Cancer Research UK have launched a campaign to raise awareness about the plain packaging debate that could see branding and the use of design, colour and tobacco company logos on packets of cigarettes. The campaign, ‘The answer is plain’, asks people to sign a petition on the charity’s website to show the support for the idea of a plain packaging law on cigarettes. The campaign page on Cancer Research’s website contains a video showing children looking at packets of cigarettes and commenting on them. Comments from the children in the video include ‘it looks like a Ferrari’, ‘it makes you feel like you’re in a wonderland of happiness’ and ‘it’s really bright colours; it looks like it would be quite fun to play with’. Cancer Research UK have been very outspoken in their support of the proposed plain packaging law, claiming that children are drawn to the attractive packaging used on cigarette packets and by making such designs illegal, fewer children will be drawn to trying smoking in the first place. Other leading smoking researchers and campaigners are also in support of a plain packaging law, including Professor Robert West, Director of tobacco research at University College London. He recently commented: “Tobacco companies claim they don't market their products to children. But the truth is their products are attractive to children”. The debate on the plain packaging of cigarettes is set to intensify over the coming months as the government continue their consultation on the topic.

The mayor of New York, Michael Bloomberg, has pledged $220 million to help combat smoking in some of the world’s poorest countries. The donation from Mr Bloomberg will go towards anti-smoking efforts in countries where smoking is an increasing problem, including Bangladesh, China, India, Indonesia and Russia. Mayor Bloomberg’s donation will help organisations that are trying to tackle high levels of smoking in the world’s low – middle income countries. The funds boost is to be used to try and persuade the governments in the countries concerned to consider introducing smoking policies and legislation. Other initiatives from the World Health Organisation’s Global Framework Convention on Tobacco Control that will be promoted include encouraging higher sale prices on cigarettes, more restrictions on tobacco advertising and banning smoking in public places. Commenting on the global issue of smoking, Mr Bloomberg said: "There is nothing that any of us here will do that will save as many lives as stopping people smoking. It is a scourge all over the world”. Bloomberg has also made previous criticisms of the tobacco companies in relation to global smoking, saying there is a definite targeting of poorer, less educated people in their campaigns. The mayor has been instrumental in the introduction of some of the world’s foremost smoking policies in New York City. Mr Bloomberg is one of the US’s richest individuals, with an estimated personal fortune of $19.5bn. the $220 million donation will be made from Bloomberg Philanthropies.

A report has revealed that millions of smokers are unaware of all the risks associated with smoking tobacco. The World Heart Federation (WHF) report, released this month, highlighted the lack of knowledge in countries such as India, where a reported 138 million of the 275 smoking population were unaware that smoking tobacco can cause strokes. 92 million Indian smokers were also ignorant of the fact that smoking causes heart disease and shockingly, half of Chinese smokers and a third of Indian smokers did not know of the overall harm smoking can have on the heart. The report, entitled Cardiovascular Harms from Tobacco Use and Second Hand Smoke’, further highlighted that there is a lack of understanding in low to middle income countries, such as India, about the dangers of second hand smoke. There are also concerns expressed in the study that tobacco companies are increasingly targeting countries in this bracket due to the lack of restrictions and smoking legislation. The president of the Public Health Foundation of India commented on the report: “Indians need to wake up to the threat of CVD’s (cardiovascular diseases) which are having a devastating impact on the nation’s health, growth and development. Joint government and public action on tackling these diseases is the need of the hour”. According to statistics from the World Heart Federation, one in ten deaths associated with cardiovascular disease are caused by smoking tobacco or second hand smoke inhalation.

A leading cancer professor in the United States has claimed that half of all cancers in the country could be prevented if people strictly followed guidance based on what we know about smoking, diet and exercise. Speaking about cancer prevention in a report written for the journal Science Transitional Medicine, Professor Colditz, associate director at the Siteman Cancer Center, also claims that of the cancers caused by smoking; including lung cancer, bladder cancer and kidney cancer, over 70% of deaths could be prevented. The problem, according to Colditz, is that not enough is being done to act upon what we already know when it comes to improving our health, diets and stopping smoking. The figures in Colditz’s report come from analysis of a variety of US cancer studies. Commenting on his research, Professor Colditz commented that there is a disparity in the resources being spent on treatment and prevention: “The reality is that if we could shift just a fraction of the research to prevention, we'd have a major payoff for society." Although focussed on the United States, Colditz recognises the need for stronger cancer prevention strategies in countries with low to middle incomes. Despite calling for more to be done in terms of policy making and the allocation of research funds, the problem, according to Colditz, is one that extends far beyond the realms of health professionals alone. He commented: "We need the whole of our society to accept the responsibility and the strategies to maintain a healthy lifestyle and avoid cancer."

Doctors in Scotland are pioneering a new screening programme that aims to detect signs of lung cancer at an early stage. The programme, which will involve GP’s at 60 practices in the country offering a blood test which detects antibodies linked with the disease, will be undertaken over the next four years. Where the initial blood test indicates higher levels of the antibody in question, the patient will then be sent for further investigative tests. Those at greatest risk of developing lung cancer, ie. long-term smokers, are to be the main target for the programme. The aim of the initiative is to increase survival rates of the disease, of which an estimated 8 out of 10 instances are thought to be smoking-related, through early detection. Lung cancer, which accounts for 35,000 deaths a year, has a very low survival rate. This is mainly due to the fact that the disease can take between 20 and 30 years to develop to the point whereby symptoms are observable, by which point it has often become untreatable. Statistics from research in Scotland have found that over half of those diagnosed with the disease do not survive longer than four months following diagnosis. The Scottish Health Minister, Nicola Sturgeon, commented: "If the disease is diagnosed early patients have a 60 per cent chance of survival, but if the cancer is well advanced the survival rate drops to just one per cent. Early detection is paramount”.

A date has been set for the consultation on cigarette plain packaging laws in England. The consultation on the matter began on Monday 16th April 2012, the Health Secretary Andrew Lansley has announced. The consultation is being launched as part of the government’s ongoing tobacco reduction initiatives, aiming to cut to the smoking rate in England. One of the main groups the plain packaging law is set out to tackle is young smokers, who are said to be influenced and attracted by the packaging of cigarettes. Australia is currently the only country in the world that is pressing ahead with plain packaging. Provided the Australian government are able to overcome the legal challenges presented by tobacco companies, the plain olive green packets of cigarettes will hit the shelves down under at the end of 2012. However, Conservative MP Mark Field has raised concerns over the proposals for England, commenting that plain packaging could lead to “negative impacts”, including increasing the dangers posed by counterfeit cigarettes and leading to an increase in smuggled tobacco. Mr Field also outlined concerns that removing branding from packets of cigarettes could damage the competitiveness of tobacco companies. He said: “The enforced introduction of plain packaging would infringe fundamental legal rights routinely afforded to international business, erode British intellectual property and brand equity”. Simon Clark, director of smoking rights group Forest has already come out in fierce opposition over the new plain packaging proposals. He stated: 'Plain packaging is yet another attack on retailers and adult consumers. People are sick of being nannied by government.'

The government in Bulgaria have voted in favour of banning smoking in all enclosed public places. The ban, which will come into force on 1st June 2012, was passed on 11th April as part of amendments to the Health Care Act, and will extend the ban on smoking to all enclosed public spaces, including restaurants, bars and the immediate surroundings of schools and playgrounds. Although there had previously been a smoking ban in place in the country (brought into force in 2005), this had initially only covered certain areas and types of establishment; including government buildings, schools and public transport. Under the previous smoking restrictions, people were still allowed to smoke in restaurants and bars, as long as they were seated in a separate, specifically designated areasto do so. Venues which were too small to allow separate sections (those under 100 square metres) could choose whether to be either a smoking venue or a non-smoking venue. The new extended ban, which will ban smoking in indoor public places outright, was fiercely opposed by the hospitality industry in the country due to fears of losing trade. Owners of bars and restaurants had previously succeeded in getting the ban postponed; the law had originally been due to be passed in 2010. The new smoking restrictions are also particularly controversial due to the popularity of smoking in Bulgaria. Statistics showing that some 44% of the population smoke; this figure puts Bulgaria second only to Greece in terms of the smoking rates amongst European countries.

The World Health Organisation (WHO) has issued a warning about shisha smoking, claiming that an hour spent smoking in a shisha bar can be as harmful to the body as smoking 100 cigarettes. The warning, issued by the WHO earlier this month, comes as the number of shisha bars in the UK is reported to have increased by over 200 per cent in the past 5 years. According to the World Health Organisation, smoking from shisha pipes during an hour long session can amount to around 200 drags of 0.15 to 1 litre of smoke each. This is opposed to the number of drags and litres of smoke inhaled whilst smoking a conventional cigarette – typically between eight and 12 puffs, and 0.5 to 0.6 litres of smoke respectively. in addition to the potentially large volumes of smoke inhaled during a shisha smoking session, there are also concerns that people who are visiting the bars and participating in smoking are not aware of the risks. In some cases, it is claimed that people are under the illusion that shisha smoking is ‘safer’ than smoking conventional cigarettes; a claim for which there is no supporting scientific evidence. Professor Robert West of University College London commented: ‘Shisha smoking is a growing concern because people aren’t aware of the risks like they are with cigarette smoking”. ‘Shisha cafes should have prominent notices saying, “Smoking shisha can kill” - just like you would on a cigarette packet.’

This month saw No Smoking Day in the UK. The day (it was on Wednesday March 14th if you missed it) came and went with relatively little media attention. The idea of No Smoking Day is to remind people of why they wanted to quit in the first place; raising awareness of the dangers of smoking and providing support and access to help for people who need it. For many people, the dawn of a new year provides the much-needed impetus to try and quit smoking. But by mid-March, already nearly a quarter of the way into the year, most people have long-forgotten their new year’s resolutions, however, and have slipped back into old habits. Although organisers of No Smoking Day claim that via the promotion of the day, along with a series of organised local events; one million Brits attempt to quit smoking on No Smoking Day. The reality is, however, that despite the big investment and all of the efforts put into bringing the day to people’s attention, the majority of smokers pay no attention to No Smoking Day and of those who do attempt to quit, a large number will return to smoking cigarettes. With quitting smoking an evidently arduous task, many smokers are looking towards smoking alternatives, such as electronic cigarettes, rather than quitting smoking altogether. Electronic cigarettes (also referred to as e-cigarettes or e-cigs) can be used as a long-term form of nicotine replacement and therefore a viable alternative to smoking conventional cigarettes. Designed to look like cigarettes and replicate the ‘puffing’ action of smoking, electronic cigarettes are rapidly growing in popularity; particularly in the UK and the US.

A taxi driver from Chesterfield has been fined and ordered to pay costs after he was found guilty of smoking in his cab. The taxi driver, Alfonso Desideri, has been fined £73 and ordered to pay costs of £150 for breaking the law against workplace smoking. Mr Desideri originally denied the offence when he was charged under a fixed penalty. On 1st July 2007, it became illegal in England to smoke indoors in places of work and places open to the general public. Mr Desideri contravened the law by smoking in his cab, which is both a place of work and an enclosed space that is available to the general public. Furthermore, Mr Desideri was seen to throw his cigarette butt out of the window, and was also fined in this respect. The charges against Mr Desideri comes at a time when a wider ban, which would make it illegal for anyone to smoke in their cars, be it a place a of work or not, is being considered. The suggestion was first publicly raised in the UK by the Northern Ireland Health Minister in November. Although initially proposed as a measure of reducing the exposure of any children passengers to passive smoke, it was suggested that this would be difficult to police, and a wider ban on all smoking in cars was thereafter proposed. The notion was brought to the fore again in February this year as a survey by YouGov in Wales revealed that 83 per cent of Welsh people would support a ban on smoking in cars with children.

A study has found that banning smoking in ‘beer gardens’ and outside bars in designated ‘smoking areas’ would reduce the likelihood of people lighting up. The New Zealand based study of so-called ‘social smokers’ found that of those interviewed, 92% reported that they would support an extension of the ban to cover pub gardens. The participants also indicated that they would find it easier not to smoke if bars were made smoke-free altogether. The research, which was undertaken by academics at the University of Otago in New Zealand, was published last month in the Tobacco Control journal. The authors of the research said that legislation to ban smoking in outdoor areas at pubs would assist people who were trying to quit smoking by "changing the environment that facilitates it". Jean King of Cancer Research UK commented: “This small study highlights some interesting points about what triggers some social smokers to light up”. Interestingly, the participants in the New Zealand study didn’t actually consider themselves to be smokers due to the fact that they only smoked whilst they were consuming alcohol. Pro smoking groups have called the validity of the research into question, however, due to its small sample number of only 13 participants. Simon Clark, director of Forest, also commented “the smoking ban was brought in allegedly to protect bar workers. Banning smoking outdoors would have nothing to do with that”.

The Welsh government are to consider an amendment to the ban on smoking by allowing cigarettes to be utilised on television and film sets in Wales where it is “artistically integral” to the drama. Currently, the legislation in place in Wales makes it illegal for cigarettes to be smoked in any enclosed public spaces and places of work, including film sets and studios. Despite this proposed amendment to the smoking legislation, which is being considered by some as a ‘relaxation’ of the law, the Welsh government have launched a high profile campaign to outlaw smoking in cars in the country. The Fresh Start campaign, which was launched last month, is being used as an initial step to try and drive down smoking in cars where children are present. The Welsh government have committed to tackle the problem by way of enforcing a ban should the campaign not be sufficiently effective after three years. Dr Tony Jewell, chief medical officer for Wales said: "There is robust evidence that the level of toxic chemicals is very high in cars, even with a window open. The Fresh Start Wales campaign aims to make people aware that smoking in cars is dangerous for their passengers, particularly children." According to a You Gov Survey for Ash Wales, four out of five Welsh adults supported a ban on smoking in cars when under 18’s were present. Last year the British Medical Association called for an outright ban to be brought in on smoking in cars, regardless of the age of any passengers.

Major tobacco companies have made fresh claims that the plain packaging law, which will see all branding and logos stripped from packets of cigarettes and tobacco in Australia, is unlawful. The tobacco companies claim that the new law will breach the country’s constitution with the government’s suppression of branding; effectively acquiring brands and intellectual property without compensation.  Many have branded this legal challenge a ‘long shot’, saying it would be very difficult to prove a breach of the constitution in this way.

The Australian government, however, claim that the tobacco companies involved in raising the legal challenge are just trying to use their weight to stop the law coming into force. There are even claims that Phillip Morris, the tobacco giant at the centre of the row, have undertaken underhand tactics to challenge the law, including transferring the business from Swiss ownership to being Hong Kong based just so they could claim plain packaging constituted an infringement under the 1993 Bilateral Investment Treaty (BIT) between Australia and Hong Kong. Phillip Morris claim there were legitimate business reasons for the change.

Furthermore, there is a potential argument under the UN’s commission on International Trade that a government cannot bring on a policy that will damage a business’s sales without that policy being based on scientific fact.

Despite the continuing threat of legal action from the tobacco companies, Australia still say that the plain packaging law on cigarettes will come into effect in December this year. A consultation on a similar law possibly being enforced in the UK is due to commence this year. 

A recent study undertaken by researchers in Italy has found that electronic cigarettes were effective in encouraging smoking cessation. The study, undertaken by researchers at the University of Catania, took 40 ‘hardened smokers’, who according to the researchers had no intention of quitting. Results of the study reported that over half of the participants quit smoking conventional cigarettes by the end of the study. Whilst studies such as this indicate that e cigs can be effective in assisting smokers who want to quit, many see that in the long term, electronic cigarettes should be viewed as an ‘alternative’ to smoking rather than an anti-smoking aid. Electronic cigarettes can be a viable alternative to smoking as they replicate two of the most addictive elements of smoking, namely the act of puffing on a cigarette itself, and the nicotine ‘hit’ that comes from smoking a cigarette. In addition, electronic cigarettes release water vapour as a by-product, meaning they are widely accepted in many places where conventional cigarettes are banned, including in bars, pubs and restaurants. Whilst the dangers of smoking cigarettes, with the 4000 plus chemicals contained within their inhaled smoke, are well-known, electronic cigarettes remain somewhat of a lesser-known entity. As e cigs do not contain the vast majority of the chemicals contained in cigarettes (for example e cigs do not contain tar or tobacco), many are hailing e cigarettes as not only a viable, but a ‘safer’ alternative to cigarettes.

The past 10 years has seen the introduction of major regulation changes and increasing restrictions on smoking and tobacco, but what, if any effect, have these policies had on the smoking rates in the UK? On first inspection of the statistics, it would seem quite substantial. Go back to 2002, the rate of smoking in the UK was reported at 27%. And yet in 2010, the figure averaged at 21% of UK adults. The ban on tobacco advertising, which was brought into force in 2002, the ban on smoking in public places and places of work, which came in in 2007, and the introduction of ‘smoking kills’ messages along with graphic images, seem therefore to have had a dramatic impact during this relatively short period of time. Figures from the other side of the world in Australia, where restrictions on smoking are even more severe than in the UK, also report a drop in smoking rates. 15% of adults in Australia smoke, with the level of 14- to 17-year olds who smoke coming in at just 2.5%. Some argue, however, that rather than the smoking bans that have come into force in the UK, it is simply that people’s awareness of the dangers of smoking cigarettes has continued to increase. Certainly, if you look at the smoking rates of some 40 years ago, when 51% of men and 41% of women in 1974 smoked, there is strong suggestion that smoking levels in the UK have followed a general decreasing trend over many years. Ultimately, it is difficult to conclude whether the rate of smoking would have continued to fall without the active intervention of the government. What is certain is that there will be further restrictions and bans on cigarette smoking and the tobacco industry to come, with plain packaging on cigarettes looking set to be the next controversial step.

Northern Ireland is to introduce a ban on tobacco vending machines from 1st March 2012. The ban will make it illegal for cigarettes and tobacco to be sold from vending machines in pubs and bars. The ban is brought into force following research that suggests 14% of smokers under 16 regularly use vending machines to purchase cigarettes. The announcement that the ban is to be introduced was made in January by Health Minister Edwin Poots. Whilst recognising that the vending machine ban will not eradicate the issue of under 16’s taking up smoking, Mr Poots commented that he hoped it would contribute to alleviating the problem, by removing a source of tobacco sales that he called ‘largely unsupervised’. The Minister commented: “Children and young people are particularly vulnerable consumers in that they are generally unaware of the long-term health implications of tobacco use”. Mr Poots added that he hoped the ban on cigarette vending machines would also support the many adults who try and quit smoking each year. A similar ban has been in place in England since October 2011, and the purchase of cigarettes from vending machines will become illegal in Wales on 1st February 2012, with Scotland said to be introducing a ban in the near future. The Northern Ireland minister said the ban on sales of cigarettes from vending machines was just one element of a new ‘tobacco control strategy’; further details of which are to be announced later this month.

An investigation has found that tens of thousands of people are smoking counterfeit cigarettes in Lancashire. The investigation found that there is a serious problem with the sale of illegal cigarettes in Blackburn, with half of the city’s shopkeepers saying they knew of local illegal tobacco traders. The investigation found that there is a problem with unregulated shisha tobacco products in the city, as well as illegal cigarette sales in alleys, pubs, car parks and even shops. Shopkeepers selling legitimate cigarettes have reported a slump in cigarette sales caused by the volume of counterfeit tobacco products available in the locality. The local County Council estimate that 50,000 residents in the area are smoking illegal/counterfeit cigarettes. In addition to issues concerning VAT fraud from the purchase of these illegal cigarettes, and the links between illegal cigarette trading and organised crime, there are also concerns that the fakes contain substances to ‘bulk out’ the cigarettes, including sawdust and rat droppings, which could be putting people’s health at risk. Unregulated products, such as shisha tobacco, also do not carry the correct health warnings in the vast majority of cases. The findings of the investigation have prompted a crackdown on counterfeit cigarettes in the city, and an Illicit Tobacco Team has been launched. The head of Trading Standards at the local Council, said “With these extra resources we have been able to give this particular problem more emphasis, leading to significant seizures in the last couple of months on counterfeit and incorrectly marked products.”

A new survey has found that young people in the UK are being ‘hoodwinked’ into smoking because of the packaging on cigarette packs. The survey, by the British Heart Foundation (BHF), reports that of the 16 – 25 year olds who took part in the survey, 69% said that they considered cigarette packaging to be a form of advertising and would make a purchase decision based on the branding of cigarette packs.

The survey also found that 25% of young people concluded that one type of cigarette was more harmful that another based on packaging design alone, and 87% considered that plainly packaged cigarettes were ‘less attractive’ than those packs with branded design and logos. Other findings from the survey include the fact that one in six respondents would be influenced by the packaging design when choosing which cigarettes to buy.

The BHF survey is based on responses from more than 2,771 young smokers and non-smokers and may provide backing for the ‘plain packaging’ argument that is to be brought to public consultation by spring 2012. Australia will take the lead in cigarette plain packaging – it will become law for all cigarettes sold to be packaged in plain green packs with large health warnings in December 2012. Tackling smoking in young people is seen as one of the key strategies to reducing overall smoking levels in the UK. Over 200,000 young people in the UK are thought to take up smoking every year. Of the 10 million smokers in the UK, two thirds are estimated to have started before they were 18.

A new health initiative, recently launched in the Isle of Man, will provide people with the opportunity to quit smoking during their lunch break. The free drop in clinic programme, called Quit4You, is currently being trialled in the local church in Douglas and includes a session which runs from 12:30 pm to 1:30 pm.

So instead of taking their lunchtimes as a chance to have a cigarette break, workers can instead use their break to try and quit the habit. The Quit4You service is designed as a ‘one stop shop’ for residents who are thinking about stopping smoking, providing a combination of advice, practical support and tips to help them get through the process. Initially, people will receive a 45 minute one to one session with a stop smoking expert to discuss smoking patterns and try to establish the best approach to quitting. People can then attend the sessions for ongoing support and help as and when they need it.

Aids to quit smoking, including nicotine replacement therapy are discussed during the sessions, and where it is deemed appropriate, vouchers are handed out to attendees, meaning they do not have to visit their GP to get a prescription.

The Isle of Man’s Health Minister David Anderson said: ‘The Quit4You Stop Smoking Service of course helps to raise awareness about the dangers of smoking, but first and foremost it’s about providing smokers who wish to quit with information, support and advice to help them achieve this”. Over 1500 people on the Isle of Man are reported to have already used the service, during both the lunchtime and evening sessions.

A supermarket in Leicestershire has become the first place in the UK to ban the display of cigarettes and tobacco products in its kiosks. Tesco in Market Harborough recently initiated the tobacco display ban as a trial in the store, with all cigarettes and tobacco items now being stocked on shelves hidden by plain white sliding doors. The scheme has also brought a ban on all signage advertising the sale of cigarettes at the tobacco kiosk indeed anywhere in the store. Tesco plan to roll out the trial to 2,865 stores across the UK before the UK-wide ban on tobacco displays in larger stores comes into force in April 2012. The new law, which will also be enforced on tobacco displays in smaller shops by 2015, is aimed at reducing the number of people who smoke in the UK from 20% to 18.5% of the population by 2015. The ‘under the counter’ approach is intended to reduce the temptation to by cigarettes in an ‘out of sight, out of mind’ mentality. It is hoped that the ban on cigarette displays will especially discourage younger people from purchasing cigarettes. Anne Milton, Public Health Minister, commented on the Tesco trial: "We welcome this move by Tesco in Market Harborough. "Tobacco displays will come to an end in supermarkets in April next year, and in all shops in 2015. "This will help discourage young people from taking up smoking and help adult smokers who are trying to quit."

Patients who are on waiting lists for surgery at one hospital in the UK are being asked to quit smoking before their operation takes place. People who are awaiting non-urgent surgical procedures in Portsmouth, including knee and hip replacement surgery, are being put onto courses to help them to stop smoking in the run up to their operation. Whilst people who are not able to quit smoking will ultimately not be denied access to surgery, Doctors at NHS Portsmouth said smoking cessation beforehand can reduce recovery time, hence why they were asking patients to try and quit the habit. According to research, patients who stop smoking before surgery are much less likely to suffer unwanted complications as a result of their operation, such as infections, breathing difficulties and lung problems. Even where smoking is stopped for just a few weeks before an operation, there can be a positive effect on the speed at which wounds can heal. Director of public health for NHS Portsmouth said: "We want to highlight the harm that they can do through continuing to smoke, and the possible potential dangers of having an operation while you smoke." Smoking costs the NHS as much as £5 billion per year, and calls by leading health advisors to make patients quit smoking before they are allowed access to surgery is not a new idea. A study by the NHS in Portsmouth found that 70% of patients want to quit smoking but do not know how.

Following on from an article we published a couple of weeks ago about ministers in Northern Ireland proposing a ban on smoking in cars, the story hit the headlines as a UK-wide ban was proposed by the British Medical Association (BMA). A ban on smoking in cars when children are present has been proposed in Northern Ireland, and a consultation on the issue will be launched. The British Medical Association suggested further extensions of these proposals last week, saying that the ban should be extended to cover the whole of the UK, and that the ban should be on smoking in cars altogether – not just where children are present. The BMA have stated that the ban would ‘protect people’ from high levels of toxins - citing research which shows that the levels of toxins present in the air after smoking in a car can be 23 times higher than the levels of toxins from the air in a smoky bar. Despite the headline-grabbing recommendations, the Government in the UK and Scotland have made no indication that they will be proposing any such ban. In Wales, a public awareness campaign is underway warning people about the dangers of smoking in cars. Health officials have said that if the campaign does not have the desired effect, they will consider bringing a ban in in three years’ time. Smoking in cars when children are present is already banned in Australia, Canada, and in some states in the United States.

A US study into smoking at different times during the day has revealed that people who smoke in the morning are pitting themselves at a far greater risk of developing cancer than those who light up later in the day. The study, published in the Journal of Cancer, found that people who smoked during the first 30 minutes after waking up were up to 79% more likely to develop cancer than those smokers who habitually waited over an hour until their first cigarette. The study of 7,610 smokers was carried out at the Penn State College of Medicine, and accounted for the ‘smoking habits’ of participants in their findings (ie. how frequently they reported they smoked). A further study, published in the same journal, found similar results, although developing cancer was found to be 59% more likely in this particular group of participants. Although the correlation between the time taken to light up and the development of cancers in the study was strong, researchers are uncertain as to how to explain the apparent link. Some experts, such as researchers at Cancer Research UK, claim that those who smoke within half an hour of waking up smoke more intensely, so are inhaling more vigorously, and therefore taking more toxins into the lungs. Others have commented that smoking so soon after waking is indicative of a stronger addiction, perhaps therefore meaning that they smoke more frequently than their counterparts who wait longer until their first cigarette of the day. Authors of the second study commented that "it is uncertain what explanation there is for the relationship".

A recent article in the British Medical Journal (BMA) has recognised electronic cigarettes as a ‘low risk’ alternative to normal cigarette smoking. In the article by Ron Borland, a UK cancer prevention research specialist, it was also suggested that health professionals should be allowed to recommend the use of electronic cigarettes as a cigarette substitute for those who are struggling to stop cigarette smoking.

Whilst the article doesn’t go as far as to advocate the promotion of electronic cigarettes as a healthy way to smoke, it does state that ‘the risks are probably far lower than smoked tobacco’. The article also recognises that overall, electronic cigarettes pose ‘no serious immediate risk’ and are a far safer way to smoke than normal cigarettes.

Boland also states that the relaxed approach on the sale of electronic cigarettes in the UK, as advocated by the UK government, is a step which follows the ‘greatest potential public health benefit’.

The article goes on to say that more research into the long-term use of cigarettes is needed. As with any form of treatment or drug, health professionals can only recommend tried and tested methods, which have research behind them and are backed up by a series of clinical trials. More research would almost certainly pave the pathway for more widespread recommendation of the use of electronic cigarettes as a method of assisting with withdrawal from cigarettes, or as a healthier alternative for people to continuing smoking. 

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