Showing the truth, saving lives’

The government has issued a legal notice that will make pictorial health warnings on cigarette packets obligatory within 15 months, and within 21 months on other tobacco products, in a bid to encourage smokers to quit.

The legal notice (LN 302 of 2009) is aimed at implementing a decision of the European Commission on the use of colour photographs or other illustrations as health warnings on tobacco packets; the decision establishes rules for the use of colour photographs or other illustrations to depict and explain the health consequences of smoking.

The LN includes the pictorial warnings and text that cigarette and tobacco importers and manufacturers will be legally obliged to use (some of which are published here, without the text warnings), and specifies that the warnings will have to be rotated at least once a year.

The Maltese government chose a set of pictorial warnings from the ones recommended by the EU and the World Health Organisation (WHO).

It is estimated that one in every four people in Malta smokes, meaning that about 300,000 people could be suffering the consequences of indirect smoking.

Charmaine Gauci, head of the Health Promotion and Disease Prevention Department, recently quoted a Health Interview Survey, saying that the number of smokers had gone down from 23.3 per cent of the population in 2002 to 20 per cent in 2008.

However, she said, the Health Behaviour in School Children (HBSC) survey showed that the number of 15-year-old smokers increased from 38.8 per cent in 2002 to 42 per cent in 2006.

Dr Gauci had spoken about the problems associated with smoking, saying that while lung cancer is the main disease related to tobacco, smokers stand a high risk of developing other cancers (mouth, throat and pancreatic cancer, for instance), and cardiovascular disease, and they are also more susceptible to infections.

She also mentioned the cost related to smoking, both the direct cost to smokers, the burden on the health system, as well as productivity levels due to sick leave.

A WHO report, entitled Showing the truth, saving lives: the case for pictorial health warnings, reveals that studies carried out after the implementation of pictorial package warnings in Brazil, Canada, Singapore and Thailand reveal remarkably consistent findings on the impact of the warnings.



Brazil

A study published by the Datafolha Instituto de Pesquisas, entitled Public Opinion: Campaign Against Smoking, shows that more than half (54 per cent) of smokers changed their opinion on the health consequences of smoking as a result of the warnings.

Two thirds of smokers (67 per cent) said the warnings made them want to quit. And according to the Cavalcante T. Labelling and Packaging in Brazil, in the six months following the widespread implementation of graphic health warnings on tobacco packaging, calls to the toll-free quit-line number increased almost nine times over.



Canada

Another study, published by the Canadian Cancer Society, and prepared by Environics, Focus Canada, entitled 'Evaluation of new warnings on cigarette packages', found that 58 per cent of smokers thought more about the health effects of smoking as a result of the warnings.

Nearly half of smokers (44 per cent) said the warnings had increased their motivation to quit, while more than one quarter of people (27 per cent) smoked less inside their home as a result of the warnings.



Singapore

In Singapore, the Health Promotion Board reported that more than two thirds (71 per cent) of smokers said they knew more about the health effects of smoking as a result of the warnings.

More than a quarter of smokers (28 per cent) admitted they consumed fewer cigarettes as a result of the warnings.

One out of six (14 per cent) smokers said they avoided smoking in front of children as a result of the warnings.



Thailand

And in Thailand, the International Tobacco Control Policy Evaluation Project found that four out of five young people (aged 13-17) – 81 per cent – and more than half of adult smokers said the new pictorial warnings made them think more about the health impact of smoking.

About 44 per cent of the smokers said the pictorial warnings made them “a lot” more likely to quit over the next month.



New Zealand

In New Zealand, a study by J. Li and M. Grigg found that in the six months following the implementation of graphic health warnings on tobacco packaging, new registrations on the quit-line increased by 14 per cent over the previous six months.

Within three months of introduction, the proportion of new quit-line callers who had obtained the quit-line number from the package warnings increased nearly threefold, overtaking the proportion of those who had obtained the number from television advertising.



Young people respond to health warnings

According to WHO, young people respond to information about the health risks of tobacco use, if the information is presented meaningfully. Young people tend to respond to shocking, realistic images and to real-life testimonials from smokers about the impact of smoking on their health.

The International Tobacco Control Policy Evaluation Project found that young people in Thailand indicated that pictorial warnings made them think more about the health risks and to reduce the amount they smoked.

And a study by V. White, B. Webster and M. Wakefield concluded that Australian cigarette packs were associated with increased cognitive processing of messages among adolescents, and more adolescents thought about quitting or cutting down.



Second-hand smoke

WHO data shows that second-hand smoke causes 600,000 premature deaths globally per year. There are more than 4,000 chemicals in tobacco smoke, of which at least 250 are known to be harmful and more than 50 are known to cause cancer.

In adults, second-hand smoke causes serious cardiovascular and respiratory diseases, including coronary heart disease and lung cancer. In infants, it causes sudden death. In pregnant women, it results in low birth weight.

Separate or ventilated smoking areas do not protect non-smokers from second-hand smoke. Second-hand smoke can spread from a smoking area to a non-smoking area, even if the doors between the two areas are closed and even if ventilation is provided. Only 100 per cent smoke-free environments provide effective protection.

About 40 per cent of all children are regularly exposed to second-hand smoke at home. Thirty-one per cent of the deaths attributable to second-hand smoke occur in children.

Youths exposed to second-hand smoke at home are one-and-a-half to two times more likely to start smoking than those not exposed.

Ten per cent of the economic costs related to tobacco use are attributable to second-hand smoke. Tobacco use imposes both direct economic costs on society, such as those associated with treating tobacco-related diseases and indirect costs, such as those associated with reduced productivity or lost wages because of death or illness.



The Independent
Thursday, 28th January 2010
Prisoners in their own home
http://www.independent.com.mt/news.asp?newsitemid=100792

Studies are once again being carried out to try and establish the extent of just how deep-rooted domestic violence is in Maltese families.

We have not heard many figures, but the Commission Against Domestic Violence has expressed concern about how many cases remain hidden and do not come to light.

Throughout the developed world, it is an accepted fact that while more and more cases of domestic violence seem to make the courts, it is not a case of a dramatic increase in the actual number, but the fact that more and more women are reporting them.

It is clear, when women (and a minority of men) are abused, they feel that they can turn to the authorities and other support organisations for help.

In Malta, sadly, it seems we lack behind. One case made the headlines last week where it was heard how a man treated his wife and child as objects, his possessions that had to do as they were told, when they were told and were expected to live off his ‘charity’.

And while the support structures are lacking (an issue we will tackle later in this essay), the fundamental problem we face is one of mentality.

Psychologists we are not, but it is pretty clear that the first thing that needs to be rooted out, from an early age, is the tribal chief mentality. If people think that these issues are related to the older generation, they are gravely mistaken – there are men and women who think that their partners and families are simply there to be used and abused of as they see fit.

How we are going to achieve this is beyond comprehension and is a result of systematically ignoring the problem for far too long. It is not that long ago, only a few years actually, when priests even used to tell battered women that they could never leave their husbands, no matter what they did to them. This is fact and while social norms have changed, such ‘advice’ can never be condoned, justified or repeated ever.

And this leads us in to the support structure argument. It is good that the police have a very able and understanding squad who deal with these women and it is also promising to see that they do get the cases to court and the victims feel empowered. It is also very heartening to see that the courts, in the vast majority of cases, send the perpetrator back to their mother’s (literally) so as to afford the victim security and a roof over their head in the matrimonial home.

But what happens to all those other women who sit at home in the kitchen, cowering... waiting for that next slap, forced sex, maybe a punch or a tirade of mocking abuse that saps their will day after day?

What about those victims who feel trapped in their own home, those who have been told that they will be hunted down like vermin and killed if they ever leave? What about those who have no family and nowhere to turn to? What about those who have given up and have consigned themselves to the fact that they will never get out of their miserable plight?

This is no exaggeration. This is what the government, its ancillary support arms, the law and society in general must strive to change.