Big tobacco tries new lure

In a touch of marketing brilliance, Imperial Tobacco is promoting an alternative to cigarettes -- an addictive smokeless tobacco called snus.

The tobacco product, a tea bag-sized sachet that's placed in the mouth between the teeth and the gums, is currently being test-marketed in Edmonton, to the chagrin of Canadian anti-tobacco activists.

"You give any opening to the tobacco companies and they will exploit it enormously," says Rob Cunningham, policy analyst for the Canadian Cancer Society.

"(Snus) is still linked to cancer and the tobacco industry is marketing this product in a way to get around smoking bans and we know that smoking bans are one of the most effective ways to reduce smoking," he says.

Imperial Tobacco recently ran two half-page ads in the Edmonton Journal promoting snus under the du Maurier brand. Their "pasteurized" tobacco (makes it sound healthy, doesn't it?) is smoke-free, flame-free and spit-free, the ad explains. To be fair, the ad also stresses in large letters that "this product is highly addictive."

It makes you wonder why Imperial Tobacco isn't promoting the patch or nicotine gum if it's so interested in being a good corporate citizen and reducing addiction. Oh, right, there's no money in that.

Snus users don't chew and spit, like with chewing tobacco. Instead, the nicotine is slowly absorbed through the mucous membranes of the mouth.

16 SACHETS DAILY

A typical user, according to a recent report on snus by Physicians for a Smoke-Free Canada (PSC), consumes about 16 sachets a day. The average user keeps snus in the mouth for 11 to 14 hours a day.

Snus is less harmful than smoking cigarettes because it doesn't contribute to oral cancer or cardiovascular disease. But it has been linked to increased rates of pancreatic cancer. And it's addictive.

It's true that Sweden has slightly lower rates of daily smoking among men than Canada. But the overall smoking rate (daily and occasional) is 26% in Sweden, compared with only 19% here, according to the PSC report.

And the overall smoking rates among Swedish women are also much higher than those of Canadian women.

In fact, when smokeless products are included, about half of adults in Sweden use tobacco products, compared to only about 20% of Canadian adults.

So much for the use of snus as a harm-reduction strategy. Between 1994 and 2004, the per capita use of cigarettes declined by 39% in Canada, but it only dropped by 24% in Sweden. But snus use rose 34% over that time period in Sweden. Is this the result we want -- one addiction replaced by another?

If Canada and Sweden continue to reduce smoking at current rates, smoking among men will be close to zero within 20 years in Canada, but 12% in Sweden, PSC predicts.

"It may be true that people are better off taking their nicotine from another source other than cigarettes and I'll accept that," says PSC executive director Cynthia Callard. "But there's no need for it to be a tobacco-based product. There are patches, there's nicotine gum and there are nicotine inhalers."

The du Maurier snus ads, she says, may prompt some to try cigarettes as well. In Sweden, people smoke some days and use snus other days.

Some public health experts in other countries support snus, arguing it's safer than cigarettes. But there's still that addiction thing. Beware: You snus, you lose.

Smoking ban proposed for England

Smoking could be banned in every cafe, restaurant and most pubs in England in four years under plans unveiled by the government on Tuesday.

The White Paper on Public Health plans to make most enclosed public areas, including offices and factories, smoke-free.

Only private clubs, where members voted to allow smoking, and pubs which do not serve prepared food would be exempt.

The White Paper also covers obesity, drinking and sexual and mental health.

The proposals for a smoking ban go further than had been expected. They mean that up to 90% of bars could be smoke-free within a few years.

Welsh Secretary Peter Hain has signalled that similar measures will be adopted in Wales.

But some opponents of smoking are disappointed that they stop short of an outright ban, while pro-smokers have attacked "an attempt to demonise smokers".

The Scottish Executive put forward a blanket ban on smoking in enclosed public places last week, but Health Secretary John Reid did not go that far in the proposals for England.

Smoking will still be allowed in pubs which limit their food sales to snacks such as crisps, rather than prepared meals.

However, this is still further than the voluntary measures that had been considered by ministers.

Speaking in the Commons, Mr Reid pledged to cut the number of people smoking by 2 million over the next five years.

He said: "In a free society, men and women ultimately have the right within the law to choose their own lifestyle, even when it may damage their own health.

"But people do not have the right to damage the health of others, or to impose an intolerable degree of inconvenience or nuisance on others.

"We will ensure that people will be able to go to their workplace, or choose to go out for a meal or a drink without the damage, inconvenience or pollution from second-hand smoke.

"This is a sensible solution which balances the protection of the majority with the personal freedom of the minority in England."

Smoking restrictions will be phased in, with a ban on smoking in NHS and government buildings by 2006, in enclosed public places by 2007, and with the restrictions on smoking in licensed premises introduced by the end of 2008.

There will be wide consultation, including with the catering and pro-smoking lobby.

However, Mr Reid stressed that even in pubs where smoking will be allowed, nobody will be able to light up in the bar area.

The government has also proposed legislation to ban retailers who repeatedly sell tobacco products to young people from selling such products, either temporarily or permanently.

Other measures

In the foreword to the White Paper, the government says it wants to create an environment in which people are encouraged to adopt healthy lifestyles - but does not believe it is its role to force people to become healthy.

The paper was drawn up after one of the largest public consultations, involving 150,000 people, over the summer.

The Department of Health received more than 1,000 submissions from individuals alone - unheard of for a white paper.

Among other plans are restrictions on junk food advertising and a "traffic light" system showing shoppers how healthy the food they are buying is.

Ed Gershon, of the pub chain JD Wetherspoon, said the smoking ban would be good for business.

"The majority of people don't like to be around smoky areas. We think it will bring a lot more people back into pubs long-term."

But the reforms do not impress some campaigners, who had called for more radical measures.

The British Medical Association (BMA), which wants a complete ban on alcohol advertising and smoking in public places, welcomed the traffic light coding proposals.

But Dr Vivienne Nathanson, head of science and ethics at the BMA, was disappointed not to see a total ban on smoking in enclosed public places.

"If this is the case, he [John Reid] will be letting down every infant, child and adult in England," she said.

Deborah Arnott, of Action on Smoking and Health (Ash), said the proposals might be unworkable.

"We know from Ireland that what makes a ban work is to have a simple, level playing field where you can't smoke in any workplaces."

Pro-smoking campaigners said businesses should be allowed to choose the policy that best suited their staff and customers.

Forest director Simon Clark said most people would be happy with more no-smoking areas and better ventilation.

"They do not want a complete ban on public smoking enforced by an army of tobacco control officers," he said.

"We support further restrictions but we vehemently oppose what has become a systematic attempt to demonise smokers and their perfectly legal habit."

The opposition parties were also sceptical of the impact the government's reforms will have.

Liberal Democrat health spokesman Paul Burstow said: "If the Health Secretary admits that passive smoking kills and that there is no safe level of smoke, then there can not be any exceptions for a ban on smoking in enclosed public places.

"Dr Reid must understand that smoking still kills even when you are not eating food."

Shadow Health Secretary Andrew Lansley said the Tories would achieve more and do it more quickly by working with the industry to achieve a "smoke-free environment in the great majority of pubs and restaurants and public places."

Smoking Ban Proves More Beneficial For Non-Smokers

Described as a filthy habit by many, smoking has long been considered a threat by most if not all non-smokers. Health-wise, the discrimination is quite reasonable, if only because the health risks to non-smokers are even greater than on those who are. Despite the fact that smoking might have benefits as a form of self-medication for depression, the “high” it produces is temporary. Needless to say, the risks associated with smoking far outweighs its very few benefits, if that word can be used at all in the context of smoking. Most people would rather not be exposed to the cigarettes and the smoke emitted from it. This is especially true in public places, if the number of territories and countries where smoking is banned in public places is any indication. However, aside from public convenience and the supposed “discrimination” against smokers, there are health benefits for non-smokers because of the smoking ban.

Recent studies show that better respiratory health has been achieved or at least is perceived to be now more attainable among non-smokers. The reason behind this positive health perception is the passage of legislation to ban smoking in public. A recent study found that non-smokers who were not exposed to second-hand smoke were showing better signs of respiratory and circulatory health than they were prior to the ban being put into place. Interestingly, most countries that have public smoking bans in place did not foresee this happening and had originally placed legislation against the habit to help cut down the number of people engaged in it. No one is complaining about this unexpected development, of course, being that it is a welcome thing for the non-smoking population.

The data contradicts the expectations of the people who institute such bans. Most people who issue legislations to ban the public consumption of tobacco and cigarettes believe it would cut down on the number of people who did so. Recent research seems to indicate that this is not the case, with the rate of people people quitting the habit remaining steady before and after the bans. This suggests that banning them from smoking in public is not helping them quit and may simply be forcing them to do so in other, less accessible areas. However, since these areas are out of the public arena, non-smokers are reaping the benefits of cleaner, smoke-free air in areas where a ban is in effect.
The study also took into consideration the number of people being hospitalized for smoke-related ailments. Two areas were investigated, with one having a clear and long-standing public smoking ban, and another that had no such legislation passed. The study specifically chose two hospitals, one in each area, that admitted patients for those smoke-related ailments. The study found that less people went to the hospital for heart and respiratory conditions related to smoking were much lower in the area where the ban was in place, whereas it remained steady in the area without a ban.

The research team noted that even just a little exposure was capable of doing much damage to the cardiovascular system with evidence being provided by the study itself. The smoke causes blood vessels to constrict and reduces the amount of oxygen that goes into the brain. The study showed that, even if the non-smoker has no other risk factors, mere exposure to second-hand smoke can increase the risk of cardiovascular damage greatly.

Women Who Smoke At Increased Risk Of Lung Disease

Here's another reason not to smoke, especially for women: chronic obstructive pulmonary disease (COPD).

This disabling breathing disorder is increasingly becoming a problem for women, according to the January issue of Mayo Clinic Women's HealthSource. The most important risk factor for COPD is long term cigarette smoking.

Chronic obstructive pulmonary disease is a broad term that describes any of a group of illnesses that block airflow through the lungs. The most common are emphysema and chronic bronchitis. Signs and symptoms of COPD -- persistent cough, increased mucus production, shortness of breath and frequent colds and respiratory problems -- often develop gradually, and people don't realize they have the disease until it's advanced.

Chronic obstructive pulmonary disease is the fourth leading cause of death in the United States. The COPD death rate for women rose much faster between 1980 and 2000 than it did for men. In 2000, the number of women dying of COPD surpassed men for the first time. According to recent research, women with the disease experience more breathlessness, higher rates of depression and lower quality of life than men with the disease -- even those women reported fewer years of smoking than men.

The increase in female rates of COPD likely reflects the increase in the number of female smokers since the 1940s, when advertisers began promoting smoking as a symbol of independence for women.

Chronic obstructive pulmonary disease can be treated, but not cured. The most important treatment is to stop smoking. For smokers with COPD, quitting smoking reduces subsequent loss of lung function by half and cuts the death rate by nearly half. And some better news for women is that those who quit smoking receive twice as great an improvement in lung function as men.

Mayo Clinic
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http://www.mayoclinic.com

New "Smoke-Free Cars With Minors" Law Protects California's Children From Secondhand Smoke In Cars

Los Angeles-California state health officials commemorates the ten-year anniversary of smoke-free bars in California and highlighted a new law that protects Californians against the danger of secondhand smoke. The "Smoke-free Cars with Minors" law, which took effect January 1, bans smoking in a car carrying a minor.

"Our efforts to address the dangers of secondhand smoke in California began over a decade ago," said Kimberly Belshé, Secretary of California's Health and Human Services Agency. "Today, our state continues to be a leader by ensuring that children and youth traveling in cars are not exposed to secondhand smoke."

California's "Smoke-free Cars with Minors" law, authored by Senator Jenny Oropeza, D-Long Beach, prohibits smoking in a motor vehicle when a minor (17 years old and under) is present. A violation is punishable by a fine of up to $100.

"Infants and children are especially susceptible to the harmful effects of secondhand smoke," said Dr. Mark Horton, Director of the California Department of Public Health. "Smoking in a car, or any confined space, increases the level of pollution inhaled by children and adults, thereby increasing the likelihood of suffering from the negative health effects of secondhand smoke."

Studies of secondhand smoke exposure have shown that levels of secondhand smoke caused by one person smoking in a car can make the air inside the vehicle up to 10 times more toxic than the level the U.S. Environmental Protection Agency says is hazardous for breathing.

Evidence suggests that children are especially vulnerable to the health effects caused by secondhand smoke. Exposure to secondhand smoke by children increases the risk of asthma attacks, ear infections, bronchitis and pneumonia. Long-term exposure also has been linked to heart disease and lung cancer in adults.

California's leadership and commitment to protecting residents from secondhand smoke began in 1994 with the passage of California's Law for a Smoke-free Workplace. The smoke-free bar provision of this law took effect in January 1998.

California's public health policies are major contributing factors to the state's low smoking rates. California also has the lowest cigarette consumption per capita in the U.S. and serves as a model for other states and countries.

The California Department of Public Health's Tobacco Control Program is the nation's longest running and most comprehensive anti-tobacco program. More information about the "Smoke-free Cars with Minors" law and the state's tobacco control efforts is available here.