UK government's delay on plain tobacco packaging: how much evidence is enough?

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Article Date: 01 Aug 2013 - 0:00 PDT Current ratings for:
UK government's delay on plain tobacco packaging: how much evidence is enough?

On bmj.com today, senior research fellow Crawford Moodie asks how much more evidence is needed before the UK government make a decision on plain tobacco packaging.

In July, the UK government announced that there would be a delay on the decision on plain packaging, until findings from Australia emerge. The first study from Australia published since plain packaging came into effect found that smokers who used plain packs perceived their cigarettes to be "less satisfying and poorer quality" and "were more supportive of plain packaging and more likely to think about and to prioritise quitting".

Past research shows that desire to quit is a "reliable predictor" of whether someone tries to stop smoking with studies showing that high motivation is an important factor in quitting.

Moodie draws on the findings from the Australian study which he says supports one of the UK Government's public health policy priorities, namely to encourage smokers to quit, but questions whether they are enough to influence UK policy. He says that there is a "rapidly growing body of evidence on this issue" which is consistent in its findings: plain packaging would reduce appeal; increase the effectiveness of health warnings and reduce the ability of packaging to mislead consumers about the harmful effects of smoking.

The European Parliament's Committee on the Environment, Public Health and Food Safety supports pictorial health warnings covering 75% of the front and back of tobacco packaging, which should help reduce "pack appeal, enhance the visibility of warnings and disrupt tobacco companies' ability to communicate with consumers". However, Moodie argues that larger warnings would "not be enough" to prevent manufacturers using the "design of packaging and branding to detract from these warnings" or prevent consumers "being confused about the harms of the products". He points to the Framework Convention on Tobacco Control, which suggests that "only plain packaging can do this".

Moodie says that most smokers become addicted to smoking in childhood and recent figures show that the habit among children continues to fall in England and has steadily fallen since the introduction of tobacco control measures outlined in the 1998 white paper Smoking Kills. He adds however, that there is no guarantee, "this decline will continue if a tobacco control strategy is not sustained".

He concludes that as packaging is the "key marketing and communications tool for tobacco companies" since advertising, promotion and sponsorship was banned, "standardised packaging would appear to be a logical next step".

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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One Third Of World's Population Benefits From An Effective Tobacco Control Measure

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Article Date: 12 Jul 2013 - 2:00 PDT Current ratings for:
One Third Of World's Population Benefits From An Effective Tobacco Control Measure

At 2.3 billion, the number of people worldwide covered by at least one life-saving measure to limit tobacco use has more than doubled in the last five years, according to the WHO Report on the Global Tobacco Epidemic 2013. The number of people covered by bans on tobacco advertising, promotion and sponsorship, the focus of this year's report, increased by almost 400 million people residing mainly in low- and middle-income countries.

Furthermore, the Report shows that 3 billion people are now covered by national anti-tobacco campaigns. As a result, hundreds of millions of nonsmokers are less likely to start.

However, the Report notes, to achieve the globally agreed target of a 30% reduction of tobacco use by 2025, more countries have to implement comprehensive tobacco control programmes.

Bans on tobacco advertising, promotion and sponsorship are one of the most powerful measures to control tobacco use. As of today, 24 countries with 694 million people have introduced complete bans and 100 more countries are close to a complete ban. However, 67 countries currently do not ban any tobacco advertising, promotion and sponsorship activities or have a ban that excludes advertising in national broadcast and print media.

"If we do not close ranks and ban tobacco advertising, promotion and sponsorship, adolescents and young adults will continue to be lured into tobacco consumption by an ever-more aggressive tobacco industry," says WHO Director-General Dr Margaret Chan. "Every country has the responsibility to protect its population from tobacco-related illness, disability and death."

Tobacco is the leading global cause of preventable death and kills 6 million people every year. It can cause cancer, cardiovascular disease, diabetes and chronic respiratory diseases. If current trends continue, the number of deaths attributed to tobacco smoking is projected to rise to 8 million a year by 2030. In defiance of the deleterious effects of smoking, tobacco companies are spending tens of billions of dollars each year on advertising, promotion and sponsorship.

"We know that only complete bans on tobacco advertising, promotion and sponsorship are effective," stresses Dr Douglas Bettcher, the Director of WHO's Prevention of Noncommunicable Diseases department. "Countries that introduced complete bans together with other tobacco control measures have been able to cut tobacco use significantly within only a few years."

Other key findings of the report include:

Effective health warning labels on tobacco packaging continue to be established by more countries. In the past five years, a total of 20 countries with 657 million people put strong warning label requirements in place, with 11 countries (with 265 million people) doing so since 2010.More than half a billion people in nine countries have gained access to appropriate cessation services in the past five years. However, there has been little progress since 2010, as only four additional countries with a combined population of 85 million were newly provided access to cost-covered servicesincluding a toll-free national quit line.Creation of smoke-free public places and workplaces continues to be the most commonly established measure at the highest level of achievement. There are 32 countries that passed complete smoking bans covering all work places, public places and public transportation means between 2007 and 2012, protecting nearly 900 million additional people. Since 2010, 12 countries and one territory, with 350 million people, passed strong smoke-free laws at a national level.

In 2008, WHO identified six evidence-based tobacco control measures that are the most effective in reducing tobacco use. Known as "MPOWER", these measures correspond to one or more of the demand reduction provisions included in the WHO Framework Convention on Tobacco Control (WHO FCTC): Monitor tobacco use and prevention policies, Protect people from tobacco smoke, Offer help to quit tobacco use, Warn people about the dangers of tobacco, Enforce bans on tobacco advertising, promotion and sponsorship, and Raise taxes on tobacco.

This year's report is the fourth in the series of WHO reports on the status of the MPOWER measures. These measures provide countries with practical assistance to reduce demand for tobacco in line with the WHO FCTC, thereby reducing related illness, disability and death.

The WHO FCTC entered into force in 2005 and, with 177 Parties today, is a powerful tool to combat the deadly tobacco epidemic.

Panama was chosen for the launch of the report because of its leadership in implementing tobacco control measures. It is one of five countries in the Americas that have completely banned tobacco advertising, promotion and sponsorship and was the first to do so in the Region (in 2008).

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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WHO Report Demonstrates Need For Higher Tobacco Taxes

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Article Date: 12 Jul 2013 - 2:00 PDT Current ratings for:
WHO Report Demonstrates Need For Higher Tobacco Taxes

A report released by the World Health Organization concludes that tax and price measures are the "least-achieved" of a global menu of regulations to combat the growing tobacco epidemic, in spite of overwhelming evidence that higher tobacco taxes are the most effective means to lower tobacco consumption and deter children from taking up the habit.

The WHO Report on the Global Tobacco Epidemic tracks global progress of the world's first public health treaty, the Framework Convention on Tobacco Control (FCTC). Without strong action, tobacco is expected to take 1 billion lives this century, 10 times the toll of the 20th century. In response, the FCTC came into force in 2005, and has been joined by 176 countries, representing nearly 90% of the world's population. The U.S. has signed but not ratified the FCTC.

"The first phase of a global response to the tobacco epidemic has been a success," said Laurent Huber, Executive Director of Action on Smoking and Health, an anti-tobacco organization founded in 1967. "The FCTC is one of the most rapidly-embraced treaties in history. Now we must work to implement it."

The WHO report focuses on six key aspects of the FCTC, and notes important progress among some countries. However, very few nations have fully embraced all of the measures necessary to stem the tide of the tobacco epidemic, which currently kills 6 million people per year and is increasing rapidly in the developing world.

"Taxation is the single most effective way to curb tobacco use," said Huber. "The tobacco industry has been successful in claiming that increasing taxes will bring economic chaos to national treasuries, in spite of the fact that there is a long track record demonstrating that increased taxes always lead to increased government revenue."

Tobacco taxes make it more difficult for children to get cigarettes, cause smokers to decrease consumption, and inspire many to quit for good. New taxes can further benefit public health if some of the additional funds are used for tobacco control education, enforcement and other measures. Studies have shown that a 10% increase in cigarette taxes leads to a 4% reduction in consumption, and a 7% reduction among children, especially in low- and middle-income countries.

In the U.S., tobacco taxes have helped lead to dramatic declines in cigarette smoking; in some states, the percentage of smokers was cut by more than half. Financially, tobacco use still costs the U.S. nearly $200 billion a year in health and other direct costs.

Article adapted by Medical News Today from original press release. Source: Action on Smoking and Health (ASH)
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14 Jul. 2013. APA

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'WHO Report Demonstrates Need For Higher Tobacco Taxes'

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