The National Health and Medical Research Council (NHMRC) has finally released their report, the 'Health Effects of Passive Smoking'. The current document has no policy recommendations, and has been delayed from a draft report of November 1995 by Federal Court action by Philip Morris. The NHMRC had decided to consider only per reviewed literature on passive smoking and the tobacco industry protested that this was not fulfilling its charter to review all the evidence.

The NHMRC had produced a report on Passive Smoking in 1987. The reason for this review was the 1992 figure of 19,000 deaths annually in Australia from active smoking and the need to re-evaluate the risks of passive smoking or Environmental Tobacco Smoke (ETS).

The report noted that passive smoking is common as nearly 30% of the adult population smoke and many people are still exposed to smoke in their workplaces. Surveys of bars in the US have found tobacco smoke levels that are, on average, 4.5 times greater than those measured in homes of smokers. While ETS is less than 5% of the fine particular matter emitted from coal-fired power stations, it has been estimated that a 1.3% reduction in ETS would be equivalent (in terms of exposure to particulates) to eliminating emissions from all the coal-fired power plants in the US.

The report noted that the new evidence in the 1992 report from the United States Environmental Protection Agency and led the EPA to classify ETS as a known ('Group A') human carcinogen.

The terms of reference given to the Working Party were:
to review the relevant scientific evidence linking passive smoking to disease in adults and children;
to estimate the extent and impact of any illness found likely to be due to passive smoking in Australia; and
to make recommendations to reduce any illness found likely to be due to passive smoking in Australia.

It was noted that over 400 studies had been published and a significant number of these reported no association between passive smoking and ill health. But the report states 'In general, the Review Panel took a conservative approach... This means that the conclusions reached in the information paper are more likely to underestimate the number of cases of illness attributable to passive smoking than to overestimate them'.

So although there is no recommendations for action, the conclusions demand more action than governments have yet had the power to enact. In fact the Industry has had a field day in the absence of this report, with weak legislation in South Australia, delays and exemptions based on air conditioning in the ACT, delaying, pre- emptive legislation in NSW and no action elsewhere.

The full text is at: http://www.health.gov.au/nhmrc

Its conclusion is: 'The scientific evidence shows that passive smoking causes lower respiratory illness in children and lung cancer in adults and contributes to the symptoms of asthma in children. Passive smoking may also cause coronary heart disease in adults. It is estimated that passive smoking contributes to the symptoms of asthma in 46,500 Australian children each year and causes lower respiratory illness in 16,300 Australian children. It also causes about 12 new cases of lung cancer each year in adult Australians. Passive smoking may also cause 77 deaths a year from coronary heart disease'.

Action Point 1 Write to the Health Minister in your State and demand legislative action for smoke-free indoor air, not based on air-conditioning. In NSW, SA and ACT that have legislation ask that the legislation be tightened.

Prof Simon Chapman has been awarded a 1997 World Health Organisation medal for tobacco control. He is an editor of the journal 'Tobacco Control', and is a long time tobacco activist.

Some Vending Machines, Shop Ads Still OK in NSW

On 27 November the NSW Tobacco Advertising Prohibition Act was tightened up to stop use of large display cases in the street and having ads visible from the street. But amendments to ban vending machines and remove tobacco products from view were defeated by a combined vote of the Labor and Liberal parties, despite the fact that a WA study has shown that children can buy from vending machines easily.

MEDICAL

New Carcinogen Found in Passive Smokers
Dr. Stephen Hecht of the University of Minnesota Cancer Center recently discovered a new link between second-hand smoke and lung cancer in non-smokers. He found traces of a powerful tobacco carcinogen called NNK in the urine of non-smoking staff members who work in a residential section of a Canadian veterans hospital where smoking is permitted. Of the 43 known carcinogens in tobacco smoke, NNK is the only carcinogen that originates just from tobacco and can be attributed to no other source. Minneapolis Star Tribune 9/10/97.

A study from the University of Pennsylvania has found that low-level exposure to carbon monoxide, such as automobile emissions and cigarette smoke, can cause long-term, permanent damage. The research shows how carbon monoxide exposure increases levels of nitric oxide in blood. The nitric oxide manufactures oxidants and "free radicals", which are known stimulants of tissue damage and ageing. Stephen Thom, senior author of the study, suggests quitting and avoiding second-hand smoke as much as possible. Pittsburgh Post Gazette 4/11/97.

Children
A new report from the British Government indicates that parental smoking is the most significant cause of cot death. The report is in the Lancet, October 1997.

New studies of smoking in children have shown that:

The major source of children's ETS exposure is in the home.
A third to a half of current adult cigarette smokers have children living in the home.
70% of smoking adults allow smoking in some or all of the home.
Costs of complicated births due to smoking are nearly twice as high as costs for non-smokers.
Smoking during pregnancy is associated with an estimated 32,000 to 61,000 low birthweight infants and 14,000 to 26,000 admissions to neonatal intensive care units each year in the US.
Estimated medical costs for those with smoking-caused complicated births accounted for 11% of total costs of all complicated births and were $US1.4 billion in 1995. Morbidity and Mortality Weekly Report, 7/11 (http://www.cdc.gov)
More than 40% of stomach and oesophageal cancer cases could have been caused by smoking, according to the Journal of the National Cancer Institute in the US.
One in 8 hip fractures in women is attributable to smoking according to the British Medical Journal of 4 October.

No Gambling on Health Issues
Carlo Giacometti, a croupier at the Sydney Casino who complained of being affected by tobacco smoke at work settled for an undisclosed sum.

Reasons to Quit

Heavy smokers have a craving for carbohydrates, making them more inclined to be overweight than non-smokers, Professor Rudolf Schoberger has claimed in a presentation to the European Respiratory Society congress in Berlin. Daily Tele, 7/10/97

Heavy smokers can expect to lose two teeth every 10 years, and smokers are twice as likely to lose their teeth as non-smokers, according to two 30 year old studies by the US Academy of General Dentistry and reported in Nursing Review. They suggest smoking a pack a day can lead to periodontal disease. Herald Sun 10/10/97

Smokers Cost Society Less, Study Says
A controversial Dutch study published predicts that health care costs would rise if everyone stopped smoking, because smokers don't live as long as non-smokers. New Eng. J. of Med. 10/10/97. (This is what the tobacco industry has been saying to governments in its confidential submissions for years. Ed.)

SURVEYS
Smoking in Cars: A 1994 survey in NSW asked 1,461 people "Do you think it should be illegal to smoke in cars when travelling with children?" 72% agreed, 27% disagreed and 1% were undecided. More women (75.6%) than men (69.4%) agreed including 63% of current smokers. BMJ 1995;311:1164

Homes: More than half of Americans are asking their guests not to smoke in their homes, according to a survey conducted for the USA Today newspaper and CNN TV. 63% of the 1006 adults polled have asked visitors not to smoke. Straits Times 2/10/97

Schoolgirls: A third of all Queensland Year 12 girls were regular smokers, according to a survey by the Qld Cancer Fund. The survey found smoking among Year 12 girls had increased 9% since 1993. Courier Mail 25/9/97

SMOKE-FREE AIR

WA Labour Relations Minister, Graham Kierath has vowed to prosecute publicans who allow smoking in hotels after August 1 next year, despite doubts over his power to do so. He said publicans should be making preparations for the smoking ban. West Australian 22/10

In Victoria health groups have urged the State Govt to follow the NSW WorkCover Authority and ban smoking in the casino and other venues. Dozens of Crown Casino workers have complained about smoke. The Age 4/10/97 The first smokefree bingo session in Victoria was launched by RSL President, Bruce Ruxton on 8 October. Herald Sun 8/10/97

News Roundup

Muslim clerics in the home state of Malaysian Prime Minister Dr Mahathir Mohamed have been asked to stop smoking to set a good example. Straits Times 3/10/97

British Airways announced that all its flights world-wide will be smoke-free beginning March 29, 1998.

The Massachusetts State Senate approved without dissent a bill that would force the divestiture of its tobacco holdings within three years, which is $US200 million of the state's $21 billion pension fund. http://www.boston.com/dailyglobe/globehtml/

But back in Australia, NSW Democrat Liz Kirkby asked why NSW State Super, the public servants superannuation fund had $33 million in tobacco stocks. Attorney-General Michael Egan replied that the Board of the fund had decided that it had a fiduciary duty to maximise profit and did not want impediments to this, though it would monitor the situation. Hansard 22/10/97 Perhaps some cries of outrage may help!

ADVERTISING

Jacques Villeneuve will race his Williams in Melbourne's Albert Park next March wearing red Winfield colours. Rothmans has decided to promote its brand and exploit the loophole which allows 'international only' to apply to Villeneuve, according to Australian Auto Action, 7/11/97

NSMA calls for doctors to boycott cars associated with tobacco advertising, in view of the weak response by governments. The following cigarette brands are involved: Camel, Marlboro, 555 Subaru, West, Gitanes, Rothmans, Benson and Hedges, Mild Seven and Lucky Strike. The following cars are also involved: Honda, Subaru, Renault and Land Rover (made by BMW).

Cigarette marketers are usually coy on the subject of teens and smoking. But they also get away with what they can. The new ad campaign for BAT Free cigarettes in Brazil is something different. It turns the dangers of smoking into an act of fashionable rebelliousness. The ads show young people saying things like: "It's always worth taking risks". Forbes, 3/11/97

MONEY

Three in five Australians believe smokers should pay a higher Medicare levy because they knowingly damage themselves and divert funds from other health needs. The Australian 22/10/97

ASH Director, Anne Jones has suggested that employers who don't provide smoke-free workplaces should pay higher workers' compensation premiums because of the increase in the number of employees seeking workers' compensation for illnesses arising caused by passive smoking. She said that an extra levy of 15% of the premium could easily be justified. The idea is being considered by the NSW State Govt. Daily Tele 21/10

Revenue Shortfall, Profits Soar After Tax Victory

The defeat in the High Court of the States' power to collect excises such as tobacco tax, in a case brought by the tobacco industry meant that the governments who had not really prepared for the eventuality were caught flat footed. The Federal government promised to make up the deficit but did not do so. Stories were like: Victoria faces a $59m Budget blackhole after the apparent failure of a Commonwealth rescue deal to protect the state's tobacco tax revenue. Adelaide Advertiser 1/11/97 State spending in SA could be cut because of a $20m shortfall in tobacco tax collections. Herald Sun 1/11/97 A $50m one-off gain has helped tobacco giant, Rothmans, offset the effects of a cigarette price war in Australia and a 9.7% fall in first half operating profit to $48.2 million. Financial Review, 1/11/97 Whether this was incompetence or looking after their tobacco mates was not clear.

Each state has complained of a revenue shortfall and the tobacco companies have had millions in windfall profits. Rarely did the two stories appear in the media together. It was as if they were unconnected!

European Union Eliminates Duty-Free Sales

As of June 1999, duty-free sales on ships and flights within the European Union will be banned. The duty-free industry has grown dramatically over recent years, with sales of alcohol and tobacco representing almost two-thirds of the industry's profits. ASH-UK 25/9/97

NSMA calls on the Federal government to stop duty -free tobacco sales in Australia, and urges members to write. Arguments to use are: No one benefits from duty free trade - except the manufacturers who stand to sell extra It uses up extra airline fuel to carry the duty free goods. The high alcohol content is a fire risk, as the Guam air crash showed. The government loses millions in duty, and has to pay for the illness care costs from the extra cigarettes bought and smoked. Local tobacco retailers miss out on trade, as the incoming passengers come stocked up.

Action Point 2 Write to the Health Minister, Dr Michael Woolridge and ask that Australia end duty-free tobacco sales.

Myers Settles Passive Smoking Case An asthma sufferer, Milada Koliha settled a case with Myers department store on 5 November. The plaintiff complained that on repeated occasions in 1992, 1993 and 1994 she had suffered asthmatic reactions and breathing problems while shopping at Myer Melbourne. Myer had introduced a smokefree policy in 1992 but continued to allow people to smoke in the store. The settlement has been reported as in excess of $20,000.

Janet Sackman, a former Chesterfield and Lucky Strike Girl, who was diagnosed with lung cancer in 1990 has won an historic settlement against the Liggett Group. It is the first time that a tobacco company has agreed to pay damages directly to a plaintiff. Kansas City Bus. J.27/10

Argument over Tobacco Litigation Spoils

US States that have won money from the tobacco industry in settlements want to stop the US Federal government taking half of it in tax. But the real acrimony is with the anti-tobacco lawyers who want 25%. This is a cool $US2.8 billion, which works out at $11,000 an hour. Washington Post, 12/11/97

Flight Attendants Case Settled

Major US tobacco companies have agreed to pay $US300m to settle a $US5 billion lawsuit that claimed cigarette smoke from passengers injured thousands of airline flight attendants. The payments would fund research into the detection and cure of smoking-related diseases. But no money is provided for the flight attendants. Sydney Morning Herald, 13/10/97

Buying Politicians

The British Labour Party which granted an exemption to Formula 1 motor racing to advertise cigarettes has revealed yesterday that Formula 1 boss, Bernie Eccleston had donated one million pounds to the Labour Party before the last election. The money which will have to be repaid on the recommendations of the British Parliament watchdog Sir Patrick Neill. However Mr Eccleston donated ten million pounds to the Tories. The Age 13/11

The 11th World Conference on Tobacco or Health will be held in Chicago, USA on 6-10 August, 2000.

New Zealand

The Conservative National Party in New Zealand has done very little on tobacco, so consumption per adult (over 15) has increased 2% over the past two years. This is the first time that tobacco consumption has risen two years running for over 35 years. Source: Statistics NZ. ASH NZ, Trish Fraser ashnz@clear.net.nz

Smokefree ordinances do not affect bar business

California's bars become smoke-free on January 1 1998, but a new study in the American Journal of Public Health of 27 October by Prof Stanton Glantz has shown that local ordinances that make bars smoke-free have no impact on business.

EPA Scientists Relate ETS Risk to Cotinine Level in Saliva

A scientific team from the US Environmental Protection Agency led by James L. Repace have worked out a method of using Nicotine in air and Cotinine in saliva as indicators of workplace passive smoking exposure and risk. They estimate that an average salivary cotinine level of 0.4 ng/ml corresponds to an increased lifetime mortality risk of 1/1000 for lung cancer, and 1/100 for heart disease. This level of risk means that more than 95% of ETS-exposed office workers exceed OSHA's 'significant risk' level for heart disease mortality, and 60% exceed significant risk for lung cancer mortality. Translating this into mortality figures, 4000 heart disease deaths and 400 lung cancer deaths occur annually among office workers from passive smoking in the workplace, at the current 25% prevalence of unrestricted smoking in the office workplace in the USA.

Tobacco The Biggest Cause of Disability

WHO's book, 'The Global Burden of Disease' by Professor CJ Murray and Alan Lopez estimates that in the developed countries in 1990, tobacco caused 14.5% of all deaths and 16% of total years of life lost and 12% of Disability-Adjusted Life Years (DALYs) (which measure years of life lost to premature mortality and disability).

Multilateral Agreement on Investments (MAI) Will Affect Tobacco Control

A Multilateral Agreement on Investments (MAI) is currently being negotiated behind closed doors at the Organisation of Economic Cooperation and Development (OECD). If adopted, the Multilateral Agreement on Investments (MAI) could have extremely negative implications for international tobacco control efforts. MAI would require governments to treat huge multinational corporations like Philip Morris as favourably as domestic tobacco companies. The Agreement would also give private investors the same legal standing as governments to enforce the terms of the Agreement and large US tobacco companies could take the governments to court where their army of lawyers would be expected to easily defeat small and developing country governments in the World Trade Organisation.

Source: San Francisco Tobacco Free Coalition 28/10/97

Find out more at www.essential.org

American Humour

As a token gesture to keep America well-informed, Funny Town proudly presents: Answers to the most frequently asked questions about the Government's tobacco settlement:

Q: Could you please explain the recent historic tobacco settlement?
A: Basically, the tobacco industry has admitted that it is killing people by the millions, and has agreed that from now on it will do this under the strict supervision of the federal government.

Q: Will there be monetary damages assessed?
A: Yes. To compensate for the immense suffering caused by its products, the tobacco industry will pay huge sums of money to the group most directly affected.

Q: Lawyers?
A: Yes.

Q: Will the federal government also receive large quantities of money?
A: Without a doubt.

Q: How will the tobacco industry obtain this money?
A: By selling more tobacco products.

Q: What if consumers stop buying tobacco products?
A: That would be very bad. This situation would mess up the economics of the whole thing. The government would have to set up an emergency task force to figure out ways to get people smoking again in order to finance the historic tobacco settlement.

Q: If the government really wants people to stop smoking, how come it doesn't just make cigarettes illegal?
A: Because people would smoke them anyway.

Q: Then why did the government make crack cocaine illegal?
A: That is an unfair comparison. The tobacco industry is merely selling a deadly product; the crack cocaine industry is guilty of something far worse: Failure to make large political donations.

>From November 13-16, Detroit hosted the 5th annual conference for tobacco control initiatives for African-Americans and other people of colour. Public Radio Newswire, November 12, 1997. What is needed is a similar conference for Aboriginals in Australia.

Smoking Increases in Cartoons

A report presented by Hugh Klein at the American Public Health Association meeting in Indianapolis, showed that tobacco and alcohol images appearing in cartoons is on the increase. Analyzing 953 cartoons from each decade since the 1930's, researchers determined that, on average, a kid will see 100 tobacco-, drug-, or alcohol-related messages in cartoons each year. Instances of tobacco images in cartoons had gone down in the 1980's, with about 7% of cartoons showing tobacco products, but that number has increased to 11% of cartoons in the 1990's. USA Today 13/11

The Winners of the 1996 Ig Nobel Prizes for Medicine awarded September 29, 1997 were James Johnston of R.J. Reynolds, Joseph Taddeo of US Tobacco, Andrew Tisch of Lorillard, William Campbell of Philip Morris and the late Thomas Sandefur Jr. of the Brown and Williamson Tobacco Co. for their testimony to Congress that nicotine is not addictive. http://www.canoe.com/QuirkFame/fakenobels.html

Other Ig Nobel Prizes honoured studies on toast, inflatable dolls, and leeches.

FUTURE EVENTS

The World No-Tobacco theme for May 31, 1998 is "Growing up without tobacco"

ACOSH and the Young People and Smoking Project (YPSP) has a new street address Suite 5, 337 Rokeby Rd, Subiaco. The postal address, phone numbers and the fax number are unchanged at: PO Box 327, Subiaco WA 6008 Phone 08 9388 3342, Fax 08 9382 4611 (YPSP Ph 08 9388 6991)

Books:

New! THE TOBACCO EPIDEMIC, a must read for anyone interested in smoking-related issues, covers history, economics, epidemiology & psychology of tobacco use, medical consequences, nicotine replacement, prevention & legal issues. For details see http://www.karger.ch/series/prrer/prrer028.htm