Category: Harm Reduction

National quit-line launched
Following the launch of a national smoking quit-line in the Philippines, the Department of Health (DOH) hopes to reduce the country’s smoking prevalence from about 24 percent now to 15 percent by the end of President Rodrigo Duterte’s term, according to a story in the Philippine Daily Inquirer.
Launching the quit-line, Health Secretary Paulyn Jean Ubial urged the public to take advantage of the country’s newest anti-smoking initiative: the DOH quit-line 165-364.
She said that Filipino smokers should “make use of their cellphones for better health,” adding that the power to quit was in their hands.
Cellphone access in the Philippines, she added, had become a reliable and cheap communication tool even in remote areas.
“This is a dream come true for us anti-tobacco advocates,” Ubial was quoted as saying. “For so long we’ve been trying to establish a national quit-line and program for smoking cessation.”
Ubial made the remarks at the launch of the quit-line and a number of mobile cessation clinics aimed at providing counseling and support for Filipino smokers wanting to quit the habit.
She said that a “tobacco prevalence” of 29.7 percent in 2009 had dropped to 23.8 percent in 2015, which meant that about a million Filipinos had stopped “smoking”.
“We can reduce it further by nine to 10 percent, and bring it down to less than 15 percent smoking prevalence in 2022,” she said.
The World Health Organization’s 2013 estimate put the incidence of daily smoking in the country at 20.6 percent, made up of 35 percent of men and 6.4 percent of women.
The quit-line, which is accessible also by texting ‘STOPSMOKE’ to 09290165364, will be free initially in Metro Manila but toll charges will apply for long-distance calls.
The quit-line and the mobile cessation clinics will be hosted by the Lung Center of the Philippines in Quezon City, which is hiring 21 people to answer calls in two shifts, 24/7.
A budget of P27 million was allocated for the program this year, though it was said that this might go up next year.
June 20, 2017
End ‘in sight’
Last year, 15.8 percent of UK adults smoked, down from 17.2 percent in 2015, according to a story in The Guardian newspaper citing data from the Office for National Statistics (ONS).
The prevalence of adult smoking stands at 15.5 percent in England, a figure that rises to 16.9 percent in Wales, 17.7 percent in Scotland and 18.1 percent in Northern Ireland.
Duncan Selbie, chief executive of Public Health England, said there were now more than half a million fewer smokers in England than in 2015 and that the UK had the second-lowest smoking rate in Europe after Sweden.
“What is really fantastic news is that this steep decline is even greater among young adults [aged 18 to 24], where smoking has fallen by a staggering quarter since 2010, reversing a long trend,” he said
In 2010, 26 percent of the 18-24 age group smoked, but this had dropped to 19 percent in 2016.
“It’s now hard to believe that back in 1974 almost half of adults smoked,” said Selbie. “But now an end really is in sight and we have a real opportunity to virtually eliminate all the harm, misery and death caused by smoking.”
However, Dr. Penny Woods, chief executive of the British Lung Foundation, warned against complacency. Smoking, she said, was still the UK’s biggest cause of early preventable death.
“Approximately 100,000 people die needlessly from smoking-related diseases every year in our hospitals – it’s time to tackle the human and financial cost the tobacco industry creates,” she said.
“These statistics confirm that e-cigarettes are mainly being used to help people quit. Given half of long-term smokers die as a result of their habit, using vaping to help someone stop smoking could literally save their life.”
Meanwhile, the director general of the UK’s TMA Giles Roca said that the drop in smoking prevalence during the past few years had been due to the emergence of harm reduction technology, such as electronic cigarettes, which the tobacco industry had been at the forefront of developing and putting onto the market.
“This stands in direct contrast to the impact of the tranche of tobacco control measures implemented by successive governments over the last decade that have had minimal effect or indeed negative consequences such as making the problem of black market tobacco even worse,” Roca said.
“As the government looks at its next tobacco control strategy and the measures within it, it would be worth reflecting on these findings and the reasons for them.”
Across the UK, 5.6 percent of people – around 2.9 million – used e-cigarettes in 2016.
June 20, 2017
Glo ready to go in Korea
British American Tobacco’s South Korea-based unit plans to start selling glo tobacco-heating devices in August, according to a story in The Korea Herald, citing the Yonhap News Agency.
BAT Korea said on Tuesday that it was joining the race for the burgeoning heated-tobacco-device market. The previous day, it had opened a teaser website for glo.
Earlier this month, the company completed the expansion of its production facility in Sacheon, 437 km southeast of Seoul, which will produce Neostiks, the consumable item of the glo system.
Neostiks are heated by the glo device to create a vapor that delivers to the consumer an experience that is said to be similar to that of smoking a cigarette.
BAT’s glo was first launched in December in Sendai, Japan, where its regional market share was said to have reached more than seven percent within six months of its debut.
Philip Morris launched its iQOS heated-tobacco device nationwide in South Korea earlier this month.
And KT&G, the country’s leading tobacco manufacturer, is planning to launch a heat-not-burn device, though the story did not say when.
June 20, 2017
Pollution austerity-fed
A suggestion that ‘harsh austerity measures’ could lie at the bottom of some negative health outcomes associated with pollution has been sidestepped by the EU Commission.
Professor Kostas Chrysogonos, a Greek member of the European parliament recently asked three questions of the Commission under the heading of Child deaths due to pollution and an insanitary environment.
In a written preamble to his questions, Chrysogonos said that, according to the World Health Organization, a quarter of the deaths of children under the age of five worldwide were due to pollution and passive smoking. ‘In particular, the WHO reports that insanitary environments lead to fatal cases of diarrhoea, malaria and pneumonia, endangering the lives of 1.7 million children each year, since their developing organs and immune systems are unable to cope with the dangers,’ he said. ‘At the same time, the data show that the dangerous exposure of children starts with pregnancy, especially in areas where families use alternative sources of energy and heating, such as coal or unprocessed organic waste.’
Chrysogonos said that, in view of these facts, would the Commission say:
1. ‘What figures does it have about the deaths of children in Europe from the above factors, especially in regions of southern Europe where thousands of families are unable to cope with the harsh austerity measures and resort to the incineration of waste and timber of doubtful quality to warm up during the winter months?
2. ‘What measures does it plan to take to reduce the risks faced by children?
3. ‘Does it consider that the restrictions imposed on smoking in public places have had sufficient results?’
The Commission, in its written reply to question one, said it estimated EU-wide ambient particulate matter levels in 2010 caused more than 1,800 cases of infant (up to one year) mortality. In addition, annual estimates pointed to more than six million cases of bronchitis in children aged 6 to 12 years.
In answer to question two, the Commission said that EU policy measures pursued safeguarding the public and sensitive groups, including children, from significant negative health impacts due to ambient air pollution. ‘This is achieved by enforcing the EU ambient air quality standards as well as pursuing emission reductions at source, both for individual source categories and overall national emission reductions,’ it said. ‘The Commission will also incentivise and promote better implementation of current policy measures through regular Clean Air Fora and Clean Air Dialogues with member states as well as through projects under the LIFE program, such as the Clean Heat project that aims at reducing the particulate matter emissions from domestic heating.’
And in answer to question three the Commission said the Council recommendation on smoke-free environments called on member states to develop measures to reduce children’s and adolescents’ exposure to second-hand tobacco smoke. ‘A report from 2013 indicates that all member states have now introduced smoke-free legislation,’ it said. ‘Recent surveys confirm that exposure to smoke in public places continues to decline. This illustrates that the recommendation has had a positive impact, although more has still to be done, particularly as the enforcement differs considerably across member states. Moreover, other tobacco control measures taken by the EU and its member states, including product regulation, advertising restrictions, tax measures and anti-smoking campaigns, aim at further reducing tobacco consumption.’
June 15, 2017
A burning question
British American Tobacco is due today to describe at a conference in Warsaw, Poland, how five criteria can be used to establish whether tobacco is being burnt or heated in a tobacco-heating product (THP).
The conference, the Global Forum on Nicotine, is being held at the Marriott Centrum Hotel, Warsaw, on June 15-17.
The main GFN program, which is scheduled for June 16 and 17, will examine the rapidly developing science in relation to nicotine use and the changing landscape, including policy responses and the influence of different stakeholders in this.
Whether tobacco is heated or burnt is important because it determines the chemical composition of the vapor produced. The very high temperatures at which cigarettes burn mean that there are more than 100 chemicals formed that are thought to be associated with the development of smoking-related diseases.
‘THPs are one of several new categories of product being designed as alternatives to conventional cigarettes – electronic cigarettes are a well-known example,’ BAT said in a pre-conference press note.
‘The burning zone in a cigarette can reach temperatures of between 600 and 950̊ºC, whereas in THPs, the temperature is hundreds of degrees lower. It is high enough to release nicotine and flavorings but not so high as to result in the burning of the tobacco and the creation of many of the very high temperature smoke toxicants thought to be involved in the development of the serious diseases associated with smoking. THPs therefore produce emissions that contain fewer toxicants and as a result have the potential to be significantly reduced risk compared to conventional cigarettes.’
BAT said that though various THPs were commercially available, they differed in the way they heated tobacco and in their temperature characteristics. And currently, there was no standard way of assessing whether a product was mainly heating rather than burning tobacco. So, scientists at BAT had developed a five-step approach to comprehensively assess this aspect of a THP.
“To ensure a THP is producing an aerosol by heating rather than burning tobacco, it is important to characterise the way the tobacco is heated,” Dr. Chuan Liu, head of THP science at BAT, was quoted as saying.
“Our five-step approach provides a comprehensive yet practical assessment irrespective of the heating mechanism in the device.”
The five steps are:
Step 1: ‘Measure any physical or chemical changes in the tobacco as it is heated all the way to cigarette combustion temperature to identify the safe temperature window for THP operation. In glo, British American Tobacco’s THP, the maximum heating temperature is set below 245ºC.
Step 2: ‘Establish the maximum temperature the tobacco is heated to and how long it is heated for when the THP is actually used…
Step 3: ‘Analyse the levels of the following combustion products: CO, CO₂, NO and NOx produced by the device when heating tobacco. These are key markers for tobacco that is heated to high temperatures or burnt. Their levels should be much lower than those found in the emissions of a reference cigarette.
Step 4: ‘Measure the level of emissions of a range of other known cigarette smoke toxicants potentially produced by the device. For example, some aldehydes are known to be formed by low-temperature decompositions of carbohydrates. Their levels can be used to judge the extent by which we control this low-temperature breakdown.
Step 5: ‘Examine the physical integrity of the tobacco rod after it has been heated in the device, to assess the extent of any degradation from heating to high temperatures or burning. No charring or ash should be formed.’
June 15, 2017
Acting on child labor
In the wake of World Day Against Child Labor on June 12, some US politicians are attempting to reintroduced the Children Don’t Belong on Tobacco Farms Act, according to a TMA report citing Congressional Documents and Publications.
The act, if passed, would amend the Fair Labor Standards Act effectively to prohibit children under the age of 18 from working on tobacco farms.
One of the sponsors of the bill, US Senator Dick Durbin (D-IL), was quoted as saying that it had been known for decades that tobacco companies had no qualms marketing their deadly products to minors.
But Big Tobacco’s willingness to exploit children for profit didn’t end there, he said. Children as young as 11 or 12 had been found risking nicotine poisoning and long-term health consequences from handling tobacco plants.
US law prohibited children under the age of 18 from buying cigarettes, but children as young as 12 were permitted to work in tobacco fields, where handling tobacco plants could lead to nicotine poisoning.
Tobacco companies and growers’ associations in the US recently adopted voluntary standards to limit child labor in tobacco work, but this bill would codify the implicit agreement that a tobacco farm is no place for children to work.
June 14, 2017
BAT glowing in Japan
British American Tobacco said today that the performance of its heated-tobacco product, glo, in Sendai, Japan, was continuing to exceed its expectations.
Presenting its First Half Pre-Close Trading Update 2017, the company added that it was on track for further ‘Japanese and international rollout in the second half’.
‘In vapor, our share growth in Western Europe continues and we are making encouraging progress with the rollout of Vype Pebble,’ BAT said in a note posted on its website.
‘A city test of Vype e-Pen III is on track for Q4.’
Meanwhile, the company said that, as highlighted in February, its first-half volumes were ‘lapping a strong prior year comparator’ and would be impacted by the phasing of shipments in some key markets, including Pakistan.
‘Full year volume is expected to outperform the industry, which we anticipate will be down around four percent,’ the company said.
‘We expect our market share to continue to grow, driven by the GDBs [global drive brands].
‘Trading in our key markets continues to reflect the trends discussed at the preliminary results in February with Canada, Romania, Bangladesh and Ukraine performing well and conditions remaining challenging in Brazil, South Africa, Malaysia, France and the UK.’
BAT said that its first-half revenue was expected to benefit from good pricing.
‘As previously stated, profit growth is expected to be weighted to the second half of the year, mainly due to the timing of volume shipments, as well as the phasing of NGP [new generation product] investments and marketing spend,’ the company said.
‘If exchange rates stayed the same for the remainder of the year, there would be an adverse transactional impact on operating profit of two percent for both the first half and the full year. For translation, this would be a tailwind on operating profit of approximately 13 percent for the half year and seven percent for the full year.
‘First half EPS is expected to benefit from a significant translational foreign exchange tailwind of around 14 percent.’
June 14, 2017
PMI investing in Russia
Philip Morris International intends to invest 2.49 billion rubles (US$42 million) in modernizing its factory in the Leningrad region of Russia, according to a Construction.RU story.
Construction.RU said that it had been told on Tuesday by the regional administration’s press office that the work was due to be carried out in 2017-18.
It said the project would be one of biggest to have been undertaken in the region for years.
Following completion of the modernization, Russia would follow Italy in becoming a base for the manufacture of tobacco sticks for heated-tobacco products.
Last month, PMI said that its wholly-owned subsidiary, Papastratos, had begun transforming its factory in Aspropyrgos, a suburb of Athens, Greece, into a producer of tobacco sticks to be used in PMI’s iQOS heated-tobacco product.
The plan was to use Greece as one of the PMI’s bases to produce sticks for exports to more than 30 countries by the end of 2017.
June 14, 2017
Snus not appreciated
In a piece published by Bloomberg, Joe Nocera has described as ‘truly maddening’ the fact that most countries refuse to acknowledge the reduced-harm potential of Swedish snus.
Nocera starts his piece with the ‘astonishing’ fact that the number of daily smokers in Sweden is five percent, when the medical journal, The Lancet, defines as ‘tobacco-free’ a country with a smoking rate of lower than five percent.
He traces the massive switch that has seen Swedish smokers turn to snus and the almost-total risk-reduction that that has implied. When smokers were offered a nicotine fix without the carcinogens that came with smoking those smokers embraced that solution, he said.
What was truly maddening was that despite the powerful evidence provided by Sweden, most countries refused to acknowledge it.
‘Most tobacco-control advocates in the West continue to push the idea that quitting all forms of tobacco and nicotine is the safest policy – which is true, though it is a classic example of the perfect being the enemy of the good,’ he said.
‘And they continue to harbor a deep suspicion of alternative nicotine products.
‘Their understandable animus towards Big Tobacco has clouded their ability to see that replacing one kind of tobacco product (combustible cigarettes) with another (snus) can save lives.’
Nocera’s piece is at: https://www.bloomberg.com/view/articles/2017-06-08/sweden-figured-out-how-to-stop-people-from-smoking.
June 12, 2017
Myanmar plans bans
The Myanmar government is planning to ban smoking in public places in Yangon, according to a Xinhua News Agency story.
But the project seems to be modest in its ambition. With the help of the non-profit organization, the Public Health Foundation, the government is said to be making efforts to establish 20 smoke-free zones in 20 years in the former capital.
The story said that, for the purpose of protecting citizens, especially young people, from being impacted by smoke-related health problems, the authorities would set up smoke-free areas in sports arenas and stadiums, public parks, playgrounds, schools, universities, bus stops, cinemas, markets, hospitals and pagodas.
June 7, 2017