Recto wants lower rates for tobacco?

Advocates of the sin tax bill expect the measure to be diluted further when the Senate comes out with its committee report on the bill in October. Health Secretary Enrique Ona and Finance Secretary Cesar Purisima met with Senate ways and means committee chair Ralph Recto on September 18 in a bid to persuade him about the benefits of the bill, a source, who belongs to an organization working with the Finance and Health departments in pushing for the bill, told Rappler.

But Recto, who earlier expressed misgivings about the “high” taxes that will be imposed especially on tobacco, seemed to be unconvinced. Recto reportedly wants a 3-tier excise tax system for cigarettes, diluting the 2-tier provided in the bill passed by the House of Representatives in June. Apart from this, Recto also reportedly wants lower rates imposed on the tiers.

The tiers – for low-priced, medium-priced and high-priced cigarettes – will have tax rates of P3.50, P8.50 and P12.50, said the source. The rates are close to what were provided in the bill Representative Victor Ortega of the tobacco-growing province La Union earlier filed in the House. There is no word, however, on the tax structure for alcohol products. Authored by Cavite Rep Jun Abaya, approved House Bill 5727 seeks to raise at least P31 billion additional revenues from a 2-tier tax system for tobacco (with tax rates of P22 and P30) and 2 and 3 tiers for fermented liquor and distilled spirits.

The bill was a watered-down version of the one originally filed by Abaya that sought to raise P60 billion. In the Senate, Senator Miriam Defensor-Santiago filed bills, which carry the same provisions as the original Abaya bill in the House. The additional revenues from the sin tax measure will be used to fund the Aquino government's universal health care program and assist tobacco farmers in shifting to viable, alternative crops. The Senate held Thursday, September 20, its fourth and possibly, last public hearing on the measure.

Bland packaging a way to cut the appeal of cigarettes

We may not judge a book by its cover, but we appear to judge a cigarette by its packaging, an insight that could help cut smoking rates. According to a new study of 640 young women in Brazil, placing cigarettes in plain packages may be a way to cut down on their appeal.

 The study, published in BMC Public Health, asked women to compare the appeal of brand cigarettes with those placed in generic packaging. In one part of the study, the women were asked to choose whether they would like to be given the gift of a brand pack of cigarettes or a pack in plain packaging. Three times more chose the branded pack.

 "The women in this study rated branded packs as more appealing, more stylish and sophisticated than the plain packs," said David Hammond, a University of Waterloo researcher and the study's leader. "They also thought that cigarettes in branded packs would be better tasting and smoother. Removal of all description from the packs, leaving only the brand, further reduced their appeal." Australia recently passed a law making plain packaging mandatory for cigarettes.

Anti-smoking campaign hopes gift cards do the trick

The federal health care overhaul is a complex structure woven through with carrots and sticks, incentives and disincentives. Physicians get payments to implement sleek new electronic health records systems. Hospitals get penalized financially if too many patients require readmittance. Now, in California, an Affordable Care Act grant is offering select Medi-Cal enrollees $20 retail gift cards in a leading-edge, anti-smoking trial. All they must do is call the California Smokers' Helpline and complete the sign-up protocol to participate in telephone counseling sessions.

Skeptics may dub it dialing for dollars. But experts say the program may show monetary incentives to be an important tool in improving health and reducing the growth of health care costs in the long run. An initial pilot project already finished in Sacramento showed positive results, doubling the number of calls to the Smokers' Helpline, said Elisa Tong, an associate professor at UC Davis Medical Center and a member of the outreach team for the project. Sacramento was a natural place to begin because it has an "embarrassingly high" number of Medi-Cal enrollees with health complications who smoke, Tong said. Medi-Cal is California's version of the federal Medicaid program for people with low incomes or who have certain disabilities.

Compared with the statewide average of about 12 percent, 35 percent of at-risk Medi-Cal consumers in Sacramento are smokers. California's Department of Health Care Services recently expanded the pilot project statewide, to further test the effectiveness of offering financial incentives. Researchers involved in the project will identify Medi-Cal patients with chronic conditions and invite them to take part. Within that group, some will be selected in a randomized, controlled trial to receive certificates of completion that can be traded for free nicotine patches. Another slice of the larger group will be eligible to receive $10 retail gift cards for each relapse-prevention call they complete to the hotline. Also being tested is another tier of incentives for those who tried but were unable to quit smoking.

This would allow a selected number of beneficiaries to receive up to $40 to re-enroll. Broadly speaking, the California project is but one of many layers of carrots and sticks nestled in the Affordable Care Act with the aim of re-engineering the nation's health care system into one of better outcomes, fewer mistakes and lower costs. California received a federal grant of $10 million to pay for the program, which will target 75,000 Medi-Cal members over five years of incentives and study. The state was deemed well-positioned for the project because the California Smokers' Helpline has been up and running for 20 years at the University of California, San Diego. Controls and tracking methods are in place to prevent fraud, Tong said, and the trained hotline counselors are able to weed out profiteers who may be attracted to the program by the $20 gift cards.

The gift cards are good at major retailers such as Walmart, Target and Safeway, said Norman Williams, deputy director for public affairs at the state Department of Health Care Services. Williams said it makes sense to seek out ailing Medi-Cal members who smoke to try to change their behavior. "If you have a chronic disease, we are going to pay especially close attention to you," Williams said, noting that treating tobacco-related disease absorbs 11 percent, or $15 billion, of Medi-Cal's budget. Tong hopes the hotline program will take hold in California's rural areas, which have smoking rates among Medi-Cal enrollees as high as 45 percent.

"It's long overdue in rural California," she said. "We need to address this quickly." A 2004 study in the American Journal of Preventive Medicine determined that economic incentives to change consumers' preventive health behaviors worked 73 percent of the time. "Economic incentives are effective in the short run for simple preventive care, and distinct, well-defined behavioral goals," according to the abstract of the study. "Small incentives can produce finite changes, but it is not clear what size of incentive is needed to yield a major sustained effect." Tong said California researchers hope to pull together a comprehensive picture of what combination of financial incentives are most effective at changing behavior. Already, she said, the project is "helping to generate a lot of discussion about how this program can become a model for the nation."

Steuben ponders smoking ban on county properties

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Tobacco users may need another place to light up or chew, with Steuben County legislators considering a tobacco ban on all county property. The county Legislature’s Human Services, Health and Education Committee unanimously adopted a draft law prohibiting the use of tobacco on county-owned or leased property. The prohibition would include county offices located in Corning and Hornell. Deputy County Administrator Jack Wheeler said complaints from those entering county buildings and lobbying from county Public Health officials led the committee to approve Wednesday the draft law banning tobacco.

Several years ago, the county decided to restrict smoking to within 50 feet of county office entrances. However, tobacco users have tended to encroach on the 50-foot perimeter since then, Wheeler said. In some areas – such as the small courtyard between the main county building and the county Clerk’s office – a strict application of the 50-foot application prevents any smoking, he said. Banning smoking has gatherered steam in recent years, with municipalities restricting smoking in certain areas.

Chemung County does not have a ban, but the City of Elmira – the site of county offices – keeps tobacco users 25 feet away from building entrances, according to www.tobaccofreenys.org.. Allegany County also restricts smoking to 25 feet of entrances. In Yates County, county workers are not allowed to smoke at county building entrances, the Web site reported. However, Ontario, Schuyler and Seneca counties recently adopted outright bans on county owned or leased properties, according to the organization. Locally, the tobacco-free initiative is endorsed by the Southern Tier Tobacco Awareness Community Partnership, which has teamed up 10 years ago with the American Lung Association, American Heart Association, and the Chemung, Schuyler, and Steuben health departments to work towards tobacco-use prevention and cessation.

Since then, the American Cancer Society and a variety of youth, school, civic organizations, and hospitals to join in, and allowed for increased grant funds, according to the group. The measure will be presented to the Legislature when it meets Sept. 24. If approved, the draft would be up for final adoption after a public hearing at the regular board meeting in October. The real question is whether the ban is enforceable, Wheeler said. “It’s going to be hard for our staff to keep an eye on things,” Wheeler said. “But if we’re going to hold our employees to a standard, it’s only fair the public be held to the same standard, too.”

Smoking ban for city owned vehicles

Municipal workers in Houston, Miss., can smoke, just not in city-owned vehicles. The Northeast Mississippi Daily Journal reports that the new city policy - which applies to cigarettes, cigars and pipes as well as chewing tobacco - was adopted by the board of aldermen in August.

Employees who violate the ban will be reprimanded and those who violate it three times can be terminated, according to the policy. The city has had a "no-smoking" policy in city buildings - for the public and employees - for several years. Officials say the policy is for public health reasons, safety reasons and a desire by the city to endorse a healthy lifestyle in the community.

Hannon Announces New Law Banning E-Cigarettes from Minors

Electronic cigarettes (also known as “e-cigarettes”) are battery operated devices that vaporize cartridges filled with nicotine, flavor and other chemicals, and are currently marketed as a smoking-cessation produce or as a "healthier alternative" to traditional smoking products. “Almost all Americans who use tobacco products become addicted to the nicotine contained in those products before they turn 18,” said Senator Kemp Hannon (R-Nassau). .

“While electronic cigarettes are often used to help smokers to quit, there is also a very real danger that their use by minors can cause the very addiction they are designed to break.” Despite their widespread use, there are little data available detailing the risks associated with smoking e-cigarettes, although the FDA (United States Food and Drug Administration) has found that e-cigarettes may be dangerous to users because they contain carcinogens and other chemicals, and the FDA does not currently regulate their use. This law, which becomes effective on January 1, 2013, bans the sale and distribution of e-cigarettes to anyone under the age of 18.

Boulder's medical marijuana industry thins in face of strict city regulation

When Boulder first established a specific license to help regulate medical marijuana businesses in 2010, more than 200 pot-related companies -- dispensaries, grow operations and infused-product manufacturers -- already were up and running throughout the city, remitting sales and use taxes under generic business licenses. In November of that year, city officials received applications for the new medical marijuana licenses from 119 businesses, most of which already were open.

Yet today, nearly two years later, Boulder's marijuana industry has thinned significantly, with just 26 dispensaries and 32 grow operations still operating in the city. A strict approach to background checks weeded out many of those initial applicants, forcing them to shutter or abandon plans to open. But closures continue in Boulder; as recently as March, there were 32 active wellness center licenses in the city.

Some medical marijuana business owners say Boulder's strict approach to regulation has pushed even "good" operators out of the trade, and they wonder whether the intent of regulation was to winnow the number of businesses that opened during the green rush of 2009 and 2010. "It's like one strike and you're done," said Diane Czarkowski, one of the founders of Boulder Kind Care, the first Boulder dispensary to receive a business license from the city. Tired of dealing with regulations, Czarkowski -- who describes herself as "more of a vision person" -- sold her shares and got out of the pot business in March, though she still works as a consultant and advocate. Boulder Kind Care does not appear on a current list of licensed dispensaries provided by the city, and the center's outgoing phone message says it is "temporarily closed due to lack of product."

Boulder officials say their goal always has been a well-regulated medical marijuana industry, not necessarily fewer dispensaries. "I have never heard that or gotten the impression that that's what council wanted," Senior Assistant City Attorney Kathy Haddock said of limiting the number of dispensaries. "I do think they want businesses that follow the rules and that's important." Boulder is in the process of revising its medical marijuana ordinances in preparation for November's expiration of a moratorium on new business licenses.

The city is taking public comment on the issue until Sept. 21, and, as of Friday, officials had received more than 400 responses. At a meeting Friday with marijuana business owners, many pushed back against possible restrictions on advertising (could a T-shirt be considered advertising?) and labeling requirements (labs that purport to test the THC content of marijuana can return widely differing results, they noted). Afterward, Czarkowski, who hasn't ruled out getting back into the business, said she felt like Boulder is being more open to business concerns. "I left there feeling so much better about the attitude," she said. "I felt like we had a voice."