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• Tomorrow’s regular customers? Stamping out tobacco use in the Middle East and Africa (PDF) 

Tomorrow’s regular customers? Stamping out tobacco use in the Middle East and Africa is a research paper written by the Economist Intelligence Unit and sponsored by Pfizer. . . .

The findings are based on more than 40 interviews with experts from government, academia, NGOs and the tobacco industry in the Middle East, Africa and elsewhere. We would like to thank the Economist Intelligence Unit’s extensive network of country analysts for organising and conducting most of these interviews. . . .

This report focuses on one portion of the developing world—the Middle East and Africa (MEA)— which has become a key battleground in the struggle over government policy and public attitudes.

Although the region can lay claim to adult smoking rates mostly on par or lower than those of many Western and developing nations, expanding populations mean that even if rates were to stay relatively steady, the absolute numbers of smokers would still rise.

The MEA region also poses other deeply entrenched challenges. These include rising youth smoking rates, particularly among girls, a prevailing culture of acceptance around tobacco, especially the water pipe, widespread governmental ambivalence and a strong tobacco industry lobby. But charities and other non-governmental organisations (NGOs) have gained a foothold in recent years. They often work on a shoestring, but are increasingly supported with much-needed financial lifelines from rich Western philanthropists.

“There is a change in mentality in our region. Ministries of health are working with the WHO and other NGOs—bringing together all the people working on tobacco control,” says Dr Jean-Pierre Baptiste, a regional adviser with the WHO’s Tobacco Free Initiative in Algeria. He is one of more than 40 experts from government, academia, NGOs and the tobacco industry interviewed for this report.

But are their efforts enough? In this paper, we investigate the progress that has been made, the challenges that remain, what lessons can be drawn from successful policies elsewhere and how the landscape could look in a decade or two. We examine ten major markets in-depth—four in North Africa: Egypt, Algeria, Morocco and Tunisia; two in Sub-Saharan Africa: Nigeria and South Africa; and four in the Middle East: Lebanon, Jordan, Saudi Arabia and the United Arab Emirates (UAE). The key findings of the report are highlighted below.

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Contribution of smoking during pregnancy to inequalities in stillbirth and infant death in Scotland 1994-2003: retrospective population based study using hospital maternity records (Full Text) 

WHAT IS ALREADY KNOWN ON THIS TOPIC

Rates of both stillbirth and infant death show social gradients within developed countries Smoking during pregnancy has been clearly linked to stillbirth and infant deaths Quantifying the contribution that smoking during pregnancy has on the social inequalities gap in stillbirths and infant deaths is of interest

WHAT THIS STUDY ADDS

Social gradients existed in the stillbirth and infant death rates in Scotland during 1994-2003 Smoking during pregnancy accounted for 38% of the inequality in stillbirths and 31% of the inequality in infant deaths

In addition to tackling smoking during pregnancy and reducing infants’ exposure to tobacco smoke, other measures are needed to reduce social inequalities in these outcomes

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Contribution of smoking during pregnancy to inequalities in stillbirth and infant death in Scotland 1994-2003: retrospective population based study using hospital maternity records 

Conclusions Both tackling smoking during pregnancy and reducing infants' exposure to tobacco smoke in the postnatal environment may help to reduce stillbirths and infant deaths overall and to reduce the socioeconomic inequalities in stillbirths and infant deaths perhaps by as much as 30-40%. However, action on smoking on its own is unlikely to be sufficient and other measures to improve the social circumstances, social support, and health of mothers and infants are needed.

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• Stillbirths And Infant Deaths Related To Smoking During Pregnancy And Socioeconomic Inequalities 

New research published on bmj.com today reports that addressing the problem of smoking during pregnancy may help to reduce the socioeconomic inequalities in stillbirths and infant deaths by as much as 30 to 40 percent.

Without a doubt smoking during pregnancy has been associated with stillbirth. In addition, infant deaths and smoking rates during pregnancy vary strikingly with socioeconomic position. In order to find out more, a team of researchers began the task of measuring the effects of smoking during pregnancy and on the social inequalities gap in stillbirths and infant deaths.

They assessed the records of 529,317 live singleton births and 2,699 stillbirths delivered at 24 to 44 weeks' gestation in Scotland from 1994 to 2003.

Information on smoking during the pregnancy was gathered. A deprivation score was designated using postcode data from the 2001 population census.

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• Jobless found more likely to smoke  

A new federal report on tobacco use shows that unemployed people are more likely than workers to smoke.

Among those respondents who are working, the report says that people in the food service industry have the highest rate of smoking compared with other industries.

The report follows the June enactment of the Family Smoking and Prevention Tobacco Control Act, which authorizes the Food and Drug Administration to regulate tobacco.

The Substance Abuse and Mental Health Services Administration (SAMHSA) released a survey that shows 28.4 percent of workers ages 18 to 64 had smoked in the previous month. Among the unemployed, the rate was 45.4 percent.

The survey also asked respondents to list their occupation. The highest rate of smoking was in the food service and preparation industry, with a 44.7 percent smoking rate.

The next highest industry, with a rate of 42.9 percent, was construction.

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Anti-smoking info campaign targets minorities  

A statewide anti-smoking campaign aimed at minorities and those in poverty that highlights the dangers of second-hand smoke has begun.

Dubbed "Everybody Smokes When Anybody Smokes," the campaign will use radio, bus and billboard advertisements to get the message across. And local anti-smoking advocates say they hope it will bolster their ongoing efforts to reach into minority communities to underscore the dangers of smoking.

"There are definitely certain groups that are impacted in different ways," said Mandy Myszka, public health educator for the Marathon County Health Department. "For instance, the lower socio-economic population, the tobacco companies really target them specifically. They can offer them free tobacco products to get them started, for instance."

The state campaign -- promoted by the Wisconsin Tobacco Prevention and Control Program, a coalition of community anti-smoking activists and the state Department of Health Services -- will use minority spokespeople to help make the connection with minority groups. For example, Blia Lor, a Hmong woman from Milwaukee, will be featured on billboards.

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• EDITORIAL: Unhealthy business 

Once again the profit motive may trump the government in its efforts to improve the general health of the nation. The government had announced the introduction of pictorial health warnings on cigarette packs and had given the industry a six-month deadline to print them as from January 1st 2010; thus joining 30 other countries having similar warnings. . . .

It is reported that a series of meetings between industry representatives and senior officials of the health department has been held in an effort to slow down the implementation of the requirement for pictorial warnings on packets. . . .

We are a desperately unhealthy nation with a poor spread of primary healthcare services; and an even poorer spread of specialist oncology units. The causal linkage between smoking, cancers, and respiratory illness is well known. Our implementation of anti-smoking legislation has been patchy at best and as the tobacco producers are on the retreat in the developed world; they are increasingly focused on the undeveloped and developing world to extend their market footprint. We hope that the government will hold the line and not cave in to assorted pressures. This is sensible governance and clearly to the ultimate benefit of the entire population. Smoking kills - pictorial warnings on packets may lead to fewer of us dying of tobacco-related disease; and we have scant sympathy for the tobacco lobby.

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NOTHDURFT: Top Ten Reasons Not to Raise Tobacco Taxes 

Smokers have become a favorite target of many legislators across the country. Some policymakers seem to think taxing smokers is a win-win way to curb smoking and raise revenue, without hurting the economy. . . .

The hypocrisy surrounding tobacco taxes doesn't end there. Moreover, they are not the boon many people believe them to be, for the following 10 reasons.

1. They are regressive . . .

The use of targeted tax increases serves only to push sound fiscal policies and real budget reforms to the public policy back burner. Legislators concerned with the public health effects of tobacco should encourage the use of readily available smoking cessation products and services, instead of supporting bad tax policy. . . .

Top Quality E Cigarettes For Every Budget 

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Now, aspiring smokers and current e cigarette users can find the best products in the vaping industry on a new website that features the top quality brands at affordable prices. E Cigarettes Depot offers a full line of e cigarette kits, disposables, refill cartridges, e liquid, and more from the top names in the industry: SS Choice No. 7, Gamucci, NJOY, and Smoking Everywhere.

In fact, E Cigarettes Depot offers a very inexpensive disposable e cigarette for those who are unsure

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• Tobacco Use Worsens Malnutrition in Developing Countries 

But some economists find there's an fiscal risk as well. In many poor countries, in order to light up, smokers spend a significant amount of money to pay for cigarettes.

Economist Steven Block learned this by examining data from Indonesia about the household expenses of smokers. He says it turns out that tobacco is a surprisingly large expenditure in those households where there is a smoker.

"The percentage of men in Indonesia that smokes is over 60 percent," Block says. "A substantial number of households has one smoker, and it turns out that even among very poor households in rural central Java... when there is a smoker in the household, they spent approximately 10 percent of their household budget on tobacco products."

Block used data collected by the not-for-profit Helen Keller International a group that gathers information about household consumption patterns around the world every few months.

Block says the data show the relatively high percentage of money spent on tobacco held true in the poorest families where food budgets take up between 60 to 70 percent of total income. . . .

What's more, Block says, the data was able to show that having a smoker in the family resulted in the children having physical changes.

"Because these tobacco expenditures are displacing food expenditures we can document that the children are slightly shorter on average in those households," Block says.

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• Tobacco Takes Toll on Environment 

A group of anti-cancer organizations have compiled information and data about smoking and its effects into a new online resource — the Tobacco Atlas.

Doctor Thomas Glynn heads the international cancer control section at the American Cancer Society. He says they compiled the Atlas because they wanted to present information about the health effects of tobacco in a new way… and get the word out to the billion men and about 250 million women around the world who light up every day.

"There is no one who smokes for very long who is not going to become sickened by it in one way or another, either from a lung disease such as chronic bronchitis or emphysema, or from a cancer, or from heart disease," Glynn says.

"There is virtually no one who is immune from becoming sick from it. We also know that as many as half of people who use tobacco over a lifetime will die because from their tobacco use."

The Tobacco Atlas is available both online and as a book. . . .

"As an example, in China, about 4… 5… 6 percent of women across China are using tobacco," he says.

"But yet in places like Shanghai where tobacco companies are focusing we are starting to see figures like 20 or 25 percent."

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Report addresses cigarette tax issue 

A new report is casting doubt on whether a higher cigarette tax would be a good idea in Utah.

The report from the Utah Tax Review Commission was released Thursday. It acknowledges raising the cigarette tax from 69.5 cents per pack to $2 could add an additional $50 million to the state budget. But the commission's report says the tax targets a narrow base of taxpayers, it's regressive in nature and squeezes money from people with an addiction.

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Smoking tax burns hole in wallets 

Governor Jodi Rell didn't sign the budget that passed in the General Assembly last week. But, it still became law today. And part of that budget increased taxes on cigarettes.

Democrats and Republicans alike jumped on the cigarette tax as a way to balance the budget in a cash-strapped year. The habit will bring in $500,000 to our state coffers.

But it will cost one-billion dollars in health-related costs. So some say we're being penny-wise and pound-foolish. And smokers, well, they're just fed-up with being a target.

"It's gonna cost me a lot of money, I won't pay it," said Leah Charney of Milford.

Charney is a woman on a mission.

She's buying tobacco, rolling papers and a machine. She plans to roll her own from here on out; an act of defiance against yet another tax increase on cigarettes.

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• Tobacco sales down in wake of new tax 

Cigarette sales have plunged, and smokers have been streaming across the border since Florida's $1-a-pack tax went into effect July 1.

The latest figures from the Department of Business and Professional Regulation show a 28-percent drop in the sale of cigarette packs from July 2008 to July 2009 — 76.8 million packs sold this year compared to 106.6 million packs a year ago.

Sales are also down from June, the month before the buck-a-pack increase was added, 17 percent less in July than June, when 92.9 million packs were sold.

The state's convenience stores, where most cigarettes are sold, and where tobacco makes up 34 percent of non-gasoline sales, are already feeling the sting, said Jim Smith, head of the Florida Petroleum Marketers and Convenience Store Association.

Some owners are working longer hours behind the counter and cutting employee hours to make ends meet, Smith said. Layoffs are inevitable, he said.

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• Adult Smoking Drops Again, Saving Lives and $2.8 Billion in Future Health Care Costs 

Washington's adult smoking rate has hit a new low for the sixth consecutive year. Results from the state's most recent survey show the smoking rate has dropped to 15.3 percent -- down from 16.5 percent the previous year. Washington has the sixth lowest smoking rate in the nation and remains well below the national rate of 18.4 percent.

"Tobacco prevention and control is a priority in our state, and it's paying off. Fewer people who smoke means fewer people suffering or dying from tobacco-related diseases. It also means our state will save billions of dollars in future health care costs," said Governor Chris Gregoire. "We must continue to look for ways to reach people who are addicted to this deadly habit, and keep kids from ever starting so they'll live longer, healthier lives."

The adult smoking rate in Washington has dropped more than 30 percent since the state began its Tobacco Prevention and Control Program in 2000. There are now 295,000 fewer people smoking in the state and an estimated 98,000 people will be spared early, tobacco-related deaths. The decline in smoking will save an estimated $2.8 billion in future health care costs. The state has reached its 10-year goal of reducing the adult smoking rate to 16.5 percent or less by 2010. With that the Department of Health has established a new goal of reducing adult smoking to 14 percent or less by 2013.

The department is refocusing efforts to help groups still smoking at higher rates. There are 770,000 adults who smoke in Washington; the majority are from either lower income or lower educational backgrounds. The smoking rate for people with low income is 31 percent; that's more than three times as high as the 10 percent smoking rate for people with higher income.

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