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Singapore/world: trade fairs shunned

Singapore is the latest country to see a major tobacco trade fair cancelled. The official reason given by organisers was lack of government commitment, however it is likely the threat of civil society action played a part, given a rising tide of protests. World Tobacco Asia 2014 had originally been planned for April in Jakarta, Indonesia, but was relocated to Singapore and rescheduled to November after the Inter-tabac Asia Trade Fair planned for February in Bali was cancelled abruptly under orders of the provincial governor following international protests.

Daily Singapore broadsheet the Straits Times had slammed the event being held in Singapore in an editorial published on 26 May. It described as ‘absurd’ Singapore being the site of the fair, given the country had successfully hosted the World Conference on Tobacco or Health in 2012, and the government's commitment to reduce smoking prevalence to below 10% by 2020.

All articles written by Marita Hefler unless otherwise attributed. Ideas and items for News Analysis should be sent to: marita.hefler@menzies.edu.au

The trade journal Tobacco Journal International published an upbeat interview with World Tobacco Sales Manager Colin Case on 5 May 2014, in which he described Singapore as “…the ideal place … Just about everyone we've spoken to is very happy with the move (from Jakarta)…we expect another great event.” His optimism was in stark contrast to the curt article published in the same publication just 6 weeks later on 17 June, which announced the event had been ‘cancelled due to a negative government response.’ A World Tobacco representative was quoted as stating: “From here forward such an event in Asia looks less likely than ever”—welcome news in a region which bears a huge health and social toll from tobacco.

The cancellation leaves a decreasing number of options for tobacco trade fairs, most of which are likely to face strong international criticism. The city of Dortmund, Germany will host an Inter-tabac Europe in September 2014. It will be the subject of a protest campaign by German organisation Forum Rauchfrei, which spearheaded the successful campaign against Bali Inter-tabac in February. Forum Rauchfrei spokesman Johannes Spatz has suggested there is a domino-effect. Tobacco trade fairs had been cancelled in Istanbul and Moscow in 2013 and the Bali, Jakarta and Singapore events in 2014. “Tobacco trade fairs won't find their place in this world anymore,” Spatz says.

Upcoming fairs listed on the World Tobacco website include North America (Richmond, Virginia in May 2015), Middle East (Dubai, April 2016), and Europe (Hamburg, Germany in November 2016). Hosting these events will put these countries at odds with the global health community, and would be a striking failure of political leadership, given the increasing resistance of low and middle income countries to accommodating tobacco industry trade fairs. The Dubai event can expect a particularly strong global backlash, with the United Arab Emirates hosting the World Conference on Tobacco or Health 2015 in Abu Dhabi.

UK: Lifesaving quit campaign awarded

A major integrated mass media campaign in North East England to raise awareness that one in two long term smokers will die early from a tobacco related cause has generated thousands of responses and earned two national advertising awards.

Figure 1

A heart-rending scene from the FRESH—Smoke Free North East ‘Don't be the 1’ advert.

FRESH—Smoke Free North East's ‘Don’t be the 1’ TV advert won the Grand Prix prize (outstanding) and gold for TV/Cinema commercial at the prestigious Roses Creative Awards—beating off competition from major international commercial brands. It ran in February and March across TV, radio, cinema and digital, and triggered 13 900 responses via Facebook adverts and over 9000 website visits.

Deliberately upsetting, the television advert highlighted the reality faced by the families and children of smokers suffering from a terminal illness. A street survey of 500 smokers carried out before the campaign found 9 out of 10 underestimated the 50% risk of early death. Nearly half believed the risk was between 1 in 10 and 1 in 20. When told the true odds, 65% said it worried them.

A post campaign survey to evaluate awareness and behaviour change found 31% who saw the advert, around 92 600 smokers, took some form of quitting-related action. It led to a 125% increase in smokers correctly identifying the 1 in 2 risk, with 63% of smokers reporting they felt more concerned and 57% of smokers saying they felt more likely to quit after seeing it.

Fresh worked with a 47-year-old former smoker, who had been diagnosed with terminal small cell lung cancer, and who was widely interviewed across TV and radio news to add to the call for smokers to quit.

Ailsa Rutter, Director of Fresh, said: “We have advocated over many years for the power of health harms adverts. However, we found there was appallingly low awareness that tobacco will kill half of all long term smokers. Lessons can always be learned by tobacco programmes working with each other across the world, and we took inspiration from Quit Victoria's powerful Last Dance campaign, but also worked with doctors and real people to show the impact on families. We were humbled by the bravery of our former smoker, Michelle, who invited journalists into her home to warn of the consequences of leaving it too late to quit.”

“It's always a challenge to bring statistics alive in campaigns, and we used an emotional route to show this on real lives...Our insight has shown it can be very effective to ask smokers to put themselves into the shoes of someone who didn't quit and share their terrible situation for just a few seconds.”

The advert can be viewed at http://www.youtube.com/watch?v=nXloClpBXHc. Fresh plans to re-run the campaign later this year. Ailsa Rutter was recently awarded a World No Tobacco Day medal by the WHO, testament to the impact of Fresh's work.

Andy Lloyd

Fresh—Smoke Free North East, UK

andy.lloyd{at}freshne.com

New Zealand: industry spins doubt on plain packs

Following the Australian Plain Packaging Act (2011), the New Zealand government is currently considering the introduction of plain packaging for tobacco products. The Smoke-free Environments (Tobacco Products and Packaging) Amendment Bill passed its first reading in parliament in early 2014. However there has been increasing resistance by tobacco companies, who have claimed that Australia's policy is ineffective.

The Australian claims, raised mainly by British American Tobacco Australia (BATA) and the Murdoch-owned national newspaper The Australian (which has a history of publishing articles favourable to the tobacco industry and by authors from industry-funded think tanks), are that plain packaging is causing a rise in the sales of low priced cigarettes and the growth of the illicit tobacco market in Australia.

The New Zealand tobacco industry is pushing a similar line, using the Australian data provided by BATA to suggest increased tobacco sales and illegal tobacco trade as potential consequences of plain packaging in New Zealand. However apart from industry figures which have not been independently validated, the evidence for either eventuality is weak. In fact, recent figures released in Australia show a continuing decline in smoking prevalence, as detailed below.

In contrast to Australia, the New Zealand tobacco market is already strong in the low-price and ultra-low price segment, a response to tax increases in recent years. The New Zealand Government raised tobacco tax in 2010 by 12.5%, and this has been followed by an annual increase of 10%. Since then, the ultra-low-cost or budget brand segment has continued to grow.

Although further research is needed to assess the profit margins made by tobacco companies in the ultra low-price segment, the increased sale volumes of ultra low-price cigarettes implies that tobacco companies are already very competitive in this section of the market. Consequently, plain packaging is unlikely to produce a cascade of budget cigarettes in the New Zealand market.

There is also no reliable evidence to suggest a link between plain packs and illicit tobacco trade in New Zealand. The assertions made by the industry are either based on overseas data or industry funded surveys and reports, which have been found to be selective at best.

It is evident that plain packaging represents a setback for an industry that has always tried to produce and market products which are attractive for first time and casual users. With tobacco companies being forced to shift their focus towards cost reduction, the ultra low-price cigarettes appearing in the market now are much less appealing in terms of both packaging and perceived taste.

Plain packaging is designed to reduce the attractiveness of tobacco to youth and adolescents. Its effect will show in lower rates of first time smoking among adolescents and the subsequent decline in young adult smoking rates over the next decade. For New Zealand, it is important to be clear on the actual research behind plain packaging and to realise that the real effect of upstream policies like this manifest across 5–10 years and shouldn't be measured by tobacco sales figures 18 months after the legislation's introduction.

Ali Ajmal

Action on Smoking and Health (ASH) New Zealand

aajmal{at}ash.org.nz

Australia: smoking down after plain packaging

Figures from the latest Australian National Drugs Strategy Household Surveys show a continuing decline in prevalence, much of it due to record numbers of young people never having smoked—95% of 12–17 year olds and 77% of 18–24 year olds. People aged 40–49 are now the most likely to be daily smokers, with prevalence at 16.2%.

The survey figures are a powerful rebuttal to the scare mongering and slanted reporting emanating from the tobacco industry and its acolytes, and recycled in countries where plain packaging is on the legislative agenda. Murdoch-owned newspaper The Australian has been slammed for inaccurate and selective reporting—full details, including an expose by the widely-respected Australian Broadcasting Corporation show Media Watch, can be viewed on our blog at http://blogs.bmj.com/tc/2014/06/24/academics-and-the-australian-go-up-in-smoke/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+tc%2Fblogs+%28Latest+from+Tobacco+Control+blog%29.

Ireland: leading the EU on plain packaging

Ireland will become the first country in the European Union to introduce plain packaging, following a government bill published on 10 June. Predictably, the announcement has been met with warnings that Ireland can expect to face compensation claims and other legal challenges. The threats have been met with defiance by the health minister James Reilly, who pointed out the contradiction of the industry position: “It is quite amazing that on the one hand they claim: ‘This will have no effect. It is foolish’. Then on the other hand they say they will sue us for the equivalent of our gross domestic product for the losses they might sustain.”

Turkey: taking the ban outside

The Turkish government is stepping up its measures against exposure to secondhand smoke and availability of tobacco to children. A range of new regulations are planned to ban smoking in private cars carrying pregnant woman and children, and outdoor public spaces where children are vulnerable to exposure include schoolyards, playgrounds and mosque courtyards. Cigarette sales in shops close to schools will also be banned.

Canada: twisting the LEGACY name

In tobacco control circles, the word ‘legacy’ has come to have special meaning, referring to the US$206 billion settlement agreed in 1998 by the four largest USA tobacco companies—Phillip Morris, RJ Reynolds, Brown & Williamson and Lorillard—to a coalition of attorneys general of 46 states and five US territories as compensation for tobacco-related Medicaid costs.

Figure 2

The door to the ‘Legacy Tobacco Room’ at the liquor store of the same name in British Columbia, Canada.

Known as the Master Settlement Agreement (MSA), the legacy created by this historic case included the creation of the American Legacy Foundation (ALF) a not-for-profit organisation dedicated to preventing teen smoking and encouraging smokers to quit. With funds from the MSA, the ALF funded the establishment of the Legacy Tobacco Documents Library, a collection of more than 40 million pages of internal documents of the tobacco industry. Fully searchable, and available on-line in perpetuity, analyses of the documents have led to the publication of hundreds of peer-reviewed papers, reports and other unique evidence about the decades of deceit by an industry whose product kills half of its customers.

Given the close association of the term legacy with tobacco control, it is surprising to come across its use in the Canadian province of British Columbia (BC) for an upscale liquor store which also sells tobacco products using artful displays.

Historically, the retail sale of liquor products has been tightly controlled by the BC Liquor Control and Licensing Act and Regulations. Until 2002, the retail sale of wine, beer and spirits was only through government-owned BC Liquor Stores. Legal restrictions have since been relaxed, including the government licensing of so-called licensee retail stores. These privately-owned stores have flourished and now far outnumber government outlets. Current regulations still seek to maintain the distinction between liquor stores and other retailers, with one of the key requirements being that a private liquor “store must not resemble a convenience store, and…may not stock other items, such as milk and newspapers.”

There is no danger of this misapprehension when walking into the Legacy Liquor Store (https://legacyliquorstore.com/about-us/our-team). Located in the heart of False Creek in the former Vancouver 2010 Olympic Village, overlooking scenic English Bay, Legacy is now the largest privately-owned liquor store in BC. Bottles of carefully selected craft beers, and specialty wines and spirits, are enticingly displayed in an interior of wooden beams and crates, oak barrels, and muted lighting. Given the relative austerity of government liquor stores, customer reviews are overwhelmingly positive.

Setting aside the complexities of alcohol policy in BC, which will be liberalised further in 2015 to allow sales in grocery stores, it is notable that Legacy has extended this upmarket retail experience to include tobacco products. BC boasts the lowest smoking prevalence rate in Canada (14.2% in 2011) thanks to the adoption and enforcement of strong regulations. These regulations include point of sale restrictions on the retail display of tobacco, and on the advertising or promotion of tobacco use by means of a sign or otherwise. Low smoking rates, in a province known for its natural beauty and healthy living, have led to the lowest cancer rates in the country.

These achievements appear at odds with Legacy's alluring tobacco product marketing. As required by law, the private liquor store does not openly display tobacco products. However, unlike the behind-the-counter utilitarian cabinets used by most BC tobacco retailers, Legacy makes an asset of the forbidden theme by locating tobacco products behind frosted glass doors mysteriously illuminated from within. Sited at the end of a side room of the store, beyond plump leather armchairs which create the feeling of a gentleman's club, a sign beckons customers into the ‘The Legacy Tobacco Room’ where ‘No one under the age of 19 [is] permitted’. Through the doors, the small room inside is lined with gleaming glass cabinets and special marble topped displays, all carefully lit to show off aesthetically placed cigarette packs, positioned like prized artefacts or relics in a museum. The created effect is one of rarity and luxury.

In this way, ‘legacy’ takes on a very different connotation, one where smoking is marketed as ‘retro’ forbidden fruit, to be viewed peep show style, but in the best of taste. Apart from the poor choice of name, the Legacy Liquor Store's decision to market tobacco products in this upscale, highly glamourised way, sharply contrasts with the deadly reality of the products’ impacts on human health.

Kelley Lee

Simon Fraser University, Canada

kelley_lee{at}sfu.ca

USA: Florida jury sends $23 billion message

The impact of 1994 footage of tobacco industry executives claiming nicotine is not addictive continues to reverberate two decades later.

The lawyer for a Florida woman who sued R J Reynold because her husband died of cancer after chain-smoking for more than 20 years said the jury seemed most persuaded by the footage, along with 60 year old internal documents showing the company knew the truth then.

The case resulted in a $23 billion punitive judgement against the company, as well as $17 million in compensatory damages. R J Reynolds will appeal, and while it is expected that the judgement will be significantly reduced, it nonetheless sends a strong message of the industry's complicity and cover-ups. The case is one of the largest among a set of cases known as ‘Engle progeny’ which arose from a 2006 court decision that prevented class-action suits by tobacco victims, but allowed individuals to sue. About 70% of the suits filed by smokers and their families have been successful. Currently up to 8000 cases from the original class action lawsuit are pending, and R J Reynolds has paid $144 million, although many cases are still being appealed.

Canada: campaign for tobacco fraud justice

More than 130 prominent Canadians, including the head of health agencies and professions, deans of public health schools and professor of law, have released a letter to urge provincial and territorial governments to make public health remedies essential objectives of their health care cost recovery lawsuits against the tobacco industry. The letter and coalition was put together by the Campaign for Justice on Tobacco Fraud which is supporting litigation against the industry that has the potential to lead to public health benefits and changed industry behaviour. The campaign website is http://www.justiceontobaccofraud.ca

Figure 3

An image from the Canadian Campaign for Tobacco Fraud Justice.

Philippines: graphic health warnings

The Philippines president Benigno Aquino III signed approval for a new graphic health warning law on 18 July, significant progress for a country which has long had a strong tobacco industry lobby. The new law requires half of the cigarette pack display area to be given to pictorial warnings on the front and back of the pack. There are 12 warnings to be rotated every 2 years.

Indonesia: tobacco companies flout pictorial laws

In Indonesia, much of the tobacco industry is taking the well-worn route of delay in complying with new graphic health warning requirements. The law came into effect on 24 June, following an 18 month lead time, far longer than the lead time for neighbouring countries Singapore, Brunei, Malaysia and Vietnam.

Although the Indonesian tobacco industry exports packs with graphic health warnings elsewhere in Southeast Asia, by the time the law came into effect only around 13% of Indonesian brands had registered the photos they intended to use.

It is no surprise that the industry is resisting. Indonesia has a notoriously lax record in taking strong tobacco control action, a fact reflected in the 10 800 children aged 10–14 who are estimated to start smoking each day, adding 3.9 million to the 65 million smokers each year. Indonesia's health minister has said companies will be issued warnings, and may face fines of up to US$42 000 and 5 years in prison.

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