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A review of the health benefits of plain packaging for cigarettes, written by the leading paediatrician Sir Cyril Chantler, has been published. The government asked Sir Cyril to consider the health benefits for children in particular in his review. Sir Cyril concludes that he is “satisfied there is sufficient evidence derived from independent sources that the introduction of standardised packaging as part of a comprehensive policy of tobacco control measures would be very likely over time to contribute to a modest but important reduction in smoking prevalence especially in children and young adults.” In response to the report’s findings, Public Health Minister Jane Ellison told Parliament that the government is moving forward with plans to ban branding on cigarette packs, but also said that she was publishing draft regulations for a final "short consultation." BBC News reports that Ms Ellison denied the government was dragging its heels, saying the final legislation had to be "robust" and part of broader efforts to combat smoking and all "stakeholders" had to have their say. She added: "We want our nation's children to grow up happy and healthy and free from the heavy burden of diseases that tobacco brings." Ms Ellison said the government's intention was "clear" and she promised changes before the next national election in May 2015, although MPs would be given a vote on the proposals before they came into force.
The fifth Foundation for Alcohol Research and Education's (FARE) Annual Alcohol Poll: Attitudes and Behaviours found increased public concern about alcohol-related harms. In 2014, 78% of those surveyed thought Australia has a problem with excess drinking or alcohol abuse, compared with 75% in 2013. More than one in three Australians (37%) have been affected by alcohol-related violence, and 4.2 million Australians continue to drink to get drunk. Eighty-one percent considered alcohol and violence as the problem they were most concerned about. Sixty-four percent of Australians believe governments are not doing enough to reduce harms, an increase of 8% from the previous year. FARE Chief Executive Michael Thorn said, "We are starting to see a greater awareness and a better understanding in the Australian community of the many ways in which alcohol can harm not only the drinker, but also those around them. Repeated alcohol-related tragedies across Australia, and a renewed focus and interest from the media, mean we are reminded on an almost daily basis of the negative and far-reaching consequences of alcohol use and abuse."
The World Health Organisation has published guidelines with recommendations on the identification and management of substance use and substance use disorders for health care services that assist women who are pregnant or have recently had a child, and who use alcohol or drugs or who have a substance use disorder. The guidelines aim to provide evidence-based technical advice to health-care providers on identifying and managing substance use and substance use disorders in pregnant women. The guidelines also aim to enable pregnant women to make healthy decisions about alcohol and other substance use in the context of pregnancy and breastfeeding.
Opium poppies will be grown commercially in the Australian state of Victoria after a bill passed Victoria’s parliament. Under the proposed Victorian poppy regime, growers and processors will have to register their contracts, keep extensive records and grow and dispose of their crops under tight security, subject to regular inspection by police and government inspectors. Worldwide demand for painkillers tripled between 1993 and 2012, according to UN figures, and pharmaceutical companies such as GlaxoSmithKline (GSK), Johnson and Johnson and TPI Enterprises are increasing and diversifying their supplies. Tasmania currently produces 49% of the world’s legal supply of opium. “The global demand for opiates has increased dramatically in the last three to five years and uncertainty in the climate in Tasmania makes it hard to meet those demands. It’s a tough crop to grow and can be badly affected by fluctuations in the weather,” a spokeswoman for GSK said. “It’s important to spread risk by finding new places to grow.”
A RAND report commissioned by the Office of National Drug Control Policy estimates that around 1.5 million Americans were “chronic heroin users” in 2010. Chronic use was defined as anyone who has consumed heroin on four or more days in the previous month. This figure compares with the estimate of about 600,000 daily and near daily heroin users in the 2010 National Survey on Drug Use and Health (NSDUH). The RAND report uses data from the Arrestee Drug Abuse Monitoring Program (ADAM), which includes urinalysis as well as a survey. However, both the NSDUH data and the RAND estimates of heroin consumption indicate “essentially no change” from 2000 to 2010.
The New York Times reports that the Food and Drug Administration (FDA) has approved an easy-to-use device that automatically injects the right dose of naloxone without having to use a separate needle and syringe. Available via prescription, the product, called Evzio, enables anyone to inject naloxone from a pre-filled, single-use device into a person who is overdosing. Evzio is similar to devices used by laypeople to administer epinephrine in cases of severe allergy and the auto-injector gives recorded instructions to the user describing how to deliver the medication. The instructions also emphasise the need to seek emergency medical attention immediately. FDA officials said they speedily approved the device in just 15 weeks because it is critical to prevent deaths. Some commentators have criticized the high cost of the device but executives of the drug's manufacturer, kaléo, Inc., said it is too early to say how much Evzio will cost and that they are working with health insurers to get broad coverage.
Speaking at the launch of the International Narcotics Control Board (INCB) annual report, President Raymond Yans of the INCB said “The INCB, taking into account the relevant international conventions on human rights, the various protocols, the various resolutions of the General Assembly, of the ECOSOC, and of UN human rights bodies concerning the death penalty, we encourage state parties, part of the conventions, that still provide for the death penalty for drug-related offences in their national legislation and practice it, to consider the abolishing of the death penalty for drug-related offences.” This marks the first time the INCB has spoken out against the death penalty and other human right violations around criminal sanctions for drug offences. The 2013 INCB annual report raises the INCB’s concern with "misguided initiatives" on cannabis legalisation in Uruguay and Colorado and Washington. In the foreword to the report Raymond Yans says these moves “would pose a grave danger to public health and well-being, the very things the States, in designing the conventions, intended to protect.” The report includes a thematic chapter on the economic consequences of drug abuse which also outlines its counter arguments against the potential cost benefits of alternative drug control policies. The INCB observes that “Emerging data from the State of Colorado of the United States suggest that since the introduction of a widely commercialized “medical” cannabis programme (poorly implemented and not in conformity with the 1961 Convention), car accidents involving drivers testing positive for cannabis, adolescent cannabis-related treatment admissions and drug tests revealing cannabis use have all increased.” The INCB is also concerned about illicit opium poppy cultivation in Afghanistan, which in 2013 reached 209,000 hectares, a 36% increase compared with 154,000 hectares in 2012.
The Sydney Morning Herald reports that the New South Wales (NSW) government has introduced legislation for another six mandatory minimum sentences, including reckless grievous bodily harm (four years minimum) and reckless wounding (three years minimum), where the perpetrator is intoxicated or appears affected by drugs or alcohol. These new proposals follow the legislation passed in January that created a minimum mandatory sentence of eight years for assault causing death, where alcohol or drugs were a factor. The government decided against introducing mandatory minimum prison terms for lesser charges, including assaulting police, after criticisms from civil liberties groups and concern about the cost to the prison system if there was a dramatic increase in convictions. The Sydney Morning Herald also reports poll findings that a majority of NSW voters (58%) said they wanted courts to have discretion in sentencing, depending on the circumstances, and 78% of 18- to 24-year-olds, the group most likely to feel the impact of the initiatives, believed courts should have discretion in sentencing.
InSight Crime reports that statistics from the US State Department's annual drug control report demonstrate that Mexico and Central America are still the most common drug trafficking routes to the United States. InSight Crime had earlier reported that drug traffickers in the Dominican Republic had paid local police over $100,000 in bribes each month. Such cases had led commentators to suggest that the Caribbean had become a prime drug transit route. However, the State Department report estimated that approximately 86% of the cocaine trafficked to the United States in the first half of 2013 first moved through the Mexico/Central America corridor, an increase from 80% in 2012. The drug control report also records that Bolivia, Burma, and Venezuela were designated by the US President as having “failed demonstrably” during the previous 12 months to adhere to their obligations under international agreements. The president determined that continued support for bilateral programmes in Burma and Venezuela is vital to the national interests of the United States.
BBC News reports that the Italian Constitutional Court has ruled that the 2006 Italian drug legislation is unconstitutional. The 1990 drug legislation, as amended by a 1993 referendum which decriminalized possession for personal use), has been restored. This decision may mean that 10,000 people may be released from prison as a result. Prison rights group Antigone said the 2006 law had caused prison overcrowding, with 40% of all inmates serving sentences for drug crimes. In January 2013, the European Court of Human Rights ruled that overcrowding in Italy's jails violates the basic rights of inmates. The Italian authorities were fined 100,000 euros and ordered to solve the overcrowding issue within a year. Under the 2006 legislation cannabis was classified as a Schedule 1 drug with heroin and cocaine, with sentences for the cultivation, sale and trafficking of cannabis from 2-6 years to 6-20 years.
The New York Times reports that the US Treasury Department and the Justice Department have separately issued guidelines intended to give banks confidence that they will not be punished if they provide services to legitimate cannabis businesses in states that have legalized the medical or recreational use of the drug. But as cannabis is still illicit under federal law, the policy does not grant immunity from prosecution or civil penalties to banks that serve legal cannabis businesses. The guidance requires banks to monitor cannabis business customers and directs prosecutors and regulators to give priority to cases only where financial institutions have failed to adhere to the guidance. The banks responded that the guidance was not enough to meet their concern. “While we appreciate the efforts by the Department of Justice and FinCEN, guidance or regulation doesn’t alter the underlying challenge for banks,” Frank Keating, president of the American Bankers Association, said in a statement, referring to the Financial Crimes Enforcement Network, the Treasury unit that issued part of the guidelines. “As it stands, possession or distribution of marijuana violates federal law, and banks that provide support for those activities face the risk of prosecution and assorted sanctions.” Legal marijuana/cannabis entrepreneurs say that access to banking has been their most pressing concern. Their businesses are conducted almost entirely in cash because it is difficult for them to open and maintain bank accounts, or to accept credit cards.
The Independent reports that the Portland Hotel Society, a drug treatment centre in Vancouver, has installed vending machines that dispense newly packaged crack pipes for $0.25. Each machine holds 200 pipes and is restocked every five days. The aim is to prevent the spread of HIV and hepatitis among crack users. “We packaged a crack pipe in polka dots and people were very intrigued by it and wondered what it was,” said Kailin See, the director of the Drug Users Resource Centre. “It was a hit right away.” Kailin See also said "They don't run the risk of then sharing pipes, or pipes that are chipped or broken,” adding “everything from flu, colds, cold sores, HIV: if you cut your lip on a pipe that someone else has been using, there are risks there." The initiative follows an earlier crack pipe pilot programme in 2011 which distributed 60,000 pipes per year. “We disagree with promoters of this initiative,” said Steven Blaney, Canada’s Minister of Public Safety and Emergency Preparedness. “Drug use damages the health of individuals and the safety of our communities,” Mr. Blaney added.
The European Centre for Monitoring Alcohol Marketing (EUCAM) reports that starting in 2015, existing alcohol advertising regulations in Finland, which include a prohibition of advertisements for strong alcoholic beverages in public spaces and a time ban for television, will be accompanied by a prohibition on advertising for mild alcoholic beverages with campaigns in which consumers are asked to participate in games, lotteries or contests. Content produced or shared by consumers, including social media-type posts, photos, video clips or ads, will no longer be allowed in advertising. The Finnish government said the amendments leading to further restrictions on alcohol marketing were initiated out of concern for children and young people being exposed to such advertising.
The Guardian reports that two e-cigarette manufacturers have started the process of obtaining licences for their products from the United Kingdom medicines regulator, Medicines and Healthcare Regulatory Authority (MHRA). The UK company Nicolites said its application was "well-advanced" while British American Tobacco's Nicoventures has also started the process. The status of "medicines" will give the companies a commercial advantage and allow them to market their products internationally, including in sponsorship deals, a move that will be banned for competitors not in the same bracket. The decisions on whether their products are prescribed on the National Health Service will be made by local commissioning groups. The MHRA wants to persuade manufacturers and importers to apply voluntarily for a licence and meet specific rules, including rules on the amount of nicotine provided. The Advertising Standards Agency is also about to launch a consultation on new rules to cover e-cigarettes, and the framework is likely to be in place by autumn.
The Guardian reports that a bipartisan group of senators has passed legislation proposing substantial reductions in federal prison terms for non-violent drug offenders, and an end to the disparity between crack and powder cocaine sentencing. This follows a call by Attorney General Eric Holder last August for a new approach to the drug issue. Senate Democratic whip Dick Durbin, a co-sponsor of the bill known as the Smarter Sentencing Act, said it would help tackle a 500% increase in the federal prison population since the early 1980s, half of whom are drug offenders. “It has been 30 years since we reviewed some of these laws,” he said. “There has also been a 1,100% increase in spending on incarceration.” The bill cuts some mandatory minimum sentences by more than half, gives judges greater discretion to exempt individual cases, and will allow parole hearings to redress a gulf between crack and powder cocaine punishments. The vote came as the Justice Department asked defense lawyers to recommend clients serving long drug sentences for future presidential pardons. President Obama recently commuted the sentences of eight non-violent crack cocaine offenders and more presidential action may be pending.
Bhutan’s Upper House has resolved that the ban on the sale and import of tobacco products into the country must end in order to control the black market. Bhutan was the first country to ban completely the manufacturing, import and sale of any tobacco products, but the government was criticised for harsh prison sentences for those found carrying small amounts of tobacco products (see News and Notes, December 2011). Many who were imprisoned for selling tobacco were subsequently released on the king’s order. The resolution needs to pass through the National Assembly before it becomes law.
New laws passed by the New South Wales (NSW) parliament in January include a mandatory minimum eight year jail sentence for so-called “one punch” assaults. Other measures include an increase in the maximum penalty for serious assault by two years, a new state-wide 10pm closing time for all bottle shops and liquor stores, new police powers to conduct drug and alcohol testing where they suspect an offender has committed an alcohol- or drug-fuelled violent assault, an extension of the existing liquor license freezes to the new Sydney Central Business District Entertainment Precinct, and removing voluntary intoxication as a mitigating factor in sentencing. The NSW government introduced the measures in response to pressure over the death of Daniel Christie from a single punch at Kings Cross in Sydney. NSW Premier Barry O’Farrell said, “The NSW Government has today sent the strongest possible message on behalf of the community – drug and alcohol-fuelled violence won’t be tolerated anywhere in NSW.” The Public Health Association of Australia (PHAA) Alcohol spokesperson, Professor Mike Daube, said, “This may be a turning point in changing the binge-drinking culture. Premier O’Farrell is to be congratulated on a strong, comprehensive approach that will do much to reduce alcohol harms in both the short and long term.” The president of the Newcastle Bar Association in NSW, Peter Cummings SC, said that mandatory sentencing for alcohol and drug-fuelled violence would erode the independence of the justice system, create unjust sentences, cause delays in the court system and be of great cost to taxpayers.
In a letter published on the E-cigarette Research Advocates Group website, a group of 15 leading scientists has warned the EU Health Commissioner that several of the recitals and provisions of Article 18 of the Tobacco Products Directive (TPD) concerning e-cigarettes lack or misrepresent the scientific understanding of the relevant issues. These issues include the comparison of nicotine delivery from tobacco and e-cigarettes, the assumption about nicotine toxicity, and the assumption that e-cigarettes are a gateway to smoking. The scientists’ letter concludes “If wisely regulated, electronic cigarettes have the potential to obsolete cigarettes and to save millions of lives worldwide. Excessive regulation, on the contrary, will contribute to maintain the existing levels of smoking-related disease, death and health care costs.”
In an interview with the New Yorker, President Barack Obama said smoking cannabis is no more dangerous than alcohol, but still called it a "bad idea." Obama said cannabis is less dangerous than alcohol “in terms of its impact on the individual consumer. It’s not something I encourage, and I’ve told my daughters I think it’s a bad idea, a waste of time, not very healthy.” He also said that poor people, many of them African Americans and Latinos, were disproportionately punished for cannabis use, whereas middle-class users mostly escaped harsh penalties. Referring to the legalisation of cannabis in the states of Washington and Colorado, Obama said, “Having said all that, those who argue that legalizing marijuana is a panacea and it solves all these social problems I think are probably overstating the case. There is a lot of hair on that policy. And the experiment that’s going to be taking place in Colorado and Washington is going to be, I think, a challenge.”
In the reportThe Health Consequences of Smoking -- 50 Years of Progress, published in January, the US Acting Surgeon General, Dr. Boris D. Lushniak, has expanded the list of illnesses caused by cigarette smoking. The report concludes, after reviewing the evidence, that there is a causal link between cigarette smoking and diabetes, colorectal and liver cancers, erectile dysfunction and ectopic pregnancy. The report also concludes that there is a causal relationship between cigarette smoking and neovascular and atrophic forms of age-related macular degeneration, tuberculosis, rheumatoid arthritis, impaired immune function and cleft palates in children of women who smoke. The report is intended to inform the public as well as doctors and other medical professionals about the newest proven risks of smoking. While smoking has declined sharply since the 1964 Surgeon General Report that concluded smoking caused lung cancer, that decline has slowed in recent years, and the new report calls for stronger action in tackling smoking.
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