Anti-smoking

Thursday, December 5, 2013

Why smokers still SMOKE?

It’s not that they are all hopeless addicts. Many smokers are capable of quitting.
It’s not that they are ignorant. Studies show that smokers are at least as informed as nonsmokers about the risks of smoking — and possibly more informed.
You might suspect, then, that smokers tend to be risk takers by nature. And some evidence suggests that smokers do take more risks than nonsmokers: they are more often involved in traffic accidents, less likely to wear seat belts and more likely to engage in risky sexual behavior. Women who smoke even have mammograms less frequently than their nonsmoking counterparts.
But we don’t believe that smokers have a greater tolerance for risk. As we argue in a study published this month in the journal PLoS One, the personality trait that distinguishes smokers from nonsmokers is their relative inability to delay satisfaction and respect long-term considerations (like their health). In other words: it’s their poor self-control.
Key to our study is a card game known as the Iowa gambling task, commonly used to measure risk taking. You are presented with four decks of cards. Each card reveals a financial outcome: “You won $100,” or “You lost $250,” for example. Your task is to keep picking cards from whichever decks you would like, trying to make as much money as you can. The twist is that the decks have different payoff distributions: two of them offer higher risk (cards with larger gains and larger losses) but long-term overall losses; the other two decks offer lower risk (smaller gains and smaller loses) but long-term gains.
Most participants, after selecting several dozen cards from the various decks, learn to stick with the two “good” decks and end up faring well. Studies have shown, however, that people with brain lesions affecting decision making tend to favor the “bad,” riskier decks and fare poorly. The same is true of chronic cocaine and cannabis users. But when smokers and nonsmokers perform the Iowa gambling task there are no significant differences between the two groups, as the psychologist Carl Lejuez and his colleagues have demonstrated. This strongly suggests that smokers are not, in fact, especially tolerant of risk.
So what accounts for smokers’ risky-looking behavior? Our contention is that smokers exhibit poor self-control in the face of immediate temptation — which can look like a willingness to assume risk. (For instance, you might choose to have sex without a condom not because you are comfortable with the risk but because you are too weak-willed to bother with the inconvenience.)
To test our hypothesis we took 100 research participants (smokers and nonsmokers) and had them perform a modified version of the Iowa gambling task. We focused on a subtle difference between the two “bad” decks. One offers payoffs that commonly result in immediate satisfaction — it produces a gain of $100 in 9 out of 10 draws — but in 1 of 10 draws it produces a disaster: losing $1,250. The other bad deck is less immediately satisfying — the losses are smaller ($250) but more frequent, occurring about every second draw. Thus both decks are bad overall but the first is more satisfying in the short run.
In addition, in our modified version, every time a participant selected a card from one of the four decks, we showed the outcomes that would have resulted from selecting from the other three decks. This increased the salience of the immediately satisfying deck, since when choosing any other deck, 9 times out of 10 the player could see that this deck produced the best outcome.
We found that as the game progressed, smokers selected this deck about 1.5 times more than nonsmokers. They could not resist the short-term pleasure despite the long-term disaster.
(We also had our research subjects play another version of the game in which the good and bad decks differed in terms of risk but not in the immediacy of their satisfying outcomes. This change wiped out the differences between smokers and nonsmokers, confirming the Lejuez team’s finding that smokers are not more tolerant of risk.)
Our finding is admittedly nuanced: it is not risk taking per se that drives smokers’ risky behavior; it’s a weakness for activities that are profitable most of the time yet hazardous eventually.
This distinction may suggest strategies for fighting smoking. For example, hospitals and universities have started to ban smoking not only inside buildings but also at their perimeter; while originally proposed to address secondary smoking hazards, this may also have the benefit of imposing an additional short-term inconvenience on smoking. If we are right that smokers tend to have poorer self-control, such manipulations may be used to help sustain their willpower.


Eyal Ert is a senior lecturer of behavioral and management sciences at the Hebrew University of Jerusalem. Eldad Yechiam is an associate professor of behavioral sciences at the Technion-Israel Institute of Technology.

source: http://www.nytimes.com/2013/07/28/opinion/sunday/why-smokers-still-smoke.html?_r=0

More switching to cheaper kinds of smoke

Rise in imports of loose tobacco leaves and smokeless tobacco


THE global financial crisis in 2008 may have caused many people here to stub out more expensive cigarettes and opt for unconventional but cheaper alternatives. The latest figures from the Singapore Customs show that higher amounts of ang hoon (loose tobacco leaves) and productssuch as chewing tobacco were imported in the last three years. These are commonly sold in neighbourhoodprovision shops and convenience stores.
Last year, imports of ang hoon at 61,150kg were more than double the 2008 figure of 29,634kg. Imports of smokeless tobacco - including the chewing and sucking types - rosefrom 10,854kg in 2008 to 11,326kg last year. But imports of beedies dipped about 10 per cent to 42,178kg last year, from 47,565kg in 2008. These are slim cigarettes filled with tobacco flakes and wrapped in a leaf. The Customs authorities also foiled attempts to smuggle in beedies, confiscating 42kg last year, up from 6kg in 2008. Some 770kg of smokeless tobacco was also seized by Customs last year, about twice as much as the figure in 2008.
Addiction expert Munidasa Winslow, a psychiatrist in private practice, said the numbers may be a reflection of the economy. The financial crisis worldwide in 2008 may have caused many to fall on hard times, making them switch to cheaper alternatives. There is also a black-market demand for duty-unpaid contraband goods because they are much cheaper.
 In Singapore, cigarettes still make up the bulk of local tobacco sales, with 2.43 million kg sold last year, up from 2.12 million kg in 2008. Earlier in February, taxes for non-cigarette tobacco products were raised by between 5 per cent and 10 per cent while those for cigarettes remained the same. A Straits Times check of 15 heartland provision shops revealed that prices of unconventional alternatives have gone up by 10 to 30 cents this year. But people continue to buy them, with most shops reporting steady sales. “They are still cheaper when compared with cigarettes,” said Ms EileenHuang, 28, who works in a convenience store. A pack of cigarettes costs an average of $12, but chewing tobacco costs between $1 and $2.50 a pack. A bundle of 25 beedies sells for $3 or less while 20g of ang hoon goes for about$3.
Ang hoon is especially popular among the elderly Chinese, while beedies are mostly favoured by young foreign workers from India and Bangladesh, said provision store owner Jessie Lim. Several other shops have also observedyounger Singaporeans asking for these cheaper alternatives. Associate Professor Winslow said these products may be “more tempting for young people without purchasing power”. But the higher taxes did curb demand in some shops.Mr Abdul Hamead Jafar, operations manager of a store in Buffalo Road, said sales of ang hoon and beedies havedropped by 10 per cent.
The store raised prices of ang hoon by 30 cents and prices of beedies by 20 cents earlier this year. “Some used to smoke 20 sticks of beedies a day, but now they smoke five to six sticks fewer because of the higher prices,” he added.These products are unfiltered, which means more chemicals like tar enter the body, said Prof Winslow. But the “nicotine hit”, which determines the level of addiction, is about the same as that of cigarettes, he added.
Smoking-related diseases include cancer, heart disease, stroke and chronic obstructive pulmonary disease. All are ranked among the nation’s top 10 killers, according to Ministry of Health data. The latest National Health Survey revealed that there are more smokers in Singapore, especially among the youth.
Last year, 14.3 per cent of adults here were smoking daily, up from 12.6 per cent six years ago. Among those aged 18 to 29, the figure stood at 16.3 per cent last year, up from 12.3 per cent in 2004. In a bid to stem the trend, the HealthPromotion Board runs smoking-cessation programmes, such as those targeted at workplaces. The Institute of Mental Health also runs personalised smoking-cessation programmes. The consultation charge is $18, excluding medication.

source:http://www.healthxchange.com.sg/News/Pages/More-switching-to-cheaper-kinds-of-smoke.aspx

Effects of second hand smoke

By now, it's become very clear that smoking is bad for your health. The government,American Lung Association, and variety of other health organizations havelaunched campaign after campaign to illustrate the grim repercussions (from lung cancer to hear diseaseof lighting up and to encourage Americans to kick the habit.
What may be less obvious is the effect smoking has on those who are exposed to it secondhand. That exposure can be significant, especially for those who live or work with a smoker. In reality, most of the smoke from a burning cigarette doesn't get sucked down into a smoker's lungs -- it escapes into the air, where it can be inhaled by anyone unfortunate enough to be nearby.
In an effort to protect the health of nonsmokers, many states have passed laws outlawing smoking in public places such as restaurants, bars, airplanes, and offices. Yet there are still many people who can't escape secondhand smoke, especially the children of smokers, who regularly breathe in the toxic fumes from their parents' cigarettes and cigars. Even smokers who try to be careful about where they light up may not be doing a good enough job of protecting those around them.

What Is Secondhand Smoke?

When you breathe in smoke that comes from the end of a lit cigarette, cigar, or pipe (sidestream smoke) or that is exhaled by a smoker (mainstream smoke), you're inhaling almost the same amount of chemicals as the smoker breathes in. Tobacco smoke contains more than 4,000 different chemical compounds, more than 50 of which are known to cause cancer. These are just a few of the chemicals that float into your lungs when you are exposed to secondhand smoke:
  • Hydrogen cyanide -- a highly poisonous gas used in chemical weapons and pest control
  • Benzene -- a component of gasoline
  • Formaldehyde -- a chemical used to embalm corpses
  • Carbon monoxide -- a poisonous gas found in car exhaust
A 2006 surgeon general's report confirmed that secondhand smoking (also called involuntary or passive smoking) can kill, and it concluded that there is no amount of exposure to secondhand smoke that is safe. The more secondhand smoke you breathe in, the more your health risks increase.
Here are a few statistics on the effects of secondhand smoke exposure:
  • 126 million nonsmoking Americans are exposed to secondhand smoke at home and work.
  • Secondhand smoke exposure causes nearly 50,000 deaths in adult nonsmokers in the U.S. each year.
  • Nonsmokers increase their risk of developing lung cancer by 20% to 30% and heart disease by 25% to 30% when they are exposed to secondhand smoke.
  • About 3,000 deaths from lung disease in nonsmokers each year are caused by secondhand smoke exposure.
  • An estimated 46,000 nonsmokers who live with smokers die each year from heart disease.
  • Between 150,000 and 300,000 children under the age of 18 months get respiratory infections (such as pneumonia and bronchiti) from secondhand smoke; 7,500 to 15,000 of them must be hospitalized.
  • More than 40% of children who visit the emergency room for severe asthma attacks live with smokers.
Secondhand smoke can have a number of serious health effects on nonsmokers, particularly cancer and heart disease.

source:http://www.webmd.com/smoking-cessation/effects-of-secondhand-smoke

Raise legal smoking age to 21 to deter NSFs

Raise the legal age for smoking from 18 to 21 to deter young men from lighting up during national service - that is the proposal a non-profit organisation submitted to government agencies early last month.
Sata CommHealth chief executive K. Thomas Abraham noted that it was common for young people to pick up smoking during NS, sometimes due to peer pressure. He said: 'If we push the legal age up to 21, most people would have finished their NS by then.'
He also observed that more young women had started smoking, without providing figures.
According to the 2010 National Health Survey, the proportion of smokers among young Singaporeans aged 18 to 29 stood at 16.3 per cent in 2010 - a 33 per cent increase from 12.3 in 2004.

Source:http://www.straitstimes.com/breaking-news/singapore/story/raise-legal-smoking-age-21-deter-nsfs-organisation-20130601

"NO Smoking" rules in Singapore

In Singapore, the smoking ( prohibited in certain places), enforced by the National Environment Agency, renders it an offence to smoke in a prohibited place  listed under the Act.
For a comprehensive list of the prohibited places, do consult the First and Second Schedule of the Smoking (prohibited in certain places) Notification.
Generally smoking is banned in public transportations. It is also prohibited in most indoor areas, such as cinemas, shopping malls, and foodshops.
The list of prohibited areas was updated recently, adding the following to the new smoke free areas of Singapore:
  • Linkways from bus stops to residential blocks
  • Void decks
  • Corridors
  • Staircases
  • Stairwells
  • Multi-purpose halls
  • Covered walkways and linkways
  • All pedestrian bridges
  • 5 metres from the edge of bus stops
  • Hospital outdoor compounds
Smoking is permitted in certain designated areas of food and entertainment establishments, subject to the approval of the NEA. NEA provides a list of areas where smoking is generally allowed.
The onusis on the manager of the premises to enforce the rules. If you should see a person smoking in a prohibited area, you should contact the management to report the act. However, if the smoking takes place in a prohibited public area with no specific management agent, do contact the NEA, at 1800-CALL-NEA (1800-2255 632) to file a report.
Persons caught smoking in a prohibited place are liable on conviction to fines of $200. If convicted in court, the offender may be liable to a fine of up to $1,000.

Source:http://singaporelegaladvice.com/smoking-prohibition-in-singapore-2/

Singapore to make more public areas smoke free. (extended)

Smoking Ban in Public Places


NEA is extending the smoking ban to more places with effect from 15 January 2013. The new list of smoke free areas  included in the Smoking (Prohibition in Certain Places) Act extends to cover common areas of residential buildings such as common corridors, staircases, stairwells and void decks as well as multi-purpose halls, covered walkways and linkways, all pedestrian overhead bridges, within 5 metres of bus shelters and hospital outdoor compounds. Smokers who wish to smoke may do so at other areas. Please see the list of areas where smoking is allowed here.
Our main concern is the harmful effects of second-hand smoke. There is no safe level of exposure to second-hand smoke; also, the majority of Singapore’s adult population are non-smokers. Second hand smoke contributes to a range of serious and often fatal diseases, including heart disease, respiratory illness and lung and other cancers. Hence, we encourage smokers to play their part to observe the ban.
We also encourage non-smokers to be gracious when they see smokers lighting up in a prohibited area, reminding them gently that smoking is banned and requesting them to finish their cigarette elsewhere.
- See more at: http://app2.nea.gov.sg/public-health/smoking/faq-on-smoking-ban-in-public-places#sthash.iHmNtguM.dpuf

Tough to get youth to quit smoking

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Concerned about young people smoking, the Health Promotion Board (HPB) is thinking of having tougher laws to curb this disturbing trend.
But experts worry that so long as the young see smoking as 'cool' and harmless, it will take a lot to get them to stub it out.
Private student Sarah Elizabeth, 17, said: 'No matter how high prices are, I'll find a way to smoke. It's quite an addiction now and it's also a social habit.'
Dr Carol Balhetchet, director of youth services at the Singapore Children's Society, said: 'Young people won't stop smoking just because of regulations.' And they are getting younger too, she said.
'The youngest case I've ever seen was someone who picked it up at seven years old. It used to be that 14 or 15 was considered young.'
Among the proposed measures the HPB announced two weeks ago to deter the young from smoking are: Heavier fines for underage smoking, banning the sale of certain tobacco products, barring some places from selling them, and lowering permitted tar and nicotine levels. HPB, in partnership with the Health Sciences Authority, is also conducting a four-week public consultation which ends on Aug 28.
The public can access www.hpb.gov.sg or www.moh.gov.sg to give feedback and comments.
Anyone under the age of 18 is considered an underage smoker. First- to third-time underage offenders currently get a minimum composition fine of $30.
HPB's proposal is to increase the amount from $30 to $100 for first- to fourth-time offenders.
Apart from putting cigarettes beyond the reach of youth, HPB is also concerned about the many other ways someone can have a 'fix'.
For instance, a 19-year-old student, who wanted to be known only as Allan, told The Sunday Times he now uses hand-rolled cigarettes.
'A regular cigarette pack costing $10 or $11 will last me only three days. Now I pay $12 for paper and tobacco which can last me two weeks,' he said.
HPB also noted that young people have new tobacco products like shisha and cigarillos, or mini cigars, to turn to.
National serviceman Greg Chan, 19, does not smoke cigarettes but enjoys shisha every three months with his friends. 'I know it is more harmful than cigarettes but it's relaxing and since we do it only occasionally, it doesn't bother me,' he said.
Shisha, or water-pipe smoking, involves burning a flavoured tobacco mixture and smoking it through a pipe connected to a water vessel.
The 2007 National Health Surveillance Survey showed that smoking has risen among young adults aged 18 to 29, from 12.3 per cent in 2004 to 17.2 per cent in 2007.
Dr John K.E. Tan, executive director of the Children-At Risk Empowerment Association, said: 'As teens are not yet cognitively mature, they may have a hard time grasping the long-term effects of tobacco use.'
HPB is proposing to restrict the number of tobacco retailers, including premises which sell youth-centric products such as candies and toys. It also wants to ban misleading labels such as 'light', 'mild' or 'low tar'.
Dr Munidasa Winslow, a specialist in psychiatry at Raffles Hospital, said: 'For the really addicted ones, even if they are smoking cigarettes with lower nicotine content, they may still smoke more to get the same high. All cigarettes pose some form of damage.'
Ms Yasmin Ng, a senior pharmacist specialising in smoking cessation at Changi General Hospital, said alternative forms of smoking are also harmful.
'Water-pipe smoking may increase the smoker's exposure to carcinogens because a water-pipe is used over a long period of time,' she said. In just one water-pipe session, the smoker may inhale smoke equivalent to smoking 100 or more cigarettes.
She also said that bidi - a type of hand-rolled cigarette - delivers more nicotine, carbon monoxide and tar than regular cigarettes.
Nominated Member of Parliament and sociologist Paulin Straughan, who specialises in youth issues, made this observation: 'Youth may smoke to 'be different'. The more elusive tobacco is, the more desirable it will become and they won't listen to the authorities or establishment.
'We need to approach them through their peers, and provide them with venues for social activities to express themselves so they won't resort to smoking.'
This article was first published in The Straits Times.

Source:http://news.asiaone.com/News/Education/Story/A1Story20090818-161768.html