Friday, 24 June 2016

Smoking May Have Negative Effects On Sperm Quality: Study

Men, take note! Cigarette smoking may significantly damage the DNA of your sperm and affect fertility as compared to non-smokers, a new study has warned.

Researchers also assessed 422 proteins in participants' sperm. One protein was absent, 27 proteins were under-represented, and 6 proteins were over-represented in smokers.

Analyses of these proteins suggest that cigarette smoking may promote an inflammatory response in the male reproductive tract.

The study published in the journal BJU International included 20 non-smoking men and 20 men who smoked.

"More and more studies are demonstrating a harmful effect of smoking on male fertility," said Dr Ricardo Pimenta Bertolla, senior author of the study.

"Our results point in the direction of important semen alterations: semen of smokers presents an inflammatory nature, associated with decreased capacity of sperm to achieve fertilisation and generate a healthy pregnancy," said Mr Bertolla.

"It is especially noteworthy that, in our study, sperm DNA fragmentation was increased. Other studies have proposed this to be a potentially promutagenic effect, which is to say that sperm with altered DNA may lead to health problems in the offspring," Mr Bertolla said.

Source: NDTV

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Tuesday, 14 June 2016

From a smoker to a smokeless tobacco user: Study

Even as the state and the country is preparing for the next round of the Global Adult Tobacco Survey (GATS), a recent study based on the current edition of this globally followed survey has found that switching to equally harmful smokeless tobacco use is the most common smoking cessation method.

The study by Achutha Menon Centre for Health Science Studies of Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum shows that more than a third of the former smokers in India reported switching to smokeless tobacco for quitting smoking. The study has been published in a recent edition of the international peer-reviewed journal ‘Public Health’.

GATS 2009-10 posed a question to all 2035 successful quitters on the method they used for cessation. Among the options given to the respondents were smoking cessation clinic; nicotine replacement therapy; a quit line or a smoking telephone support line; and switching to smokeless tobacco. The majority 44.4 per cent of total successful quitters including 50.8 per cent men and 8.7 women reported switching to smokeless tobacco use. 

The GATS was conducted covering all the 29 states and two union territories in the country. This nationally representative household survey covered 69,296 individuals aged 15 years and above using a standardised methodology.

Highlighting the policy implications, Dr KR Thankappan, Prof and Head, Achutha Menon Centre and principal researcher of the study said, “Switching to smokeless tobacco is not a safer option as it is equally harmful as smoking. Coordinated measures including high levels of taxation on all tobacco products, strict enforcement of 85 per cent graphic warnings, and concerted awareness generation on harms of smokeless tobacco products is very important.”

Specifically for Kerala, he called for strict enforcement of the ban on pan masala and gutkha containing tobacco or nicotine, steps to combat smuggling of these products and targeted awareness building for the migrant population who are among the prime users of smokeless tobacco products.

Senior Project Fellow, Achutha Menon Centre and co-author of the study Dr GK Mini said, “Across the country, smokeless tobacco use surpasses smoking. If switching over is also added, the disease burden from smokeless tobacco use will be compounded. Studies have shown that smokeless tobacco users have a more than three-fold higher risk for cancer.”

As per GATS 2009-10, the number of adult current users of smokeless tobacco in India is 206.0 million, much higher than the number of current tobacco smokers of 111.2 million.

GATS is conducted once in five years; the next round is slated for 2016-17. In India, it is conducted under the coordination of the Union Ministry of Health & Family Welfare with technical assistance from the World Health Organisation.
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Wednesday, 1 June 2016

Government for stringent action against substances harming humans: Kerala Health Minister

The Government will take strong action against substances such as tobacco, alcohol or other drugs that cause harm to the human body. Concerted action will be taken up against tobacco and drug use, said Hon’ble Minister for Health and Family Welfare Smt KK Shyalaja while inaugurating the World No Tobacco Day observance event here today.

The Health Minister, formerly a teacher, expressed concerns over the increasing availability of pan masala and other drugs in the form of candies near educational institutions. She called upon all enforcement agencies to identify the availability of these products and initiate stringent action.

In his presidential address, Hon’ble Minister for Electricity & Devaswom Shri Kadakampally Surendran said that schools and colleges are continuing to be centres of easy availability of pan masala, tobacco products and other drugs. “Continued efforts are needed with the support of civil society to achieve success in reining tobacco use in our state,” he added.

Director, Subhodham, Government of Kerala Dr K Ambady who delivered the keynote address said that collective and coordinated action that hinges on a three-pronged approach including supply, demand and harm reduction strategies are required for bringing down use of tobacco, alcohol and other drugs.

Dr Paul Sebastian, Director, Regional Cancer Centre (RCC), while delivering the welcome address said there is a need for generating awareness against tobacco harms in youngsters between the ages of 10 and 20 years. “Youngsters should be made ambassadors for propagating tobacco harms leading to the creation of a tobacco free society,” he added.

The Health Minister also gave away the media award for best article on cancer instituted to Regional Cancer Association (RCA) to Shri Santhosh Sisupalan, Senior Sub Editor, ‘Manorama Arogyam’. TKM Arts and Science College, Kollam won the award for the best cancer detection camp held in association with NSS volunteers.

Dr R Ramesh, Director of Health Services (DHS); Dr KR Thankappan, Prof and Head, Achutha Menon Centre for Health Science Studies of SCTIMST; Shri Johnson J Edayaranmula, Director, ADIC-India and Hon.Advisor, Subhodham and Dr Babu Mathew, Hon.Secretary, RCA also spoke in the inaugural session.

The importance of advocacy for tobacco control came to the fore as Dr Babu Mathew spoke on the topic "Battle against tobacco - the RCC experience”. Dr KR Thankappan while speaking on the “Relevance of tobacco cessation programmes in India” said both prevention and control are needed to address tobacco, a silent killer.

Dr. AS Pradeep Kumar, Former Addl.DHS & Senior Research Officer, Achutha Menon Centre for Health Sciences Studies apprised participants on “Legal aspects of tobacco control” by highlighting various sections of Indian tobacco control law COTPA, 2003.

A panel discussion on the topic “Towards Tobacco Free Educational Institutions in Kerala – Experiences, Challenges & Plans Ahead” and ensuing discussions witnessed thoughts on the need for self-control, role of students and peers in curbing tobacco use in schools, counseling students with love and care and migrants as suppliers of these products.

Dr Bipin Gopal, Assistant Director of Health Services and State Nodal Officer, NTCP and NCD; Dr Binoy S Babu, Junior Administrative Officer, DHS; Smt Anila George, Joint Director (Academic), DPI; Shri Saju Itty, Executive Director, Kerala Voluntary Health Services and Shri S Jayaraj, State Coordinator, Tobacco Free Kerala spoke. Shri Surendran Chunakara, PRO, RCC moderated the discussion.

Dr R Jayakrishnan, RCC made the closing remarks in the function in which School Health Nurses, Student Police Cadets, NCC cadets and NSS volunteers were present. 
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Monday, 30 May 2016

Get ready for plain packaging of tobacco products

Following Australia’s example, for this year's World No Tobacco Day on May 31 the World Health Organisation is calling on countries to “get ready for plain packaging of tobacco products”. Plain packaging refers to “measures to restrict or prohibit the use of logos, colours, brand images or promotional information on packaging other than brand names and product names displayed in a standard colour and font style (plain packaging)”.

Against all odds, Australia was the first country to successfully introduce plain packaging in 2012 and has since seen a decline in smoking.

The WHO’s call for action comes at a time when the tide is firmly turning against the tobacco companies. For instance, during the first week of May this year, the tobacco companies lost a long-run legal challenge against the European Union rules that force them to print graphic images on both sides that cover two-thirds of a cigarette packet.

It didn’t stop there. The Court said that the 28 member states can go beyond the requirements of the European directive and introduce plain packaging. According to a May 28 editorial in The Lancet, the European Court of Justice said last month that the new EU law on plain packaging was legal.

France, Ireland, and the U.K. have passed legislation that makes plain packaging mandatory from May 20 this year. All cigarette packets manufactured in these countries will have to be plain, standardised in the same drab green colour with the product name on the pack in a standard font.

Encouraging results
A little more than three years after Australia introduced plain packaging, and on the eve of the introduction of plain packaging in the U.K., Australia has reported that its plain packaging experiment is working well.

A post-implementation report published in February this year by Australia said: “The measure has begun to achieve its public health objectives of reducing smoking and exposure to tobacco smoke in Australia and it is expected to continue to do so into the future.”

Between December 2012 and September 2015, plain packaging together with enlarged graphic warnings and 25 per cent tax increase since 2010 reduced average smoking prevalence among Australians aged 14 years and over by 0.55 percentage points. This reduction is would result in at least 118,000 fewer smokers.

Also, experimental studies, surveys and focus group studies have also found that plain packaging achieves its objectives — deter young people from taking up smoking in the first place than making smokers to quit.

“Tobacco packaging is a mobile billboard promoting consumption of tobacco products. Tobacco packaging makes products more attractive, advertises and promotes tobacco consumption, distracts from health warnings and deceives people into thinking that some products are less harmful than others,” notes the WHO in a recently published report.

“If you strip back the decoration, gloss and misleading elements of tobacco packaging, you are left with little more than a box of deadly and addictive products that kills approximately 6 million people a year and harms the health of many more. Plain packaging helps reveal the grim reality of tobacco products,” the WHO report adds.

Uneven success
Although some countries have successfully taken on the Big Tobacco by introducing plain packaging, globally tobacco control has been very uneven. The “least compliant countries are often the ones with the highest rates of tobacco use,” notes the editorial. Hence it wants the global community to “remain vigilant to ensure a robust and even implementation of strategy across all countries”.

For instance, in the case of India, small and locally produced bidis are being displaced by cheap manufactured cigarettes, says a March 14, 2015 paper in The Lancet.

Despite tremendous pressure from tobacco companies India stood its ground by introducing pictorial warning covering 85 per cent of the front and back sides of all tobacco products. The next step for India should be to go in for plain packaging.

There is every reason for India to introduce plain packaging as nearly 1 million people die each year due to tobacco-related diseases. And like Australia, the taxes should be raised steeply to deter young people from smoking and chewing tobacco products.

Australia has reported that its plain packaging experiment is working well.

Source: The Hindu

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Tuesday, 24 May 2016

States told to withdraw tobacco packs without 85 per cent pictorial warning

The Centre has set May 31 deadline for the States and Union Territories to withdraw from the market tobacco products whose 85 per cent packaging space is not covered with pictorial warning.

A communiqué from the Tobacco Control Division of Union Ministry of Health and Family Welfare, New Delhi, dated May 20, 2015, has requested the Chief Secretaries of all States and Union Territories to take steps for strict enforcement of the new rules on pictorial warnings.

The Pictorial Warning Rules under Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act (COTPA) 2003 had come into force from April 1, 2016. The communiqué said that packages not compliant with the new rules be allowed for sale “only by printing, pasting or affixing the new warnings thereon covering 85 per cent of the principal display area.”

Referring to continued sale of cigarette packets bearing a pictorial warning only on 40 per cent of the display area, U.S. Vishal Rao, member of Karnataka Government’s High Power Committee on Tobacco Control, told The Hindu that cigarette manufacturers were “misleading the public”.

Though the Union Health Ministry’s notification on the larger size of pictorial warning was issued in September last year to come into force from April 1, the cigarette manufacturers continued to mislead the public by restricting the warning to 40 per cent of the display space on one side. “The rest of the space, 60 per cent on one side and 100 per cent on the other, continues to be an advertisement,” he said.

Dr. Rao also said the stores had been directed to display the product in such a manner that the side of the cigarette packet without warning faces the public.

Meanwhile, most cigarettes packs available in Mysuru not only bore a pictorial warning that was restricted to just 40 per cent of the display area on one side, but also a packaging date that was prior to April 1, 2016, when the law on larger pictorial warning came into force.

Though wholesale cigarette dealers, speaking on condition of anonymity, said they did not possess any pack packaged prior to April 1, they did not rule out the possibility of retail shops and stores continuing to sell old stock.

Source: The Hindu
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Monday, 9 May 2016

The bumpy road to 85%: How tobacco packs came to have bigger warnings

A Supreme Court directive last week that tobacco packs would have to adhere to the 85% pictorial warning norm may have finally brought the curtains down on a long and bitter battle that had been raging in the country for about 19 months. Here’s all you need to know about the battle that has been as much about public health as it has been about politics and business. 

When was the decision taken to increase the size of pictorial warnings on tobacco packs to 85% of the principal display area instead of the original 40%?
The Cigarettes and Other Tobacco Products (Packaging and Labelling) Amendment Rules 2014 were notified in October 2014 under which the size of the pictorial warning was to be increased, the intention being to reach out to people who may be illiterate, or may not notice small warnings. The larger warnings were to come into effect from April 1, 2015. Many believed the move was powered by then Health Minister Dr Harshvardhan’s firm commitment to the anti-tobacco cause — his sudden removal from the Health Ministry less than a month after the notification was issued, likewise led to frenzied speculation about the hand of the “tobacco lobby”.

How did the Committee on Subordinate Legislation come into the picture?
The Committee, among whose members is Allahabad MP Shyama Charan Gupta, the owner of a self-declared bidi empire that has an annual turnover of Rs 200-250 crore, suo motu decided to examine the notification soon after the first reshuffle of the Cabinet. It tabled an interim report in Parliament in March 2015, asking the Health Ministry to postpone the implementation of the warnings until it had managed to examine various aspects in greater detail. The report made a strong pitch for exempting bidis, saying: “Bidis are natural product and are very small as compared to cigarettes. As such, bidis should not be compared with cigarettes as far as rules are concerned… There is no alternative crops for bidi/tobacco farmers… The new rule that 85% of the bidi wrapper should contain horrific warnings etc. will cause the bidi industry to collapse.” Outside of Parliament, Committee chairman Dilip Gandhi got into another major controversy after he claimed that there was no Indian study to prove that tobacco actually causes cancer.

What was the response of the government? 
Immediately after the report of the Committee on Subordinate Legislation came in, the Health Ministry decided to put on hold the five-month-old notification, five days before it was to have come into effect. This, despite the fact that the report of the Committee was not binding on the government. There have been numerous instances of governments having gone ahead with decisions despite objections from Parliamentary panels — a recent example being the Juvenile Justice (Care and Protection) Act, 2015 that mandated that children aged between 16 and 18 years, who are accused of heinous crimes, may be tried under adult laws if certain conditions are fulfilled. Health Minister J P Nadda defended the decision saying he believed in stakeholder consultation. 

Did the government share the Committee’s concerns about the loss of livelihood for tobacco farmers etc.?
In its written reply to the Committee, the Agriculture Ministry said that alternative crops had been mapped out in regions engaged in tobacco production, so there would be no great implications for farmers’ livelihood. The crops thus identified were onion, chilli, maize and sunflower in Tamil Nadu; sugarcane, soyabean, groundnut and sorghum in Karnataka; potato, maize, wheat and mustard in West Bengal; and maize, sunflower, black gram and chickpea in Andhra Pradesh. 

So what forced the Health Ministry to move on the pictorial warnings? 
In August last year, the Rajasthan High Court, responding to a PIL, ordered the Centre and the state government to immediately implement the 2014 rules under the anti-tobacco law. “After hearing the learned counsel appearing for the petitioner and considering the research as well as orders passed by various High Courts and the Supreme Court, we find it imperative, and in larger public interest, to stay the operation of the corrigendum. The rules of 2014 will come into force immediately, and will be enforced by the Centre and the Government of Rajasthan,” stated the order, passed by a two-judge bench of the High Court on July 3, 2015. The Centre was forced to make a commitment that the rules would come into effect from April 1, 2016, exactly one year after its original date of implementation. 

And did the Committee on Subordinate Legislation too come round to the idea that 85% warnings on tobacco packets is a public health requirement? 
It did not. In its final report submitted in the Budget Session of Parliament this year, it said: “The Committee are of considered view that in order to have a balanced approach, the warning on the cigarette packets should be 50% on both sides of the principal display area instead of 85% of the principal display area as it will be too harsh and… will result in flooding of illicit cigarettes in the country.” On bidis, it held: “The Committee strongly feel that the Government need to re-consider their decision to cover bidi industry under the amended rules and recommend that a practical approach in the matter may be adopted by increasing the size of warning up to 50% on one side of the bidi pack, chewing tobacco and other tobacco, products namely zarda, khaini, misri etc. which will be feasible to follow and which would also ensure that a large number of people in the trade will be saved from being rendered unemployed.” 


Who went to the Supreme Court? 
The Karnataka Bidi Association had approached the apex court against the notification on the bigger pictorial warnings. “Tobacco manufacturers have a duty towards the society. Bigger pictorial warnings on tobacco products are necessary to educate people. They should know about its effect on health,” observed a Bench of Justice P C Ghose and Justice Amitava Roy.

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Saturday, 7 May 2016

Indian Trains Carry Tobacco Harms Messages

In India, millions of people commute to and from work via train. The Indian rail network is the fourth largest in the world, and is used most heavily by low-and middle-income Indians. 

As such, the Union Ministry of Health and Family Welfare’s (MoHFW) new outdoor campaign is set to reach a significant portion of the Indian population. MoHFW launched “Tears You Apart,” an anti-tobacco campaign that will appear on the exterior of trains on some of India’s busiest major railway routes across eight states from 27 April until September 2016. Vital Strategies has provided technical assistance to the Ministry.

The campaign is one of the most geographically extensive health promotion campaigns to utilize the world’s most heavily used railway network, which is used by over 10 million people a day. The campaign will also feature a PSA a Public Service Announcement (PSA) filmed in B. Barooah Cancer Institute in Guwahati, Assam and at the Tata Memorial Hospital in Mumbai, Maharashtra, which shows real victims suffering from horrific cancers and disfigurements as a result of their chewing addiction. It also includes the victims’ relatives, who describe how tobacco-related disease has destroyed careers and family life, and added to their financial burdens. The railway ads could reach people who had not previously seen the campaign on TV.

Although smoking rates have declined in many parts of the world, it has not gone down equally for all segments of society. Low- and middle-income individuals maintain the highest smoking rates in many countries, including India, and tobacco industry tactics continue to be directed towards this segment of the population—especially youth. This campaign is an enormous opportunity to reach those people who suffer the greatest harm from the global tobacco epidemic.

That means a chance to reduce the burden of death and disease that tobacco continues to place on the Indian people and their government. According to the Tobacco Atlas, 120 million adults and over 2.5 million children continue to use tobacco in India. Of those, nearly one million people are killed by a tobacco-related disease every year in the country.

According to Mr. C.K. Mishra, Additional Secretary, Ministry of Health and Family Welfare, Government of India, “The Government is committed to ensuring healthcare and social safety for all Indians. Warning people about the dangers of tobacco is a key part of our strategy, using mass media campaigns, Film Rule, and all other methods of Behaviour Change Communication. Tears You Apart shows that tobacco-related suffering isn’t limited to disease and disability among patients; their loved ones also share immense health, emotional and financial pains and hardships. It was important for us to highlight this reality in this campaign.”

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Thursday, 5 May 2016

Supreme Court reminds tobacco makers of their 'duty to society'

The Supreme Court on Wednesday reminded tobacco makers of their "duty to society" and to carry pictorial warnings spread over 85% of both sides of their packaging as mandated under the government's amended 2014 rules, staying a Karnataka High Court order that had prevented implementation of these rules.

"You owe a duty to society," a bench of justices Pinaki Chandra Ghosh and Amitava Roy said while staying the Dharwad bench order.

The earlier 2008 rules required pictorial warnings on just 40% of the packaging on one side.

The new rules mandate pictorial warnings that the industry has said are "gruesome", "gory" and "extremely repulsive", intended to "shock and terrorise the user" rather than being factual and intended to warn the consumer.

The industry has said that the images as well as the textual warnings prescribed are false and misleading. It has said there is no evidence to prove that the images on the pictorial health warnings are of tobacco­related diseases or tobacco consumers.

However, non­governmental organisation Health for Millions, which has been demanding its implementation, urged the court to impose a stay on the high court order.

The Cigarettes and other Tobacco Products (packing and Labelling) Amendment Rules,2014, made under the Cigarettes and Other Tobacco Products (Prohibition of Advertisement and regulation of Trade and Commerce, Production, Supply and Distribution), Act of 2003, were notified to take effect from April 1, 2016.

These were immediately challenged in different high courts. A plea was later made to transfer all these petitions pending in different high courts to the top court which could then deal with the legality of these rules. Instead the top court transt transferred all these pending cases to the Karnataka High Court for a decision.

The top court requested the Karnataka High Court chief justice to ensure that the case was disposed of within eight weeks and despite resistance from the tobacco companies asked them to implement the rules in the meantime. To facilitate this, the top court bench stayed a Dharwad bench order which had prevented these rules from coming into effect for now.

The Dharwad stay "shall not be given effect to till further orders of the Karnataka High Court", it said. Earlier, appearing for the Tobacco Institute of India, senior advocate Arvind P Datar, argued that these rules were "unreasonable", "arbitrary", "unforceable" and violative of the 2003 Act. Datar argued that no consultations were made with the industry before enacting rules which made it mandatory to carry such "gruesome" warnings.

The earlier rule, covering 40% of the packaging only on one side, cannot be overruled without any consultation as it has a huge socioeconomic impact on many sections, Datar argued. "The rules were ultra vires of the Act... as it does not empower the central government to prescribe the size of the warnings.

The Act merely requires the warnings to be legible, prominent and conspicuous as to the size and colour which were met by the unamended 2008 rules. This increase is completely arbitrary, unreasonable and is not based on any parameter," Datar said.

The industry association claimed that the new warnings would prevent tobacco makers from appropriately displaying their trademarks and would cause the market to be flooded with counterfeit products. It said that the tobacco crop directly and indirectly supports 38 million people engaged in production, processing, marketing and exports, including six million farmers.


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Tuesday, 3 May 2016

Exposure to tobacco in home increases risk of childhood illness: New study

The study found children who lived with a smoker or who had exposure to tobacco smoke inside the home were significantly more likely to have had any medical care visit, including sick care.

The dangers of smoking near a child have been well-documented and now, a new study has revealed that exposure to tobacco smoke inside the home can increase their childhood illnesses.

Researchers analysed 2011-2012 data from the National Survey on Children's Health, which is conducted by the US Centres for Disease and Control Prevention's National Centre for Health Statistics. They looked at patterns of health care utilisation among children ranging in age from newborn to 17 who were living with smokers compared with those who not exposed to tobacco smoke at home.

Results showed a total of 24% of the 95,677 children in the study, corresponding to a weighted total of 17.6 million children across the United States (US), lived with smokers. About 5% of the children lived with someone who smokes inside the home, equivalent to a weighted sum of 3.6 million US children.

Researchers said that children who lived with a smoker or who had exposure to tobacco smoke inside the home were significantly more likely to have had any medical care visit, including sick care. At the same time, researchers said, they were considerably less likely to have had any dental care visits.

Lead author Ashley Merianos of the University of Cincinnati said that settings with a high volume of children exposed to tobacco smoke at home, including paediatric emergency departments, could serve as effective outlets for health messages to inform caregivers about the dangers of smoking around children and help decrease these potentially preventable tobacco smoke exposure-related visits and associated costs.

The research is being presented at the Paediatric Academic Societies 2016 Meeting.

Source: DNA
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