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CSU 33/2009: TWELVE MYTHS THAT UNDERMINE TOBACCO CONTROL/ SIX ITEMS ON TOBACCO AND YOUTH SMOKING

Wednesday, 27th of May 2009 Print

  CHILD SURVIVAL UPDATE 33/2009: TWELVE MYTHS THAT UNDERMINE TOBACCO      

                          CONTROL/  SIX ITEMS ON TOBACCO AND YOUTH SMOKING
 
 Most of the progress against smoking has come in the industrialized
 countries, whereas most of the marketing pressure from Big Tobacco has come
 in the developing countries, which have the most to gain by such
 anti-tobacco measures as taxation and bans on smoking in public places.
 
 The incoming CDC director, Thomas Frieden, in a co-authored article from
 the American Journal of Public Health, lays to rest 12 myths about tobacco.
 Text is at http://www.ajph.org/cgi/content/full/95/9/1500
 
 Good reading.
 
 Bob Davis
 
 
 
 1) Good news from Washington: President Obama has signed into law a bill
 almost tripling the federal excise tax on cigarettes.
 
 This item from the New York Post gives the views of some New York smokers
 on the $10 they will now be paying per cigarette pack.
 
 'LATEST TAX PUSHES LOWEST CIG COST PAST $10'
 By DAVID HASTIE
 
 Web edition, New York Post, consulted 2 April 2009
 
 Breathe in and exhale slowly, city smokers -- your cheapest cigarettes will
 soar past $10 a pack today.
 The federal excise tax on every pack of cigarettes is now $1.01 -- up from
 39 cents -- pushing most packs of 20 toward the $11 mark in Manhattan.
 The 62-cent rise was part of the State Children's Health Insurance Plan law
 that was signed by President Obama on Feb. 4.
 The New York City price is the highest in the nation and more than twice
 the national average.
 And don't forget to add the retail mark-ups, which could drive the price of
 your favorite smokes even higher.
 The latest tax hike has left smokers fuming.
 Hakima Ougribe currently spends $10.95 on a pack of Marlboro Milds on the
 Upper West Side. She can now expect to pay well over $11 for a pack --
 that's more than 55 cents a smoke.
 "I've got 20 bucks in my pocket at the moment and I'm saving it for
 cigarettes," the pack-a-day smoker said.
 "I'm mostly angry at myself. They know they can cash in on smokers like me.
 "But I choose to smoke, they don't force me.
 "The most frustrating thing is it's going to cost me around 80 bucks a week
 now."
 
 So is it time to butt out?
 Restaurant owner Frank Rossi said he would give up his Newports as of
 today.
 "How does the government get away with it?" Rossi, a smoker of 15 years,
 said.
 "It's legalized drug dealing and they're cashing in.
 "That's it, I'm quitting. I'll start investing in Nicorette instead."
 Michael Southward, 24, of Hell's Kitchen said he could no longer afford to
 smoke.
 "I'm already paying over $10 a pack and that's already too much," he said.
 
 Chinatown electrician Keith Knight, 50, has smoked for more than 30 years.
 While he wasn't happy he'd be paying more, he said it's only fair
 cigarettes be taxed along with everything else.
 "I don't like it, but it's fair," Knight said. "It's my vice. It's my
 choice to smoke, so I'll have to wear it. It won't be slowing me down,
 though."
 
 The New York Health and Hospitals Corp. said the price rise would push the
 cost of cigarettes to more than $250 a month for pack-a-day smokers.
 Up to 20,000 New Yorkers are expected to quit after today's price rise.
 "Now is the time to quit," city Health Commissioner Dr. Thomas Frieden
 said.
 "Smoking is hurting your health and your wallet.
 "For many New Yorkers looking to save money during these tough times . . .
 You will feel better, your families will be safer and you will save
 thousands of dollars."
 
 2) The World Bank gives its take on the most efficacious means of reducing
 tobacco consumption. Cut and paste the URL address for full text, with
 weblinks, which is at
 http://web.worldbank.org/WBSITE/EXTERNAL/TOPICS/EXTHEALTHNUTRITIONANDPOPULATION/EXTPHAAG/0,,contentMDK:20799536~menuPK:64229773~pagePK:64229817~piPK:64229743~theSitePK:672263,00.html
 
 The Bank concludes that raising taxes on tobacco is one of the most
 effective ways to reduce tobacco consumption. Ministries of Finance will
 not be unhappy at seeing the resulting revenue increases, especially in
 cash strapped countries.
 
 In Nairobi, the cheapest unfiltered cigarettes cost 70 shillings per pack,
 or less than $1. It is remarkable that African governments, who are most in
 need of revenue, place such light taxes on a product which places burdens
 on their overworked hospitals.
 
 3) In a national case/control study from India,  Jha and colleagues
 conclude that about 1/20 of female deaths and 1/5 of male deaths
 among Indians aged 30 to 69 -- those in their economically productive years
 -- are attributable to tobacco. India may have the world's highest
 tobacco-related mortality, with an estimated 1 million deaths per year from
 tobacco-related diseases. Authors' summary follows.
 
 ABSTRACT
 Background The nationwide effects of smoking on mortality in India have not
 been assessed reliably.
 
 Methods In a nationally representative sample of 1.1 million homes, we
 compared the prevalence of smoking among 33,000 deceased women and 41,000
 deceased men (case subjects) with the prevalence of smoking among 35,000
 living women and 43,000 living men (unmatched control subjects). Mortality
 risk ratios comparing smokers with nonsmokers were adjusted for age,
 educational level, and use of alcohol.
 
 Results About 5% of female control subjects and 37% of male control
 subjects between the ages of 30 and 69 years were smokers. In this age
 group, smoking was associated with an increased risk of death from any
 medical cause among both women (risk ratio, 2.0; 99% confidence interval
 [CI], 1.8 to 2.3) and men (risk ratio, 1.7; 99% CI, 1.6 to 1.8). Daily
 smoking of even a small amount of tobacco was associated with increased
 mortality. Excess deaths among smokers, as compared with nonsmokers, were
 chiefly from tuberculosis among both women (risk ratio, 3.0; 99% CI, 2.4 to
 3.9) and men (risk ratio, 2.3; 99% CI, 2.1 to 2.6) and from respiratory,
 vascular, or neoplastic disease. Smoking was associated with a reduction in
 median survival of 8 years for women (99% CI, 5 to 11) and 6 years for men
 (99% CI, 5 to 7). If these associations are mainly causal, smoking in
 persons between the ages of 30 and 69 years is responsible for about 1 in
 20 deaths of women and 1 in 5 deaths of men. In 2010, smoking will 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.
 
 Conclusions Smoking causes a large and growing number of premature deaths
 in India.
 
 Full text is available at
 http://content.nejm.org/cgi/content/full/358/11/1137
 
 4) The tobacco companies, faced with declining sales in the industrialized
 world, are now targeting developing countries, especially potential youth
 customers. The Centers for Disease Control has,  at
 http://www.cdc.gov/tobacco/global/gyts/results.htm , a webpage on the
 Global Youth Tobacco Survey.
 
 
 5) Smoking declined among Panamanian youth between 2002 and 2008, at a time
 when Big Tobacco was intensifying its marketing efforts in LDCs and middle
 income countries. The whole story is at
 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5753a4.htm
 
 6) Writing in Tobacco Control, Lee and colleagues gauge the impact on
 government revenue and on smoking of raised excise taxes in Taiwan. For
 everyone except the manufacturers, raised taxes were a win/win proposition.
 Smoking declined, but revenue increased. Full text is at
 http://tobaccocontrol.bmj.com/cgi/content/short/14/suppl_1/i71


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