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• The effectiveness of display bans: the case of Iceland (PDF) 

Executive summary

In this brief report I summarise the findings of my empirical investigation of the expected impact of display bans on tobacco consumption.

Display bans are regulations that prohibit the visual display of tobacco products within the point of sale. They are the most restrictive of all point-of-sale regulations, which include limitations on height and visibility of displays, prohibition of self-service displays, and restrictions on logos, banners, and window posters.

Whether display bans have an impact on tobacco consumption is an empirical question.

Also, the likely magnitude of that impact can only be estimated using empirical techniques. This is why this paper considers the case of Iceland, the only country in Europe to have introduced display bans before 2009.

Iceland introduced display bans in August 2001.1 . . .

The results I have just described are robust. I re-estimated the regression model including additional control variables (in particular health expenditure and different measures for tobacco prices) and found that the results remained qualitatively unchanged. Similarly, I re-estimated the model using data for all European countries with publicly available smoking incidence data.9 This implied extending the set of benchmark countries. I continued to find that point of sale regulation had no statistically significant impact on Icelandic smoking prevalence.

In summary, my analysis of the data shows that certain tobacco control measures reduce smoking prevalence and clearly establishes the impact of tobacco prices on consumption. But the data does not support the claim that a display ban is likely to cause a reduction in smoking prevalence. To the extent that there is a relationship, it is very small and the evidence shows it may be purely due to random chance. My statistical analysis therefore confirms the conclusions suggested by a simple inspection of Figure 1 and Figure 2 above: there is no evidence that the display ban in Iceland caused a reduction in smoking prevalence. . . .

I have been asked by Philip Morris International (PMI) to analyse the expected impact of display bans on tobacco consumption. . . .

Conclusions

My empirical investigation of the impact of display bans on tobacco consumption in Iceland shows that the introduction of this regulatory measure had no statistically significant effect on smoking prevalence in that country. This is true for all age groups for which data was available. Therefore, I found no support for the claim that a display ban is likely to cause a reduction in smoking prevalence.

In contrast, tobacco price increases, driven mainly by increases in taxes, had a negative and statistically significant impact on smoking prevalence. Furthermore, other tobacco control measures, like bans on smoking in public areas and health warnings on cigarette packages were effective tobacco control measures, as they had a negative and statistically significant effect on smoking prevalence.

In other words, the experience in Iceland does not suggest that a display ban would reduce smoking prevalence, and instead shows that other measures may be more effective in controlling tobacco consumption.

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I found no support for the claim that a display ban is likely to cause a reduction in smoking prevalence. In contrast, tobacco price increases, driven mainly by increases in taxes, had a negative and statistically significant impact on smoking prevalence. Furthermore, other tobacco control measures, like bans on smoking in public areas and health warnings on cigarette packages were effective tobacco control measures, as they had a negative and statistically significant effect on smoking prevalence.
Display bans must be tremendously threatening to Philip Morris if its own report establishes taxes, warning labels and smoking bans as effective tobacco control measures. It seems PM would prefer ANYTHING but a display ban.

Massive decline in rates of coronary death in Iceland are largely attributed to risk factor reductions in the population 

Decline attributable to lower levels of cholesterol (36%), blood pressure (26%), and reduced smoking (20%). In the 25 years between 1981 and 2006 mortality rates from coronary heart disease (CHD) in Iceland decreased by a remarkable 80% in men and women aged between 25 and 74 years. How could such a huge decline be explained? Were the health services of Iceland so much better, or were its citizens reducing their risks?

To find out Dr Thor Aspelund and colleagues from the Icelandic Heart Association and the University of Iceland applied a validated CHD analysis model (the IMPACT mortality model) to official Icelandic death statistics, national quality registers, published trials and meta-analyses, clinical audits and a series of national population surveys.

Results of the study are presented at EuroPRevent 2009 and show that approximately three-quarters of the mortality decrease in Iceland was attributable to reductions in risk factors throughout the general population. These were principally (36%) in the reduction of cholesterol levels, smoking (20%) and systolic blood pressure (26%) and in the greater uptake of physical activity (5%).

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• Massive decline in rates of coronary death in Iceland are largely attributed to risk factor reductions in the population 

In the 25 years between 1981 and 2006 mortality rates from coronary heart disease (CHD) in Iceland decreased by a remarkable 80% in men and women aged between 25 and 74 years. How could such a huge decline be explained? Were the health services of Iceland so much better, or were its citizens reducing their risks?1

To find out Dr Thor Aspelund and colleagues from the Icelandic Heart Association and the University of Iceland applied a validated CHD analysis model (the IMPACT mortality model) to official Icelandic death statistics, national quality registers, published trials and meta-analyses, clinical audits and a series of national population surveys.2

Results of the study are presented at EuroPRevent 2009 and show that approximately three-quarters of the mortality decrease in Iceland was attributable to reductions in risk factors throughout the general population. These were principally (36%) in the reduction of cholesterol levels, smoking (20%) and systolic blood pressure (26%) and in the greater uptake of physical activity (5%).

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Indonesia's addiction to cigarettes 

The most frequently ignored phrase in Indonesia must surely be 'Dilarang Merokok' - No Smoking.

In restaurants, cinemas, hotels and shopping malls, No Smoking signs can often be spotted behind a haze of cigarette smoke.

Indonesians really love their durries - they smoke an estimated 220 billion of the things a year.

A staggering 63 per cent of Indonesia's men are smokers, and women and children are taking up the habit at a remarkable rate, according to anti-tobacco campaigners.

The average Indonesian household spends around 11 per cent of its income on cigarettes - that's second only to rice, and well ahead of fruit and vegetables, meat, education and housing. . . .

Indonesia has done pretty much nothing.

It is one of a handful of countries that refuse to sign up to the World Health Organisation's Framework Convention on Tobacco Control, which came into force in 2005. . . .

Meanwhile, at least 200,000 Indonesians are dying every year from smoking-related illnesses, anti-tobacco campaigners say.

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• A Smoking Gene: deCODE Shows How a Single Variant in the Sequence of the Genome Confers Nicotine Dependence and Risk of Lung Cancer and Other Disease 

Today scientists from deCODE genetics and their colleagues from several universities report in the journal Nature a clear link between a single-letter variant in the sequence of the human genome (SNP) and susceptibility to nicotine dependence. Moreover, in part because of this impact on smoking behavior, each copy of the risk variant of this SNP confers an approximately 30% increase in risk of lung cancer and a 20% increase in risk of peripheral arterial disease (PAD) . . .

The SNP, rs1051730, is located on chromosome 15q24 in a nicotine acetylcholine receptor called CHRNA3. The paper, 'A variant associated with nicotine dependence, lung cancer and peripheral arterial disease,' is published today in the online edition of Nature, at www.nature.com.

"These findings provide an example of the power of human genetics for shedding light on the most complex health challenges. . . .

The deCODE team began this study with a smoking history questionnaire distributed to some 50,000 Icelanders

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• Minister of Health against Smoking Room for MPs 

Minister of Health Gudlaugur Thór Thórdarsson said in light of the smoking ban in public places, which took effect in Iceland in June 2007, he believes the Althingi parliament should remove its special smoking facilities for MPs.

It is legal, with exceptions, for workplaces to establish smoking facilities for employees, but Thórdarson dislikes the idea of Iceland?TM)s parliament having such facilities because MP?TM)s should serve as role models for others, Fréttabladid reports.

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Respect Freedom, Respect the Smoking Ban 

Bar owners can whine about losing customers and having their rights deprived by the smoking ban as much as they like, but by not respecting my freedom as a non-smoker they have lost me as a customer. I will not set my foot inside any pub, bar or nightclub which permits smoking indoors until they decide to comply with the law. I urge everyone who respects the freedom of others to boycott these places too.

Apparently bar owners think the smoking ban is vague in terms of how to punish those who are in breach of it, but as it turns out, they can be deprived of their operating license. And if they don't come to their senses soon, I hope they will.

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• Reykjavík Bars Ignore Smoking Ban 

Some bar owners in Reykjavík have decided to ignore the smoking ban, which took effect last June, in protest of lack of facilities for smokers. Their actions are in breach of the law and as a result they may be deprived of their operating license.

Baldvin Skúlason, who operates the venues Barinn, Q-bar and Oliver in downtown Reykjavík, told ruv.is that bar owners are not equal in the face of the law and that he has requested a meeting with Minister of Health Gudlaugur Thór Thórdarson to discuss the matter.

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• Labor MK forms pro-smoking lobby in Knesset  

Labor MK Yoram Marciano wants the anti-smoking legislation that took effect last month to go up in smoke.

To that end, he recently formed a lobby in the legislature to push for the repeal of the anti-smoking laws.

The Knesset has lobbies of lawmakers who join forces on issues such as the environment, helping Gush Katif evacuees and bringing home the kidnapped IDF soldiers. But this is the first time a lobby has been formed to fight on behalf of smokers.

Marciano vigorously denied allegations from MKs that he had received campaign contributions or kickbacks from tobacco companies. He said allowing people to smoke in restaurants was a matter of human rights.

"Smoking is legal in this country and therefore it is a human right," Marciano said. "I call upon Israelis not to smoke and I admit that cigarettes are a bad thing that harm people's health. But we need to protect the rights of smokers. This isn't a Third World country."

Marciano, who quit smoking a few years ago but whose wife still smokes, was elected to a slot on the Labor candidates list representing poor neighborhoods, where smoking rates are much higher than the rest of the country.

He was investigated and cleared of charges earlier this year for his role in a pub fight. Now he wants to fight on behalf of pub owners, who have complained that their profits have gone down by as much as 20 percent since the law took effect.

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• Iceland introduces smoking ban in bars and restaurants  

Iceland on Friday introduced a total ban on smoking in public places amid protests from bar and restaurant owners who feel the prohibition is too severe and poorly executed.

"The authorities didn't give us any opportunities to create a smoking area outside bars and restaurants so most people have to resort to smoking on the pavement," Arnar Thor Gislason, owner of a popular Reykjavik bar and restaurant, told AFP.

Due to everchanging Icelandic weather conditions and a fairly chilly climate even in summer, many bar owners have set up gas heaters on pavements and some restaurants will be lending blankets to customers.

Most venues have increased their staff of doormen and bouncers because of the expected increase in the number of guests going in and out to smoke.

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• Bollywood face fear of 'A' 

For adults only — sex, excess violence and now smoking. Filmmakers might end up with 'A' certificates for their movies if the big bad villain chews a cigar or the macho hero lights a fag on screen.

The I&B Ministry has apparently agreed to the Health Ministry's suggestion that a movie with smoking scenes be certified 'for adults only'—that is, only viewers above 18 can watch it, at least in cinemas.

So if stars like Shah Rukh Khan don't want to lose fans under 18, they may have to shun smoking on screen. The clause is not be restricted to Indian movies alone. Spider-Man 3 will also be off-limits for children if the proposal becomes law. Sources said the decision was based on a 2003 WHO study —'Bollywood: Victim or Ally' —which spoke about the influence of smoking in movies on younger audience.

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• Tobacco no Longer Frozen out in Iceland  

Tobacco products may once again be displayed in certain tobacco stores in Iceland so as to be visible to smokers, following a Supreme Court ruling reported recently by the country's Public Health Institute.

It has been illegal to display tobacco products and tobacco trademarks since 2001, but the law was recently challenged by tobacco groups.

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• One fifth of Icelandic adults smoke 

According to a recent Gallup survey, 19.2% of Icelanders from the age of 15 - 89 smoke on a daily basis, reports Morgunbladid. Female smokers (19.2%) have increased since 2004 when 18.6% of Icelandic females smoked. The figure of male smokers decreased from 21.1% last year to 19.3% in 2005.

Smoking has decreased in the countryside with figures now similar as in ReykjavÃfÂ-k. Last year, 22% of adults in the countryside smoked.

Morgunbladid reports that education makes a big difference in the ratio of smokers

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'How can they ban smoking in buses?' 

To ensure cleaner air in the city, the administration has endorsed a bylaw which criminalizes smoking in enclosed public places and encourages building operators, restaurants, hotels and malls to pay more attention to the needs of non-smokers. The Jakarta Post asked some people for their opinions on the issue.

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Study finds genetic link to lung cancer 

Lung cancer appears to run in families, researchers said Tuesday, though exposure to tobacco smoke is still the dominant cause of the disease even for those who may be genetically predisposed.

The strongest family link was found in the relatives of patients who developed the disease at age 60 or younger. The parents of such people had nearly a three-and-a-half times higher risk of also developing the disease compared to the general population, the study said.

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