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Many of the tobacco prevention and harm reduction policies called for by
the Royal College of Physicians also should be approved by the US FDA (for
NRT products) and/or amended into the Altria/CTFK backed US FDA tobacco
legislation, which outrageously protects future markets for the deadliest
tobacco product (cigarettes) and severely restricts future markets for the
least hazardous smokefree tobacco products.  

Please urge the FDA to approve the NY State Health Commissioner's petition
to alter NRT warning labels to inform smokers that NRT products are far
less hazardous alternatives to cigarettes, to allow NRT to be sold in less
expensive daily dose units, and to allow NRT to be sold in all stores that
sell cigarettes.
Go to:
http://www.regulations.gov/fdmspublic/component/main?main=DocketDetail&d=FD
A-2008-P-0116
Then click on the "Add Comments" icon to the right of the first document
"State of New York Department of Health - Citizen Petition"  

Bill Godshall

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http://www.rcplondon.ac.uk/news/news.asp?PR_id=416

News : 07 September 2008
End tobacco smoking by 2025

A new report issued today by the Royal College of Physicians says that if
the Government was prepared to take far more radical measures to combat
smoking, we could practically eradicate smoking in Britain by 2025.  

The report "Ending tobacco smoking in Britain:  Radical strategies for
prevention and harm reduction in nicotine addiction" forms part of the
RCP's response to the Department of Health's consultation on the future of
tobacco control which closes tomorrow, Monday September 8.

It says that the conventional approaches to preventing smoking that have
been implemented in the UK - increasing the cost of cigarettes, advertising
bans, smokefree public places and workplaces, health promotion campaigns,
cessation programmes - will only deliver a drop in smoking prevalence of
between 0.5 and 1.0 percentage points per year.  That means it will take
between 11 and 22 years for the smoking rates in England to drop even by
half from 22% to 11% - from 10 million to 5 million people.

The report argues that much more could and should be done to make smoking
as unappealing and unacceptable as possible, and importantly, to make
alternative, less hazardous nicotine products as affordable and attractive
as possible. The report therefore calls for the introduction of a wide
range of newer and more radical measures on smoked tobacco, existing and
new medicinal nicotine products, and non-medicinal smoke-free nicotine
products:

Smoked tobacco:  Make smoking and smoked tobacco products as unappealing,
unattractive, unaffordable and unavailable as possible, as quickly as
possible. Proposed measures include: 

- Increase the tax on smoked tobacco by 10% every year 
- License tobacco retailers and prohibit the sale of smoked tobacco in
premises where children are admitted 
- Crack down on tobacco smuggling, and apply Class A drug penalties for
tobacco smuggling and under-age sale 
- Protect children from exposure to smoking role models in the media

Existing medicinal nicotine products:  To make this product group as
available and attractive to smokers as possible, and to encourage smokers
to switch as completely as possible to use of medicinal nicotine instead of
smoking: 

- Encourage sale of low cost single day nicotine packs, available from any
retail outlet 
- Encourage and promote commercial competition to make medicinal nicotine
attractive and affordable 
- Permanently exempt medicinal nicotine from VAT 
- Provide free medicinal nicotine for all smokers on the NHS, not just
those on a smoking cessation programme

New medicinal nicotine products:  Encourage development and marketing of
new medicinal nicotine products that are more acceptable and satisfying
alternatives to smoking than current products: 

- Encourage development of products that deliver doses of nicotine as
quickly as cigarettes 
- Remove unnecessary restrictions and regulations that currently inhibit
development of new, more effective cigarette substitutes 
- Make these products widely available to smokers at competitive prices

Non-medicinal smoke-free nicotine products: Realise any benefit that
smokeless tobacco and other potential nicotine sources might offer as
reduced hazard alternatives to smoking, while minimising the hazard to
users by: 

- Allowing restricted marketing of products for which there is evidence of
efficacy as a smoking substitute from randomised clinical trials, and for
which potential hazard has been reduced as far as reasonably possible 
- Prohibiting the sale of all other non-medicinal nicotine products
currently on the market

The report also calls for the establishment of a new Nicotine Regulatory
Authority, independent from the tobacco and pharmaceutical industries, to
implement these changes, monitor their impact on smoking behaviour, and
tasked to reduce the prevalence of smoking as quickly as possible. 

Professor John Britton, Chair of the RCP Tobacco Advisory Group, said:
"Smoking is still the biggest public health problem in the UK, and a
problem of this magnitude and importance demands radical and effective
action to prevent any further avoidable loss of life. Our governments have
shown themselves more than willing to react decisively to other public
health problems, but despite the progress of the past 10 years, still do
not seem willing to take all the actions in their power to prevent children
from starting to smoke, or encourage existing smokers to quit. The UK has
led the world in many areas of public health in the past; here is our
opportunity show the world that tobacco smoking can be driven out of our
society."

Professor Ian Gilmore, President of the Royal College of Physicians, said:
"As a country, we have a real opportunity to build on previous steps, and I
believe the public are ready for strong action.  They would support bold
government in resolute steps to attack what remains the number one threat
to the nation's health, smoking."

Journalists: For further information on any story, please contact Linda
Cuthbertson, Press and PR Manager on 020 7935 1174 ext.254 or e-mail
Linda.Cuthbertson@rcplondon.ac.uk

- - - 

http://www.rcplondon.ac.uk/pubs/brochure.aspx?e=259

Ending tobacco smoking in Britain
Radical strategies for prevention and harm reduction in nicotine addiction
Report by the Tobacco Advisory Group of the Royal College of Physicians
  
Summary
Preventing people from starting smoking, and helping smokers to stop
smoking, are crucial if the massive burden of premature death and
disability caused by smoking in the UK is to be reduced. 

The Royal College of Physicians has argued consistently for more effective
tobacco control policy in the UK, including harm reduction strategies to
help to achieve this. In particular, we strongly advocated the
establishment of a Nicotine Regulatory Authority to implement a radical
overhaul of the way that nicotine products are regulated in the UK. This
Authority would rebalance the restrictions on the different nicotine
products and maximise the likelihood that smokers who want to stop smoking
will succeed. Also, those who fail or do not want to stop using nicotine
are would be more likely to choose a less hazardous nicotine source that
tobacco.

We acknowledge and applaud the progress that has been made in implementing
tobacco control policy in the UK over the past ten years, but we belive
that a great deal more could and should be done. In this short report we
outline how more effective tobacco control and harm reduction policies
could be designed and implemented. In it we call for a dramatic increase in
the restrictions on availability, affordability and promotion of smoked
tobacco; and for the radical liberalisation of the medicinal nicotine
market. We provide a framework to harness any potential public health
benefit from other, non-medicinal sources of nicotine, including
tobacco-based products. We also set out the primary responsibilities of a
Nicotine Regulatory Authority in overseeing these changes. We believe that
these approaches, if fully implemented, have the potential to end tobacco
smoking in the UK within the next 20 years.

Contents
Why we need radical solutions to the smoking epidemic 
What are conventional approaches to preventing smoking, and how do they
work? 
What is harm reduction, and how would it work for smoking? 
What is the safest way to provide nicotine without smoking? 
What are the alternatives to medicinal nicotine? 
How should harm reduction be incorporated into conventional tobacco
control? 
How are nicotine products regulated at present? 
How should nicotine regulation be reformed? 
Regulating, monitoring and managing nicotine product use: the need for a
Nicotine Regulatory Authority
.