Five years have passed since the Framework Convention on Tobacco Control went into effect (Feb. 27, 2005). The FCTC, the first treaty negotiated under the auspices of the World Health Organization, has 168 parties and covers 86 percent of the world population. Nevertheless, tobacco products remain the cause of serious health damage, including cancer and cardiac and pulmonary diseases, and hampers fetal growth.

On Feb. 25, the health ministry issued a notice to prefectural and municipal governments, calling on them to make public spaces nonsmoking areas in principle. Although the notice does not provide for punishment of violators, it is a step forward in protecting people from secondhand tobacco smoke.

The “WHO Report on the Global Tobacco Epidemic, 2009″ calls tobacco use “the leading cause of preventable death,” adding that it is estimated to kill more than 5 million people each year worldwide. It warns that if current trends continue, by 2030 tobacco will kill more than 8 million people annually the world over, and could kill a billion or more people by the end of this century. In Japan, more than 130,000 people each year die of health damage related to tobacco use.

In 2004, the Diet unanimously approved the FCTC and Japan became the 19th country to ratify the treaty. But Japan is lagging behind in controlling advertisements for tobacco products, using visual images on packages to warn of possible health damage from using such products, raising the sales price of tobacco products and preventing the inhalation of secondhand smoke. Japan needs to rectify this situation as other countries are pushing more aggressive smoke-free policies.

Raising the tobacco tax and abolishing the tobacco business law — whose purpose has been to nurture the “healthy growth” of the tobacco industry — are important. A 2008 WHO survey shows that in terms of progress in smoke-free policies, Japan was second to worst out of five categories, while Canada and Britain were ranked in the best category.

FCTC guidelines call on the parties to the treaty to take legal steps by the end of February 2010 to totally ban smoking in indoor public places and indoor workplaces. The health ministry’s Feb. 25 notice apparently takes this into consideration.

The notice declares that it is scientifically clear that secondhand smoke causes health damage. It reminds local governments that the health promotion law, which went into effect in May 2003, calls on managers of places where people gather to take necessary measures to prevent secondhand smoke.

Because the law has not led to sufficient efforts to prevent secondhand smoke, especially in restaurants and workplaces, the notice says that in principle, smoking should be totally banned in spaces used by many people and that clear notices should be put up to win over the understanding and cooperation of people who visit such places.

The notice lists places where smoking should be totally prohibited in principle: public facilities such as schools, government offices, hospitals and social welfare facilities; entertainment facilities such as theaters, museums, game centers and outdoor sports facilities; commercial facilities such as department stores, shops, banks, restaurants and drinking places; public transport facilities such as bus terminals, airports and ferry terminals and railway stations. Trains, buses, taxis, ships, aircraft, hotels and offices are also listed.

The notice says that measures to prevent secondhand smoke should also be taken in outdoor places where children are expected to gather.

At the same time, it says that in places where a total ban on smoking is “extremely difficult,” appropriate measures to prevent secondhand smoke should be pursued in view of the structure of the facilities and the needs of users. It says measures must be taken to prevent tobacco smoke from a smoking area from entering a nonsmoking area.

Although the notice has no coercive power, a total smoking ban should be carried out in such places as hospitals, government offices, schools and public transport. Companies also should take steps quickly to protect employees from secondhand smoke. A 2007 health ministry survey shows that 56 percent of the polled suffered from secondhand smoke at workplaces.

There is resistance to a total ban on smoking from operators of drinking places and inns and hotels where drinking parties are held. But they should be aware that there are many customers who do not want to be exposed to tobacco smoke.

Importantly, the notice underlines the need to disseminate information on health damage from tobacco based on evidence. It also calls on smokers to be aware that they are exposing other people to tobacco smoke. Health minister Akira Nagatsuma said that after judging the effects of the notice, the government will decide whether stronger steps are needed. Ideally, heightened public awareness will lead to the proliferation of smoke-free places.

An Auckland academic says smoking rates in New Zealand would plummet if tobacco products could not be displayed at shops.

Dr Marewa Glover of Auckland University told a select committee today that progress in tobacco control was poor and it was having a particularly bad effect among Maori.

She said outside the hearing that she disagreed with tobacco industry giant British American Tobacco New Zealand (BAT) that banning smoking or restricting its sale would merely produce an uncontrolled black market.

“There just will not be the death and illness to such an extent from so few people smoking, and the fastest way to do that is to get rid of the product off the shelves,” Dr Glover said.

She said BAT’s suggestion that they were offering a legal product which people were choosing to use was “a pack of lies”.

“Nicotine is highly addictive and people do not have freedom of choice. It’s a psychoactive drug, it works on the brain, it manipulates thought, it manipulates motivation and they are driven to smoke.”

Dr Glover said she didn’t want smoking banned but she wanted its over-the-counter sale banned, leaving it for internet purchase or grow-your-own customers only.

When asked about removing the product from visibility in stores but not removing them altogether, BAT managing director Graeme Amey said research showed this would have little impact on the prevalence of smoking.

But after Green Party co-leader Metiria Turei asked why BAT opposed this move if it would make no impact on smoking, Mr Amey said his company could lose market share as a result.

“We operate a commercial business and we are in the business of improving market share,” he said. “Brand switching would become an issue.”

Mr Amey would not tell the committee its marketing strategies in an open hearing, saying it was commercially sensitive. He said he would provide them to the committee confidentially.

Maori Party MP Hone Harawira thanked BAT for addressing the committee, but said he hoped that once the inquiry was complete, “we can ban these products forever”.

Dr Glover said much of tobacco marketing came via its packet design, and removing these from public view would therefore help reduce smoking.

She told the committee that more than half Maori women of childbearing age were smokers, more than double the rate of the whole population, and that smoking among Maori women 14-18 weeks into pregnancy was still high at 45 per cent.

She said 62 per cent of the 328 sudden unexpected deaths among infants (sudi) between 2003 and 2007 were Maori.

“Smoking during pregnancy is a key risk factor for sudi,” she said.

As well as restricting sale, Dr Glover said services to help people quit smoking needed to be easier to access.

“That sort of help needs to be as easy as going to the dairy to buy a packet of smokes.”

Several people told the committee how smoking-related illnesses had claimed the lives of loved ones in their families.

Ngaire Rae of Manaia Public Health Organisation in Whangarei said she had just buried her father, who died from a smoking-related disease at the age of 68.

She said her story was all too common in Northland, where a huge proportion of Maori were smokers.

“He should be sharing his life stories with his whanau, and instead we are deprived of his wisdom and his life stories,” she said.

“I am pleased make sure that there are some strong actions as a result of this inquiry. Let’s not make this a talkfest, let’s make sure your time and ours is not a waste.”

While a Senate committee began hearings on bills to increase sales taxes and tobacco taxes, another bill has been advanced that would increase the cost of a 12-ounce can of soda.

The Senate Assessment and Taxation Committee began hearings over raising tobacco taxes by 55 cents and will continue hearings regarding Kansas Gov. Mark Parkinson’s plan to increase the state sales tax by 1 percent from 5.3 percent to 6.3 percent for three years.

The soda tax, which was advanced by Sen. John Vratil, R-Leawood, increases the tax on soda by one penny for every teaspoon of sugar — or an estimated 10 cents — and would raise an estimated $90 million during the next fiscal year, which begins on July 1.

“It is amazing just to see how much can be generated,” said Sen. Les Donovan, R-Wichita, chairman of the Assessment and Taxation Committee. “There is a lot more consumed than I could have ever dreamed.”
Both the tobacco and sales tax increases would constitute an overall increase of just over $377 million in the state general fund receipts in the next fiscal year. Currently, the state is facing a projected $467 million shortfall for FY 2011.

“We’re hoping that the gap is not that broad,” Donovan said. “If it is we have bigger problems than we thought.”
Vratil proposed his soda tax during a meeting of the Senate Ways and Means Committee, which agreed to sponsor it. The committee also agreed to sponsor a bill that doubles the per-gallon taxes paid by distributors of beer, wine and liquor and the tax that retail stores pay on their gross receipts. That measure would raise an additional $50 million.

As for the tax increases that the Assessment and Taxation Committee started hearings for Tuesday — in favor of the Governor’s increases — Donovan said that state agencies are warming up to the proposal.
“There are a lot of people that get the funding that are excited about us discussing these tax increases,” Donovan said. “They get the money … that is a pretty good connection and without the tax increases, they are not going to get the funding they need.”

The testimony came on the same day that advocates for the disabled staged several small protests at the Statehouse.
The tobacco tax proposal would increase the cigarette tax by 55 cents, to $1.34 a pack, and to quadruple the tax on other tobacco products to 40 percent.

Hearings on tax increases will continue today with cigarette tax opponents and Donovan said that hearings are scheduled to continue into next week.

“When we start hearing the other parts of the bill — soft drink tax bill and liquor bill — there will be hearings on each one of those,” Donovan said. “We want to give everyone a fair hearing and exhaust all possibilities to help those that get the funding while trying not to destroy those that are being taxed.”

By MATTHEW CLARK, Morningsun

A lawsuit over the marketing of light cigarettes could be headed back to the U.S. Supreme Court after a federal judge denied a motion to apply facts found in a previous case to the current one.

U.S. District Judge John Woodcock said in a 16-page decision issued Friday that it would not be fair to the litigants to apply the facts found by a judge in a jury-waived criminal trial in a case brought by the U.S. Department of Justice against tobacco companies to the potential class-action civil suit.

The lawsuit contends smokers of Marlboro Lights, Virginia Slims Lights and other light cigarettes were misled into thinking that the cigarettes contained less tar and nicotine than regular cigarettes.

Attorneys for the plaintiffs, who live all over the country, had asked Woodcock to apply the doctrine of collateral estoppel to the current case and adopt the facts found in the 2005 verdict in which a federal judge in Washington, D.C., concluded cigarette makers had violated racketeering statutes.

Efforts to reach attorneys representing cigarette makers this week were unsuccessful.

Bangor lawyer Samuel Lanham Jr., who represents the three Maine plaintiffs, said Tuesday he and other attorneys were “considering all the options,” including a possible appeal to the 1st U.S. Circuit Court of Appeals in Boston.

“Judge Woodcock’s ruling means we have to be put to our proof and we are prepared to do so,” Lanham said.

The next step in the litigation is for Woodcock to consider a motion to certify the case a class-action lawsuit.

The lawsuit is the first multidistrict litigation case ever assigned to federal court in Bangor. Multidistrict litigation, or MDL, is the label the federal judiciary gives cases filed against the same party or parties in federal courts around the nation. Once cases have been combined, a three-judge panel assigns them to one federal judge.

At least 20 lawsuits from around the country were combined last year and assigned to Woodcock, who has not handled one since his appointment to the federal bench in 2003.

Moreover, the original Maine case that led to the 20-case MDL is once again in the hands of Woodcock, whom the U.S. Supreme Court reversed. In a 5-4 decision won by the court’s liberals, the justices ruled in December 2008 that smokers may use state consumer protection laws to sue cigarette makers for the way they promote “light” and “low tar” brands.

The Altria Group Inc. argued on behalf of its Philip Morris USA subsidiary that the lawsuits are barred by the federal cigarette labeling law, which forbids states from regulating any aspect of cigarette advertising that involves smoking and health.

Lanham filed the lawsuit in August 2005 on behalf of Lori A. Spellman of Levant and Stephanie Good and Allain L. Thibodeau, both of Bangor. Each smoked Marlboro Lights for 15 years or more. The plaintiffs are not seeking damages for personal injuries or health problems caused from cigarette smoking.

Instead, the lawsuit alleges that they were hoodwinked into thinking that “light” cigarettes contained less tar and nicotine than full-flavor cigarettes. The plaintiffs are seeking unspecified compensatory, punitive and other damages.

Woodcock granted summary judgment in the cigarette makers’ favor in 2006. The 1st U.S. Circuit Court of Appeals reversed that ruling the next year, and attorneys for the tobacco firm appealed to the nation’s highest court. It was the first case argued during the U.S. Supreme Court’s 2008 term.

By Judy Harrison, Bangordailynews

Nicotine builds up gradually in smokers’ brains rather than spiking after each puff, according to a study that might help point to new ways to help people quit smoking.

Dr. Jed E. Rose of Duke University reports in Monday’s online edition of Proceedings of the National Academy of Sciences that nicotine buildup in the brain was gradual over several minutes.

Scientists have theorized that there is a spike of nicotine in the brain about seven seconds after each puff, but almost no measurements had been taken until now, Rose said in a telephone interview.

“We were surprised to find that the rate of uptake was much different from what one commonly hears,” said Rose, who directs the Duke Center for Nicotine and Smoking Cessation Research, a part of the university’s School of Medicine.

Rose used brain scans to measure the nicotine levels in 13 regular smokers and 10 people who smoke only occasionally, an indication they were not addicted to nicotine.

Maximum brain levels of nicotine were reached in 3 to 5 minutes, and built up slower in addicted smokers than in casual ones, the researchers found.

“This slower rate resulted from nicotine staying longer in the lungs of dependent smokers, which may be a result of the chronic effects of smoke on the lungs,” Rose suggested.

“Now that we know there are not these spikes” that had been expected, Rose said, researchers may be better able to develop new approaches to help smokers get what they need from cigarettes, but in a way that’s not addictive.

His laboratory, for example, is working on a mist inhaler to deliver nicotine without any combustion.

Still in question: Why do some people become addicted to cigarettes and others don’t? The difference in the rate of nicotine buildup in the brain doesn’t explain this, the researchers said.

The research was funded by the giant tobacco companies Philip Morris USA and Philip Morris International. The researchers said the companies had no role in designing or carrying out the research or analyzing the results.

Rose’s findings confirm his earlier work on blood levels of nicotine, and “the brain is what really matters,” commented Dr. Kenneth A. Perkins, a professor at the University of Pittsburgh who also studies smoking addiction.

The assumption was that a critical effect of smoking was a shot of nicotine with each puff, then another shot with the next puff, and so on, Perkins said.

“He is showing that, at least when you look at the blood and brain concentration levels, that’s not really what’s going on, it’s much more gradual,” Perkins, who was not part of Rose’s research team, said in a telephone interview.

“Clinically, what you do with that, I’m not quite sure,” he added.

By RANDOLPH E. SCHMID

KATHMANDU: Health Minister Umakant Chaudhary recently introduced the landmark, Tobacco Products (Control & Regulation) Bill 2066 for discussion in parliament with the aim of formulating a comprehensive law to control and regulate the tobacco industry in Nepal.

Nepal had signed the FCTC (Framework Convention for Tobacco Control) in December 3, 2003 and the same was ratified in parliament on November 7, 2007 as part of the bid to join the global campaign against tobacco use.

The bill is laudatory in the sense that it fulfills a long standing need of controlling & regulating the tobacco industry in Nepal. Most of the provisions of the bill like ban of smoking at Public places, complete ban on advertising, health warnings on pack, etc are extremely important in the context of limiting the fallouts of tobacco usage in the long term and making sure that less and less people fall prey to this habit.

In the interests of taking a balanced view of the issues at hand and ensuring that a pragmatic, practicable law is introduced, there is, however, a need to look at some of the clauses objectively while keeping the spirit and direction of the bill intact. Also in taking the bill and most importantly its implementation forward one needs to look at the experience of the relevant legislations in the region.

The said bill has a clause on banning the sale of cigarettes/bidis/cigars in loose form. This will have a two-pronged effect; there is no way that this provision can be implemented by the lawmakers across 1 Lakh retail outlets across the country. The second impact it will have is on the earnings of retailers since anyway 80 percent of the products are sold in loose form and the retail will find ways and means to continue that. A case in point would be the recently introduced law on separate spaces for liquor in retail which has been difficult to implement. What is the point of introducing clauses that are sure to be violated?

The second point relates to the ban on display and product presentation of tobacco products at the shop level. How else would the shopkeeper be able to convey to his customers of the availability of products in his outlet. Tobacco products are legally sold in the country and the adult tobacco consumer has the right to be informed about brands so that he may make the right choice for himself. In developed countries like the USA and UK which have very stringent laws on tobacco control, the legal system has protected the consumer’s right to be informed about brands available at the stores. Even in neighbouring countries, which have over the last few years implemented very stringent laws, on and in site product presentation and communication is allowed albeit with strictly enforced warning messages. Once again, one has to question the ability of the government mechanism to ensure strict implementation of the same.

There are a few other clauses which require thought before implementation of the bill into law. The government does not have the requisite data collection and technical capacity to measure the nicotine and other contents of tobacco products. This, if implemented, would require serious processes and massive investments on the part of the government. If the government on the other hand relies on data provided by the industry, it will obviously be a self defeating exercise and once again a law which would not serve the purpose for which it has been made.

Similar is the case with warnings on packets and changing the same. The government needs to understand the practicability of these changes as anyone well versed with the packaging side of the business will point out that most of these packages require huge lead times to procure and change. One is leaving for the moment aside the huge investments it will require of tobacco companies thereby making them unviable.

Given the above factors and given the fact that the tobacco industry is one of the largest contributors to the national exchequer (estimated at about Rs 1000 Crore a year), a balanced and pragmatic view has to be taken while formulating laws. Where there is no doubt that there has to be a strong set of laws regulating the tobacco industry, it is also in the interests of the government and the public at large that the laws are practical and enforceable. It has also been seen that draconian laws often kill the local industry leading to huge underground and illegal trade which neither follows the laws of the land nor are the revenues accretive to the government.

There needs to be serious dialogue amongst the various stakeholders, both inside (Law, Finance, Health, Agriculture ministry’s) the government and outside in the public sphere (the government, various NGO’s/INGO’s working in this field, the tobacco industry, retailers, tobacco farmers) to formulate a law which is beneficial to Nepal in the long run. The idea is obviously not to import any law from abroad but to promulgate laws that work for Nepal and the cause that it envisions.

By Arun Gyawali, Thehimalayantimes

While the proven negative health consequences of smoking and tanning are undeniable, tobacco and indoor tanning advertisers would like consumers to think otherwise. In fact, a new study comparing the tactics used in advertising tobacco and indoor tanning products found several similarities in how these two industries market unhealthy products.

In the report entitled, “Comparison of advertising strategies between the indoor tanning and tobacco industries,” published online in the Journal of the American Academy of Dermatology, dermatologist David A. Jones, MD, PhD, FAAD, in private practice in Newton, Mass., presented results of an observational study which concluded that both industries employ advertising strategies to counteract health concerns of their products in order to positively influence the consumer’s perception of smoking and indoor tanning and drive industry demand.

“The indoor tanning industry reported domestic sales in excess of $2.7 billion in 2007 , and it relies heavily on advertising to sell the misleading idea of a ’safe’ or ‘healthy’ tan to the public,” said Dr. Jones. “Even though it is well documented that UV radiation from natural sunlight and indoor tanning devices is a known cause of skin cancer, the public is not always aware of the serious health risks associated with indoor tanning – and the tanning industry’s advertising practices capitalize on this fact.”

In reviewing 2,000 advertisements from four large tobacco advertising image databases, Dr. Jones and his colleague, Jennifer Herrmann, MD, identified four key strategy profiles that were used to sell their products. These strategies included: mitigating health concerns, appealing to a sense of social acceptance, emphasizing psychotrophic effects, and targeting specific population segments. Dr. Jones added that tobacco advertising was selected as a reference framework because it is well documented and designed to promote a product with known health hazards.

Subsequently, a collection of approximately 350 contemporary tanning advertisements was compiled from a variety of sources – such as industry magazines, salon and industry Web sites, and in-store promotional materials – and evaluated based on the four key strategies identified in the tobacco advertisements.

As the increased incidence of lung cancer, respiratory and cardiovascular diseases and other health risks linked to smoking continued to mount over the years, the tobacco industry adjusted its advertising strategy to mitigate these known health risks. Specifically, the tobacco industry recruited physicians as crucial allies in marketing their products, reassured the public that their brands had competitive health advantages, and commended the intelligence of smokers for choosing cigarettes marketed as “safer” cigarettes.

Using Physicians as Allies
Dating back to the 1930s and 1940s, Dr. Jones and his colleague found that physicians wearing white lab coats frequently appeared in cigarette advertisements – using the doctor’s image to reassure consumers that cigarettes were safe. Similarly, indoor tanning advertisements have resorted to using physicians and citing medical research studies to try to persuade the public that indoor tanning is somehow “safe” or “safer” than tanning outdoors.

“The thinking behind these ads is that if physicians do something, then somehow it must be okay,” said Dr. Jones. “However, these ads omit the results of a recent survey indicating that 100 percent of dermatologists and 84 percent of non-dermatologist physicians would discourage UV tanning for non-medical purposes, even in healthy patients.”

Promoting Misleading Health Advantages
When awareness of the health risks of cigarettes began to grow in the 1950s and 1960s, the tobacco industry responded with what it coined as “safer,” “filtered” cigarettes. Dr. Jones noted that the goal of these ads was to convince consumers that filtered cigarettes provided protection from harmful effects of smoking, but without admitting that smoking was detrimental to one’s health.

To dispel growing concerns about the dangers of UV exposure, the indoor tanning industry countered with “harm reduction” campaigns that were similar to those used by the tobacco industry. For example, some advertisers began promoting their tanning beds as “UVB-free” or “99% pure UVA” during the 1980s when research confirmed that UVB rays are carcinogenic. These ads, of course, failed to mention that UVA rays also are harmful and can cause skin cancer.

Another popular harm reduction tactic used in tanning advertisements is to promote the health benefits of vitamin D production from UV exposure. In these types of ads, consumers are led to believe that UV exposure from both natural sunlight and tanning beds is beneficial in producing vitamin D, which research suggests may provide protection against heart disease and other cancers.

“What these ads omit is that UV exposure increases your risk of skin cancer, and there are safer ways to get this important vitamin,” said Dr. Jones. “An adequate amount of vitamin D can be obtained from vitamin D supplements – without the health risks of obtaining vitamin D from intentional UV exposure.”

Nothing Smart about Ads that Appeal to the Consumer’s Intelligence
Another tactic used by tobacco manufacturers in advertising is to try to somehow make consumers believe they are “smart” by smoking a certain brand of cigarettes over another brand. Dr. Jones and his colleague found that the indoor tanning industry makes similar appeals to the intelligence of consumers by promoting sunburn prevention at tanning bed facilities through trained professionals who teach consumers how to “tan safely” without getting sunburned.

“This tactic fails to mention that tanning to prevent sunburn provides only an SPF protection of 3, while simultaneously causing damage to the skin that can lead to future skin cancers,” said Dr. Jones. “In addition, studies also show that staff members of indoor tanning facilities do not always enforce the tanning intensity of tanning beds and time regulations of their patrons.”

While Dr. Jones and his colleague concluded that further consumer education about the dangers of tanning is needed, they also point out that the lack of government regulation has allowed the tanning industry to thrive on the public’s misconceptions about tanning through deceptive advertising practices.

FTC Bans Misleading Indoor Tanning Ads
Recognizing the seriousness of this issue, in January 2010 the Federal Trade Commission (FTC) issued a consent order that prohibits the Indoor Tanning Association (ITA) from making false health and safety claims about indoor tanning. The American Academy of Dermatology (Academy) raised its concerns about the false statements being made by the ITA with the FTC in 2008 after the ITA launched an advertising campaign designed to portray indoor tanning as safe and beneficial.

“The American Academy of Dermatology commends the FTC for its investigation into the false and deceptive health and safety claims about indoor tanning being perpetuated by the indoor tanning industry,” said dermatologist David M. Pariser, MD, FAAD, president of the American Academy of Dermatology. “The scientific facts are clear: Exposure to UV radiation – either from the sun or from artificial light sources such as indoor tanning – increases the risk of developing skin cancer, including melanoma, the deadliest form of skin cancer.”

SOURCE American Academy of Dermatology

The more that teens see cigarette ads, the greater their risk of taking a puff. A new study shows that the particular content of tobacco marketing resonates with youth and that the vivid imagery in tobacco advertising captures their interest, although teens typically are more resistant to the promotional seduction of other products.

“Cigarettes have created a brand for every personality trait,” said study lead author Reiner Hanewinkel, Ph.D., director of the Institute for Therapy and Health Research in Kiel, Germany.

“If you are looking to project independence and masculinity, think of the lonely cowboy in the Marlboro ads,” added Hanewinkel, who collaborated with Dartmouth Medical School. “On the other hand, if you’re looking to project a desire for romantic relationships, and friendships are playing a role, then you will choose Lucky Strike if you are a man and Virginia Slims if you are a woman.”

Kids with high exposure to tobacco advertising were twice as likely to have tried smoking and three times as likely to have smoked in the past month, compared to those with low exposure. Exposure to tobacco advertising also was associated with higher intent to smoke in the future among the never-smokers, suggesting that it affects how adolescents perceive smoking even before they start.

The study, which appears online and in the April issue of the American Journal of Preventive Medicine, has relevance for the United States and other nations with partial advertising bans similar to Germany’s restrictions.

The 2008 survey involved 3,415 German schoolchildren, ages 10 to 17, in rural and urban areas. Students saw images (with all the writing and brand logos removed) of six cigarette ads and eight commercial products such as clothing, cars, candy and detergent.

With the brand information missing, researchers measured adolescents’ ad recognition by applying psychological assumptions about attention and memory. They inquired about how frequently students had viewed each ad image and asked about smoking habits and intentions.

“We were amazed at how often they had seen the images and could correctly recall the cigarette brand,” said study collaborator James Sargent, M.D., a professor of pediatrics at Dartmouth. “For example, 55 percent had seen the Lucky Strike image and almost one quarter correctly decoded the brand.”

After analyzing the data, the researchers assessed how likely nonsmokers were to try smoking. Researchers classified survey participants as current smokers if they reported smoking at least once a month.

“This is a well-done study. They controlled for all the things they needed to control for,” said Stanton Glantz, Ph.D., director of the Center for Tobacco Control Research & Education at the University of California, San Francisco. Among the outside variables was whether a parent or peers smoke.

“It’s a nice contribution to the literature showing that cigarette advertising is very powerful,” Glantz said, noting the strong link between the amount of ad exposure and the level of youth response.

By Susan Kreimer, Cfah

Ghana has been selected to host the second working group meeting on World Health Organisation (WHO) Framework Convention on Tobacco Control (FCTC) in April this year.
The meeting is to, among other things, identify and develop opportunities for practical cooperation with competent intergovernmental and non-governmental organisations in the promotion of sustainable alternatives to tobacco growing.

It is also to help achieve the FCTC’s objective of protecting present and future generations from the devastating health, social, environmental and economic consequences of tobacco consumption and exposure to smoking, as well as the reduction of demand for tobacco products.

At the inauguration of a nine-member Local Planning Committee to plan for the meeting scheduled for April 20 to 23, outgoing Deputy Minister of Health, Dr Oakley Quaye-Kuma, said the WHO convention on tobacco control was the first treaty negotiated under the auspices of WHO, which is an evidence-based treaty that reaffirmed the right of all people to the highest standards of health.

The objectives of the working group meeting is among other things to interact with other global players and to deliberate and strategise on alternative livelihoods to tobacco growing in order to protect the environment and the health of persons in the production and manufacturing of tobacco products.

About 40 participants from 18 member countries would be attending the meeting.

The FCTC treaty adopted in 2003 by the World Health Assembly, is the world’s first treaty devoted to health to get people to quit smoking and to reduce the estimated five million deaths annually caused by smoking.

He said tobacco smoking was unhealthy and caused chronic diseases that could lead to death, adding that smoke damaged the lungs and was the principal cause of lung or bronchial cancer and chronic obstructive pulmonary disease.

“What many people, smokers and non-smokers alike, may not know is that tobacco use increases risks of cancer of many sites in the body in addition to the lungs.

“These include the head and neck (covering cancers of the oesophagus, larynx, tongue, salivary glands, lip, mouth and pharynx) urinary bladder and kidneys, uterine cervix, breast, pancreas and colon,” he said.

The Deputy Minister said people who cultivated and handled tobacco leaves were equally at risk of tobacco related diseases, such as green tobacco sickness, pesticide intoxication, respiration and dermatological disorders and other types of cancers.

To this end, the FCTC called on all parties to the Convention to raise awareness about the addictive and harmful nature of tobacco products and about industry interference with tobacco control policies, as well as avoid conflict of interest from government officials and employees.

According to the Deputy Minister, Article 17 and 18 of the Framework Convention deals with provision of support for economically viable alternative activities and protection of the environment and the health of persons.

Parties to the Convention were, therefore, required to promote economically viable alternatives for tobacco workers, growers and, as the case may be, individual sellers, he said.

In order to make progress in the promotion of sustainable alternatives to tobacco growing at the district, regional, national and international levels, Mr. Quaye-kuma said, there was the need to increase the participation of specialized local and international agencies which are recognized experts in this process.

The Chairman of the local Planning Committee, Dr Akwasi Osei, Chief Psychiatrist at the Ministry of Health, said issues to be discussed at the meeting would be adopted by the General Assembly towards the end of the year as a guide for the world towards the control of tobacco production, marketing and consumption.

He said Ghana was in the good books of WHO, hence the choice for the second meeting and pledged the committee’s readiness to ensure a memorable and very productive meeting.

SARATOGA SPRINGS – Fewer high school students are using tobacco these days, but those who are still picking up the habit do not always get the tools they need to quit, school officials in Saratoga Springs fear.

So teachers at the Saratoga Springs High School will offer smoking cessation classes in early May that they hope will provide tools to help students give up the unhealthy habit.

The eight-week, after-school class is voluntary and will show students the long-term effects that smoking or chewing tobacco can have on their health, as well as the ways the habit affects their personal finances. It will also provide a venue for peer support, organizers say.

The class will also be open to staff members who are trying to quit.

Several students have already indicated their desire to quit and enrolled in the program, said Lynette Whaley, the high school’s 12th-grade principal.

“A lot of the kids who skip classes do so because they can’t get through the day without a cigarette,” she said recently. “Once they realize they’re addicted and they can’t make it through the day, I think we have an opportunity to catch them.”

The cessation class, which will be taught by a health teacher and a biology teacher who quit smoking cold turkey years ago, is a rarity among area high schools, organizers say.

But even before the first class, fears have arisen over whether state funding to train teachers and buy materials for the course will disappear because of New York’s budget woes.

Greg Stevens, the tobacco-free school policy coordinator for Saratoga County, said he hopes state leaders will see the value of such programs and recognize that the progress made in recent years will be sustained only if efforts to combat tobacco use continue.

Campaigns and education efforts undertaken by the school and other anti-tobacco groups have been shown to produce results, he

said.

In 2000, 35 percent of 12th-grade students and 20 percent of 10th-grade students at Saratoga Springs High School said they smoked. Eight years later, those numbers had fallen to 22 percent and 12 percent respectively, according to a study by the Saratoga Partnership for Prevention.

Those numbers will fall even further when students are given the tools they need to quit, such as the cessation class, Stevens said.

“Kids are at a stage in their life where they feel fearless, so half of the struggle is just getting them to the point where they say they want to quit,” he said. “But we also have to give them the tools to do that.”

The cessation class is one example of the school district’s recent push to expand and enhance its tobacco-control policy.

Officials have also checkered the school with new signs to make it clear that students — as well as adult visitors — are not to use tobacco while on school grounds.

Staff members patrol the area to look for evidence of smoking, like cigarette butts or the smell of smoke.

Whaley, the principal, said another important change was revising the school’s tobacco policy to include all forms of tobacco use, including smokeless tobacco, which she said has become more common in recent years.

“I don’t know if kids are seeing it from sports figures or in entertainment or what, but we want to make it clear that anything they do with tobacco is not safe,” she said.

Rick Stoddard, a popular anti-smoking speaker who lost his wife to lung cancer, will also speak with students during an assembly on March 5.

Whaley said she hoped the totality of the school’s efforts will be enough to counteract the heavy influence of tobacco companies.

“The marketing is always going to be out there, so we have to do our part to present the other side of it,” she said.

By DREW KERR, Poststar

There have been recent successes in repelling tobacco industry attempts to overturn federal regulation. But this is no time for complacency.Physicians and other public health advocates fighting in the tobacco wars have claimed some major victories in recent months but also have seen reminders of the need to remain vigilant against the onslaught of a committed foe.

Soon after the June 22, 2009, enactment of a landmark tobacco regulation law, some members of Big Tobacco launched the first of an expected series of legal challenges in an attempt to weaken the flanks of the statute. Anticipating this tactic, public health champions stepped up to defend the law and the public it was designed to protect.The outcome of the first big skirmish in the courts was decidedly in favor of the public’s well-being. A federal trial court in Kentucky ruled in November 2009 that tobacco firms could not use a First Amendment-rights argument to claim that the Food and Drug Administration’s new authority over the industry’s questionable marketing practices went too far. Instead, the court affirmed the argument that the massive threat posed by the No. 1 cause of preventable death in the U.S. made it clear that the government was well within its rights to take a strong stand on behalf of consumers everywhere.

The tobacco companies involved in the lawsuit claimed that better enforcement of laws already on the books before June 2009 would be sufficient. But the government has tried that time and time again, and typically, the tobacco industry showed its willingness and ability to slip out of the grasp of any regulation that came its way. All the while, smoking-related health conditions continued to worsen, more kids got hooked on nicotine, and more people died.

This time around, it won’t be so easy for the cigarette makers to escape their responsibilities.

A January ruling from the same Kentucky district court affirmed that the FDA was on solid ground in requiring larger warning labels on tobacco products and banning the sale of “light” products without prior federal approval. The decision validated some of the most significant elements of the landmark regulation statute and hobbled the ability of tobacco firms to continue misleading consumers.

Even though these were some big wins for public health, complacency is not an option for patient advocates.

The tobacco industry has such a strong economic interest in crippling the new statute that it likely will appeal any court decisions that don’t go its way. But physicians and the legal firepower at their disposal — including the Litigation Center of the American Medical Association and State Medical Societies — have an even stronger interest in protecting the law: the health and lives of their patients. Expect these advocates to continue to fight as long as it takes, even if that road eventually leads to the highest court in the land.

It should be noted that the outcomes have not gone entirely in favor of the public’s health. In the January ruling, the Kentucky district court declined to dismiss the First Amendment challenge to FDA restrictions against marketing cigarettes as safe products simply because the government is regulating them more tightly. The judges also sided with the industry on the issue of restricting color and graphics in tobacco advertising, which have been used to entice many young children to light up their first smokes and fall into addiction.

Still, there are reasons to be optimistic that public health advocates will prevail in protecting effective FDA regulation. As things stand, none of the challenges to the bill so far has targeted the heart of the statute: the affirmation that the FDA has the authority to regulate tobacco. Instead, the threats have been coming from the sides, on unrelated free-speech and marketing issues.

That said, a well-delivered blow to the flank is a well-established and highly effective maneuver. Recent events show that some members of Big Tobacco know this tactic well. Fortunately, so do advocates for the public’s health.

Ama-assn.org

RICHMOND, Va. — The Food and Drug Administration is saying in letters to two tobacco companies that flavored, dissolvable tobacco products — that the agency compares with candy and says contain a lot of nicotine — could be particularly appealing to kids and young adults.

The FDA’s Center for Tobacco Products wrote to R.J. Reynolds Tobacco Co., maker of Camel cigarettes, and the smaller Star Scientific Inc. on Feb. 1 voicing concern over smokeless products that are consumed like breath mints but made from finely milled tobacco.

“CTP is concerned that children and adolescents may find dissolvable tobacco products particularly appealing, given the brightly colored packaging, candy-like appearance and easily concealable size of many of these products,” Dr. Lawrence Deyton, director of the Center for Tobacco Products, told the companies.

Deyton said regulators are worried the products’ nicotine content and rapid dissolution could cause nicotine dependence and addiction and be especially dangerous to children and young adults.

He asked the two best known makers of dissolvable tobacco products to provide their research and marketing information on how people under age 26 perceive and use the products.

Exercising new power to regulate tobacco that the FDA was granted in June, Deyton also requested research on misuse of the products, including potential accidental nicotine poisoning.

Regulators also want a summary of user demographics, including at what age “tobacco-naive consumers” start using the products.

The products are available in few markets and account for a small share of the tobacco industry.

Star Scientific, based in Petersburg, Va., markets its Ariva and Stonewall tablets in wintergreen, coffee and tobacco flavors. The first versions appeared about nine years ago.

R.J. Reynolds, which is owned by Reynolds American Inc. in Winston-Salem, N.C., is test-marketing dissolvable tablets, strips and a toothpick shape under the names Camel Orbs, Camel Strips and Camel Sticks in mint and other flavors.

The Orbs last about 15 minutes, the strips dissolve in five minutes or less and the sticks, which are slightly bigger than toothpicks, last 15 to 20 minutes.

The FDA is seeking the information as its Tobacco Products Scientific Advisory Committee prepares to study the issue later this year.

Reynolds spokesman David Howard said that company is reviewing the FDA’s request and plans to help regulators evaluate the products.

“Our products are made for, and marketed to, adult tobacco consumers,” Howard said. He said dissolvable items are sold on the same shelves as other tobacco products and carry the same warnings and age restrictions.

Star Scientific, which has been involved in a patent dispute over some of the technology behind its dissolvable products, disagrees with the FDA’s characterization of them and looks forward to speaking with regulators, spokeswoman Sara Troy Machir said.

“The challenge that we have faced in attempting to meet the needs of adult smokers … is to develop a product that is palatable to the customer while at the same time not making it attractive to the non-tobacco user,” she said

Machir said flavors are added to the products to make them taste less harsh.

Tobacco companies are focusing on cigarette alternatives — such as cigars, snuff and chewing tobacco, as well as other forms of nicotine replacement — for future sales growth as demand for cigarettes continue to decline.

By MICHAEL FELBERBAUM