knock years off your life but also shrug off the cultural stigmas — the dwindling number of smoke-friendly public places, the dirty looks — and the fact that heavily-taxed smokes are priced at a point only a one-percenter could easily afford.
If we’ve seen a “denormalization of smoking,” as the CDC describes it, do we need to drop hundreds of millions of dollars on a familiar message during cash-strapped times? If all those appeals to the brain, wallet and pride don’t work, how will a bunch of ads?

As it turns out, anti-smoking ads actually do work. There’s plenty of academic research proving it. And there’s circumstantial, but no less compelling, evidence that in the absence of advertisements, smoking rates don’t go down as quickly as they would without the nagging. And that entails its own costs.

Smoking’s steady decline, which began in the 1960s after the Surgeon General’s initial warning, has leveled off in recent years. Between 1998 and 2005, the adult smoking rate dropped 13%, but since 2005, any changes have been minimal. For the better part of six years, it has been at the 20% mark or just below. All-important youth-smoking rates declined 40% between 1997 and 2003, but between 2003 and 2009, that decline slowed to 21%.

Meanwhile, during those years funding decreased dramatically for the main national anti-tobacco advertising player, Legacy, the foundation funded by the 1998 settlement between tobacco companies and the attorneys general of 46 states. According to Kantar, Legacy’s media budget between 2007 and 2010 totaled about $100 million. That’s the amount Legacy would spend in a single year in its early days. And, at the state level, average household exposure to anti-smoking ads peaked in 2006 and 2007 and has been coming down since, according to a study of Nielsen data by the University of Illinois-Chicago.

“There’s no consistency at the state level,” said Eric Asche, chief marketing officer at Legacy. “And the general trend has been to spend less, not more.”

Connecting the slowing decline in smoking with the steeper drop in anti-tobacco ad spending is to draw a broad correlation. It’s a mug’s game to chart smoking-rate changes directly to the rise and fall of advertising budgets. Media spending is not the only factor in smoking prevention, and probably not even the most important. That distinction goes to taxes. There are other factors, especially smoke-free-air laws that effect bans in workplaces and other public places. With all the activity, it’s difficult to isolate the effects of advertising.

But there’s no doubt that the leveling off of the smoking rate has occurred at a time when many states, amid deep cuts to tobacco-prevention budgets, are spending next to nothing on ads and have been getting little air cover from the national level. This is bad news when you consider how effective those ads have been.

Research scientists have been studying the impact of anti-smoking ad campaigns for decades, even before the “Truth” campaign launched in 2000, when the job was mainly the province of individual states.

Many have found what Sherry Emery, a health economist who has studied the impact of media campaigns at the state level, has. Ms. Emery said that analyses of youth and adult reaction “showed that higher levels of exposure to the state media campaigns were associated with less smoking and more anti-smoking attitudes and beliefs.”

The campaign aims to raise awareness of the harmful effects of both active and passive smoking. The campaign will encourage and motivate people not to smoke in public places in order to reduce the damaging effects of passive smoking. The campaign had been organized in Hanoi on November 1 by the Ministry of Health (MOH) and the World Health Organization (WHO).

According to the Ministry of Health, the country spent up to VND2,304 billion (US$ 109 million) on treating lung cancer, coronary artery disease and obstructive pulmonary disease besides 25 other tobacco-related diseases in people, in 2010 alone.

According to a World Health Organization representative, last year Vietnamese people spent around US$1 billion on buying cigarettes.

The campaign will run from November 1 to December 1. The media is fully supporting the campaign and providing free multimedia promotional material to be shown on TV, pasted on buildings, bus stations, supermarkets and public places.

The campaign also hopes to garner the support of communes and policy-makers in the country.

At the launch ceremony, Dr. Luong Ngoc Khue, head of the Health Examination and Treatment Department under MOH, said Vietnam is among 15 countries in the world which has the highest number of smokers.

According to a survey conducted by MOH and WHO in 2010, the percentage of Vietnamese male adults who smoke is 47 percent (or 15.3 million of the total population) with 33 million being passive smokers at home and 5 million being passive smokers at their workplace.

40,000 people die of smoking every year, three times more than the number of people dying from road accidents.

A cancer center in Kentucky, the state that leads the nation in smoking, is promoting a quit-smoking campaign that encourages people to opt for a smokeless pinch between gum and cheek, the Associated Press reports. The campaign runs counter to the public health community position that there is no safe way to use tobacco. But the James Graham Brown Cancer Center and the University of Louisville say their “Switch and Quit” campaign makes sense because smokers who switch to smokeless tobacco are more likely to stay off cigarettes than those who use a nicotine patches or other methods.

The effort targets Owensboro and the surrounding area, where about 3 million cigarettes are consumed a week, the AP says. That amounts to well over a pack for every man, woman and child.

“We need something that works better than what we have,” Donald Miller, an oncologist and director of the center, told the AP. “This is as reasonable a scientific hypothesis as anybody has come up with and it needs to be tried.”

The National Cancer Institute at the National Institutes of Health says on its website that the use of all tobacco products “should be strongly discouraged,” and that there is “no scientific evidence that using smokeless tobacco can help a person quit smoking.”

But this year it approved funding for a study that might provide some of that evidence afterall.

“Americans are largely misinformed about the relative risks. … They think smokeless tobacco is just as dangerous,” Brad Rodu, a professor of medicine at the University of Louisville, told the AP. “This level of misinformation is an enormous barrier” to using smokeless tobacco as a tool to quit smoking.

The program is funded through Rodu’s research money, which includes grants from the tobacco industry. “There’s absolutely no influence whatsoever,” Rodu said. “I would not have a situation where there was some control over the kind of projects I undertake.”

Dubai: The Dubai Health Authority (DHA) will intensify its anti-tobacco initiatives through its cessation clinics and campaigns especially targeting schoolchildren aged 12 to 21, an official said yesterday. “Through our smoking awareness campaigns which we have conducted in 2010 and this year, we realised that there is an urgent need to create regular community awareness activities with regard to tobacco use because of the significant number of youngsters using tobacco,” Dr Hanan Obaid, Head of Community Health Services Programmes Section at the DHA, said.

High risk
“They are our productive population and are at a high risk of developing diseases caused by long-term use of tobacco,” she added.
According to the World Health Organisation, young people who smoke may experience respiratory and non-respiratory effects, addiction to nicotine, and shortness of breath. They could have a lower level of lung function and reduced rate of lung growth compared to those who have never smoked.
In 2010, the DHA conducted 98 anti-smoking campaigns targeting 6,221 people from various schools, colleges, malls, government institutions, and sports clubs.
The data collected from these institutions prompted the DHA to reach out to more schools in Dubai.

Australia’s government may have to delay plans for the world’s toughest anti-tobacco laws after conservative opposition lawmakers postponed a final vote on the controversial legislation in parliament. The new laws, which will force cigarettes to be sold in plain packaging from 2012, are being closely watched by New Zealand, Canada, the European Union and Britain, which are considering similar restrictions.

Health Minister Nicola Roxon said the conservatives, who managed to postpone an upper house Senate vote on the bills during a rancorous day in parliament for the minority Labor government, were playing into the hands of big tobacco firms.

“Given the delays in passing the bill caused by the opposition, the government now has no choice but to reconsider the impact on implementation timeframes,” Roxon said.

Australia says the new laws reflect its obligations under the World Health Organisation’s 2005 framework against tobacco, which urges states to consider plain packaging laws. The WHO estimates more than one billion around the world are regular smokers, with 80% in low and middle income countries.

The laws have angered tobacco producers who have threatened a High Court challenge, while the governments of Nicaragua and Ukraine said the new measures breached international trade rules and would be challenged in the World Trade Organisation.

Prime Minister Julia Gillard’s government is hoping the laws will come into effect on January 1 next year, although the main provisions forcing all cigarettes to be sold in plain packaging only come into operation on July 1, 2012.

The delay in the Senate means the laws will not be voted on before November, forcing the government to reconsider now whether it can meet its deadlines.

Australia’s Cancer Council said the Senate should end the political delays and get on with passing the legislation, with authorities estimating smoking now kills 15,000 Australians each year and costs the health system $32 billion.
“We know the tobacco industry is vehemently opposed to plain packaging, which is just another indication that plain packaging has great potential to reduce tobacco,” council chief executive Ian Olver said.

Analysts say tobacco companies like Britain’s Imperial Tobacco and Philip Morris are worried that plain packaging could spread to emerging markets like Brazil, Russia and Indonesia, and threaten growth there.

Australia’s tobacco market generated total revenues of around $10 billion in 2009, up from A$8.3 billion in 2008, although smoking generally has been in decline. Around 22 billion cigarettes are sold in the country each year.

British American Tobacco , whose brands include Winfield, Dunhill and Benson & Hedges, has said the government’s plans would infringe international trademark and intellectual property laws, promising a court challenge to the laws.

Adding exercise improved the results of a smoking cessation program among teen boys according to a CDC funded study published Monday in the journal Pediatrics. Teen girls in the program were more successful without the exercise, the study found. “In the context of a smoking cessation program, the study suggests that a relatively small amount of time dedicated to motivating youth to increase their physical activity may have high payoff in terms of health and health economics,” said study author Kim Horn, Ed.D of West Virginia University.

Most adult smokers pick up the habit before age 18, according to the Centers for Disease Control and Prevention.

Researchers at the university studied 233 students from 19 state high schools. The teens had all smoked more than one cigarette within the previous month. 96% of the participants smoked daily.

The 14 to 19 year olds were randomly divided into three groups. One was given a brief 15 minute intervention, which consisted of general instruction on the reasons why it’s important to quit smoking.

The second group was assigned N-O-T (Not On Tobacco), a smoking cessation program from the American Lung Association that’s been successful. It consists of 10 one hour-long sessions. Participants are given information on the consequences of smoking but also focus on developing coping skills needed to quit. They also discuss peer pressure and controlling weight after stopping.

The third group combined the N-O-T program with physical activity. During each session, the teens were given guidance about activity, pedometers, a log and journals with options for exercise.

After the teens had been enrolled in the program for three months, they were asked if they had smoked a cigarette within the past seven days.

“We found that the physical activity added to the N-O-T program just really boosted the effect for boys,” said Horn. Of the 107 boys studied, the ones in that group were four times more likely to stop smoking than the ones in the other two groups.

Horn said she was surprised the results were not the same for girls; they quit more successfully on N-O-T alone. The reasons are not understood.

“It’s very difficult to speculate- certainly we need a further study to understand what intervention parts were effective for males and females,” she said.

Overall, those in the brief intervention group were at nearly three times higher risk of continued smoking, compared to the teens in a program.

Horn, who is a co-founder of the N-O-T program, cautions against generalizing the findings though, as the study only included youths from West Virginia.

“But if this type of intervention is effective for a high-risk group as we see here with our high smoking rates and our low physical activity rates, then there is certainly some hope that this will be effective for other kids who may not be as high-risk,” she said.

She added that the study shows that kids can quit smoking, given the correct tools.

“We simply need to make sure that those tools get out into the community so that kids can get to them.”

A U.S.-made drug to help smokers quit has been tied to several cases of impaired awareness, causing at least one car crash, the Ministry of Health, Labor and Welfare announced on Aug. 30. The ministry stated that it had received six reports of impaired awareness stemming from U.S. pharmaceutical giant Pfizer Inc.’s Varenicline — sold under the trade name Champix — between its May 2008 Japanese release and April this year.

According to the health ministry, the six cases of impaired awareness occurred among both male and female patients between the ages of 40 and 79. One patient in his 60s was behind the wheel of his car when he began shivering, blacked out and drove the vehicle into a ditch about 20 minutes after taking the drug.

The ministry has called on doctors to warn patients not to drive after taking Champix, and has instructed Pfizer to add “impaired awareness” to the list of the drug’s major side effects.

Champix functions by acting on the nicotine receptor in the brain, delivering the same satisfaction as smoking a cigarette, according to the ministry. Unlike other medications to help smokers kick their habit, Champix does not require patients to take nicotine supplements, and had seen steady growth in prescriptions. In the year ending this past June, some 414,000 people in Japan had used the drug.

While thumbing through the Internet recently I came upon a story from the Indianapolis Star about a new anti-smoking policy at Indiana University Health that extends a smoking ban for hospital employees during their off-campus break times. The Star article called the ban “one of the most restrictive smoking policies in the nation.” That is not accurate. Other health systems are far more aggressive. A growing number of providers, for example, have said they will no longer hire smokers, and will screen job applicants for traces of the vile weed. Now that’s restrictive!

Sheriee Ladd, senior vice president for human resources at IU Health, tells HealthLeaders Media that the health system sees its ban as one that can be justified as patient safety issue.

“We have told our employees that as the leading health system in the state, it is incongruent with our brand assurance to our patients and our commitment to wellness for our staff for us to continue to tolerate smoking, because of the irritants that come back into the workplace, not only for the employees but for the patients and their families,” Ladd said.

Of course, there is also an HR component at play. Employee smoking and obesity are among the biggest healthcare cost drivers for employers. If a ban on break-time smoking off-campus also encourages employees to quit smoking, everybody wins.