Tobacco.org

Emergency department-initiated tobacco control: a randomised controlled trial in an inner-city university hospital  

Objectives: Emergency department (ED) patients show high smoking rates. We investigated the effects of ED-initiated tobacco control (ETC) on the 7-days abstinence at 12 months.

Methods: Randomised-controlled intention-to-treat trial (Trials Registry no.: ISRCTN41527831) in 1,044 patients in an urban ED. ETC consisted of on-site counselling plus up to 4 telephone booster sessions. Controls received usual care. Analysis was by logistic regression. . . .

Conclusions: ETC, in the form of on-site counselling with up to 4 telephone booster sessions, showed no overall effect on tobacco abstinence after 12 month. A non-significant trend for a better performance of ETC in more motivated smokers was observed.

WHAT THIS PAPER ADDS:

Although there is evidence that the smoking prevalence of emergency department patients exceeds the smoking prevalence in the population and a joint statement of US Emergency Medicine Organizations encourages administrators to implement tobacco control services, the effectiveness of such services is still unclear.

In a randomised controlled trial in more than 1000 emergency department patients with a median smoking intensity of 15 cigarettes per day, emergency department-initiated tobacco control (ETC) showed a non-significant overall effect on 7-days-abstinence at 12 month. Unmotivated smokers do not seem to profit from ETC while, in ambivalent and motivated smokers, a non-significant clinical effect of ETC was observed.

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Images plus text work best to put people off smoking  

Health warnings on cigarette packs that combine strong pictures with written warnings are most effective in motivating smokers to quit smoking and deterring those who have never smoked or who have quit. The warnings should cover at least half of the packet and be part of a mass media campaign.

This is the conclusion of a report from the German World Health Organization tobacco control centre in Heidelberg, which presents the results of 20 international studies as evidence for combined warnings.

Unlike 30 countries worldwide, among which in Europe are the United Kingdom, Switzerland, Romania, Latvia, and Belgium, Germany has not yet introduced combined warnings; there cigarette packs just carry mandatory text warnings about the health risks of smoking.

However, Sabine Bätzing, the German commissioner on drug misuse, announced in an interview with the German newspaper Die Welt on 31 May that combined warnings will be introduced next year when examples of combined warnings from the European Union have been tested.

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Iron will and good health key to giving up cigarettes 

reports the German Centre for Addiction Questions, one in every four German adults continues to smoke. Quitting is easier said than done. The problems are often underestimated, says Rainer Mathias Dunkel, a doctor of psychosomatic medicine and psychotherapy in Wiesbaden. The danger of relapse is very high.

Men aged 35 to 45 are the most likely to smoke. In general, people have their first puff at age 13. But the number of young smokers is on the decline.

"In 2001, about a third of all 12 to 17-year-olds smoked. In 2008, it was 15 per cent," says Marita Volker-Albert of the German Federal Centre for Health Questions in Cologne.

Weaning people off nicotine has shown some promise in patients who suffer greatly from breathing problems, lung infections or recurrent illness.

It's best to try to find some help when on the path to becoming a non-smoker. There are numerous books on the topic, along with self- help groups and telephone hotlines.

The internet is another good place to go

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Images plus text work best to put people off smoking 

Health warnings on cigarette packs that combine strong pictures with written warnings are most effective in motivating smokers to quit smoking and deterring those who have never smoked or who have quit. The warnings should cover at least half of the packet and be part of a mass media campaign.

This is the conclusion of a report from the German World Health Organization tobacco control centre in Heidelberg, which presents the results of 20 international studies as evidence for combined warnings.

Unlike 30 countries worldwide, among which in Europe are the United Kingdom, Switzerland, Romania, Latvia, and Belgium, Germany has not yet introduced combined warnings; there cigarette packs just carry mandatory text warnings about the health risks of smoking.

However, Sabine Bätzing, the German commissioner on drug misuse, announced in an interview with the German newspaper Die Welt on 31 May that combined warnings will be introduced next year when examples of combined warnings from the European Union have been tested. The pictures show, for instance, large tumours or an embryo but are less severe than images used in other countries such as Canada. . . .

The report is at www.tabakkontrolle.de/pdf/Band_10_Kombinierte_Warnhinweise_2009.pdf.

See www.tabakkontrolle.de/pdf/Methodische_Anmerkungen_Warnhinweise_Bd10.pdf for details of the studies.

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• Implementation of electronic locking devices for adolescents at German tobacco vending machines: Intended and unintended changes of supply and demand 

Background: Starting on 01.01.2007, electronic locking devices based on proof-of-age (via electronic cash cards or a European driving licence) were installed in approximately 500,000 vending machines across Germany to restrict the purchase of cigarettes to those over the age of 16. . . .

Results: Between 2005 and 2007 the total number of tobacco sources decreased from 315 to 277 within the study area. Although the most obvious reduction was detected in the number of outdoor vending machines (-48%), the number of indoor vending machines also decreased by 8%. Adolescents changed from vending machines to other sources for cigarettes, particularly kiosks or friends (+ 31%-points usage rate, p<0.001; +35%-points usage rate, p<0.001, respectively).

Conclusions: Although the number of tobacco vending machines decreased, this has not had a significant impact on cigarette acquisition by underage smokers as they were able to circumvent this new security measure in several different ways.

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Environmental tobacco smoke and cardiometabolic risk in young children: results from a survey in south-west Germany 

Conclusion: Among children, ETS exposure was associated with a low-grade inflammatory response and altered markers of lipid metabolism, which may initiate atherosclerosis in early life. However, longitudinal studies are necessary to determine the potential causal relevance of these associations.

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Childhood smoke exposure could initiate atherosclerosis early on in life 

Children exposed to cigarette smoke have a low-grade inflammatory response and altered markers of lipid metabolism that may initiate atherosclerosis early on in life, a German study suggests.

Environmental tobacco exposure was associated with unfavourable levels of several cardiometabolic biomarkers in 10-year-olds, which the researchers say suggests an adverse effect on the vascular wall very early in life.

They add: “Most importantly from a public health perspective, avoidance of environmental tobacco smoke exposure during childhood may reduce risk for cardiometabolic diseases in later life.”

Gabriele Nagel (Ulm University) and colleagues studied 383 children in Baden-Wuerttemberg, of whom 127 (33.2%) were exposed to smoking according to the answers of a parental questionnaire.

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Audrey Hepburn Stamp Fetches Euro67, 000 in Germany  

A rare stamp portraying movie star Audrey Hepburn smoking sold for euro67,000 ($93,800) at an auction in Germany on Tuesday.

The Schlegel auction house declined to identify the buyer, who was represented by an agent.

A minimum bid of euro30,000 was set for the stamp, of which only five copies are known to exist. . . .

The print run was destroyed after Hepburn's son, Sean Ferrer, objected to the cigarette holder dangling from the actress' mouth and refused to grant copyright.

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• BAT trials ‘less toxic’ cigarettes  

British American Tobacco has revealed it is testing a new “less toxic” tobacco.

The cigarette manufacturer, which owns brands such as Lucky Strike, Kent and Pall Mall, has made three prototype products for the £6m analysis.

The 22-week trial will be carried out in Germany on 250 volunteers by an independent research organisation.

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COLEMAN: Down with public smoking! 

Before coming to Hamburg, I worked for two years in Bratislava where there was no such smoking ban. So it was a great relief to arrive in Germany and find that I could enjoy a restaurant meal without fear that my food might actually taste like cigarette butts.

In Hamburg, Berlin or any other city, we can easily predict what the great majority of bar/restaurant owners would decide, if given a choice, about smoking in their establishments. If they allowed smoking, they would earn more money not only from smokers frequenting their establishments but also from sales of cigarettes to those customers. The result of the vote can be predicted based on pure self-interest. . . .

So wake up, Germany! Let’s join the 21st century. The referendum we need is NOT one to “protect” the rights of nicotine addicts to smoke regardless of hazards to non-smokers. What we really need is a government-supported, organized effort to gather signatures on a petition to ban all public smoking. That’s right: If the nicotine addict chooses to smoke, let him/her do so inside the home, with windows closed to protect non-addicted neighbors. I seriously propose that anyone caught smoking anywhere in public should be arrested and fined for a first offense, should spend a night in jail for a second offense, and should serve a weekend in jail -- plus pay a fine -- for any offense thereafter. This would afford residents and tourists alike much greater “enjoyment of life” in the cities of Germany -- with its beautiful trees, canals, ports, and architecture -- but without the carpet of butts and the general stench of cigarettes that currently blight this wonderful country.

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JACKSON: Steppin' out for a smoke 

Having lived in Berlin for the better part of three years, I've been asked to write something about my 'right' to smoke here. But I'm not sure I have one. The real question, I think, is: who has the right to forbid me to smoke, and on what grounds? Consider the following:

(1) Tobacco is legal in Germany. (2) Smokers are adults. (3) Smokers contribute enormous amounts of tax revenue. . . .

In the case of 'second-hand' smoke, though, anyone who really looks at the evidence - how the studies are done, who pays for them, what the statistics really mean - is soon reminded of the old story of The Emperor's New Clothes. . . .

How do they know? Well, they don't. They have just cherry-picked a few dubious statistics from a few trashy studies, and done computer projections from them. They can't actually prove even one death. . . .

People need to look beyond their personal prejudices and wake up. The phenomenal recent success of the anti-smoking movement is evidence not of the ascendancy of a noble cause, but of phenomenal infusions of cash. Hundreds of millions of dollars have been extorted out of the US tobacco industry in behind-the-scenes deals like the Master Settlement Agreement. Add to that punitive taxation and especially, the enthusiastic support of the pharmaceutical industry - which wants to sell nicotine products and antidepressants to the world's 1.2 billion smokers. This is how a fairly small network of prohibitionist fanatics grows into a juggernaut which simply intimidates any opposition into silence.

Anti-tobacco in Europe is driven to a large extent by the World Health Organisation - in an explicit partnership with three of the world's biggest drug companies.

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• BAT puts 'less toxic' tobacco to the test 

British American Tobacco is recruiting 250 volunteers in Germany to test experimental cigarettes designed to produce less toxic smoke than conventional products. . . .

BAT has made three "prototype combustible products" for the German trial. They incorporate tobacco that has been processed in several ways to generate fewer "toxicants" as it burns, including treatment with enzymes similar to those in biological washing powders. The prototypes also have new filters, with activated charcoal and resins to absorb harmful chemicals.

Momentum Pharma Services, a contract research organisation that normally works for drug companies, is carrying out the �6m analysis. It has been registered on an independent clinical trials database - a first for BAT - and results will be published in a scientific journal next year.

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German Cigarette Trade Influenced by Strong Competition 

Competition within the European Union 27 among cigarette exporters intensified in the last several years. Greater exports from France and Poland to customers in other EU contributed to a slowdown for German cigarette exports to Europe. The days of dramatic growth for German cigarette exports to European countries may be over. After scoring spectacular growth of cigarette exports to Eastern Europe from 2003 through 2005, it now appears that German cigarette exports to Europe may decline slightly in 2009. Competition from other EU countries has gained momentum. Exports of cigarettes from Poland and France made astonishing gains in 2008. Poland has already surpassed the UK as a cigarette exporter, and may eventually have exports in the range shown for the United States.

Germany was the leading world exporter of cigarettes in 2007 with shipments of 159.2 bn pieces, valued at $3.478 bn. The average price for German cigarette exports rose from 39 cents per pack of 20 in 2006 to 43.7 cents per pack in 2007. After rising by 46% between 2003 and 2006, the pace of growth for German cigarette exports slowed down to a 3.2% rise for 2007 over 2006. More competition from other exporting countries within the EU has made further expansion of German cigarette exports more difficult. The high value of the euro in comparison to the US dollar and some other currencies tended to make German cigarettes more costly to buyers in some countries, while the change had little impact on shipments to 14 other EU countries using the euro as their official currency.

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Germans losing thirst for beer 

German breweries sold less beer than ever in the first quarter of 2009 as the recession and a smoking ban in bars took its toll, according to figures released Thursday. The Federal Statistics Office said sales of the amber liquid were down 6.8 per cent . . .

A smoking ban introduced in most pubs and restaurants last year has been hitting sales, as is the economic slowdown, which has seen tens of thousands of workers put on reduced hours at less pay.

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Nashville firm launches electric cigarette  

Makers of a smokeless cigarette will be launching their product in Germany.

Nashville-based Smokefree Innotec Inc. has entered into an agreement with Ubema GmbH for the German marketing of Rauchless, the world's first smokeless "electric cigarette."

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