The snowball that was set in motion in Australia in 2012 rolled through Norway today. An overwhelming majority of Parliament endorsed recommendations formulated on 1 December 2016 by the parliamentary Standing Committee on Health and Care Services. The measure will be introduced at the same time as the EU Tobacco Products Directive measures on packaging and labelling.

Tobacco advertising is deadly. It seeks to addict people to a product that kills almost half of its long-term users. Today, Norway becomes one of the first countries in the world to introduce standardised cigarette packs and the first country to standardise smokeless tobacco boxes. Smokeless tobacco use increased dramatically among young people in Norway during the last decade. The new measure will contribute to ensure that children and young people never start with tobacco and thus avoid tobacco-related suffering and death.

Anne Lise Ryel, Secretary General of the Norwegian Cancer Society said:

“Norwegian politicians have taken a historic step forward to reduce the consequences of tobacco advertising. Advertising works, especially with children. Norway was the first country in the world to introduce bans on all traditional forms of advertising of tobacco products. Ever since, cigarette packs have become mini billboards for tobacco industry marketing. With this morning’s event, the tobacco industry loses its last vehicle to lure children into addiction, disease and possibly death. This is truly a ground-breaking public health reform, and a landmark day for the cancer cause”.

The Norwegian Cancer Society congratulated Minister of Health and Care Services Bent Høie for his leadership in support of the measure in the face of persistent pressure and campaigning from the tobacco industry.

Source: Erik Vigander, Norwegian Cancer Society (December 9, 2016)

Three tobacco companies have lost their appeal against the government’s plain packaging rules for cigarettes packs.

The case, brought by British American Tobacco, Imperial Tobacco and Japan Tobacco International, comes after a challenge against the new rules was dismissed at the High Court in May.

The UK is the first country in Europe to require cigarettes to be sold in plain, standardised packaging,

The government has said it means a generation will “grow up smoke-free”.

Deborah Arnott, chief executive of health charity ASH, said: “This is a victory for public health and another crushing defeat for the tobacco industry.

“This ruling should also encourage other countries to press ahead with standardised packaging, now that the industry’s arguments have yet again been shown to be without foundation.”
But Simon Clark, director of the smokers’ group Forest, said the government was targeting the consumer as well as the tobacco industry with the new rules.

“Plain packs are unlikely to stop people smoking but the impact on consumer choice could be significant because some brands will almost certainly disappear from the market.”

“Tobacco is a legal product. The law should not impose excessive regulations on consumers who know the health risks and don’t need this type of finger-wagging measure.”

Source: BBC News (November 30, 2016)

The Health Ministry has announced new restrictions on cigarette sales as Health Minister Recep Akdağ revealed a rise in the rate of smokers in a country hailed for its exemplary anti-tobacco campaigns.

Speaking at a parliamentary session where the budget for his ministry was being discussed yesterday, Akdağ said they plan to introduce plain packaging for cigarettes, a plan scrapped during the tenure of his predecessor and cigarette displays in stores will be covered to prevent attraction.

Akdağ said smoking among adults has decreased to 23.2 percent in recent years but it rose again to 27.3 percent and they needed “a serious program” to tackle the issue. “In 2017, we will introduce plain packaging where the brand of cigarettes will almost be invisible and sellers will be obliged to store the cigarettes in closed cases instead of transparent displays,” Akdağ said.

Smoking is one of the habits most associated with Turks and even led to the emergence of the expression: “To smoke like a Turk.” Today, the country, which has a high prevalence of smokers, is marking the seventh year since the most comprehensive smoking ban came into force. Figures show the ban, along with escalated taxes and free treatment for smokers, helped decrease smoking in the country. A World Health Organization (WHO) report released in 2015 showed a 12 percent decline in tobacco sales and a decline in the prevalence of tobacco smoking from 31.2 percent to 27.1 percent in the four years prior to the report.

Plain packaging is a practice that has had mixed success in the countries it has been implemented. The thinking behind the idea is that young people are the main target for tobacco companies who attract customers with shiny packaging.

The Health Ministry also plans to ban smoking in public parks, gardens and other public places, but specific areas will be designated for smoking.

In 2009, Turkey banned smoking in all indoor spaces, including restaurants, bars, cafes and similar establishments and, one year later, the ban was extended to smoking in various sites such as stadiums, mosque courtyards and hospitals. Then Prime Minister Recep Tayyip Erdoğan, a staunch teetotaler, is largely credited for the effective implementation of the ban that significantly limited space for smokers. Erdoğan did not abandon his anti-smoking policy after he was elected president and even though he officially has no say in daily politics, he personally sees that people he comes across give up the habit, seizing their cigarette packs before having them “pledge” to quit smoking until their next meeting. Turkey is among the top seven countries that have passed 100 percent smoke-free laws, according to the WHO. Moreover, Turkey is one of the few countries combating smoking effectively with efforts to curb smoking by helping addicts. Smokers are provided with Bupropion HCI and Varenicline, two drugs used as smoking cessation aids and nicotine replacements.

Source: Daily Sabah (November 14, 2016)

The Canadian Cancer Society has released the 5th edition of its report, Cigarette Package Health Warnings: International Status Report.

The report finds that there are now more than 100 countries and territories that require graphic picture warnings.

The report ranks 205 countries and territories based on the size of their health warnings on cigarette packages and lists countries that have finalized requirements for picture warnings.

Cigarette Package Health Warnings report in English

Cigarette Package Health Warnings report in French

Tobacco companies in Canada have launched a public relations campaign to oppose plain packaging regulations. Click here to view the ‘Both Sides of the Argument’ website.

The U.S. Food and Drug Administration is being sued over its delay in issuing a final rule about graphic health warnings on cigarette packs and ads.

The legal action was launched by eight public health and medical groups — including the American Cancer Society — and several individual pediatricians. They filed suit Oct. 4 in federal court in Boston.

Besides the cancer society, the organizations involved in the lawsuit are: the American Academy of Pediatrics, the Massachusetts Chapter of the American Academy of Pediatrics, the American Cancer Society Cancer Action Network, the American Heart Association, the American Lung Association, the Campaign for Tobacco-Free Kids, and Truth Initiative.

Under a 2009 federal law, the FDA was given until June 22, 2011 to issue a final rule on graphic cigarette warnings covering the top half of the front and back of cigarette packs, and 20 percent of cigarette advertising.

The FDA met the deadline but the specific warnings required by the agency were struck down in August 2012 by an appeals court. However, the ruling applied only to certain images proposed by the FDA and did not affect the underlying requirement of the 2009 law.

In March 2012, another appeals court upheld the law’s requirement for graphic warnings and the U.S. Supreme Court turned down a tobacco industry appeal of that ruling.

The court decisions mean the FDA is still legally obligated to require graphic health warnings on cigarette packs and ads, according to the lawsuit plaintiffs.

The FDA said in March 2013 that it planned to issue a new rule on those warnings but has yet to do so, even though several of the groups involved in the lawsuit have repeatedly urged the FDA to take action, according to a news release from the Campaign for Tobacco-Free Kids.

The lawsuit alleges that the FDA’s failure to issue a new rule is “agency action unlawfully withheld” and seeks a court order requiring the FDA to issue a new rule.

“The FDA has been in violation [of the 2009 law] for more than four years. During that time, over 3 million Americans, the vast majority of them minors, have begun to smoke on a regular basis. Half of them will die prematurely as a result of tobacco-related disease,” according to the lawsuit.

A 2013 study of graphic cigarette warnings in Canada suggests that if the United States had implemented such warnings in 2012, as planned, the number of adult smokers in the United States would have fallen potentially by as much as 8.6 million in 2013.

Tobacco use is the leading preventable cause of death in the United States. Tobacco kills more than 480,000 Americans and costs about $170 billion in health-care expenses each year, according to the U.S. Centers for Disease Control and Prevention.

Source: CBS News (October 4, 2016)

Plain packaging for tobacco is on the way after legislation passed its final hurdle tonight.

Associate Health Minister Peseta Sam Lotu-Iiga took a large cigarette packet prop into Parliament’s debating chamber to show what plain packaging could look like.

“This is what will make a difference,” he said.

“When cigarette packs come out of a smoker’s pocket or are left lying around on the table where others can see, there will be nothing but a drab, ugly background colour and large, prominent, graphic pictorial warnings.”

Lotu-Iiga said no other product was so widely used that posed such a direct level of risk to users. Smoking led to between 4500 and 5000 premature deaths in New Zealand each year, he said.

“This bill takes away the last means of promoting tobacco as a desirable product. It stops the promotion of smoking as cool, fun, glamorous.

“About 13 people die prematurely every day from smoking-related illnesses … this is a bill to protect children and young people from being tempted from trying cigarettes.”

The legislation passed 108 to 13 votes, with opposition from New Zealand First and the Act Party.

New Zealand First health spokeswoman Barbara Stewart said all parties would be in agreement as to the damage that smoking could cause.

However, New Zealand First had concerns about a lack of evidence that plain packaging was effective, and possible unintended consequences such as an increase in black market sales.

“We have to remind people that $1.6 billion in excise tax is going into the Government coffers every year … there is a clear ulterior motive here, and it is not public health, as it should be.

“We remain unconvinced that plain or standardised packaging is effective at reducing tobacco consumption.”

Plain packaging is part of measures designed to make New Zealand smoke-free by 2025, a key goal of the Maori Party.

Maori Party co-leader Marama Fox referenced her confrontation with Imperial Tobacco spokesman Dr Axel Gietz on TV3’s The Nation in June.

Fox stormed out of the TV interview after accusing Gietz of “peddling death and destruction and misery”.

Tonight, she said last night she was visited by a person whose wife had recently died after being a smoker for 40 years.

“He came to bring me his wishes to tackle tobacco control in this country. He said she tried everything … e-cigarettes, patches, cold turkey.

“She could not kick the habit, and eventually she died trying. Today I want to remember her.”

Plain packaging for tobacco is likely to be in place early next year.

The Government in May released draft regulations and a consultation document which aims to standardise the look of cigarette packs.

New Zealand had been keeping an eye on the outcome of legal challenges against Australia’s plain packaging, one from tobacco firm Philip Morris and another from tobacco-producing countries via the World Trade Organisation (WTO).

Australia won the case against Philip Morris in December.

The WTO challenge is ongoing, but the Government received advice late last year that the Government was on a “firm footing” to progress plain packaging because several other countries, including the UK and Ireland, had introduced it.

These countries did not face a challenge under the WTO.

A pack of 20 cigarettes in New Zealand will increase from about $20 now to around $30 in 2020 after hefty excise increases were announced as part of May’s Budget.

The tax on tobacco will rise by 10 per cent on January 1 each year for the next four years.
That is expected to bring in an extra $425 million in tax over that period.

It will affect the about 15 per cent of adult New Zealanders who smoke each day – about 550,000 people.

That rate increases to 35 per cent for Maori, and 22 per cent for Pacific people.

Lotu-Iiga last month released a consultation document that includes a proposal to legalise the sale of e-cigarettes in New Zealand.

Nicotine patches and gum can be bought, but nicotine e-cigarette liquid must be bought from overseas.

Other countries, like the UK, allow the e-cigarettes or vaporisers to be sold in supermarkets and dairies.

The products would not be allowed to be used in smoke-free areas, and safety measures including child-proof containers will be considered.

Source: New Zealand Herald, Nicholas Jones (September 8, 2016)

The Australian Government has posted online its “Integrated Executive Summary of Australia’s Submissions”, dated March 23, 2016, in the World Trade Organization (WTO) plain packaging case. Click here to view the summary.

Additional documents in this WTO proceeding are available here.

New Zealand and Norway intend to force tobacco companies to remove branding on cigarette packets and other tobacco products as more countries follow the lead of Australia across the world.

The New Zealand government, which aims to become a smoke-free nation by 2025, is proposing plain cigarette packaging with all tobacco imagery removed and with prominent and gruesome health warnings covering at least 75 percent of the front of the packs. The Norwegian government will send a bill to parliament in June that would strip tobacco products of logos, Health Minister Bent Hoeie said at a conference in Oslo Tuesday.

Australia has led the way in plain packaging after legal challenges failed to overturn new tobacco branding laws there. The U.K., Ireland and France were the first European countries to back the measure, which prompted legal challenges from cigarette makers including Philip Morris International Inc. and British American Tobacco Plc.

“The louder they scream, the more effective the measure must be,” said Douglas Bettcher, a World Health Organization director who spoke in Oslo on the occasion of World No-Tobacco Day. “The tobacco industry’s nightmares are in fact lifesavers.”

Brand names will be allowed in New Zealand but regulations will standardize printing and placement, Associate Health Minister Peseta Sam Lotu-Iiga said. The regulations are expected to take effect after legislation is passed later this year, he added.

New Zealand announced last week that the tax on tobacco will be increased by 10 percent each year for the next four years, driving the price for a standard pack of 20 cigarettes up to around NZ$30 ($20).

Norway will require cigarettes and snus — a form of smokeless tobacco — to be sold in dark green packs. Young people in the country have been smoking less though their use of snus has increased dramatically in the past decade, according to the government.

“It will look like the addictive and dangerous product it is,” Norwegian Health Minister Hoeie said. “We are moving toward a smoke-free generation. Someday tobacco will look as unbelievably outdated as smoking in airplanes.”

Source: Matthew Brockett, Bloomberg (May 30, 2016)

Recent moves to introduce plain (standardized) packaging of tobacco products can save lives by reducing demand for tobacco products, according to WHO and the WHO Framework Convention on Tobacco Control Secretariat (WHO FCTC).

Plain packaging of tobacco products restricts or prohibits the use of logos, colours, brand images and promotional information on packaging other than brand and product names displayed in a standard colour and font style.

In December 2012, Australia became the first country to fully implement plain packaging. On 20 May 2016, France and the United Kingdom of Great Britain and Northern Ireland each began implementation of plain packaging. Ireland is also preparing to introduce the measure, while other countries are exploring the option.

How plain packaging works

“Plain packaging reduces the attractiveness of tobacco products. It kills the glamour, which is appropriate for a product that kills people,” says WHO Director-General Dr Margaret Chan. “It restricts tobacco advertising and promotion. It limits misleading packaging and labelling. And it increases the effectiveness of health warnings.”

Plain packaging is recommended in WHO FCTC guidelines as part of a comprehensive approach to tobacco control that includes large graphic health warnings and comprehensive bans on tobacco advertising, promotion and sponsorship.

Australia’s story

Smoking in Australia has been steadily declining for years. Australia introduced plain packaging, in conjunction with new and enlarged health warnings, in 2012. Between December 2012 and September 2015, there was an additional 0.55 percentage point fall in smoking prevalence among those aged 14 and above attributable to the packaging changes, according Australia’s post-implementation review. This equates to more than 108,000 people quitting, not relapsing or not starting to smoke during that period.

Dr Oleg Chestnov, WHO’s Assistant Director-General for Noncommunicable Diseases (NCDs) and Mental Health, says Australia’s plain packaging results demonstrate the great potential of the measure. “Plain packaging can reduce consumption of tobacco products, as clearly seen in Australia. It offers a powerful tool to countries as part of a comprehensive approach to tackle the scourge of tobacco use,” says Dr Chestnov.

The theme of this year’s World No Tobacco Day – Get ready for plain packaging – highlights this new trend in global efforts to control tobacco products, which kill almost 6 million people annually, notes Dr Douglas Bettcher, WHO’s Director for the Prevention of NCDs.

Defying the tobacco industry

“Plain packaging is going global as more and more countries seek the important health gains it can bring to communities,” says Dr Bettcher. “The tobacco industry has been getting ready for plain packaging for some time, conducting massive misinformation campaigns to block the measure.”

“So it is encouraging to see more and more countries defy the industry’s tactics and implement plain packaging to reduce demand for tobacco products and put the health of their populations first.”

To mark World No Tobacco Day, WHO is launching a new guide to plain packaging of tobacco products, which gives governments the latest evidence and guidance on implementing the measure.

“Most governments are committed to curbing the tobacco epidemic and reducing tobacco-related harm, such as deaths from cancers, heart and lung diseases,” says Dr Vera da Costa e Silva, Head of the WHO FCTC Secretariat. “It is vital they have access to evidence-based, effective guidance that can support their efforts to protect the health of their populations.”

Click here for materials from the World Health Organization in support of the theme for World No Tobacco Day: Get Ready for Plain Packaging.

Source: World Health Organization (May 31, 2016)