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Plain packaging will work - That's why tobacco companies oppose it

Thu, 06 Sep 2012 13:28:33 +1200

6 September 2012 - Smokefree Coalition - Tobacco Control Update
On 6 August Lower Hutt Mayor Ray Wallace officiated as Imperial Tobacco in Petone launched an expansion of production capacity. Ironically, the same day the Mayor turned on the 8000-cigarettes-per-minute death machine, the University of Otago Wellington hosted an international expert on tobacco addiction.

Professor Joseph DiFranza, from the University of Massachusetts, has conducted ground-breaking research that shows addiction begins with the very first cigarette as the nicotine hit causes changes to the brain's hardwiring that fuels cravings. Further, his research shows that addiction sets in well before people commence smoking on a daily basis, undermining the tobacco industry's stance that smoking is an 'informed choice'.

14 April 1994 is an infamous day for the tobacco industry. The chief executives of the seven largest tobacco companies in the United States testified before Congress that nicotine and tobacco products are not addictive. This fraud perpetuated the tobacco industry's ongoing deception of the public, and Mayor Wallace's repetition of the 'personal choice' mantra to justify his support of the factory shows that industry deception continues to this day.

Despite the global tobacco industry publically disavowing addiction, internal documents reveal the truth was acknowledged behind closed doors. For example, Director of Marketing Research and Development at Imperial Tobacco Canada Bob Bexon wrote a confidential memo in the late 1980s which read: "The only remaining 'benefit' of cigarette smoking is the psychological assist it provides in terms of stress reduction. If our product was not addictive we would not sell a single cigarette next week in spite of these positive psychological attributes." Bexon later became the CEO.

And there are more little-known truths. In 2006, a United States court found Phillip Morris USA dedicated "substantial resources to devising techniques to modify and manipulate the amount of nicotine that their products deliver". Unsurprisingly, nicotine levels have been increasing over time, making cigarettes more addictive and harder to quit. Researchers at the Harvard School of Public Health analysed the amount of nicotine in hundreds of cigarettes sold in the United States between 1997 and 2005, and found an average increase in nicotine yield of 1.1 percent each year.

But cigarettes are not the same around the world. Scientists at British American Tobacco in the United Kingdom analysed the tobacco butts of 5703 smokers in eight countries, including New Zealand. Their test results, published just last year, showed that New Zealand and South African smokers were exposed to significantly more nicotine and tar than smokers from other countries.

The majority of people who smoke in New Zealand became addicted while they were teenagers, and nearly all have come to regret ever starting. The 'adult choice' that four out of five smokers actually want to make is to break free from their addiction and become smokefree. But that is another truth you won't hear publically acknowledged by a tobacco company.

However, apparently none of this really matters because Imperial is a "good employer", "putting bread and butter on the table" for thousands of Lower Hutt residents since the 1920s. What about the nails they've put in the coffins of thousands already killed, and the many thousands more that will die as a consequence of this machine, Mr Wallace?

By Ninya Maubach – Postdoctoral Fellow in the Department of Marketing at the University of Otago

Do you miss the feeling of having a cigarette between your fingers?
Do you miss the feeling of a cigarette between my lips and/or sucking on a cigarette?

If the answers to the above questions are Yes, then you could be what is known as being highly kinaesthetic.

Find out suggestions and strategies to help you! START NOW

Plain packaging: This time it's serious

Sat, 01 Sep 2012 13:28:33 +1200

1 September 2012 - The NZ Herald
In the Mad Men days of the 1960s advertising agencies persuaded cigarette companies they needed branding to entice customers.

The global tobacco industry - which barely flinched when New Zealand banned smoking in pubs and hiked cigarette prices - is fighting back furiously against plain packaging. Geoff Cumming examines why.

It's just a small box, fits neatly in the palm of a hand. With ugly images of cancer victims and health warnings taking up much of the packet, we might think the rest isn't worth scrapping over. But New Zealand is about to become the front line in one of the biggest battles yet fought between public health campaigners and the tobacco industry - over what goes on the packet.

Hard on the heels of retail display bans, campaigners are wheeling out plain packaging as they seek a decisive blow in their push towards "endgame" - the point where smoking rates are so low that tobacco ceases to be a dominant public health issue.

The industry has endured so many hits in recent years - smokefree bars and restaurants, the graphic warnings, price hikes and now retail display bans - that we might be forgiven for thinking it was gasping for breath. But global cigarette sales continue to soar and addiction rates here remain stubbornly high.

Researchers are focused on the Government target of a (largely) smokefree New Zealand by 2025 and have yet more weapons in their sights: axing duty free sales, licensing retailers, banning sales within a kilometre of schools ...

But the box - the only avenue left for companies to promote their brand - looms as something of a trophy.

As if to vindicate the campaigners' fixation, the industry - which mustered only token public resistance against tax increases and the display ban - is making a real stand against plain packaging, summoning-up its legendary influence and strategic cunning.

The companies are behind a volley of legal moves to try to head-off Australia's introduction of plain packs on December 1, after failing to deter politicians with a "hearts and minds" publicity campaign waged on radio, television and the internet. While Australia's High Court has rejected a challenge brought on constitutional grounds, plain packaging faces a series of tougher hurdles before the World Trade Organisation and investor-state dispute tribunals. New Zealand has obtained third party (observer) status for the hearings.

Tobacco firms portray their stance as principled: defending their rights to use branding to distinguish and promote their legal products.

"Branding and intellectual property are an integral part of a lawful and free market economy," says Imperial Tobacco, whose NZ brands include Horizon, Peter Stuyvesant and Superkings.

"Plain packaging would fundamentally weaken the robust system of domestic and international intellectual property protection on which New Zealand businesses rely," says one of two websites launched here to fight the move. British America Tobacco NZ last week launched a print, TV and radio advertising campaign while the companies are also lobbying politicians and opinion leaders. Recent public comments by Winston Peters, Ron Mark and Rodney Hide are strikingly similar to concerns expressed on one website that alcohol and obesity are as big a threat to Maori and Pacific communities as smoking.

More worrying for decision-makers are the thinly veiled threats about what New Zealand risks if it follows Australia's lead. Plain packaging would violate trademark rights protected by international law by effectively eliminating the use of trademarks for tobacco products, says Imperial Tobacco.

On BAT's agreedisagree website and in media statements, the industry claims plain packaging would weaken our ability to protect our exports from similar labelling and brand expropriation policies - even suggesting our wine and dairy exports could be forced into plain packages.

We could be shooting ourselves in the foot: New Zealand relies on WTO free trade protections, as we did in forcing Australia to accept our apples. And how hypocritical to demand plain packaging for cigarettes when we're planning to use the WTO to oppose plain packaging on alcohol in Thailand ...

Even the US Chamber of Commerce has waved its finger, warning that - with the Trans Pacific Partnership negotiations under way - it is "most troubling" that the Government would consider destroying an industry's "legitimate trademark protection and branding rights long protected under law and international treaties". The subtext: see you in court.

To health campaigners, this shows the industry is running scared and fears Australia's legislation could have a domino effect.

"I've been in some extremely entrenched campaigns such as the ban on smoking in pubs and sponsorship in sport but I've never seen anything as big as their opposition to this," says Simon Chapman, professor of public health at Sydney University. "The only conclusion is that they have a complete understanding of how this will affect their bottom line."

Australia's initiative has attracted global interest, with Britain, India and South Africa among countries interested in following suit. Health authorities in the European Union have called a conference in Turkey next month to discuss the measure.

But New Zealand is next cab off the rank. The Government agreed in principle to plain packaging in April and consultation is under way on a Ministry of Health proposal modelled on the Australian approach. There, cigarettes will be sold in olive packs with graphic health warnings covering 75 per cent of the front of the pack. Warnings on the back will continue to cover 90 per cent. New Zealand's proposals are similar, with logos and embossing banned. Only the brand name and variety would be printed on the front in regulated size, font, colour and position.

Australia faces WTO challenges from Ukraine, the Dominion Republic and Honduras - their claims presumably financed by the tobacco industry.

None has significant tobacco trade with Australia but claim they would like to have, says Professor Jane Kelsey, an international trade expert at the Auckland University law school.

The claimed violations of WTO rules protecting intellectual property have been widely condemned - including by our Trade Minister Tim Groser.

"It's an outrageous thing for these companies to be using the WTO as a backdoor attack on Australia," Groser said last month.

But legal commentators caution that WTO outcomes are difficult to predict and Kelsey believes claimants might gain traction with their claims that plain packaging constitutes a "technical barrier to trade". Labelling rules covered by this agreement mean countries cannot impose measures without scientific proof that the policy will achieve its objective. Countries are required to adopt the least onerous measures to achieve their objectives.

The industry has been quick to seize on the lack of direct evidence that plain packaging will prompt smokers to quit and deter youngsters from starting.

"Tobacco packaging has never been identified as a reason why people start to smoke or continue to smoke," Imperial Tobacco claimed earlier this year.

A separate legal move shows the tobacco industry has lost none of its dexterity, captured in movies The Insider and Thankyou for Smoking. More than a year after Australia's plain packaging legislation was mooted, Hong Kong-based Philip Morris Asia bought out Philip Morris Australia. This has allowed the company to seek arbitration under the Hong Kong-Australia Bilateral Investment Treaty, claiming plain packaging would breach the treaty's intellectual property protections.

The blatant manipulation has been savaged by Australian commentators and few expect the case to go the distance. But it will take time and money to have it thrown out.

New Zealand has a free trade agreement with Hong Kong which contains an exception to allow legislation for public health purposes - but it is not watertight, warns Kelsey. The Ministry of Foreign Affairs and Trade's regulatory impact assessment on plain packaging says there is a "reasonably high risk" that New Zealand could face a WTO complaint like Australia.

"The real worry is the chilling effect these [trade and investor law disputes] could have on government decision-making."

As for the claimed lack of evidence that plain packaging will succeed, this is seen as another clever piece of industry spin - how can there be evidence when it has yet to be tried anywhere? But volumes of research suggest plain packaging will put young people off starting to smoke, campaigners claim.

That research may be crucial, if Kelsey is correct that WTO rules covering technical barriers to trade loom as a significant test for the measure.

Another worry for campaigners is Prime Minister John Key's lukewarm support for plain packaging (in contrast to the bullishness of Australian political leaders). Key told Fairfax Media in July: "I don't see it as critically important as raising the price - I think that's more likely to have an impact ... Yes, it's important but I wouldn't die in a ditch over it.

"Plain packaging is one more step in the desire to see fewer New Zealanders smoke but it's probably going to be less effective than some of the other things we've done anyway."

Kelsey says such statements will be seized on by the industry to use in trade cases, to sow doubt that the measure is justified under the narrow exemptions for public health measures. Others wonder how genuine is the Government's commitment to the "aspirational" goal of making New Zealand smokefree by 2025, given the billion dollars it collects from the industry each year, rising with every excise tax increase.

But Simon Chapman expects the Australian measure will survive the WTO. "We've got very tough gun laws in Australia - you don't see Smith & Wesson and Glock taking Australia to the WTO because we have tough gun laws."

It's many years since the cigarette packet was a blank canvas for the imaginations of advertising and marketing men - as captured in the TV series Madmen - who persuaded tobacco companies that branding and the images conveyed were as important to sales as the label on a champagne bottle. With the truth about the product's lethal impact hidden in a haze of denial and obfuscation, box design helped to convey the allure of the product - none more successfully than the Marlboro man, a rugged cowboy used to counter the feminine image of filtered cigarettes. Names like Virginia Slims were introduced to cater for women while brand variants like "menthol", "low tar" and "mild" created a myth that some cigarettes were safer than others. As recently as the 1980s, Camel used a cartoon figure to appeal to children.

Health researchers claim that even with graphic warnings, consumers and especially children remain vulnerable to subliminal advertising.

The industry maintains it does nothing to entice children and young adults to smoke. But researchers say "they would say that, wouldn't they?"

"Packaging is incredibly important to tobacco companies," says Professor Janet Hoek, of Otago University's marketing department.

"Cigarette packets are what's known as a badge product. We know from research that younger smokers are very influenced by branding.

"The companies are in a really invidious position - they kill half their customers so they have to keep recruiting young people."

The ability to vary the packaging to distinguish product is also vital to the industry. Chapman says companies have increasingly looked to premium brands for profits as smoking numbers have dropped in developed markets - even though blind tests suggest the products are virtually indistinguishable.

"They know that if all packs look the same, that smokers are going to say 'hang on, why am I going to fork out an extra $3 or $4 for something that tastes the same'?"

Philip Morris NZ corporate affairs manager Christopher Bishop says cigarette blends can be very different in the quality and type of tobacco used.

If branding is as crucial - and the industry as worried - as health campaigners maintain, could plain packaging be the tipping point which pushes smoking rates towards "endgame"? Evidence suggests shareholders should not be deserting Big Tobacco just yet.

Despite two decades of apparently decisive blows, the industry's global profits have continued to soar. Philip Morris International alone has more than doubled global cigarette sales, from 400 billion sticks in 1992 to almost 900 billion in 2010.

The industry's growth has come in developing countries where public health campaigns are less well-funded, particularly China, India, Indonesia - the three today account for more than half of global tobacco consumption - and Brazil. The Asia/Pacific region is now the world's biggest tobacco market, the Sydney Morning Herald reported, with 6 million new smokers recruited in 2009 and a further 30 million expected to be added by 2014. Companies eye a bright future in Egypt, predicted to become the fifth biggest tobacco market in the next 40 years.

Researchers say firms have also countered declining smoking trends in "enlightened" countries by introducing so-called premium products. In New Zealand, Imperial Tobacco boosted sales in 2010/11 to $345 million (up nearly $50 million on the previous year) and expects production at its recently-expanded Petone plant (which manufactures for the Australian market) to treble from 1.1 billion cigarettes in 2010/11 to 3.5 billion this financial year.

Though falling slowly, the overall adult smoking rate (23.6 per cent in 2009) masks significant distortions, says Professor Richard Edwards, head of public health at Otago University's Wellington campus. In 2009, 44 per cent of Maori (more women than men); 35 per cent of Pacific men and 30 per cent of 20-24 year olds smoked.

"It's been 50 or 60 years since it was clearly shown tobacco causes cancer," says Edwards, who also heads the Aspire 2025 research project. "But we still have these significant rates among young adults and Maori and Pacific people. So we need a suite of strategies. Plain packaging is a big step but far from sufficient.

"We need to increase the price, we need to do everything. This is a public health emergency which has been continuing for the last 60 to 70 years."

By Geoff Cumming - www.nzherald.plainpackaging

the tens of thousands of people who have died as a result of a tobacco-related illness but we can begin to build a healthier smoke-free future for our children.

By John Loof - www.nzherald.tobaccoisadyingindustryhoweveryouviewit

Do you miss the feeling of having a cigarette between your fingers?
Do you miss the feeling of a cigarette between my lips and/or sucking on a cigarette?

If the answers to the above questions are Yes, then you could be what is known as being highly kinaesthetic.

Find out suggestions and strategies to help you! START NOW

Tobacco is a dying industry however you view it

Tue, 28 Aug 2012 13:28:33 +1200

29 August 2012 - The NZ Herald
Tobacco companies are demanding the right to sell more cigarettes in New Zealand.

The argument against plain packaging is based on perverse logic, writes John Loof, chief executive of the Cancer Society Auckland.

A corporate giant came out last week with a major public relations campaign. It issued a statement on its website saying it acknowledges that its product is harmful. At first view you would think it should be congratulated for its frankness.

Most of us would then expect this organisation to say something like, "and we are doing everything in our power to reduce the harm to our customers."

Strangely, this organisation has no such plans. Its aim is to continue to manufacture this product, to gain greater market share and to find new customers.

Imagine for a moment a car maker, an electronics company or food manufacturer stating that its product was indeed harmful but that it had no intention of doing anything about it. There would be calls for legal action, a recall of products and the public would likely abandon that particular brand in droves. Regrettably, this isn't an easy choice for consumers in this example as they are chemically addicted to the product.

By now you have probably guessed that the corporate giant in this scenario is British American Tobacco, which has launched a campaign to persuade us that plain packaging of cigarettes is a bad idea.

It is a real Alice in Wonderland moment when a company acknowledges the harm done by its products while campaigning for more marketing freedom. The Australian Government hasn't been fooled by this perverse logic and it appears our Health Minister, Tony Ryall, doesn't buy it either.

All manner of dire consequences are predicted by the tobacco industry, such as the growth of a black market and violations of international trade agreements. There is no evidence to suggest that smokers will seek out criminal gangs for a pack of Rothmans and if there are fewer smokers there will be no demand for black market cigarettes anyway.

The trade agreement argument is a particularly shameful and immoral one. Tobacco companies are demanding the right to sell more cigarettes in New Zealand against the policies of our democratically elected Government which is seeking to improve health outcomes for its citizens.

The highest court in Australia ruled this as being unconstitutional and hopefully this was a show of strength and purpose that has put the tobacco industry on notice that it has a real fight on its hands.

Every year 5000 New Zealanders lose their lives to smoking-related diseases.

Opponents of tobacco control often point to a simplistic and ideological solution by saying the Government should either make tobacco illegal or leave it alone. Organisations like the Cancer Society and those working in the field of public health wish it were that easy.

If it were possible to prohibit tobacco tomorrow we would do it, but lessons learned from alcohol prohibition and control of illegal drugs need to be heeded.

Our Government has set a target to be a smoke-free New Zealand by 2025. To do this requires a number of strong measures including tax increases, continued support for people to quit, more smoke-free spaces and places where children aren't surrounded and influenced by adults who are smoking.

We have removed the ubiquitous marketing displays of tobacco products in the corner dairy and now it is time to further reduce the marketing opportunities available to tobacco companies by introducing plain packaging. There is much evidence that children find the bright colours on the packets appealing and recognise cigarette branding from a very early age.

Research tells us that in New Zealand children as young as 14 are starting to smoke. We also know that if people are not smoking by the age of 18 they are unlikely to start. This categorically means that the key target audience to increase the uptake of tobacco products is people in their early teens who are very susceptible to marketing tactics and packaging.

In years to come there will likely be further restrictions on the sale and purchase of tobacco products. All these practical measures will result in the percentage of adults who smoke reducing inexorably from today's figure of around 20 per cent to less than 5 per cent by 2025.

The proverb "He muka no te taura whiri" tells us that it takes many strands to make one rope. We know we need a very strong rope to haul back the tobacco industry from continuing to profit at the expense of the lives of New Zealanders. British American Tobacco should pause and reflect very carefully on the real meaning of its own words. It needs to once and for all recognise that it is part of a literally dying industry.

We may not be able to rewrite history for the tens of thousands of people who have died as a result of a tobacco-related illness but we can begin to build a healthier smoke-free future for our children.

By John Loof - www.nzherald.tobaccoisadyingindustryhoweveryouviewit

Do you miss the feeling of having a cigarette between your fingers?
Do you miss the feeling of a cigarette between my lips and/or sucking on a cigarette?

If the answers to the above questions are Yes, then you could be what is known as being highly kinaesthetic.

Find out suggestions and strategies to help you! START NOW

Smokers save Govt cash, says report

Tue, 29 May 2012 13:28:33 +1200

29 May 2012 - The NZ Herald
A Treasury report has admitted that smoking saves the Government money because smokers die earlier and pay more in tobacco tax than their health problems cost.

The regulatory impact statement on tobacco taxes prepared ahead of the Budget said smokers' shorter life expectancies reduced the need for superannuation and aged care.

"When the broader fiscal impacts of smoking are considered ... smokers are probably already 'paying their way' in narrowly fiscal terms."

In last week's Budget, Associate Health Minister Tariana Turia introduced tobacco levies that will increase the price of a 20-pack of cigarettes to more than $20 in four years.

The charges would increase the Government's tax take from tobacco from $1.3 billion to around $1.7 billion by 2016.

The Treasury document acknowledged that the revenue gathered in tobacco taxes already exceeded the health costs of smoking.

A University of Otago study in 2007 estimated that the direct cost of smoking to the Ministry of Health was $300 million to $350 million.

The Treasury cited a Ministry of Health study that estimated the indirect health costs of smoking at $1.9 billion, but acknowledged the figure had been disputed and was far higher than previous estimates.

In comparison, alcohol tax revenue was $682 million. The immediate health cost of alcohol-related problems has been estimated at $700 million and the indirect cost up to $5 billion (though this figure was also disputed).

The regulatory impact statement said taxing smokers was a much more reliable way of generating income for the Government than taxing other goods and services.

It said tobacco taxes were "very efficient" for raising revenue because the addictive nature of nicotine meant smokers were not highly sensitive to price increases.

Mrs Turia said last week that for every 10 per cent increase in the price of cigarettes, tobacco consumption fell by about 5 per cent.

The Treasury was more conservative, estimating a 3.5 to 4 per cent decrease in smoking consumption after each tax rise.

The Treasury said a Budget night tax rise would have prevented people from stockpiling cigarettes but price increases signalled in advance were more likely to encourage smokers to quit. The first rise takes effect in January.

Tobacco tax has been increased by more than 40 per cent since 2010.

By Isaac Davison www.nzherald.co.nz

Budget 2012: Smokers open wallets wide

Fri, 25 May 2012 13:28:33 +1200

25 May 2012 - The NZ Herald
The Budget's $5 increase in the price of 20 cigarettes has been welcomed by public health experts, but some wish the Government had added a much bigger "shock" hit to its series of smaller rises.

Associate Health Minister Tariana Turia announced tobacco excise taxes would rise by 10 per cent a year on January 1 for the next four years.

That will lift the average price of a packet of 20 from about $14 now, to $15.40 next year and $20.50 in 2016.

Read all of nzherald.co.nz's Budget coverage here.

The good news for Government coffers is an estimated revenue rise from $1.2 billion a year to $1.7 billion by 2016.

Professor Richard Edwards, head of public health at Otago University in Wellington, said the tax rises were a good move and would help to reduce smoking.

"Increasing the tax and therefore the price of cigarettes is one of the most effective ways to help people stop smoking and reduce the number of people who start smoking.

"On the down side, we would have liked there to be an even larger increase because there's evidence that large increases of 20 or 30 per cent have an additional shock value."

Adding a rise of that magnitude among the series of 10 per cent rises would have a much greater impact on smoking. It would act as a big trigger and many more people were likely to say, "I've had it, I'm going to stop".

"If you have a big hit, it's difficult for the tobacco industry to cut that. With smaller ones, they can adjust their prices and smooth the effect of an increase. With a big hit, they have less ability to do that."

The increases announced yesterday are in addition to the annual tax increases linked to inflation and follow the excise rise of 25.4 per cent on loose tobacco and 10 per cent on cigarettes in April 2010 and two later rises each of 10 per cent on both types of tobacco.

Calls to the Quitline increased dramatically in the weeks after the April 2010 rises. Mrs Turia's advisers said , based on tobacco company data, the volume of tobacco consumed fell 14 per cent from 2009 to 2011.

Mrs Turia said: "We know that for every 10 per cent increase in the price, tobacco consumption falls by about 5 per cent. Many smokers will quit and many more will reduce their tobacco consumption."

She also announced $20 million would be spent over the next four years on programmes to encourage quitting and to discourage people from taking up smoking.

Imperial Tobacco spokesman Brendan Walker said the tax rises would create "a lucrative black market for tobacco".

But Action on Smoking and Health communications manager Michael Colhoun dismissed this "industry scaremongering" as a "tired old argument".

Before the January excise rise, the Government's next tobacco control measure will be the ban on displays of tobacco products in dairies and other shops, from July 23.

The public will be consulted on any moves to forced plain packaging.

The cost of smoking

Cost of a 20 pack / Tax increase on a 20 pack of cigarettes

$20.50 10% 2016
$18.60 10% 2015
$16.90 10% 2014
$15.40 10% 2013
$14.00 10% 2012 Jan ($16.00 for more expensive brands)
$12.60 10% 2011 Jan
$11.20 10% 2010 April (On cigarettes; 14% on all other tobacco products)
$8.40 14% 2000 May (Plus extra 6% by tobacco companies)
$6.50 10% 1998 May (On all tobacco)
$5.80 37% 1995 Dec (On non-cigarette tobacco products)

Tobacco revenue to rise from $1.2 billion a year to $1.7 billion by 2016

Regular adult smokers

1990 28%
2005 23.5%
2009 21.3%

By Martin Johnston – www.nzherald.co.nz

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'Big Tobacco' on trial: Canada's biggest-ever lawsuit

Mon, 12 Mar 2012 13:28:33 +1300

12 March 2012 - The NZ Herald
A groundbreaking trial gets underway in Montreal later today against three leading tobacco companies which face a $25 billion lawsuit for allegedly failing to adequately warn smokers of the dangers of cigarettes.

Plaintiffs have filed two separate class actions in what is Canada's biggest-ever civilian lawsuit, against Imperial Tobacco, JTI-Macdonald and Rothmans Benson & Hedges in the Superior Court of Quebec.

The first class includes 90,000 current and former smokers in Quebec who say they have fallen ill with a range of smoking-related ailments including emphysema and cancer of the throat and larynx, and are seeking $105,000 Canadian per person (NZ$129,000).

The second suit was filed by 1.8 million current smokers who say they are unable to quit the tobacco habit, and are seeking $10,000 per person.

According to court documents, the plaintiffs accuse the Canadian tobacco companies of hiding research which has established a link between smoking and serious health problems like cancer.

The suit also alleges that tobacco firms in Canada have tried to manipulate the levels of nicotine in their cigarettes, increasing the levels of dangerous tar and have also added certain products such as ammonia.

Mario Bujold, director general of the Quebec Council on Tobacco and Health told AFP that one of the witnesses will be Robert Proctor, author of "Golden Holocaust," a book alleging nefarious practices by the US tobacco industry.

Quebec is only one of several Canadian provinces seeking monetary damages from the tobacco manufacturers.

Several provinces, led by British Columbia, are also suing Canada's tobacco companies in hopes of recovering billions of dollars spent by their health insurers to treat the victims of tobacco use.

- AFP – NZ Herald www.nzherald.co.nz

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Youth smokers fall to 8.2% low

Fri, 02 Mar 2012 13:28:33 +1300

2 March 2012 - The NZ Herald
Youth smoking has fallen to an 8.2 per cent low, with many saying they can't afford the habit, according to a survey.

Key findings from the annual survey by anti-smoking group Ash indicate youth smoking rates have fallen across all ethnic groups, especially among Maori students, whose percentage of regular smokers dropped from 20.9 to 18.1 between 2010 and last year.

Ash has sampled about half of New Zealand's Year 10 smokers each year since 1999.

The Ash survey also revealed a significant rise in students who had never smoked, up from 64.3 per cent in 2010 to 70.4 per cent last year.

Associate Health Minister and Maori Party co-leader Tariana Turia expressed her delight at the results.

"It is an absolute success, one that I am proud to have worked towards."

Ash spokesman Michael Colhoun called the latest results "a major victory against smoking addiction for New Zealand".

He and Mrs Turia agree the results indicate a shift in the attitudes of young people towards smoking.

"It seems that smoking is no longer socially accepted as widely as it once was," Mr Colhoun said.

Despite the positive results, significant disparities remain between Maori and non-Maori, with the number of Maori students who smoke regularly more than three times that of non-Maori students.

Maori anti-smoking advocate Shane Bradbrook highlighted the need to continue increasing anti-tobacco initiatives, especially in light of the positive results revealed in the Ash survey.

"There is no doubt that the increase in tobacco taxes within the last 18 months contributed to the reduced usage amongst youths.

"Now, I would like to see a more Maori-specific approach to combating tobacco addiction amongst our youth," Mr Bradbrook said.

Ash director Ben Youdan put the drop in smoking levels across the board down to tax hikes.

"I think probably the biggest factor in terms of the reduction in youth smoking has been the recent tax increases," he said.

"The tax on cigarettes has increased by about 30 per cent over the last 18 months, and I think that's had a huge impact because young smokers are especially sensitive to how much cigarettes cost."

Society's perception around buying and smoking cigarettes was changing, with more communities and councils discussing smoke-free zones, Mr Youdan said.

"We're getting more and more quit attempts by adults as well.

"The environment in which these young people are growing up and the way in which they are being exposed to tobacco and the risk factors around smoking is also undergoing a change, and I think that's influence which is trickling down to their behaviour."

PUFFING PLUNGE

2011 regular smokers, Year 10:

Pakeha: 5.6 per cent (1.6 per cent decline)
Maori: 18.1 per cent (7.8 per cent decline)
Pacific: 10.7 per cent (1.5 per cent decline)

- Additional reporting: APNZ

By Teuila Fuatai www.nzherald.co.nz

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How to quit smoking

Sat, 25 Feb 2012 13:28:33 +1300

25 February 2012 - The NZ Herald
Some researchers say the growth of nicotine substitutes is clouding the only real way to give up cigarettes - make a firm decision and go cold turkey. Health reporter Martin Johnston looks at the evidence

Former smoker Scotty Darnill hoped nicotine skin patches would help him quit cigarettes. But for him, they turned out to be useless.

"I actually found I carried on smoking. That was six or seven years ago. I was starting to think 'I've had enough of smoking' and I always kept thinking about those withdrawal symptoms that everyone talks about, that I needed something just to cover it, so I got the patches at the chemist.

"It made no difference to me. I still smoked," says the 46-year-old from Pukekohe, who sells leases for trucks and is a volunteer fireman.

"I was hoping it would take away the feeling that I needed to have a smoke - and it probably wasn't until I stopped last year that I realised that that feeling actually for me wasn't the craving but the habit."

Darnill quit at 4.30pm last September 9. He chewed a few pieces of nicotine gum - given to him by a workmate - but disliked them, so didn't continue with the 12-week course recommended by the makers. Quitline gave him a prescription, which he never filled.

Instead, he credits what he considers his cold-turkey success to a making a clear decision and the support of other, anonymous quitters on a Quitline internet blog site.

His quitting method puts him in a controversial majority of ex-smokers. Controversial because some tobacco control researchers, such as Simon Chapman, are questioning the effectiveness of cessation drugs, now central to many state-funded quit programmes, and urge that more emphasis be placed on unassisted quitting.

They cite a paper in the journal Tobacco Control last month by Hillel Alpert, of Harvard University, on study findings that ex-smokers relapsed at equivalent rates whether or not they used nicotine replacement therapy to help them quit.

"Before these [drugs] were invented in the early 1980s, the American Cancer Society said more than 30 million people had quit in the 1960s and 70s," Chapman, professor of public health at Sydney University, told the Weekend Herald. "There will be hundreds of millions of people around the world in the 60s and 70s who quit unaided.

"Now, with the messages about how we quit smoking, the opposite applies. Most of the messages say if you want to quit smoking, you shouldn't try to do it yourself; you should use pharmacotherapies like nicotine replacement therapy."

"I'm not saying they don't work and are no good to anybody; just that the message has become very distorted, that 'you won't be able to do it by yourself', that 'you need to use these products'," says Chapman, who is planning an interviews-based study of unaided quitting.

He and Macquarie University colleague Ross MacKenzie lamented in a medical journal how unhelpful it was that quitting had become medicalised and that this risked distorting public awareness of how most people quit, "to the obvious benefit of pharmaceutical companies".

"Furthermore, the cessation research literature is preoccupied with the difficulty of stopping. Notably, however, in the rare literature that has bothered to ask, many ex-smokers recall stopping as less traumatic than anticipated."

They cite a large British study from the 1980s, prior to quitting drugs becoming available: 53 per cent of the ex-smokers reported it was "not at all difficult" to stop, 27 per cent that it was "fairly difficult" and the rest found it very difficult. Other research had found that at least two-thirds of ex-smokers had stopped unaided.

Darnill says his decision to quit was "like an awakening. What the hell am I doing this for? It doesn't achieve anything. I just didn't like being addicted."

Before stopping, he smoked at least 25 cigarettes a day, Holiday Reds. He took up the habit in his late teens.

Cigarette cravings lasted for a month after he quit. Harder to withstand were the habits, the almost unconscious rituals that for nearly 40 years had woven the practices of smoking into virtually every part of his daily life.

"You get to work in the morning, you have a smoke - coffee, smoke; lunch, smoke; on the phone. I would always do my phone calls outside so I could have a smoke."

After he quit, when his cellphone rang he found himself standing up and walking towards the door befor in and reminded him: "hang on, I don't do that anymore".

He admits it was difficult sticking to his decision in the first month, during which he got "a wee bit snappy - my wife will tell you that". Linda is a non-smoker and dislikes smoking.

But it was all about changing the details of his life. In the past when he tried to quit, he wasn't clear in his mind why he wanted to.

"You're always looking for an excuse to have a cigarette when you stop if you're not 100 per cent in your mind.

"Let's say you had a really stressful day at work and you think, 'I'll just have that one cigarette, it will make it better'. Well that starts you again, you're gone.

"So this time I made sure I stayed positive in my attitude towards it and didn't try to find an excuse. If it was a stressful day at work or we had a bad job at the Fire Brigade, I just learned to deal with it. In the past you would have a smoke, thinking that it relaxed you. Well, actually it didn't and I found just sitting down and having a glass of water, that was five minutes away from the computer or whatever I'm dealing with, actually is just as good."

In 2010, the Government predicted its tax-take from tobacco next year, following the 33 per cent-plus excise increase - its key quit-smoking policy - would exceed $1.3 billion. But that falls well short of the Health Ministry's estimate that smoking's health costs are around $1.9 billion. Smoking-related illnesses kill up to 5000 people a year.

The Government, which is committed to New Zealand's becoming smokefree by 2025, spends about $67 million a year on tobacco control, including $9 million for Quitline and its phone counselling service.

Nearly $13 million goes on nicotine replacement therapy (NRT) and $14.5 million on three other smoking cessation drugs - Champix, Zyban and nortriptyline - although Pharmac says these figures exclude "confidential rebates", patient contributions and pharmacy costs.

There are uncertainties around how many smokers use NRT, because of gaps in the recording of their health identification numbers, but it was probably around 210,000 in the last financial year. That's nearly a third of adult smokers - it is estimated that 650,000 or around 20 per cent of the adult population smoke.

Adults' smoking prevalence has declined greatly since 1976, when it was 36 per cent, but has dropped little since 1992, when it was 23 per cent.

Given this small reduction since NRT was subsidised in 2000, is it a good taxpayer investment?

"Absolutely," says Karen Evison, the Health Ministry's head of tobacco control.

She explains the apparently limited effect of NRT on smoking prevalence by pointing to people continuing to take up the habit (although mid-teen prevalence is declining) and the "relatively minor" use of the drug until 2008/9.

That was when the rules were changed to give quitters subsidised access to NRT on a doctor's prescription; previously the subsidy was only available through the Quitline. It was also when health workers were required under the Government's revamped health targets to ask hospital patients if they smoked, encourage smokers to quit and offer quitting treatment.

NRT use has been increasing since then, but there have been no national smoking surveys since 2009, so whether it has reduced will not been known for several months.

But Evison says "strong anecdotal evidence" - localised studies with small samples - indicates "we are making a difference".

One is from Middlemore Hospital's emergency department. Of 86 recent patients who had been smokers and recalled receiving quitting advice at the ED, 17 reported they had reduced their smoking and 51 had attempted to quit.

At four weeks, 26 were smokefree and 14 were still smokefree after three months.

The dispute over NRT's effectiveness is essentially about research methods.

The strong supporters of using quitting medicines say they at least double the chances of a smoker's being smokefree at 12 months follow-up, from - depending on the study - 3 to 8 per cent cold-turkey, to 15 to 20 per cent.

Auckland University researcher associate professor Chris Bullen says there is a "huge weight of evidence" for this superior effectiveness of the medicines, from good quality clinical trials in which patients are randomly allocated, to treatment with a new therapy or either standard care or a placebo - so-called randomised, controlled trials.

"We are getting around 20 per cent here in New Zealand with the Quitline service and with our randomised trials which [compare] people who have a new intervention, and usual care," says Bullen, the director of the university's Clinical Trials Research Unit.

Chapman, however, asserts that the clinical trials of quit drugs, many of which were funded by drug companies, produce unrealistically positive results.

Participants tend to be highly motivated people, compliance with medication is higher than in the general population, the mentally ill, typically a hard-core smoking group, are excluded, and nicotine addicts in the placebo arm of a trial will soon know they are not getting their nicotine and will often have a high relapse rate.

Bullen responds: "We conduct our randomised controlled trials for smoking cessation interventions [such as patches and very-low-nicotine cigarettes] in very much a real-world setting.

"We have recruited participants through callers to the Quitline, so the intervention is run through the Quitline, just like the normal service. We try and make the interventions a pretty minimal change to what people would usually get."

"We are not tainted by industry funding; our work is public-good funded ... by the Health Research Council.

"Randomised controlled trials eliminate the risk of most of the biases that you get in some of these non-randomised studies such as the one Alpert reports on."

Criticisms of the Alpert paper include that because its participants chose their quitting method rather than being randomly allocated either to cold-turkey quitting or to NRT, the NRT users might have been affected, for instance, by factors that predisposed them to relapsing and which were not measured.

"You might choose to use NRT if you have tried numerous times before [to quit] but haven't succeeded," says Hayden McRobbie, a British quit-smoking specialist and academic, a colleague of Bullen's and co-author of New Zealand's Smoking Cessation Guidelines.

"That may be a factor of tobacco dependence, but also of other things not measured, for example living with smokers, being in lower socio-economic groups."

He says the Alpert paper doesn't lead to the conclusion that NRT is useless. "My reading of that paper was that relapse rates didn't differ between groups. You wouldn't expect relapse rates to differ. NRT is used primarily short-term. The goal in the short-term is to increase quit rates. We know people are still going to relapse over time. We don't have good interventions to prevent relapse."

One point where there is agreement is the value of encouraging smokers to make quit attempts, because of research evidence of just how many attempts long-term smokers make before they stop permanently. Typically 20 attempts by the age of 40, according to McRobbie.

"I tell my patients stopping smoking is like learning to ride a bicycle. Some people learn quickly. Others get on, fall off, ride a bit, fall off."

The theory is that "tension" factors like tax hikes, gruesome warnings on tobacco packets, plain packaging (forthcoming in Australia and under consideration here) and restrictions on where people can smoke all increase the motivation to quit. The official line then is to increase the quitting rate by providing treatment for those who want it.

Scotty Darnill didn't want it, but still he is loving the changes in his life from quitting.

"I'm enjoying the taste of food again. I'm looking at different foods, fruits and vegetables, where before I would be quite happy just having a big hamburger. Strawberries taste a hell of a lot better than they used to.

"Your sense of smell is the other thing that comes back. I have learned how much a smoker stinks after they have had a cigarette. It's not nice."

By Martin Johnston www.nzherald.co.nz.how to quit smoking

Do you miss the feeling of having a cigarette between your fingers?
Do you miss the feeling of a cigarette between my lips and/or sucking on a cigarette?

If the answers to the above questions are Yes, then you could be what is known as being highly kinaesthetic.

Find out suggestions and strategies to help you! START NOW

Nicotine patches no better than will power to quit smoking

Mon, 09 Jan 2012 13:28:33 +1300

9 January 2012 - The Telegraph
Nicotine patches may not help smokers to stub out the habit, according to a new study.

Researchers are now calling for greater regulation of which nicotine products can be sold over the counter.

Researchers found nicotine replacement therapies (NRTs) designed to help people stop smoking - specifically patches and gum - do not appear to be effective in helping smokers quit long-term, even when combined with counselling sessions.

The study was conducted by researchers at Harvard School of Public Health (HSPH) and the University of Massachusetts in the United States who are now calling for greater regulation of which nicotine products can be sold over the counter.

Lead author Hillel Alpert, a research scientist at HSPH, said: "This study shows that using NRT is no more effective in helping people stop smoking cigarettes in the long-term than trying to quit on one's own."

The researchers followed 787 adult smokers in Massachusetts who had recently quit smoking. They were surveyed over three time periods: 2001-2002, 2003-2004, and 2005-2006 and were asked whether they had used a nicotine replacement therapy in the form of the nicotine patch placed on the skin, nicotine gum, nicotine inhaler, or nasal spray to help them quit, and if so, what was the longest period of time they had used the product continuously.

They were also asked if they had joined a quit-smoking programme or received help from a doctor, counsellor, or other professional.

The results showed that, for each time period, almost a third of recent quitters reported to have relapsed. The researchers found no difference in relapse rate among those who used NRT for more than six weeks, with or without professional counselling. No difference in quitting success with use of NRT was found for either heavy or light smokers.

Mr Alpert said that even though clinical trials have found NRT to be effective, the new findings demonstrate the importance of empirical studies regarding effectiveness when used in the general population.

He added that using public funds to provide NRT to the population at large is of questionable value, particularly when it reduces the amount of money available for smoking interventions shown in previous studies to be effective, such as media campaigns, promotion of no smoking policies, and tobacco price increases.

Smoking cessation medications have been available over the counter for more than a decade.

Co-author Gregory Connolly, director of the Centre for Global Tobacco Control at HSPH, said: "What this study shows is the need to approve only medications that have been proven to be effective in helping smokers quit in the long-term and to lower nicotine in order to reduce the addictiveness of cigarettes."

The study was published online by the journal Tobacco Control. www.telegraph.nicotinepatchesnobetterthanwillpower

Do you miss the feeling of having a cigarette between your fingers?
Do you miss the feeling of a cigarette between my lips and/or sucking on a cigarette?

If the answers to the above questions are Yes, then you could be what is known as being highly kinaesthetic.

Find out suggestions and strategies to help you! START NOW

Big Tobacco's brazen denials and dirty tricks

Sat, 03 Sep 2011 13:28:33 +1200

3 September 2011 - The NZ Herald
Ever since the link between smoking and lung cancer was established more than 50 years ago, the tobacco industry has displayed extraordinary tenacity when it comes to denying the scientific evidence showing that smoking kills.

In 1952, British scientist Richard Doll, working with his mentor Professor Bradford Hill, compiled a seminal study published in the British Medical Journal that established a "real association between carcinoma of the lung and smoking".

Over the next few years and decades, the evidence became stronger, but just as soon as this evidence began to emerge, Big Tobacco quickly launched a damage-limitation exercise. As early as 1953, the tobacco industry sought to spread disinformation to counter medical evidence. Tobacco companies hired New York public relations company Hill & Knowlton to "get the industry out of this hole", as industry documents released four decades later as part of legal processes revealed.

"We have one essential job - which can be simply said: Stop public panic ... There is only one problem - confidence, and how to establish it; public assurance, and how to create it," one Hill & Knowlton paper said.

"And, most important, how to free millions of Americans from the guilty fear that is going to arise deep in their biological depths - regardless of any pooh-poohing logic - every time they light a cigarette."

In Britain, British American Tobacco (BAT) even invented a secret code word for lung cancer that was to be used in its internal memos.

The "C" word was to be substituted by Zephyr. As one BAT memo written in 1957 stated: "As a result of several statistical surveys, the idea has arisen that there is a causal relationship between Zephyr and tobacco smoking, particularly cigarette smoking."

Throughout the 1960s and 1970s, tobacco companies were brazen in their denials despite the mounting scientific evidence linking smoking with a range of cancers.

"None of the things which have been found in tobacco smoke are at concentrations which can be considered harmful," said a 1976 Philip Morris document. "Anything can be considered harmful. Apple sauce is harmful if you get too much of it."

During the 1980s, behind closed doors, there were doubts about whether the denialist charade could be maintained much longer. "The company's position on causation is simply not believed by the overwhelming majority of independent observers, scientist and doctors," said one internal BAT document.

And then in the 1990s came another bombshell. Second-hand smoke inhaled by "passive smoking" was linked with ill-health and there were calls to introduce smoking bans.

In 1992, the US Environmental Protection Agency produced a report on "environmental tobacco smoke" and concluded that it is a cancer-causing substance. In Britain, a 1998 report of the Scientific Committee on Tobacco and Health stated: "Passive smoking is a cause of lung cancer and childhood respiratory disease. There is also evidence that passive smoking is a cause of ischaemic heart disease and cot death, middle-ear disease and asthmatic attacks in children."

Despite the evidence, tobacco companies refused to accept the conclusions. Philip Morris, the world's biggest cigarette company, began a campaign to undermine the scientific case against second-hand smoke, highlighting what it labelled "junk science".

Its strategy was best summed up in a letter written in 1993 by Ellen Merlo, senior vice-president of corporate affairs, to the chief executive. "It is our objective to prevent states and cities, as well as businesses, from passive-smoking bans," she wrote.

Many tobacco companies have accepted that smoking causes lung cancer, but refuse to admit that passive smoking can cause disease in non-smokers. But having lost the debate over smoke-free offices and public spaces, the industry is turning its sights against the possible introduction of plain packaging.

Their fight against these proposals is based on undermining scientific evidence that plain packaging can reduce the number of children and young adults who take up smoking. They seek to discredit the research, a tactic they have used for more than 50 years of scientific denialism.

By Steve Connor - INDEPENDENT http://www.nzherald.co.nz/Big Tobacco

Use our free tool to find out how your learning style can help you quit smoking START NOW

New law: Smokes, tobacco in shops to be hidden

Fri, 15 Jul 2011 13:28:33 +1200

15 July 2011 - The NZ Herald
Tobacco products and advertisements will have to be kept out of sight in shops under a law passed by Parliament yesterday.

All but three Act MPs voted for the Smoke-free Environments (Controls and Enforcement) Amendment Bill, which gives retailers until next July to hide away cigarettes and tobacco.

Associate Health Minister Tariana Turia said the tobacco industry used displays to prey on young people.

"No longer will people go into a dairy for milk and a newspaper only to be confronted by a wall of cigarettes.

"These 'power walls' not only encourage young people to try smoking, they also make it harder on those attempting to quit."

Her next move is a bill for plain packaging for tobacco, saying it was another "biggie" that the tobacco industry strongly resists.

"It sends a very clear signal to the tobacco industry just how serious we are. In an ideal world this is not a product that should be sold at all. So I'm going to continue to press to pass legislation that hopefully means by 2025 there will be no tobacco in Aotearoa."

Act MPs Sir Roger Douglas, Heather Roy and Hilary Calvert voted against the bill on the grounds of rational personal choice. However, all other MPs supported it.

Mrs Turia also acknowledged the role of Hone Harawira in forcing a select committee inquiry into the tobacco industry.

Mr Harawira had hoped to vote for the bill after being sworn into Parliament, but was denied the chance after the Speaker ejected him for delivering the wrong oath.

Labour MP Iain Lees-Galloway called on New Zealand to be as brave as Australia in moving to plain packaging. Vending machines should also be targeted.

National's Paul Hutchison said it was also good the bill covered herbal products which also could harm health.

The internet, duty free stores and sponsored events were all covered by the change in the law and there was evidence it would make a difference, he said.

Action on Smoking and Health director Ben Youdan welcomed the law, saying it was particularly pleasing that it got such widespread support in Parliament.

CBD STREET BAN RULED OUT

Auckland Council leaders have quickly snuffed out a councillor's bid to have smokers banned from gathering in front of CBD buildings.

Penny Webster, who is acting mayor while Mayor Len Brown and Deputy Mayor Penny Hulse are overseas, said any ban would impact on Auckland's image.

"What are we trying to say? Are we saying: 'Well, Auckland is not a fun city'. What are you going to look at next? Sex between consenting adults in the bedroom?" she said.

Mrs Webster's dismissal showed how upset council leaders were by community safety forum chairman George Wood saying in yesterday's Herald that he wanted a smoking ban bylaw for streets outside CBD buildings, because other footpath users were breathing in their smoke.

Mr Wood was confident of getting support from councillors for a penalty-based ban. He welcomed Auckland Transport's investigation into a bylaw to ban smoking in open bus shelters.

But he was disappointed when most forum members rebuffed his call for the promotion of smoke-free public places and for work towards a strategic commitment to a smoke-free city.

Councillor Cameron Brewer was concerned that smokers were being treated like lepers and pushed outside. Giving them nowhere to go would drive them back into the family home and family car.

"I think that's more damaging to their family and friends than standing on Queen St."

But councillor Richard Northey said people had the right to breathe without being subjected to passive smoke.

At some council events, like concerts in the Auckland Domain, people had no choice but to have someone smoking near them; smoking in public places should be discouraged.

By Wayne Thompson www.nzherald.co.nz/smoking/news/article

WHAT DOES THE NEW LAW DO?

* Bans advertising from shops.

* Bans display of tobacco products.

* Increases fines for those who sell to under-18s.

WHAT COULD BE NEXT?

* Plain packaging for cigarettes - strongly resisted by the tobacco industry.

WHAT IS THE AIM?

* Bill architect Tariana Turia wants tobacco use ended by 2025.

By Claire Trevett

No ban on anti-smoking drug linked to heart attacks

Tue, 05 Jul 2011 13:28:33 +1200

5 July - 3 News / RadioLive
The Ministry of Health will not ban a potentially harmful quit-smoking drug because it believes the benefits outweigh the risks.

A study has found that middle aged men using Champix have a 72 percent higher chance of suffering heart problems resulting in hospitilisation or death.

But Dr Enver Yousuf from Medsafe says the agency will not take any immediate action.

Research published today in the Canadian Medical Association Journal shows that Champix increases the risk of serious cardiovascular events, with one in 28 users experiencing problems.

Champix is Government funded, with eligible people able to undergo a 12-week course for free.

Last month, nearly 10,000 doses of the drug were given to Kiwi smokers.

3 News / RadioLIVE www.3news.co.nz

New alert over drug to quit smoking

Tue, 05 Jul 2011 13:28:33 +1200

5 July 2011 - The NZ Herald
Researchers have issued a new caution over the use of Champix quit-smoking tablets after finding they are linked to a 72 per cent increased risk of heart attacks and related conditions.

The Ministry of Health said last week it would recheck the safety of Champix. This followed the instigation of reviews by medicines regulators in Canada and the United States.

Health Canada said there might be a "slightly increased risk of heart-related side-effects" in Champix patients with cardiovascular disease.

Smoking increases a person's risk of developing cardiovascular disease.

The Intensive Medicines Monitoring Programme at Otago University said it had received reports of changed heart rhythms and sudden death in users of Champix, whose active ingredient is varenicline. It had also received reports of heart attacks in 12 patients who appeared to have had no history of heart disease.

When Pharmac funded Champix last year, it estimated up to 8000 smokers a year would use it.

The new research, published today in the Canadian Medical Association Journal, was based on 14 trials involving 8200 patients. Most trials excluded people with a history of heart disease.

The researchers found a 72 per cent greater risk of "serious adverse cardiovascular events" - including heart attacks, strokes and changed heart rhythm - among tobacco users on Champix than among tobacco users on a placebo. Other research has linked Champix to depression, suicidal thoughts and other mental disorders.

Dr Sonal Singh and colleagues say in their paper that safety signals in the US about Champix and cardiovascular events in 2006 were not followed up by suitably powerful safety trials.

Until that happened, they said, clinicians should carefully balance the risk of serious cardiovascular and neuropsychiatric problems against the known benefits of the drug in helping people to quit smoking.

NZ National Heart Foundation medical director Dr Norman Sharpe said yesterday that he had seen the journal's latest Champix data, which added to a large body of information indicating concern about the drug.

"I would say it's a significant concern and something that needs to be followed closely."

However, a commentary in the journal by Dr J. Taylor Hays, of the Mayo Clinic in the US, said that although Champix users in the analysis were at a 72 per cent increased risk of serious cardiovascular problems, their absolute risk was small: just 1.06 per cent of the 4908 Champix users suffered these adverse events.

"The small absolute risk of cardiovascular events associated with taking varenicline is outweighed by the enormous benefit of reducing cardiovascular morbidity [sickness] and mortality that can be achieved with successful abstinence from smoking."

By Martin Johnston www.nzherald.co.nz/nz/news/article

Nicotine replacements poisoning kids

Thu, 03 Mar 2011 13:28:58 +1300

3 March 2011 - The NZ Herald
People who use nicotine replacement therapy are being warned of the harm it can do to children - after a huge rise in calls to the National Poisons Centre and three "serious exposures".

Nicotine gum, lozenges and related products are safe if used by smokers at recommended dosages, but major overdoses can cause symptoms including irregular pulse, breathing difficulties and, in some cases, death.

The Government, through the Quit Group, promotes and subsidises nicotine replacement therapy (NRT) as a quit-smoking aid.

The National Poisons Centre has recorded a steady increase in the number of calls it receives about the exposure of children to NRT, from five in 2004 to 27 in 2009 and 49 last year.

In a report this year to the Ministry of Health, the centre says paediatricians have noticed an increased number of children being exposed to NRT.

"There have been three serious exposures recently in Nelson."

Nelson-Marlborough District Health Board paediatrician Dr Nick Baker said yesterday that three pre-schoolers had been hospitalised with symptoms including nausea, salivation, agitation and vomiting.

They recovered.

"Many people carry around a potentially lethal dose of nicotine. We advise that people treat their nicotine replacement therapy as a medicine and keep it out of reach of children."

The poisons centre report says in one case it investigated, the child had ingested 25 pieces of gum.

NRT gum comes in a range of flavours, such as mint, fruit and liquorice. The products' data sheets say it tastes bad if chewed too quickly.

"The risk of poisoning from swallowing the gum is very small, as absorption in the absence of chewing is slow and incomplete," says one brand's data sheet.

The poisons centre says brief skin or oral exposure to used NRT skin patches in children is usually not harmful, causing "few if any symptoms".

Three-quarters of the children about whom calls were made to the centre required medical referral for treatment or monitoring.

"Any more than a minor exposure to pharmaceutical nicotine should be considered potentially toxic in children," poisons centre medical toxicologist Dr Michael Beasley told the Herald.

The ministry's senior adviser on tobacco control, Carl Billington, said that after it was notified of the issue last week, it asked the Quit Group to remind parents to keep NRT, like any medicine, out of children's reach.

The Quit Group said it had sent the new warning to its Quitline advisers and quit-card providers.

Its practice was to tell clients NRT was a medicine, to store in a cool place and to dispose of leftover NRT carefully, away from children and pets.

SPOTTING OVERDOSE

* Symptoms can include sweating, vomiting, convulsions.

* Lethal dose in children is 1mg per kg of bodyweight - 30mg in a 30kg child, for instance.

* Nicotine gum contains either 2mg or 4mg of nicotine per piece.

* 5 calls to National Poisons Centre in 2004 about children exposed to nicotine replacement therapy.

* 49 calls last year.

By Martin Johnston www.nzherald.co.nz

Bootleg cigarettes contain ASBESTOS, trading standards chief warns

Tue, 01 Feb 2011 13:29:06 +1300

1st February 2011 - MailOnline
Smokers looking for a bargain have been warned not to buy a bootleg brand of cigarettes from Russia, after it was found to contain asbestos.

The warning came from trading standard chiefs after a batch of Jin Ling cigarettes was reportedly offered around British pubs and clubs.

The cigarettes, which come in yellow packs with the words Jin Ling and USA emblazoned across the front, are thought to be twice as strong as an ordinary cigarettes.

Many of those tested have been revealed to contain toxins such as industrial chemicals and asbestos-lined Chinese drywall.

It is believed the cigarettes are created specifically for the black market, as the brand on offer is not available over the counter.

One man, who wished to remain anonymous, said he had been offered 200 of the Jin Ling brand while drinking in a Hartlepool club.

He said: 'The fella wanted about £25 for 200, which is a bargain for normal cigarettes if you think you are paying £6 for 20.

'I didn't actually buy any because I hadn't heard of the brand and when I checked on the internet I'm pleased I didn't if they contain asbestos.'

Asbestos fibres trigger an inflammatory reaction when these fibres penetrate the lung tissue. They can also cause a rare form of cancer. Symptoms typically only appear years after exposure.

Last year, the World Health Organisation (WHO) issued a warning after the emergence of Jin Ling cigarettes in other European countries.

A WHO spokesman said: 'Jin Ling is the most disturbing new development anywhere in the world in the illegal tobacco trade.

'They are flooding into Europe.'

A trading standards and licensing officer for Hartlepool Council, Ian Harrison, said: 'I am fully aware of this brand, as is probably ever other trading standards officer across Europe.

'This particular brand is made to be smuggled, it is not a brand which can be bought in shops.

'Because of that, there is no quality control and the people who are selling them have no interest in what they are selling or who they are selling it to.

'There is no doubt they are dangerous, and I am aware that there has been asbestos found in this brand.

'I would warn any smoker tempted to buy them in the hope of getting a bargain not to because they could be inhaling anything.'

Ailsa Rutter, director of Fresh, the anti-smoking campaign, said: 'All cigarettes, even legal ones, kill.

'Your average packet of 20 bought down the local shop contains a horrendous list of poisons and toxins used in preserving dead bodies, batteries, industrial solvents and chemical weapons.

'Illegal cigarettes are such a danger because many sellers have no qualms selling to children, which makes it easier for them to smoke, expose their lungs to these poisons and sows the seed of a new generation ending up on our hospital wards.'

By Daily Mail Reporter www.dailymail.co.uk/health

Nicotine in cigarettes linked to breast cancer

Tue, 24 Aug 2010 13:28:33 +1200

24 August 2010 - The NZ Herald (the findings are published in the Journal of National Cancer Institute)
Nicotine in cigarettes has been linked to breast cancer for the first time as researchers find the substance may promote the growth of tumours.

Nicotine is the chemical in cigarettes which causes addiction and has now been linked to the development of breast cancer.

Previously smoking was not thought to be a major cause of breast cancer although it is known to increase the risk of several other forms of the disease.

Researchers at Taipei Medical University examined 276 samples from human breast cancer tumours and found the cells had large numbers of receptors which nicotine was able to attach to when compared with normal cells.

They also found that when normal cells were treated with nicotine, it promoted the development of cancer characteristics.

Because the findings were linked to nicotine and not the usual carcinogenic chemicals in cigarettes, it raises questions over nicotone gum, inhalers and patches, that many use to help them quit the habit.

Rebecca Smith www.telegraph.co.uk/health

Smoking: Why women are at great risk

Tue, 15 Dec 2009 13:28:33 +1300

15 December 2009 - The Sunday Telegraph
We all know that smoking is bad for us, but women are more vulnerable than men when it comes to some of the potential nasty outcomes.

If you are serious about your health, fitness and general wellbeing, you simply can't afford to smoke. That isn't a new message, of course.

It has been known for 40 years or more that smoking causes lung cancer, heart disease and strokes. In fact, it is estimated that smoking is associated with more than 50 different diseases or disorders.

Recently, further scientific evidence has emerged to suggest that women may be at particular risk from smoking.

This year, a Norwegian study of almost 2000 women showed that women were at a higher risk of chronic obstructive pulmonary disease (COPD) at a younger age, and after smoking less heavily, than men.

COPD is an umbrella term that incorporates emphysema and chronic bronchitis. There are four stages of the condition, which are ranked in terms of their severity.

"We estimate that 2.1 million people in Australia have some form of COPD, and half of them don't know it," says Heather Allan, director of the COPD National Program at the Australian Lung Foundation.

COPD is characterised by shortness of breath and repetitive coughing with mucous, usually in the mornings. It gradually worsens if you don't do anything about it. "Simple daily activities become almost impossible," says Allan. "Eventually, you can't walk from the living room to the kitchen without stopping twice along the way to catch your breath."

"Many people believe that a few cigarettes a day represent a minimal risk," says one of the Norwegian researchers. "Our findings show that there is no safe level of exposure to cigarette smoke, and this is particularly true for female smokers."

The female factor

This isn't the first study that suggests that women may be more at risk from smoking than men. A 2005 Monash University found that women were more susceptible to exposure to smoke than men. Allan says researchers believe this could be because women have narrower and more sensitive airways than men.

A report by the British Lung Foundation in 2005 suggested it may be because women's lung capacity is smaller, and population studies have also suggested that there may be a genetic element involved.

This is why health campaigners are so concerned that more young women in their teens and 20s are starting and continuing to smoke than men.

COPD usually appears in people between the ages of 35 and 40, though Allan says increasingly, younger people are being diagnosed. "Before, it was an older person's disease.

Now we're seeing people in their early 30s with COPD." She says the incidence of COPD in Australia is starting to plateau in men, but it is rising in women.

"People don't take their lung health seriously," she says. "Women are very aware of their heart and their breasts, but not so much their lungs."

She says at a recent focus group she conducted in Melbourne with smokers and ex-smokers, all the participants said their health was fine, but none had climbed the flight of stairs to get to the meeting. "They had all started to adjust their lifestyles," she says. "COPD creeps up gradually without you even realising it."

The reasons for women's increased risk of lung disease have not yet been fully researched. According to NHS Direct in the UK, a gene that speeds up the growth of lung tumours is known to be more active in women.

The female hormone oestrogen is also known to affect the development of such tumours.

A conference on thoracic oncology in Switzerland earlier this year also found that women were more susceptible to tobacco carcinogens (cancer-causing substances), and a Spanish expert spoke of the growing awareness that smoking was, indeed, riskier for women.

It is sometimes said that more women have an "addictive" gene that makes it harder for them to give up smoking, and also that, while men tend to become physically addicted to nicotine, one of the most addictive substances, women tend to be more psychologically addicted.

Giving up

The good news is that though COPD is not curable, you can stop the progress of the condition if you catch it early, so it's important that it gets diagnosed. See your GP if you have any of the symptoms.

Allan says that simply by quitting smoking, at any age, and exercising, you can halt the decline of COPD. She says immunisation from disease and influenza is also important as any infection can easily spread to the lungs.

There is plenty of help out there for quitting smoking, from your local GP to Quit Now. There's always nicotine-replacement therapy too, which comes in the form of patches, tablets, gum or dummy cigarettes. Alternatively, you could try the complementary therapy approach with herbal cigarettes or hypnotherapy.

Drugs such as Champix and Zyban are also available, but on authority prescription only - your doctor has to call for approval as there are various conditions which need to be met, such as ensuring the patient is enrolled in a support program.

Where to get help

For the cost of a local call from anywhere in Australia, the Quitline provides advice and assistance to smokers who want to quit.

The Quitline can help smokers plan their attempt and give advice on different techniques. You can also access a free copy of the Quit Pack and download the free self-help book, the Quit Booklet. Call 13 18 48 or 13 78 48 or visit www.quitnow.info.au

The Australian Lung Foundation has launched a free online Lung Health Checklist this month to encourage early diagnosis of lung disease. Visit
www.lungfoundation.com.au

Why non-smoking women are healthier
1 Women who don't smoke are far less likely to develop lung, mouth, throat, pancreatic, bladder or cervical cancer.

2 Non-smokers' risk of coronary heart disease and strokes is much reduced.

3 Non-smokers' risk of these conditions when taking the contraceptive pill is also reduced.

4 Non-smokers reach the menopause two years later than smokers.

5 Non-smokers have fewer fertility problems and a lower risk of miscarriage and pregnancy complications than smokers.

6 Non-smokers' babies are bigger and healthier at birth, with a lower risk of stillbirth or neonatal death (when a baby dies in the first 28 days of its life).

7 Non-smokers tend to store body fat around their hips rather than their waists, lessening their risk of diabetes
and heart disease.

8 Non-smokers have lower cholesterol than smokers.

9 Non-smokers are less likely to lose their teeth, have gum disease, become incontinent or suffer from eye damage.

10 Non-smokers have stronger bones and a lower risk of osteoporosis.

By Jill Eckersley www.heraldsun.com.au/news/sunday-heraldsun

Quit-smoking pill sparks health warning

Tue, 19 May 2009 13:28:33 +1200

19 May 2009 - The NZ Herald
Health authorities have issued a new warning on the mental health risks of a quit-smoking pill introduced to New Zealand in 2007.

More than 3300 people were prescribed Champix, which contains the chemical varenicline, in the first year of its use in New Zealand.

There were 22 reports of people experiencing depression for the first time after taking Champix. Recurrence or worsening of existing depression, and other psychiatric and neurological symptoms, were also reported.

The majority of the new cases of depression were probably caused by the tablets, according to the Intensive Medicines Monitoring Programme, which collected the data from pharmacists and doctors. Three of these people also thought about suicide and two of these cases were resolved after stopping the medicine, says the programme's director, Dr Mira Harrison-Woolrych, in a Health Ministry newsletter to prescribers.

"Psychiatric reactions have emerged as a potential safety issue with varenicline and patients should be advised accordingly," she says.

Dr Stewart Jessamine, group manager of the ministry's Medsafe unit, said yesterday the monitoring programme's findings reflected international experience with Champix.

"Since the introduction of Champix to New Zealand there have been additional warning statements around neuro-psychiatric side-effects in particular. We knew from clinical trials it could cause neuro-psychiatric side-effects. Their frequency has become more obvious as it has been used in the general population; therefore the data sheet was updated to reflect the increased risks over time."

The international consensus of major drug regulators was that the benefits outweighed the risks, but patients should carefully read the information supplied with the product.

Dr Jessamine said it was not known whether the patients involved in the monitoring were smoking at the time of their adverse reactions.

Dr Harrison-Woolrych's article notes that nicotine withdrawal can itself cause depression and other psychiatric symptoms.

Dr Jessamine said similar psychiatric side-effects had been reported by users of another quit-smoking medicine, Zyban, although it had not been intensively monitored because it was not the first in a new class of drugs.

The Champix data sheet says serious symptoms have continued in some using the medicine even when they continued to smoke.

"Although a causal association between Champix and these symptoms has not been established, in some reports the association cannot be excluded.

"Patients being treated with Champix and their families should be alerted to the need to monitor for neuro-psychiatric symptoms including changes in behaviour, agitation, aggression, depressed mood, suicidal ideation, and suicidal behaviour."

By Martin Johnston www.nzherald.co.nz

British American Tobacco is a ‘funky, friendly and fun’ place

Sun, 30 Nov 2008 13:28:43 +1300

30 November 2008 - The Sunday Star Times
ASH had this letter published in response to an article in the Sunday Star-Times about how British American Tobacco is a ‘funky, friendly and fun’ place to work.

“De-funked
Funky, friendly and fun, with time off to plant trees- that’s life at work for the folk who make our cigarettes [‘A Breath of Fresh Air’, November 16].

I wonder if British American Tobacco would extend the tree-planting scheme to include time off to lay flowers on the graves of 4500 people who were killed by their products last year? I wonder how friendly the families of the tobacco victims would be to the BAT staff who are ‘funking it up’ with the proceeds of the product that killed their loved ones.

It’s no wonder BAT has to be such a fun place to work. The gorgeous harbour view offices, plenty of time off, community work and overseas travel all help to ease the conscience when your job is to addict people to a product that kills one in two of your customers. The motto to remember those who gave their lives for our freedom is ‘lest we forget’; it seems the motto for BAT seems nearer to ‘best we forget’ those who gave their lives for our funk. Ironically, the work ‘funk’ is an obsolete term for smoking – something not a lot of BAT employees interviewed seem keen on doing themselves.

Frankly, BAT can funk off.

By Ben Youdan (Director, ASH New Zealand), Auckland www.ash.org.nz/site

Tobacco Explained

Mon, 25 Jun 2001 13:28:50 +1200

25 June 1998 - ASH (Action on Smoking and Health) ... Summary
Thousands of internal tobacco industry documents released through litigation and whistleblowers reveal the most astonishing systematic corporate deceit of all time. ASH has undertaken a survey of the documents, extracted 1,200 relevant and revealing quotes, and grouped these together under common themes. A subset of these are set out in this compendium and the full collection is held in chronologies available on the ASH web site...

…it is a predatory industry whose market dynamics demand that it recruits young people. It does this by deploying vast promotional expenditures to create, communicate and amplify a set of positive values associated with the product. Once the glamour phase subsides, nicotine addiction takes over making the customer dependent on the product and securing a profitable cash flow. Trapped by nicotine addiction, the smoker is subject to a variety of sub-lethal illnesses which culminate in a one in two probability of death through smoking-related disease. The smoker’s death means a replacement customer must be found - and the cycle begins again….

Newsroom

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Find out suggestions and strategies to help you! START NOW

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If the answers to the above questions are Yes, then you could be what is known as being highly kinaesthetic.

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Do you miss the feeling of having a cigarette between your fingers?Do you miss the feeling of a cigarette between my lips and/or sucking on a cigarette?

If the answers to the above questions are Yes, then you could be what is known as being highly kinaesthetic.

Find out suggestions and strategies to help you! START NOW

Nicotine patches no better than will power to quit smoking

Do you miss the feeling of having a cigarette between your fingers?Do you miss the feeling of a cigarette between my lips and/or sucking on a cigarette?

If the answers to the above questions are Yes, then you could be what is known as being highly kinaesthetic.

Find out suggestions and strategies to help you! START NOW

Big Tobacco's brazen denials and dirty tricks

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Tobacco Explained

Do you miss the feeling of having a cigarette between your fingers?
Do you miss the feeling of a cigarette between my lips and/or sucking on a cigarette?

Do you miss the feeling of having a cigarette between your fingers?
Do you miss the feeling of a cigarette between my lips and/or sucking on a cigarette?

Do you miss the feeling of having a cigarette between your fingers?
Do you miss the feeling of a cigarette between my lips and/or sucking on a cigarette?

Do you miss the feeling of having a cigarette between your fingers?
Do you miss the feeling of a cigarette between my lips and/or sucking on a cigarette?

Do you miss the feeling of having a cigarette between your fingers?
Do you miss the feeling of a cigarette between my lips and/or sucking on a cigarette?