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Global Tobacco Surveillance: The Opportunity is Now

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Household and School-based Comparison. Household. expensive. lot of time and effort required ... their surveys. GSPS. Global School Personnel Survey, 2000-2004 ... – PowerPoint PPT presentation

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Title: Global Tobacco Surveillance: The Opportunity is Now


1
Global Tobacco Surveillance The Opportunity is
Now
World Health Organization
2
Potential Opportunities
  • Establishing International Surveillance System
    for Tobacco Control
  • Youth (GYTS)
  • Monitoring Country National Tobacco Control
    Action Plans
  • Monitoring FCTC Articles
  • -- Adults (GSPS and GHPS)
  • Monitoring Country National Tobacco Control
    Action Plans
  • Monitoring FCTC Articles

3
Establishing International Surveillance System
for Tobacco Control
Youth Global Youth Tobacco Survey
(GYTS) Adults Global School Personnel Survey
(GSPS) Global Health Professionals Survey
(GHPS)
4
Fundamental Principles
  • Partnerships
  • Consistency
  • questionnaire content
  • methods implementation
  • data management
  • Sustainability
  • Cost effectiveness
  • Feasibility of repeat surveys

5
(No Transcript)
6
Global Youth Tobacco Survey
  • Purpose
  • To enhance the capacity of countries to design,
    implement, and evaluate their comprehensive
    tobacco control programs and to monitor the FCTC

7
GYTS Topics
  • Tobacco use
  • Media and advertising exposure
  • Secondhand smoke exposure
  • Access to tobacco products
  • Cessation
  • School curriculum

8
How do the components relate to tobacco
prevalence?
9
Direct Determinants of Tobacco Use
Access/Availability Price
Knowledge Attitudes
ETS Exposure
School Curriculum
Tobacco Use Prevalence
Media Advertising
Cessation
10
GYTS Development Methodology
  • What type of survey?
  • Household vs. School

11
GYTS Development Methodology
Household and School-based Comparison
  • Household
  • expensive
  • lot of time and effort required
  • less reliable responses
  • School-based
  • relatively cheap
  • quick
  • very reliable responses

12
GYTS Development Methodology
  • What grade or ages?
  • Country review showed drop-out rate was
    substantial after age 15
  • Concern with comprehension for very young
    students
  • Group decided to focus on grades with ages 13-15

13
GYTS Methodology
  • Two-stage sample design
  • First, schools selected proportional to
    enrollment size
  • Second, classrooms chosen randomly in selected
    schools
  • All students in selected classes eligible for
    participation

14
GYTS Methodology
  • CDC already had the software developed for this
    methodology
  • Countries, WHO, and CDC would work together to
    determine
  • the geographic scope of each country survey
  • the sample size of schools
  • the sample size of students

15
GYTS Methodology
  • All Countries, WHO and CDC agreed
  • Countries would provide CDC with school
    enrollment files in electronic format for sample
    selection
  • CDC would select all of the samples and provide
    all data management forms to the countries

16
GYTS Questionnaire
  • Numerous existing surveys on youth tobacco use
    were reviewed

17
GYTS Core Questionnaire Components
  • Prevalence Consumption
  • Knowledge and attitudes
  • Young peoples access/availability price
  • Environmental tobacco smoke (ETS)
  • Cessation
  • Media and advertising
  • School curriculum

18
Data Collection Procedures
  • Self Administered
  • Anonymous
  • Use generic Answer Sheet
  • No more than 99 questions (recommend 75-80)
  • no skip patterns (answer all questions)
  • maximum of 8 response categories

19
GYTS Plan
  • Program
  • Workshop
  • Media
  • ETS
  • Cessation
  • School
  • Access/Availability
  • Analysis
  • Workshop
  • Epi Info Training
  • Analysis of Data
  • Report Writing
  • Survey Workshop
  • sampling procedures
  • survey administration

Conduct GYTS
Report Data
Evaluate and Modify Programs
Tobacco Control Program
Repeat GYTS Every 3-4 Years
Implement Programs
20
GYTS Country Summary
21
GYTS
  • Active in 151 countries
  • 1.7 million students have participated
  • More than 30 countries are now
  • repeating their surveys

22
Global Youth Tobacco Survey
23
Key GYTS Findings
  • 1 in 7 students smoke cigarettes
  • 1 in 4 smokers first tried by age 10
  • 2 in 3 smokers want to quit immediately
  • Half of students exposed to smoke in homes
  • 80 saw tobacco ads
  • Source Tobacco Control 200211252-270

24
Potential Opportunities
  • Monitor Country National Tobacco Control Action
    Plans
  • Monitor WHO FCTC Articles

25
Monitoring Country National Action Plans
  • WHO Region Office Tobacco Control Staff are
    working with Member States to develop Country
    Tobacco Control Action Plans
  • GYTS has been used by countries to
  • Develop Action Plan Objectives
  • Focus Legislation on Tobacco Control
  • Evaluate Tobacco Control Components

26
Philippines 2000 to 2003
  • Over 30 decline in cigarette smoking
  • Almost 40 decline in other tobacco use
  • Factors influencing the change
  • Clean Air Act of 1999
  • Smoking Cessation Program of 2003
  • Tobacco Regulatory Act of 2004

27
Country Use of GYTS Data
  • Media and Advertising
  • Egypt 2002 Law Total ban on ads sales to
    minors
  • Niger MOH calling for restrictions on tobacco
    advertising
  • Philippines Tobacco Regulatory Act 2003
    Regulates the packaging, use, sales distribution,
    ads of tobacco products
  • India 2003 Law Total ban on ads promotion

28
Country Use of GYTS Data
  • Assessment of School Health Education Programs
  • Egypt
  • Jordan
  • Haiti
  • Philippines
  • Saudi Arabia
  • Serbia
  • United Arab Emirates
  • Uruguay
  • Cuba
  • Costa Rica

29
Monitoring FCTC Articles
  • Article 8 Protection from exposure to tobacco
    smoke
  • Article 12 Education, communication, training
    public awareness
  • Article 13 Tobacco advertising, promotion
    sponsorship
  • Article 14 Demand reduction measures concerning
    tobacco dependence and cessation
  • Article 16 Sales to by minors

30
Justification FCTC monitoring protocol…Sec. 20.2
  • …integrate tobacco surveillance programs into
    national, regional, and global health
    surveillance programs so that data are comparable
    and can be analyzed at the regional and
    international levels, as appropriate.

31
Article 21 Reporting and Exchange of
Information
32
Percent Current Cigarette Smoking and Current Use
of Other Tobacco Products, Global Youth Tobacco
Survey by WHO Region
33
Article 13 Tobacco advertising, promotion and
sponsorship
34
Percent Media Exposure, Global Youth Tobacco
Survey by WHO Region
35
Percent With Tobacco Logo on Object or Offered
Free Cigarettes, Global Youth Tobacco Survey by
WHO Region
Have Tobacco Logo on an Object
Offered Free Cigarettes
36
Article 14 Demand reduction measures concerning
tobacco dependence and cessation
37
Percent Current Smokers Desire to Stop and Tried
to Stop, Global Youth Tobacco Survey by WHO Region
Desire to Stop
Tried to Stop in Past Year
38
Some examples of GYTS Data Use to influence
policy decisions legislative actions in
countries…
39
Country Use of GYTS Data
  • Media and Advertising
  • Egypt 2002 Law Total ban on ads sales to
    minors
  • Niger MOH calling for restrictions on tobacco
    advertising
  • Philippines Tobacco Regulatory Act 2003
    Regulates the packaging, use, sales distribution,
    ads of tobacco products
  • India 2003 Law Total ban on ads promotion

40
Country Use of GYTS Data
  • Assessment of School Health Education Programs
  • Egypt
  • Jordan
  • Haiti
  • Philippines
  • Saudi Arabia
  • Serbia
  • United Arab Emirates
  • Uruguay
  • Cuba
  • Costa Rica

41
Global School Personnel Survey
  • Purpose
  • To collect information from school personnel
    concerning their use of tobacco and their tobacco
    related school policies and programs and to
    monitor the FCTC

42
GSPS
  • Active in over 40 countries
  • Expansion expected in all 6 WHO Regions
  • More than 20 countries are now
  • repeating their surveys

43
Global School Personnel Survey, 2000-2004
44
Key GSPS Findings
  • Teachers in schools with tobacco control policies
    are less likely to use tobacco than teachers in
    schools without policies
  • Few schools have teaching materials regarding
    tobacco prevention and use available to teachers
  • The majority of teachers are in favor of schools
    enacting tobacco use policies for students and
    school personnel

45
GSPS and FCTC
  • Article 20 Research, surveillance exchange of
    information
  • Article 21 Reporting exchange of information
  • Article 12 Education, communication, training
    public awareness
  • Article 14 Demand reduction measures concerning
    tobacco dependence and cessation

46
Global Health Professionals Survey
  • To collect information from third-year students
    attending dental, medical, nursing, and pharmacy
    schools concerning their use of tobacco and
    their tobacco related school policies and
    programs and to monitor the FCTC.

47
GHPS Topics
  • Tobacco use
  • Knowledge and attitudes
  • Exposure to second-hand smoke
  • Cessation
  • School curriculum and training

48
Global Health Professionals Survey, 2004-2005
49
GHPS
  • GHPS collects information from third-year
    students attending dental, medical, nursing, and
    pharmacy schools concerning their use of tobacco
    and their tobacco related school policies and
    programs
  • Pilot in 9 countries at least 1 in each WHO
    Region in 2004/2005

50
GHPS and FCTC
  • Article 20 Research, surveillance exchange of
    information
  • Article 21 Reporting exchange of information
  • Article 8 Protection from exposure to tobacco
    smoke
  • Article 12 Education, communication, training
    public awareness
  • Article 14 Demand reduction measures concerning
    tobacco dependence and cessation

51
Next Steps
  • Establish GYTS, GSPS and GHPS as primary data
    sources for monitoring FCTC
  • Work with countries to use GYTS, GSPS and GHPS
    data to develop and monitor their Action Plans
  • Expand data dissemination GYTS Public Use Data
    Release
  • Sustain resources for the global tobacco program
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