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Press releases Saturday 28 January 2006
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(1) TOBACCO INDUSTRY PROMOTED “INEFFECTIVE” VENTILATION SYSTEMS
(2) UK PLANS TO CUT STREET PROSTITUTION WILL THREATEN SEX WORKERS’ HEALTH
(3) UNPLANNED QUIT ATTEMPTS MORE LIKELY TO SUCCEED
(4) VACCINATE INFANTS OF HEPATITIS B MOTHERS, SAY EXPERTS
(1) TOBACCO INDUSTRY PROMOTED “INEFFECTIVE” VENTILATION
SYSTEMS
(Blowing smoke: British American
Tobacco’s air filtration scheme)
http://bmj.com/cgi/content/full/332/7535/227
Newly released documents reveal that, despite knowing that ventilation and air filtration are ineffective at removing environmental tobacco smoke, British American Tobacco (BAT) promoted these technologies to the hospitality industry as viable options to smoking bans.
Writing in this week’s BMJ, researchers argue that a total ban on smoking in public places is the only way to protect all employees from environmental tobacco smoke.
The documents show that, although BAT concluded that the air filtration units were only 34% efficient at removing particulate matter from tobacco smoke, it continued to install units worldwide. According to BAT scientist, Nigel Warren, the company’s interest in air filtration was primarily, “To negate the need for indoor smoking bans around the world …”
BAT targeted the hospitality industry by pushing a so-called “smoker resocialisation” initiative, which aimed to portray smoking in a “more positive and stylish context” and to lobby against smoke-free public places.
In June 2000, BAT also installed “smoking tables” designed to suck tobacco smoke down through a filter and re-circulate the partially filtered smoke out into the room again. But, even if the technology was improved from earlier filtration units, the tables would be ineffective because isolation of the source or the worker are the only control measures that yield air quality that is safe to breathe, write the authors.
In November 2004, the UK government published proposals to end smoking in most workplaces and public places, but with exemptions for private clubs and pubs that do not serve food.
The public health community should reject these proposals, say the authors. Without a comprehensive smoke-free workplace law, the tobacco and hospitality industries can continue to mislead the public about the hazards of exposure to environmental tobacco smoke by promoting separate seating, ventilation, and air filtration as viable options to smoking bans.
This will do nothing to reduce the risk of lung cancer among employees. All workers deserve to work in smoke-free environments. The United Kingdom should follow the lead of countries such as Bhutan, Cuba, Ireland, Italy, Malta, New Zealand, and Norway in legislating for a total ban on smoking in public places, they conclude.
Contact:
Richard Hurt, Director, Nicotine
Dependence Center, Mayo Clinic, Rochester, MN, USA
Email: rhurt@mayo.edu
(2) UK PLANS TO CUT STREET PROSTITUTION WILL THREATEN
SEX WORKERS’ HEALTH
(Editorial: Sex workers to
pay the price)
http://bmj.com/cgi/content/full/332/7535/190
(Personal View: Prostitution
shake-up: one sex worker's view)
http://bmj.com/cgi/content/full/332/7535/245
(Vice versa)
http://bmj.com/cgi/content/full/332/7535/0
Plans to cut street prostitution, set out by the UK government last week, will threaten sex workers’ health, warn experts in this week's BMJ.
The Home Office strategy aims to challenge the view that street prostitution is inevitable; achieve an overall reduction in street prostitution; improve the safety and quality of life of communities affected by prostitution; and reduce all forms of commercial sex exploitation.
But the strategy does not explicitly tackle health and human rights and will not, therefore, do enough to reduce vulnerability and exploitation, argue the authors.
For instance, the proposed strategy rejects calls to licence premises, which could ensure that children were not employed, employees were not in possession of drugs, and foreign nationals had work permits.
Instead the strategy focuses on disrupting sex markets. Kerb crawling will be policed in established red light areas, despite evidence that this can lead to increased violence, pressure to abandon safer sex practices, and increased public disorder.
Specialist healthcare services in red light areas, such as provision of condoms and needle exchange schemes, could also be compromised if this strategy is enforced, they warn. This could have profound consequences both for sex workers and the wider population.
Furthermore, collaborative work by healthcare professionals, social services, and sex workers will be disrupted if red light areas are phased out, as the strategists intend, they add. Collaborative working gives sex workers the support and confidence to report violent clients and other predators who aim to coerce and control them.
“The lack of detail in the strategy about implementing the new approaches, especially regarding indoor sex work, leaves most of the sex workers we have spoken to feeling uneasy that they will have to wait and see how the strategy affects their access to health care and their contact with the criminal justice system,” conclude the authors.
Disappointment about the UK government not going further towards legalisation is reflected in a personal view by Juliet, a prostitute based in London. She believes that the government has “failed enormously" and argues that neither having sex nor getting paid are inherently degrading, abusive, exploitative, or harmful. The problems, she says, are the associated coercion, drug dependency, and lack of choices, not prostitution itself.
BMJ Editor, Fiona Godlee also supports the idea of legalisation. “It is surely time for an end to the arguments of moral opprobrium and for some bolder steps towards legalisation if we are to improve public health and human rights,” she writes.
Contacts:
David Kyle or Nial Gordon, Communications
Department, University of Paisley, Scotland, UK
Email: david.kyle@paisley.ac.uk;
nial.gordon@paisley.ac.uk
(3) UNPLANNED QUIT ATTEMPTS MORE LIKELY TO SUCCEED
Online First
(“Catastrophic” pathways to smoking cessation: findings from national
survey)
http://bmj.bmjjournals.com/cgi/rapidpdf/bmj.38723.573866.AE
Unplanned attempts to stop smoking are more likely to succeed than planned ones, concludes a study published online by the BMJ today.
The process of stopping smoking has been thought to involve a series of stages, going from thinking about stopping, through planning an attempt, to actually making the attempt. Such planning is widely thought to be important for success.
Over 1,900 smokers and ex-smokers in England were interviewed about their attempts to quit, whether their most recent quit attempt was planned in advance, and whether quit attempts made at least six month’s before had been successful.
Almost half of attempts to stop smoking involved no previous planning and, surprisingly, unplanned quit attempts were more likely to succeed, even after adjusting for age, sex, and socioeconomic group.
These findings do not necessarily imply that planning quit attempts is counterproductive, say the authors. Indeed, use of behavioural support and nicotine replacement therapy are known to improve the chances of success even though they generally require planning ahead.
More likely, whether a quit attempt is planned or unplanned reveals something about the state of mind of the smoker at the time, which has importance for whether the attempt will last.
They propose a theory in which smokers have varying levels of motivational “tension” to stop and then “triggers” in the environment lead to a sudden renunciation of smoking. This concept has been incorporated in a general theory of motivation and its application to addictive behaviours.
They suggest that public health campaigns should perhaps focus on what might be called the “3 Ts”: creating motivational tension, triggering action in smokers who are on the cusp of a change in their orientation to smoking, and immediate availability of treatment such as nicotine patches and counselling to support those attempts.
Contact:
Robert West, Professor of Health
Psychology, University College London, UK
Email: Robert.west@ucl.ac.uk
(4) VACCINATE INFANTS OF HEPATITIS B MOTHERS, SAY EXPERTS
Online First
(Effect of hepatitis B immunisation in newborn infants of mothers
positive for hepatitis B surface antigen: systematic review and meta-analysis)
http://bmj.bmjjournals.com/cgi/rapidpdf/bmj.38719.435833.7C
Immunising newborn infants of mothers with hepatitis B prevents infection being transmitted from mother to child, finds a study published online by the BMJ today.
There are around 350 million hepatitis B carriers worldwide. The virus is transmitted by contact with blood or body fluids of an infected person. Mother to child transmission around the time of birth is common and accounts for up to half of all carriers.
Researchers analysed randomised trials to assess the beneficial and harmful effects of hepatitis B vaccines (active production of antibodies) and hepatitis B immunoglobulin (passive transfer of antibodies) in newborn infants of mothers positive for hepatitis B surface antigen.
They found that hepatitis B vaccine, hepatitis B immunoglobulin, or the combination of vaccine plus immunoglobulin given to the newborn infants of mothers positive for hepatitis B surface antigen prevents the occurrence of hepatitis B. Furthermore, the combination of vaccine plus immunoglobulin was superior to vaccine alone.
There was no difference between the two types of vaccine currently available.
“Although this study confirms that vaccines and immunoglobulin are effective, more research is needed to identify the optimal dose and treatment schedule of hepatitis B immunisation,” conclude the authors.
Contacts:
Yan Gong, Research Assistant, Cochrane
Hepato-Biliary Group, Copenhagen Trial Unit, Centre for Clinical Intervention
Research, Copenhagen University Hospital, Denmark
Email: ygong@ctu.rh.dk
or
Christian Gluud, Head of Department,
Cochrane Hepato-Biliary Group, Copenhagen Trial Unit, Centre for Clinical
Intervention Research, Copenhagen University Hospital, Denmark
Email: cgluud@ctu.rh.dk
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