Tobacco Control Policy

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Tobacco Control Policy

• Linda Waverley, MSc, PhD
• Research for International Tobacco Control (RITC)

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Global Burden of Non Communicable Diseases (NCDs)

• Tobacco use linked causally to cancers,
  cardiovascular disease, respiratory diseases,
  tuberculosis, and diabetes
• Population aging and changes in risk factors have
  accelerated the epidemic of NCDs in many
  developing countries
• Burden of NCDs is increasing, accounting for
  nearly half of the global burden of disease (all
  ages)
• Many developing countries now face a double
  burden

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Why is Tobacco Unique as a Policy Issue?

• Tobacco use sustained through addictive
  properties, low prices, social norms, vigorous
  marketing by powerful multinational corporations
• Perceived by many to contribute to social and
  psychological well-being
• Tobacco epidemic exacerbated by complex factors
  with cross border effects, including trade
  liberalization, foreign direct investment, global
  marketing transnational advertising, promotion
  and sponsorship international movement of
  contraband and counterfeit cigarettes.

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Global Tobacco Consumption

• Approximately 1.3 billion people smoke cigarettes
  (1 in 5 of the worlds population 1 in 3 of
  those over 15)
• Global prevalence (2000) 29 (47
  men 10 women)
• One in two long-term smokers will die from a
  tobacco related disease - many before 65
• Tobacco expected to be the leading global cause
  of death before age 65 by 2020

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Past and Future Annual Deaths due to Tobacco Use
Source Who (2002) The Tobacco Atlas, p.36.
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Stages of the Tobacco Epidemic
Source WHO, 1995, after Peto Lopez
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Policy Challenges in Developing Countries

• Appropriate balance between
• Population Strategies
• High Risk Strategies
• Need to switch from an infectious disease
  paradigm to primary and secondary prevention
• Need to incorporate economic policies as well as
  health policies (e.g. tobacco taxes)

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The Framework Convention on Tobacco Control (FCTC)

• First global treaty to focus on a health issue
• Negotiated under the auspices of the WHO
• Came into force in Feb. 2005 following
  ratification by 40 countries
• 168 signatories 116 parties
• Includes demand and supply reduction strategies

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The FCTCincludes a variety of policy measures

• Price and tax measures to reduce demand
• Non-price measures
• Protection from exposure to tobacco smoke
• Regulation of the contents of tobacco products
• Regulation of tobacco product disclosures
• Packaging and labelling of tobacco products
• Education, communication, training and public
  awareness
• Tobacco advertising promotion and sponsorship
• Demand reductions measures concerning tobacco
  dependence and cessation

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The FCTCincludes a variety of policy measures

• Supply reduction provisions include
• Illicit trade in tobacco products
• Sales to and by minors and
• Provision of support for economically viable
  alternative activities.

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Recurring Concerns regardingTobacco Control
Research

• Lack of standardized and comparable data
• Need to focus on high-risk populations
• Absence of a network for communication of
  information, data, and best practices
• Need for better understanding of knowledge
  brokering
• Lack of adequate capacity for tobacco control
  research (especially in non-health related areas
  such as economics and policy analysis)
• Need for concerted mobilization of human and
  financial resources

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South Africaas a model for policy-making

• A policy window
• A champion in the Minister of Health
• Strong advocacy
• A sound research base
• Framing as both a health and an economic issue

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Cigarette prices and consumption
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Cigarette excise taxes and government revenue
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Tobacco Control as a Model for Other Risk Factors

• Comprehensive approach no silver bullet
• Prevention, promotion, protection and treatment
• Successful strategy includes programming, policy,
  research, communication and community development
• Multi-site interventions
• Evidence-based policy
• Country-specific evidence

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Thank YouResearch for International Tobacco
Control (RITC)http//www.idrc.ca/ritc
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Prevalence () of Never, Former and Current
Smokers in Controls by Region (INTERHEART Study)