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China’s Lung Cancer Epidemic is a Global Problem

In the West, China is arguably most well-known for its enormous population and the one child policy introduced in the 1970s to control it. Earlier this year, however, that policy was officially rescinded in order to combat a problem that most people generally associate with Europe or Japan: a rapidly falling population.

http://moderndiplomacy.eu/index.php?option=com_k2&view=item&id=1961:china-s-lung-cancer-epidemic-is-a-global-problem&Itemid=135

Indeed, after four decades of suppressing population growth, China is now afflicted by the problem of increasing numbers of retirees dovetailing with dwindling numbers of young people joining the workforce. Making things worse, China’s breakneck pace of economic development is now a major cause of preventable deaths every year. Air pollution and rampant smoking rates are making a bad demographical problem worse and Chinese authorities are slowly coming around to the idea that there is a direct connection between its population’s health and its economic prospects.

Today in China there are about 5 workers for every retiree. Given current population trends, by 2040 that ratio will stand at 1.6 workers for every retiree. The average age will rise from under 30 now to 46, with the number of people over 65 reaching 329 million by 2050, up from 100 million in 2005. The burden that this will place on the social services needed to care for the elderly in the face of falling tax revenues from a diminished workforce is only exacerbated by the fact that the country’s runaway cancer rates means that more of its elderly population will be in need of state care. Many of those sick beds will be taken up by lung cancer patients. With 600,000 deaths caused by the disease every year, expected to rise to 700,000 by 2020, China has the highest number of lung cancer patients in the world. And with an estimated 4,000 deaths a day caused by industrial pollution alone, grassroots organizations have finally decided that enough is enough and are beginning to agitate for something to be done to improve living standards.

Residents of China’s smog-filled cities have suffered for years, but it was a documentary released this year about China’s environmental problems that finally sounded a clarion call for Chinese people to rally to. Produced by Chai Jing, a former China Central news anchorwoman, the documentary racked up hundreds of millions of views before being scrubbed from the Internet by the authorities fearing that it could create a groundswell of discontent that could spill over into mass protests. Realizing the depth of feeling, the government has scrambled to get out ahead of the situation and declared its own ‘war on pollution’, culminating with President Xi’s historic agreement to cut greenhouse gas emissions sign the Paris climate agreement.

As up hill a struggle as reducing industrial pollution will prove for the Chinese authorities, the other leading cause of lung cancer in China is set to present even more of a challenge. Nearly 70 percent of Chinese men are addicted to tobacco, one in three of whom are expected to die from the habit – by 2030, over two million people would die every year from smoking if nothing changes. Current tobacco reduction efforts in the country are hampered by poor enforcement and the massive influence of the state owned cigarette manufacturer, China National Tobacco Corporation, which supports millions of jobs among tobacco farmers and retailers.

Further frustrating the drive to curb tobacco use is the fact that China has signed up to the World Health Organization’s Framework Convention on Tobacco Control, which does not recognize e-cigarettes as an efficient way of quitting, despite the fact that over 10 million people have given up the habit thanks to vaping. The FCTC’s latest meeting in New Delhi raised new obstacles to the prospect of the organization softening its stance, after delegates blocked journalists and e-cigarette producers from even observing the meetings. In line with the Convention’s advice, China is expected to take measures that will restrict e-cigarettes and tobacco alike, with the ultimate aim of banning both.

While these obstacles may seem nearly insurmountable to China’s anti-tobacco agenda, there are lessons that can be carried over from its anti-pollution drive. International pressure has played a big part in getting China to face up to its killer smog and chemical problem, a problem with which Western countries are all too familiar from their own experiences in the previous century.

As noted in Chai’s documentary, when it comes to dealing with these issues China finds itself in a comparable position to the West in the 1950s, quickly growing and struggling to contain the environmental fallout. Ending on a bright note, the documentary references London and Los Angeles, both of which were regularly choked by haze in the 1940s and 50s, but managed to massively curb their pollution levels once they faced them head on. In getting to grips with its own problems, China is going to need all the help it can get from international partners and institutions if it is to save some of the millions of lives expected to be lost to lung cancer over the coming decades. Given the increasing importance to the world economy of a healthy and plentiful Chinese workforce, their success or failure in this endeavor is of global significance.

TI RESPONSIBILITY FOR HARMFUL IMPACTS TO OUR GLOBAL ENVIRONMENT

For decades now, with cigarette sales having increased to more than six trillion in 2016, tobacco producers have refused to accept any significant responsibility for the serious, global environmental damage resulting from the production, use and disposal of tobacco products. It’s time for new regulations that hold the tobacco industry (TI) responsible for contaminating the environment, humans, and animals throughout tobacco’s lifecycle.

Tobacco leaf growing and processing involves heavy pesticide and petroleum-based fertilizer use, land degradation and deforestation. Added waste concerns arise from tobacco manufacturing, packaging, distribution and consumption. These concerns include production of greenhouse gases (C02 and methane), released by manufacturing, transport and smoking of tobacco products; environmental toxins found in secondhand smoke; newly described toxic residuals known as thirdhand smoke found attached to surfaces in homes and other enclosed environments where smoking has occurred; and post-consumption toxic tobacco product waste (TPW).

Given experience involving the pesticide, paint and pharmaceutical industries, among others, a strong case can be made for making the TI responsible for serious environmental problems throughout the tobacco product lifecycle. With butt waste being the most visible lifecycle harm, the TI clings to its long held view that smokers and local communities are responsible for post-consumer waste. The industry tries to bolster its image by funding some beach cleanups, Keep America Beautiful, and ash trays, .

These downstream actions are miniscule compared to the up-tofour billion butts polluting the globe annually. The tobacco industry has designed a product that is not only deadly when used as directed, but its cultivation, production, distribution, consumption, and post-consumption management also causes substantial and dangerous environmental contamination.

Extended Producer Responsibility (EPR) is a policy principle that promotes environmental protection by extending the responsibilities of the producer across the products entire life cycle. As set out in a Swedish doctoral thesis on corporate responsibility by Thomas Lindhqvist in 2000, EPR addresses two core tenets that are highly applicable to tobacco:

1. Internalizing the environmental cost of products into the retail price; and
2. Shifting the economic burden of managing toxicity and other environmental harms associated with post-consumer waste from local governments and taxpayers to producers.

While EPR is put forward as a legislative approach, it asserts, in the context of tobacco, that the producer would be strictly liable for TPW.

There are several legal theories pertaining to liability, involving potential legal causes of action that could be applicable. Public nuisance may be the strongest approach, although product liability or hazardous waste laws could also successfully hold tobacco producers liable for TPW.

Raising awareness about the environmental consequences of tobacco use and the responsibility of the TI for those consequences will require media messaging, PR skills, donors to help advance our agenda, and actions by governments at national and subnational levels, in order to succeed. For the FCTC, the WHO is currently developing a Monograph on Tobacco and the Environment, with publication in 2017. The foundation for the Monograph is a scientific article co-authored by WHO, the Secretariat and other authors that appeared in the WHO Bulletin, December 2015, available at: http://dx.doi.org/10.2471/BLT.15.152744 More broadly, these and other initiatives will provide opportunities to motivate and collaborate with a diverse array of stakeholders in ways that will benefit environmental protection, as well as quality of human health, while increasing the cost of tobacco and reducing tobacco use.

By Clif Curtis, ASH US Consultant Advisor; President, Cigarette Butt Pollution Project;

Cancer is not just ‘bad luck’ but down to environment, study suggests

http://www.bbc.co.uk/news/health-35111449

Cancer is overwhelmingly a result of environmental factors and not largely down to bad luck, a study suggests.

Earlier this year, researchers sparked a debate after suggesting two-thirds of cancer types were down to luck rather than factors such as smoking.

The new study, in the journal Nature, used four approaches to conclude only 10-30% of cancers were down to the way the body naturally functions or “luck”.

Experts said the analysis was “pretty convincing”.

Cancer is caused by one of the body’s own stem cells going rogue and dividing out of control.

That can be caused either by intrinsic factors that are part of the innate way the body operates, such as the mutations that occur every time a cell divides, or extrinsic factors such as smoking, UV radiation and many others that have not been identified.

The argument has been about the relative importance of intrinsic and extrinsic factors.

The team of doctors from the Stony Brook Cancer Centre in New York approached the problem from different angles, including computer modelling, population data and genetic approaches.

They said the results consistently suggested 70-90% of the risk was due to extrinsic factors.

Dr Yusuf Hannun, the director of Stony Brook, told the BBC News website: “External factors play a big role, and people cannot hide behind bad luck.

“They can’t smoke and say it’s bad luck if they have cancer.

“It is like a revolver, intrinsic risk is one bullet.

“And if playing Russian roulette, then maybe one in six will get cancer – that’s the intrinsic bad luck.

“Now, what a smoker does is add two or three more bullets to that revolver. And now, they pull the trigger.

“There is still an element of luck as not every smoker gets cancer, but they have stacked the odds against them.

“From a public health point of view, we want to remove as many bullets as possible from the chamber.”

There is still an issue as not all of the extrinsic risk has been identified and not all of it may be avoidable.

‘Convincing’

Kevin McConway, a professor of applied statistics at the Open University, said: “They do provide pretty convincing evidence that external factors play a major role in many cancers, including some of the most common.

“Even if someone is exposed to important external risk factors, of course it isn’t certain that they will develop a cancer – chance is always involved.

“But this study demonstrates again that we have to look well beyond pure chance and luck to understand and protect against cancers.”

Dr Emma Smith, from Cancer Research UK, said: “While healthy habits like not smoking, keeping a healthy weight, eating a healthy diet and cutting back on alcohol are not a guarantee against cancer, they do dramatically reduce the risk of developing the disease.”

STUDY REVEALS ENVIRONMENT, BEHAVIOR CONTRIBUTE TO SOME 80 PERCENT OF CANCERS

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Is E-Cig Waste More Dangerous Than Traditional Cigarettes?

http://www.ciwm-journal.co.uk/archives/14657

Tons of plastics and batteries from Britain’s 2m e-cigs are ending up in landfill, according to waste management company Business Waste.

The company says that the products produce just as much “dangerous” landfill waste as the tobacco products it replaces, after finding a steep rise in vaping-related products being sent to landfill and being buried in the ground.

While waste from cigarettes still makes up the vast majority of smoking refuse, with hundreds of millions of butts and their pollutants being discarded every year, the steep rise of vaping as a so-called “cleaner” alternative is causing concern, the Business Waste company says.

“The jury is still very much out on the safety of vaping as an alternative to smoking,” says BusinessWaste.co.uk spokesperson Mark Hall, “But as far as the waste handling industry goes, it’s another challenge on top of the many challenges we already face.”

According to YouGov statistics, there are 2.1m e-cigarette users in the UK, who are either regular users, or are using the devices to help give up smoking tobacco.

The use of e-cigarettes as a means to give up smoking has now overtaken other methods such as nicotine patches. This means that waste from e-smoking has increased steadily in the last two years, with a majority of the refuse being sent to landfill.

The market for e-cigarettes was worth £90m in 2014. While this figure is growing rapidly with hundreds of shops and websites catering for customers’ needs, the UK tobacco market is still worth billions, though declining slowly.

There’s little guidance on disposing of electronic cigarette waste ethically, Business Waste says.

Hall says that although amounts of electronic cigarette waste is still relatively small in relation to the tons of cigarette waste handled every day by the waste industry, but it’s of a very different type that can be just as damaging to the environment.

“Traditional cigarette ends when dumped in landfill release poisons into the ground that can harm water tables and damage plants and animals,” he explains.”E-cigarette refuse is mainly plastics and batteries that may take centuries to break down, and heaven knows what poisons they might contain.”

He also says that chemicals used in e-cigarettes are also ending up in landfill, and they could prove just as damaging as tobacco waste.

“With careful disposal, many cigarette butts can be diverted from landfill to energy recovery, where they can be burned and contribute to electricity generation. However, users don’t know how to recycle their vaping waste, so it’s slipping through the net and ending up in general waste that’s destined for landfill, and that’s something we’re keen to avoid” Hall says.

BusinessWaste.co.uk says that spent batteries from small electrical appliances is one of the greatest challenges facing the waste industry, and the tons of waste from vaping just adds to the problem.

“While most local authorities have schemes to recycle old batteries, most people find it more convenient just to fling them in the bin,” says Hall. “It’s the same for E-cig batteries, and it’s fair to say smokers do not have the greatest of reputation when it comes to disposing of their waste, and so it goes with Britain’s millions of vapers. E-cig waste is going to landfill by the ton.”

BusinessWaste.co.uk is also finding whole vaping devices in landfill as people try e-cigarettes once and decide it’s not for them.

“There are literally thousands of nearly-new E-cigs being thrown out at the moment,” says Hall, “And that’s yet another problem for the waste industry which has to try to recycle them as appropriate.”

While the health benefits of vaping are very much up for discussion, the same cannot be said for the risks in dealing with E-cigarette waste. As more people switch their smoking habits away from tobacco to electronic devices, there needs to be stronger guidance on dealing with the very different waste that vaping produces.

“Switching from cigarettes to e-cigs switches one set of poisons for another, more subtle kind. E-smokers have to be just as careful with their vaping waste as with their cigarette butts and old lighters,” says Hall.

The European health report 2015

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Science Daily: Air Pollution Puts the Health of School Children at Risk

from Science Daily:

A recently completed study by The Hong Kong Polytechnic University (PolyU) on 310 children in 12 schools across the territory found the air pollution level along the traveling routes from home to schools and particulate levels outside school both at a very high level, and most of the school children have lung function weaker than the predicted levels.

The study was done by Dr Hung Wing-tat, Professor Frank Lee Shun-cheng and Ms Lee Sin-hang of the University’s Department of Civil and Environmental Engineering. They found that children in only two out of twelve surveyed schools have lung function better than predicted levels, whilst children in the remaining ten schools have lung function weaker than the predicted levels.

The study also found that carbon dioxide levels inside five of the twelve school classrooms are found to be higher than the stipulated good class level of HK Indoor Air Quality (HKIAQ), probably due to the presence of full class of students within the monitoring period.

PolyU researchers also collected information about the traveling patterns of these 310 school children and then monitored the air pollution level along the traveling routes of the subjects. About 48% of school children go to school on foot, the second most popular choice is the school bus (24%). They found that both PM10 and PM2.5 levels in various transportation modes are high.

It is worth noting that PM2.5 levels far exceed the stipulated health levels of WHO safety level of 75 µg/m3 (24 hours average) and the situation in school buses is worst. The total volatile organic compound (TVOC) levels in all transportation modes far exceed the good class level of HKIAQ and the situation in school buses is worst.

The study also found that allergic rhinitis is very common among local school children (ranging from 13% to 59.3% in schools). Allergic rhinitis is found to be related to tobacco smoking household, incense burning at home and molds at home. However, molds and mildews are common (25.9% to 62.5%) in household because of the humid weather.

Children in tobacco smoking households also have significantly poorer lung function. The study found high percentages of smokers in the households, ranging from 25.0% to 69.6%. One of the key findings is that Lung function of school children, FVC and FEV1 are found to be negatively co-related with PM10 levels in classrooms at 0.05 significant levels. It is critical to suppress the level of PM10 in classroom to protect the health of school children.

Pulmonary function tests were conducted on surveyed school pupils to assess their lung function, which was measured by a spirometer in this study.

The above story is based on materials provided by The Hong Kong Polytechnic University.

19 Nov 2013

Lung health in Europe – Facts & Figures

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Indoor Air Pollution and Health

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World of people just dying to indulge

Lifestyle-related diseases stemming from tobacco, alcohol and obesity, have taken over infectious diseases such as HIV and malaria to become the greatest killer of people worldwide.

Director-General of the World Health Organisation Margaret Chan yesterday released a report that showed non-communicable illnesses including cancer, diabetes and heart disease had contributed to 36.1 million deaths in 2008 – nearly two thirds of the 57 million deaths around the globe that year.

Speaking at a meeting in Moscow, Dr Chan said the rise of these diseases was an enormous challenge for affluent countries, but more so for low and middle-income countries that experienced 80 per cent of the 36.1 million deaths in 2008.

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”For some countries, it is no exaggeration to describe the situation as an impending disaster; a disaster for health, for society, and most of all for national economies,” she said.

”Chronic non-communicable diseases deliver a two-punch blow to development. They cause billions of dollars in losses of national income, and they push millions of people below the poverty line, each and every year.”

However, Dr Chan stressed that the diseases were largely preventable and could be treated and controlled with the right medical interventions. She said millions of lives could be spared if governments adopted stronger anti-tobacco controls while promoting healthier diets, physical activity and less harmful consumption of alcohol.

Without action, Dr Chan said the epidemic was projected to kill 52 million people annually by 2030.

In Australia, the report said about 63,400 men and 63,200 women died in 2008 because of non-communicable diseases. About 40 per cent of the population did not exercise enough with 64 per cent deemed overweight or obese.

It also noted that 17 per cent of Australians smoked daily, 36 per cent had high blood pressure and 9 per cent had high blood glucose levels. And in 2008, every Australian consumed about 10 litres of alcohol.

Professor Rob Moodie from the Nossal Institute for Global Health at Melbourne University said Australia had a high burden of non-communicable diseases and needed to ramp up its efforts to reduce the incidence.

He said although the Australian government had done well on anti-tobacco policies, it needed to limit the widespread availability of alcohol and increase pressure on the food industry to reduce the salt content of foods and advertising of unhealthy products to children.

Read more: http://www.theage.com.au/lifestyle/wellbeing/world-of-people-just-dying-to-indulge-20110428-1dyvc.html#ixzz1L0tjbpqs