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Archive for October, 2014

India: Powerful ‘Voice of Tobacco Victims’ campaign wins BMJ health advocacy award

30 Oct, 14 | by Marita Hefler, News Editor


Pankaj Chaturvedi, Prakash C Gupta, Sanjay Seth, Ashima Sarin

Voice of Tobacco Victims

Voice of Tobacco Victims Campaign (VOTV) was launched on 31st May 2009 by a dozen cancer survivors of Tata Memorial Hospital, Mumbai under the leadership of Dr Pankaj Chaturvedi. The campaign aims to make Tobacco Victims (cancer survivors and their relatives) the public face of the anti-tobacco campaign and get them justice. There are more than 300 patients and their relatives who are engaged in battling a powerful industry that sold them cancer and suffering. Most are cancer patients who were treated by Dr Chaturvedi in Tata Memorial Hospital, Mumbai. They are supported by 168 motivated oncologists all over India who are performing exemplary voluntary advocacy with highest policy makers. 

Led by cancer survivors, VoTV conducted a sensitization programs for the Chief Ministers, Members of Parliament, State legislators, Police Departments, Education Departments, Food inspectors and other government officials. We took up the matter in several High Courts and the Supreme Court, where Dr Chaturvedi made a deposition in front of Justice Singhvi in Ankur Gutka matter. 

The Campaign played a pivotal role in the Gutka ban introduced throughout India, ban on all forms of flavoured, scented, packaged chewing tobacco in 9 states and the ban of flavoured supari (pan masala without tobacco) in Maharashtra. They were also instrumental in tax increases in several states. Prior to the recent budget, 300 doctors wrote to the Honorable Prime Minister to raise taxes on tobacco. 

VoTV team is also working with state governments for better implementation of tobacco control laws. VoTV has been instrumental in India’s most graphic campaign for awareness in society. The clip is shown in all cinema halls and TV channels. 

VOTV youtube









VOTV films are available on Youtube here.

Some patients filed compensation cases in the consumer court, actions that have rocked the tobacco industry.

VoTV has been recognised by the World Health Organization as an outstanding campaign. Dr Chaturvedi was nominated as a Global Cancer Ambassador by the American Cancer Society, invited as a speaker in special United Nations Summit, and served on various committees for the Ministry of Health. The campaign also received the Judy Wilkenfield Award by Campaign for Tobacco Free Kids, Washington. Most recently, on September 22, 2014, Dr Chaturvedi and VoTV won the British Medical Journal Awards in the Health Advocacy category.

According to several studies and Euromonitor, the campaign has contributed to a 26% reduction in volumes of chewing tobacco and 3% in cigarette volume. I am sure it will translate into reduction in prevalence of tobacco usage and eventually reduce the tobacco related mortality.

For more information visit

About tobacco in India:

  • In India, there are 275 million tobacco users – that means every third Indian adult uses some form of tobacco. It is the number one cause of preventable death.
  • Tobacco is responsible for nearly 50% cancers in India and 90% of mouth cancers. Half of the mouth cancer patients die within 12 months of diagnosis.
  • Around 1 million Indians die from tobacco-related diseases each year in India. This epidemic kills more people than tuberculosis, accidents, homicides, suicide, AIDS and malaria combined.
  • Among kids aged 13-15, 4 percent smoke cigarettes and almost 12 percent use other types of tobacco products. As with elsewhere in the world, children are the new consumer base for the industry.
  • Tobacco costs and enormous amount due to death, disability and diseases. According to government figures, the total revenue from tobacco excise makes up 17% of the health care cost.
  • While essential food items have become expensive over decades, tobacco has become cheaper every year.
  • The main form of tobacco consumption in India is chewing and bidis. These two industries are run by only a few dozen families in India.

VOTV award

Non-smokers exposed to three times above safe levels of particles when living with smokers

20 Oct, 14 | by Becky Freeman, Web Editor

Non-smokers who live in a house with smokers are exposed to three times the officially recommend safe levels of damaging air particles, according to a study published online in the journal Tobacco Control.

Living with smokers is the same as living in smoke-free homes in heavily polluted cities such as Beijing or London, found researchers who have said moving to a smoke-free home could have major health benefits for non-smokers.

There is already strong evidence to suggest that exposure to second hand smoke is linked to a wide range of adverse health events such as respiratory and heart illness.

Accordingly, many governments have introduced measures to restrict their population’s exposure to second hand smoke within workplace and leisure settings.

Fine particulate matter (PM2.5) such as fine dust or soot suspended in the air, has been widely used as a marker for second hand smoke exposure with data from bars and restaurants showing concentrations of second hand smoke-derived PM2.5 that frequently exceed the US Environmental Protection Agency levels described as “unhealthy for sensitive groups” 24 hour limit or the World Health Organization’s (WHO) guidance limits.

Main outdoor sources of particulate matter include exhaust fumes from motor vehicles and industrial emissions and more is known about what impact this has on health than the impact within indoor environments.

Therefore, Scottish researchers set out to explore fine particulate matter less than 2.5 ìm (PM2.5) concentrations in smoking and non-smoking homes in Scotland to estimate the amount of PM2.5 inhaled by different age groups.

The researchers studied data from four linked studies carried out in Scotland between 2009 and 2013 that had real time measurements of PM2.5 in homes, and combined them with data on typical breathing rates and time-activity patterns.

In all four studies, homes that were likely to have a significant additional source of PM2.5 (such as coal or solid fuel fires) were excluded.

Three of the studies used the same method to assess and measure PM2.5 concentrations – a personal aerosol monitor that was placed in the main living area of participants’ homes for a period of 24 hours – while the other study used a new, low-cost, particle-counting device.

Collectively, the four linked studies produced air quality data from 93 smoking homes with a further 17 non-smoking households. Most sampling was for a 24-hour period with the exception of one study data, which was generally carried out over a period of 6–7 days.

The results showed that the average PM2.5 concentrations from the 93 smoking homes were about 10 times those found in the 17 non-smoking homes.

Non-smokers living with smokers typically had average PM2.5 exposure levels more than three times higher than the WHO guidance for annual exposure to PM2.5 (10 ìg/m3).

Many non-smokers living in smoking homes inhaled similar quantities of PM2.5 to non-smokers who lived and worked in smoke-free environments in cities such as Beijing or London with high levels of air pollution.

The researchers also calculated that overall, homes where unrestricted, heavy-smoking activity took place produced second hand smoke concentrations that were, on average, about 10 times higher than homes where efforts to reduce or restrict second hand smoke exposure were more common.

Some homes studied had particularly high rates of smoking. Around a quarter of homes had 24 hour average concentrations in excess of 111 ìg/m3, more than 11 times that recommended as an annual average concentration by WHO.

The researchers also estimated that the overall mass of PM2.5 inhaled over an 80-year period for a person living in a typical smoke free home was about 0.76g compared with a similar person living in a smoking home, who would inhale about 5.82g.

Non-smokers living in smoking households would experience reductions of over 70% in their daily inhaled PM2.5 intake if their home became smoke-free, the researchers calculated, and the reduction was likely to be greatest for the very young and for older members of the population.

They concluded: “These findings ultimately support the need for efforts to reduce SHS [second hand smoke] exposure in the home, most notably through the implementation of smoke free home rules and smoke free multi-unit housing policies.”

Dr Sean Semple of University of Aberdeen and lead author, said: “Smokers often express the view that outdoor air pollution is just as much a concern as the second-hand smoke in their home.

“These measurements show that second-hand tobacco smoke can produce very high levels of toxic particles in your home: much higher than anything experienced outside in most towns and cities in the UK. Making your home smoke-free is the most effective way of dramatically reducing the amount of damaging fine particles you inhale.”

Indonesia: court upholds tobacco tax to fund health

4 Oct, 14 | by Marita Hefler, News Editor

Abdillah Ahsan
Faculty of Economics, University of Indonesia

Good news on tobacco control from Indonesia is rare. Recently, however there was a victory in the area of tobacco tax.

On 1 January 2014, Law No. 28 of 2009 on regional taxes was introduced, which allows local provinces in Indonesia to charge a local tax to cigarettes. The tariff is 10% of cigarette excise.

This tax collectively amounts to about USD 796 Million, a significant sum. Following successful international examples for funding tobacco control, a minimum of 50% of the funds raised from the tax are to be used for health promotion, in particular through public anti-smoking campaigns and enforcing smoke free public spaces. This means local governments have the authority to decide on strengthening tobacco control measures for their provinces and cities.

Unfortunately, five smokers challenged this cigarette tax policy in the Constitutional Court, calling for its abolition. Their argument was that the policy harms the constitutional rights of cigarette smokers as consumers by requiring them to pay both excise tax and local cigarette tax. They argued this amounts to double taxation, which is prohibited by the tax law and is unjust.

However public health won, and the suit was rejected by the Constitutional Court in May 19, 2014. In the judgment, the Court stated that in accordance with Law No. 11/1995 on Excise Tax, the subject of excise tax is manufacturers, distributors, and importers, while its object includes cigarettes, cigars, tobacco leaf and tobacco strips. In the provisions of Articles 26 and 27 of the Local Tax Law on the other hand, the object of local cigarette taxes is consumption of cigarettes and the subject of this tax is cigarette consumers. “Thus, there is a difference between the object and the subject of excise tax in comparison to the object and subject of local cigarette tax,” said one of the Constitutional Judges.

The Court ruled that the cigarette excise tax paid together with local cigarette tax is the “politics of taxation” to increase state revenues as well as provide compensation on the negative health impacts of smoking. According to the judge, “Simultaneous excise tax and local cigarette tax have positive impact on reducing cigarette consumption and improve society’s health.”

Several benefits will arise from the Court’s rejection of the suit and implementation of the tax. The first is that the local cigarette tax will increase cigarette prices, thereby making cigarettes less affordable, and in turn likely direct reducing smoking uptake among children. The second benefit is local governments will receive increased funds as revenue to go towards local development and increased living standards. A third benefit is the increased funding available to be used exclusively for health promotion and law enforcement. This includes anti-tobacco campaigns and strengthened enforcement of tobacco control regulations such as non smoking areas.

Together, these measures will change the scenario of tobacco control at the local level and enhance local government efforts to better protect children and the poor from the harms of tobacco. It represents a welcome step forward in a country that has been dubbed a paradise for tobacco companies due to lax regulation.

New Zealand: Dirty Politics raises conflict of interest concerns

2 Oct, 14 | by Marita Hefler, News Editor

Nathan Cowie, MPH.
Cowie Research and Communications

Disclosure: The author has previously undertaken paid employment for Centre for Tobacco Control Research, University of Auckland, and Action on Smoking and Health New Zealand.

Investigative journalist Nicky Hager released a book in August 2014 on the seamier side of New Zealand politics. Dirty Politics: How attack politics is poisoning New Zealand’s political environment is based on the hacked (and subsequently leaked to Hager) emails and Facebook messages of Cameron Slater, who runs the right wing Whale Oil Beef Hooked blog website, and other figures related to the currently governing National party.

One such figure is public relations consultant and former British American Tobacco (NZ) corporate affairs manager Carrick Graham. The book alleges that Graham fed Slater a large amount of material, often attacks on scientists and advocates in the public health field working on tobacco, alcohol and obesity issues. Slater would schedule the posts unedited according to Graham’s instructions and with no indication that an external party supplied the posts. For this service, it is alleged that Graham paid Slater NZD$6555 per month.

The book did not include direct evidence of Graham’s clients, however the correspondence between Slater and Graham does implicate Katherine Rich, who is both the chief executive of the Food and Grocery Council (FGC, representing companies selling alcohol, soft drinks, confectionery, tobacco), and a board member of the government’s Health Promotion Agency (HPA, informing health promoting policy and practice). A series of ‘hits’ was coordinated to defend the interests of FGC members:

Dirty politics extract 1 dirty politics extract 2















 Acting on behalf of the FGC, Rich has made public submissions to parliamentary committees and ministerial consultations opposed to tobacco control policies. In January 2011, the FGC opposed legislation to ban the retail display of tobacco products. In October 2012, March and May of 2014, her name was attached to submissions from the FGC opposing plain packaging of tobacco products. On each occasion, Rich deployed stock standard tobacco industry/front group arguments.

Rich is facing renewed criticism and questions of about conflict of interests between her industry role and her service on the HPA board from the Green, New Zealand First, and Labour parties. Green Party health spokesperson Kevin Hague has said that her role is no longer tenable “Katherine Rich, Carrick Graham and Cameron Slater have all been involved in a systematic undermining of health promotion in New Zealand. She cannot tenably remain on the board of that organisation.”

Dr Barrie Gordon, senior lecturer in health and physical education at Victoria University said that the government had been either naïve or staggeringly cynical when it appointed Ms Rich to the HPA board. “Now that it’s been exposed what she’s been up to, and the conflicts, I assume she will resign” he told Radio New Zealand.

Prime Minister John Key was reluctant to say whether it was appropriate for Rich to receive public money through the HPA.   “I wouldn’t want to offer a view on it, unless I could see all the facts,” he said.

Health Minister Tony Ryall however told Radio New Zealand that he was confident Rich could manage any conflicts appropriately.

An Official Information Act request has recently been made by Stuart Yeates for conflict of interest statements from all HPA board members past and present. The response is due on or before 17 September 2014.

Concerns had been raised in the past by addiction specialist Professor Doug Sellman about the suitability of Rich to serve on the HPA board. Sellman was subsequently a frequent target of the Whaleoil blog.

The hacker Rawshark, who leaked the messages between Slater and others that form the basis of Dirty Politics had been leaking selected correspondence via the twitter account @Whaledump. Material released so far includes screenshots of correspondence between Rich, Graham, and Slater. While Rich does not directly implicate herself in the source material, there is substantial correspondence between Graham and Slater, with Graham coordinating the ‘hits’ labelled ‘KR’ for Katherine Rich, and in line with FGC interests. Other correspondence released includes Graham advising Slater of payment for $6,555, and a confidential proposal to FGC member Nestle from Graham for public relations services.

whaledump screenshot






The day after the release of the above material, Twitter suspended the @whaledump account. Slater confirmed he had made a complaint to Twitter about the @whaledump account, and would do so again if required. Hours later a new account (@whaledump2), and at least two false accounts, were created.

The relationship between Rich, Graham, and Slater is just one story continuing to unfold in a scandal that has upset a lot of interests, and already led to the resignation of a senior cabinet minister, just weeks before a general election. How the Dirty Politics affair will affect the tenability of Rich’s service on the HPA board, remains to be seen.

laking tweet






Food & Grocery Council submissions on tobacco control policies:

 Smoke-free Environments (Controls and Enforcement) Amendment Bill – 28 January 2011

Plain Packaging Consultation – Ministry of Health – 5 October 2012

 Smoke−free Environments (Tobacco Plain Packaging) Amendment Bill 2013 – 28 March 2014 

Smoke-free Environments (Tobacco Plain Packaging) Amendment Bill -Introductory statement from Katherine Rich, New Zealand Food & Grocery Council – 20 May 2014


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