ANTI TOBACCO 


Cancer Research UK launches campaign to protect children from tobacco (Yahoo News-15/09/2008)

Through 'Out of Sight, Out of Mind', the charity is aiming to protect the next generation from this deadly addiction and is calling on people across the UK to sign up to a petition to support its aims. Research shows that the younger people start to smoke, the harder they find it to quit and to stay quit for good, a worrying statistic as over 80 per cent of smokers start before the age of 19.
The focus of the new campaign is on protecting children from cigarette advertising that makes smoking look glamorous and attractive. Despite the ban on cigarette advertising and marketing, children continue to be exposed to cigarette advertising on a daily basis because of loopholes in the ban. The charity wants the Government to close the existing loopholes and protect children by preventing tobacco being displayed in shops at the point of sale, prohibiting the sale of cigarettes from vending machines and making plain packaging for tobacco products compulsory. Jean King, Cancer Research UK's director of tobacco control, said: "It's a shocking fact that half of all long-term smokers will die from smoking. What's even more frightening is that the majority of smokers could be putting themselves in this fatal situation at an age when they are easily influenced. "We have launched this campaign to help protect all children from the dangers of tobacco. We know that many underage smokers buy cigarettes from vending machines. We also know that attractive branding makes cigarettes more appealing to young people and dilutes the impact of health warnings. We want to keep cigarettes out of sight and out of mind to help prevent young people from taking up smoking in the first place."

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College students continue to take up smoking (Yahoo News-08/09/2008) 

An "unacceptably high" number of college students -- roughly one in five in 2006 -- continues to smoke cigarettes, according to an American Lung Association report released Monday. The association says aggressive tobacco industry marketing on college campuses is largely to blame. To gauge the current status of tobacco use and policies on college and university campuses, the American Lung Association analyzed published research, surveys and tobacco industry documents. Their findings are compiled in a report, "Big Tobacco on Campus: Ending the Addiction." The report says that in 2005, the tobacco industry spent more than $1 million a day sponsoring events and giveaways targeting college students. In a recent survey of 119 colleges, students at 109 schools reported seeing tobacco promotions in on-campus events. College students are often social or occasional smokers. "Tobacco companies exploit vulnerability among young smokers by sponsoring promotions in bars, nightclubs, and other venues to encourage smoking as a social norm, moving them from an 'experimenter' to a 'mature' smoker," the report states. When it comes to college students, "the industry's return on investment is staggering," Bernadette A. Toomey, American Lung Association President and CEO, said in a written statement. "Every college student in America has a target on their back as far as the tobacco industry is concerned." Toomey believes colleges and universities "have a responsibility to provide safe spaces in which their students can learn and live. This should include an environment free from secondhand smoke and advertising that encourages young adults to use deadly tobacco products."

In the report, the American Lung Association calls upon the higher education community to join the Smokefree Air 2010 Challenge -- a nationwide movement to eliminate exposure to secondhand smoke in public places and workplaces no later than 2010 and reduce smoking-related illnesses, by implementing the following policies and initiatives in this school year: 
*Prohibit tobacco use at all indoor and outdoor facilities, private offices, residence halls and dormitories.
*Stop the sale and advertising of tobacco products on campus and in college controlled publications, properties and events.
*Refuse all research and sponsorship funding from the tobacco industry.
*Provide smoking cessation programs to all students, faculty and staff.
*Implement and enforce strong policies to aid in the prevention, cessation and elimination of tobacco use across campus.
*Educate students and faculty about the harmful effects of using tobacco products, the resources available for cessation and campus policies.
*Promote and fund research to design and implement smoking and tobacco use interventions that specifically target college students.
*Lobby state legislatures to create laws to prohibit tobacco use on campus.

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In just 5 years tobacco caused 2.4 million cases of cancer in the U.S. (Yahoo News-8/09/2008) 

The latest report from the Centers for Disease Control and Prevention (CDC) in the U.S. reveals some shocking figures. The CDC report says in the five year period between 1999 to 2004, tobacco was responsible for 2.4 million cases of cancer in the U.S. Top of the table were as might be expected, lung and bronchial cancer which accounted for almost half the cases, but the CDC says cancers of the larynx, mouth and pharynx, esophagus, stomach, pancreas, kidney, bladder, cervix, as well as acute myelogenous leukemia, were also found to be caused by tobacco. The CDC says the data in the report provides additional, strong evidence of the serious harm associated with tobacco use. Dr. Sherri Stewart of the CDC's Cancer Prevention and Control Division, who led the study, and her colleagues examined cancer surveys and registries covering 92 percent of the U.S. population. The study revealed Kentucky had the highest rates of lung cancer among men and women, while western states with low rates of smoking also had low rates of cancer; tobacco-related cancers were more common among blacks, non-Hispanic whites and men, reflecting the groups that use tobacco more. The CDC says tobacco use is the leading preventable cause of disease and premature death in the United States and the most prominent cause of cancer. Dr. Matthew McKenna, from the CDC says tobacco use causes a third of the cancers in America, kills 438,000 people prematurely every year, including 38,000 people who breathe secondhand smoke.

The CDC says tobacco use causes more deaths each year than alcohol use, car crashes, suicide HIV/AIDS, homicide, and illegal drug use combined and accounts for $167 billion annually in health care expenditures and productivity losses. For the report the CDC researchers analyzed data from the National Program of Cancer Registries and the National Cancer Institute (NCI) Surveillance, Epidemiology and Results Program. The study is the first by the CDC reporting on all tobacco-related cancers for more than 90 percent of the population.

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Tobacco control programs reduce health-care costs (Yahoo News-25/08/2008)

Tobacco control programs not only reduce smoking, but reduce personal health care costs as well, says new research published in PLoS Medicine by Stanton Glantz and colleagues at the University of California San Francisco. Glantz and colleagues analysed data on smoking, health care expenditures, and exposure to the recent California state tobacco control program, and compared them to data from 38 control states in the United States. Control states were those without comprehensive tobacco control programs prior to 2000 or cigarette tax increases of $0.50 or more per pack over the study period. The researchers found savings of US$86 billion in personal health care expenditure between 1989, the start of the tobacco control program, and 2004. These cost savings grew over time, reaching 7.3% in 2003-2004. The personal health care expenditure savings represented about a 50-fold return on the $1.8 billion spent on the tobacco control program during the same period. Glantz and colleagues found that 3.6 billion fewer packs of cigarettes were sold during the 5 years of the tobacco control program, which represents a loss of $9.2 billion to the tobacco industry in pre-tax cigarette sales. These findings on cost savings are important, say the authors, because so little money has been invested in tobacco control programs despite large amounts of money generated from state tobacco taxes and legal settlements with the tobacco industry. According to the 2008 WHO report on the Global Tobacco Epidemic, not a single country fully implements all key tobacco control measures. The report also states that governments around the world collect 500 times more money in tobacco taxes each year than they spend on anti-tobacco efforts. Glantz and colleagues' study provides the first evidence that tobacco control programs can reduce health care costs, providing further justification for funding such programs. The California Tobacco Control Program (CTCP) is a state-funded public policy intervention established in 1989 with the goal of decreasing tobacco-related diseases and deaths in California by reducing tobacco use across the state. The program is focused on adults and social norm change rather than on adolescent tobacco use prevention, on the premise that "the next generation cannot be saved without changing the generations who have already reached adulthood."

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Tobacco Marketing Promotes Youth Cigarette Use (HealthDay News-21/08/2008)
 
Mass media has the power to both encourage tobacco use, especially among young people, and to discourage it, according to a landmark study released Thursday by the U.S. National Cancer Institute. "This is the first report to conclude that tobacco advertising and promotion increases tobacco use," said Melanie Wakefield, senior scientific editor of the report, The Role of the Media in Promoting and Reducing Tobacco Use. "It's the first report to make the conclusion that there is a causal relationship between exposure to depiction of smoking in the movies and youth beginning to smoke," she said. The findings in the hefty, nearly 700-page report aren't all bad about media and its effects on tobacco use, however. "Mass media can change youth attitudes about tobacco use," Wakefield said. Mass media campaigns to discourage tobacco use have proven to change youth attitudes about tobacco, reduce the chances children will smoke, and encourage adult cessation, the authors said during a press conference in Washington, D.C. The report, which took four years to compile, involved expert analysis from 23 authors as well as input from numerous other experts, Wakefield said. They analyzed more than 1,000 scientific studies on the role of media in encouraging and discouraging tobacco use. The report reached several major conclusions, including:

Media play a key role in shaping knowledge, opinions, attitudes and behaviors among people and within communities. "Cigarettes are one of the most heavily marketed products in the United States," the authors wrote. Tobacco manufacturers in the United States spent about $250 billion (in 2006 dollars) between 1940 and 2005 on cigarette advertising and promotion. Most of this, the authors found, was allocated to promotional activities, such as price discounts, which are particularly attractive to youth. 
The tobacco industry lures smokers with three themes: That tobacco provides satisfaction, that the dangers of tobacco shouldn't provoke anxiety, and that tobacco is associated with desirable outcomes such as social success. 
A causal relationship exists between tobacco promotion and ads and increased tobacco use. 
Depiction of smoking is still pervasive in movies. It occurs in three-quarters or more of contemporary box-office hits. This exposure leads to more youth smoking. 
On the positive side, media campaigns meant to reduce tobacco use do work, helping to change youth attitudes about tobacco, thereby reducing the chances children will start smoking. 

The authors noted a nationwide decline in smoking -- about a 50 percent drop in adult smoking over the past 40 years -- but pointed out that one in five Americans still smokes, and more than 4,000 children and teens smoke their first cigarette each day. Citing statistics from the U.S. Centers for Disease Control and Prevention, the report authors said cigarette smoking is responsible for more than 400,000 premature deaths each year, and reduces the life expectancy of smokers by an average of 14 years. "The report stops at synthesizing the evidence," Wakefield said. "Now it is up to the government to consider the evidence and think about what it needs to do in terms of advertising and promotion." While the report was released by the U.S. National Cancer Institute, "other nations will take note of this report," she said. William Corr, executive director of the Campaign for Tobacco-Free Kids, who also spoke at the press conference, said: "This report sends an unmistakable message to our elected officials that they can dramatically reduce tobacco use by children and by adults by passing legislation that would authorize the Food and Drug Administration to regulate tobacco products and by adequately funding their state prevention and cessation programs." Bill Phelps, a spokesman for the Altria Group, the parent company of Philip Morris USA, took issue with some of the findings. "It appears that many of the conclusions in the report are based on marketing practices that are more than 30 or 40 years old," he said. "We think it's important to focus on the marketing practices that we have in place today." He said that spending for cigarette brand advertising for Philip Morris USA, which includes Marlboro cigarettes, has dropped 46 percent in the past 10 years. Philip Morris supports federal legislation under consideration to regulate tobacco products, he said. In July, the U.S. House of Representatives passed legislation that would subject the tobacco industry to federal regulation, including granting the FDA the power to regulate tobacco products. The Senate has yet to act on a similar measure.

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One cigarette can get some people hooked:(CBC News-05/08/2008) 
 
It may take just one tobacco cigarette for some people to get addicted to nicotine because of how their brains are wired, a Canadian study suggests. By manipulating receptors in the brains of rats, the researchers were able to control whether the first exposure to nicotine was enjoyable or repulsive. The study appears in the Aug. 6 issue of the Journal of Neuroscience. During the early phase of tobacco exposure, many individuals find nicotine highly unpleasant and aversive, whereas others may become rapidly dependent on nicotine and find it highly rewarding," said Steven Laviolette, a professor of anatomy and cell biology at the University of Western Ontario. "We wanted to explore that difference," he added in a release. The team experimented on two types of receptors for dopamine, a chemical messenger in the brain's reward circuitry. By blocking the receptors, the researchers were able to switch how nicotine was processed — from repulsive to rewarding or positive. The natural variations that occur between people may explain why some are more likely to become addicted to nicotine. "Importantly, our findings may explain an individual's vulnerability to nicotine addiction, and may point to new pharmacological treatments for the prevention of it, and the treatment of nicotine withdrawal," said Laviolette. For example, the researchers were able to reduce withdrawal symptoms in the rats studied. The research was funded by the Canadian Institutes of Health Research and the Canadian Psychiatric Research Foundation.

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Three MP villages become tobacco free (Yahoo News-29/07/2008)

Indore, July 29 : As a part of a drive under the National Tobacco Control Programme to eradicate the menace of tobacco from Khandwa and Gwalior districts in Madhya Pradesh, three villages in Khandwa district have been made tobacco-free. ''Several efforts are being taken up to spread awareness about ills of tobacco. These include organising workshops and seminars,'' State Tobacco Control Cell Coordinator B M Shrivastava told reporters here. The success of Chinchgohan, Dugwada and Roshia villages could be gauged from the fact that no tobacco product is either sold or consumed here. These villages have a total population of 10,000. Anti-tobacco campaigns are carried out at weekly markets and religious programmes. He admitted that tobacco consumption could not be controlled without public cooperation despite stringent laws. He expressed happiness that people were coming forward for controlling tobacco. 

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Nurses Can Help Patients By Taking A Stand Against Smoking: (Yahoo News-19/07/2008)

Nicotine is one of the most heavily used addictive drugs in the United States, and more than one in five people use some form of the drug (cigarettes, cigars, pipes and chewing tobacco). Despite the fact that research consistently indicates tobacco use or exposure to tobacco smoke is harmful, new smokers initiate smoking each day. In the June 2008 issue of MEDSURG Nursing, Paul C. Lewis describes the prevalence of tobacco use and the challenges associated with smoking cessation. The younger adolescents begin to use tobacco, says Lewis, the heavier their usage as adults is likely to be. Cessation efforts have focused on quitting, but because nicotine is recognized as a highly addictive drug, nicotine abstinence (staying away from tobacco completely) is now recognized as the most effective way to stop smoking. Any reduction in smoking or days of abstinence reduces health consequences, says Lewis. One method that has consistently helped people stop smoking is talking, and Lewis says this is an area where nurses can help. Medical-surgical nurses can play a significant role in getting patients to quit just by educating them about the dangers of tobacco use and offering assistance to quit. By following up and encouraging patients, nurses can take a stand against this significant national health threat. 

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Big Tobacco Lures Young Smokers With Menthol Cigarettes: (HealthDay News-16/07/2008)

Tobacco companies are manipulating menthol levels in cigarettes to appeal to newer, younger smokers, part of a deliberate strategy to get younger people, particularly African-Americans, hooked, a new study contends. Menthol makes cigarettes more palatable to the novice smoker. "If anything, menthol is being used as a candy to help the toxin go down," said Dr. Gregory Connolly, senior author of a paper being published in the September issue of the American Journal of Public Health. "If we let the industry go ahead and willy-nilly design the product the way they want to, it's going to lead to the premature death of millions and millions of Americans. Our research says we have to go after this." A bill pending in Congress would give the U.S. Food and Drug Administration power to regulate menthol and other additives in cigarettes. "This study provides evidence of one of the many ways tobacco companies manipulate the ingredients in cigarettes in an effort to entice and addict new consumers," John R. Seffrin, chief executive officer of the American Cancer Society, said in a news release. "Legislation in Congress would give the FDA the authority to regulate tobacco products and put an end to tobacco industry practices that prey upon children and blatantly mislead adults. The bill would end the marketing of tobacco products to children, force companies for the first time to disclose the ingredients in their products and allow the FDA to regulate all tobacco products, including menthol cigarettes, based on science." 

Menthol itself is not addictive, but it can ease the "delivery" of nicotine, which is highly addictive. More than 70 percent of African-American smokers use menthol cigarettes, compared with about 30 percent of white smokers. It's unclear if menthol cigarettes are more harmful than "regular" cigarettes, the study authors said. Connolly and his colleagues looked at internal tobacco-industry documents which showed that companies researched how menthol levels could affect sales among different demographic groups. Cigarettes with milder menthol levels appeal to younger smokers. Then they measured menthol levels in mentholated cigarettes, which proliferated after the signing of the Master Settlement Agreement in 1998, the historic settlement between tobacco companies and 46 U.S. states. Newport had the lowest levels of menthol, while traditional Kool cigarettes the highest, the researchers said. Last, they looked at an existing survey of smoking in the general U.S. population. "We found that, once again, menthol was the predominant brand smoked by African-American teens, and they smoked it at higher rates than older African-Americans," said Connolly, who is professor of the practice of public health and director of the Tobacco Control Research Program at the Harvard School of Public Health. "Surprisingly, we found that Caucasian teens smoked menthol at higher rates than expected, indicating that hip-hop was moving into the suburbs." 

The deliberate manipulation of menthol levels was accompanied by more focused advertising of mentholated cigarettes (advertising for non-mentholated brands fell) and the introduction of new brands such as Marlboro Milds in 2000, the researchers said. "The product itself stands outside the law, and industry is exploiting that, tailoring their brands to specific groups and integrating that with what marketing they have left and, unfortunately, they're being successful," Connolly said. "The outcome should be regulation of menthol by the FDA. It's the one hole." The study authors also argued that this industry practice is a violation of the Master Settlement Agreement (MSA), which prohibits companies from marketing directly or indirectly to youths. The new study was funded by The American Legacy Foundation (formed in the wake of the MSA) and the U.S. National Cancer Institute. David Sylvia, a spokesman for cigarette maker Philip Morris USA, said: "We don't believe that this study's hypothesis or conclusions are supported by the facts cited in the study. In fact, we disagree with their conclusion that menthol levels in our products were manipulated to gain market share among adolescents, and are unable to find any evidence supporting that conclusion within this study. "This study almost exclusively relies on information about young adults who are legal-aged smokers who are at or above the legal age of smoking," he added.

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Quit Smoking (Yahoo News-02/07/2008) 

To prevent a relapse, remember the 4 D's
When quitting tobacco use, cravings are just part of the game. Most people experience them in some form or another with varying frequency and intensity. When going through the quit process watch out for these four main triggers to relapse: Hunger, Anger, Loneliness, Tiredness. So, when cravings pop up, remember to H.A.L.T. Stop for a moment and check in on how you're feeling. Pay attention to what you need. It is important to have some strategies to deal with cravings when they strike. One must have a "fire plan," a way to escape urges without falling back into the flames of tobacco use. A few easy tricks to remember are the 4 D's: 
Delay — do not respond to your cravings, but wait for them to pass. 
Distract — in order to help cravings pass more quickly, get your mind engaged in something else. 
Drink water — drinking water can help by giving you something to hold in your hands and put in your mouth. 
Deep breathe — taking slow, deep breaths not only helps calm you, it also mimics the motion your body goes through when you smoke. This can help you to feel more comfortable when combating urges by minimizing "missing" the cigarette. On holiday weekends and other special occasions when you might be in high-risk situations, think of specific ways in which you can maintain your independence from tobacco. Plan ahead. Have substitutes handy. Limit alcohol use or avoid it all together. If you are attending events where other smokers are present, try to stick with the non-smokers. Find ways to remove yourself from tempting situations and be in touch with a support person when needed.

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Smokeless Tobacco Products Do Raise Cancer Risk (HealthDay News-02/07/2008)

Smokeless tobacco products (STPs), which include products such as snuff and chew tobacco, do increase the user's risk of cancer -- just not as much as smoking does. So say researchers who examined worldwide patterns of STP use and the associated risk of cancer. Reporting in the July issue of The Lancet Oncology, a team led by Dr. Paolo Boffeta, of the International Agency for Research on Cancer, in France, noted that STPs contain more than 30 carcinogens, including nitrosamines and metals. Their analysis of studies from around the world found that STP users had an overall 80 percent increased risk of oral cancer and a 60 percent increased risk of esophageal cancer. They also had a similar increase in the risk of pancreatic cancer. European studies suggest no increased risk of lung cancer among STP users, but American studies suggest an 80 percent increased risk of lung cancer, the team said. Cancer rates associated with STPs vary between countries. For example, more than 50 percent of oral cancers in India and Sudan are attributable to STPs, compared with 4 percent in the U.S. The findings are published in a special edition of the journal devoted to lung cancer. Overall, studies do support a strong association between STPs and cancer, said the authors, who did not recommend smokeless tobacco as a substitute for smoking. "We do not intend to address explicitly the use of smokeless tobacco to reduce the risk from tobacco smoking -- e.g., by promoting smokers to switch to smokeless products or by introducing these products in a population where the habit is not prevalent," the researchers concluded. "Nevertheless, several conclusions can be reached based on the available data ... the risk of cancer, especially that of oral and lung cancer, is probably lower in smokeless tobacco users in the USA and northern Europe than in smokers, and the risk of cancer is higher in smokeless tobacco users than in non-users of any form of tobacco," the team wrote. "Available data for a possible benefit of switching from smoking to smokeless tobacco come from few studies and models from the USA and Sweden."

Another article in the July issue of The Lancet Oncology suggests that DNA screening for certain biomarkers could help assess lung cancer risk in people exposed to secondhand smoke. Many carcinogens in cigarette smoke are known to cause DNA lesions called DNA adducts and many carcinogens are known to leave unique signatures on cancer-related genes in the form of specific mutations at specific locations, noted Dr. Ahmad Besaratinia and Dr. Gerd Pfeifer, of the Beckman Research Institute of the City of Hope National Medical Center in Duarte, Calif. They noted that a technique called DNA-lesion footprinting, in conjunction with mutagenicity analysis, is currently used to find carcinogen signatures. They proposed this technique be used in cancer-relevant genes, which are commonly mutated in smoke-related lung cancer. In fact, this method has already been used successfully to find adducts connected with various smoke-derived carcinogens, the researchers said.

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Ban All Tobacco Advertising Says WHO (Yahoo News-02/06/2008) 

The World Health Organization (WHO) wants a ban on all tobacco advertising, promotion and sponsorship, in a bid to protect the world's 1.8 billion young people. The organization said it is urging all governments to to clamp down on the tobacco industry's efforts to attract young people through "sophisticated marketing". WHO said research shows that the more exposed young people are to advertising, the higher the chance they turn into smokers, and yet comprehensive bans on advertising, promoting and sponsorsing tobacco products only covers about 5 per cent of the world population. The organization accused tobacco companies of targetting young people by linking tobacco use with glamour, sex appeal and energy.
Dr Margaret Chan, Director General of WHO said: "In order to survive, the tobacco industry needs to replace those who quit or die with new young consumers." "It does this by creating a complex 'tobacco marketing net' that ensnares millions of young people worldwide, with potentially devastating health consequences," she added, urging all governments to bring in a total ban on tobacco advertising, promotion and sponsorship, which she referred to as a "powerful tool we can use to protect the world's youth". Most people take up smoking before they are 18, and nearly a quarter of these before they even reach 10 years old. In a study sponsored by WHO, the researchers found that all over the world, more than half of 13 to 15 year olds reported seeing advertisements for cigarettes on billboards within the previous month, and 1 in 5 of the youngsters said they owned an item with a cigarette brand logo on it.

WHO said tobacco companies promote their products in lots of places frequented by young people: the cinema, the internet, magazines, and venues for sporting and music events. The most aggressive targetting of young people by tobacco companies is in the developing world, where more than 80 per cent of the world's youth lives, said WHO in a prepared statement. Most vulnerable to this targetting are women and girls. Director of WHO's Tobacco Free Initiative, Dr Douglas Bettcher, said: "The tobacco industry employs predatory marketing strategies to get young people hooked to their addictive drug." "But comprehensive advertising bans do work, reducing tobacco consumption by up to 16 per cent in countries that have already taken this legislative step," he added, saying that "half measures are not enough", and: "When one form of advertising is banned, the tobacco industry simply shifts its vast resources to another channel." He urged all governments to impose a complete ban, and "break the tobacco marketing net".

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Smoke exposure heightens risk (Yahoo News-05/06/2008) 

Children who are exposed to secondhand tobacco smoke early in life are at greater risk of being hospitalised for infections than those brought up in a smoke-free environment, researchers from Hong Kong report. The risk of being hospitalised was greatest among babies six months old and younger, but the increased risk persisted up until the children were eight years old, Dr M Kwok of the University of Hong Kong and colleagues found. Children who were premature or low birth weight were particularly vulnerable. The findings suggest that secondhand smoke exposure may not only be harmful to children's respiratory tracts, but to their immune systems as well, Kwok and colleagues say. Hong Kong banned smoking in public places in 2007, but babies and children may still be exposed to secondhand smoke at home, the researchers note in their report in the journal Tobacco Control. While the danger smoke exposure poses to children's developing respiratory systems is well understood, less is known about its effects on overall infection risks. To investigate, the researchers looked at a group of 7,402 children born in 1997 who were followed up until age eight. At the study's outset, nearly 42% were exposed to secondhand smoke at home. Children who had been within three metres of a person smoking cigarettes at any point during their first 18 months of life were 14% more likely to be hospitalised for any type of infection by eight years of age, the researchers found.

The greatest difference was seen among infants, with 1 in 3 exposed babies being hospitalised for an infection by the time they were one year old. Exposure during the first three months of life had the strongest effect. Preemies and low birth weight infants seemed to be more vulnerable to the effects of secondhand smoke, for a longer period of time; they were twice as likely to be hospitalised for an infection by age eight than unexposed children. "What this study adds is evidence of a window of greater vulnerability to secondhand smoke exposure in early infancy, which extends to all infectious illnesses not just respiratory and related infections, and which may have a larger and more long-lasting impact in developmentally more vulnerable subgroups, such as premature or low birth weight infants," the researchers conclude.

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More U.S. Nonsmokers Are Protected by Smoke-Free Laws (CDC Reports)

Good News as World Celebrates “World No Tobacco Day 2008”
The number of states with laws prohibiting smoking in private sector worksites, restaurants, and/or bars in the United States tripled and the number with no such laws was halved between 2005 and 2007, according to a report in this week's issue of Morbidity and Mortality Weekly Report (MMWR), published by the Centers for Disease Control and Prevention (CDC). The study, which compared the status of state smoking restrictions, focused on private sector worksites, restaurants, and bars where adult nonsmokers were most likely to be exposed to secondhand smoke -- especially employees in restaurants and bars, who are at risk of exposure to high concentrations of secondhand smoke. The report updates a study that used data compiled from CDC's State Tobacco Activities Tracking and Evaluation System database and was released in July 2005. The number of states with prohibitions in private sector worksites, restaurants, and/or bars rose from 8 to 25, and the number of states with no such prohibitions fell from 16 to 8, the report said.

“Smoking restrictions such as these reduce the risk of heart disease and lung cancer among nonsmoking adults,” said Janet Collins, Ph.D., director of CDC's National Center for Chronic Disease Prevention and Health Promotion. “These findings are encouraging as they suggest that we may achieve the national health objective of establishing laws making indoor public places and worksites smoke-free in all states by the year 2010.” During the study period that ended Dec. 31, 2007, 18 states changed the level of their smoking restrictions for private sector worksites. Also, 18 states changed the level of their smoking restrictions for restaurants; some of those states also changed worksite restrictions. Twelve states changed the level of their smoking restrictions for bars. All the changes made the restrictions more protective. During the study period, states that required all three settings to be smoke-free increased from three to 12, while the number of states with no smoking restrictions for any of these three settings decreased from 16 to eight.

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Global Partner Sees Benefits of the Prevention Efforts (Yahoo News)

A separate MMWR article illustrates the dramatic impact that restrictions on tobacco advertising and marketing can have on youth smoking. Findings from the Global Youth Tobacco Survey (GYTS) conducted in Sri Lanka in 1999, 2003, and 2007 indicate steady declines in cigarette smoking, while other tobacco use remained unchanged between 1999 and 2007. Current cigarette smoking among boys (ages 13-15) decreased from 6.2 percent in 1999 to 1.6 percent in 2007. Parental smoking also decreased, from 50 percent to 30 percent. Exposure to pro-tobacco advertising and promotion did not change from 1999 to 2003 but decreased significantly from 79 percent in 2003 to 67 percent in 2007. However, exposure to secondhand smoke in public places remained unchanged, at more than 65 percent. According to the World Health Organization (WHO), Sri Lanka has taken strong measures in tobacco control in recent years including prohibiting tobacco advertisement through national broadcast and local print mediums, at places where tobacco is sold, and on the Internet.

In addition, exposure to secondhand smoke is banned in health care, education, and government facilities, as well as indoor workplaces. However, smoking restrictions do not ban secondhand smoke exposure in restaurants, pubs, or bars. These exclusions may explain the lack of change in secondhand smoke exposure from 1999 to 2007, according to the study authors. “Together, these studies show that restricting smoking in public places and strong limits on cigarette marketing and advertising work,” said Matthew McKenna, M.D., director of CDC's Office on Smoking and Health. “They protect the health of nonsmokers and prevent many from starting.” On May 31, many countries will observe World No Tobacco Day — an annual event sponsored by WHO to help raise public awareness of the dangers of tobacco use. This year's theme is “Tobacco-Free Youth: Break the Tobacco Marketing Net.”

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BMA Scotland welcomes ambitious new plan to tackle children's addiction to tobacco (Yahoo News-21/05/2008)

Doctors’ leaders have welcomed the publication of a new Smoking Prevention Action Plan for Scotland. Dr Andrew Buist, a member of the BMA’s Scottish Council and Deputy Chairman of the Scottish General Practitioners Committee, said: “Tackling children’s addiction to tobacco is rightly a top priority for this government. A lifetime addicted to tobacco is a death sentence. Every day 35 Scots die because of smoking related illnesses, but each day 41 new smokers are recruited. We must therefore do all we can to stop youngsters getting hooked in the first place by tackling the availability and attractiveness of cigarettes. “Young people often buy cigarettes from vending machines because of the lack of age checks or they buy packs of ten because they are cheaper. Addressing these two issues would significantly reduce the availability of cigarettes to young people. “There is evidence to suggest that the age limit regarding tobacco sales is not always properly enforced, which raises questions as to how effectively the recent age increase will be policed. The BMA supports tougher point of sales enforcement such as a positive licensing scheme, supported by a wider strategy to reduce young people’s access to tobacco products. 

“The BMA would like to see serious consideration given to other means of reducing young people’s access to tobacco supported by long term investment in educational services to encourage young people not to start smoking and assist those wishing to stop. In particular more needs to be done to target youngsters from relatively deprived backgrounds. “Too many people begin smoking during childhood or adolescence and continue into adulthood. Only through a multifaceted range of measures will we be able to tackle the biggest preventable cause of death in Scotland.” Dr Buist highlighted the importance of obtaining UK-wide support for this Scottish Action Plan. He said: “The recommendations in this report are welcome but many of these need the support of the UK government in order to be implemented. We know that Scotland’s politicians have the courage to take bold steps to tackle Scotland’s biggest killer and it is now their job to convince politicians at Westminster to support this agenda.” 

The Smoking Prevention Action Plan is available online at: http://www.scotland.gov.uk/Publications/2008/05/19144342/0
In April 2007, the BMA published the report ‘Breaking the cycle of children’s exposure to tobacco smoke’, which explores effective ways of protecting some of the most vulnerable people in society from short and long-term harm, and recommends evidence-based policies that need to be adopted to break the cycle of children’s exposure to tobacco smoke. This report can be found at: http://www.bma.org.uk/ap.nsf/Content/breakingthecycle

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Link Between Ear Infections And Passive Smoking (Yahoo News-20/05/2008)

A new report from Perth's Telethon Institute for Child Health Research has found a strong link between childhood ear infections and exposure to tobacco smoke. The results are published in the latest edition of the Medical Journal of Australia. The families of 100 Aboriginal children and 180 non-Aboriginal children participated in the Kalgoorlie Otitis Media Research Project, allowing the collection of social, demographic, environmental and biological data to investigate the causes of otitis media (middle ear infections). The children had regular ear examinations from birth until 2 years of age. Chief Investigator Dr Deborah Lehmann, who heads the Institute's infectious diseases research, said ear infections were the most common reason that young children see a doctor and can cause life-long problems. "Up to 20 per cent of children have more than three ear infections between 1 and 2 years of age. If their hearing is damaged, it can seriously affect their educational outcomes and social circumstances in adulthood," Dr Lehmann said. 

"In Aboriginal children, these ear infections typically start at a younger age, are much more common and more likely to result in hearing loss." 
Key findings from the project include: 
Otitis media was diagnosed at least once in 74% of Aboriginal children and 45% of non-Aboriginal children. 
64% of Aboriginal children and 40% of non-Aboriginal children were exposed to environmental tobacco smoke. 
If we eliminated exposure to tobacco smoke we estimate that we could reduce ear infections by 27% in Aboriginal children and 16% in non-Aboriginal children.
The impact of passive smoking in the home on ear infections was reduced if the children also attended day care. 
Dr Lehmann said there is evidence that passive smoking can increase the adherence of bacteria in the respiratory passages and depress the immune system. "These results highlight the importance of reducing children's exposure to passive smoking, and this is particularly important for Aboriginal people where the rates of both smoking and otitis media are high," she said.  "Few Aboriginal children have access to formal childcare despite studies showing that it is an effective way to improve early development and educational outcomes for disadvantaged children. The fact that it could also reduce the burden of ear infections in Aboriginal children adds weight to calls for appropriate childcare facilities to be provided."