MAKING A DIFFERENCE IN

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MAKING A DIFFERENCE IN GLOBAL TOBACCO CONTROL
FROM TURKISH PERSPECTIVE EDUCATION, RESEARCH
AND PRACTICE
Dilek ASLAN,MD. Hacettepe University, Faculty of
Medicine Department of Public Health diaslan_at_hace
ttepe.edu.tr
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WHY TOBACCO CONTROL IN TURKEY?

• One of the major public health priorities
• Frequent problem
• Mortality
• Morbidity
• Disability
• Economic aspect
• PREVENTABLE

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STAGES OF TOBACCO EPIDEMIC
Mortality ()
Prevalence ()
Esson KM, Leeder SR. The Millennium Development
Goals and Tobacco Control. An Opportunity for
Tobacco Control. WHO, Switzerland, 2004.
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Health Promotion

• Any combination of health education and related
• organizational, economic, and environmental
• supports for behavior conducive to health.
• 1980

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HEALTH PROMOTION
Healthy lifestyle
Ensuring quality of life
Improvement of health status (Healthy people)
Environmental changes
Behavioral enhancement
H E A L T H EDUCATION
Legal arrangements
Intersectorial collaboration
Communication
Motivation techniques
Community participation
Organizing resources
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• HEALTY LIFE SKILLS
• Adequate and balanced nutrition
• Physical exercise
• Smoke-free life
• Alcohol and drug free life
• Prevention from hazardous of sun exposure
• Combat with stress
• Safe sex
• Active livingproductivity

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• HEALTY LIFE SKILLS
• Adequate and balanced nutrition
• Physical exercise
• SMOKE-FREE LIFE
• Alcohol and drug free life
• Prevention from hazardous of sun exposure
• Combat with stress
• Safe sex
• Active livingproductivity

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Tobacco control
1. Not to start to smoke 2. Quit smoking 3.
Prevent from passive smoking
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INTERNATIONAL POINTS WHICH HAVE INFLUENCES ON
TOBACCO CONTROL GLOBALLY
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MDG--2000
Th e Millennium development goals and tobacco
controlan opportunity for global
partnership/Katharine M. Esson, Stephen R.
Leeder. WHO, 2004.
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MILLENNIUM DEVELOPMENT GOALS Correlates of
income poverty and the role of tobacco 2.
Achieve universal primary education The tobacco
industry employs children in cultivation and
production in the developing world. Very poor
families spend money on tobacco rather than
education for their children. 3. Promote gender
equality and empower women Advertising encourages
women in developing countries to smoke as a sign
of independence and success. The number of women
smoking is set to increase from 218 million in
2000 to 259 million in 2025.
Th e Millennium development goals and tobacco
controlan opportunity for global
partnership/Katharine M. Esson, Stephen R.
Leeder. WHO, 2004.
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MILLENNIUM DEVELOPMENT GOALS Correlates of
income poverty and the role of tobacco 4.Reduce
child mortality 5. Improve maternal health Poor
maternal nutrition and health are major causes of
infant mortality. Money spent on tobacco deprives
mothers and babies of food, and possibly medical
attention.
Th e Millennium development goals and tobacco
controlan opportunity for global
partnership/Katharine M. Esson, Stephen R.
Leeder. WHO, 2004.
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MILLENNIUM DEVELOPMENT GOALS Correlates of
income poverty and the role of tobacco 6.
Combat HIV/AIDS, malaria and other
diseases Smoking causes further illness in those
with HIV/AIDS, including bacterial pneumonia and
AIDS-related dementia. Smoking causes subclinical
tuberculosis to advance to clinical tuberculosis
and increased risk of death. 7. Ensure
environmental sustainability Land is cleared for
tobacco farming and wood-fired curing at the rate
of 200 000 hectares per year. This accounts for
5 of deforestation in developing countries,
especially among major tobacco producers such as
China, Malawi and Zimbabwe.
Th e Millennium development goals and tobacco
controlan opportunity for global
partnership/Katharine M. Esson, Stephen R.
Leeder. WHO, 2004.
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FCTC and Turkey a. Signed on 28th of April,
2004b. Ratified on December 2004
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What has happened after ratification of FCTC ?
New legistlation on May, 2008 (smoke-free
except bars, restaurants, cafes, coffee
houses)On 19th of July (2009) the country will
be a totally smoke-free (13th in rank globally)
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TOBACCO CONTROL IN TURKEY EDUCATION
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AimTo increase awarenessTo provide change in
the perception of the generations from smoking
to non-smoking society
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Public educationEducation of professionals,
students Curriculum development Producing
web-based documents for professionals
(pyhsicians MoH in collaboration with other
sectors)
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HACETTEPE UNIVERSITY FACULTY OF MEDICINE PHASE
I- CELL SCIENCES COMMITTEE 2008-2009 ACADEMIC YEAR
TOBACCO CONTROL and ROLE of the
PHYSICIAN GUIDELINE for GRUP DISCUSSION
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CHECK LIST FOR A PHYSICIAN (MEDICAL STUDENT) IN
ORDER TO LEARN THE HISTORY OF A PERSON ON
HIS/HER SMOKING EXPERIENCES
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TOBACCO CONTROL IN TURKEY RESEARCH
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Esson KM, Leeder SR. The Millennium Development
Goals and Tobacco Control. An Opportunity for
Tobacco Control. WHO, Switzerland, 2004.
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ObservationQUANTITATIVE work
Why start to smoke? Underlying factors
!! Determinants?? QUALITATIVE work
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QUANTITATIVE RESEARCHNationwide
surveys Started in 1988 GYTS, 2003 Recent
results are from 2008 (GATS)Local
surveysSurveys on specific professionals
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Source Tobacco Atlas, pp. 36-37.
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Currently smokers, Turkey (GATS results,
2009) Men (47.9) Women (15.2) Total (31.3)
Source TSI press release, April 30, 2009.
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Prevalence of smoking among Pyhsicians GPs
(39.3) Specialists (30.9) Dentists/pharmacists
(37.1) Nurses/midwives (40.7)
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QUALITATIVE RESEARCH
Why ? To understand determining factors of
smoking better How? Focus group discussion In
depth interviewing techniques
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QUALITATIVE RESEARCH
Smoking behavior
Experience Culture Tradition Perception of
health Other determinants
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Focus of the work started to change from
prevalence (frequency) studies to arising
problems such as water pipe, womens smoking,
passive smoking, cessation programs, etc
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TOBACCO CONTROL IN TURKEY PRACTICE
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NATIONAL PLAN ON TOBACCO CONTROL proposed and
prepared by Ministry of Health2008-2012
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NEW REGULATION ON TOBACCO CONTROLSMOKE FREE
COUNTRY
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STRUCTURAL CHANGE IN MINISTRY OF HEALTHTOBACCO
CONTROL GROUPS AT THE PROVINCE LEVEL
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INCREASE IN NUMBER OF THE PUBLICATIONS Original
articles Reviews Translation of international
documents
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TRANSLATED INTO TURKISH
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Increase awareness
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NGOs SUPPORT GRASSROOT MOVEMENT
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National Coalision on Tobacco OR Health (SIGARA
VE SAGLIK ULUSAL KOMITESI (SSUK) http//www.ssuk.
org.tr/
SINCE 1995
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MEMBERS Aile ve Sosyal Arastirmalar Genel
Müdürlügü Atatürk Sanatoryumu Çalisma ve Sosyal
Güvenlik Bakanligi ISGÜM Çankaya Belediyesi
Saglik Isleri Müdürlügü Diyanet Isleri
Baskanligi DSÖ Türkiye Temsilciligi Gençlik ve
Spor Genel Müdürlügü Geriatri Dernegi Halk
Sagligi Uzmanlari Dernegi Kamu Isletmeciligini
Gelistirme Merkezi Keçiören Egitim ve Arastirma
Hastanesi Kültür ve Turizm Bakanligi Marmara
Üniversitesi Tip Fakültesi Marmara Üniversitesi
Bilissel Davranisçi Terapiler Dernegi Milli
Egitim Bakanligi Saglik Isleri Daire Baskanligi
Milli Egitim Saglik Egitim Vakfi Pratisyen
Hekimlik Dernegi SB Kanserle Savas Dairesi
Baskanligi SB TSHGM Ruh Sagligi Daire Baskanligi
SB TSHGM Tütün ve Bagimlilik Yapici Maddelerle
Mücadele Daire Baskanligi SB Tedavi Hizmetleri
Genel Müdürlügü TMMOB Ziraat Mühendisleri Odasi
Turizm ve Çevre Gazetecileri Dernegi Tüketici
Haklari Dernegi Türk Akciger Kanseri Dernegi
Türk Demokrasi Vakfi Türk Dishekimleri Birligi
Türk Hemsireler Dernegi TÜRK-IS Konfederasyonu
Türk Kanser Arastirma ve Savas Kurumu Türk
KBB-BBC Dernegi Türk KBB-BBC Vakfi Türk
Tabipleri Birligi Türk Toraks Dernegi Türkiye
Esnaf ve Sanatkarlari Konfederasyonu Türkiye
Halk Sagligi Kurumu Dernegi Türkiye Istatistik
Kurumu Baskanligi Türkiye Ziraatçilar Dernegi
Tütün Eksperleri Dernegi Tütün ve Alkol
Piyasasi Düzenleme Kurumu Tütünsüz Yasam Dernegi
 
National Coalision on Tobacco OR Health
http//www.ssuk.org.tr/
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MEMBERS Aile ve Sosyal Arastirmalar Genel
Müdürlügü Atatürk Sanatoryumu Çalisma ve Sosyal
Güvenlik Bakanligi ISGÜM Çankaya Belediyesi
Saglik Isleri Müdürlügü Diyanet Isleri
Baskanligi DSÖ Türkiye Temsilciligi Gençlik ve
Spor Genel Müdürlügü Geriatri Dernegi Halk
Sagligi Uzmanlari Dernegi Kamu Isletmeciligini
Gelistirme Merkezi Keçiören Egitim ve Arastirma
Hastanesi Kültür ve Turizm Bakanligi Marmara
Üniversitesi Tip Fakültesi Marmara Üniversitesi
Bilissel Davranisçi Terapiler Dernegi Milli
Egitim Bakanligi Saglik Isleri Daire Baskanligi
Milli Egitim Saglik Egitim Vakfi Pratisyen
Hekimlik Dernegi SB Kanserle Savas Dairesi
Baskanligi SB TSHGM Ruh Sagligi Daire Baskanligi
SB TSHGM Tütün ve Bagimlilik Yapici Maddelerle
Mücadele Daire Baskanligi SB Tedavi Hizmetleri
Genel Müdürlügü TMMOB Ziraat Mühendisleri Odasi
Turizm ve Çevre Gazetecileri Dernegi Tüketici
Haklari Dernegi Türk Akciger Kanseri Dernegi
Türk Demokrasi Vakfi Türk Dishekimleri Birligi
Türk Hemsireler Dernegi TÜRK-IS Konfederasyonu
Türk Kanser Arastirma ve Savas Kurumu Türk
KBB-BBC Dernegi Türk KBB-BBC Vakfi Türk
Tabipleri Birligi Türk Toraks Dernegi Türkiye
Esnaf ve Sanatkarlari Konfederasyonu Türkiye
Halk Sagligi Kurumu Dernegi Türkiye Istatistik
Kurumu Baskanligi Türkiye Ziraatçilar Dernegi
Tütün Eksperleri Dernegi Tütün ve Alkol
Piyasasi Düzenleme Kurumu Tütünsüz Yasam Dernegi
 
National Coalision on Tobacco OR Health
http//www.ssuk.org.tr/
NGOs Governmental bodies Other sectors
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www.havanikoru.org http//www.havanikoru.org.tr/il
etisim.html Tütün irtibat merkezi telefon
numaralari
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STUDENTS MOVEMENTS AT UNIVERSITIESAnkara,
Izmir, Edirne,
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HACETTEPE UNIVERSITY NON-SMOKERS GROUP
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Brochure preperationSeminarConferenceResearch
31th of May activitiesBullettinWeb-siteWorksho
p
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SPECIAL DAYS FOR ANTI-TOBACCO ACTIVITIES31th of
MayParallel with the theme on the WHO agenda
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May 31, 2009
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TO BE STRONGER IN TOBACCO CONTROLCapacity
developmentMonitoring-evaluationMotivationColla
borationEvidence based medicine.Hope
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TOTALLY SMOKE-FREE COUNTRY July 19, 2009
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THANK YOU... diaslan_at_hacettepe.edu.tr