Tobacco Use - Tobaccosis - ICTOH

23
Tara Singh Bam The Union Asia Pacific, Singapore [email protected] Tobacco control: Best practices

Transcript of Tobacco Use - Tobaccosis - ICTOH

Tara Singh Bam

The Union Asia Pacific, Singapore

[email protected]

Tobacco control: Best practices

http://www.worldtobacco.co.uk/asia/

Indonesia is a recognized tobacco-friendly market with no smoking bans or other restrictions and regulations in contrast to neighboring ASEAN countries.

Tobacco emergency

• About 800 million adult men worldwide smoke cigarette (20% in high income and 80% in low income countries)

• Nearly 200 million adult women worldwide smoke cigarette

• Each year Tobacco kills more

than 5 million worldwide

and > 200,000 people in Indonesia

World cigarette consumption (5.9 trillion) by region, 2009

Source: World Health Organization

Tobacco Is Now the World’s Leading

Single Agent of Death

5.0

3.9

3.0

1.8 1.71.2 1.0

0.6

0

1

2

3

4

5

6

Tobacco Lower

Resp

Infect

AIDS Diarrheal

Disease

TB Traffic

Injuries

Malaria Measles

Glo

ba

l D

ea

ths

pe

r Y

ea

r

(millio

ns

)

Unless urgent action is taken, tobacco will soon kill twice as many people and could

kill 1 billion people this century

Source: World Health Organization

Interventions are needed

– prevent youth from starting to

use tobacco

– encourage and help users to

quit

180

parties

The International Responses

MPOWER- A key strategy

Source: World Health Organization

• monitor tobacco use and prevention

policies

• protect people from tobacco smoke

• offer help to quit tobacco use

• warn about the dangers of tobacco

• enforce bans on tobacco advertising,

promotion and sponsorship

• raise taxes on tobacco

Source: Levy et al "Smoking-related deaths averted due to three years of policy progress", Bulletin, WHO 2013, 91:509–518

Raise tobacco taxes

Protect air

Warnings on

packages

Offer cessation Enforce marketing bans

0 million

1 million

2 million

3 million

4 million

5 million

6 million

7 million

8 million

Deaths averted by 2050

Effective policy reduces smoking-related deaths The evidence from 41 countries

Best Practices Pictorial Health Warnings

Pictorial Health Warnings are effective

• Educate people on danger of tobacco use

• Motivate smokers/tobacco users to quit

• Convince youth not to start smoking/tobacco use

• Re-convince ex-tobacco users to remain quitter

Countries requiring picture warnings on cigarette packages- 2016

1 2 2 3 5 11 12

18

26

34 40

55

63

70

77

102 105

0

20

40

60

80

100

120

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

Source: Cigarette packaging health warnings. International Status Report 2016, Canadian Cancer Society Global Tobacco Epidemic 2015. World Health Organization

50%+ Countries/jurisdictions requiring warnings of at least 50% of package (on average)

24 32

46

66

94

0

10

20

30

40

50

60

70

80

90

100

2008 2010 2012 2014 2016

Source: Cigarette packaging health warnings. International Status Report 2016, Canadian Cancer Society Global Tobacco Epidemic 2015. World Health Organization

Pictorial Health Warning in South and South East Asian Countries

90% 85% 85% 85%

80% 75% 75% 75%

55% 55% 50% 50% 50% 50%

40%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Source: Cigarette packaging health warnings. International Status Report 2016, Canadian Cancer Society Global Tobacco Epidemic 2015. World Health Organization

Nepal 90% Thailand 85% India 85% Sri Lanka 80%

Brunei 75% Myanmar 75%

Larger Pictorial Health Warning

Malaysia 55% Lao PDR

Cigarettes produced in Indonesia carry a 90% pictorial health warning on packaging for Nepal, 75% PHW for

Brunei and plain packaging for Australia

Nepal 90% Brunei 75% Plain Packaging Australia

Myanmar- Comparison between text and pictorial health warning in building public awareness on danger of

tobacco use

34.1%

85.9%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Textwarning

PictorialWarning

Not scary Scary

37.6%

88.1%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Textwarning

Pictorialwarning

Not scary Scary

Adult population Youth population

Source- Ministry of Health, Myanmar 2014

Evidences proved that PHWs are effective

• In Thailand, nine out of 10 current smokers noticed a pictorial health warning on cigarette packs, and six in 10 current smokers intended quitting because of PHW (GATS 2011)

• In Australia, PHW and plain packaging was found effective. Number of adolescents currently smoking reduced by more than 70 per cent, from 23.5% in 1996 to 6.7% in 2014 (Dessaix A et al Public Health Res Pract. 2016).

Larger pictorial health warnings are effective PHW made the smokers to reduce cigarettes smoked/day

Indonesia Nepal

Source: Indonesian Public Health Association, 2015 (N=5355, current smokers – 1901)

Action Nepal and Nepal Health Research Council, 2015 ( N = 2250, current smokers - 670)

15

11

0

2

4

6

8

10

12

14

16

Cigarettes smoked(text warnings)

Cigarettes smoked(PHW)

11

5

0

2

4

6

8

10

12

14

16

Cigarettes smoked(text warnings)

Cigarettes smoked(PHW)

27% 55%

Retailers support Pictorial health warnings

policies and implementation

84.6% of the

retailers support government policy on pictorial health warnings

90% of the retailers

were found selling cigarettes with pictorial health warning

92.6% of the

retailers support government policy on pictorial health warnings

99.3% of the

retailers were found selling cigarettes with pictorial health warnings

Indonesia (N = 1425) Nepal (N = 270)

Source: Tobacco Control Support Centre, Indonesian Public Health Association, 2015

Action Nepal and Nepal Health Research Council, 2015

Indonesia: RI farmers support tougher

tobacco control, study says -

62.5%

83.3%

70.4%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Current tobaccofarmers

Ex-tobacco farmers All

Don't know

Not support

Support

Source: http://www.thejakartapost.com/news/2015/10/28/ri-farmers-

support-tougher-tobacco-control-study-says.html#sthash.GYBfj6fJ.dpuf

Muhammadiyah University Yogyakarta, October 2015

Public Health WINS • UK- Tobacco companies have lost a High Court challenge over

government “standardised packaging” – 19 May 2016

• European Union (EU)- Tobacco companies have lost a legal challenge against EU rules that force them to put graphic images on cigarette packages warning people of the dangers of smoking – 4 May 2016

• India – Supreme Court ruling to require 85% pictorial health warning – 4 May 2016

• India - The Supreme Court issued notice to the Health Ministry on a PIL which sought immediate implementation of plain packaging rules for cigarette and other tobacco products – 8 March 2016

Summary

• Larger PHWs are more effective

• All segments of community support PHW; public, youth, retailers and tobacco farmers

• PHW is the most cost effective strategy – No cost to government, easy to implement and monitor – Government commitments

Indonesia: Let’s join hands together to increase a size pictorial health warning to at least 75%

Indonesia- ready for larger pictorial health warning and plain packaging

Text warning 40% PHW 90% PHW Plain packaging