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Attacking the source of a 6 million deaths per year epidemic: tobacco industry divestment

20 Oct, 16 | by Marita Hefler, News Editor

Dr. Bronwyn King

CEO, Tobacco Free Portfolios

I never would have imagined my work as a doctor would take me to corporate boardrooms across the globe, from Melbourne to London, Paris, New York and more. But then I never would have imagined I would be invested in the tobacco industry either.

In my early time as a doctor, I did a placement on the lung cancer ward of the Peter MacCallum Cancer Centre in Melbourne. Despite being able to offer the very best medicine available, the majority of my patients died, many of them in their 50’s and 60’s, some as young as 40. It was shocking to bear witness to the true impact of tobacco. Whilst the treatment and care of patients is paramount, we must deal with the source of the problem – tobacco and the companies that manufacturer it.

Once I discovered that through my compulsory pension fund, I was invested in and actually owned a part of a several tobacco companies, I couldn’t just do nothing – I had to take action.

In my quest to disentangle the Australian pension sector from tobacco I’ve become well informed about tobacco and the extent of the ‘tobacco epidemic’, as it is referred to by the World Health Organisation. The numbers astound me. Six million deaths per year are attributed to tobacco and we are on track for one billion tobacco related deaths this century.

Many, including investors (both individual mums and dads as well as big financial institutions), aren’t actually aware of the extent of their tobacco exposure. Tobacco stocks are generally picked up in standard products. Often, tobacco companies have not been selected specifically for investment, but they are wrapped up within default investment products, so they still find a way into your portfolio.

I founded Tobacco Free Portfolios to collaboratively engage with leaders of the finance sector to encourage tobacco free investment. Finance executives have been alarmed also, at the scale of the tobacco problem and have deeply considered the role they can play in addressing this pressing global issue. One by one, they have acted and are now proud to lead organisations that are tobacco free. There are now 35 tobacco free pension funds in Australia – just over 40% of all funds. Each tobacco free announcement is met with resounding public support.

Tobacco Free Portfolios recently took a global step and we were delighted to work with the global insurance giant AXA who announced a tobacco free decision in May 2016, divesting $1.8B Euro of tobacco assets. More organisations are soon to follow suit. That is the way of the future. Affiliations with the tobacco industry are no longer wanted. There are very few individuals or organisations that actively seek to be a part of the tobacco industry. The associations are often so deep and longstanding that it can seem overwhelming – but they must be addressed and they must be undone.

Momentum for tobacco-free investment continues to grow steadily and I can confidently say that the conversation in Australian has largely moved from ‘should we go tobacco-free?’ to ‘how can we go tobacco-free?’ This is a pleasing development and a terrific case study, however, there is still much to do to accelerate action across the globe. The good news is that conversations I have in Paris, Singapore, London and New York are received with exactly the same concern as the conversations I have in Melbourne, Sydney and Canberra. The devastating impact of tobacco is felt everywhere on Earth. Tobacco is everyone’s problem, not just the doctors that provide the care and treatment. We should all feel obliged to do something about it and all those with investments, including those through compulsory pension schemes have a role to play.

It’s up to us to keep tobacco control on the agenda and in public dialogue. A tobacco free future that will allow our children and the generations to come to enjoy long and healthy lives should be our shared hope.

Further details available at www.tobaccofreeportfolios.org

This article will also be published as part of the conference materials for the 17th World Conference on Lung Cancer, to be held in Vienna, 4-7 December 2016. 

The world of predatory publishing: what is it, and what might it mean for tobacco control?

23 Sep, 16 | by Marita Hefler, News Editor

 

Raymond Boyle

ClearWay Minnesota

If your email inbox is anything like mine, you receive a near constant stream of requests to send a manuscript to the next new journal. Most researchers are familiar with this type of academic spam: the journal name might sound familiar, but these requests usually appear as a generic template.

While such requests are straightforward to detect and delete without response, a colleague recently received a request that sounded interesting. It was an email thread from an editor expressing strong interest in an update of his research from six years ago. How flattering it would be for an editor to not only pay such attention to the work, but also consider it worthy of an update! Except…this marketing ploy had been identified in a recent blog devoted to the misbehavior of predatory open access publishers. The blog, posted at Scholarly Open Access was written by Jeffrey Beall, a librarian and associate professor at the University of Colorado Denver.

Jeffrey has been a critic of the practices employed by predatory open access publishers since he started tracking the industry in 2009. I asked Jeffrey if he would be willing to help us understand this variant of open access publishing.

Jeffrey, many thanks for agreeing to share your knowledge. My first question:  What is going on – why are so many people asking in email if I’m having a good day, and would I send them my next manuscript, or join their editorial board?

They want your money. These people are representatives of open-access publishers and standalone journals using the gold (author-pays) open-access scholarly publishing model. While some open-access publishers are honest and ethical, many are not, and these have come to be called predatory publishers. Now, becoming a scholarly publisher is quite easy — all one has to do is get a website, name a few journals, and he or she is in business. This low barrier to entry has enabled the creation of hundreds of unethical publishers seeking to profit from researchers. Because there are now so many, the competition among them is intense, so they spam incessantly, hoping to be the one that grabs your interest and your manuscript submission.

Next is a multi-part question: I have been casually following the changes in publishing for a few years, but you have devoted some significant effort to the topic. Can you talk about your motivation, the creation of Beall’s list, and your top 5 markers that a publisher is a predatory publisher?

My initial interest was as a researcher myself. I was on tenure track and was always alert to new publishing opportunities. At the same time, the gold open-access model began to become popular and some of these open-access publishers began spamming. I initially created lists of such publishers merely as a curiosity. Now the mission of my lists is to help researchers avoid submitting their work to these exploitative publishers, to help protect them from the predators.

In the broadest terms, predatory publishers are not honest, not transparent, and do not follow scholarly publishing industry standards. They use deceptive spam emails to attract article submissions, and many of them give false information about their journals’ metrics, specifically claiming that they have impact factors when they really don’t. These publishers do a fake peer review, or they don’t do it at all. Peer review, as you know often ends with papers being rejected, but this is contrary to the mission of predatory publishers, who hope to accept as many papers as possible so they can earn the revenue from the authors.

In recent years your efforts as a critic have been met with resistance from a few academics and the publishers you are shining a light on.  The term “predatory” appears to bother some of your detractors.  Are we living in a post predatory publishing time?  Is predatory still accurate?

The terminology isn’t as crucial or worrisome as the threats to researchers and the threats to science that the predatory publishers pose. I coined this term over six years ago, so it’s natural that the usage might not fit as well now as it did when the concept was new. I’ve also learned that the term doesn’t translate well into some other languages. I am not arguing that we keep the term, just that we continue to alert researchers to the perils of these unethical, low-quality, and parasitic publishers.

For those of us conducting research in the field of tobacco control, should we be concerned about the proliferation of open access publishing?  What are your concerns for the future of OA publishing?

You should be concerned about the proliferation of predatory open-access publishing, in my opinion, and about the negative influences it is having on the scholarly publishing industry as a whole. Standards are being lowered across the board and peer review is being devalued. Moreover, scholarly indexes are including predatory journals among those they cover, meaning much junk science, activist science, and conspiracy theory science is being mingled in the indexes with legitimate research. Science is cumulative, with novel research built on the foundation of science as recorded in the scholarly record. But this record is slowly filling with unvetted research, threatening the future of science itself.

Finally, has anyone used the automatic acceptance offered by predatory journals to publish ‘research’ showing that smoking is harmless?

No, but some have used predatory journals to make many unscientific claims about health issues, so a research finding that tobacco is safe for humans cannot be far behind.

UK plain packs court decision: interests at stake ‘collide in the most irreconcilable of ways’

4 Jul, 16 | by Marita Hefler, News Editor

The decision on 19 May 2016 by the High Court of Justice of England and Wales to dismiss the legal challenges brought by the four multinational tobacco companies against the UK’s tobacco plain packaging legislation was a major blow to the industry. The 386 page ruling addresses a wide range of legal claims and evidence; together with lessons learned from the industry’s failed attempts to overturn Australia’s 2012 plain packaging legislation, it provides an important resource for countries planning to introduce similar laws.

The McCabe Centre for Law and Cancer, a joint initiative of Cancer Council Victoria and the Union for International Cancer Control, has prepared a paper on the UK decision which draws out eight key aspects likely to be of widest relevance to litigation and policy development in other jurisidictions. Included in the aspects of the ruling which are explored and analysed are: the intent and limits of the laws, the conflicting interests of the tobacco industry and public health, the complementary nature of comprehensive tobacco control measures, and the relevance of the World Health Organisation Framework Convention on Tobacco Control.

Some notheworthy points in the analysis:

  • “…the Court points out that tobacco companies overstate the restrictive effects and implications of standardised packaging legislation” (page 4)
  • “The Court noted that the interests at stake ‘collide in the most irreconcilable of ways” (page 4)
  • “The Court notes that not all rights and interests are of equal value or worth. The protection of public health is one of the highest of all public interests. Health is a fundamental right” (page 5)
  • “…the Court notes that effective tobacco control requires the implementation of a number of complementary, mutually reinforcing measures, and that it can be difficult (if not impossible) to evaluate the contribution of individual measures in isolation to the reduction of tobacco use” (page 6)
  • “…the Court recognises that tobacco control does not and cannot stand still if it is to be effective (page 7)
  • “…the Court recognises the fundamental reality of intellectual property rights – they are created and protected to serve public purposes and interests, and are not absolute. Their exercise can be limited or restricted to serve other public purposes and interests. Public health is universally recognised as a public purpose and interest which justifies limitations and restrictions on the exercise of intellectual property rights” (pages 10 and 11)
  • “…the Court explains why, even if standardized packaging laws did constitute an expropriation of property, standardized packaging would fall within the category of ‘exceptional’ circumstances in which it would not be appropriate to require the payment of compensation” (page 13)

The full paper can be accessed by clicking here.

The McCabe Centre for Law and Cancer Framework Convention on Tobacco Control Knowledge Hub provides a public resource on legal issues relevant to tobacco control. Click here to link to the Hub.

 

Obituary: Yul Francisco Dorado, a visionary tobacco control leader in Latin America

6 Jun, 16 | by Marita Hefler, News Editor

Latin America, and the global tobacco control community, lost a champion of public health on 1 May 2016. Yul Francisco Dorado was born in Popayán, in southwest Colombia, where he completed his studies in Law and Political Science. At a young age he became interested in the right to health and environment. He became a key leader in the fight against tobacco in Latin America.

With a postgraduate degree in Public Law, he moved to Chile and worked for Consumers International. In 2003, he returned to his native Columbia, where he later established the Latin America regional office of Corporate Accountability International.

Over the last 13 years, he devoted himself to contributing to the creation of national and international networks for tobacco control, as well as the protection of the right to water and healthy environment. His dedicated work as an advocate led him to find a way not only among international organisations, but also among health authorities, the media and general public opinion, for Latin America to trigger alarms on the epidemic of tobacco-related disease and death.

He was a key figure in the movement within Latin America to implement the standards and laws provided by the WHO Framework Convention on Tobacco Control. He worked energetically on high impact campaigns to prevent tobacco consumption, especially among minors. Every year, on May 31, Yul Francisco addressed the media to promote a message during the celebration of the World No Tobacco Day.

Governmental entities understood Yul Francisco’s fight, not only in Colombia, but at an international level. Before he joined Corporate Accountability International in 2005 as Director for Latin America, he worked for Consumers International, supervising and supporting the ratification and implementation processes of the FCTC in Chile, Colombia, Ecuador, Guatemala and Costa Rica.

He travelled all around the world, bringing a message of solidarity and friendship to all meetings, winning the affection and recognition of several international organizations.

Yul Francisco Dorado was a determined leader, teacher and relentless health advocate. His work will live on through his many friends and colleagues who have learned from, and been inspired by him.

Dr Vera Luiza da Costa e Silva, Head of the FCTC Convention Secretariat, paid tribute to his legacy:

“Yul’s impact on the tobacco control movement has, and will undoubtedly continue to save millions of lives. His work has ensured that people are valued above the profits of the tobacco industry and that this industry will no longer be allowed to have a voice in public health policy. Yul will be sorely missed and our COP meetings will never be the same as they will miss his kind and strong presence. Nevertheless, his legacy will live on for its support to the WHO Framework Convention on Tobacco Control”.

Yul’s colleage at Corporate Accountability International Patti Lynn, expressed the personal sadness of many of his friends and colleagues:

“Yul Francisco Dorado, our beloved Latin America Director and dear friend, died on 1 May after a life that touched and inspired so many of us. Yul was recently diagnosed with cancer, and was in Bogota with his family. He was surrounded by love and left in peace. Yul loved life. He loved his family – they were his heart and strength and joy. His colleagues became dear friends and there are so many of us around the world that have learned from and loved Yul. Today is a sad sad day and our hearts are breaking. All of our hearts and prayers are with Yul’s family now. And even through our tears we see Yul’s smile.

We think of how he believed we could accomplish what seemed impossible. And we are deeply grateful for the spirit and determination that he brought to the corporate accountability and tobacco control movements. The FCTC and its implementation are so much stronger for Yul’s work and vision. And we who worked alongside, knew and love Yul are stronger too. We will continue to believe in and accomplish what seems impossible is his spirit. And we will be here for each other now, with care and warmth as he would, to support all who love him through this incredibly sad time.”

Yul Francisco Dorado is survived by his wife and three sons.

More:

  • Click here to read a celebration of his life by Corporate Accountability International Executive Director Patti Lynn
  • Video interview with Yul at the 2012 World Conference on Tobacco or Health, speaking about an award for Coporate Accountability International’s work:

Yul Franciso Dorado

Figure 6 Obituary Yul Francisco Dorado

World No Tobacco Day 2016: Get Ready for Plain Packaging

31 May, 16 | by Marita Hefler, News Editor

This year for World No Tobacco Day, the World Health Organization is urging governments to build on advertising and promotion bans by introducing plain packaging of tobacco products.

The measure is the next logical step in stripping away any hint of glamour associated with smoking. It is also an important way of preventing packaging creating misleading suggestions of some tobacco products being less harmful. There is also evidence that plain packaging enhances the impact of graphic health warnings.

Evidence from Australia, the first country in the world to introduce plain packaging, demonstrates the effectiveness. The UK has now introduced plain packaging. Ireland and France have passed plain packaging legislation, and several other countries are set to follow.

Read more:

Tobacco Control Podcast

20 Apr, 16 | by Becky Freeman, Web Editor

In the latest TC podcast Becky Freeman talks to Dr Robert McMillen about his paper in Tobacco Control entitled “Public support for raising the age of sale for tobacco to 21 in the United States”.

They discuss where the public support is the most strong and some surprising findings for people ages 18-24.

Other podcast topics include:

Economics of tobacco control, e-cigarette use amongst youth, and smoking and pregnancy

 

New Zealand study: Dissuasive cigarette sticks – the next step in standardised (‘plain’) packaging?

1 Apr, 16 | by Marita Hefler, News Editor

 

A study published by Tobacco Control in December 2015 by a team of New Zealand and Australian researchers explored extending the concept of plain packaging one step further – to the cigarette stick itself. New Zealand is moving towards introducing plain packaging; incorporating dissuasive cigarette sticks would put it at the forefront of innovative tobacco control measures.

The study authors explain more in a blog published by Aspire 2025 and reproduced here with permission:

As New Zealand moves towards legislating for plain packaging of cigarettes, the Government should consider measures that extend and improve upon Australia’s model, ASPIRE2025 researchers believe.

In this study, based on an online survey of 313 New Zealand smokers, our researchers and colleagues in Australia have found that cigarette sticks with printed health warnings or unattractive colours could enhance the effects of plain packaging and further reduce the appeal smoking has to young people.

Professor Janet Hoek says the team tested reactions to images of four cigarette sticks that either featured printed warnings or had unattractive colours, such as yellow-brown and green.

“We found that smokers were significantly less likely to choose the test sticks and found all significantly less appealing than the status quo — a white cigarette with a brown filter tip,” she says.

A “minutes of life lost” graphic that went from one minute near the tip up to 15 near the butt had the strongest aversive effect relative to the other sticks tested.

“Requiring cigarette sticks and rolling paper to feature such a graphic, or to be produced in dissuasive colours, would likely increase the impact plain packaging will have on those who smoke, while also deterring others from taking up smoking,” Professor Hoek says.

View a short video about this research here:

Study abstract:
Background
Standardised (or ‘plain’) packaging has reduced the appeal of smoking by removing imagery that smokers use to affiliate themselves with the brand they smoke. We examined whether changing the appearance of cigarette sticks could further denormalise smoking and enhance the negative impact of standardised packaging.

Methods
We conducted an online study of 313 New Zealand smokers who comprised a Best–Worst Choice experiment and a rating task. The Best–Worst experiment used a 2×3×3×6 orthogonal design to test the following attributes: on-pack warning message, branding level, warning size and stick appearance.

Results
We identified three segments whose members’ choice patterns were strongly influenced by the stick design, warning theme and size, and warning theme, respectively. Each of the dissuasive sticks tested was less preferred and rated as less appealing than the most common stick in use; a ‘minutes of life lost’ stick was the most aversive of the stimuli tested.

Conclusions
Dissuasive sticks could enhance the effect of standardised packaging, particularly among older smokers who are often more heavily addicted and resistant to change. Countries introducing standardised packaging legislation should take the opportunity to denormalise the appearance of cigarette sticks, in addition to removing external tobacco branding from packs and increasing the warning size.

Citation
Hoek, J., Gendall, P., Eckert, C., & Louviere, J. (2015). Dissuasive cigarette sticks: the next step in standardised (‘plain’) packaging?. Tobacco control, tobaccocontrol-2015. doi:10.1136/tobaccocontrol-2015-052533

For more information, contact:
Professor Janet Hoek
University of Otago
Email janet.hoek@otago.ac.nz

Tobacco industry attacks WHO, but only incriminates itself

26 Feb, 16 | by Marita Hefler, News Editor

 

Mary Assunta, Southeast Asia Tobacco Control Alliance

The tobacco industry lost the health argument 50 years ago, and in the past decade the WHO Framework Convention on Tobacco Control (FCTC) developed the antidote to reverse the smoking epidemic. However the tobacco industry is stepping up direct attacks, particularly at WHO. Recently the industry took pot shots yet again at WHO and the FCTC Conference of the Parties (COP) in its mouthpiece, Tobacco Reporter. The article, (Snail Mail, Jan 2016) makes several ludicrous accusations against both WHO and the COP but ends up only incriminating itself. We pull quotes from the article and provide our response.

TR: “Most of the besuited classes that turn up at COP7 will have few insights into the lives of the financially impoverished people who tend to make up the world’s smokers.

SEATCA: In reality the tobacco industry has been making billions in profits from selling cigarettes to financially impoverished people all over the world. Eighty percent of the world’s 1.2 billion smokers are in developing countries http://www.who.int/mediacentre/factsheets/fs339/en/. Studies have shown that in the poorest households in many low-income countries, spending on tobacco products often represents more than 10% of total household expenditure http://www.who.int/tobacco/research/economics/rationale/poverty/en/. Don’t forget the famous response from the R.J. Reynolds executive when asked why he didn’t smoke: “We don’t smoke that shit! We just sell it. We reserve the right to smoke for the young, the poor, the black and the stupid.”

TR: “People who turn up at COP7 will almost certainly be well-fed and cossetted

SEATCA: Government officials make up the bulk of the delegates who attend the COP and it seems the industry has no qualms insulting them.

TR: “Wonder whether these smokers really want to trade in what is possibly one of the few enjoyments they have for the few extra years of poverty and struggle …

SEATCA: Most smokers started smoking when they were still minors and did not know any better. Most smokers (70%) want to quit. What the industry refers to flippantly as “few enjoyments” actually leads to illness for many million smokers. Worldwide, about 6 million people die each year , often painfully, because of smoking. This not only affects smokers – it devastates families, emotionally and financially.

TR: “There are far too many people demonizing smokers…

SEATCA: The FCTC does not demonise smokers. It does the reverse to help smokers quit. Smokers are addicted to nicotine and exposed to the thousands of harmful chemical compounds in the product. Two out three of the tobacco industry’s long term customers die prematurely because of their smoking, however the industry continues to push this harmful product. FCTC measures are aimed squarely at the industry, protecting non-smokers and supporting smokers to quit.

TR: “… making decisions about cigarette smoking without understanding it.

SEATCA: There is no misunderstanding because the evidence is in – cigarette smoke contains 7,000 chemical compounds, many of which are carcinogenic.

TR: “People choose to smoke.

SEATCA: Nicotine addiction is not a choice. Most smokers want to quit but find it hard – the addiction is potent displaying similarities to hard drugs such as cocaine and heroin. For decades, the tobacco industry denied or downplayed the harms of tobacco, and it has engineered its products to enhance their addictiveness. It has fought regulations to protect non-smokers from cigarette smoke, restrictions on advertising, and health warnings to inform the public about the danger of smoking.

The WHO is fulfilling its responsibility to support 180 governments’ obligation to implement the FCTC to reduce tobacco use and reverse the smoking epidemic to save lives. An industry that continues to peddle a product that kills has lost the basic concept of humanity.

Shame on the tobacco industry for exploiting the poor and taking pot shots at the WHO and the COP.

 

Last Dance

18 Aug, 15 | by Becky Freeman, Web Editor

Powerful anti-tobacco ad from Cancer Council Tasmania.

A systematic review of the economic evaluations of tobacco control mass media campaigns show such campaigns offer good value for money.

Please feel welcome to share ads you think are helping smokers quit.

Point of Sale Display: A Call to Action on Prohibition of Tobacco Products in Nepal

5 Aug, 15 | by Becky Freeman, Web Editor

By Amrit Banstola and Ashik Banstola

In Nepal, tobacco products are smoked, inhaled, chewed, and sucked in many different forms. All forms of these tobacco products seriously damage health. In a situation where the country is undergoing a shift in burden from infectious diseases to chronic diseases, Non-Communicable Diseases [NCDs] caused by tobacco are increasingly outstripping the conventional cause of mortality related to acute infectious diseases.

Nepal signed the WHO Framework Convention on Tobacco Control on 3 December 2003, ratified on 7 November 2006, implemented on 5 February 2007, and passed the comprehensive tobacco control law in 2011. It includes bans on smoking in public places, bans on advertising, promotion and sponsorship and provision of smoking cessation. Recently, Nepal also implemented 75% pictorial health warnings on all tobacco products. From May 15, 2015, it increased this proportion of health warning to 90%. Indeed, all of these are significant steps towards combating tobacco-related diseases.

At the moment, however, there is no action being taken for the prohibition on the visible display of tobacco products at the Point of Sale (PoS) in Nepal. In Nepal, almost 19% of adults aged 15-69 years currently smoke tobacco daily, and over 84% of these smokers smoke over six manufactured cigarettes daily on average. The PoS of most of these manufactured cigarettes and other tobacco products include small shops, street vendors, teashops and cafes. Across the country, tobacco POS can be seen on footpaths and at bus stops along the highways where most buses stop for snacks.

No smoking sign in Nepal

No smoking sign in Nepal. A sign posted at a rural health facility in Naubise, Dhading reads “No Smoking Zone/Area”. Nepal. Photo: Aisha Faquir/World Bank.

Image credit: World Bank Photo Collection/Flickr CC BY-NC-ND

Research shows that PoS displays have a direct impact on young people’s smoking. A study conducted in the UK on adolescents’ perceptions on tobacco control measures shows that PoS displays encourage smoking and are considered ‘cool, fun, and attractive’. A New Zealand study published in Tobacco Control (2009) provides evidence that exposure to tobacco displays at the point of sale significantly increases youth smoking. Studies from Australia and USA suggests that the display of cigarettes at the PoS creates a perception that cigarettes are easily accessible, available and also help young people remember brands and may aid in the popularity of products. PoS displays are often considered as a promotional tool in its own right. Young people who makes spontaneous choices and ex-smokers are vulnerable to this silent marketing campaign.

Studies from Ireland, Norway, and Australia have shown the effectiveness of a ban on the display of tobacco products at the point of sale. A study on the evaluation of the removal of point-of-sale tobacco displays in Ireland shows an immediate compliance of 97%. According to this study, there was a decrease in the proportion of young people believing more than a fifth of youth of their age smoked from 62% to 46%. Similarly, post-legislation, 38% of teenagers thought the law would make it easier for children not to smoke.

There is an urgent need to prohibit on the visible display of tobacco products at the point of sale in Nepal.

 

Competing interests: None declared.

 

Amrit Banstola is a Global Student Award Scholar at the University of the West of England, UK and founder of Public Health Perspective Nepal.

 

Ashik Banstola is a PhD Fellow at University of Otago, New Zealand and an Executive Director of Public Health Perspective Nepal.

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