Tobacco Control (Professor Bill Bellew)

Tobacco – a special briefing for journalists

In association with the National Press Foundation

Professor Bill Bellew The Union

Acknowledgments: Prof Simon Chapman: University of Sydney Anne Jones: ASH Australia

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First – what’s on your mind?

• For 2-3 minutes• Talk to person next to you (2s or 3s)• What are the questions you would like to see

addressed in this session?• What are the issues you want to hear about?

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Secondly – what’s in your power?

• An issue to keep in mind during the session• What’s your role and responsibility as a

journalist re TOBACCO?• What are the questions your public would like

to see addressed ?• What issues are in the PUBLIC INTEREST that

people should read/see/hear about?

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Overview

• History• Health impact• Tobacco control• The tobacco industry

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history

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TOBACCO IN HISTORY

• TOBACCO USE IS THOUSANDS OF YEARS OLD• 3500 BC, people in Peru and Mexico used tobacco

(both chewed or smoked) and there are records indicating that they regarded it as a valuable, tradable substance.

• 600-1000 CE: UAXACTUN, GUATEMALA. First pictorial record of smoking

• A pottery vessel found here dates from before the 11th century. On it a Mayan is depicted smoking a roll of tobacco leaves tied with a string.

• The Mayan term for smoking was sik'arRead more: http://www.faqs.org/health/topics/19/Smokelesstobacco.html#ixzz14eySSSie

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Sir Walter Raleigh1552 – 1618

www.luminarium.org

Often credited with ‘discovering Tobacco and introducing it to theEuropeans

In fact it was introduced earlier, by the Spanish

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1492-11 Rodrigo de Jerez and Luis de Torres Discover Smoking

Rodrigo de Jerez and Luis de Torres, in Cuba searching for the Khan of Cathay (China), are credited with first observing smoking. They reported that the natives wrapped dried tobacco leaves in palm or maize "in the manner of a musket formed of paper." After lighting one end, they commenced "drinking" the smoke through the other. Jerez became a confirmed smoker, and is thought to be the first outside of the Americas. - became the First European Smoker http://logicophilosophicus.org

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Jean Nicot 1530-1600

• French diplomat who introduced tobacco to the French court.

• 1560, while serving as ambassador in Portugal, he was shown a tobacco plant in the garden of Lisbon botanist Damião de Goes, who claimed it had healing properties.

• Nicot sent home seeds and leaves of tobacco, recommending its therapeutic value. Nicot also sent snuff to Catherine de Medici, the Queen of France to treat her migraine headaches.

• She was impressed with its results. The tobacco plant, Nicotiana tabacum, and its active substance, nicotine, derive their names from him. http://www.britannica.com

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Nicotiana tabacum

http://www.scientificamerican.com http://www.britannica.com

Tobacco – all pervasive!

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Tobacco – industry exposed

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health impact

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More than 4000 chemicals have been identified in cigarette smoke – some of them are shown)

Carbon monoxide binds to haemoglobin in red blood cells, preventing affected cells from carrying a full load of oxygen.

Carcinogens in tobacco smoke damage important genes that control the growth of cells, causing them to grow abnormally or to reproduce too rapidly.

Smoking affects the working of the immune system and may increase the risk for respiratory and other infections.

Source: WHO report on the global tobacco epidemic, 2009: implementing smoke-free environments (2009

http://drugabuse.gov/NIDA_notes/NNVol22N2/Imaging.html

2008 Study

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Nicotine Receptors in the Brain

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NIDA Vol. 20, No. 2 (August 2005)

http://archives.drugabuse.gov/NIDA_notes/NNvol20N2/Site.html

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A descriptive model of the cigarette epidemic in developed countries. Lopez AD, Collishaw NE, Piha T. Tobacco Control, 1994; 3: 242-247.

Four Stages of the Tobacco Epidemic

Stage one: steep rise of smoking prevalence among male population

A descriptive model of the cigarette epidemic in developed countries. Lopez AD, Collishaw NE, Piha T. Tobacco Control, 1994; 3: 242-247.


Stage two: increase of female smokers, 50 % or more increase of male smokers


Stage three: a plateau and a slow decrease in smoking among males, plateau in female smokers


Stage four: a plateau and decrease of prevalence among females, further decrease among males.

India - 10 lakh (1 million) victims study

How Times of India reported the

‘10 lakh victims’ landmark study; March 2008

Conclusions of the study:• In 2010, smoking estimated to cause about 930,000 adult deaths in India; of the dead, about 70% (90,000 women and 580,000 men) will be between the ages of 30 and 69 years.• Because of population growth, the absolute number of deaths in this age group is rising by about 3% per year.• Among 30-69 year-olds studied, smoking doubled the risk of death from any medical cause among women and increased this risk by 70% among men;• Tobacco was responsible for 1 in 5 of all male deaths and 1 in 20 of all female deaths in middle age (30-69 years);• Daily smoking of even a small amount of tobacco was associated with an increased death rate.

• Compared with non-smokers, smokers had greater rates of deaths that were chiefly due to tuberculosis (women three times the risk, men 2.3 times the risk of dying from TB); excess deaths also resulted from respiratory and vascular diseases, as well as from cancers.

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Tobacco use is a risk factor for six of the eight leading causes of death in the world

Source: WHO MPOWER: a policy package to reverse the tobacco epidemic (2008)

Second-hand tobacco smoke is toxic

• Combination of smoke emitted from the burning end of a tobacco product and smoke exhaled by the smoker

• Contains thousands of known chemicals

• 250 toxins or known carcinogens

No safe level of exposure

Exposure to second-hand smoke causes death and disease

Source: Office of the U.S. Surgeon General. The health consequences of involuntary exposure to tobacco smoke: a report of the Surgeon General, 2006

Magnitude of SHS exposure is high

• Most workers are not protected from SHS exposure

• Worldwide, for children in school aged 13-15, – 44% are exposed to smoke in the home,

and – 56% are exposed in public places (data from 132 countries)

tobacco control

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What is the WHO Framework Convention on Tobacco Control (WHO FCTC)?

– A legally-binding international treaty to which 171 countries are Parties. This means those countries have agreed to be bound by the FCTC’s obligations.

WHO Framework Convention on Tobacco Control

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WHO FCTC and MPOWER are tools to implement the most effective

tobacco control interventions

• Each measure can be powerful on its own• Comprehensive implementation is best:

Individual effects of policies + synchronistic impacts of combination of policies

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WHO FCTC

• All Parties to the FCTC are required to submit regular reports on progress (every 2-3 years)

• The Framework Convention Secretariat provides regular summary reports on progress

http://www.who.int/tobacco/mpower/en/

Protection from second-hand smoke

WHO FCTC 2009 Summary Report on global progress in th implementation of the WHO Framework Convention on Tobacco Control. FCS. http://www.who.int/fctc/secretariat/en/

A recommended package

Shocking picture

Warning on top part of pack

Non-misleading ingredient information Clear text warning,

quitting encouragement

PLAIN PACKAGING: No branding, standard background, no misleading descriptors

Warning is 80% of main surface

Parallel to the top of the principal display

surfaces

Parallel to the top of and as close as possible to the top edge of the principal

display surfaces

Japan, October 2010 – POS advertising at vending machine

Camel Smoking Room

Frankfurt Airport 10 November 2010

tobacco industry

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Tobacco’s global epidemic5.4 m deaths every year

175m deaths by 2030 with vast majority in LMICs

Of the 1 billion smokers alive today, 500m will be killed by tobacco

Spread not by a virus but by marketing tactics of a powerful global tobacco industry (TI).

Acknowledgment: ASH Australia; Anne Jones

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The Tobacco Industry is different

“Tobacco is the only legally available consumer product which kills people when used entirely as intended”

(The Oxford Medical Companion, 1994)42nd

“No sir, nicotine is not addictive” Tobacco Executives 1994


The Tobacco IndustryWho are they?

Tobacco companies: Philip Morris, BATA, Imperial plus several smaller companies Many other names/ identities depending on the country Sometimes owned by the government

Shareholders, interrelated companies High profile individuals Associated interests: retail, hospitality, gaming Front groups Lobbyists, legal advisers, consultants, think tanks Charities accepting TI funding Governments and politicians accepting donations,

hospitalityAcknowledgment: ASH Australia; Anne Jones

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ChinaVietnamPDR KoreaThailandMyanmarLaos

EgyptLibyaIranIraqYemenSyriaTunisiaAlgeria

BulgariaMoldovaBosnia

Source: Tobacco Atlas 2011

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State OwnedMonopolies

TI – your sources of information?• The industry itself – company websites• TI documents• TI and related industry publications• Court records• Freedom of Information requests• Mandatory filings with governments under

FCTC• Monitoring of marketing tactics and activites


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http://legacy.library.ucsf.edu/

Industry secrets reveal ‘true colours’Industry documents, now reviewed and cited in many reports and publications provide evidence of how the tobacco corporations:•knew their products were harmful;•knew that nicotine was highly addictive;•publicly denied the dangers of tobacco use and exposure to second-hand smoke and the addictiveness of tobacco use; and•continued to target young people with advertising and promotions to perpetuate the use of their products

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Evidence shows… The Tobacco Industry spends billions each year

- misinforming governments, politicians, businesses, public

- hiding health harm, duping smokers- targeting young people and users with advertising, promotions and sponsorships- opposing tobacco control legislation and policies

If these tactics are not countered they will succeed in further blocking and delaying reforms leading to more preventable loss of life, chronic diseases and costs

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TOBACCO INDUSTRY INTERFERENCE

STRATEGIES

Electronic Cigarettes

Further trials are necessary to confirm these results and especially, to try electronic cigarettes as a strategy for smoking cessation among smokers who are motivated to quit. Nevertheless, the results of this initial clinical trial are encouraging

Busting Tobacco Industry Myths

Simon ChapmanProfessor of Public Health

University of Sydney

Courtesy of:

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3 areas where myths abound

• Health effects• Marketing targets (“we don’t want kids to

smoke)• Economic impacts (“tobacco control will ruin

business & the economy”)

Acknowledgment: Prof Simon Chapman: University of Sydney

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The scream test

• What does the tobacco industry complain about & lobby against?

• What does the tobacco industry support?

• What should the answers to these questions tell us?


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From sales data, the tobaccoindustry knows the immediate, medium & long term impact of every marketing & tobacco controlvariable


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What does the tobacco industry “scream” about?

• Tax rises• Smoking restrictions/denormalisation• Advertising bans• Big, hard-hitting TV campaigns• Picture-warnings on packs• Plain “generic” packs

The ‘Scream Test’


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What does the tobacco industry support?

• Voluntary codes of advertising control• Small, general pack warnings• Separate smoking areas• Signage in shops re not selling to kids• Pamphlets, advice on quitting

Industry Tactic – False cooperation


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Industry lines on Health effects

• For decades, tobacco industry denied tobacco caused disease

• Availability of millions of internal industry documents (1998) showed they knew dangers for many years


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Economic myths1. Tobacco control will:•- reduce tax receipts to government•- put 1000s out of work

2. Smokefree restaurants, bars will:•- not work (people will ignore .. Smoking “police” needed)•-cause major economic losses


No loss of revenue to governments

Smoke-Free Workplace Laws Do Not Harm Businesses

Source: Philip Morris Internal Document


5

6

7

8

9

10

11

12

1992 1993 1994 1995 1996 1997 1998 1999 2000

Sal

es i

n $

Bil

lio

ns

Smoke-Free Workplace Laws Aren’t Bad for Business – Sales

Smoke-free Restaurants

Smoke-free Bars

Taxable sales in CaliforniaSource: California Board of Equalization.

Bars/Restaurants Serving Beer\Wine Only

Bars/Restaurants Serving All Alcohol

770000790000810000830000850000870000890000910000930000950000

1992

1993

1994

1995

1996

1997

1998

1999

2000

Year

Nu

mb

er

of

Em

plo

ye

es

Smoke-free Restaurants

Smoke-free Bars

Source: State of California, Employment Development Department, Labor Force Statistics, April 2001

Smoke-Free Workplace Laws Aren’t Bad for Business – Jobs

0%

5%

10%

15%

20%

25%

1993 1994 1995 1996 1997 1998 1999 2000

Year

Per

cent

age NYC

LA

SF

Miami

Source: Office of Tourism, International Trade Association, US Department of Commerce, ITA Survey of International Air Travel.

Smoke-free restaurants in NYC, LA, & SF

Smoke-free bars in LA & SF

There is No Relationship between Smoke-Free Policies and International Travel

US Cities Visited by International Travelers: 1993-2000

Industry Strategies to Stop Smoke-free Workplace Laws• Create front groups including smokers and

restaurant/bar owners• Manufacture economic impact “studies”• Intensely lobby elected officials• Offer counter proposals and delay tactics• Launch advertising campaigns• Encourage law-breaking and try to overturn

statute after passedAcknowledgment: Prof Simon Chapman: University of Sydney

Reprise

• History• Health impact• Tobacco control• The tobacco industry (busting

tobacco industry myths)

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Reprise – what’s in your power?

• An issue to keep in mind during the session• What’s your role and responsibility as a

journalist re TOBACCO?• What are the questions your public would like

to see addressed ?• What issues are in the PUBLIC INTEREST that

people should read/see/hear about?

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100 articles that every journalist should read about journalism

http://www.upstart.net.au/2010/04/28/100-articles/?mid=5000285

Thank You!

[email protected]

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Documents

Tobacco Control (Professor Bill Bellew)