Tobacco.org

COLEMAN: End is in sight for smoking drivers  

IT WAS music to my ears this week to learn that a number of Senators are working to introduce legislation which will finally make it illegal for adults to smoke with children in cars. It's appalling that this selfish and dangerous act has not already been outlawed.

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• ‘Youth in Europe’ drug prevention programme sees youth drinking drop from 42% to 9%  

The Youth in Europe (YIE) drug prevention programme has released research tracking the incidence of smoking (daily), drinking and cannabis experimentation amongst 15 to 16-year-old students in Iceland from 1998 to 2011. And the results are astonishing. . . .

The level of youngsters smoking on a daily basis has decreased from 23% to 5%, and those experimenting with cannabis from 17% to 3%.

Iceland and Actavis continue to support the fight against substance abuse

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LUNDBERG: Let's Medicalize Tobacco Use  

Not aggressively preventing initial nicotine addiction is radical, considering the consequences to individuals and populations.

Tobacco nicotine addiction is best handled by primary prevention. If a person does not experiment with tobacco until adulthood, that person is unlikely to become addicted. Tobacco should be kept out of the hands of teenagers, even for experimentation.

Addiction, once established, does deserve therapy.

Nicotine can be delivered to tobacco addicts who "simply must have it" through a variety of modalities. Using the modality of tobacco smoking does deliver nicotine to treat withdrawal, but also delivers so many other more toxic substances as to render that modality the most harmful.

With this new creative initiative, physicians could decide on what, if any, nicotine delivery system is best for their patients and write the script.

Will this solve the tobacco problem? No.

Black markets for cigarettes; tobacco as a street drug; physicians who run "pill mills" might also run "fag shags". Morality really can't be legislated.

But we should hope that Iceland does enact this groundbreaking legislation. And the rest of the world can watch closely for results.

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VIDEO: Iceland: MP wants cigarettes to be sold by prescription 

A bill proposing selling cigarettes only by a prescription from a doctor has been drafted in Iceland.

The proposal is part of a 10-year plan to cut smoking - already on the decline in Iceland - still further.

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Iceland proposes cigarette prescriptions 

Under proposed legislation, only those with valid medical certificates would be permitted to buy cigarettes from pharmacies.

"I think Iceland can be a test tube to try out progressive things because we are a small country and we don't have a massive lobby for tobacco," said Thorarinn Gudnason, a cardiologist at Landspitali University Hospital in Rejkyavik. "We are taking care of people who are dying of this disease in their 40s and we're fed up with it."

Iceland's smoking rate is already one of the lowest in Europe. Just 15 per cent of the population lights up compared to an average of 31 per cent across the continent. However, the story among young Icelanders is more worrisome: 20 per cent of children and teenagers smoke. Dr. Gudnason hopes the new plan will dramatically reduce that figure and cut overall smoking rates to less than 10 per cent.

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Prescribe me a smoke, Doc 

The Parliament in Reykjavik is to debate a proposal that would outlaw the sale of cigarettes in normal shops. Only pharmacies would be allowed to dispense them -- initially to those aged 20 and up and eventually only to those with a valid ­medical certificate.

The radical initiative is part of a 10-year plan that also aims to ban smoking in all public places, including pavements and parks, and in cars when children are present.

Iceland wants to follow Australia's lead by forcing tobacco manufacturers to sell cigarettes in plain brown packaging. Under the mooted law doctors will be encouraged to help addicts kick the habit with treatments and education programmes. If these do not work, they may prescribe cigarettes.

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Iceland debates prescription-only cigarettes 

ICELANDIC lawmakers were today considering a proposal to ban the retail sale of cigarettes and make them a prescription-only product.

Under the proposal, smokers would need a valid medical certificate to buy tobacco products, which would only be available from pharmacies, The Guardian reported. Smoking "patients" would also need to submit to regular health checks.

The private members' bill was brought by Siv Fridleifsdottir, Iceland's former health minister, who told local media that the country needed to "wake up" to the dangers of smoking.

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Iceland debates prescription-only cigarettes 

ICELANDIC lawmakers were today considering a proposal to ban the retail sale of cigarettes and make them a prescription-only product.

Under the proposal, smokers would need a valid medical certificate to buy tobacco products, which would only be available from pharmacies, The Guardian reported. Smoking "patients" would also need to submit to regular health checks.

The private members' bill was brought by Siv Fridleifsdottir, Iceland's former health minister, who told local media that the country needed to "wake up" to the dangers of smoking.

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• What a drag … Iceland considers prescription-only cigarettes 

Iceland is considering banning the sale of cigarettes and making them a prescription-only product.

The parliament in Reykjavik is to debate a proposal that would outlaw the sale of cigarettes in normal shops. Only pharmacies would be allowed to dispense them – initially to those aged 20 and up, and eventually only to those with a valid medical certificate.

The radical initiative is part of a 10-year plan that also aims to ban smoking in all public places, including pavements and parks, and in cars where children are present. Iceland also wants to follow Australia's lead by forcing tobacco manufacturers to sell cigarettes in plain, brown packaging plastered with health warnings rather than branding.

Under the mooted law, doctors will be encouraged to help addicts kick the habit with treatments and education programmes. If these do not work, they may prescribe cigarettes.

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• 20% Of Young Males Use Mouth Tobacco 

While smoking is declining, the use of mouth tobacco is on the rise, RÚV reports.

The data was supplied by the Ministry of Welfare in response to a question asked by Progressive MP Siv Friðleifsdóttir. According to their findings, the sale of snuff increased from 11.7 tonnes in 2003 to 25.5 tonnes in 2010. Although snuff is typically intended to be snorted, it is common - especially among young Icelandic males - to use the powdered tobacco orally.

At the same time, smoking has been decreasing steadily. Among adults between the ages of 15 and 89, 19.8% smoked daily in 2004, which then reduced to 19% in 2007, 17.6% in 2008, 15.4% in 2009 and 14.2% last year. Among 16-year-olds, that figure declined from 12% in 2004 to 7% today.

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Cigarette Sales Decrease in Iceland, Snuff on the Up 

The sale of cigarettes has decreased significantly this year compared to 2009. According to the State Alcohol and Tobacco Company of Iceland (ÁTVR), sales dropped by almost 13 percent in the first nine months.

However, at the same time the sale of snuff and chewing tobacco has increased by 9.2 percent—at the end of September almost 18.8 tons of snuff and chewing tobacco had been sold in Iceland, Morgunbladid reports.

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deCODEing Smoking: New Genetic Factors Behind Nicotine Dependence and Lung Cancer 

Cigarette smoking is a major cause of illness and death worldwide. But it is a complex behavior, and how much people smoke, how hard they find it to quit, and the impact of long-term smoking on health varies greatly among individuals. A substantial portion of this variability is genetic. Two years ago, deCODE discovered the first common, single-letter variation (SNP) in the sequence of the human genome, on chromosome 15q25, associated with nicotine addiction and risk of lung cancer. Today, deCODE scientists and academic colleagues from 23 institutions in a dozen countries build on this work with the discovery of common SNPs on chromosomes 8p11 and 19q13 that among smokers increase the number of cigarettes smoked per day (CPD), a measure of nicotine addiction, and increase risk of lung cancer.

The study, published today in the online edition of Nature Genetics, analyzes detailed genotypic and smoking data from more than 130,000 participants.

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

Executive summary

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

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

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

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

Iceland introduced display bans in August 2001.1 . . .

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

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

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

Conclusions

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

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

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

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

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

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

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

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

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

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

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

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

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