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Archive for March, 2015

Bloomberg Philanthropies Honors Tobacco Control Organizations

23 Mar, 15 | by Becky Freeman, Web Editor

by Stan Shatenstein

Bloomberg Philanthropies hosted the third Bloomberg Philanthropies Awards for Global Tobacco Control as part of the 16th World Conference on Tobacco or Health in Abu Dhabi last week. The Awards were created to recognise governments and non-governmental organizations demonstrating excellent progress or achievement in the implementation of MPOWER measures in low-and middle-income countries.

MPOWER, established by the WHO and consistent with the WHO FCTC, describes six of the most effective tobacco control measures: Monitoring the epidemic and prevention policies; Protecting people from second-hand smoke; Offering help to people who want to quit; Warning about the dangers of tobacco; Enforcing bans on advertising, promotion and sponsorship; and Raising taxes and prices. A panel of global tobacco control experts selected the winners.

This was the first time there were honorees in all six MPOWER categories. After the third award of the night, Bloomberg was joined by independent TV presenter, Mona Ibellini, for an on-stage conversation. The two came together awkwardly, centre stage and, when Ibellini hesitated, Bloomberg bemused and philosophical asked, “Why are we here?”

The audience enjoyed the early banter, but the two settled into a casual yet informative dialogue, with Bloomberg responding to a first question about his generosity by noting that while Bloomberg Philanthropies have spent $600 million fighting to lessen the damage wrought by tobacco use, the industry is spending $6 billion annually and, as Bloomberg noted, “this year, they’ll sell more tobacco products than any other year. If that isn’t impetus for change, what is?”

In response to a question from Ibellini about New York City, the former three-term mayor, who used his position to push through aggressive tobacco control measures against strong resistance, noted that it’s now rare to see smokers huddled outside buildings, the norm having changed. “And if you do, they’re so embarrassed, they put [the cigarette] behind their back.”

Bloomberg then announced the launch of the Anti-Tobacco Trade Litigation Fund, a new joint effort to combat the tobacco industry’s use of international trade agreements to threaten and prevent countries from passing strong tobacco-control laws. Backed by Bloomberg Philanthropies and the Bill & Melinda Gates Foundation, the new support for low and middle-income countries is the most recent element in a comprehensive strategy to reduce tobacco use globally.

After describing the tremendous pressure placed on Uruguay, one of the evening’s honorees and under double legal assault from the tobacco industry, Bloomberg received a strong round of applause for noting that, while the country of just 3 million people could be forced to withdraw measures due to an inability to match the industry’s funds, “We’re here to make sure that doesn’t happen.”

Numerous countries have been threatened with legal action by the tobacco industry, a tactic that can lead to delays by governments in passing and implementing the best-practice tobacco control laws. In addition to supporting countries facing suit before international trade tribunals, the Anti-Tobacco Trade Litigation Fund includes:

  • Technical assistance in legislative drafting and documentation to avoid legal challenges and potential trade disputes from the passage of tobacco-control laws
  • Support of global best practices in tobacco control and coordinated efforts to document industry wrongdoing
  • Litigation support to low- and middle-income countries to help defend laws in the form of financial support and access to high quality legal assistance
  • Communications support to educate and inform the public about the industry challenges to tobacco control policy and abuse of the trade system
  • Assistance in accessing knowledgeable tobacco control experts and mobilizing support among the global public health community to help countries defend against tobacco industry litigation
  • Creation of a network of senior lawyers, experienced in trade litigation to support countries

A complete list of award winners can be found here.


Blockbuster Special Issue: Evaluation of the Australian tobacco plain packaging policy

18 Mar, 15 | by Becky Freeman, Web Editor

The latest supplement from Tobacco Control is a must read. All papers mentioned below are available open access.

Features audio and news grabs are also available from the Cancer Council Victoria.

Key findings of the evaluation include:

• Plain packaging has delivered on its aim to reduce appeal of packs, particularly with adolescents and young adults

• There was no evidence of an increase in the consumption of illicit “cheap white” cigarettes

• The impact of plain packaging extends beyond expectation with studies suggesting the initiative encourages thinking about quitting and quit attempts

Cluster bomb of new research explodes tobacco industry lies about plain packs

Simon Chapman, University of Sydney

There is near-universal agreement that Australia’s implementation of tobacco plain packaging in December 2012 has seen the most virulent opposition ever experienced from the global tobacco industry.

While the industry bravely insisted early in its campaigning that plain packs “would not work” their legal actions, campaign expenditure, lobbying and general apoplexy rather suggests they feared it would be a devastating policy, with long term global ramifications.

Indeed, eleven other nations (Ireland, England, New Zealand, France, Norway, Finland, Chile, Brazil, India, South Africa, Turkey) have either legislated plain packaging or are now warming up to do so.

University of Sydney researcher Becky Freeman and I catalogued the full range of industry lies in our recently released (free) book Removing the Emperor’s Clothes. The Cancer Council Victoria has also published extremely detailed rebuttals to the major industry scuttlebutt.

Now today, the British Medical Journal’s specialist journal Tobacco Control has published a special collection of new research which puts further 10,000 watt arc lights on specious industry claims.

Key industry claims have included that plain packs would:

  • Drive prices down, as smokers turn away from buying expensive premium brands because they look exactly the same as cheap brands (other than brand names). More affordable cigarettes, they argued, would cause more smoking, including among children
  • Flood Australia with illegal tobacco
  • Cause smokers would stop buying cigarettes at small convenience stores
  • Prompt smokers to use special covers to conceal the large-scale graphic warnings on packs.

Price falls?

One of the new Tobacco Control papers monitors changes in recommended retail prices RRPs from one year before plain packs were introduced until one year after. Prices were adjusted to 2013 prices, and for inflation and average cigarette price stick and grams of roll-your-own tobacco.

The RRPs of tobacco products were higher in real terms one year after the legislation was implemented. Importantly, these increases exceeded increases resulting from consumer price indexation of duty and occurred across all three major manufacturers for both factory made and roll-your-own brands, all three cigarette market segments and all major pack sizes.

Tobacco prices rose most for leading and premium brands 10.0% and 10.1%, respectively) and among packs of 30s (18.3%) and 50s (12.5%). So far from seeing cigarette prices fall across the board, the industry raised prices.

Floods of illicit tobacco?

The tobacco industry’s most common claim was that plain packs would see smokers turn away from buying the purposefully confronting and unattractive plain packs and seek out illegal products not in plain packs.

Tobacco spokespeople made the outrageous claim that about one in seven of all cigarettes being smoked were such illegally obtained cigarettes. Apparently, while ordinary smokers across the country knew where to buy these easily, the full might and resources of the Australian Federal Police could not work out where these were being sold.

Tobacco companies have been proven wrong.
Curran Kelleher/Flickr, CC BY

Another study in the collection questioned 8,679 smokers across the country in telephone surveys conducted continuously, from six months before plain packs until 15 months afterwards.

The study found no significant increases in reported purchasing of “cheap whites” (illegally imported Asian sourced brands), of international brands selling for 20% or more less than the normal retail price, or of unbranded loose tobacco (so-called “chop chop”).

Rates of purchase of cheap whites and heavily discounted products were at around half of one per cent of smokers, nothing remotely like one in seven.

Small shops losing customers?

One of the most bizarre claims the industry made was that plain packs would see smokers deserting corner stores for larger retail outlets like supermarkets. This was an appeal designed to tap into wider public sentiment about local corner store owners being crushed under the dead weight of government regulation.

Those making the claim never explained why smokers would abandon small retailers for large ones because of plain packs when the very same packs would be sold in both. Consumer preference for larger retailers is entirely driven by price discounting, something never mentioned in the industry propaganda.

A third paper in the collection examined where smokers purchased their cigarettes. Unsurprisingly, it found no changes from prior to and after the introduction plain packs in where smokers bought their supplies.

Covering up the packs?

In the month that plain packs were introduced, a Queensland small businessman got his 15 minutes of fame from publicity about special pack covers that could block out the unforgettable graphic warnings. Like children covering their eyes from scary scenes in movies, the idea was that many smokers would rush to do the same, outsmarting the hapless bureaucrats who planned the legislation.

A fourth paper which reports on unobtrusive observations of smokers handling their packs in outdoor cafés found that prior to plain packs, just 1.2% of outdoor café smokers used pack covers. This rose to 3.5% in the early months of plain packs and then fell back to 1.9% one year later.

In any event, evidence shows that smokers who actively try to avoid exposure to pack warnings by covering them up, have higher subsequent rates of quit attempts than those who don’t.

Importantly too, these observations recorded that of all café outdoor patrons, one in 8.7 displayed a pack prior to the introduction of plain packs with this reducing to one in 10.3 afterwards. Such a fall is consistent with both a reduction in smoking prevalence and with growing self-consciousness among smokers about showing that they smoke in public.

Impact on adolescents?

There were several principal objectives of the plain packs legislation. But outstanding among these was the goal of making smoking less desirable among young people. This would continue the trend away from smoking, as each successive cohort of children chose not to take up the habit.

A fifth paper used school-based surveys prior to and after plain packs to examine students’ ratings of the “character” of four popular cigarette brands, and variables including perceived harmfulness, look of pack and positive and negative perceptions of pack image.

Positive character ratings for each brand reduced significantly between 2011 and 2013. Significantly fewer students in 2013 than 2011 agreed that “some brands have better looking packs than others” and packs were rated more negatively, with positive ratings decreasing most in smokers.

The tobacco industry and its acolytes can be expected to try to torture these reports to spin yet more denials of the impact it fears will quickly inspire even more countries to follow Australia’s lead.

Australia is fortunate in having some of the very best researchers in the world whose work has contributed to the development of plain packs and now to the evaluation of its impact.

Editor’s note: please ensure your comments are courteous and on-topic.

The Conversation

This article was originally published on The Conversation.
Read the original article.

16th World Conference on Tobacco or Health: regional delegates refused visas

17 Mar, 15 | by Marita Hefler, News Editor

Simon Chapman, University of Sydney

(Editor update: at the time of this post being published, we were able to confirm 38 delegates had been refused visas. The organisers subsequently issued a statement with an estimate that approximately 60 delegates were refused visas. To read the statement click here.) 

Every three years, the world tobacco control community convenes for a world conference to hear the latest research, discuss strategy and train young researchers and advocates in how to get potent legislation adopted by governments. There have been 15 conferences since the 1967 meeting in New York, opened by Robert Kennedy.

This week the 16th is running in Abu Dhabi in the United Arab Emirates. The host countries are selected by a panel of leading international agencies and past conference hosts. There has never been a conference in the Middle East and with heavy smoking rates among men in particular, and generally immature tobacco control policies in place, a strong case weighed heavily in the voting for this weeks’ gathering.

One argument was that the conference would provide a global stage for regional leaders to make announcements about how the Middle East was moving ahead in tobacco control. Another was that the meeting would inspire regional delegates and help them network with global leaders.

The three day conference started on the 17th and as I write, at least 38 registered delegates we know of, many whose presentations had been accepted by the conference and some who were to chair sessions, are still waiting for their visas to be issued.  These are from Bangladesh (29), Iraq, Tunisia, Nigeria and Syria. They have a combined experience of  over 200 years in tobacco control.

This email is typical of the anguished emails we have seen or received directly:

I am writing to you in a situation when I am waiting at a friend’s house, packed up all my bags and posters for presentation and checking email every 6 secs.

I was invited as a speaker for sessions to be held today and tomorrow at the WCTOH. With a full scholarship I was assured about participation and thence I cleared all my appointments for these days.

I live in a distant town, 120 km away from the airport, and when I was leaving my house, my only daughter (8 months old) was sick and this stress was increased when I was waiting at the airport yesterday for hours with an expectation that I will get a visa.

Before that, I had to cancel my flight and it was so uncertain that I have never had such a thing in my travel history. Further, I couldn’t stop myself writing to the logistics people and got a little number of responses in the last few days.

The thing is I have never had the chance to show my travel history and I have two USA visas including one multiple entry valid for several years. I also have visas from Singapore, Malaysia, Turkey, Netherlands, Germany, Japan, China, Indonesia and South Africa on the same passport.

This is seriously awful when I have prepared  my speech and I have not yet  got the visa to fly. With my 12 years of  professional career I got opportunities to lead a number of  platforms on health and tobacco control. [lists his international experience]

However this experience has made my disappointment so terrific that I am truly faded up on choosing a country which doesn’t respect the professionals, experts and researchers who are leading people’s health and well-being issues in this region and worldwide.

Today is the last day when I am waiting for a visa and if I don’t get this by 3PM UAE time, I will surely miss my speech. So I may not go at all to this conference if it is not today.”

A Facebook page set up by a high ranking UAE public health official to facilitate  pre-conference discussions and news transfer was suddenly switched to secret status on Monday and later closed down.

The same person had earlier responded to frustration from delegates still waiting for their visas: “UAE hosts sponsored 400 scholars from low and middle income countries. Some are still awaiting visas and it elicits abuse of the hosts. “No good deed goes unpunished.” This is a small developing country that faces manpower challenges. Yes. The delays for a few have been long and disruptive. I am sorry for that. Thousands of others will enter without hindrance. Hopefully all who want to attend will be admitted and they will enjoy the conference in safety.”

This ‘small developing country’ has the world’s 7th highest GDP per capita.

Prof Wasim Maziak is a Syrian now working in the USA and a distinguished tobacco control researcher. As a member of the conference Scientific Committee he has withdrawn in protest from the Conference. Maziak was a key organizer of the largest collection of research yet assembled on health aspects of waterpipe use, published open access in Tobacco Control in time for the conference. Waterpipe is a major public health problem in the Middle East in particular.

He wrote to us:

I have since years been conducting regular training opportunities for researchers in the Middle East and have established last year a seed grants program (funded by my grant from NIH) to junior tobacco control researchers in the region. I gave 6 of these grants, and I organized a symposium at WCTOH for them, and sponsored them to attend in order present their data from the seed grants for the first time.
Three out of six participants in my symposium were denied visa (Syria, Iraq, Tunsia). Needless to say that these young researchers are devastated because they had such great hope to be on such international theater.
I have been warning the organizers for more than a year about this issue, because I know that UAE has discriminatory visa policy, but finally I had to make a stand being a member of the Scientific Committee in hope to elicit some actions to help denied participants” .
I was very enthusiastic that the conference came to the region, thinking that it will boost tobacco control in a region in much need for that. My disappointment is utter.”

The Abu Dhabi conference is the first that I have missed since the 5th meeting in Winnipeg, Canada in 1983. I had no expectation of what has now happened. I am very glad I did not attend and hope the international organisers will be highly critical of what has happened, apologise to those excluded and  ensure that all their expenses are met.

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