Light, Low-Tar, Mild - Plain Tactics

A study published online in the Journal of Public Health found that while it is important to ban misleading health descriptors such as ‘light’, ‘low-tar’, and ‘mild’, it is also important to ban other tactics used to undermine the impact of the elimination of these terms. For example, the study demonstrates that the industry has used descriptions of taste, such as ‘smooth’ and ‘full flavor’, and elements of package design (e.g. color-coding) on cigarettes formerly labeled ‘light’, ‘mild’ or ‘low tar’ to continue to mislead consumers.

The study was conducted in Ontario, Canada, where tobacco companies were court-ordered to stop using misleading descriptors by August 2007. More than 600 smokers and non-smokers were asked about their perceptions of packs with varying terms, colors, and design.

Study Findings

• Respondents were more likely to rate packages with the terms ‘light’, ‘mild’, ‘smooth’ and ‘silver’ as delivering less tar and having lower health risk compared with ‘regular’ and ‘full flavor’ brands.

• Respondents rated packages with lighter colors and a picture of a filter as significantly more likely to deliver less tar and lower health risk.

Conclusion

• Perceptions of risk and tar delivery are strongly associated with package design elements such as other descriptors, tar levels, and colors.

• Current regulations banning misleading terms have failed to remove misleading information from tobacco packaging due to the industry’s use of other package design elements.

Key Messages

• Laws regarding misleading information should encompass misleading design innovations by the tobacco industry.

• Laws regarding misleading descriptors should give a governmental agency the authority to adopt new rules to quickly address innovative ways the tobacco manufacturers adopt to continue to mislead consumers.

• Enforcement of the law should include all aspects of package design that may mislead consumers such as other descriptors, colors, and tar levels.

Full study available in English from:
http://jpubhealth. oxfordjournals. org/cgi/reprint/ fdp066v1

Too Busy to Blog

Being formal in Kobe, Japan

Having Fun in Palawan

Tobacco and illegal drugs have kept me busy past six weeks that’s why I did not have time to update my three blogs. Nope, I did not use those substances, on the contrary, I involved myself in a series of workshops to prevent and control tobacco and illegal drugs, which took me to Kobe, Japan and Puerto Princesa, Palawan, among other places.

In Kobe, I attended the Regional Workshop on Monitoring Secondhand Smoke Exposure conducted by the Johns Hopkins School of Public Health. In the next months, I will be a part of a cross-country study measuring secondhand smoke (SHS) exposure in nine (9) East and Southeast Asia, namely: Bangladesh, China, India, Indonesia, Japan, Korea, Philippines, Thailand and Vietnam. The study will measure SHS in selected public places such as government offices, hospitals, secondary schools; restaurants and entertainment venues. Air nicotine and particulate matter (PM2.5) will be measured in key locations in each place. In conjunction with the collection and analysis of the data, a dissemination strategy will be implemented to distribute messages to media outlets and others to generate attention on the need for strong smoke-free legislation.

In Palawan, I facilitated the Health Promotion Implementation Review and Planning workshop for the Dangerous Drugs Prevention and Treatment Program of the Department of Health. This gauged where we are now and what we will do next in promoting drug abuse prevention.

Anyway, I’m not complaining with the additional workload that will keep me tremendously busy in the days and weeks ahead. I just hope I will not have to sacrifice doing my blogs.

Warnings for June

It's the end of the month, so I am reposting the 4 Health Warnings I posted as photo on the top right side of this blog. The photos were taken from health warnings on cigarette packs in various countries.

The Trouble with Nicotine

NICOTINE: A DANGEROUS DRUG?

“Classify nicotine as a dangerous drug,” stated a Department of Health resolution from the National Health Sector Meeting in November 2008.

What?!? I wondered why a substance that is so common in a popular commodity would merit a harsh recommendation for a national policy? I am not a smoker, but my inquisitive mind tells me there is something more I need to know about this so-called “dangerous drug”.

People can get hooked on a particular TV show, a sports or a hobby, and even a person. In the same way, they can also get hooked on nicotine. People can indulge in the certain activities for some time, and later on, forget them if they no longer find them interesting. But it may be a different story when it comes to nicotine. People who got hooked on nicotine for a time do not really find a way to unhook themselves from it, even when they already decided to do so.

“Addicting” is the word to describe this substance mainly found in cigarettes. And addiction is a brain disease that can be cured, but the habit it forms is surely hard to break.

Nicotine is actually a drug, just like heroin and cocaine, that develops naturally in the tobacco leaf. Scientifically, it is an alkaloid or a chemical substance containing nitrogen as its organic base. Nicotine, as a drug, powerfully affects the brain and central nervous system. When the smoke from the cigarette is inhaled, the nicotine travels from the lungs to his blood stream and brain in less than seven seconds. Nicotine also travels through the blood to other vital organs.

NICOTINE FOR THE EMOTIONALLY DISTRESSED

I had a classmate in high school who I can say was a chain-smoker. At that young age, he seemed to already have a high tolerance to nicotine. From time to time, he could be seen smoking cigarettes; that is why he was called “sunog-baga” (direct translation: burning lungs) by my classmates and other students.

Although skinny and feeble, his lungs seemed to be ironically strong against the powerful smoke that frequently came in and out of his mouth. Many boys in our school wanted to be “siga” (bully), and to achieve this status, they have to enlist themselves in a fraternity group and learn three things: smoking, drinking, and taking drugs (marijuana or “tsongki” was the widely-used, available and affordable to students during that time and maybe even now).

This particular classmate is one of the most-revered “siga” in our school and a distinguished member of the top fraternity group in our school. I did not know if he had engaged in the other two tough-guy stuff; all I know is that he is an obvious smoker. And I think he had mastered the art of smoking because I could see him emit smokes of various forms and shapes and also through the nostrils.

The name of my classmate is Angelito, and as his name suggests, there was something of an angel in him that had been thoroughly covered by his rugged appearance and studied rude speech and behavior. As far as I could discern, he really possessed a mild disposition and a keen mind. Through his soft eyes, he could be taken for a kind and intelligent honor student. He is, most of the time, silent, but is not too timid to express himself, especially his tough-talks.

Rumors in our school had it that one of the reasons he went astray of the good boy’s path is that he was greatly affected by family problems. Angelito had a melancholy personality, and I can tell his thinking matured early. Perhaps he was pre-maturely confronted with the ugly reality of the life he had been living with his family which he was not supposed to see too soon. But not being too melodramatic, maybe that was just his upbringing, that his family members are not too concerned of him becoming a great man, though I can say he had the potential.

Ian M. Newman, who wrote for the Journal of School Health, saw cigarette smoking among adolescents as compensatory behavior. Based on the findings of a participant observation study he conducted in 1970 of ninth-grade adolescents, both male and female smokers saw themselves as failing to meet the expectations of parents and school, which seemed to be supported by school results and behavior; whereas non-smokers perceived themselves as more nearly meeting these expectations.

Smoking is seen as a compensatory action by youngsters who do not succeed academically and socially. The role of the school is seen as often reinforcing smoking behavior by its failure to adequately provide alternative modes of achieving success.

Nicotine is regarded as a perfect cure for those who are emotionally distressed, as can be seen in television soap operas and in real life. This claim may be grounded by the fact that nicotine increases the alpha waves in the brain that causes relaxation. Smoking stimulates the release of endorphins, which the body’s natural tranquilizers.

Nicotine can act as a stimulant or sedative in the body depending on the time of the day, metabolism, and stress levels.

According to Charles E. McArthur in his Psychology of Smoking, smokers start smoking largely because of environmental pressure but continue because it satisfies personal needs, especially among the ‘emotionally constricted types’ and anxious people who see smoking as a tension reducer.

In the case of my classmate, he may have had a valid reason to start smoking, but his continued smoking activity is already his own inclination and no longer has anything to do with his family problem.

You may have observed some instances when a person after taking a heavy meal, after having sex, or when nervous and stressed smokes a cigarette. This instinct of a person to smoke during these occasions is brought about by the relaxation effect that nicotine can produce. The feeling of relaxation occurs when nicotine is inhaled after three minutes.

As far as the smoker is concerned, hitting cigarettes makes him feel relaxed; but ask the organs inside his body, and they will tell you they are not relaxed. The pressure is only transferred from the chest cavity to the heart. With nicotine taking effect, the blood is sent to the heart, causing increased blood flow in this area. As a response, this involuntary muscle will have to work a lot. The heart beats faster and brain wave activity increases. This may cause a difficulty in breathing. The exhaustion that heart and lungs experienced during the smoking activity would require more oxygen.

Poor heart.

NICOTINE IS HABIT FORMING & LETHAL

We have to understand that nicotine is actually a lethal substance. Nicotine is one of the main ingredients of an insecticide solution, which we know is meant to exterminate insects. Nicotine is both a stimulant and a poisonous drug. Through it, insects are killed with their neurotransmitters being disturbed.

Humans have the same neurotransmitter in their brains. Neurotransmitters are chemicals that link brain cells together. This could lead us to think that if nicotine can kill insects at best, it can also kill humans little by little, unconsciously. We heard the saying for so long that it is already becoming a cliché, “a stick of cigarette can reduce five minutes of your life”.

Nicotine is mainly responsible for the development of smoking habits. Murray E. Jarvik, a contributing writer of Learning Mechanisms in Smoking, says that nicotine is the essential ingredient in tobacco responsible for developing and maintaining smoking habits through reinforcing effects produced by stimula-ting the reward mechanisms in the brain. Nicotine, therefore, has the capability of changing an individual into a whole different person. By no means does nicotine set itself different from heroin, cocaine, shabu, or marijuana, for being an addictive and destructive drug.

Another contributing writer, William A. Hunt, defined “habit” as “a fixed behavior pattern overlearned to the point of becoming automatic, and marked by decreasing awareness and increasing dependence on secondary rather than primary reinforcement.”
But giving the benefit of the doubt, although nicotine is seen as a necessary factor for the maintenance of the smoking habit, it may not be a sufficient reason. Man is a rational being and he is still in supreme authority over himself — his own body. He is the one who decides whether to be victimized by nicotine or not.

A person who has acquired the habit of smoking through the help of nicotine could be trapped in the so-called “smoking cycle”, especially those who consume 20 or more cigarettes a day. A smoker who decided to abstain from smoking for some time may inevitably break his vigil sooner than his original plan, for surely he will crave for the nicotine he feels he was deprived of.

During his vigil, he becomes anxious and implacable, and wishes that a cigarette is available at hand. For him, the easiest answer for his inexplicable pangs is none other than the cigarette itself, “even just one stick” he would say to himself. This dilemma in the life of the wretched smoker is called “nicotine withdrawal syndrome”. This happens and obviously felt when a smoker already resolved upon quitting smoking cigarette for life.

Nicotine is the drug in tobacco that reinforces a person’s desire to smoke. Smokers who prefer to take the process of transformation back to being a non-smoker step-by-step resort to using ‘nicotine-free’ cigarettes. But eventually, they will realize that they are not getting enough of this superficial stuff and will want to go for the real thing again.

The smoker rejects the improvised but therapeutic cigarette because it fails to give him the ‘hit’ that his senses are accustomed to. This struggle becoming apparent, the smoker cannot deny that he is indeed ‘hooked’ on nicotine.

Nicotine as a foreign substance is naturally unacceptable to the human body, and if it is forcibly taken in, the body cannot help but react strangely and cause some abnormalities within it. The smoker must overcome the nicotine withdrawal syndrome. He can take this negative thing as a good sign, because it means that the process of his healing has already begun.

The objective here is to return, though not totally, to the body’s pristine quality. The smoker may find his healing process formidable, or he may feel himself in a state of equilibrium where he struggles between opposing weights, but he must not doubt the validity of his resolution, because breaking free from nicotine is indeed the right thing to do.

After all that has been said, I am for the classification of nicotine as a dangerous drug!

---
This article is written by Marven T. Baldo, a student of Polytechnic University of the Philippines and an on-the-job trainee of the Department of Health’s National Center for Health Promotion. This article has been published in the DOH HealthBeat Magazine, Issue No. 53, March - June 2009. Photo above from the Internet.

Pinoy No Smoking Rap

MODUS OPERANDI composed and performed this No Smoking Rap for the youth. This video in incorporated in the "Silang Kabataan Ayaw sa Sigarilyo" produced by the Department of Health, Silang Municipal Office of Cavite, and the Seventh Day Adventist. (FYI - The video was written and directed by me. Hehehe.)

And Now, Third-Hand Smoke

Okay, everybody knows that cigarette smoke leaves an unpleasant smell on the breath of the smoker. The stink also remains in his/her clothes, hair and skin. But wait, there’s more.

The gases and small particles in cigarette smoke are deposited on every surface the smoker comes in contact with and the environment where the cigarette was smoked in. These toxic particles remain long after the cigarette has been put out and any secondhand smoke has been removed from the area.

This is called “third hand smoke”, a new term coined by researchers at Massachusetts General Hospital for Children (MGHfC) to describe another set of dangers associated with cigarette smoke.

“Third-hand smoke presents a serious health risk for young children who may crawl on contaminated surfaces and ingest toxins via hand-to-mouth,” said Jonathan Winickoff, the lead research author and a professor of Pediatrics at Harvard Medical School and a member of the American Academy of Pediatrics’ Richmond Center.

Particulate matter from tobacco smoke has been proven toxic. According to the National Toxicology Program, these 250 poisonous gases, chemicals, and metals include hydrogen cyanide, carbon monoxide, butane, ammonia, toluene (found in paint thinners), arsenic, lead, chromium (used to make steel), cadmium (used to make batteries), and polonium-210 (highly radioactive carcinogen). Eleven of the compounds are classified as Group 1 carcinogens, the most dangerous.

Winickoff explained that the developing brain of a child is uniquely susceptible to extremely low levels of toxins. Babies and children are closer to surfaces such as floors. They tend to touch or even mouth (put their mouths to) the contaminated surfaces. Children ingest twice the amount of dust that grown-ups do due to faster respiration and proximity to dusty surfaces.

Winickoff’s team was the first to examine adult attitudes about the health risks to children of third-hand smoke and how those beliefs may relate to rules about smoking in their homes.
The result of their study was published in the January 2009 issue of the journal Pediatrics.
The researchers surveyed more than 1,500 households in an effort to learn about adult attitudes regarding the danger third-hand smoke represents to their children and how that might affect smoking in the home. The following are highlights of what they discovered.

• On secondhand smoke: approximately 95 percent of nonsmokers and 84 percent of smokers believe that secondhand smoke is hazardous for children.

• On the issue of whether third-hand smoke threatens the health of children: 65 percent of nonsmokers and 43 percent of smokers felt that third-hand smoke harms kids.

• When asked about rules regarding smoking in the home: approximately 88 percent of nonsmokers said they didn’t allow smoking, while only 27 percent of smokers prohibit smoking in the home. However, both non-smokers and smokers who felt that third-hand smoking was harmful to children’s health were more inclined to restrict smoking in their homes.

By introducing the phrase “third-hand smoke”, the study points to the need for every smoker to try to quit. That’s the only way to completely protect their children, Winickoff stressed.

Co-authors of the study are Joan Friebely, EdD, and Cheryl Sherrod, MGHfC Center for Child and Adolescent Health Policy; Susanne Tanski, MD, Dartmouth Medical School; Georg Matt, PhD, and Melbourne Hovel, PhD, MPH, San Diego State University; and Robert McMillen, PhD, Mississippi State University. Support for the study includes grants from the Flight Attendant Medical Research Institute and the National Cancer Institute.

Photo Source

Major Poisons in Second-Hand Smoke

This newspaper advertisement says it all. The concentration of most toxins per cigarette in second-hand (sidestream) smoke is typically higher than in first-hand (mainstream) smoke the smoker inhales. (CLICK TO ENLARGE: This photo was taken from a World Lung Foundation powerpoint presentation.)