ANTI TOBACCO 

New Smoking Cessation Guideline Confirms That Now Is The Time To Quit Smoking (Medical News Today-8/05/2008)

Yesterday the U.S. Department of Health and Human Services published an update to its 1996 Public Health Service Clinical Practice Guideline, Treating Tobacco Use and Dependence, which contains revised and improved recommendations to providers and clinicians so that they can better assist smokers in quitting. The guideline also confirms that there has never been a better time for smokers to quit than right now. With the release of these new guidelines, smokers can receive improved strategies from physicians and other health care providers to help successfully quit smoking. The guidelines definitively state that combining FDA-approved pharmacotherapies and counseling is the most effective way for smokers to end addiction to tobacco products. The Public Health Service also finds that cessation treatments are cost-effective and that providing these treatments through healthcare systems will increase the number of people who seek treatment for smoking, attempt to quit and successfully quit. "These new guidelines underscore how important it is for smokers to receive assistance quitting," said Bernadette Toomey, President and CEO, of the American Lung Association. "The American Lung Association stands ready to help smokers quit through our different smoking cessation programs and resources." 

For more than 25 years, the Lung Association has offered Freedom from Smoking ® - the gold standard in smoking cessation. Freedom from Smoking ® and its online companion, Freedom from Smoking Online ®, have been proven effective to help smokers quit. Not-On-Tobacco (N-O-T), which is intended for regular smokers aged 14-19 who want to quit, is the only smoking cessation program of its kind to be named a "Model Program" by the U.S. Department of Health and Human Services' Substance Abuse and Mental Health Services Administration (SAMHSA). Finally, the American Lung Association's Helpline (1-800-LUNG-USA) is staffed by registered nurses and registered respiratory therapists with extensive experience in helping smokers quit. All of the American Lung Association's cessation programs and services utilize the Public Health Services' guideline. The updated guidelines also make clear that recommended treatments for tobacco use should be covered by public and private health benefit plans. This is particularly true for smokers enrolled in Medicaid, who smoke at rates sixty percent higher than the national average. Nationwide, 34.8 percent of the Medicaid population smokes - compared to 20.8 percent of the general population - which translates into almost $34 billion annually in Medicaid costs directly attributable to smoking. 

"Federal and state leaders must do their part in helping Medicaid recipients and others disproportionately affected by tobacco use to end their addiction to these deadly products," Toomey emphasized. "Tobacco is the number one preventable cause of death in the United States - policy change, including cessation coverage for all Medicaid recipients, is urgently needed to end this epidemic." Just yesterday, the Journal of the American Medical Association (JAMA) released a study demonstrating the health benefits to women who quit smoking. The study found that quitting smoking helps women reduce the risk of heart and lung diseases, lung cancer and other cancers. 

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Study: Restaurant Tobacco Bans Influence Teen Smoking (Yahoo News- 9/5/2008)

A Massachusetts study suggests that restaurant smoking bans may play a big role in persuading teens not to become smokers. Youths who lived in towns with strict bans were 40 percent less likely to become regular smokers than those in communities with no bans or weak ones, the researchers reported in the May issue of the Archives of Pediatrics & Adolescent Medicine. The findings back up the idea that smoking bans discourage tobacco use in teens by sending the message that smoking is frowned upon in the community, as well as simply by reducing their exposure to smokers in public places, said Dr. Michael Siegel, of Boston University School of Public Health, and the study's lead author. "When kids grow up in an environment where they don't see smoking, they are going to think it's not socially acceptable," he said. "If they perceive a lot of other people are smoking, they think it's the norm." 

Siegel and his colleagues tracked 2,791 children between ages 12 and 17 who lived throughout Massachusetts. There were no statewide restrictions when the study began in 2001 but about 100 cities and towns had enacted a hodgepodge of laws restricting smoking in workplaces, bars or restaurants. The teens were followed for four years to see how many tried smoking and how many eventually became smokers. Overall, about 9 percent became smokers - defined as smoking more than 100 cigarettes. In towns without bans or where smoking was restricted to a designated area, that rate was nearly 10 percent. But in places with tough bans prohibiting smoking in restaurants, just under 8 percent of the teens became smokers. The study found that having a smoker as a parent or a close friend was a factor in predicting whether children experiment with cigarettes. But strong bans had a bigger influence on whether smoking grew into a habit, reducing their chances of becoming smokers by 40 percent. "There is really no other smoking intervention program that could cut almost in half the rate of smoking," Siegel said. 

Age was also a factor. Smoking bans had a greater effect on younger teens than on older teens. The researchers said it's not clear whether strong bans would have the same effect in other states since local towns adopted their restrictions as part of an aggressive anti-smoking campaign throughout the state. A statewide workplace smoking ban that included restaurants went into effect in mid-2004. Since then, high school smoking rates in Massachusetts have continued to decline, from about 21 percent of students in 2005 to about 18 percent in 2007. Many restaurant owners fought the ban, saying it could drive away diners, according to Janine Harrod, director of government affairs for the Massachusetts Restaurant Association, which represents 2,000 restaurant owners. While some restaurants were hurt initially, the effects have eased over time since the ban applies to everyone, she said. Bill Phelps, a spokesman for Altria, parent company of cigarette-maker Philip Morris USA, said the study shows that the reasons teens take up smoking are complex. "There is no single reason why young people engage in risky behaviors like smoking," he said. "We believe that there should be a multifaceted approach to address youth smoking." At least 23 states, the District of Columbia and Puerto Rico require most public places and workplaces, including restaurants and bars, to be smoke free, according to the National Conference of State Legislatures. 

Another nine states ban smoking in workplaces but have various exemptions for restaurants or bars. "We already have more than enough evidence why we should pass these smoke-free laws, but certainly this study should help push them along," said Danny McGoldick of the Campaign for Tobacco Free Kids. 

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Hookahs on US college campuses becoming public health (Yahoo News-07/05/2008)

Researchers at Virginia Commonwealth University have found that more and more U.S. college students are smoking tobacco using waterpipes, or hookahs, and it's becoming a growing public health issue. The findings provide important insight into the prevalence and perceptions related to waterpipe tobacco smokers. "These results should serve as an alarm bell to anyone interested in public health in the United States. Preventing tobacco-caused death and disease means remaining alert to new forms of tobacco smoking and then understanding the health risks of these new forms and communicating these risks to public health workers, policy makers, and to smokers themselves," said principal investigator Thomas Eissenberg, Ph.D., associate professor in the VCU Department of Psychology. In a hookah, tobacco is heated by charcoal, and the resulting smoke is passed through a water-filled chamber, cooling the smoke before it reaches the smoker. According to some hookah, this method of smoking tobacco as less harmful and addictive than cigarette smoking.

However, Eissenberg said that current and prospective waterpipe tobacco smokers should be made aware that the method is not as benign as they might think. Waterpipe and cigarette smoke contains some of the same toxins -- disease-causing tar and carbon monoxide, as well as dependence-producing nicotine. Besides this, the exposure to these toxins through waterpipe smoking may be greater due to longer periods of use. Also, smokers take more and larger puffs with waterpipes, leading to inhalation of 100 times more smoke from a single waterpipe use episode relative to a single cigarette. In a cross-sectional study, approximately 744 students, mostly between the ages of 18 and 21, completed an Internet survey that included questions about demographics, tobacco use, risk perceptions and perceived social acceptability. Researchers found that approximately 43 percent of those surveyed had smoked tobacco using a waterpipe in the past year and 20 percent of them had smoked tobacco using a waterpipe in the past month. 

They also found that users were more likely to perceive waterpipes as less harmful than cigarettes as compared to those who had never used a waterpipe before. "The data we report, along with data from other schools, show that waterpipe tobacco smoking is common on college campuses across the country. Thus, prevention messages, especially those that communicate the potential risks of waterpipe tobacco smoking, should focus on college campuses," Eissenberg said. The study is published in the May issue of the Journal of Adolescent Health. 

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Researchers Find Link Between Advertising And Increased Tobacco Use Among India's Youth (Yahoo News-03/05/2008)

As the westernization of India accelerates, tobacco advertising and marketing have been linked to increased tobacco use by urban Indian children as young as 11, according to a study by researchers at The University of Texas School of Public Health. The study, "Associations Between Tobacco Marketing and Use Among Urban Youth In India," is published in the May/June issue of the American Journal of Health Behavior. Findings from an earlier published study by the researchers revealed that in 2004, Indian sixth graders were using three times the amount of tobacco as eighth graders, which the authors found might indicate a new wave of increased tobacco use. The second study sought to discover the reason for the jump. "As India becomes more westernized, more teens will use tobacco," said the study's principal investigator Cheryl Perry, Ph.D., professor and regional dean of The University of Texas School of Public Health Austin Regional Campus. "The sixth graders as a group are already thinking that smoking is cool while the eighth graders haven't been as exposed to the Western message." After the major tobacco company settlements of 1998 that included more stringent laws banning pro-smoking advertising, smoking has dropped among American youth. According to The Monitoring the Future study, daily smoking among eighth graders dropped from 8.8 percent in 1998 to 3 percent in 2007.

"The current study is the first in India to demonstrate a strong, dose-response relationship between exposure and receptivity to tobacco advertising and promotions and tobacco use among Indian youth. These associations clearly suggest a need to strengthen policy and program-based interventions to reduce tobacco use among youth in India," said Melissa Stigler, Ph.D., assistant professor at the UT School of Public Health and study co-author, who did much of the ground work in India. Chewing tobacco and aromatic cigarettes called "bidis" account for the majority of tobacco use in India with cigarettes taking 20 percent of the market. While tobacco advertising was banned in India in 2004, the year the study began, cigarette companies are coming up with new ways to reach a relatively untapped audience, Stigler said. Event sponsorship and lifestyle stores centered on tobacco products are slipping through the cracks of the law. As part of the 2004 law, smoking is also banned in public areas such as indoor malls, but tobacco companies have responded with air-conditioned mobile smoking lounges.

"On a visit there shortly after the 2004 law was enacted, I witnessed a long line of college age students lined up for one of the mobile lounges, which was parked outside an upscale shopping mall." Stigler said. The government is still working through the courts to determine the extent of the ban. For example, Stigler said, actors have started to stop smoking cigarettes in Bollywood movies but they now sing and dance about it instead. The researchers found the link between advertising and tobacco use among the Indian youth to be alarming. "I was surprised that they were so strongly influenced," Perry said. "The more exposed the youth were to tobacco advertising, the more likely they were to have ever used or be currently using tobacco." The study, which included 11,642 sixth and eighth graders, was produced in collaboration with Indian organizations Health Related Information Dissemination Amongst Youth in Delhi and Tamil Nadu Voluntary Health Association in Chennai. The researchers found that 37 percent of youth in the study had seen tobacco advertising in more than four places while 50 percent had seen advertising in one to four places. Tobacco use rose with measures of receptivity, including having a favorite tobacco advertisement, believing misleading imagery created by tobacco advertisements and being willing to use a tobacco promotional item (such as wearing a T-shirt that advertises tobacco).

The news comes on the heels of new research, published in the New England Journal of Medicine's Feb. 13 issue, which predicts that in India, by the year 2010, one million deaths per year will be the result of smoking. Funding for the UT School of Public Health study came from the Fogarty International Center of the National Institutes of Health.

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Dental Experts Blast Tobacco Companies for Expanding Smokeless Product Lines, Urge Congress to Pass Bills Giving FDA Oversight of Tobacco Products (Business Wire-30/04/2008)

New tobacco products being test marketed by U.S. tobacco companies will likely discourage users from quitting and will lure non-users, especially young people, to adopt a nicotine habit, warns Dr. Jed Jacobson, chief science officer of Delta Dental of Michigan, Ohio, Indiana, and Tennessee (Delta Dental). He said the products, known as snus (pronounced “snoose”), are not safe and should not be used by consumers. Jacobson, and Dr. Joan McGowan, associate professor at the University of Michigan School of Dentistry, say the new product lines – part of the tobacco industry’s growth strategy to counter declining smoking rates and smoking bans - should spur Congress to pass proposed legislation that would grant the U.S. Food and Drug Administration (FDA) broad authority to regulate tobacco products. Snus is a Swedish type of smokeless tobacco that is packaged in teabag-like pouches that a user sticks between the upper lip and gum. They may appeal to smokers whose habits have been curtailed by no smoking laws or who don’t like the idea of spitting out traditional chewing tobacco or snuff. Tobacco companies, and some proponents of the product, say snus is less harmful than cigarette smoking. Test marketing of the product is expanding to more metropolitan areas in the U.S. this spring.

“Tobacco companies are touting snus as a safe alternative to smoking but their claims are unproven, misleading, and, frankly, suspect,” said Jacobson. “Without rigorous oversight by a regulatory agency, American consumers will never know the full truth about the health risks of any tobacco product.” “Whatever form it’s in, tobacco is dangerous and smokeless tobacco is a direct assault on oral tissue, increasing the user’s risk for disease,” said McGowan. “It’s time to put an end to the tobacco industry’s disregard for public health and by requiring FDA approval over the manufacture and marketing of current and new tobacco products.” She continued, “While sales of cigarettes have been on the decline, sales of smokeless products have been growing for the past several years, and cigarette companies are now capitalizing on this trend. The increased use of smokeless tobacco products should be seen as a major public health problem requiring collaborative efforts on the part of dental health professionals, school personnel, parents, and community organizations to educate our children on the dangers of all these tobacco products and addiction.” The landmark bi-partisan bills (Senate Bill 625 and House Bill 1108), known as the Family Smoking Prevention and Tobacco Control Act, recently passed out of committee. They may go the full Senate and House for consideration before the Memorial Day recess. Among other things, the proposed legislation requires tobacco companies to disclose detailed information about their products and marketing efforts, authorize the FDA to require changes in current and future tobacco products to make them safer, and prohibit tobacco companies from making any explicit or implicit health claims.

Smokeless tobacco is available as chewing tobacco, snuff (including snus), and dissolvable tablets. Snus was first developed in Sweden, which is the only country in the European Union where its use is legal. Some studies have shown that Swedish-produced snus contains lower levels of cancer-causing chemicals than those found in cigarettes or U.S.-produced snuff. Recently published data suggests that the use of Swedish snus doubles the user’s risk of pancreatic cancer. “Snus” means snuff in Swedish. Without regulation, U.S. tobacco companies can brand any form of smokeless tobacco as snus. A recent study by researchers at the University of Minnesota concluded that smokeless tobacco is not a safe substitute for smoking. It found that users of smokeless tobacco had a similar exposure to one of tobacco’s most potent cancer-causing agents, known as NNK. According to the National Cancer Institute (NCI), smokeless tobacco contains 28 cancer-causing agents, including formaldehyde (the same chemical used in embalming), butanol (an industrial solvent and alternative fuel), and polonium-210 and uranium-235 (both used in nuclear weapons). In addition, the NCI also reports that the amount of nicotine absorbed from smokeless tobacco is 3 to 4 times the amount delivered by a cigarette. Nicotine is absorbed more slowly from smokeless tobacco than from cigarettes and stays in the bloodstream for a longer time. 

According to the U.S. Centers for Disease Control, an estimated 3 percent of adults are current smokeless tobacco users. In addition, 13.6 percent of all boys in U.S. high schools and 2.2 percent of high school girls use smokeless tobacco products. Sales of one category of smokeless tobacco are soaring. The Federal Trade Commission reported that sales of moist snuff in the U.S. more than doubled in volume from 1986 to 2005. For more information about tobacco and cancer, go to www.cancer.gov (National Cancer Institute). To learn about efforts to prevent children from becoming tobacco users, go to www.tobaccofreekids.org. For consumers who want to contact their U.S. senator or representative about the proposed legislation, go to www.thomas.gov for Congressional phone numbers and email addresses.

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Half Of Europe's Workforce Remain Unprotected From Secondhand Smoke At Work (Yahoo News-17/04/2008)

Less than a third of the European Union's Member States have introduced fully comprehensive smokefree legislation, three years after the world's first public health treaty on tobacco control - the World Health Organisation (WHO) Framework Convention on Tobacco Control (FCTC) - introduced the need for protecting employees from the dangerous effects of secondhand smoke. Today's 'Spotlight on the FCTC*' reveals how only nine of the 25 EU Member States that have signed and ratified the WHO treaty have so far introduced comprehensive smokefree legislation - leaving over half of Europe's workforce exposed to secondhand smoke. When tobacco smoke contaminates the air, it is breathed by everyone - smokers and non-smokers alike. There are more than 4,000 chemicals in tobacco smoke including 69 known carcinogens. Comprehensive smokefree legislation has been introduced in Estonia, Finland, France, Ireland, Italy, Malta, Slovenia, Sweden and the UK. Jean-Luc Eiselé, Executive Director at the European Respiratory Society said: "The scientific evidence is clear: secondhand smoke kills. Only comprehensive smoke free legislation fully protects workers from the detrimental effects of second hand smoke. We congratulate those countries that have taken the steps necessary to become smokefree, but all workers in the EU should have the same level of protection" 

Jean King, Director of Tobacco Control at Cancer Research UK added: "Countries that have already introduced comprehensive smokefree legislation are finding that the legislation is workable and has almost immediate health benefits. We hope these examples will encourage the countries that have not yet taken the necessary action to introduce smokefree workplaces to do so as soon as possible." The Framework Convention on Tobacco Control (FCTC) aims to protect people from the health, economic and social impacts of tobacco. It recognises that secondhand exposure to tobacco smoke has been scientifically proven to cause death, disease and disability. Countries that have signed and ratified the FCTC are required to reflect its principles in their national legislation and polices including the provisions concerning second hand smoke. 'Spotlight on the FCTC' , prepared by the Smokefree Partnership, highlights how the European Commission, European Parliament and EU Member States have met, or in some cases failed to meet, their obligations to tackle second hand smoke, according to Article 8 of the convention. 

The booklet also draws attention to the fact the European Parliament failed to maintain its own comprehensive smoking ban, which was introduced in January 2007, and lasted 43 days before being revoked by the governing body of MEPs. A ruling by the European Ombudsman found that the Parliament was failing to protect the health of its staff. A 2007 Parliamentary report led by MEP Karl Heinz Florenz in response to a Commission Green Paper on a smokefree Europe, states that 'only a full smoking ban in all enclosed workplaces, including catering and drinking establishments, and all public buildings and transport, can protect the health of employees and non smokers'. The report also called on the Parliament's Bureau, in the light of its duty to set an example, to implement a full smoking ban in all parts of the Parliament - but no action has yet been taken. 

MEP Gerard Onesta said: "The alarming decision by the European Parliament to scrap its own smokefree rules highlights a dangerous disregard some MEP's have for the health of those workers affected. Their original commitment to a smokefree European Parliament showed they understood the dangers of secondhand smoke. They urgently need to lead by example and reverse this disastrous setback for the future of a healthy Europe." MEP Karl Heinz Florenz added: I will continue to fight for strong smoke free policies at national and European level as well as in the European Parliament itself. MEPs and the European Parliament as an institution should live up to their public health responsibilities and take the lead on this issue. The smoking ban in the European Parliament needs to be put into effect now! 

This article has been written on behalf of the European Respiratory Society and Cancer Research UK. The Smoke Free Partnership (SFP) is strategic, independent and flexible and aims to promote tobacco control advocacy and policy research at EU and national levels in collaboration with other EU health organisations and EU tobacco control networks. The 'Spotlight on the FCTC' is a series of briefing papers on the FCTC and EU's associated obligations prepared by the Smokefree Partnership. 

Smokefree Partnership
49-51 rue de Tréves, 1040 Brussels
http://www.smokefreepartnership.eu

The FCTC

The FCTC is the world's first international public health treaty. It recognises the harm that tobacco products and the companies that produce them can cause. The Treaty sets out legally binding objectives and principles that countries or regional economic integration organisations such as the European Community (known as Parties) who ratified and thus agreed to implement the Treaty must follow. All EU Member States, with the exception of Italy and the Czech Republic, have signed and ratified the FCTC so the principles of the Treaty must be reflected in their national legislation and polices. The European Community (EC), represented by the European Commission, is also a Party to the FCTC. The Framework Convention Alliance for Tobacco Control (FCA).

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Global Smoking Cessation Aids Market To Reach 2.6 Billion Dollar (Yahoo News- 23/04/2008)

Tobacco use is one of the major causes of premature deaths in the world. More than five million people die each year due to tobacco related illnesses. Given the fact that consumption of tobacco products is on the rise, especially among youngsters in the developing countries, there exists strong potential for growth of smoking cessation aids in Asia-Pacific, Middle East & Africa and Latin America. Smoking cessation aids, also known as Nicotine Replacement Therapies (NRT), are medications that deliver smokers with a temporary replacement source of nicotine and aids to reduce severity of cravings for cigarettes. NRT also aids to minimize some of the withdrawal symptoms associated with smoking such as irritability, drowsiness, difficulty in concentrating, anxiety and restlessness, thus offering support for effective smoking cessation. Most commonly used smoking cessation aids include alternatives of nicotine such as nicotine patches, gums, lozenges, nasal sprays and inhalers. Certain NRT products such as nicotine patches, gums, and lozenges need no prescription and are sold OTC (over-the-counter), while nasal sprays and inhalers are available only through expert prescription. 

World Smoking Cessation Aids market is forecast to grow at a CAGR of 9.13% over the period 2011 through 2015. Major regional growth is expected from stem from Asia-Pacific (inclusive of Japan), Middle East & Africa and Latin America. Together, these markets are forecast to witness a 13.81% growth over the aforementioned period. In Europe, sales of Nicotine Patchesa are forecast to reach $341.35 million by the year 2012. In the United States, where adult smoking has declined over the years, demand for lozenges & tablets is projected to dwindle to $141.17 million by the year 2015. &nb sp; Global and regional players operating in the industry include GlaxoSmithKline Plc, Johnson & Johnson Inc, Novartis Consumer Healthcare Inc., Perrigo Company, Pfizer Inc., Nabi Biopharmaceuticals, Watson Pharmaceuticals, Inc., Alza Corporation, Cedar Health Ltd., and Fertin Pharma A/S. "Smoking Cessation Aids: A Global Strategic Business Report", published by Global Industry Analysts, Inc. provides a comprehensive review of market trends, drivers, product profile, recent developments, mergers, acquisitions and other strategic industry activities. Analysis is presented for major geographic markets such as United States, Canada, Europe and Rest of World. Analytics for product markets such as, Nicotine Gum, Nicotine Patches, and Lozenges & Tablets, are presented for the period covering 2000 through 2015 for select markets. 

About Global Industry Analysts, Inc. 

Global Industry Analysts, Inc., (GIA) is a reputed publisher of off-the-shelf market research. Founded in 1987, the company is globally recognized as one of the world's largest market research publishers. The company employs over 700 people worldwide and publishes more than 880 full-scale research reports each year. Additionally, the company also offers a range of over 60,000 smaller research products including company reports, market trend reports, and industry reports encompassing all major industries worldwide.

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Fetal exposure to drugs, alcohol or tobacco may change brain structure of kids (Yahoo News - 8/04/2008)

A new study has found that babies born to women who use cocaine, alcohol or tobacco during pregnancy may have brain structure changes that continue into early adolescence. Using magnetic resonance imaging (MRI) brain scans, researchers at the Children's Hospital Boston and the Boston Medical Center studied brain structure of 35 young adolescents prenatally exposed to cocaine, marijuana, alcohol or tobacco. The children aged 12 years at the time of imaging, were part of a historic cohort of children assembled by Deborah Frank, MD at Boston Medical Centre and followed them since birth. "We found that reductions in cortical gray matter and total brain volumes were associated with prenatal exposure to cocaine, alcohol or cigarettes," said Dr Michael Rivkin, neurologist at Children's Hospital Boston.

"Importantly, although volume reductions were associated with each of these three prenatal exposures, they were not associated with any one of these substances alone after controlling for other exposures," he added. While analysing the MRI images, the researchers noticed that the effects were additive, the more substances a child was exposed to in utero, the greater the reduction in brain volume. Previous studies have also shown brain effects of prenatal alcohol exposure. Researchers initially set out to study cocaine exposure, but they were struck by the finding of brain effects of prenatal tobacco exposure. "Approximately 20 percent of women who smoke continue to smoke during pregnancy," said Rivkin. "From the vantage point of preventive health care, it is important to determine the consequences on brain structure of prenatal exposure to cigarettes, alone and in combination with other substances," he added. The study was funded by the National Institute on Drug Abuse. 

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Research Snuffs Out Notion That Smokeless Tobacco Is Lesser Of Two Evils- (ScienceDaily- 19/1/2008) 

Millions of Americans make the New Year’s resolution to stop smoking, but far too many break ranks before Jan. 2. Their dismal success rate has health officials scrambling to come up with easier ways to quit, and many have toyed with the idea that smokeless tobacco could ease the transition off cigarettes. But research by University of Florida scientists suggests that tactic would be a catch-22, especially in younger smokers. More than 40 million Americans smoke, according to the Centers for Disease Control and Prevention, and about 70 percent of them are trying to kick the habit. The CDC estimates that the long-term health problems associated with smoking — particularly lung cancer, chronic lung disease and heart disease — result in 438,000 deaths every year. Public health officials are unanimous in the belief that something must be done. But what?

“There have been a number of papers saying that the health community should tell the public that smokeless tobacco is ‘safer’ than smoking — but not ‘safe’ per se,” said Dr. Scott Tomar, department chairman and a professor of community dentistry and behavioral science at UF’s College of Dentistry. That theory, called “tobacco harm reduction,” aims to wean smokers off cigarettes by advising them to switch to smokeless products, such as snuff and chewing tobacco. Tomar’s research suggests that few smokers seem interested in making this switch and he worries that promoting smokeless tobacco could encourage nonsmokers to pick up a dangerous and addictive habit. “I don’t think there’s any doubt among members of the scientific community that smokeless tobacco carries a lower risk of death than does cigarette smoking,” Tomar said. “On the other hand, that alone doesn’t necessarily make it an appropriate recommendation coming from the health community.”

Smokeless tobacco products contain almost 30 ingredients known to cause cancer. A recent study by the International Agency for Research on Cancer linked smokeless tobacco to cancers of the mouth and pancreas, as well as oral problems such as recessed gums and bone loss. Nonetheless, supporters of the tactic insist that smokers might show a greater interest in switching to smokeless tobacco if they were made aware of the reduced health risks.

“There have been claims by proponents of smokeless tobacco that the public can’t separate the risks of smoking from the risks of other types of tobacco use,” Tomar said. Younger smokers are especially worrisome. Experts warn that lighting up at a young age can set the stage for a lifetime of dependence. More than 80 percent of older smokers lit up for the first time before they turned 18, according to the CDC. And every day, about 3,900 youth are doing just that.
To find out if younger smokers could differentiate between health risks associated with various tobacco products, Tomar analyzed data from more than 11,000 high school seniors over a five-year period. The data were collected through the Monitoring the Future project conducted by the University of Michigan’s Institute for Social Research.

Tomar’s study, which was published in the November issue of Nicotine & Tobacco Research, revealed that high school seniors who smoke greatly underestimate the risks associated with their tobacco use. Fewer than half of those interviewed perceived a great risk of harm from cigarettes. In contrast, more than 80 percent of nonsmokers regarded smoking as hazardous to their health. “Very few smokers in 12th grade perceive that what they’re doing is harmful,” Tomar said. “That’s really what makes this whole idea so challenging. Advocates are saying you should tell these young smokers, ‘We’re not saying smokeless tobacco is safe, but it’s safer than cigarettes.’ But you’re telling that to a population who already tremendously underestimates their own risk.”

But would the advice work?

“We’ve seen almost no smokers moving toward smokeless tobacco. If anything, it tends to be in the other direction,” Tomar said. “We’ve done previous studies of 17-year-olds who were only using smokeless tobacco. Four years later, 40 percent of them had either added cigarettes to the use of smokeless tobacco or completely switched to smoking. We saw almost no movement in the other direction.” Many experts agree that the marketing strategy could do more harm than good. “There is concern that a major advertising campaign of smokeless tobacco as less harmful than cigarettes may threaten the major reduction in adolescent initiation that we have seen in recent years,” said John Pierce, the Sam M. Walton professor for cancer research at the University of California at San Diego Cancer Center. “There is plenty of evidence that advertising influences younger people.” Tomar’s findings suggest that advertising money might be better spent on educating younger smokers about the hazards of tobacco use. “People will only take steps to change if they perceive that their current behavior is harmful,” Tomar said. “With young people, what they’re reporting is that they don’t think they’re at risk for harm. Why would they want to switch to something that’s less harmful?”

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New CDC Global Survey Finds Tobacco Taking Massive Toll on World's Children- (PRNewswire-USNewswire- 24/1/2008) 

The following statement was issued today by Matthew L. Myers, President, Campaign for Tobacco-Free Kids:


A new global survey released by the U.S. Centers for Disease Control and Prevention (CDC) finds troubling rates of tobacco use, and even higher rates of exposure to secondhand smoke, among children around the world. According to the CDC, several findings of the Global Youth Tobacco Survey indicate that the global death toll from tobacco use, already the world's leading preventable cause of death, may be increasing even faster than thought. These include higher rates of smoking among girls than have been previously found, high levels of exposure to secondhand smoke, and a high level of exposure to tobacco marketing. The survey was published in the January 25 edition of the CDC journal Morbidity and Mortality Weekly Report. Tobacco use already claims about five million lives a year worldwide. That number has been projected to double by 2020, with more than 70 percent of these deaths in developing nations. However, stunningly, the data in the new study suggest that the estimate of a doubling of deaths from smoking could well underestimate the actual future death toll. Altogether, tobacco use is projected to kill one billion people worldwide this century unless urgent action is action. The new survey underscores the need for nations to take immediate and aggressive action to reduce tobacco use by implementing the measures called for by the World Health Organization international tobacco control treaty, the Framework Convention on Tobacco Control. The treaty calls on ratifying nations, which now number 152, to implement scientifically proven measures to reduce tobacco use and exposure to secondhand smoke, including higher tobacco taxes; laws requiring that all workplaces and public places be smoke-free; stronger, larger health warnings on tobacco products; bans on all tobacco advertising, promotions and sponsorships; and effective tobacco public education and cessation programs.


The CDC survey includes data collected during 2000-2007 from 140 countries, as well as several territories and regions (for countries that have conducted several surveys during this time period, only the most recent data were included). Key findings include:

-- Rates of tobacco use vary greatly in countries around the world, with
youth cigarette smoking rates topping 30 percent in several
countries. Worldwide, 9.5 percent of students surveyed currently
smoked cigarettes, and 10.1 percent used other tobacco products (such
as pipes, water pipes, smokeless tobacco and bidis).

-- Approximately half of the students surveyed reported that they were
exposed to secondhand smoke in public places during the week
preceding the survey. Secondhand smoke contains more than 4,000
chemicals, at least 69 of which are known to cause cancer. It is a
proven cause of lung cancer and heart disease in nonsmoking adults
and of sudden infant death syndrome (SIDS), low birth weight, acute
respiratory infections, ear infections and asthma attacks in infants
and children.

-- Approximately two in 10 students own an object with a cigarette brand
logo on it - a marketing tactic associated with increased tobacco use
known as indirect advertising.

-- One in 10 students have been offered free cigarettes by a tobacco
company representative.

-- Approximately seven in 10 students who smoked were not refused
purchase of cigarettes from a store during the month preceding the
survey.


The good news is that the tobacco epidemic is entirely preventable. We urge governments to act on the huge body of evidence like that found in the new CDC report and protect the public health and economic well-being of their citizens.

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Tobacco ads influence students to chew and puff: Study -(DH News Service) 

Despite the ban on tobacco advertisements, cleverly made surrogate spots from 
tobacco companies are influencing school students to take up the deadly habit to a large extent, says new research... Indian students can recall brands like Wills and Pan Parag, which are the two most popular cigarette and chewing tobacco brands. This happened because despite legal prohibitions on tobacco advertisements, these brands continue to be advertised through surrogate means, says the new study published last week in the online edition of the American Journal of Health Behaviour. 

Two Central legislations – Cable Television Network (regulation) Act and 
Cigarettes and Other Tobacco Products (prohibition of advertisement and 
regulation of trade and commerce, production, supply and distribution) Act – 
prohibits almost all types of tobacco advertisements except small display boards at the tobacco shops. Despite the ban tobacco promotion – by surrogate means like brand stretching – plays an “important influence contributing to the increase in tobacco use and change in tobacco use patterns among urban Indian adolescents,” says the research conducted by the University of Texas, Austin, All India Institute of Medical Sciences and a Delhi-based non governmental organisation, HRIDAY. 

The research was conducted on 11,642 grade six and eight students in 32 schools in Delhi and Chennai. As many as 665 students have been able to recall multiple tobacco brands including Wills, Gold Flake and Red and White. 
“The number is sizable and statistically significant. This is the first study 
showing a clear association between surrogate advertisement and influence on 
students,” HRIDAY director Monika Arora told Deccan Herald. Denying that the 
number (665 students who responded positively) is too small to arrive at a 
definitive conclusion, Ms Arora said, “The fact that there is a recall is our 
concern. The trend is on the rise.” The new findings have come at a time when the Union Health ministry is experiencing stiff political opposition in implementing mandatory publication of gory pictures on cigarette and beedi packets – a decision approved by the Union cabinet headed by Prime Minister Dr Manmohan Singh. The matter has been referred to a group of ministers headed by Pranab Mukherjee, which had earlier turned down the Health ministry’s proposal. 

While the politically powerful tobacco industry claims severe loss of livelihood 
if the sale of cigarette and beedi drops due to these warning images, the Health 
ministry’s counter is that tobacco kills eight lakh people every year every year 
and the government spends 27,000 crore rupees annually to treat tobacco-related diseases. The outcome of this study that throws light on the influence of tobacco commercials on students remains to be seen. But what is clear is that steps need to be taken in this regard, and more studies are needed too.

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Snuff Not a Safe Tobacco Option- Quitting Smoking? Researchers Advise Against Switching to Smokeless Tobacco- (WebMD Medical News- 21/12/2007) 

Planning to quit smoking? Smokeless tobacco isn't a safe alternative, says a University of Minnesota cancer expert. "The results of our studies do not support the concept that smokers should switch to smokeless tobacco," writes Stephen Hecht, PhD. "Long-term use of nicotine replacement therapy may be a better option." Hecht has been studying smokeless tobacco -- mainly as oral moist snuff -- for more than 20 years.He notes that smokeless tobacco -- which can cause oral and pancreatic cancer -- contains carcinogens called nitrosamines in levels similar to nitrosamines in cigarettes.

Nitrosamine levels are about 1,000 times higher than in other consumer products, and products touting "low nitrosamine" claims don't eliminate the risk, according to Hecht. Smokeless tobacco products bear a warning label about health risks. But sales of moist snuff have "continued to increase" in the U.S., notes Hecht. Hecht's report appears in Chemical Research in Toxicology.

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Tobacco and poverty drive cancer in developing world- (Reuters- 20/12/2007) 

Rising tobacco use and poverty will fuel cancer across the developing world, more than doubling the number of new cases to 27 million by 2050, experts predicted on Thursday. Cancer is already the No. 2 cause of death globally, after heart disease and ahead of AIDS, malaria, tuberculosis and other causes. And as people live longer and adopt bad habits such as smoking, cancer cases will rise, said Dr. Nancy Davidson of Johns Hopkins University in Baltimore.

"It accounts for 10 percent of deaths," said Davidson, who is president of the 
American Society of Clinical Oncology. She cited this week's report by the International Agency for Research on Cancer that 7.6 million people will die of cancer this year, 5 million of them in developing countries. The statistics contradict a perception that cancer is a disease of rich nations. Cancer deaths have fallen in the United States, dropping by more than 2 percent between 2002 and 2004. "There will be 12 million new cancer cases diagnosed worldwide in 2007. By 2050, this number will more than double to 27 million, even if the rates don't change," Dr. Lynn Ries of the U.S. National Cancer Institute said in a telephone briefing. Of these, 5.4 million cases will be in economically developed countries and 6.7 
million in developing countries, Ries said. Cancer is caused by a mix of factors, including genes, diet, lack of exercise and, rarely, chemical exposure. But the No. 1 cause is smoking. And more people are using tobacco, said the National Cancer Institute's Deirdre Lawrence.

"According to World Health Organization current estimates, the annual number of tobacco-related deaths worldwide is projected to rise from 4.9 million in 2000 to more than 10 million by 2020, unless effective interventions take hold," Lawrence told the briefing. She said 70 percent of the deaths would be in the developing world. In 1970, 3.26 million cigarettes were smoked globally. In 2000, it was 5.7 million. The problem is notably clear in China, said Dr. Tony Mok of the Chinese University of Hong Kong. "China produced about 39 percent of the world's tobacco production," Mok told the briefing. About 6 percent of this was exported, meaning the rest was consumed in China. "In other words, we consume about 33 percent of world tobacco production," Mok said. "We smoke a hell of a lot of tobacco."

Mok said 320 million people were smokers in China in 2004, a 4 percent increase from 2003. "Cancer prevention has not been a top priority in our country," he said. The same goes for India, said Dr. Ketayun Dinshaw, director of the Tata Memorial Centre in Mumbai. He said there are no organized screening programs in India. Nigeria tries but poverty intervenes, said Dr. Clement Adebamowo of the University of Ibadan. "There is limited availability of even basic diagnostic oncology facilities," Adebamowo said. "Chemotherapy drugs are available but are very expensive and not affordable to the majority of cancer patients."