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The recent article by Cai et al, reported that male gender, young
age, low educational attainment, and tobacco cultivation are predictors of
tobacco use and second-hand smoke (SHS) exposure in rural China [1].
Neighborhood-level income was the only contextual predictor of tobacco use
and SHS exposure identified. Hence, the authors suggested that "future
interventions to reduce smo...
The recent article by Cai et al, reported that male gender, young
age, low educational attainment, and tobacco cultivation are predictors of
tobacco use and second-hand smoke (SHS) exposure in rural China [1].
Neighborhood-level income was the only contextual predictor of tobacco use
and SHS exposure identified. Hence, the authors suggested that "future
interventions to reduce smoking and exposure to SHS in China should focus
more on tobacco farmers, less-educated individuals and on poor rural
communities." (pg. ii19)
Nevertheless, Cai and colleagues also found that the Han majority had
higher prevalence of smoking and SHS exposure when compared to ethnic
minorities (p<0.05). Differences in health outcomes and risk factors
have been reported among the Han population when compared to other Chinese
ethnic minorities [2,3]. Stratified analysis might elucidate unique risk
factors to smoking and SHS exposure between ethnic groups important for
the design of tobacco control strategies.
In addition, Cai et al. showed that townships varied widely in the
proportion of the population who were ethnic minorities (3.1% to 97.1%).
In the study of contextual determinants of health, results and
implications should not ignore such vast differences in ethnic composition
between areas. Important information might be conveyed if results were
stratified by the proportion of ethnic minorities in the area (e.g. high,
medium, low). Ethnic minorities living in areas with a high proportion of
the population of the same ethnic minority may experience better health
[4]. Therefore, it might also be important to compare the risk of smoking
and SHS exposure among individuals living in areas highly populated by
their ethnic group versus those residing in areas where they are the
minority group.
Cultural differences and ethnic composition of a geographic area
should be considered in the design and implementation of tobacco control
programs and in the allocation of resources. Resources may be better spent
in areas with a high proportion of the Han population; while areas with a
high minority population may be at decreased risk. Interventions should be
culturally appropriate to minimize the expenditure of resources on
ineffective strategies.
Diana M. Sheehan, MPH
References
1. Cai L, Wu X, Goyal A, et al. Multilevel analysis of the
determinants of smoking and second-hand smoke exposure in a tobacco-
cultivating rural area of southwest China. Tob Control
2013;22(suppl2):ii16-20.
2. Ruixing Y, Hui L, Jinzhen W, et al. Association of diet and
lifestyle with blood pressure in the Guangxi Hei Yi Zhuang and Han
populations. Public Health Nutr 2009;12(4):553-561.
3. Sun H, Zhang Q, Luo X, et al. Changes of adult population health
status in China from 2003 to 2008. PLoS One 2011;6(12):e28411.
4. Inagami S, Borell LN, Wong MD, et al. Residential segregation and
Latino, black and white mortality in New York City. J Urban Health
2006;83(3):406-20.
NOT PEER REVIEWED
To the Editor:
The habit of water pipe smoking is rapidly extending in all occidental
countries. This rise in popularity appears to be correlated with the
advent on store shelves of an array of fruit-flavored tobacco mixtures,
which list ''molasses'' as a primary ingredient. Also there is a
widespread misperception among smokers that the water through which the smoke
bubbles acts as a filter, rendering...
NOT PEER REVIEWED
To the Editor:
The habit of water pipe smoking is rapidly extending in all occidental
countries. This rise in popularity appears to be correlated with the
advent on store shelves of an array of fruit-flavored tobacco mixtures,
which list ''molasses'' as a primary ingredient. Also there is a
widespread misperception among smokers that the water through which the smoke
bubbles acts as a filter, rendering it considerably less harmful than that
of cigarettes [1]. A recent systematic review showed that the main motives
for water pipe tobacco smoking were socializing, relaxation, pleasure and
entertainment. Peer pressure, fashion, and curiosity were additional
motives for university and school students [2]. However, the habit of
smoking tobacco in water pipes is an old practice in the Eastern
Mediterranean countries like Egypt, Jordan, Syria, Lebanon and Iraq [3].
Recently, Jaboc and collaborators (2013) published a crossover study about
biomarkers of toxicant exposure with water pipe compared with cigarettes.
The study included 13 volunteers from San Francisco (USA) who smoked both
cigarettes and water pipes. The results showed that water pipe was
associated with greater exposure to carbon monoxide, polycyclic aromatic
hydrocarbons and benzene compared with cigarette smoking. Finally, the
authors concluded that water pipe smoking is associated with a high risk of
leukemia related to high levels of benzene exposure [4].
If Jaboc and collaborators' (2013) conclusions were right, we would expect
higher prevalence of leukemia in the Eastern Mediterranean region compared
with the Occidental Countries.
Reviewing cancer registries in GLOBOCAN 2008, we can notice that adjusted
standardized mortality rates of leukemia in males are comparable in the
European Region (5.0 per 100.000) to the Eastern Mediterranean Region (4.7
per 100.000). A similar rate is noticed in the Americas Region (5.0 per
100.000) [5].
Deficient registration systems could not be the explanation. Neoplasms
principally attributed to smoking like lung, laryngeal and oro-pharyngeal
cancers have similar prevalence in Egypt like many of the occidental
countries [5].
Water pipe tobacco brands used in the study of Jacob and collaborators
(2013) were Nakhla and Al-Waha. These are the same brands usually consumed
in the Eastern Mediterranean countries, like Egypt. On examining the box
of Nakhla Double Apple brand, widely consumed in Spain, we can find a
clear notice that it contains 0% tar.
During the smoking process cigarette tobacco burns directly, whereas water
pipe tobacco does not burn in a self-sustaining manner and requires an
external heat source such as charcoal. I think that the high level of
polycyclic aromatic hydrocarbon and benzene in the urine samples of water
pipe smokers in the study of Jaboc and collaborators (2013) could be
attributed to the charcoal disks used in many occidental countries. These
quick lighting charcoal disks are impregnated in gasoil rich in polycyclic
aromatic hydrocarbons and benzene. Smoke from these impregnated charcoal
disks is inhaled by water pipe smokers [1]. In Eastern Mediterranean
countries like Egypt, natural charcoal is used and is burned slowly in
special clay or metallic receptacles [1,3]. This could explain the
comparable prevalence of leukemia in Egypt and Occidental Countries.
Examining quick lighting charcoal disk tubes available in Spain, we can
notice that they lack labeling about the hazards of their use for water
pipe smoking. Regulations and control for the use of these impregnated
charcoal disks in the European Countries are urgently needed.
REFERENCES
1. Shihadeh A. Investigation of mainstream smoke aerosol of the argileh
water pipe. Food Chem Toxicol 2003;41(1):143-52.
2. Akl EA, Jawad M, Lam WY, Co CN, Obeid R, Jihad Irani J. Motives,
beliefs and attitudes towards waterpipe tobacco smoking: a systematic
review. Harm Reduct J 2013;10:12.
3. Chaouachi K. The medical consequences of narghile (hookah, shisha) use
in the world. Rev Epidemiol Sante Publique 2007;55(3):165-170.
4. Jacob P 3rd, Abu Raddaha AH, Dempsey D, Havel C, Peng M, Yu L, Benowitz
NL. Comparison of nicotine and carcinogen exposure with water pipe and
cigarette smoking. Cancer Epidemiol Biomarkers Prev 2013;22(5):765-72.
5. International Agency for Research on Cancer. GLOBOCAN 2008. Available
at: http://globocan.iarc.fr/ (Accessed 31 August 2013).
NOT PEER REVIEWED The article by Berman et al "Estimating the cost of a smoking employee" has attempted to quantify the costs associated with employing smokers. As the article indicates several companies are now actively discriminating against smokers so it is important that any costs are fully justified. One area that concerns me about this is a tendency towards oversimplification of a complex situation. In particular the assu...
NOT PEER REVIEWED The article by Berman et al "Estimating the cost of a smoking employee" has attempted to quantify the costs associated with employing smokers. As the article indicates several companies are now actively discriminating against smokers so it is important that any costs are fully justified. One area that concerns me about this is a tendency towards oversimplification of a complex situation. In particular the assumption that the breaks a smoker takes from work are a cost to the employer. Clearly a smoking break is time away from workplace tasks, but the assumption that this is just about time at the desk ignores a growing body of evidence that taking regular breaks from work is beneficial to individual health (1), which might counter some of the negative health risks associated with smoking, and that breaks are also beneficial to workplace productivity. Research has suggested that people taking regular breaks are more creative, more focussed and ultimately more productive (2,3). Prolonged attention to an individual task has, somewhat counter-intuitively, been shown to hinder performance. Taking a break from the task improves overall focus (2). Similarly breaks that have a positive association for the person taking the break are linked to positive performance effects and lower levels of negative emotions (3). All of this suggests that smokers taking breaks might actually increase their performance and benefit employers. Not taking such effects into account is potentially unfair to smokers and also risks breaks being associated by employers with negative effects for all of us.
References:
1) Levene: http://dx.doi.org/10.2337%2Fdb10-1042
2) Ariga: http://dx.doi.org/10.1016/j.cognition.2010.12.007
3) Trougakos: http://dx.doi.org/10.1108/S1479-3555(2009)0000007005
We appreciate Dr. Blum's interest in our study and his comments.
Data used for our study were collected and coded based on the public
health surveillance model, which is more fully described elsewhere (1).
Only a carefully selected set of items from tobacco news stories were
coded over an extended period of time, with editorial cartoons and letters
to the editor not included in the system. The newspapers were
specific...
We appreciate Dr. Blum's interest in our study and his comments.
Data used for our study were collected and coded based on the public
health surveillance model, which is more fully described elsewhere (1).
Only a carefully selected set of items from tobacco news stories were
coded over an extended period of time, with editorial cartoons and letters
to the editor not included in the system. The newspapers were
specifically chosen based on their larger circulation numbers and
geographic representation. As often occurs with surveillance system data,
they can be more useful for generating than testing specific research
hypotheses (2).
We agree it would be valuable to assess the level of news coverage
for tobacco issues in the broader context of media coverage for other
topics; unfortunately, doing so was far beyond the scope this project.
There were, of course, many more tobacco activities or events over
the 7-year period contributing to higher levels of news coverage than we
could possibly highlight in the figures. We agree that prominence
accorded to tobacco news stories by news media gatekeepers, as assessed by
whether they appear on the front page of a newspaper or are mentioned
early in television broadcasts, or if they appear in elite media outlets
such as the New York Times, is important (3).
Additional items were added to the system beginning in 2007 that
allowed for some analyses of prominence from 2007-2010, and these findings
were mentioned in our paper. More research about prominence along the
lines suggested by Dr. Blum is warranted, and such research would,
ideally, confirm or deny his impression that there were only been a
handful of significant tobacco stories in recent years.
We believe the prominence versus quantity argument as it pertains to
news media coverage of tobacco represents a false choice: both are
important and they are interrelated. Tobacco control and prevention
activities or events that result in news stories in elite media are likely
to generate a large quantity of news coverage over time in other media
outlets. Conversely, if a large number of news stories about a specific
tobacco-related topic appear in other media outlets, they will likely gain
the attention of elite media gatekeepers and result in increased coverage
in their news venues.
1. Nelson DE, Evans WD, Pederson LL, et al. A national surveillance
system for tracking tobacco news stories. Am J Prev Med. 2007;32:79-85.
2. Lee LM, Teutsch SM, Thacker SB, St. Louis, ME (eds). Principles
& Practice of Public Health Surveillance (3rd ed). New York: Oxford
University Press; 2010.
3. Gorman L, McLean D. Media and Society into the 21st Century: A
Historical Introduction (2nd ed). Hoboken, NJ: Wiley-Blackwell; 2009.
NOT PEER REVIEWED Because the authors cite just seven major tobacco-related news events
in the seven year period they reviewed (Figure 2), I question whether
their tabulation of the "volume of news media stories on tobacco" (page 6)
provides a meaningful representation of the coverage of tobacco-related
issues in the mass media. Is not a front-page article on a tobacco-
related subject in The New York Times or The Washingt...
NOT PEER REVIEWED Because the authors cite just seven major tobacco-related news events
in the seven year period they reviewed (Figure 2), I question whether
their tabulation of the "volume of news media stories on tobacco" (page 6)
provides a meaningful representation of the coverage of tobacco-related
issues in the mass media. Is not a front-page article on a tobacco-
related subject in The New York Times or The Washington Post--or a lead
story on NBC NIghtly News or The Today Show--of far greater importance, in
terms of both content and readership, than the publication of any number
of brief items? In other words, missing from this analysis is a year-by-
year list of nationally significant news stories on tobacco.
One measure that could be used to quantify the relative importance of
tobacco stories in a given year is the daily Index to Businesses in The
Wall Street Journal (WSJ). By this indicator (and by my daily reading of
the print editions of the WSJ, The New York Times, The Financial Times,
USA Today, and two local US dailies), my impression is that in recent
years there has been a relative handful of significant tobacco news
stories. This is at odds with the authors' finding of an average of 3
tobacco-related newspaper stories, 4 newswire stories, and 1 television
news story each day for seven years. Although the authors attempted to
correct for duplication, I suspect a large percentage of these stories
were variations on a theme or the same news thread.
Another measure is newspaper editorial cartoons. Even taking into
consideration the decimation in the ranks of political cartoonists at US
dailies due to the steep decline in newspaper readership, editorial
cartoons on tobacco issues are now rare. In the heady days of anti-
tobacco activism in the US in the 1980s and 1990s, I catalogued more than
700 editorial cartoons on tobacco.
I wonder if the best way to gauge the weight given to the coverage of
tobacco-related issues in a given year would be to compare it to the
attention given to other issues, both health-related (eg, AIDS, obesity,
gun control, alcohol problems) and less directly health-related (eg, the
economy, unemployment, terrorism).
Ultimately, I am unconvinced that quantity beats quality when it
comes to reports on tobacco in the mass media. What matters is the
prominence of news coverage of significant issues, not the number of
articles all counted as equal.
NOT PEER REVIEWED
I really welcome this kind of discussion.
I acknowledge your 'why and how' argument, however you may find that
things like telephone counselling and many group programs will however
then fall into your unassisted quitting category as well. This is because
they are simply being coached to enhance those natural skills they already
have.
I am aware you are conducting an interview style...
NOT PEER REVIEWED
I really welcome this kind of discussion.
I acknowledge your 'why and how' argument, however you may find that
things like telephone counselling and many group programs will however
then fall into your unassisted quitting category as well. This is because
they are simply being coached to enhance those natural skills they already
have.
I am aware you are conducting an interview style 'unassiSted attempt'
project, and I think this is really useful for workers in the field. What
I am convinced you are going to find is that people use a range of
positive self talk strategies, and challenging negative thoughts at times
of cravings to overcome them. Things such "I can do this', 'Just say no',
and/or visualising the long term consequences of smoking, to name a few.
These cognitive strategies that people naturally use are great, and it's
what telephone counsellors and group clinicians would support in any drug
and alcohol envronment, or even clincians that work solely with
psychopathologies. There is nothing wrong with this, except that in group
and individual counselling, you can practice and enhance these cognitive
processes - and add more of them. In addition, you can offer other
strategies, dare I say - NRT, in combination. This is what makes group
behaviour therapy for example so useful.
There is nothing new about congnitive restructuring techniques.
Psychologists have been assisting clients for years as part of any CBT
strategy. Your study, although I'm not aware of the details, seems to be
collection of natural cognitive processes. Again, all this is fine, but
wht not build on this as part of treatment? After all, you say you are not
against treatment.
Your have linked your statement about pharmaceutical companies in
with services like mine. i.e 'you spend a lot, with little proportional
return.' This is an apples and oranges argument. Firstly, I personally can't
see the problem in a pharmaceutucal company (or any company for that
matter) spending their own money to advertise their own products. I also
can't see any problem with them making a profit from this, as long as the
evidence supports their products' use.
Importantly, the last time I looked, almost nothing has been spent by the
government or by anyone else on our service up until recently, and yet I
receive hundreds of enquiries each year for assistance, usually from
desperate workplaces.
Your final point is a good one. There is a lack of motivation by the
majority of smokers to take up professional assistance. Yet if
interventions like group behaviour therapy, for example, doubles cessation,
and treatment really is supported by public health teams, then why aren't
public health experts continually studying and supporting ways to
effectively enhance uptake? This is where I see failure.
It would be fantastic if all smokers could quit with 'unassisted'
self talk strategies by 30-35. Yet in NSW more than 60% of smokers are
over 35 as of 2011 (Health stats data). Their unassisted quit attempts did
not work, but maybe treatment would have.
NOT PEER REVIEWED
The warning of this article is important, but not limited to the
Trans-Pacific Partnership. Switzerland and USA, as countries which have not ratified, are not obliged to follow
Article 5.3 of the WHO Framework Convention on Tobacco Control. One of the
reasons for the largest tobacco companies to move their headquarters to
Switzerland was the location of the World Trade Organisation in this
country. Some...
NOT PEER REVIEWED
The warning of this article is important, but not limited to the
Trans-Pacific Partnership. Switzerland and USA, as countries which have not ratified, are not obliged to follow
Article 5.3 of the WHO Framework Convention on Tobacco Control. One of the
reasons for the largest tobacco companies to move their headquarters to
Switzerland was the location of the World Trade Organisation in this
country. Some time ago I attempted to draw attention to this danger:
https://secure.avaaz.org/en/petition/exclude_tobacco_nicotine_from_free_trade_agreements/.
I hope that Fooks and Gilmore will succeed in starting a broader movement.
NOT PEER REVIEWED Smokeless Tobacco(ST) such as Gutkha-ban (and the like) in India does
not work!
There have been repercussions from sections of growers following the ban of
Gutka (and similar products) in Karnataka, a South -Western state of India with the
highest production of Areca-nut (one of the major constituents of ST, used
in commercial sachet (such as Gutka etc) and home-made/vendor-made
Tambula/Paan...
NOT PEER REVIEWED Smokeless Tobacco(ST) such as Gutkha-ban (and the like) in India does
not work!
There have been repercussions from sections of growers following the ban of
Gutka (and similar products) in Karnataka, a South -Western state of India with the
highest production of Areca-nut (one of the major constituents of ST, used
in commercial sachet (such as Gutka etc) and home-made/vendor-made
Tambula/Paan as well.
It is essential to ban Gutkha, because tobacco containing Gutkha is
highly carcinogenic, killing millions of Indian and SE- Asian
people annually. Some of the areas of India have higher incidence
rates of mouth cancer -- more than 30% of all cancers are oral cancer,
and there is no doubt that the tobacco containing Gutkha and Tambula/Paan
(usually home or vendor-made: it's a local name in Karnataka and other
states of India) is strongly associated with mouth cancer-- evidenced
by several studies conducted elsewhere. Hence banning of Gutkha is a step
forward to help prevent mouth and head-neck cancer-- provided it has been
implemented properly.
But the setback of the ban is that none of the state
governments and relevant agencies in India have so far come up with a strategic way of implementing the ban, including evaluation of its effectiveness. In this
context, I mention that the estimated growth rate of new Gutkha and similar
commercial sachets is much higher compared to the pre-ban era, and a
few expensive brands are also advertised on some of the national TV
channels.(Source:Department of Oral Biology & Genomic Studies, Nitte
University, India)
However, as one of the member-states of UN, India has signed the Framework Convention for Tobacco Control of WHO, and the country is
obliged to comply with that directive. Rightly India has got its own
parliamentary verdict to ban tobacco consumption such as smoking in
public places (although 'public place' is not clearly defined, and there
is no definite say on Gutkha-chewing habits. On this I wrote to WHO
published (
http://www.who.int/bulletin/bulletin_board/82/news06041/en/index1.html).
We understand that the police can catch and penalize a smoker violating smokefree laws,
but not a chewer.
Therefore, as one of the researchers in tobacco addictions at
Nitte University of India jointly with the Warwick University of the UK
also being a Stakeholder of smokeless tobacco (ST) control of National
Institute of Clinical Excellence (NICE) at the department of Health (DoH)
in the UK, I find the demand of Areca-nut growers in Karnataka needs to
be solved amicably and sensibly, because, although millions of people may depend upon
Areca-farming, we cannot reconcile their living with the expense of the rising
death toll from mouth cancer and disturbing disability from Oral Sub-mucus
Fibrosis(OSF).
However, according to classification of Gutkha (ref. Oral Cancer
Screening & Education: A Guideline Protocol: authored by Professor
Chitta Chowdhury
http://www.nature.com/bdj/journal/v210/n9/full/sj.bdj.2011.380.html), I
need to say that "Pan-Parag" and similar products may not have tobacco in them.
So probably it will be difficult to ban all the sachets not containing
tobacco. But the commercial sachets containing Areca-nut without tobacco
are also carcinogenic. Again
the elemental copper in Areca-nut is one of the causes of oral sub-mucus
fibrosis (OSF)- a disabling disease condition mentioned, and 2-7% OSF
turns into full-blown mouth cancer--this is a public health concern too.
If we are
able to reduce the concentration of copper to a permissible limit in Areca
-nut(The minimum recommended dietary allowance (RDA) for copper is 0.9
milligrams per day for most adults, 1 milligram for pregnant women, and
1.3 milligrams for women who are breast-feeding: Source-FDA, USA) or to produce
totally copper-free Areca-nut, also removing carcinogenic compounds, this could be good news for the Areca-nut growers. Of
course, there are many beneficial effects of Copper, but continuous
consumption (by habitual chewers) of Areca-nut will exceed RDA and
cause adverse effects, such as OSF and eventually cancer.
In this context, I strongly recommend that we need to ensure that none
of the Gutkha and "Pan-Parag" sachet contains tobacco products or any
carcinogenic compounds, including Areca-nut, and in my opinion that is
absolutely impossible. Therefore, a complete ban of commercial sachets (eg. Gutkha
etc) is a must. Also how to stop vendor-made and home-made
Tabula/Paan products needs to be addressed urgently, because there are
carcinogenic products in them as well, and these are consumed by more
people compared to commercially produced Sachets. Now the question is--
how the law enforcement, health and safety regulators and policy-
administrators will effectively implement the ban of Gutkha(ST) in India.
Professor Chitta Chowdhury
NRT Services and Addiction Research Unit
Oral & Maxillofacial Cancer Services (Prevention & Control),
Department of Oral Biology & Genomic Studies,
Nitte University, Deralakatte, Mangalore-675018, India & The
University of Warwick Education & Development Medical Faculty PG
Dentistry aliened with De Monte University of Leicester, England.
The prospect of a tobacco endgame in which death and disease from
tobacco would be virtually eliminated is very exciting. We read the May
2013 issue of Tobacco Control on the Tobacco Endgame with great interest.
The issue features 20 articles by esteemed co-authors who are known
internationally for their work on tobacco control. Each individual
article is excellent; however, we were surprised and disappointed that
thi...
The prospect of a tobacco endgame in which death and disease from
tobacco would be virtually eliminated is very exciting. We read the May
2013 issue of Tobacco Control on the Tobacco Endgame with great interest.
The issue features 20 articles by esteemed co-authors who are known
internationally for their work on tobacco control. Each individual
article is excellent; however, we were surprised and disappointed that
this special issue ignored the very substantial problem of psychiatric
comorbidity among smokers. Studies increasingly demonstrate that this
group buys and uses more tobacco than any other disparity group (MMWR
2013). They are also very likely to die early from tobacco use, suffer
economic burden, and suffer unique consequences such as psychiatric
medication complications. The focus of much of the issue is on regulatory
approaches or potential changes to tobacco products that may reduce
cigarette smoking. While these empirically supported approaches are
important, data from New York
(http://www.health.ny.gov/prevention/tobacco_control/reports/statshots/volume5)
indicates that many important public health policies do not adequately
influence smokers with psychiatric comorbidity. A true "end game"
strategy must acknowledge the tremendous proportion of smokers with
psychiatric comorbidity and offer strategies for addressing this
vulnerable population.
We agree with Dr Malone when she says that a tobacco endgame "addresses
tobacco as a systems issue...{that} reframes strategic debates...{and}
advances social justice (Malone 2013, p i42)." Dr. Malone's words
validate our concern that psychiatric comorbidity was rarely mentioned in
this issue. The word "mental" appears twice (Thomas p56; Chapman p 35) and
"comorbid" appears twice (Hatsukami, p 36; Benowitz p 16). A special
issue on a tobacco endgame that ignores a group that is hugely
overrepresented among current smokers makes it even more likely that this
disparate population will continue to be ignored.
In past decades the US was successful in driving down smoking rates
through public health efforts. Recently these efforts have stalled and we
need to consider a new approach. While detailing a comprehensive strategy
is beyond the scope of this letter, we are calling for focused efforts,
targeting disparate population groups like the poor and the mentally ill.
A population approach is reasonable as long as it is also mindful of the
"who" that are left smoking. These groups should be given a priority
designation for future funding, policy and research efforts because any
"endgame" that leaves them behind is no endgame at all.
NOT PEER REVIEWED
Surface nicotine levels in non-smoking rooms of smoking and smoke-free hotels were found to be significantly different. However, the authors found that
"Geometric mean urine cotinine levels did not differ
between non-smoking confederates staying in non-smoking
rooms of smoke-free and smoking hotels."
Therefore surface nicotine is not important.
No significant difference was found between air nicotine levels, w...
NOT PEER REVIEWED
Surface nicotine levels in non-smoking rooms of smoking and smoke-free hotels were found to be significantly different. However, the authors found that
"Geometric mean urine cotinine levels did not differ
between non-smoking confederates staying in non-smoking
rooms of smoke-free and smoking hotels."
Therefore surface nicotine is not important.
No significant difference was found between air nicotine levels, which is the major cause of concern to those who believe extremely low levels of ETS to be harmful. Also, non-smoking rooms in smoking hotels recorded nicotine levels 1/15th those of smoking rooms. The usual estimate for cigarette equivalence to spending 4 hours a day in a smoky bar is 10 cigarettes a year. The highest I have read claimed by anti tobacco campaigners is 150 cigarettes a year. Roughly, staying in a non-smoking room in a smoking hotel poses at most the same risk as smoking 10 cigarettes a year and more probably, less than one cigarette a year. Both these risks are negligible.
See also http://tobaccoanalysis.blogspot.co.uk/2013/05/new-study-warns-of-dangers-of-thirdhand.html
NOT PEER REVIEWED Dear Editor,
The recent article by Cai et al, reported that male gender, young age, low educational attainment, and tobacco cultivation are predictors of tobacco use and second-hand smoke (SHS) exposure in rural China [1]. Neighborhood-level income was the only contextual predictor of tobacco use and SHS exposure identified. Hence, the authors suggested that "future interventions to reduce smo...
NOT PEER REVIEWED To the Editor: The habit of water pipe smoking is rapidly extending in all occidental countries. This rise in popularity appears to be correlated with the advent on store shelves of an array of fruit-flavored tobacco mixtures, which list ''molasses'' as a primary ingredient. Also there is a widespread misperception among smokers that the water through which the smoke bubbles acts as a filter, rendering...
We appreciate Dr. Blum's interest in our study and his comments. Data used for our study were collected and coded based on the public health surveillance model, which is more fully described elsewhere (1). Only a carefully selected set of items from tobacco news stories were coded over an extended period of time, with editorial cartoons and letters to the editor not included in the system. The newspapers were specific...
NOT PEER REVIEWED Because the authors cite just seven major tobacco-related news events in the seven year period they reviewed (Figure 2), I question whether their tabulation of the "volume of news media stories on tobacco" (page 6) provides a meaningful representation of the coverage of tobacco-related issues in the mass media. Is not a front-page article on a tobacco- related subject in The New York Times or The Washingt...
NOT PEER REVIEWED I really welcome this kind of discussion.
I acknowledge your 'why and how' argument, however you may find that things like telephone counselling and many group programs will however then fall into your unassisted quitting category as well. This is because they are simply being coached to enhance those natural skills they already have.
I am aware you are conducting an interview style...
NOT PEER REVIEWED The warning of this article is important, but not limited to the Trans-Pacific Partnership. Switzerland and USA, as countries which have not ratified, are not obliged to follow Article 5.3 of the WHO Framework Convention on Tobacco Control. One of the reasons for the largest tobacco companies to move their headquarters to Switzerland was the location of the World Trade Organisation in this country. Some...
NOT PEER REVIEWED Smokeless Tobacco(ST) such as Gutkha-ban (and the like) in India does not work!
There have been repercussions from sections of growers following the ban of Gutka (and similar products) in Karnataka, a South -Western state of India with the highest production of Areca-nut (one of the major constituents of ST, used in commercial sachet (such as Gutka etc) and home-made/vendor-made Tambula/Paan...
The prospect of a tobacco endgame in which death and disease from tobacco would be virtually eliminated is very exciting. We read the May 2013 issue of Tobacco Control on the Tobacco Endgame with great interest. The issue features 20 articles by esteemed co-authors who are known internationally for their work on tobacco control. Each individual article is excellent; however, we were surprised and disappointed that thi...
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