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Showing posts with label smoking. Show all posts
Showing posts with label smoking. Show all posts

Friday, September 1, 2023

300 million smokers and counting

The world’s largest producer and consumer of tobacco, it has an estimated 300 million smokers, nearly a third of the world’s total.

Despite years of anti-smoking campaigns – Chinese President Xi Jinping reportedly gave up smoking in his 40s and banned smoking in government buildings – many continue to light up, driven by social mores, cheap cigarettes, a lack of public education and, crucially, the protection of Big Tobacco.

Cartons of smokes are considered appropriate business gifts while tobacco shops dot the streets, with prices ranging from as little as 10 yuan (RM6.40) a packet to over 200 yuan (RM127.70). Convenience stores prominently display a dizzying array of varieties.

But kicking the habit is far harder than simply going cold turkey. The tobacco industry is both regulated and controlled by the State Tobacco Monopoly Administration (STMA), an agency that provides jobs for over half a million people across the country.

In recent years, the problem has taken on a new dimension with the startling popularity of electronic cigarettes, making nicotine palatable – and readily available – even to the young.

How did the world’s second-largest economy get so addicted to smoking? And as the world moves towards tobacco-free societies, would it ever be truly possible for China to kick the habit?

Cigarette normalisation

Shortly after the establishment of the People’s Republic of China in 1949, Beijing declared that tobacco farms and cigarette manufacturing would be consolidated and managed by local governments.

When the country was put through rationing in those early years, cigarettes were among the “essentials” doled out to villagers and residents who registered with the local authorities, allowing officials to document the population.

Cigarette manufacturers also tapped iconography significant to China’s national consciousness. Brands like Xiongmao (Panda), Chunghwa (a metonym for China) and Zhongnaihai (a former imperial garden that now houses China’s leadership complex) all date back as far as the 1930s.

By the time STMA and its commercial arm China National Tobacco Corporation were created in the 1980s to consolidate and centralise tobacco production and sales, smoking was widely accepted.

Leaders ranging from Mao Zedong to Premier Zhou Enlai and Deng Xiaoping have all been photographed holding cigarettes, with ashtrays and spittoons commonplace in offices and government buildings across the country.

And it continues to play a significant role in society today.

When bistro owner Jeanne He was a bridesmaid in 2022 at a childhood friend’s wedding in Yunnan province – the country’s largest producer of tobacco – she had an important responsibility.

“I was in charge of arranging the cigarettes on trays for bridesmaids to hold up and offer to guests before the wedding dinner,” she said.

“The groomsmen had trays of snacks and candy.”

In much of China, working in the tobacco industry is seen to be as prestigious as being in the civil service, with its stable income, generous salaries and employee benefits.

In surveys of fresh graduates, China’s big tobacco firms – largely state-owned enterprises (SOE) – are consistently rated some of the best companies to work for, with degree holders happy to take on blue-collar jobs on the factory lines.

Some 98% of China’s tobacco firms are SOEs with little wiggle room for other market players. Manufacturing some 2.4 trillion cigarettes a year, the industry raked in 132 billion yuan in profits in 2022, nearly 12% up from the 118 billion yuan the year before.

China National Tobacco Corporation does not report sales figures but posted a record-breaking taxable income of 1.44 trillion yuan in 2022.

The second-highest tax payer, the Industrial and Commercial Bank of China, reported taxable income of 109 billion yuan.

The pressure that STMA exerts on the government is largely why tobacco regulation has hit a roadblock, said Dr Gan Quan, director of the China office of the International Union Against Tuberculosis and Lung Disease, a Paris-headquartered non-profit organisation aimed at eradicating tuberculosis and lung disease.

While major cities such as Beijing, Shanghai, Guangzhou and Shenzhen have been able to completely ban smoking indoors since 2007, this has been far more challenging in other cities like Chongqing.

In 2020, the city passed a law banning smoking in public places, but a loophole meant that certain establishments such as restaurants, hotels and entertainment venues were allowed to set up indoor smoking areas, exposing countless others to second-hand smoke.

“Smoking is strictly prohibited in the indoor areas of public places where smoking areas can be designated,” said the text of the law.

Dr Gan, who has spent his career studying China’s tobacco control policies, said: “It has become a pattern that whenever sub-national jurisdictions try to pass smoke-free laws, you have the STMA following them (to exert pressure to water down the laws) because they don’t want the momentum to spread from big cities like Beijing and Shanghai.”

Crucially, there is no national-level smoke-free legislation that will make it mandatory for all provinces and regions to adhere to, wrote Peking Union Medical College’s Dr Xia Wan in CCDC Weekly, a publication by the Chinese Centre for Disease Control and Prevention, in an article in 2022.

In November 2014, the State Council released a draft on national tobacco control guidelines to meet its obligations under the WHO FCTC, the first time such guidelines had been introduced at a national level.

“This draft was supposed to finish seeking advice, opinions and comments from the public by the end of 2014,” Dr Xia wrote.

“But unfortunately, the draft is still stuck in that stage and has not progressed further.”

Furthermore, regulation across cities remains lax, and it is not an uncommon sight to see people lighting up under “no smoking” signs in eateries.

STMA did not respond to a request for comment.

In 2021, China’s top health body, the National Health Commission, released its second report detailing the ill effects of smoking – an update from a 2012 version.

With more than half the male population smoking, over one million people lose their lives to tobacco use every year, a number that could double by 2030.

It also noted that “e-cigarettes are unsafe and pose a health hazard” but offered no solutions to the issue.

Electronic cigarettes

Electronic cigarettes and electronic nicotine delivery systems – more commonly known as vapes – have been regulated in China since 2022, and cartridges with flavours have been banned in a bid to stop young people from picking up smoking.

But results are mixed: While such vapes are no longer easily available, one can still walk up to any number of e-cigarette shops dotting the streets, where retailers pull out flavoured stock from under the counter.

In private chats on social media platform WeChat, sellers also directly market to consumers, sending catalogues every time a new flavour hits the market.

At a shop in Beijing, where this reporter was offered an ice lemon tea-flavoured vape, the shop assistant said it was impossible to stamp out demand.

“We’re just more discreet about it and don’t display what we have on offer. Also, if we see young people coming in to buy, we won’t sell to them,” said the assistant, who wanted to be known only by her surname Su.

In eateries and even shops across major cities, people can still be seen puffing away indoors, leaving cloyingly sweet vapour in their wake.

With smoking so socially accepted, those who have successfully quit say it usually takes a life-changing event to provide a much-needed jolt.

Aircraft engineer Li Peng, 52, kicked the 30-year habit only after discovering nodules in his lungs during a medical check two years ago.

“I’ve been smoking since I was a young apprentice nearly 30 years ago, and even though my wife kept urging me to quit, I found it hard because it’s such a social activity, too,” he said.

“After the medical scare, where the doctor told me I could either quit or risk it developing into something more severe, I got the boost I needed to go cold turkey.

“But I’ll admit it was very difficult in the beginning, especially during mornings in the toilet.”

Yet, given the industry’s strong hold over the market, China is unlikely to go cold turkey any time soon.

Dr Gan said: “The anti-smoking lobby is calling for the tobacco monopoly to be broken up from the regulator, but I don’t think the government is willing or interested in doing that because it takes huge political will and capital.”

Since 2021, STMA has been swept up in a corruption probe that has involved nearly two dozen current and former senior executives, including the retired head of an Anhui subsidiary who killed himself after investigations started.

The arrests and investigation of several top STMA officials for corruption are merely part of the anti-corruption campaign rather than an attempt to reform and rein in the tobacco industry, Dr Gan noted.

“The main issue is really a lack of (anti-smoking) education... for instance, if you compare cigarette packets to places like Hong Kong and Singapore, the language is very weak and not prominently displayed,” he said.

“And we don’t do that because of opposition from the tobacco monopoly.” — The Straits Times/ANN

The writer,ELIZABETH LAW  is the China Correspondent at The Straits Times.

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Saturday, July 23, 2022

'SAY YES TO ANTI-SMOKING LAW'

NGOS call for serious support to curb addiction, save lives

The lines have been drawn over the proposed Tobacco and Smoking Bill, the ‘Generational End Game’ law. Health NGOS and civil society are urging MPS to not let this opportunity slip away. Health Minister Khairy Jamaluddin has his work cut out but is prepared to go the distance to get the naysayers and fence-sitters on board.


 

Malaysia’s plan to ban smoking and vaping among future generations is a bold move, but the challenge lies in getting all parliamentarians to support the proposed Tobacco and Smoking Control Bill.

With the bill scheduled to be tabled in the current Parliament sitting, health experts as well as advocacy groups have banded together to urge MPs to support the proposed law, dubbed the Generational End Game.

Leading the call to end the smoking and vaping habit is Health director-general Tan Sri Dr Noor Hisham Abdullah, who posted a clarion call on Facebook.

“Act now before it’s too late. Smoking or vaping is an immoral habit and should not be emulated. Stop your addiction and save the next generation,” he wrote.

Heeding the call was a group of 43 health and consumer rights non-government organisations (NGOs), who urged MPs not to let slip the once-in-a-lifetime chance to produce a smoke-free generation.

“If we had had the same evidence on the hazards of smoking in the 1960s... tobacco wouldn’t have become a substance widely available to everyone,” said National Cancer Society Malaysia (NCSM) president Datuk Dr Saunthari Somsundaram.

“There would have been curtailments, with rules and regulations in place to make sure smoking was not widespread.

“We have the opportunity now. Let’s be brave and support this generational end game. We are talking about supporting and protecting generations to come.

“If the MPs do not pass this law now, they must ask themselves again in 20 years’ time. Realise that it was your legacy that you were not brave enough to do something that you know is right and is evidence-based,” Dr Saunthari told a press conference here yesterday.

The NCSM is one of the 43 NGOs who are calling on MPs to support the Tobacco and Smoking Control Bill.

Others include the Malaysian Women’s Action for Tobacco Control and Health (MyWatch), Drug Prevention Association of Malaysia (Pemadam), Malaysian Pharmacists Society (MPS), National Kidney Foundation, the Malaysian Association of Adolescent Health, and the Consumers Association of Penang (CAP).

ALSO READ:  Igniting the BAN on SMOKING

MPS president Amrahi Buang said nicotine addiction is very difficult to quit, and imposing a generational ban on smoking will prevent more people from falling into the habit.

“The smoking habit is like a deep pit that is very difficult to get out of. And when one is addicted to cigarettes, we know that it could then lead to drug addiction.

“So, we must prevent a whole generation from falling into this,” said Amrahi.

Addressing concerns that a smoking ban would result in an increase in the illicit cigarette trade, NCSM managing director Dr M. Murallitharan said data has shown that such a scenario would not produce more smokers.

“The tobacco industry claims that 80% of cigarettes in the market now are illicit. While we do not really believe it is that high, we take their word for it.

“Therefore, despite the high number of illicit cigarettes available in the market, our data has shown that the number of smokers in the country has not increased.

“One of the reasons why we do not have a high number of smokers is because of existing laws on smoking.

“So, if you put in a law that bans people born after 2005 from smoking, we can control the habit.

“You may not be able to get 100% as some will try to circumvent the ban, but we will still be able to block a large number of people from starting to smoke,” said Dr Murallitharan.

Pemadam secretary-general Burhanuddin Disa called on MPs who are on the fence about the bill to speak with health advocacy groups.

“We are ready to explain to MPs at any time of the day. Meet us over coffee and we can explain. We need to support this generational endgame plan,” he added.

The proposed Tobacco and Smoking Control Bill aims to ban the sale of cigarettes and vape products to those born on Jan 1, 2005 and onwards in a move to reduce the number of smokers in the country.

The Health Ministry said tobacco use contributed to 22% of cancer deaths in the country. 

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Sunday, August 18, 2019

E-cig & vape devices targeting teens


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Some of the latest e-cig and vape devices are cheap, as small as your thumb and can even be worn as a watch. Tobacco control experts say awareness among parents and teachers are crucial in keeping this new addiction out of schools. 

LET’S be clear – e-cigs and vape (ECV) are electronic drug delivery devices that can be used with the likes of meth and marijuana, warns Universiti Malaya Centre of Addiction Sciences (UMCAS) chief coordinator and the varsity’s Nicotine Addiction Research & Collaboration Group (NARCC) coordinator, Assoc Prof Dr Amer Siddiq Amer Nordin.

The smoking cessation specialist says there’s a chance that students using ECV will be exposed to other drugs.

“And it’s likely they’ll face the same problems – like poor grades – as students who smoke.”

Dr Amer Siddiq was commenting on findings published in the July edition of the Journal of Criminal Justice.

‘It’s all the rage! Exploring the nuances in the link between vaping and adolescent delinquency’ suggests that there may be something “criminogenic about vaping among adolescents”. But the strength of the relationship between vaping and delinquency depends on what is being vaped, with marijuana vaping being most heavily correlated with delinquency.

Dr Nur Amani@Natasha Ahmad Tajuddin, the lead of the NARCC smoking prevention programme in schools, says when the use of ECV is related to crimes like theft, violence, fighting, bullying, and running away from home, more effort is needed to curb the habit.

“Parents must realise that ECV has negative health, mental, economic and academic impact on youths.”


Young at risk.

Four years ago, ECV use among students was less than 3% because the devices were too pricey for most teenagers, Assoc Prof Dr Anne Yee notes..

According to the Tobacco and E-cigarette Survey among Malaysian Adolescents 2016 (Tecma), a whopping 36.9% of students start on the devices between the ages of 14 and 15, and now, we’re seeing a spike in teenage use..

Easily passed-off as a smart watch, thumb drive or pen, the eye-catching devices look like the latest fashion accessories, says the addiction psychiatry expert and UMCAS member..

“Sellers are going all out to push the product to teens by making it cheaper and more accessible..

“Many even give it free to attract young customers. Drug pushers use the same tactic to get people hooked so that they keep coming back.”.

These days, huge, eye-catching banners adorn night markets with traders openly displaying their wares. Clearly, the colourful e-liquid bottles with fancy names were designed for kids, teenagers and women, she says. These are groups that may never smoke yet we’re turning them into ECV users..

“If sellers are targeting adult smokers who want to quit, they wouldn’t need gimmicks. Why make such fancy designs?”.

Dr Nur Amani says a recent study reported that 22% of children aged between 11 and 15 in England, use ECV compared to 18% who start smoking..

“This is because ECV ads are appealing. Here we have celebrities promoting ECV on social media to entice kids.”.

Dr Amer Siddiq says more needs to be done to prevent a new generation of nicotine addicts from emerging..

“ECV isn’t safe. The devices could burn and the e-liquids could be adulterated.”.

While studies have shown that children and adolescents see ECV as cool, pleasurable and fun to use, Dr Nur Amani says there’s a pattern of kids from lower socio-economic income groups being targeted by unscrupulous sellers..

Getting the girls.

National Union of the Teaching Profession (NUTP) secretary-general Harry Tan says teachers nationwide are noticing a rise in ECV use among girls..

“This is scary because with cigarettes, it was mostly just the boys. But these devices are popular among both boys and girls.”.

Dr Yee is worried because nicotine is being touted as a way to lose weight. It’s like what drug pushers tell women about meth..

As it is, more young girls are experimenting with e-cigs as compared to cigarettes..

Cute cartoon packaging and fruity flavours are aimed at female non-smokers.

Society still has a negative perception of women who smoke. But with ECV, the message is that even ‘‘good girls’’ use it because it’s fashionable and can help you lose weight, adds Dr Yee.

In December last year, The Star highlighted how ECV and e-liquids were promoted as weight management aids.

“Even e-liquids that claim to be nicotine-free contain the drug. And you’ll never know for sure how much nicotine is inside. It could be equal to 20 cigarettes.

“A nicotine high lasts for less than two hours before the craving starts. So getting youngsters hooked on ECV is a business tactic, ” explains Dr Yee.

If your kids are turning to cigarettes, ECV or drugs, it could be because they’re bored or have no one to turn to, she says, adding that children who feel a sense of belonging in the family don’t need these harmful distractions.

Easily addicted

Dr Yee says teenagers are much more susceptible to addiction compared to adults. Some even start to have nicotine cravings after just one try.

“The teenage brain has yet to mature. That’s why adolescents are more impulsive, emotional and susceptible to advertisements aimed at influencing their behaviour.”

Parents whose children are already smoking aren’t helping by getting them an ECV. While it’s better than a tobacco cigarette, ECV is harmful for non-smokers.

When inhaled, tiny chemical particles in the e-liquids can enter the bloodstream and cause long-term harm.

Those between the ages of 10 and 18, adds Dr Nur Amani, are especially vulnerable to addiction.

The medical doctor says e-liquids contain toxic materials like lead, arsenic, manganese and chromium. Exposure to even small amounts can worsen symptoms of ADHD (attention deficit hyperactivity disorder).

ECV use among varsity students is also worrying, says Dr Amer Siddiq, who was among the researches behind The use of e-cigarettes among university students in Malaysia journal paper published in December.

The study, funded by the Education Ministry, involved 1, 302 students in six Malaysian varsities.

“Over 40% of students smoke and use ECV. This means that ECV has not helped them quit smoking, ” he says, adding that some users even experienced adverse effects like dizziness, coughs and headaches.

Anti-vape campaign

The Education Ministry recently announced that it would intensify awareness campaigns after claims of ECV being freely distributed among students, and photos of youths vaping, went viral.

Calling on parents and society to stop students from bringing the devices to schools, the ministry’s director-general Datuk Dr Amin Senin notes that ECV has become the norm these days – becoming more sophisticated and difficult to distinguish from other electronic gadgets.

Welcoming the ministry’s move, Dr Nur Amani feels it’s important to get tobacco cessation experts onboard to work with teachers.

More awareness campaigns need to be conducted by health scientists, educationists, politicians and non-governmental organisations, to show that ECV use is not “normal behaviour”.

Group activities, instead of talks, work better to impart knowledge. And, it’s more sustainable.

“The children themselves can then act as ‘peer experts’. The impact is greater when the message is shared by those of the same age group.”

Campaigns can be effective if we target parents and teachers, says Dr Yee.

With children and adolescents, the more you say no, the more they will want to try it, she says, adding that parents shouldn’t over-react if they find their child smoking, using ECV or taking drugs.

“It’s not the end of the world. Be an ally to your children instead of acting like the police.”

She suggests talking to children about the dangers out there instead of sweeping things under the carpet.

“Make them realise that sellers only want to make money by getting youths hooked on an addictive habit whether it’s nicotine or drugs.”

The Health and Education Ministries are already working together on the Kotak (Kesihatan Oral Tanpa Asap Rokok) programme to highlight the harms of cigarettes and its related products, says Dr Amer Siddiq.

But with the introduction of newer ECV models, there’s a need to raise awareness among the adults

Citing some pod-and-USB-like devices as examples, he says these have very high nicotine content but most parents and teachers don’t know about them.

Recently, children were mimicking vaping because of what they see on social media, Dr Amer Siddiq says in reference to the crackdown on Ghost Smoke – a candy consumed by sucking on a straw to produce a vapour-like effect.

“The Kotak programme must be enhanced to cover ECV and its dangers especially the impact on young developing brains.”

NUTP’s Tan says most teachers are in a cocoon when it comes to ECV.

“We need to expose teachers to this new threat so that they know what to look out for.

“And teachers must be given more authority. Since we cannot cane and are vulnerable to lawsuits, we want legislation that compels parents of problematic students to come to school and be responsible for their kids’ behaviour.”

UM, says Dr Nur Amani, has been conducting educational and advocacy programmes in schools through its No-Cotine Club and Community and Sustainability Centre (UMCARES).

Trained students go to colleges and schools to carry out activities that de-normalise smoking and vaping, she says.

“Soon we’ll be approaching 80 partner schools to tell our children that EVC is not just ‘evaporated water’.

“The effects are harmful and it’s haram for Muslims. Hopefully when they go home, they’ll share the message with their parents.”

Smoking and IR 4.0

ECV will be among the hot topics at the upcoming KL Nicotine Addiction International Conference (KLNAC) 2020, says its organising chairman Dr Amer Siddiq.

As the country moves towards realising the National Strategic Plan to make Malaysia smoke-free by 2045, it’s crucial to look at all forms of technology that can prevent the uptake of cigarettes, he says.

“We’ve decided on the theme ‘Mission IR 4.0: Redesign Tobacco Control’ because of the emergence of various disruptive technologies that can either assist quitting, prevent youths from starting the habit, or attract people to smoking.

“ECV was initially touted as a way to help smokers quit but we’ve seen how Juul has ended up enticing youths to take it up instead.”

UM, he says, is already using data and technology in its tobacco control efforts.

The varsity’s dental group is working on an app for school children to prevent initiation to smoking.

And, Dr Yee is collecting data to match smokers with cessation apps that are right for them.

“We’ve thousands of smoking cessation apps yet the success rate is only 25%. Each app caters to specific personalities so we’re trying to match smokers with apps that cater to their preferences. This will ensure a higher success rate.”

By CHRISTINA CHIN - Source link

Teens the target for vape products

Cause for concern: Subbarow showing the smart watch vape gadget at the CAP office in Jalan Masjid Negeri, Penang.

GEORGE TOWN: Vape products in all shapes and sizes have been flooding the market, including those targeting schoolchildren.

Besides vape pens and chocolates, the latest is the vape smart watch.

The gadget, which has a strap and detachable watch, is being sold openly in shops for RM132 each.

“These watches can cost less than RM130 and some students are using pooled money to buy and share them.

“They also pay RM50 for a 30ml bottle of liquid nicotine, ” said Consumers Association of Penang (CAP) education officer N.V. Subbarow.

He said recently, teachers in two schools in the state seized vape gadgets from students, showing a disturbing trend of students vaping.

“They look like regular smart watches and teachers may not easily identify them. The liquid is poured into the detachable watch face unit, and the vaping device is shared among the students.

“One can easily lay their hands on the China-made product as they seem to be used by schoolchildren. This could lead to serious health issues.

“The government may have banned cigarettes in schools or public places, but the law still allows e-cigarettes. Sadly, many unscrupulous traders are promoting these products as gifts, ” he said in an interview.

Subbarow also claimed that a preschool teacher confiscated a “cigarette pad” from a five-year-old recently.

“When you roll each page torn off from the small note pad, it looks like a cigarette. This seems to be a plaything among the children.

“There is like a pattern now where smoking is being promoted at an early age, which would have disastrous effects on a growing child. There are no laws stopping profiteering from these gadgets, ” he said.

Subbarow added that students often got away with vaping, compared to smoking cigarettes because they come in many flavours and are water-based, without emanating much smoke or smell.

“The fruity flavours of apple, orange or strawberry cause the vapers to have fresh breath, making it difficult for teachers and parents to know if their children are vaping, ” he said.

When met, two 16-year-olds from a school in Jelutong, who were vaping near the CAP office at Jalan Masjid Negeri, said they bought an e-cigarette for RM100 and liquid nicotine for RM50 and that they smoked outside the school.

One of them said he had borrowed money from another friend and it was nothing new as many peers in his school have e-cigarettes.He said they would also meet after school for vaping sessions.

Subbarow cautioned that thousands have died from lung infections and other diseases due to smoking, which is higher than those who were killed in accidents.

“Our checks in about eight schools showed that the situation is critical. Prompt action must be taken to address the issue, including amending the laws to ban vaping in public places.

“The anti-vape campaign started five years ago when vaping was a hot issue but it soon fizzled out as the Health Ministry did not follow through, ” he said.

“It’s time for drastic action or we’ll lose an entire generation, who will end up becoming vaping addicts.”

By R. SEKARAN - Source link


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