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Hiilamo H.,Social Insurance Institution of Finland | Crosbie E.,University of California at San Francisco | Glantz S.A.,University of California at San Francisco
Tobacco Control | Year: 2014

Objective: To analyse the evolution and diffusion of health warnings on cigarette packs around the world, including tobacco industry attempts to block this diffusion. Methods: We analysed tobacco industry documents and public sources to construct a database on the global evolution and diffusion of health warning labels from 1966 to 2012, and also analysed industry strategies. Results: Health warning labels, especially labels with graphic elements, threaten the tobacco industry because they are a low-cost, effective measure to reduce smoking. Multinational tobacco companies did not object to voluntary innocuous warnings with ambiguous health messages, in part because they saw them as offering protection from lawsuits and local packaging regulations. The companies worked systematically at the international level to block or weaken warnings once stronger more specific warnings began to appear in the 1970s. Since 1985 in Iceland, the tobacco industry has been aware of the effectiveness of graphic health warning labels (GWHL). The industry launched an all-out attack in the early 1990s to prevent GHWLs, and was successful in delaying GHWLs internationally for nearly 10 years. Conclusions: Beginning in 2005, as a result of the World Health Organisation Framework Convention on Tobacco Control (FCTC), GHWLs began to spread. Effective implementation of FCTC labelling provisions has stimulated diffusion of strong health warning labels despite industry opposition. Source


Sanders-Jackson A.N.,University of California at San Francisco | Song A.V.,University of California at Merced | Hiilamo H.,Social Insurance Institution of Finland | Glantz S.A.,University of California at San Francisco
American Journal of Public Health | Year: 2013

Objectives. We quantified the pattern and passage rate of cigarette package health warning labels (HWLs), including the effect of the Framework Convention on Tobacco Control (FCTC) and HWLs voluntarily implemented by tobacco companies. Methods. We used transition probability matrices to describe the pattern of HWL passage and change rate in 4 periods. We used event history analysis to estimate the effect of the FCTC on adoption and to compare that effect between countries with voluntary and mandatory HWLs. Results. The number of HWLs passed during each period accelerated, from a transition rate among countries that changed from 2.42 per year in 1965-1977 to 6.71 in 1977-1984, 8.42 in 1984-2003, and 22.33 in 2003-2012. The FCTC significantly accelerated passage of FCTC-compliant HWLs for countries with initially mandatory policies with a hazard of 1.27 per year (95% confidence interval = 1.11, 1.45), but only marginally increased the hazard for countries that had an industry voluntary HWL of 1.68 per year (95% confidence interval = 0.95, 2.97). Conclusions. Passage of HWLs is accelerating, and the FCTC is associated with further acceleration. Industry voluntary HWLs slowed mandated HWLs. Copyright © 2013 by the American Public Health Association®. Source


Salminen A.-L.,Social Insurance Institution of Finland | Karhula M.E.,GeroCenter Foundation for Research and Development
Scandinavian Journal of Occupational Therapy | Year: 2014

Objective: To describe the challenges to activity and participation faced by young people with visual impairment within the framework of the International Classification of Functioning (ICF). Methods: 14 young persons (aged 16-22 years) with visual impairment and their parents (n = 22) participated in the study. The Canadian Occupational Performance Measure (COPM) was used to describe challenges of participation as perceived by the young persons themselves. Individual interviews with the young persons and their parents were used to investigate in more depth the challenges the young persons face with regard to participation. Results: Young persons with visual impairment face challenges to participation most frequently with regard to mobility, domestic life, interpersonal interaction and relationships, major life areas, and leisure activities. The environment in which they live has a central role as a barrier or facilitator of participation. Conclusions: The challenges related to activities and participation that young persons with visual impairment face are diverse. It is important that these challenges are assessed individually and with the help of subjective measures. Serving as a broad framework for classifying the data, the ICF proved to be a useful tool, but used strictly at category level it may limit the coding of data and narrow interpretation. © 2014 Informa Healthcare. Source


Lamminpaa A.,State Treasury | Vaananen-Tomppo I.,State Treasury | Hinkka K.,Social Insurance Institution of Finland
Journal of Occupational and Environmental Medicine | Year: 2011

OBJECTIVE: To study the association between employee well-being and sick leave, occupational accident, and disability pension. METHODS: A random population of 967 civil servants participated in a survey on psychosocial factors and health at work in 2000 in Finland. The median follow-up time was 7.3 years. RESULTS: The risks of sick leave and disability pension were decreased by job satisfaction (RR = 0.78, 95% CI = 0.58 to 1.05; RR = 0.47, CI = 0.20 to 1.06; respectively), good work ability (RR = 0.35, CI = 0.22 to 0.56; RR = 0.11, CI = 0.04 to 0.33), good health (RR = 0.42, CI = 0.27 to 0.64; RR = 0.32, CI = 0.11 to 0.98), and strong sense of coherence (RR = 0.53, CI = 0.36 to 0.79; RR = 0.17, CI = 0.07 to 0.37). Employee well-being was also associated with occupational accident but somewhat less consistently. CONCLUSIONS: Employee well-being is associated with sick leave, occupational accident, and disability pension. It is important to find means to support employee well-being both in general and at work. ©2011The American College of Occupational and Environmental Medicine. Source


Hiilamo H.,Social Insurance Institution of Finland | Glantz S.A.,University of California at San Francisco
Tobacco Control | Year: 2013

Objective To analyse how local tobacco companies in the Nordic countries, individually and through National Manufacturers' Associations, cooperated with British American Tobacco and Philip Morris in denying the health hazards of smoking and undermining tobacco control. Methods Analysis of tobacco control policies in the Nordic countries and tobacco industry documents. Results Nordic countries were early adopters of tobacco control policies. The multinational tobacco companies recognised this fact and mobilised to oppose these policies, in part because of fear that they would set unfavourable precedents. Since at least 1972, the Nordic tobacco companies were well informed about and willing to participate in the multinational companies activities to obscure the health dangers of smoking and secondhand smoke and to oppose tobacco control policies. Cooperation between multinational companies, Nordic national manufacturer associations and local companies ensured a united front on smoking and health issues in the Nordic area that was consistent with the positions that the multinational companies were taking. This cooperation delayed smoke-free laws and undermined other tobacco control measures. Conclusions Local tobacco companies worked with multinational companies to undermine tobacco control in distant and small Nordic markets because of concern that pioneering policies initiated in Nordic countries would spread to bigger market areas. Claims by the local Nordic companies that they were not actively involved with the multinationals are not supported by the facts. These results also demonstrate that the industry appreciates the global importance of both positive and negative public health precedents in tobacco control. Source

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