The problem of the easy availability and increasing use of smokeless tobacco products by young people of south Asian origin in the UK needs to be urgently addressed.

Legislation exists, but is often flouted with the consequence that these products, which are associated with significantly increased risk of oropharyngeal cancers in young people,1 are available for as little as £0•20.

Cancer of the oropharynx constitutes one of the ten commonest cancers in the world. Important causal agents include the alkaloid content of the habit-forming betel nut (areca)—commonly known as supari among south Asians—and tobacco, whether smoked in cigarettes, bidis, or through a hookah or chewed as gutka or paan.2
Gutka is made up of tobacco, betel-nut fragments, fennel, and other spices, and is marketed in attractive colourful sachets that are appealing to children (figure). The recent addition of chocolate-flavoured ingredients may further enhance this appeal. Gutka can be bought by young people from “corner shops” in many UK inner cities for only a few pence.3

Source: The Lancet 12th July 2008
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More than half a million illegal cigarettes have been seized from a home in Harlow. HM Revenue and Customs (HMRC) officers visited the house on the edge of the town on Friday July 4 and found the counterfeit cigarettes. The stockpile, thought to be worth £87,350, originated from China and was meant to be sold in Essex.

A man was arrested and charged and has been released on bail pending further enquiries. Maddy Ratnett from HMRC said: "Anyone who may think they are getting a bargain might not realise this illegal trade damages honest businesses in the area, costs billions in lost revenue and lines the pockets of criminals instead of funding public services.So if you are tempted to buy cheap smuggled cigarettes remember that you are funding crime."

If you know of anyone selling cheap or duty free cigarettes and tobacco from their house or work or seen large quantities of cigarettes being unloaded contact the HMRC's new information line, in confidence, on 0800 59 5000.

Source: The Harlow Herald 10th July 2008
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Calls are being made to 'make smoking history' for children across the north east. Over 80 delegates from across the region gathered at St James' Park in Newcastle, where leading tobacco experts presented evidence to support further measures to protect children from the harmful effects of tobacco. The event marked the regional launch of the Government's National Tobacco Strategy consultation.

Those attending the event were told the results from a nationwide public opinion survey showed that 65 per cent of those questionned supported a ban on selling cigarettes from vending machines, 60 per cent called for the price of cigarettes to increase beyond that of inflations, and 59 per cent were in favour of banning the display of tobacco products.

Director of Fresh, Smoke Free North East, Ailsa Rutter, said: "The north east has the worst health inequalities and the highest rates of smoking in the country, so we have the most to gain from a fully funded tobacco strategy. "It is up to us to ensure we respond to the government's consultation and provide our children with the future they deserve, and make smoking history for our children."

Source: News Guardian, 9th July 2008
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Films that show smoking in a way that "condones, encourages or glamorises" the activity should be considered for reclassification – restricting them to an older audience, the British Medical Association said. The association called yesterday for new curbs on the promotion of smoking in the media and said the Government should set a target to make England smoke-free by 2035.

More than one in five adults smokes and most start before they are 18 when they are most vulnerable to images that "increase the allure of the habit", the BMA said in a report from its board of science. The portrayal of smoking in films declined from 1950 to 1990, but has since increased. The poster for the 1994 movie Pulp Fiction, showing a sultry Uma Thurman smoking, was a gift to the tobacco industry and an example of the sort of image the BMA wants to outlaw. In the US, smoking has increased in films targeted at teenagers since 2002, the report says.

The BMA says films showing smoking in a positive light should also be preceded by an anti-smoking advert. A similar strategy to curb the promotion of cigarettes on television led to the voluntary withdrawal of tobacco advertising in the 1970s. Cigarettes should be banned from sale in vending machines, removed from display in shops and supermarkets and presented in plain packaging, the report says. The UK has one of the most comprehensive tobacco control policies in Europe with a ban on smoking in public places, an advertising ban, regular tax increases, an increase in the minimum age for buying cigarettes (from 16 to 18) and health warnings on packets. But further efforts to reduce the appeal of smoking to the young are essential to achieve the goal of eliminating it, the BMA says.

Source: The Independent, 7th July 2008 Also reported in The Guardian The Times BBC News
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Superproducer Mark Ronson is facing prosecution after he was caught smoking onstage at a gig last weekend. The Grammy-winner was performing at Britain's Wakestock Festival in the grounds of Blenheim Palace in Oxfordshire, England on Saturday night but he broke the UK's strict no smoking laws by sparking a cigarette up during the concert.

And now West Oxfordshire District have confirmed they have launched an investigation into the allegations and will be examining photo evidence of the gig. A council spokeswoman tells the Daily Mirror, "Our environmental health department will be investigating it and meeting with organisers and reviewing what went on. We can't say now whether we're prosecuting him (Ronson) or not." If he is prosecuted over the offence, Ronson will receive a minor £50 penalty but the event's organiser will be fined £2,500.

Source: Yahoo News, 6th July 2008
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Students at high schools that value caring and inclusiveness are significantly less likely to be smokers than their peers at schools placing a heavier emphasis on academics, Scottish researchers report. Students' attitudes toward a school and the quality of student-teacher relationships also appeared to play a role in whether or not students chose to smoke cigarettes, especially for boys. "Schools can make a difference," Dr. Marion Henderson of the Medical Research Council Social and Public Health Sciences in Glasgow, who led the study, told Reuters Health. "It's worth schools trying to think about the social environments they're creating."

Current anti-smoking efforts at schools, which usually focus on individuals rather than the school environment, have done little to discourage smoking among teens, Henderson and her colleagues note in the journal BMC Public Health. They sought to investigate whether the quality of the school environment itself might be related to students' likelihood of picking up the habit by looking at 5,092 students at 24 high schools in Scotland. Overall, 25 percent of males and 39 percent of females smoked. But smoking rates varied sharply from school to school, from a low of 8 percent to a high of 33 percent for male students. For girls, the percentage of smokers ranged from 28 percent to 49 percent.

Even after the researchers accounted for factors associated with smoking such as a student's socioeconomic status, the amount of spending money he or she had, or whether a student lived with both parents, school-to-school differences in smoking rates remained. Kids attending schools with worse student-teacher relationships as rated by students, teachers and the researchers themselves were more likely to be smokers. And when more students said they didn't like their school, the percentage of smokers in the student body also was higher. Both factors had a particularly strong influence on whether or not boys smoked.

The researchers also found male students at affluent schools were more likely to be smokers if student-teacher relationships at the school were poor. "The affluent schools, particularly those with poor relationships, may be more likely than deprived schools to have an academic focus, perhaps at the cost of the social climate or health-related goals," the researchers suggest. The findings in this study make it clear that it's not only individual factors such as deprivation that influence the likelihood a student will smoke. "Once you've leveled the playing field for these things, schools can make a difference (in) smoking just by being nicer social environments to be in," Henderson said in an interview.

Schools could build more positive environments by finding ways to make all students feel valued, even if they are not top academic achievers, the researcher said. This might include offering apprenticeships and practical training to those who aren't necessarily "university material," Henderson suggested. And making sure that teachers are people that the students respect and like could ensure that any health-related messages they offer won't be dismissed, she added.

Source: Reuters UK, 4th July 2008
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New research by ASH NZ found that the more teenagers visit shops where cigarettes are on display, the more likely they are to start smoking.

A survey has been conducted among thousands of students around the country each year since 1999.

Last year 27,000 Year 10 students from 238 schools were asked questions which indicated their susceptibility to smoking such as "If your best friend offered you a cigarette, would you smoke it?" and "At any time in the next year do you think you will smoke a cigarette?". With four possible responses, anyone not choosing "definitely not" was deemed at risk.

Researchers found teens who visited shops such as dairies two or three times a week rated twice as likely to start or experiment with smoking than those who visited less than weekly.

Researcher, Dr Janine Paynter said, " It's a dose response. The more visits they are making the higher the likelihood of their susceptibility to smoke,"

Those who visit the dairy daily recorded three times the risk of the sub-weekly shoppers.

Dr Paynter said the size of the survey meant it could be adjusted for other factors such as parental smoking, peer smoking, decile, and ethnicity.

The survey was carried out before cigarette packets began carrying pictures of various smoking-related diseases, but
Dr Paynter did not believe their introduction would have much effect.

"My feeling is not enough of the packet is taken up with graphic warnings. They don't disrupt the brand imagery enough."
ASH said the research proves a "significant" association between the displays and smoking.

"Our recommendation is that tobacco displays are removed. It is not going to stop all teens smoking, but we believe it will stop a proportion of them," Dr Paynter said.

"Anything that can be done to protect children from an addictive and deadly habit like smoking is worthwhile. It is important teens get the message that tobacco products are not everyday, normal products like the bread and milk alongside which they are sold."

Source: nzherald, 3rd July 2008
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These and other findings are published in a special report of this month's the Lancet Oncology.

The report, by the International Agency for Cancer Research (IARC), also showed that smokefree policies do not decrease the business activity of the restaurant and bar industry.

The author said, "A reduction in the lung cancer burden is plausible, but relevant evidence will only become available in the future."

Dr John Pierce of the University of California and Dr Maria Lean from IARC's Tobacco and Cancer Team prepared the report in collaboration with scientists from around the world.

The working group comprehensively assessed peer-reviewed published work and accessible governmental reports on the effect of smokefree policies.

Strong evidence was found that smokefree workplaces decrease the prevalence of adult smoking; that smokefree policies decrease tobacco use in youths; that the introduction of smokefree legislation decreases heart disease morbidity; and that smoke-free home policies decrease smoking in youths."

The working group recommended that governments implement smokefree policies that conform to the WHO Framework Convention on Tobacco Control (FCTC).

"Not only do these policies achieve their aim of protecting the health of non-smokers by decreasing exposure to secondhand smoke, they also have many effects on smoking behaviour. The authors pointed out that up to now, most research has been done in high resource countries."

Source: IOL, 2nd July 2008
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One year after the country took a dark turn into state control and an unpleasant, puerile attitude to other people's business. Or is it one year into a brave new world where the country became fitter, healthier and more civilised? One year since the smoking ban in England and Wales, and passions remain high on both sides.

"Plainly it's been a huge success," says Martin Dockrell, policy manager for ASH. "Not only has there been very little need for enforcement, because compliance was so high, but the benefits have been coming in thick and fast. It's indisputably the big political success of the year. It's just gone on getting more and more popular. These people who oppose it are pretty damn noisy, but they're outnumbered ten-to-one by those who support it."

One of those noisy people is Neil Rafferty, a spokesman for FOREST, the pro-smoking group. "For smokers, it's been a pretty rough year," he says. "A huge chunk of their lives has transformed dramatically. They can no longer socialise in the way they wanted to. ASH will say Britain is a healthier place. But the underlining point of that is they think health is more important than anything else. We think happiness and freedom is just as important, if not more important," he adds. "The debate in this country has become so hysterical that we're now in an atmosphere where freedoms are being thrown away every day because of this religious fervour of the Labour party and their campaign allies."

The civil liberties argument received a fair amount of attention in the build-up to the ban, but anti-smoking campaigners don't think it stands up. "It's pretty straightforward," says Mr Dockrell. "John Stuart Mill said people were free to do whatever they like as long as they don't hurt anyone else. While we thought smoking in public was harmless, it was fine. But once the evidence about the harm from second-hand smoke became pretty conclusive the argument changed. Your freedom to swing your fist ends where my face begins."

But FOREST contests the evidence the passive-smoking argument is based on. "This is double-speak from ASH," says Mr Rafferty. "The reason they pushed for the ban was because they felt it would contribute to the de-normalisation of smoking. That was why they wanted to ban it. It has nothing to do with protecting bar staff. There's no evidence bar staff are badly affected by smoking. They claimed 50 bar staff a year are dying from passive smoking in Scotland, but they've yet to name one. They simply have not presented any credible evidence at all. There are still plenty of environments where you're exposed to carcinogens. Cooking red meat in a restaurant exposes you. Road workers are being subjected to a huge cocktail of lethal poisons, but do you ever see them using face masks?"

The battle isn't over yet, either. The Department of Health (DH) is in consultation on a wide range of anti-tobacco measures designed to tackle underage smoking and cut down on demand. Proposals are being aired to ban cigarette vending machines, hide point-of-sale displays of ten packs and put photo warnings on packets. The proposals give a fairly good indication of the priorities of health groups like ASH.

"People are still being exposed to second hand smoke, especially outside of offices," Mr Dockrell explains. "Their right to smoke does not trump my right not to smoke. But the idea of smoke-free outside areas isn't the big issue. Once you're in the open air there's much less evidence of harm. We want to constrain the opportunities tobacco companies have."

It's been one year, and no one needs telling the difference it's made. Not just in terms of smell, or huddles of people shivering outside in the winter, but also a marked change in the perennial argument between health and pleasure. Whichever side of the argument people ended on, the smoking ban opened the doors to further changes in legislation. Barely a day of news passes without mention of fatty foods, alcohol, smoking or lack of physical activity. Britain is becoming obsessed with health and the battle over the government's role in addressing it isn't over yet.

Source: politics.co.uk, 1st July 2008
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Pro-smoking group FOREST pressured MPs yesterday to amend the smoking ban and allow licensed smoking rooms in pubs and clubs. Speaking at a House of Commons reception hosted by Tory MP Philip Davies the group’s director Simon Clark highlighted the plight of pubs to an audience of MPs. Handing them each a complimentary Montecristo No. 2 cigar, he said: “Many pubs and clubs have suffered serious economic hardship and for many smokers the social impact has been equally severe. It is very unfair, especially on older smokers. For some mental health sufferers the impact of the ban has been devastating.

"Smokers are not going to disappear like a puff of smoke, so let’s be fair and practical about this. We are asking the government to amend the legislation so that pubs and clubs can apply for a license to introduce well-ventilated separate smoking rooms. We want to bring back some element of choice for consumers, owners, and members of staff.” Clark will launch FOREST's renewed ‘Amend the Smoking Ban’ campaign exactly a year after the ban’s implementation, supported by documents detailing its social and economic impact.

Source: The Publican, 1st July 2008
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