Simon Chapman's pictures on page 367 of the latest Tobacco Control
points out that the 7-11 chain of convenience stores in Thailand was
refusing to cover their cigarette products as required by the Ministry of
Health's requirements on advertising. They are now complying with the
regulation and do not have the open display of cigarette products. This
means that all retail shops in Thailand are no longer displaying any...
Simon Chapman's pictures on page 367 of the latest Tobacco Control
points out that the 7-11 chain of convenience stores in Thailand was
refusing to cover their cigarette products as required by the Ministry of
Health's requirements on advertising. They are now complying with the
regulation and do not have the open display of cigarette products. This
means that all retail shops in Thailand are no longer displaying any
tobacco packs or cartons at point of sale. This is an important
achievement in Thailand and comes at the same time that the tax on tobacco
has also just been raised by 4% to 79% of the base price. Price
increases, new picture warning labels, and a ban on point of sale
advertising is a combination that should accelerate the already declining
trend in smoking.
Since my original publication in 1995 reporting high rates of denial
of smoking in Japanese women,1 and Prof Yano's alternative assessment of
the evidence,2 there has been an ongoing correspondence between the two of
us.3-6 In his latest letter6 Yano asks whether my paper1 should have been
published because it suffers from "erroneous interpretations based on
invalid measurements."
Since my original publication in 1995 reporting high rates of denial
of smoking in Japanese women,1 and Prof Yano's alternative assessment of
the evidence,2 there has been an ongoing correspondence between the two of
us.3-6 In his latest letter6 Yano asks whether my paper1 should have been
published because it suffers from "erroneous interpretations based on
invalid measurements."
My calculations critically depended on the detection of high urinary
cotinine/creatinine ratios (CCR) of >100 ng/mg in 28 women who reported
that they were nonsmokers. Yano argues that the CCR measurement may have
been unreliable because the dry ice sent with the urine samples had
sublimated before it reached the laboratory (a problem I have no record or
memory of), and that, if the sample had been exposed to high temperature,
the measurement might have been inaccurate. Although other references7,8
argue that cotinine levels in unfrozen samples are reliable for research
purposes, Yano cites the results of one study9 which did show some
increase in cotinine levels in samples stored at high temperatures.
However, even at the highest temperature (60°C) and longest storage time
(30 days) tested, the increase was by less than 2-fold. In contrast, in
25 of the 28 women reclassified as current smokers, their CCR was more
than 2-fold above the, conservative, 100 ng/mg cut-off used, and in 23 of
them the CCR was over 500 ng/mg. I do not consider this doubt about
possible exposure of samples to high temperature is relevant. If Yano
thought it was, why was it not mentioned in his paper?2 I note that Yano
states that the potential problem only applied to the first batch of
samples. If so, it would be relevant to compare the results for the two
batches. My database does not have details of batch. Does Yano's?
Using 100 ng/ml as indicative of true smoking, I estimated that 28/98
= 29% of true smokers denied smoking. In contrast 8/298 = 2.7% of true
nonsmokers could be reclassified as smokers. The former misclassification
rate, which can cause
substantial bias to estimates of lung cancer risk in nonsmokers
associated with spousal smoking, is much higher than the reverse
misclassification rate, which in any case has a much lower biasing
effect.10
The calculations in Yano's latest letter6 are off the point as they
are based on the assumption that self reported smoking is 100% accurate
and that it is CCR which is subject to error. The whole point of the
study was to test the accuracy of self report using CCR as the gold
standard. Clearly CCR is not 100% accurate, but Yano gives no reason why
such inaccuracy should affect the major conclusion of my paper.1
Yano is concerned that my formula depends on the prevalence of
smoking. I am not sure why. One is attempting to answer the question
"What proportion of true smokers deny smoking?" and clearly the number of
true smokers must be the denominator in the calculation.
Yano states that Proctor "finally understood and accepted my point on
the misclassification formula," but that was before he had consulted me
and realized that Yano's approach was erroneous. Then, as now, my views
and Yano's seem irreconcilable, and as it was not possible to prepare a
paper satisfactory to all, I was asked by Proctor to prepare a paper under
my name. Clearly the situation is not ideal, but at least the data and
the differing interpretations are in the literature for scientists to form
their own judgement. I retain my view that my interpretation is correct
and that the measurements made are valid enough for the conclusions I
draw.
Peter N Lee
P.N. Lee Statistics and Computing Ltd.,
17 Cedar Road,
Sutton, Surrey, SM2 5DA, UK.
References
1. Lee PN. "Marriage to a smoker" may not be a valid marker of
exposure in studies relating environmental tobacco smoke to risk of lung
cancer in Japanese non-smoking women. Int Arch Occup Environ Health
1995;67:287-94.
2. Yano E. Japanese spousal smoking study revisited: how a tobacco
industry funded paper reached erroneous conclusions. Tob Control
2005;14:227-35.
3. Lee PN. Japanese spousal study: a response to Professor Yano's
claims [Commentary]. Tob Control 2005;14:233-4.
4. Yano E. Response to P N Lee [Commentary]. Tob Control
2005;14:234-5.
5. Lee PN. Response to E Yano and S Chapman [Letter]. Tob Control
14:430-1.
6. Yano E. Should a paper with erroneous interpretations based on
invalid measurements be published? [Letter]. Tob Control 2005;14:431-2.
7. Foulds J, Feyerabend C, Stapleton J, Jarvis MJ, Russell MAH.
Stability of nicotine and cotinine in unfrozen plasma. J Smoking-Related
Dis 1994;5:41-4.
8. Greeley DA, Valois RF, Bernstein DA. Stability of salivary
cotinine sent through the U.S. mail for verification of smoking status.
Addict Behav 1992;17:291-6.
9. Hagan RL, Ramos JM, Jr., Jacob PM, III. Increasing urinary
cotinine concentrations at elevated temperatures: the role of conjugated
metabolites. J Pharm Biomed Anal 1997;16:191-7.
10. Lee PN, Forey BA. Misclassification of smoking habits as a
source of bias in the study of environmental tobacco smoke and lung
cancer. Stat Med 1996;15:581-605.
Editor: This correspondence is now closed
Nathan K Cobb raises an important point. This paper has been reviewed
by the Centre for Reviews and Dissemination [1], which provides critical
assessments of the quality of economic evaluations. They raised this issue
along with some other noteworthy points relating to the costs of the
program. Specifically, the costs and the quantities were not reported
separately, which limits the generalisability of the authors' results...
Nathan K Cobb raises an important point. This paper has been reviewed
by the Centre for Reviews and Dissemination [1], which provides critical
assessments of the quality of economic evaluations. They raised this issue
along with some other noteworthy points relating to the costs of the
program. Specifically, the costs and the quantities were not reported
separately, which limits the generalisability of the authors' results.
Also, the date to which the prices related was not reported, hindering any
possible reflation exercises.
The review also reports an error in the cost-effectiveness ratio
calculated by the authors. To calculate this ratio the authors divided the
average cost per client of the counselling service ($60) by the
incremental effect on cessation rates (4.5%). In this incremental
analysis, the authors failed to include the costs incurred by patients in
the self-help group (i.e. those receiving the booklets only), which
amounted to $15 per client. Hence, the incremental cost-effectiveness
ratio of the telephone counselling service would be lower than that
calculated by the authors, and would be around $1,000 ($45 divided by
4.5%)[1]
References
1. Telephone assistance for smoking cessation: one year cost
effectiveness estimations [Abstract 20040366] NHS Economic Evaluation
Database, available http://nhscrd.york.ac.uk/welcome.htm [2005, 5
December]. Abstract of: Telephone assistance for smoking cessation: one
year cost effectiveness estimations, McAlister A, Rabius V, Geiger A,
Glynn T, Huang P, Todd R., Tobacco Control, 2004, 13(1):85-86.
In the latest issue of Tobacco Control, Radu and others report on
tobacco use among Swedish schoolchildren (Tobacco Control 2005;14:405-
408). As a Swede, I was surprised to read about some of their findings.
Children who smoke daily or almost daily are defined as “regular
smokers”. The percentage of regular smokers is reported to have decreased
to 4 per cent among 16-years-old boys and 15 per cent among girls by...
In the latest issue of Tobacco Control, Radu and others report on
tobacco use among Swedish schoolchildren (Tobacco Control 2005;14:405-
408). As a Swede, I was surprised to read about some of their findings.
Children who smoke daily or almost daily are defined as “regular
smokers”. The percentage of regular smokers is reported to have decreased
to 4 per cent among 16-years-old boys and 15 per cent among girls by 2003.
These figures differ significantly from the data found in the
original (Swedish) reports from the CAN (Swedish Council for Information
on Alcohol and Other Drugs). According to the latest CAN report (2005) the
percentage of “regular smokers” in 2003 was 7 per cent among boys and 13
per cent among girls. So, how can the authors reach the figure 4 per cent
for boys?
One explanation, which can be hypothesized from Figure 2 in the
paper, may be that “regular smokers” who also use oral snuff, have been
excluded from the category of “regular smokers”. If this is the case, I
find this to be a highly innovative method of presenting data in order to
make them support one’s favourite, preconceived conclusions. Smokers who
also use oral snuff – are they not smokers?
The “gender gap” in tobacco habits certainly exists – it has been
there ever since the early 1970s, when this series of surveys was started
and the use of oral snuff was practically non-existent among boys. The
main explanation for this gap seems to be the fact that 16-year-old girls
are – biologically and socially – more “grown-up” than boys of the same
birth cohort. Additional explanations may of course exist – tobacco
initiation is a complex development where several social, psychological
and other influences are active.
During the last few years there has been a marked decrease of regular
smoking among both boys and girls. At the same time, regular use of oral
snuff has also decreased among boys.
To reach – from these data – the conclusion that “snus use suppresses
smoking among boys”, appears to be a daring exercise. To me, the jump is
far to big.
Paul Nordgren
National Institute of Public Health,
Stockholm, Sweden
paul.nordgren@fhi.se
In a visit to Catalonia in Spain during October 2005, I noticed a
number of changes in the smoking culture and regulations, compared to a
visit in 2001.
Smokefree legislation is expected to be passed in 2006. The Catalonia
regional government plans to take up the same tough stance as Ireland, the
Netherlands and Norway. But there are already changes in Catalonia.
In a visit to Catalonia in Spain during October 2005, I noticed a
number of changes in the smoking culture and regulations, compared to a
visit in 2001.
Smokefree legislation is expected to be passed in 2006. The Catalonia
regional government plans to take up the same tough stance as Ireland, the
Netherlands and Norway. But there are already changes in Catalonia.
In comparison to 2001, I came across several cafes and restaurants
that had smokefree areas, (some locals cynically suggested that they were
there not there to protect staff but to please the tourists). In 2001,
many cafes had sawdust all over the floors, partly to cope with the
cigarette butts being ground under heel by smokers. This practice may
still exist, but was certainly not as extensive as previously. It was also
a pleasure to be served food and drink by people who were not smoking
while they worked.
I noticed the biggest difference in the Spanish airports. Most areas
of the Barcelona and Palma airports are smokefree, with the designated
areas for smoking being the occasional café and corners in the departure
lounge. Every so often, a voice would boom out in Spanish and in English:
“It is by decree of the King, order no ** sub section **, that this
airport is designated a smokefree building. It is an offence to smoke in
any area other than the areas that are designated for smoking.”
Some people by habit still lit up in the smokefree areas of the
airports, but others were quick to point out that they were breaking the
law. I was impressed how quickly smokers reacted and put out their
cigarette, or hurried over to the smoking area. There was no abuse by the
smokers, it was just done.
A friend of my son (who lives in Barcelona) gave up smoking while I
was there. He had taken to wearing his nicotine patch proudly, like a
tattoo! The patches cost 40 euros (per packet?).
Among my son’s friends the women are very clear that they will not
smoke while pregnant. However, there appeared to be still not too much
awareness of the dangers of second hand smoke, as the women were all sure
that they would start smoking again after the baby was born. This may not
be the norm, as the research sample was only six.
Official figures indicate that 50,000 people die from tobacco-related
diseases each year in Spain, comprising 16 percent of all deaths of people
over 35. Smoking kills more people than Aids, alcohol-related illnesses
and traffic accidents combined.
When we received the August 2005 issue of Tobacco Control, we found
much in it to help inform our work, as usual.
I am writing, however, because we have some concerns about one of the
articles published. “The perimetric boycott: a tool for tobacco control
advocacy,” is described as a comprehensive analysis of a number of
boycotts, including one organized by Infact (now Corporate Accountabi...
When we received the August 2005 issue of Tobacco Control, we found
much in it to help inform our work, as usual.
I am writing, however, because we have some concerns about one of the
articles published. “The perimetric boycott: a tool for tobacco control
advocacy,” is described as a comprehensive analysis of a number of
boycotts, including one organized by Infact (now Corporate Accountability
International).
A key point overlooked by the authors is that Corporate
Accountability International’s Boycotts are one strategy within a broader
campaign challenging life-threatening corporate actions. Though we lifted
the Kraft Boycott in June 2003 in celebration of the adoption of the WHO
Framework Convention on Tobacco Control, our Tobacco Industry Campaign
continues to build momentum—-using the most effective strategies at any
given time, and helping to make the WHO FCTC one of the most rapidly
embraced UN treaties of all time.
As a membership organization, Corporate Accountability International
has developed and carried out a number of grassroots consumer campaigns
that have altered the cost/benefit ratio for a corporation to engage in
irresponsible and dangerous practices. Our Nestlé Boycott is often cited
as pivotal to the emerging corporate accountability movement in the 1970s.
Some of the most significant documented costs to Philip Morris/Altria
from the Kraft Boycott included: harm to corporate name, reputation and
image—among the most valuable assets of any corporation; direct expenses
of salaries for management time spent dealing with the Boycott and its
impact; lost management time that could have been spent on acquiring new
sales and increasing shareholder value; public relations, advertising and
corporate giving to maintain goodwill with consumers, the media and
political leaders; and loss of employee morale, affecting both recruitment
and retention.
While thorough attention to the effectiveness of our strategies as a
movement is important for learning lessons as we move ahead, so too is
careful attention to detail and context when critiquing strategies that
have advanced our collective work.
Sincerely,
Patti Lynn
Campaigns Director
Patti Lynn
Campaigns Director
Corporate Accountability International (formerly Infact)
Campaign Headquarters
46 Plympton Street
Boston, MA 02118 USA
Phone: 617-695-2525
Fax: 617-695-2626
plynn@stopcorporateabuse.org
www.stopcorporateabuse.org
The recent article by Al-Delaimy et al (TC 14:359) makes two
conclusions. The first is that use of over-the-counter (OTC) nicotine
replacement therapy (NRT) for reasons other than smoking cessation is
uncommon. This result is consistent with several other studies not cited
in this letter (Nic Tobacco Research 6:79; Nicotine Safety and Toxicity (N
Benowitz, ed) p 147). The second conclusion is that "some smokers may be...
The recent article by Al-Delaimy et al (TC 14:359) makes two
conclusions. The first is that use of over-the-counter (OTC) nicotine
replacement therapy (NRT) for reasons other than smoking cessation is
uncommon. This result is consistent with several other studies not cited
in this letter (Nic Tobacco Research 6:79; Nicotine Safety and Toxicity (N
Benowitz, ed) p 147). The second conclusion is that "some smokers may be
questionning the efficacy of NRT for quitting." This conclusion is based
on the observation that among those who had ever used NRT, many had not
used it in their last quit attempt. This is not a necessary deduction
from this observation. For example, assume a) we have a treatment that is
proven effective but is effective in a minority of patients, b) that
patients have a chronic relapsing disorder that requires several treatment
episodes and c) most patients are reluctant to use any treatment that has
failed in the past. Under these conditions, all effective treatments will
be unlikely to be used in the last treatment episode. For example, I
would wager that most smokers who used behavioral therapy for smoking
cessation did not use behavioral therapy on their last attempt.
Concluding that this data means that patients are "questionning the
efficacy" suggests that over time the treatment is loosing its efficacy.
This is not a necessary deduction from the above observation. If so, then
we would have to conclude that all treatments effective in a minority of
patients are loosing efficacy over time.
When Hong and Bero published their study �"How the tobacco industry responded to an influential study of the health effects of secondhand smoke�" in 2002, I was supporting the law suit against a railway company
to get smoke-free environment for workers and passengers in Japan.
At that time, non-smokers had been annoyed by secondhand smoke for a long
time regardless of our many claims.
The company had been denying the harmfu...
When Hong and Bero published their study �"How the tobacco industry responded to an influential study of the health effects of secondhand smoke�" in 2002, I was supporting the law suit against a railway company
to get smoke-free environment for workers and passengers in Japan.
At that time, non-smokers had been annoyed by secondhand smoke for a long
time regardless of our many claims.
The company had been denying the harmful effects of second hand smoke,
because tobacco industry affiliated authors were publishing many studies
which denied the health effects of tobacco smoke and these studies were
used for the many other tobacco-related law suits by many companies to
reject the control of secondhand smoke.
So I carefully read the Hong� and Bero study and accessed to the tobacco
documents.
I thought Hong� and Bero's study was correct, because I found that the company had
used many studies produced by tobacco industry affiliated authors to
reject tobacco control.
Therefore I decided to use the tobacco documents which described the
conspiracy of tobacco industry affiliated author for the law suit.
Then I and lawyers submitted the evidence to the court. Amazingly, I
was successful in having the court admit the necessity of controlling secondhand smoke on
January 3, 2005. The court decided that tobacco industry
affiliated authors were unreliable and the studies produced by them were
incredible.
This judgment was an epoch-making success in Japan. It enabled us to
introduce more effective tobacco control measures very smoothly.
Thanks to Hong and Bero, Japan made a great progress in tobacco control.
In response to Mr. Lee’s comment1 which follows previous responses2,3
and my paper4, I offer further
explanation to resolve an apparent misunderstanding of the validity and
reliability of cotinine/creatinine ratio (CCR) measurement and his mishandling
of the formula of misclassification. I also express concerns about the lack of
scientific integrity in his reporting5 of the Japanese spousal study,
including his authorship.
As I demonstrated4, all indices of nicotine exposure (ambient
room,personal sampler monitors, and salivary
cotinine)
were well correlated but correlated poorly with CCR, raising doubts about the
validity of the CCR measurement.Yet
Lee maintains that CCR measurement in this study was the gold standard for
distinguishing true smokers from falsely reporting smokers.
There are several possibilities about why the CCR
measurement may have been invalid and unreliable in this study. In 1991 when I
sent the urine samples to the RJR laboratory (where the measurement was
performed), I was informed that all the dry ice sent with the sample had
sublimated before it reached the laboratory. This suggests that the sample was
not maintained at low temperature before analysis. Cotinine measurement is
temperature sensitive and measurement after the sample is exposed to high
temperature can make the measurement inaccurate6.
As I calculated4, the misclassification
and reverse misclassification were equally high suggesting inappropriateness of
the CCR measurements as the gold standard.Lee’s
neglect of reverse
misclassification, thusallows
him to claim an inflated false negative rate of smoking.Lee continues to justify his
misclassification formula by referring to his previous use of the formula.
However, this formulais dependent
on the prevalence of smoking among the study population and thereby artificially
inflates the misclassification rate
ofpopulations with low smoking
prevalence. By way of illustration, consider two hypothetical populations of
1000 people each with smoking rates of 10% (A) and 30% (B).Suppose that, due to the inaccurate CCR measurement, just 3% of true
smokers are classified as non-smokers by erroneously low CCRand3% of true non-smokers are classified as smokers by erroneously high CCR
(for the sake of simplification, I assume no false reports by the subjects). We
will get the following results.
A: If 10% smoke
Self report
Smoker
Nonsmoker
Total
CCR
High
(>100ng/mg)
97
27
124
Lee’s
Misclassification formula
Low(<100ng/mg)
3
873
876
=27/124=0.21
Total
100
900
1,000
B:
If 30% smoke
Self report
Smoker
Nonsmoker
Total
CCR
High
(>100ng/mg)
291
21
312
Lee’s
Misclassification formula
Low(<100ng/mg)
9
679
688
=21/312=0.06
Total
300
700
1,000
As
can be seen, Lee’s formula for misclassification is dependent on the
prevalence of smoking. With only a
slight (3%) inaccuracy in CCR measurement, he can thereby easily get more than
three times higher (0.21
vs.0.06) misclassification in a population with lower smoking prevalence, such as with Asian women.
After a long discussion between Proctor and me, Proctor finally
understood and accepted my point on the misclassification formula7.
Our final draft of the misclassification paper8, which Proctor sent
to me on November 9, 1992 with my name as a sole author, clearly mentioned the
high proportion of misclassification in both sides (self-reported non-smoking
subjects with high CCR and self-reported smokers with low CCR).
Lee
insists that reverse misclassification is relatively unimportant in his
abundant mathematical publications. However, I note that he seems to have
realized his mistake of using 28/106 as the misclassification rate of
self-reported smokers in his original study5 , having quietly
switched to 28/98 for this rate1 after I pointed out his confusion.
Despite his claim that reverse misclassification is implausible, it was observed
as a fact.
Lee
states that as
far as he is aware the
data never belonged to Yano. He should be aware that I developed the
questionnaire, and selected the study areas and subjects. I supervised the
survey at the study area (Shizuoka), erroneously referred to in Lee’s paper as Shizoka5. I planned and ordered the
data input, performed the data analysis and sent the disk to Proctor. On
learning from the experience of possible sample damage (from dry ice
sublimation) by the commercial shipment at the first phase study in 1991, I even
transported the second phase samples myself to the RJR laboratory, Winston
Salem, NC where CCR was measured. I discussed the scientific content of the
study with Proctor many times and he accepted my points7 and revised
the draft many times, always with my name as the author, and never with Lee’s.
As can be seen in the final draft8, Proctor and I reached a certain
agreement on the misclassification formula and the importance of the reverse
misclassification rate.
Because
Lee never participated in the actual survey it may be that he was unaware of
details of the research such as the integrity of the sample which may have
seriously affected the interpretation of results. Nor did he participate in the
discussion which led Proctor and I to a deeper understanding of the analysis7.
Despite this, still Lee claims that because he proposed the research project, he
has aright to sole authorship
regardless of who actually conducted the research. This is a unique idea that
few scientists would accept.
Lee states: Had I not published the paper it seems that the findings
would never have appeared in the public domain at all.Did Yano also have sole rights to suppress the findings? Again, Iremind Lee thatProctor and I
agreed that the results did not indicate high misclassification in self-report
non-smokers but some failure in the study.7, 8 What both Proctor and
I prepared for publication, although Proctor ceased to contact me before we
could reach a final agreement, was totally different from what Lee eventually
published5. I consider that a description of a failed study
involving the inaccurate measurement of CCR was undeserving of publication.
Moreover, as a scientist committed to truth, I have a responsibility to be
critical of a report with erroneous interpretations based on invalid
measurements.
2.Yano E.Response
to P N Lee [Commentary].Tob
Control 2005;14:234-5.
3.Lee PN.Japanese spousal
study: a response to Professor Yano's claims [Commentary].Tob Control 2005;14:233-4.
4.Yano E. Japanese spousal smoking study
revisited: how a tobacco industry funded paper reached erroneous conclusions. Tob
Control 2005;14:227-35.
5.Lee PN. "Marriage to a smoker" may
not be a valid marker of exposure in studies relating
environmental
tobacco smoke to risk of lung cancer in Japanese non-smoking women.Int Arch Occup Environ Health 1995;67:287-94.
6.Hagan
RL, Ramos JM Jr, Jacob PM 3rd. Increasing urinary cotinine concentrations at
elevated temperatures: the role of conjugated metabolites. J Pharm Biomed
Anal. 1997;16:191-7.
7.Proctor
CJ. Fax to Dr E. Yano,
Teikyo
University
, October 26 1992.
I am the “WDE Irwin” quoted on page 67 as follows: “Years later
(1985), WDE Irwin, a technician with BAT in England, was asked how a
grooved filter could be made that would avoid criticism but also provide
good taste. He concluded: ‘Finally for cigarettes, I believe it to be a
self evident truth not only is there no smoke without fire, but also there
is no kick without smoke.’”
I am the “WDE Irwin” quoted on page 67 as follows: “Years later
(1985), WDE Irwin, a technician with BAT in England, was asked how a
grooved filter could be made that would avoid criticism but also provide
good taste. He concluded: ‘Finally for cigarettes, I believe it to be a
self evident truth not only is there no smoke without fire, but also there
is no kick without smoke.’”
“Technician” is not a correct identification of my status. At time
of the quote, I had 20 years experience in the tobacco industry and held
three quite separate primary degrees from British universities, majoring
in chemistry, economics and statistics. A quick search on Google would
have identified my status as “scientist”. My credibility as an iconoclast
could be compromised if I did not make this correction. Although no
longer in the tobacco industry, I may at some point seek to criticise a
report by the US Institute of Medicine, “Clearing the Smoke: The Science
Base for Tobacco Harm Reduction” published in 2001 and I shall need all
the credibility I can muster!
Simon Chapman's pictures on page 367 of the latest Tobacco Control points out that the 7-11 chain of convenience stores in Thailand was refusing to cover their cigarette products as required by the Ministry of Health's requirements on advertising. They are now complying with the regulation and do not have the open display of cigarette products. This means that all retail shops in Thailand are no longer displaying any...
Since my original publication in 1995 reporting high rates of denial of smoking in Japanese women,1 and Prof Yano's alternative assessment of the evidence,2 there has been an ongoing correspondence between the two of us.3-6 In his latest letter6 Yano asks whether my paper1 should have been published because it suffers from "erroneous interpretations based on invalid measurements."
My calculations critically depe...
Nathan K Cobb raises an important point. This paper has been reviewed by the Centre for Reviews and Dissemination [1], which provides critical assessments of the quality of economic evaluations. They raised this issue along with some other noteworthy points relating to the costs of the program. Specifically, the costs and the quantities were not reported separately, which limits the generalisability of the authors' results...
In the latest issue of Tobacco Control, Radu and others report on tobacco use among Swedish schoolchildren (Tobacco Control 2005;14:405- 408). As a Swede, I was surprised to read about some of their findings.
Children who smoke daily or almost daily are defined as “regular smokers”. The percentage of regular smokers is reported to have decreased to 4 per cent among 16-years-old boys and 15 per cent among girls by...
In a visit to Catalonia in Spain during October 2005, I noticed a number of changes in the smoking culture and regulations, compared to a visit in 2001.
Smokefree legislation is expected to be passed in 2006. The Catalonia regional government plans to take up the same tough stance as Ireland, the Netherlands and Norway. But there are already changes in Catalonia.
In comparison to 2001, I came across sev...
Dear Editor,
When we received the August 2005 issue of Tobacco Control, we found much in it to help inform our work, as usual.
I am writing, however, because we have some concerns about one of the articles published. “The perimetric boycott: a tool for tobacco control advocacy,” is described as a comprehensive analysis of a number of boycotts, including one organized by Infact (now Corporate Accountabi...
The recent article by Al-Delaimy et al (TC 14:359) makes two conclusions. The first is that use of over-the-counter (OTC) nicotine replacement therapy (NRT) for reasons other than smoking cessation is uncommon. This result is consistent with several other studies not cited in this letter (Nic Tobacco Research 6:79; Nicotine Safety and Toxicity (N Benowitz, ed) p 147). The second conclusion is that "some smokers may be...
When Hong and Bero published their study �"How the tobacco industry responded to an influential study of the health effects of secondhand smoke�" in 2002, I was supporting the law suit against a railway company to get smoke-free environment for workers and passengers in Japan. At that time, non-smokers had been annoyed by secondhand smoke for a long time regardless of our many claims. The company had been denying the harmfu...
...
I am the “WDE Irwin” quoted on page 67 as follows: “Years later (1985), WDE Irwin, a technician with BAT in England, was asked how a grooved filter could be made that would avoid criticism but also provide good taste. He concluded: ‘Finally for cigarettes, I believe it to be a self evident truth not only is there no smoke without fire, but also there is no kick without smoke.’”
“Technician” is not a correct id...
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