Posted by: Sheila Duffy ASHS | February 4, 2011

A child protection measure

“A child protection measure”. The words used by Public Health Minister Shona Robison when she launched the Tobacco and Primary Medical Services (Scotland) Bill in February 2009. The bill which became an Act just over a year ago introduces a number of measures with the clear aim of reducing youth smoking and preventing young people starting to smoke.

The passage of the bill is now the subject of a new ASH Scotland report. Counter Measures, funded by Cancer Research UK, is a comprehensive study of the campaigns against and in support of the measures in the Bill which included a ban on tobacco vending machines, a ban on retail tobacco displays, and stricter sanctions for those who break tobacco sales laws.

Introducing Counter Measures, Professor Gerard Hastings of Stirling University says, “Our children have for far too long been prey to increasingly elaborate and enticing displays of tobacco products when they go to spend their pocket money. Displays that we know, along with the design of tobacco packs, have become increasingly important marketing tools for a declining industry that has rightly been shorn of its other advertising and promotional tricks“.

It is these displays that the Act sought to ban with huge support from health and professional organisations, and the final bill received substantial cross-party support in the Scottish Parliament. That did not mean the tobacco industry did not have its say. The industry gave both written and oral evidence to the Health & Sport Committee seeking to stop both the ban on displays and vending machines going ahead and water down other areas of the bill. They failed to convince Parliament, but have not given up on their opposition to the measures.

Tobacco displayat Edinburgh Airport

Anyone who has followed tobacco industry tactics on display bans internationally will have been unsurprised that the next move from this powerful and rich industry was to turn to the courts.

Despite losing an initial petition for a judicial review calling into question the powers of the Scottish Parliament to pass such legislation, Imperial Tobacco, continues to explore further legal challenges. As a result, the intended introduction of a point of sale display ban for larger retailers which was due to be introduced in October this year, has had to be delayed.

We should ask, at what cost? The tobacco industry depends for its future on recruiting and addicting new consumers, many of whom begin smoking as children. Such legal challenges are undoubtedly costly to government in terms of both legal fees and time spent defending these public health measures through the courts. However the costs to our society run deeper still, and will be measured in lives lost as this lethal and addictive product continues to recruit new users. 

Recent evidence from Ireland on the effects of a display ban shows that when tobacco promotions are put out of sight, young people perceive smoking as less prevalent and a less normal activity. Ending point of sale displays is an important measure, and one that should be implemented in Scotland with all speed and enforced rigorously.

To quote Professor Hastings again on the issue of tobacco displays: “This is a child protection measure. This is enlightened Government.”

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Posted by: Sheila Duffy ASHS | December 30, 2010

Quit for you, quit for Scotland

This is a time of the year when many smokers are thinking of giving up and I would encourage everyone who is contemplating making it a new year’s resolution, to take that positive decision and quit.

stubbed and broken cigs

Not only will your health benefit but your wealth too. The cost of smoking to both personal finances and to Scotland’s economy can be a great motivator to quit, or stay quit, as of course are the benefits to the health of the smoker and those around them. Smoking causes over 13,300 adult deaths in Scotland every year – that’s a quarter of all deaths. In addition, thousands of others are affected by smoking-related illnesses.

Smoking is a drain on our finances – on a personal basis and to the economy. The personal cost to a smoker with a 20 a day habit is nearly £2300 a year. At a time where we are all feeling the pinch that is a lot of money that could be spent on other items or saved for the future.

By quitting, smokers can also help Scotland’s economy. As our report Up in Smoke, published late last year, showed, the price of smoking to Scotland is nearly £1.1billion every year which is a huge cost to bear. We must also remember that the tobacco revenues gained do not cover the costs of tobacco for Scotland. Even when compared to the £940 million tobacco duty the Scottish Government receives, when all the various costs of tobacco use are taken into account, there is still a deficit of at least £129 million.

Tobacco is a very addictive product so there is no doubt that quitting smoking can be both a hard decision to make – and sometimes can be hard to do. However tobacco is lethal and quitting brings short and long term benefits to your health and wealth.

There is a lot of help and advice out there to support smokers thinking about quitting. Lots of people can quit through willpower alone – and often find it easier than they thought it would be. Many people find alternative therapies help them. You can also access free stop smoking support through the NHS, your local pharmacy, and Smokeline. These services can be very effective and they are available for everyone to use.

Posted by: Sheila Duffy ASHS | December 15, 2010

EU subsidising tobacco industry

Would  you be happy to find out that the EU had granted more than three million Euros of public funds, including an estimated 1.5 million Euros from structural funds, to subsidise the activities of a major industry that makes billions of pounds every year for selling a product that kills one in two of its long term customers? Me neither.

A joint investigation by the Financial Times and the Bureau of Investigative Journalism uncovered just that, including that British American Tobacco (BAT) had been granted an estimated EUR 531,510 from EU funds for processing machinery in Germany and Japan Tobacco International (JTI) was given an estimated EUR 142,921 for retraining staff in Poland.

BAT made £2.3 billion pre-tax profits in the first six months of 2010 and JTI’s net profits for the year to March 2010 hit over £1 billion. These grants have also come at a time when the EU is also spending more than 16 million Euros trying to reduce tobacco use, which is estimated to cause as many as 650,000 premature deaths in the European community every year.

It seems absurd that public funding continues to support the manufacture of these lethal and addictive products, and it appears to go against the intentions of the Framework Convention on Tobacco Control guidelines, which recommends that “parties should not grant incentives, privileges or benefits to the tobacco industry to establish or run their businesses”. These are some of the world’s most profitable tobacco companies and tobacco is not an industry we should be in any way incentivising.

I believe it is time we stopped pretending that the cigarette business is a normal business, as opposed to a business that exerts a lethal and predatory blight on our health and prosperity. And time we gave people’s health precedence over considerations of profit, something the tobacco companies have consistently failed to do for their own customers.

Posted by: Sheila Duffy ASHS | November 5, 2010

Roll up Roll up

This week saw reports of a sharp rise in the number of roll your own (RYO) cigarettes being smoked in Britain, an increase of 35% in two years with sales of more than 5,000 tonnes of rolling tobacco a year reported. Imperial Tobacco, which owns cigarette paper brand Rizla, claimed that smokers are trading down to hand rolled tobacco in response to the recession and the high price of cigarettes. There’s no doubt that cigarettes are expensive, with an average 20 a day smoker spending well over £2,000 in the course of a year. And the proportion of tax on cigarettes is higher than the tax on rolling tobacco.

 

Around one in five smokers in the UK are thought to mainly use rolling tobacco. They are twice as likely as other smokers to believe that what they are smoking is somehow safer or contains fewer additives than cigarettes. Yet smoking machine emission studies detect far higher tar levels in rolling tobacco smoke, and EU regulations for tar and nicotine levels in cigarettes don’t apply to rolling tobacco. Because roll your own cigarettes are usually smoked without filters, they are actually likely to be more dangerous to your health than manufactured cigarettes.

In countries such as Finland where the price of hand rolling tobacco has been hiked through taxes, they have seen a fall in consumption of both manufactured cigarettes and rolling tobacco. Many smokers have quit rather than switched.

Interestingly, tobacco companies often claim that tax increases will lead to increased smuggling. This logic doesn’t seem to be reflected in recent HM Revenue and Customs reporting however, which estimates a 12% UK market share for illicit cigarettes (more highly taxed products) as against a 48% market share for hand rolling tobacco. Clearly the illicit market is subject to more complex forces than tobacco companies would have us believe.

Of course, another possible factor in the rise of RYO smoking is promotions, which are mainly targeted at young people. Recent research in the UK and France show rolling tobacco manufacturers are actively targeting a young market, using messages that portray roll your own cigarettes as natural, cool and laid back. For example, Imperial Tobacco has actively marketed the Rizla brand through sponsorship at music festivals such as Lovebox, The Big Chill, Bestival and Rockness, at boat parties in London and Glasgow, and through their sponsorship of the Suzuki MotoGP (motorbike) team, including an iPhone application. These are advertising routes that have been closed by law for tobacco products.

The Long-Term Monitoring of Health Inequalities (October 2010) report was published by the Scottish Government last month. It found that healthy life expectancy was lower for both men and women living in deprived areas, and that they are likely to die nearly two decades earlier than those in more affluent communities. Smoking is concentrated in our poorest communities where it is a major cause of health inequalities.

Smoking rates in Scotland’s poorest communities are four times higher than in richer areas, and people living in these communities are suffering the misery of heavy rates of heart disease, cancers, stroke and COPD as a result. Tobacco kills one in two of its consumers who use it regularly as intended. Of those one in two early deaths, around half occur in people’s middle years, with an average loss of life expectancy of 22 years. If we are serious about reducing health inequalities, we need the price of tobacco products to start reflecting the real costs of tobacco use. This would mean significantly increasing the price of hand-rolling tobacco through the tax system, while continuing to offer support for smokers who want to stop, and clamping down on supplies of illicit tobacco.

Posted by: Sheila Duffy ASHS | October 20, 2010

Firefighting?

Beyond Smoke-free

This week ASH Scotland launched Beyond Smoke-free, an ambitious, far-reaching set of proposals for a strategic approach to continuing to reduce tobacco harm in Scotland. These recommendations were formed after consultation with academics, NHS workers, service users and with inputs from an expert advisory group. They take account of research findings and international strategic thinking. Funding from Cancer Research UK made it possible for us to undertake this work, and to highlight the fact that tobacco is the largest preventable killer we face in Scotland. It is an epidemic we cannot afford to ignore.

Beyond Smoke-free covers smoking prevention, cessation, reducing exposure to tobacco smoke, and makes recommendations on Government, society and industry. There are 33 robust yet achievable proposals for the short and medium term, with a longer term vision for progress. I hope that all our political parties will use these to inform their thinking about Scotland’s future public health, and commit to a new comprehensive strategic approach to tackling tobacco.

One of the recommendations – to support speedy progress towards EU standards for fire safer cigarettes while ensuring the negotiations are not exploited by tobacco companies – seems especially relevant this month as new statistics were released on fire deaths in Scotland. Of the 49 fatal casualties in accidental dwellings fires in 2008-09, smoking materials were the cause of 22 of the deaths. Those most at risk of fire deaths tend to be older people living alone. Alcohol or drugs can be a factor, making it less likely that people will react in time to the danger. In many cases, fire investigators find warning signs that could have alerted people to the potential for tragedy, such as burn marks on carpets, furniture or clothes.

Fire safer cigarettes (or RIP, reduced ignition propensity) cigarettes are designed to go out rather than keep smouldering when not being puffed. They were first introduced nationally in Canada, and in 2010 were mandated throughout America, in Finland and Australia. Undoubtedly they save lives but like any other tobacco control measure this is not something that can be done in isolation. They reduce but cannot completely prevent fires. They do nothing to prevent the diseases caused by tobacco. So we also need accessible smoking cessation services, targets to reduce illicit tobacco, work to engage young people with smoke-free choices, and a continuing vigilance towards tobacco industry promotional activities. We need a new ambitious and comprehensive national tobacco control strategy and a commitment to continuing Scotland’s success in acting to reduce the impacts of tobacco on our nation’s health and prosperity.

Posted by: Sheila Duffy ASHS | September 23, 2010

Illicit tobacco is not a victimless crime

This week I took part in the first Scottish National Summit on Illicit Tobacco, which brought enforcement organisations, the Scottish Government, retailers, health organisations and community representatives together to discuss the problems of illicit tobacco in Scotland and how to tackle them.

Illicit tobacco is not a victimless crime. Cheap cigarettes or tobacco undermine people’s attempts to stop smoking and make it more likely that tobacco, a lethal product, will get into the hands of children. The cost to the public purse in lost taxation runs into billions, money that is much needed to fund our public services.

Tackling illicit tobacco is one of the few areas of concern we in public health currently share with tobacco companies. But it is a late consensus. For the tobacco companies, smuggling became a high profile issue only when the outcry over non duty paid goods led to new arrangements that penalised their own involvement in alternative retail distribution routes.

Criminal gangs then moved in to profit from the continuing demand for illicit tobacco supplies, and we heard that the same gangs that are involved in bringing drugs and weaponry into communities now count tobacco amongst their commodities. People buying cheap cigarettes or rolling tobacco from a fag house or car boot sale are unknowingly funding serious criminal activities, and in some cases terrorist activities.

Meantime, funding for the Scottish Government’s Enhanced Tobacco Sales Enforcement Programme which brings local authorities into partnership with HM Revenue and Customs to tackle illicit tobacco comes to an end in 2011, and the UK Border Agency which is charged with detection and confiscation at points of entry into the UK is said to be withdrawing funding for three posts at Stranraer Port.

 Tobacco whether fake, smuggled or duty-paid, kills. The tobacco epidemic claims one in four of the adult deaths in Scotland ever year and can’t be ignored. We need decisive action to reduce smuggling and continued action to tackle tobacco; because the cost of inaction is unbearable.

Posted by: Sheila Duffy ASHS | August 20, 2010

Inspiring women

I’m fortunate that my work brings me into contact with many inspiring people, people who generously engage their hearts and minds towards envisioning and striving for a brighter future. This month I’d like to mention two of the inspiring women whose paths have crossed mine in the past few weeks.

The first is Dr Judith Mackay. Judith made time during her annual holiday visit to Scotland and in her packed calendar to come in and catch up with our work and to update me on steady progress in tobacco control in Asia. Judith was for long years a lone campaigning voice on tobacco in Asia, labouring unpaid and in the teeth of ferocious opposition to raise awareness of the harm tobacco does. She argued successfully for measures to reduce its malign influence, and she continues to put her energy into making progress towards smoke free. She co-authored the Tobacco Atlas and was a chief architect of the Framework Convention on Tobacco Control, the first international public health treaty designed to tackle the tobacco epidemic worldwide.

Dr Judith Mackay accepting BMJ award

In recent years, Judith’s commitment and influence have been recognised, twice by Time magazine as one of the Time Asia Heroes in 2006 and in the Time 100 in 2007. She was awarded an OBE in 2008, and her work was recognised by the BMJ readership with their lifetime achievement award in 2009. Meeting Judith is always inspiring because she shows unstinting passion and courage in continuing to challenge Big Tobacco’s predations, and because she has made and continues to make such a positive difference in so many people’s lives.

My second inspiring woman is Ailsa. Ailsa was a smoker for 35 years, quitting just before her 60th birthday. It wasn’t her first quit attempt, and this time it was concern for her cat that motivated her to seek help. Ailsa had mental health problems, and she found she smoked more when she was in hospital because she felt frightened and insecure. Some people had told her she shouldn’t stop, that the timing wasn’t right.

For Ailsa, stopping smoking was a positive choice. With advice and group support she ditched tobacco and now she feels so much better. She can taste food, she isn’t breathless, and quitting smoking has given her new self confidence. Best of all, quitting smoking has meant her medication could be reduced, so her mind is clearer and she feels good that she has fewer chemicals in her body. Sparky her cat appreciates it too! Ailsa made a video to share her story, with photos and her own commentary. It is quirky and moving, and entirely her own. I hope she will decide to share it more widely, as I think many people will find something to identify with in her story.

Cigarettes are often presented as an adult or lifestyle choice. The reality is they are a highly engineered, highly toxic product that is sold on the image but is rooted in addiction and habit. Tobacco is a grim epidemic, although as someone pointed out, unlike other epidemics there is an added dimension. Malaria kills people, but mosquitoes don’t have PR agencies and expensive promotions budgets.

I’ve been thinking about the tobacco industry recently. Not that unusual, but more specifically, I have been angered at how they use their vast profits to develop tactics that aim to challenge and derail policies and legislation to reduce smoking.

Imperial Tobacco – the fourth largest tobacco company in the world – is currently taking legal action against the Scottish Government’s Tobacco and Primary Medical Services (Scotland) Act, challenging the legislative competence of the Holyrood parliament. This Act, which aims to reduce youth smoking by reducing the attractiveness and availability of tobacco, has a number of measures that are due to come in over the next few years. These include registering tobacco retailers, bringing in tougher penalties for those who sell tobacco to under 18s, introducing new offences of buying tobacco underage or for under 18s. It will also close down the retail display of tobacco and ban the sale of cigarettes through vending machines. It is these last two measures which Imperial Tobacco is challenging. The court proceedings have ended and we await the written decision of the judge, Lord Bracadale.

The tobacco industry claims legal action is a last resort, but the facts show otherwise. Philip Morris is seeking to overturn the recently introduced bans on retail tobacco displays in both Norway and Ireland. In England, British American Tobacco, Japan Tobacco, and Imperial Tobacco, are seeking a judicial review against the display ban due to come into force in 2011. In addition, Imperial Tobacco’s subsidiary cigarette vending machine company Sinclair Collins is seeking a judicial review of the English ban on tobacco vending machines also due to be introduced next year.

In Canada where an Act of Parliament mandated larger graphic warning labels on cigarette packets, Imperial Tobacco, Rothmans, Benson & Hedges, and JTI-Macdonald all took to the courts claiming the legislation was an infringement of their rights. In Australia, as soon as the federal government announced they were bringing in legislation to introduce standardised packaging with no branding, colours, or logos, Imperial Tobacco and British American Tobacco both said they would take legal action against such a move. When a tobacco control strategy for England stated it would consider the evidence surrounding plain packaging, Imperial Tobacco immediately responded by threatening a legal challenge.

Going to court is part of big tobacco’s continuing strategy of seeking to dilute, delay or derail legislation to reduce tobacco addiction and harm.

In April, Imperial Tobacco announced global sales of £13.4 billion and pre-tax profits of £974 million in the six months to 31 March. It is these huge profits made from selling its lethal products in more than 160 countries that are being ploughed into challenging the actions of governments around the world to use legislation to reduce the major harm caused by smoking to their citizens’ public health.

Earlier this year, the Office of Fair Trading fined Imperial Tobacco £112.3 million for unlawful tobacco pricing saying there was an understanding that the price of some brands would be linked to rival brands in order to limit competition. It is the largest fine ever handed out by the OFT for anti-competitive practices. However for Imperial, whose profits reached nearly a billion pounds in just six months, this is a drop in the ocean.

So that is what those of us trying to work for public health are up against. The vast profits tobacco companies make at the expense of people’s lives and wellbeing are ploughed back into more and more sophisticated marketing and recruiting practices, and into pursuing costly legal action against policies and legislation designed to reduce the deaths, diseases and anguish caused by tobacco.

In Scotland’s case tobacco accounts for a quarter of all adult deaths each year. I believe the health of our nation and our future generations is well worth fighting for.

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