In Malaysia, Kuala Lumpur City Hall (DBKL) is aiming to reduce the prevalence of smoking in the city as part of its latest initiative to create a smoke-free environment, according to a story in The Star.
The initiative was launched on Wednesday as part of the Partnership For Healthy Cities, a global network of cities committed to reducing non-communicable diseases (NCDs) and injuries.
According to studies conducted as part of the National Health Morbidity Survey 2015, the prevalence of smoking in Kuala Lumpur is about 19.1 percent.
The city’s newly launched initiative aims to reduce this number and help educate non-smokers on the risks associated with second-hand smoke.
The DBKL will, for instance, work with the Health Ministry, restaurant associations and other key organizations to boost enforcement of existing smoking restrictions.
And the DBKL will use billboards and LED signs to raise public awareness about the risks of smoking and second-hand smoke.
“The Partnership For Healthy Cities unites mayors who are committed to helping their citizens live healthier lives and to reduce NCDs and injuries,” said World Health Organization Global Ambassador for NCDs Michael R. Bloomberg.
“The actions these mayors take can prevent millions of needless deaths and protect the health of generations to come, while making their cities stronger and more prosperous.”
The Star report said the city would work with Bloomberg Philanthropies and implementing partner Vital Strategies to deploy proven solutions to save lives and improve the environments where people live, work and play.
The Partnership For Healthy Cities is an 18-month initiative that was announced in May 2017 where each city pledges to enact one of 10 proven policies identified by WHO as effective in protecting people from exposure to NCDs and injury-risk factors.
By taking part in this global initiative, Kuala Lumpur is said to have gained access to a global network of city leaders and public health experts working towards the same goals, along with a seed grant to jumpstart the local effort.
Category: Harm Reduction
Aiming for a healthy city
More support needed
The US-based Consumer Choice Center (CCC) yesterday applauded the American Cancer Society’s acknowledgement that electronic cigarettes ‘can appropriately help smokers quit’.
In a press note, the CCC said that ACS, in a clinical recommendation, had tepidly endorsed e-cigarettes in making the statement:
“Many smokers choose to quit smoking without the assistance of a clinician and some opt to use e-cigarettes to accomplish this goal. The ACS recommends that clinicians support all attempts to quit the use of combustible tobacco and work with smokers to eventually stop using any tobacco product, including e-cigarettes. Some smokers, despite firm clinician advice, will not attempt to quit smoking cigarettes and will not use FDA approved cessation medications. These individuals should be encouraged to switch to the least harmful form of tobacco product possible; switching to the exclusive use of e-cigarettes is preferable to continuing to smoke combustible products.”
CCC Senior Fellow Jeff Stier (pictured) was quoted as saying that the ACS had taken a step in the right direction by recognizing this important harm-reduction method.
‘I continue to call on the American Heart Association and other major health organizations to reverse course and support smokers who wish to quit smoking with the use of e-cigarettes, heat-not-burn tobacco, or smokeless tobacco, all of which are significantly less harmful than smoking,’ said Stier.
In a June 2016 piece for Morning Consult, Stier had called out the ACS by name for failing to support smokers – and their healthcare providers – by not only refusing to endorse the use of e-cigarettes as a way to quit smoking but for actively distorting the science to oppose it.
‘It’s no wonder that American doctors are doing a poor job helping their addicted patients make better decisions about how to get nicotine if they can’t or aren’t ready to get off of it completely,’ said Stier. ‘Public health groups in the US have been indoctrinating providers with misinformation.’
In contrast, the press note said; in the UK the government had been constantly evaluating e-cigarette use. Just this month, Public Health England had issued an update to its landmark 2015 review where it concluded: “that e-cigarettes are around 95 percent safer than smoked tobacco and they can help smokers to quit”.
‘Physician specialty groups must do a better job of educating their members and standardizing harm reduction advice,’ the press note said. ‘There’s barely a body part or function which isn’t compromised by smoking. From medical schools to credentialing organizations, the entire American medical establishment needs to kick the habit of providing politically correct quit-smoking advice and replace it with up-to-date medically validated harm reduction advice. They should do so as if their patients’ lives depend on it.’Putting the record straight
Public Health England (PHE) is trying to dispel some of the persistent inaccuracies and misconceptions that surround electronic cigarettes and vaping.
Writing on the Gov.uk Blogs website, Martin Dockrell, PHE’s tobacco control programme lead, said that e-cigarettes tended to court controversy among the public and media alike. Not surprisingly, there were lots of inaccuracies and misconceptions about e-cigarettes and vaping.
‘Our latest comprehensive independent e-cigarette review, authored by leading academics in the tobacco control field, looks at the up-to-date international data and peer-reviewed research,’ Dockrell said.
‘Despite the sometimes confused, and confusing, media reporting around the safety of e-cigarettes, there is growing consensus around the evidence. While not without some risk, when compared to smoking e-cigarettes are far less harmful.
‘This view is supported by a number of key bodies, including Cancer Research UK, Action on Smoking and Health, the Royal College of Physicians, the British Medical Association and, recently, a major US science body, the National Academies of Sciences, Engineering, and Medicine.’
Dockrell then goes on to examine and debunk five common myths about e-cigarettes and vaping.
In summary, he said, e-cigarettes and tobacco cigarettes were not the same and shouldn’t be treated as such. ‘It’s important that England’s seven million smokers are aware of the differences and have accurate information to inform their health decisions. E-cigarettes aren’t completely risk free but carry a fraction of the risk of smoking and are helping thousands of smokers to quit and stay smoke-free.’
Dockrell’s blog is at: https://publichealthmatters.blog.gov.uk/2018/02/20/clearing-up-some-myths-around-e-cigarettes/More support for e-cigs
In a position statement issued today, the American Cancer Society (ACS) says that for smokers who will not or cannot quit smoking using other methods, switching to the exclusive use of electronic cigarettes is preferable to continuing to smoke combustible products.
Although the support given to the use of e-cigarettes is much qualified; coming as it does from the ACS, it is nevertheless hugely significant.
The position statement on e-cigarettes was approved by the ACS’ board of directors and will be used to guide the society’s tobacco control and cessation efforts in relation to these products.
Under the heading, Scientific Summary, the statement said in part that, based on currently available evidence, using current-generation e-cigarettes was less harmful than was smoking cigarettes, but that the health effects of long-term use were not known.
‘The … ACS recognizes our responsibility to closely monitor and synthesize scientific knowledge about the effects of all tobacco products, including e-cigarettes and any new products derived from tobacco,’ the statement said. ‘As new evidence emerges, the ACS will promptly report these findings to policy makers, the public and clinicians.’
The statement, under the heading, Clinical Recommendations, went on to say that the ACS had always supported smokers who were considering quitting, no matter what approach they used; there was nothing more important that they could do for their health.
‘To help smokers quit, the ACS recommends that clinicians advise their patients to use FDA-approved cessation aids that have been proven to support successful quit attempts,’ the statement said. ‘Many smokers choose to quit smoking without the assistance of a clinician and some opt to use e-cigarettes to accomplish this goal. The ACS recommends that clinicians support all attempts to quit the use of combustible tobacco and work with smokers to eventually stop using any tobacco product, including e-cigarettes.
‘Some smokers, despite firm clinician advice, will not attempt to quit smoking cigarettes and will not use FDA approved cessation mediations. These individuals should be encouraged to switch to the least harmful form of tobacco product possible; switching to the exclusive use of e-cigarettes is preferable to continuing to smoke combustible products. Of course, these individuals should be regularly advised to completely quit using all tobacco products.
‘The ACS strongly discourages the concurrent (or “dual”) use of e-cigarettes and combustible cigarettes, a behavior that is far more detrimental to a person’s health compared to the substantial health benefit of quitting smoking.’
Under the heading, Policy Recommendations, the statement said that the ACS strongly recommended that every effort be made to prevent the initiation of e-cigarettes by youth. ‘The use of products containing nicotine in any form among youth is unsafe and can harm brain development,’ the statement said. ‘Furthermore, evidence indicates that young e-cigarette users are at increased risk for both starting to smoke and becoming long-term users of combustible tobacco products.
‘The ACS encourages the FDA to regulate all tobacco products, including e-cigarettes, to the full extent of its authority, and to determine the absolute and relative harms of each product. The FDA should assess whether e-cigarettes help to reduce tobacco-related morbidity and mortality, and the impact of marketing of e-cigarettes on consumer perceptions and behavior.
‘Any related regulatory regime should include post-marketing surveillance to monitor the long-term effects of these products and ensure the FDA’s actions have the intended health outcome of significantly reducing disease and death.’
The full statement is at: https://www.cancer.org/healthy/stay-away-from-tobacco/e-cigarette-position-statement.html.Canada in dialogue
The Global Forum on Nicotine (GFN) is due to stage a free-to-attend, tobacco-harm-reduction dialogue in Vancouver, Canada, in April.
The dialogue, Tobacco harm reduction: different strokes for different folks, or a consistent approach?, is to be held in partnership with the BC Centre for Disease Control and the Canadian Drug Policy Coalition.
It will be held from 09.00 to 16.30 on April 9, at the Morris J Wosk Centre for Dialogue in Vancouver.
‘The huge growth in the availability of safer nicotine products, with new technologies, such as vaping and heat not burn, as well as oral tobacco products, such as snus, has created greater opportunities for smokers to switch from a proven dangerous and unhealthy way to consume nicotine to much safer methods, according to a press note from the GFN, which has previously run series of dialogues in the UK and Ireland.
‘The emerging science surrounding both the technology and the products is positive and encouraging.
‘Vancouver has a proud tradition for supporting harm reduction for illicit drug use, including pioneering supervised consumption rooms for injecting drug use. The principles of harm reduction are well understood and have been enacted for many years with positive results.’
Participants will be addressed by international and local presenters, including:- Dr. Mark Tyndall, executive medical director, BC Centre for Disease Control;
- Professor Marjorie MacDonald, School of Nursing, University of Victoria;
- Professor Gerry Stimson, professor emeritus, Imperial College, London;
- Jacques Le Houezec, independent consultant in public health and tobacco dependence, France;
The presenters are due to examine:
- The history of harm reduction in Vancouver, the lessons learnt and the implications for this approach in relation to tobacco and smoking.
- Tobacco harm reduction as the ‘new kid on the block’ and what the emerging evidence is telling us.
- What does regulation look like and what are the elements that make for appropriate and effective regulation?
- The consumer experience – what products do people use and what are the results for them?
- What are the key issues for policy-makers and how can we ensure buy-in from all stakeholders?
Attendance at the dialogues is free, but participants are required to register at: https://gfn.net.co/dialogues/register.
More details about the dialogue are at: https://gfn.net.co/dialogues/vancouver-2018.‘Now is the time to act’
The National Tobacco Reform Initiative (NTRI) is urging US health care professionals to embrace the concept of relative risk.
The NTRI said in a press note today that a recent report by the US’ National Academies of Sciences, Engineering, and Medicine (NASEM) had lessons also for public health advocates and officials outside the Food and Drug Administration.
‘We urge these professionals, within and outside government, to embrace the concept of relative risk,’ the press note said. ‘The science base clearly demonstrates that e-cigarettes represent less of a risk for smokers than continuing to smoke.’
The NTRI team is said to be made up of 10 senior and independent national smoking control leaders who, collectively, have provided decades of service fighting the tobacco epidemic.
“After fighting the tobacco epidemic for over five decades, we now have proven harm reduction methods to help us avoid a carnage in otherwise-preventable deaths,” NTRI team member, John Seffrin, PhD, was quoted as saying.
The NTRI said the much anticipated NASEM report on e-cigarettes supported the FDA’s bold new two-part nicotine strategy for product regulation, which comprised one, reducing the addictiveness and appeal of deadly combustible cigarettes; and, two, making safer alternative nicotine products available to addicted smokers.
‘There is an urgency to help smokers since one in two of them will die from a smoking-caused disease,’ the NTRI said. ‘This outcome can be prevented. ‘Cigarettes and other combustible tobacco products are substantially more harmful than non-combustible tobacco and nicotine products, such as e-cigarettes. The fundamental truth, that smoking – not nicotine – is responsible for most of the harm, and that smokers should have a variety of potentially less harmful nicotine-containing products if they want or need to continue using nicotine, is the keystone of FDA’s approach.
‘A careful reading of the Report (…Public Health Consequences of E-Cigarettes: Health and Medicine Division) leads to the following evidence-based conclusions:- E-cigarettes are significantly less dangerous than lethal tobacco smoke;
- To date, there simply is no evidence of long-term-use damage to the heart or lungs;
- E-cigarettes use can help smokers reduce their risk of certain lethal diseases;
- E-cigarettes use can and has helped many smokers quit tobacco smoking completely;
- E-cigarettes can help reduce the risk of lethal disease in smokers who either can’t or won’t quit smoking tobacco completely.’
The NTRI said that now is the time to act.
And it presented a number of action points:
* Approach regulation of tobacco and nicotine products according to their relative risk;
* Educate smokers that nicotine delivered without smoke is a less harmful choice and that there are massive differences in risk across the products;
* Pursue regulations that work to enable smokers to switch completely to the much less hazardous non-combustible products such as snus, and e-cigarettes.
‘The NASEM Report and these evidence-based conclusions can help a consumer in making an informed choice about their use of nicotine products,’ the NTRI said.
This Report, along with FDA’s comprehensive nicotine strategy, demonstrate that we know enough to tell smokers that the most important thing they can do to improve their health is to stop inhaling smoke from burning tobacco products (like cigarettes, cigars, roll-your-own) into their lungs. And, if they continue to want to use nicotine, it is much better for their health to use it in a form that is not lit on fire and smoked.’
“Smokers have been horribly misled to believe e-cigarettes are as or are more harmful than smoking,” David Abrams, Professor of Global Public Health at New York University, was quoted as saying. “The truth can reassure those who want to switch”.SM snus volumes up
Swedish Match’s volume shipments of snus in Scandinavia during the 12 months to the end of December, at 247.6 million cans, were increased by three percent on those of the year to the end of December 2016, 241.3 million cans.
But despite the volume increase, SM’s share of Sweden’s snus market fell by 2.1 percentage points, from 67.3 percent during 2016 to 65.2 percent during 2017. And it’s share of Norway’s snus market fell by 1.4 percentage points to 52.1 percent.
Meanwhile, SM’s volume shipments of moist snuff on the US market during 2017, at 127.4 million cans were down by three percent on those of 2016, 131.4 million cans.
Also in the US, the company’s volume shipments of cigars in 2017, at 1,629 million, were increased by 11 percent on those of 2016, 1,472 million.
But, during the same period, volume shipments of chewing tobacco, excluding contract manufacturing volumes, at 6,341,000 pounds, were down by five percent from 6,709,000 lb.
SM’s worldwide shipments of matches during 2017, at 65.0 billion sticks, were down by 10 percent on those of 2016, 72.0 billion sticks.
During the same period, worldwide shipments of lighters fell by eight percent from 399.2 million to 368.1 million.
In announcing its results, SM said that, in local currencies, sales had increased by six percent for the fourth quarter and by thee percent for the full year. Reported sales had increased by two percent to SEK4,044 million for the fourth quarter and by four percent to SEK16,101 million for the full year.
In local currencies, operating profit from product areas (excluding larger one-off items and a share of the net profit of the Scandinavian Tobacco Group [STG] in 2016) increased by 15 percent for the fourth quarter and by five percent for the full year. Reported operating profit from product areas increased by nine percent to SEK1,044 million for the fourth quarter and by six percent to SEK4,218 million for the full year.
Operating profit amounted to SEK1,179 million for the fourth quarter and to SEK4,591 million for the full year.
Profit after tax amounted to SEK904 million for the fourth quarter and to SEK3,400 million for the full year.
Earnings per share amounted to SEK5.10 for the fourth quarter and to SEK18.88 for the full year. Earnings per share excluding larger one-time items, dividends from STG in 2017 and share of net profit in STG in 2016 increased by 17 percent to SEK4.24 for the fourth quarter and by 14 percent to SEK16.39 for the full year.
“I am very pleased with Swedish Match’s performance in 2017 – a year of solid growth, with higher sales and operating profit from product areas,” said CEO Lars Dahlgren.
“Investments that we have made within our consumer insights and R&D functions have strengthened our portfolio of smokeless offerings, and we have supplemented organic efforts through acquisitions.
“In recent years, global tobacco competitors have signaled a shift in their strategic agendas to acknowledge the role of less harmful alternatives. With our vision of a world without cigarettes and long history of offering tobacco consumers significantly less harmful products, Swedish Match has pioneered this effort.”Pressing the vapor case
Philippine vapers say that the latest Public Health England (PHE) report validates their position that vaping electronic cigarettes is far less harmful than is smoking cigarettes, and that e-cigarettes should form part of the country’s tobacco control program, according to a story in The Business Mirror.
The new e-cigarette evidence review, undertaken by leading independent tobacco experts, provides evidence that vaping poses only a fraction of the risks of smoking, and that switching completely from smoking to vaping conveys substantial health benefits. It recommends that e-cigarettes be made available to those who wish to quit smoking.
“Listen to the experts,” said Tom Pinlac, president of The Vapers Philippines. “It is time for the Department of Health to look into this report so that they can recommend e-cigarettes and heated-tobacco products to smokers who want to quit.”
Pinlac said it was an outrage that smokers were denied the proper information about e-cigarettes and heated tobacco products. “Educate smokers about vaping and heated-tobacco products instead of resorting to fearmongering,” he said.
Meanwhile, Edward Gatchalian, president of Philippine E-Liquid Manufacturers Association, said that more than 17 million Filipino smokers could benefit from vaping e-cigs or heated-tobacco products because they were significantly less harmful than was smoking.
“It is said that 87,000 deaths every year are attributed to smoking-related diseases,” Gatchalian said. “Smokers should switch to vaping or tobacco-heated products if they want to kick the habit of smoking. This is a very clear message embodied in the PHE report.”Scholarships on offer
Knowledge Action Change (KAC) and the Global Forum on Nicotine (GFN) have launched the 2018 Tobacco Harm Reduction Scholarship Programme.
In announcing the inaugural program, the GFN organizers said they wanted people to learn from the GFN and have the opportunity to implement that learning in their home countries.
Fifteen scholarships will be offered during the year, with funds available to support agreed projects up to the value of $7,500.
The scholarships will start at the GFN conference on June 13. The conference is scheduled to be held at the Marriott Hotel, Warsaw, Poland, on June 14-16.
The organizers say that the scholarships are intended to:- build research capacity in the field of tobacco harm reduction;
- develop the evidence base;
- raise awareness of research and its implications for public health policy;
- enable consumers to make more informed personal health choices;
- improve the implementation and understanding of tobacco harm reduction.
Applications are invited from people with an interest in tobacco harm reduction; such as:
- people intending to enter the field of research into tobacco harm reduction and/or public health;
- students
- researchers and scientists
- medical professionals
- writers
- Internet and social media professionals.
More information is at: https://gfn.net.co/scholarships
E-cig review welcomed
The UK Vaping Industry Association has described a Public Health England (PHE) evidence review as another ringing endorsement for the positive public health opportunity that vaping represents.
The PHE electronic-cigarette evidence review, which was made public yesterday, was undertaken by leading independent tobacco experts and provides an update on PHE’s 2015 review.
It covers e-cigarette use among young people and adults, public attitudes, the impact on quitting smoking, an update on risks to health and the role of nicotine. It also reviews heated tobacco products.
The reviews key findings are:
* E-cigarettes could be contributing to at least 20,000 successful new quits per year and possibly many more;
* E-cigarette use is associated with improved quit success rates over the last year and an accelerated drop in smoking rates across the country;
* Many thousands of smokers incorrectly believe that vaping is as harmful as smoking; around 40 percent of smokers have not even tried an e-cigarette;
* There is much public misunderstanding about nicotine. Less than 10 percent of adults understand that most of the harms to health from smoking are not caused by nicotine;
* The use of e-cigarettes in the UK has plateaued over the last few years at just under three million;
* The evidence does not support the concern that e-cigarettes are a route into smoking among young people. Youth smoking rates in the UK continue to decline. Regular use is rare and is almost entirely confined to those who have smoked.
“The UK Vaping Industry Association welcomes yet another ringing endorsement for the positive public health opportunity that vaping represents,” said an association spokesman.
“It is shocking that 40 percent of smokers haven’t even tried a vaping product to reduce or stop smoking, when the evidence quite clearly demonstrates it is the most effective way.
“If we are to persuade the UK’s remaining seven million smokers that there is a viable, effective, safer alternative to smoking, then the industry must be allowed to communicate effectively with smokers. Why is the vaping industry itself explicitly banned from advertising the research that Public Health England have reported on today?
“Professor Newton [Professor John Newton, director of health improvement at PHE] is absolutely right that it would be tragic if thousands of smokers who could quit are put off because of false claims and junk science. That’s why the government must deliver on its commitment to review and reform vaping-related regulation as we leave the EU to create a system that better reflects the public health reality.”
