BACKGROUND: New findings on the detrimental health effects of electronic nicotine delivery system (ENDS)/ electronic non-nicotine delivery system (ENNDS) confounds the "harm reduction" perspective of using it as an alternative to conventional cigarettes. In the Philippines, the pressing debate on its safety and efficacy had initiated actions from policy makers on legislative issues such as draft DOH Administrative Order, House Bill 4325 and House Bill 532.

OBJECTIVE: The study aimed to craft an evidence-based policy position on the regulation of ENDS/ENNDS.

METHODS: Review of literature was conducted, and the proposed scope and measures on electronic cigarette regulation were compared with WHO Framework Convention on Tobacco Control (WHO-FCTC) and existing policies of US FDA regulations on ENDS. Further, UP Manila convened experts of various related fields for evidence-based review and discussion of policy issues to arrive at a consensus policy statement and recommendations. Results. Findings showed that ENDS/ENNDS still need further research to have conclusive results on long term safety and efficacy as smoking cessation methods.

CONCLUSION: Regulations for tobacco control should be clear and supported with strict guidelines in manufacturing, distribution, advertisement, selling, and usage restrictions in public. With the current review, it is recommended that ENDS/ENNDS regulation be under the mandate of the FDA in alignment to WHO-FCTC and to engage different stakeholders from policy makers, implementers, and other involved organizations.

Human ; Smoking, Non-tobacco Products--legislation & ; Jurisprudence ; Smoking Devices

South Korea's state health insurer, the National Health Insurance Service (NHIS), is in the process of a compensation suit against tobacco industry. The tobacco companies have habitually endeavored to ensure favorable outcomes in litigation by misusing scientific evidence or recruiting scientists to support its interests. This study analyzed strategies that tobacco companies have used during the NHIS litigation, which has been receiving world-wide attention. To understand the litigation strategies of tobacco companies, the present study reviewed the existing literature and carried out content analysis of petitions, preparatory documents, and supporting evidence submitted to the court by the NHIS and the tobacco companies during the suit. Tobacco companies misrepresented the World Health Organization (WHO) report's argument and misused scientific evidence, and removed the word "deadly" from the title of the citation. Tobacco companies submitted the research results of scientists who had worked as a consultant for the tobacco industry as evidence. Such litigation strategies employed by the tobacco companies internationally were applied similarly in Korean lawsuits. Results of tobacco litigation have a huge influence on tobacco control policies. For desirable outcomes of the suits, healthcare professionals need to pay a great deal of attention to the enormous volume of written opinions and supporting evidence that tobacco companies submit. They also need to face the fact that the companies engage in recruitment of scientists. Healthcare professionals should refuse to partner with tobacco industry, as recommended by Article 5.3 of the WHO Framework Convention on Tobacco Control.
Humans ; Public Health/*legislation & jurisprudence ; Republic of Korea ; Smoking/*legislation & jurisprudence ; Tobacco Industry/*ethics

Health Promotion ; Humans ; Singapore ; epidemiology ; Smoking ; epidemiology ; Smoking Cessation ; legislation & jurisprudence ; statistics & numerical data ; Smoking Prevention

OBJECTIVETo investigate the current smoking regulations and their impacts on the environmental tobacco smoke (ETS) levels inside restaurants and bars in Beijing.

METHODSTelephone survey was used to investigate the smoking regulations. TSI Sidepak AM510 was used to measure the level of fine particles less than 2.5 microns in diameter (PM2.5) in restaurants and bars. Analysis of variance and non-parametric rank tests were used to examine the association between indoor and outdoor PM2.5 levels and (1) smoking regulations; and (2) types of restaurants and bars.

RESULTSOf the 305 restaurants and bars surveyed, 27.9% had complete or partial smoking prohibiting rules. The average indoor PM2.5, level of the 92 restaurants and bars was 253.08 microg/m3 , 102.37% higher than the outdoor level. The average indoor and outdoor PM2.5 levels in the restaurants and bars with smoking ban regulations were 93.10 microg/m3 and 110.33 microg/m3 whole 289.34 microg/m3 and 128.40 microg/m3 in those without, respectively. The average indoor and outdoor PM2.5 levels of bars were 413.46 microg/m3 and 190.62 microg/m3, respectively, while in the western fast-food restaurants, they were 83.86 microg/m3 and 104.77 microg/m3, respectively. The outdoor PM2.5 levels were higher than the indoor levels in different classes of restaurants and bars. Furthermore, there was a significant positive correlation between PM2.5 levels and the number of smokers per cube meters (r = 0.47, P < 0.001).

CONCLUSIONSmoking regulations could effectively reduce the ETS level in restaurants and bars.

Air Pollution, Indoor ; analysis ; legislation & jurisprudence ; China ; Environmental Monitoring ; Particulate Matter ; analysis ; Restaurants ; Smoking ; legislation & jurisprudence ; Tobacco Smoke Pollution ; analysis ; legislation & jurisprudence

OBJECTIVES: To evaluate the impact of the workplace smoking ban in South Korea, where the male smoking rate is high (57%), on smoking behavior and secondhand smoke exposure. METHODS: A workplace smoking ban legislation implemented in April 2003 requires offices, meeting rooms, and lobbies located in larger than 3,000 square meter buildings (or 2,000 square meter multipurpose buildings) should be smoke free. A representative cross-sectional survey, the third wave (2005) of health supplements in the National Health Nutrition Survey of South Korea, was used to measure the impact of the 2003 workplace smoking ban implementation on smoking behavior. It contained 3,122 observations of adults 20 to 65 years old (excluding self-employed and non-working populations). A multivariate statistical model was used. The self-reported workplace smoking ban policy (full workplace ban, partial workplace ban, and no workplace ban) was used as the key measure. RESULTS: A full workplace smoking ban reduced the current smoking rate by 6.4 percentage points among all workers and also decreased the average daily consumption among smokers by 3.7 cigarettes relative to no smoking ban. Secondhand smoke showed a dramatic decrease of 86 percent (= -1.74/2.03)from the sample mean for full workplace ban. However, public anti-smoking campaign did not show any significant impact on smoking behavior. CONCLUSIONS: The full workplace ban policy is effective in South Korea. Male group showed bigger impact of smoking ban policy than female group. The public antismoking campaign did not show any effectiveness.
Adult ; Aged ; Female ; Health Promotion/*organization & administration ; Humans ; Male ; Middle Aged ; Republic of Korea ; Sex Factors ; Smoking/*legislation & jurisprudence/prevention & control ; Smoking Cessation ; Socioeconomic Factors ; Tobacco Smoke Pollution/*legislation & jurisprudence/prevention & control ; Workplace/*legislation & jurisprudence

INTRODUCTIONA local study completed in Singapore, which was part of an international multi-country study that aims to develop a global assessment of exposure to second-hand smoke in indoor workplaces, gathered data regarding the indoor air quality of public areas. It was hypothesised that air would be less polluted in non-smoking venues compared to places where smoking occurred.

MATERIALS AND METHODSA TSI SidePak AM510 Personal Aerosol Monitor was used to sample and record the levels of respirable suspended particles (RSP) in the air. A broad range of venues were sampled in Singapore. The primary goal of data analysis was to assess the difference in the average levels of RSP in smoke-free and non smoke-free venues. Data was assessed at 3 levels: (a) the mean RSP across all venues sampled compared with the mean levels of smoke-free and non smoke-free venues, (b) levels in venues where smoking occurred compared with similar venues in Ireland, and (c) comparison between smoke-free and non smoke-free areas according to the type of venue. Statistical significance was assessed using the Mann-Whitney U-test.

RESULTSThe level of indoor air pollution was 96% lower in smoke-free venues compared to non smoke-free venues. Averaged across each type of venue, the lowest levels of indoor air pollution were found in restaurants (17 microg/m3) and the highest in bars (622 microg/m3); both well above the US EPA Air Quality Index hazardous level of >or=251 ug/m3.

CONCLUSIONSThis study demonstrates that workers and patrons are exposed to harmful levels of a known carcinogen and toxin. Policies that prohibit smoking in public areas dramatically reduce exposure and improve worker and patron health.

Air Pollution, Indoor ; analysis ; legislation & jurisprudence ; Environmental Monitoring ; Ireland ; Restaurants ; Singapore ; Smoking ; Workplace

OBJECTIVETo explore the access to tobacco and exam the predictors of successful tobacco purchase attempts among Chinese minors.

METHODSA simulative trial of purchasing cigarettes was participated by 201 sixth grade students to assess the prevalence of illegal cigarette sales to minors in Guangzhou. Methods of Chi-square and unconditional logistic regression were used to identify the significant predictors,with the result of tobacco purchase as the dependent variable and the characteristics of stores, retailers and minors as the independent variables.

RESULTSA total of 165 students succeeded in purchasing cigarettes but 36 failed, and the percentage of successful purchase attempts was 82. 1% . Data from univariate analysis indicated that 9 factors were significantly associated with students' success in purchasing cigarettes. They were age and height of the purchasers, types of stores, seller's gender and age, posting cigarette advertisements,showing warning signs of 'no cigarette selling to minors' ,asking buyer's age,and asking whom you buy the cigarettes for. The results of multivariable analysis showed that only three variables entering the final logistic regression: the age of students, the type of stores, and showing warning signs of 'no cigarette selling to minors'.

CONCLUSIONChinese minors have easy access to purchasing cigarettes, especially in groceries and small markets. Selling cigarettes by sellers to minors should be monitored and managed in the future.

Adolescent ; Child ; China ; Commerce ; legislation & jurisprudence ; statistics & numerical data ; Female ; Humans ; Male ; Minors ; statistics & numerical data ; Smoking ; epidemiology ; legislation & jurisprudence ; Students ; statistics & numerical data

Electronic cigarettes (e-cigarrettes) were recently introduced and advertised as a smoking cession device in South Korea. As the social norm to quit smoking has gained hold in the country, the number of e-cigarette users is growing rapidly. This phenomenon should be urgently considered, because of the lack of research that has been conducted to examine the safety of e-cigarettes and its efficacy as a smoking cessation aid. This paper raises several public health concerns on e-cigarettes in South Korea. Uncertain regulations of the government on e-cigarettes are contributing to an increase of e-cigarette users and allowing the e-cigarette industry to circumvent existing regulations. The aggressive marketing activity of this industry is also a core factor that is responsible for the rapid increase of e-cigarette use, in particular among the youth. Following the enforcement of tobacco control, some cigarette smokers may be encouraged to purchase e-cigarettes in order to circumvent the regulations, even though the dual use of e-cigarette and cigarette may be more harmful. Until there is clear evidence of the e-cigarette's safety, it is recommended that the industry's marketing and promotional activities be banned and closely monitored, and public campaigns be initiated to educate the public regarding e-cigarettes.
Adult ; *Electronics ; Female ; *Government Regulation ; Health Promotion ; Humans ; Male ; Middle Aged ; *Nicotine ; Prevalence ; *Public Health Practice ; Republic of Korea/epidemiology ; Safety ; Smoking/epidemiology/legislation & jurisprudence/*prevention & control ; Smoking Cessation/*legislation & jurisprudence ; Young Adult

Objective: To understand the current status of smoking and smoking cessation in persons aged 15 years and over in Beijing and evaluate the effect of 2015 Beijing Tobacco Control Regulation. Methods: In 2014 and 2016, based on the principles and methodology of the Global Adult Tobacco Survey. A total of 50 communities or townships were selected from 324 communities or townships in Beijing through multistage cluster sampling, and 2 community (village) committees from each community or township were selected with the method of probability proportional to size (PPS). A total of 100 surveillance sites were set, and 100 households were selected from each surveillance site by using simple random sampling. Data were collected through face-to-face interview from the eligible family members aged 15 years and over with the assistance of a tablet computer. Statistical analyses were conducted by using complex sampling analyses module of SPSS 20.0, with weights as a combination of sampling weights, non-response weights and post- stratification weights, for the calculation of current smoking prevalence, daily smoking prevalence, smoking cessation rate, etc. Results: A total of 8 484 and 9 372 valid questionnaires were obtained, respectively, in 2014 and 2016, with the response rate of 86.5% and 96.5%. The current smoking prevalence in persons aged 15 years and over was 23.4% in 2014, and 22.3% in 2016. According to the 6(th) national census data, the current smoking population decreased by 199 000 in Beijing. The proportion of daily smokers declined from 20.7% in 2014 to 19.2% in 2016. The daily number of cigarettes consumed by current smokers increased from 14.6 in 2014 to 15.4 in 2016. The smoking cessation rate was 14.9% in 2014 and 16.8% in 2016. The proportion of current smokers who had at least one smoking cessation attempt in the past 12 months increased from 22.3% in 2014 to 23.2% in 2016, and the proportion of current smokers who planned to quit smoking increased from 11.6% to 15.5%. Among the current smokers who had visited doctors in the past 12 months, the proportion of those having smoking cessation advice was 58.9% in 2014 and 59.2% in 2016. In 2016, among the current smokers who had attempted to quit in the past 12 months, 36.8% were aware of the smoking cessation clinics, and 29.5%were aware of the quitline. Among those who were aware, only 7.7% had actually visited the cessation clinics, and 5.5% had used the quitline. Conclusions: After the implementation of 2015 Beijing Tobacco Control Regulation for 1 year, the current smoking prevalence in persons aged 15 years and over showed decreasing. It is necessary to further prompt the expansion of smoking cessation service to cover more current smokers.
Adolescent ; Adult ; Beijing ; Humans ; Middle Aged ; Smoking Cessation ; Social Control, Formal ; Nicotiana ; Tobacco Products/legislation & jurisprudence* ; Tobacco Use ; Young Adult

The purpose of this study was to compare smoking control strategies between Korea and the United States. Korea and other developing countries may learn from the experience of the United States in dealing with the growing epidemic of cigarettes. In particular, smoking control objectives, structures, laws and regulations, funds, programs and activities, research, and surveillance systems were compared. The comparison was conducted at the federal, states/provincial, and county levels of the two countries. The data were collected through various governmental websites, contact with people directly, and a literature review. Based on the comparison, seven recommendations for smoking control strategies were made primarily for Korea.
Cross-Cultural Comparison ; Federal Government ; Financing, Government/organization & administration ; Government Programs/*organization & administration ; Government Regulation ; Health Education/organization & administration ; Health Policy/legislation & jurisprudence ; Health Priorities/organization & administration ; Health Promotion/*organization & administration ; Humans ; Korea/epidemiology ; Local Government ; Population Surveillance ; *Public Health Practice/economics/legislation & jurisprudence ; Research Support as Topic/organization & administration ; Smoking/epidemiology/*legislation & jurisprudence/*prevention & control ; Smoking Cessation/legislation & jurisprudence/methods ; State Government ; United States/epidemiology