Under the new law, which passed 4-1 on April 6, smoking is prohibited in indoor and outdoor areas frequented by the public, including sidewalks, parking garages, bars, restaurants, stores, stadiums, playgrounds and transit centers. It becomes effective May 20.

The citywide ban puts San Luis Obispo in the same class with two dozen other California cities that have banned smoking from all areas frequented by the public, including multi-unit residential areas.

Although San Luis Obispo’s ordinance does not ban smoking in private residences or apartments, it prohibits smoking in common areas of multi-unit residential complexes.

In December, the council voted to ban smoking in Mission Plaza, the downtown creek area and the city’s parks. Council members also directed staff to return in a few months with a comprehensive plan.

Twenty years ago, San Luis Obispo became the first city in the nation to ban indoor smoking in public places.

Police will not actively enforce the smoking ban but may issue citations for violations.

Councilman John Ashbaugh voted against the ban.

Researchers at the University of Pennsylvania School of Medicine have already discovered that some people — about three-quarters of smokers — break down (metabolize) nicotine more quickly from the patches than other people do. These people may do better by taking drugs like bupropion (Zyban).

And in the new study, researchers found that people who metabolized nicotine slowly did better if they used the nicotine patch for six months compared to slow metabolizers who were placed on the patch for only two months, followed by six months on a placebo (dummy) patch.

After six months there was no difference between the two groups.

While extended therapy helps people stay off tobacco and recover from lapses, “it only works as long as people are on it,” noted Caryn Lerman, deputy director of the Abramson Cancer Center at the University of Pennsylvania, in a press release. “Those data lead to the compelling question of whether some smokers should be on nicotine patch therapy for the long term.”

She said some patients may need to take treatment longer than the current recommended standard of two months.

The study is scheduled for release Tuesday at the American Association of Cancer Research’s annual meeting in Washington D.C.

The doctors’ group said there are 2.3 million smokers in Ontario, compared with 2.1 million in 1966.

After taking into account growth in the province’s population, from 6.7 million in 1966 to more than 12 million now, the proportion of the population smoking is much smaller, but the overall number of smokers remains high, the group said.

“It’s unfortunate, but the simple fact is there are still far too many people who smoke and who suffer from preventable tobacco-induced illness, and it is having a significant impact on our health-care system,” OMA president Dr. Suzanne Strasberg said in a release.

The doctors’ group urged the province to:

• Create a comprehensive smoking-cessation system across the province for people who want to quit, including no-cost medication, counselling and group therapy.
• Drastically reduce the thousands of retail tobacco outlets across Ontario.
• Place a moratorium on the sale of new tobacco products.
• Control contraband tobacco products, imposing sanctions against suppliers of raw materials to unlicensed manufacturers and on people in possession of contraband.

The report, titled Tobacco, Illness, and the Physician’s Perspective, said tobacco use accounts for 85 per cent of lung cancers, 30 per cent of cancer deaths and 13,000 deaths a year in Ontario

“Tobacco control in Ontario today has two faces,” the report’s authors concluded. “One is characterized by smoke-free spaces, retail and marketing controls, youth-focused initiatives, and some progress on smoking cessation. The other face of the tobacco scourge shows itself in proliferating supplies of contraband product, increasing numbers of both new combustible and smokeless products, continuing struggles of those addicted to find help breaking their addiction, and widespread and easy retail access to ‘legal’ products.”

The report noted that one-fifth of the cigarettes smoked in Ontario last year were estimated to be contraband.

The Health Sponsorship Council, a crown entity, was one of many anti-smoking groups at the Maori affairs select committee inquiry into the tobacco industry today.

The inquiry was called to look at the consequences of tobacco use for Maori.

Chief executive Iain Potter told the committee a 10-year plan, counter-attacking cigarette companies’ marketing strategies, should be adopted to reduce demand and supply of tobacco.

Mr Potter said the plan must encompass all marketing fundamentals — product, place, price, and promotion — instead of slowly implementing changes.

“The historical approach to limit the massively well-documented harms associated with tobacco has been an item-by-item, incremental approach,” Mr Potter said.

“If we continue with this item-to-item approach, we will be consigning several more generations of Maori to the ranks and consequently to an early grave. We need a paradigm shift.”

Mr Potter suggested the “power of the brand” be diminished by placing cigarettes in plain packaging, and taking displays and other tobacco imagery out of sight.

British American Tobacco New Zealand (BAT) asked the committee last month for current sale displays to remain the same.

BAT manager director Graeme Amey said research showed removing cigarettes and other tobacco products from visibility in retail stores would have little impact on the prevalence of smoking.

Mr Potter, who disagrees, said industry should also be required to provide full disclosure of all ingredients so they can be regulated.

“Tobacco can be made with less addictive and additives, both harmful and those that alter the taste should not be allowed.”

The Health Sponsorship Council also recommended tobacco tax be increased and roll-your-own tobacco tax should be equal to tailor-made cigarettes.

The Public Health Association’s submission also called on government to introduce plain packaging, ban point-of-sale displays and make major increases to tobacco taxes.

Senior analyst Keriata Stuart told the committee tax increases need to be substantial, regular and highly publicised.

“They can encourage smokers to quit. They can also encourage smokers to cut down.

“But the tax increases need to be preceded by increased funding for services and campaigns.”

Mr Potter said New Zealand was ready for drastic change as statistics show 49.8 percent of adults think that cigarettes and tobacco should not be sold in New Zealand in 10 years.

And more than 60 percent of people and 56 percent of Maori agree that tax on cigarettes should be raised. Prime Minister John Key said earlier this year a tobacco tax increase may be considered in this year’s budget.

On Monday, the Crescent City Council unanimously passed a smoking ordinance that, once enacted, will prohibit smoking in many public places throughout city limits, including in parks, near playgrounds and within 25 feet of business entrances.

The penalties for violating the provisions of the ordinance, which also includes a section related to cigarette butt littering, could result in both an infraction punishable by a $250 fine if a person is found guilty and an administrative citation from the city that carries the same $250 pricetag.

“I’m thrilled we’re finally getting this passed,” Council member Kathryn Murray said. “It’s something I’ve been waiting for for a long time.”

The council passed the ordinance in front of about a dozen sixth graders from Crescent Elk Middle School who spoke to the elected officials about the importance of preventing tobacco use. Each child’s comments were greeted with applause from the audience and approving smiles from many of the council members.

“I think it’s timely and I think it’s responsive for what we heard from the community,” Council member Charles Slert said about new smoking law.

Under the ordinance, smoking is prohibited in all city buildings and vehicles. It is also a violation to smoke in public parks, at public events, such as a farmer’s market, parade or festival, and within 25 feet of all public entrances to buildings, offices and businesses open to the general public.

Last October, city officials considered creating a stricter smoking ordinance, one that would have extended the 25 foot boundary in front of buildings to 50 feet and make employers provide cigarette butt receptacles at their businesses.

But according to a staff report written by Deputy City Attorney Martha Rice, the 50 foot barrier was “slightly unreasonable” when compared with other data, and forcing employers to provide receptacles could put an  “impractical burden” burden on businesses, especially downtown, because the containers tend to invite smokers and would likely be placed within 25 feet of an entrance.

One of Rice’s suggestions in her report is to have the city eventually place its own receptacles around the city in areas of concern, and was an idea Slert agreed should be explored.

The ordinance was developed with direction from City Council members and non-profit organizations, and through consultation with Jeff Wolsfeld, the health education coordinator for the Del Norte County’s Tobacco Use Prevention Program.

At Monday’s meeting, Wolsfeld thanked the City Council for moving ahead on the smoking ordinance, and said his group would help pay for signage around the city parks and playgrounds.

“This is like a dream come true,” he said. “You’ve exceeded our expectations.”

A first reading of the smoking ordinance was completed Monday evening, and a second reading is needed before the law is actually adopted. It will take effect 30 days after the second reading, which will likely be at the next City Council meeting.

The report, which is entitled as ‘Tobacco, Illness, and the Physician’s Perspective’ states that, smoking, costs the Canadian health-care scheme $1.6 billion per year. It is also responsible for 85% of lung cancers and 30% of cancer fatalities.

As per the report, there are 2.3 million people, who are regular smokers of the nation.

The doctor’s panel stated that after taking into consideration growth in the county’s populace, from 6.7 million in the year 1966 to no less than 12 million now, the percentage of population that smoke is minor, however, on the whole, the figure of smokers continue to be high.

OMA President, Dr. Suzanne Strasberg said that what everyone sees is very disappointing, but the simple reality that remains is that there are still so many people who are addicted to smoking and who experience preventable tobacco-induced ill health, and it is having a large impact on the health-care system of the country.

The findings were presented Tuesday at the American Association for Cancer Research’s annual meeting in Washington, D.C.

In the first report, a team led by Dr. Jing Ma, an associate professor of medicine at Brigham and Women’s Hospital in Boston, found that obesity and smoking may not be risk factors for developing prostate cancer, but they do increase the odds that a man who has the illness will die from it.

Being heavy and smoking “predispose men to a significantly high risk of cancer-specific and all-cause mortality,” Ma said during a Tuesday morning news conference.

“Compared to lean non-smokers, obese smokers had the highest risk of prostate cancer mortality,” she said.

For the study, Ma’s team collected data on more than 2,700 men with prostate cancer who took part in the Physicians Health Study. Over 27 years of follow-up, 882 of the men died, 11 percent from the cancer.

The researchers found that both weight gain and smoking boosted the risk for dying from the cancer. In fact, every five-point increase in body mass index (BMI) increased the risk for dying from prostate cancer by 52 percent. BMI is a measurement of height versus weight, with the threshold of overweight set at a BMI of 25 and the threshold for obesity set at a BMI of 30.

In addition, men who smoked increased their risk for dying from the cancer by 55 percent, compared with men who never smoked, the study found.

“These data underscore the need for implementing effective preventive strategies for weight control and reducing tobacco use in both healthy men as well as prostate cancer patients,” Ma said.

In a second report, a team led by Corinne E. Joshu, a postdoctoral fellow in the department of epidemiology at Johns Hopkins Bloomberg School of Public Health, found that men who gained weight after having their prostate removed were almost twice as likely to see their cancer return as were men who maintained their weight.

“Weight gain may increase the risk of prostate cancer recurrence after prostatectomy,” Joshu said during the AACR news conference. “Obesity, especially among inactive men, may also contribute to the risk of prostate cancer recurrence,” she said.

For the study, Joshu’s team collected data on more than 1,300 men with localized prostate cancer who underwent prostatectomy between 1993 and 2006. In addition, the men completed a survey on diet, lifestyle and other factors such as weight, height and physical activity five years before surgery and again one year after the procedure.

By the end of the study in 2008, 102 men saw their prostate cancer return. These men were older, more likely to have more aggressive tumors and less likely to have a family history of prostate cancer, compared with men whose cancer did not return, the researchers found.

Furthermore, men who had gained at least five pounds before surgery or up to one year after surgery had almost a two-fold greater chance of seeing their cancer return than did men who did not gain weight, Joshu said.

Five years before undergoing a prostatectomy, 54 percent of the men were overweight and nine percent were obese. Among men who gained weight in the year after surgery, the average weight gain was about 10 pounds. Becoming obese after surgery increased the risk for a recurrence of prostate cancer 1.7-fold, the researchers said.

“By avoiding obesity and weight gain,” Joshu said, “men with prostate cancer may be able to both prevent recurrence but also improve their overall well-being.”

In another report presented Monday at the meeting, Katherine A. McGlynn, a senior investigator at the U.S. National Cancer Institute, said that the proper control of diabetes might cut people’s odds of developing liver cancer.

The researchers used the SEER-Medicare linked database to collect data on more than 5,600 people diagnosed with liver cancer. Among them, 63 percent of the cancers were associated with conditions such as diabetes, alcohol-related disorders and hepatitis C, chronic hepatitis B, obesity and several rare metabolic disorders. The relationship was highest for Asians, at 67.9 percent, and lowest for blacks, at 53.5 percent, the researchers noted.

Among the risk factors, the leading cause of liver cancer was diabetes (33.5 percent). Other factors determined to be contributors to liver malignancy were alcohol-related disorders (23.9 percent), hepatitis C (20.7 percent), hepatitis B (5.7 percent), rare metabolic disorders (3.1 percent) and obesity (2.7 percent).

That left 37 percent of liver cancers with indeterminate origins, McGlynn noted. “We have a long way to go because one-third of the tumors are not explained by these risk factors,” she said during Tuesday’s news conference.

Such in-your-face tobacco advertising has been banned for years in the U.S. and many other countries. But in Indonesia, the world’s fourth most populous nation, tobacco companies have virtual free rein to peddle their products, from movies to sports sponsorships and television shows. The country remains one of the last holdouts that has not signed the World Health Organization’s tobacco treaty.

As smoking has declined in many Western countries, it has risen in Indonesia — about 63 percent of all men light up and one-third of the overall population smokes, an increase of 26 percent since 1995. Smoking-related illnesses kill at least 200,000 annually in a nation of 235 million.

“Indonesia is a big concern, a big epidemic, a big population, and very little control,” said Dr. Prabhat Jha, a tobacco control expert at the University of Toronto’s Center for Global Health Research. “They have a chaotic taxation and regulatory structure. They have made the mistake of letting the Marlboro Man into the country.”

In recent months, anti-tobacco forces have rallied. A new health law has declared smoking addictive and urged the government to hammer out tobacco regulations. An anti-smoking coalition is pushing for tighter restrictions on smoking in public places, advertising bans and bigger health warnings on cigarette packages.

Public debate also exploded last month after Indonesia’s second-largest Islamic organization, Muhammadiyah, issued a fatwa banning smoking. Though not legally binding, the religious ruling does put pressure on smokers in the world’s most populous Muslim nation.

Anti-smoking advocates now hope Clarkson will drop the sponsorship of Indonesia’s third-largest tobacco company, Djarum. A growing number of voices have started pleading with the Grammy-winning pop star on her Facebook page.

Two years ago, a tobacco affiliate of U.S.-based Philip Morris International, which dominates Indonesia’s tobacco market, removed its logo from ads promoting an Alicia Keys concert in Jakarta after the singer publicly denounced the sponsorship and apologized to her fans.

“If Kelly Clarkson goes ahead with the concert, she is by choice being a spokesman for the tobacco industry and helping them to market to children,” said Matt Myers, president of the U.S.-based Campaign for Tobacco-Free Kids, which has urged Clarkson to drop the sponsorship.

“She has the power now to turn this situation around and to send a clear message to Indonesian young people and, frankly, to the young people of the world.”

The Associated Press left messages and e-mailed representatives at Clarkson’s management company, Starstruck Entertainment in Nashville, as well as representatives at her record label, RCA Records in New York. Neither responded to repeated requests for comment.

About a quarter of Indonesian boys aged 13 to 15 are already hooked on cigarettes that sell for about $1 a pack or as little as a few cents apiece, according to WHO. A video on YouTube last month prompted outrage when a 4-year-old Indonesian boy was shown blowing smoke rings and flicking a cigarette. His parents say he’s been smoking up to a pack a day since he was 2.

L.A. Lights company Djarum declined to comment on its sponsorship of the April 29 Clarkson concert, or on accusations that it markets cigarettes to young people. But the company’s international brand manager, Roland Halim, said it abides by government restrictions on tobacco advertising.

Philip Morris affiliate HM Sampoerna said in a statement it has urged the government to adopt tougher regulations on cigarette sales and ads, including age limits on buying tobacco, billboard restrictions and the phasing out of television commercials.

“We recognize that our products, like all tobacco products, cause disease and are addictive,” it said. “Our advertising is intended solely for adult smokers. We sponsor events in compliance with Indonesian law. We do not advertise to minors.”

Smoking is embedded in Indonesia’s culture. Wafts of a pungent mixture of tobacco and cloves, called kreteks, can be smelled in houses rich and poor across the vast archipelago.

According to a 2008 study on tobacco revenue in Indonesia, smokers spend more than 10 percent of their household income on cigarettes; that’s three times more than they spend on education-related expenses such as school fees and books.

Indonesia remains one of the last places in the world where cigarette TV commercials still run, featuring rugged men and beautiful women smoking. Billboards plastered above four-lane highways encourage motorists stuck in Jakarta’s notorious traffic jams to “Go Ahead” or “Become a Man” or let Marlboro Lights “Style Your Party.”

Leggy women in short skirts and strappy heels promote cigarettes at events, sometimes even giving out discounted or free samples to “taste.”

Indonesia’s tobacco industry employs millions in the world’s fifth-largest cigarette-producing market. About 6 percent of the government’s revenue comes from cigarette taxes, and a powerful tobacco lobby has blocked past regulation attempts, including a move to ban TV ads.

Indonesian cigarettes are cheap by regional standards, with taxes less than 40 percent. Tobacco farmers have held massive street protests to denounce any push for higher taxes or tighter restrictions.

“Kretek cigarettes are Indonesia’s heritage just like cigars in Cuba,” ” said Nurtantio Wisnu Brata, chair of the Central Java chapter of the Indonesian Tobacco Farmers Association.

Any move to limit tobacco promotion and use in the country will require strong political will. But critics point out that even Indonesia’s smoke-happy neighbors China and Vietnam have signed the WHO’s tobacco treaty and imposed stronger controls.

“The level of advertising in Indonesia is unmatched anywhere else in Asia,” said Mary Assunta, senior policy adviser for the Southeast Asia Tobacco Control Alliance. “The Marlboro Man has ridden into the sunset in many countries, but not in Indonesia.”

There are about 2.3 million smokers in the province now compared with 2.1 million 45 years ago.

About 19% of Ontarians over the age of 12 smoke cigarettes.

“It’s unfortunate, but the simple fact is there are still far too many people who smoke and who suffer from preventable tobacco-induced illness and it is having a significant impact on our health-care system,” Dr. Suzanne Strasberg, president of the OMA, said.

Smoking-related cardiovascular disease is responsible for more than 6,000 deaths a year.

Strasberg says health care professionals need a commitment from the government in the fight against tobacco.

She says the government has taken aim at reducing the use of tobacco and curbing exposure to second-hand smoke.

“But there is more work to be done,” Strasberg said.

“I want to stress there is a tendency to demonize smokers, which we do not think is justified and not the intent of this report. People may choose to start smoking, but tobacco is a serious addiction and should be treated as such.”

The OMA wants a comprehensive province-wide system to help people quit smoking.

It also wants a reduction in the number of retail tobacco outlets and a moratorium on the sale of new tobacco products.

“Ontario’s doctors know patients want to lead healthier lives and we will remain vigilant in our commitment to not only help people who want to quit but to educate others who are thinking about lighting up,” Strasberg said.

— — —

SMOKING FACTS

Tobacco use accounts for 85% of lung cancers.

Tobacco costs Ontario’s health-care system $1.6 billion a year.

Smokers who want to quit and would like additional help either don’t know where to get it or just can’t afford it.

Many smokers don’t realize that quitting can take several attempts.

In 2009, one in five cigarettes smoked was contraband.

Yanuar Ilyas, head of the fatwa department at Muhammadiyah, Indonesia’s second largest Muslim organization, said as it had previously declared smoking haram (forbidden), all things related to it were also forbidden, adding that it was not necessary to issue a new fatwa (religious edict).

“We do not need to put another fatwa on a thing that is already clear,” Yanuar told the Jakarta Globe.

Yanuar also said that associating the famous singer with the cigarette brand L.A. Lights, was “a clear phenomenon that the cigarette company is attempting to recruit younger people.”

The ban will have little impact on the concert actually going ahead, however, with the vast majority of religious rulings ignored.

It will, however, create additional pressure those behind the concert to remove the offending advertising.

The concert promoters behind the controversial concert on April 29 say they are expecting to be able to release a statement on the issue later this afternoon.

The one-off event has sparked criticism after it was revealed it was being sponsored by the Djarum tobacco company and its brand of L.A. Light cigarettes.

A spokeswoman for promoters JAVA Musikindo said they were discussing the controversy and were expecting to make a statement soon.

Promoter Adrie Subono, however, did tweet on the social networking Web site Twitter, that “2,513 of my hairs fell out, I have a headache.”

The promoters have used Clarkson’s fame to erect giant banners and billboards depicting the singer’s image and advertising for the cancer-causing products.

The move drew sharp criticism from the Campaign for Tobacco-Free Kids in the United states.

“If Kelly Clarkson goes ahead with the concert, she is by choice being a spokesman for the tobacco industry and helping them to market to children,” Group president Matt Myers was quoted by E! Online as saying.

“She has the power now to turn this situation around and to send a clear message to Indonesian young people and, frankly, to the young people of the world.”

As smoking has declined in many Western countries, it has risen in Indonesia — about 63 percent of all men light up and one-third of the overall population smokes, an increase of 26 percent since 1995. Smoking-related illnesses kill at least 200,000 annually in a nation of 235 million.

Discussion about the issue on the Jakarta Globe Facebook Web site generated considerable discussion, with many, though not all, against the advertising.

One participant, identified as Christopher Lingle, a Hong Kong-based professor, urged others to “ignore the health fascists.”

“Leave other people alone, even if their personal habits might cause them problems. Indonesians do not complain about how fat so many Americans are!” he wrote.

It is not the first time cigarette sponsorship has drawn controversy in the capital.

In 2008, Alicia Keys was forced to “apologize for any misleading advertising initially associated with the show” after Philip Morris International advertisements for its A Mild cigarettes appeared on promotional billboards and posters for her concert.

“I am an unyielding advocate for the well-being of children around the world and do not condone or endorse smoking,” she said. “I look forward to bringing my music and message to my wonderful fans in Jakarta.”

Clarkson is yet to comment on the latest controversy.