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Sa ï d Business School 1-3 September 2004 Tobacco Working Group Learning from tobacco to address diet and nutrition more effectively Professor Martin McKee 2 September 2004 Remit

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Saïd Business School

1-3 September 2004


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Tobacco Working Group

Learning from tobacco to address diet and nutrition more effectively

Professor Martin McKee

2 September 2004


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Remit

Prepare a report of the experience of those involved in tobacco control to inform those working to tackle other risk factors for chronic disease


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CAVEAT: FOOD = TOBACCO

Areas for examination

  • The epidemiology of tobacco

    • And the need for evidence!

  • The strong pressures exerted on policies

    • Globalization

  • Policies that can make a difference

    • Who are the major players?



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The difficulty with epidemiollogical evidence for diet

  • Varying intakes over lifetimes

  • Recall of consumption

  • Varying nutritional content of natural foodstuffs

  • Processing of food


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Obesity

Type 2 diabetes

CVD

Cancer

Dental disease

Osteoporosis

Energy and fats

Hi intake energy-dense foods

C+

Saturated fats

P+

C+

Transfatty acids

C+

Dietary cholesterol

P+

Fish and fish oils

P-

Carbohydrate

High intake dietary fibre

C-

P-

P-

Free sugars

C+

Vitamins

Vitamin D

C-

C-

Minerals

High sodium

C+

Local fluoride

C-

WHO Technical Report 916


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Litigation has been successful against tobacco in the US

Investment banks are looking at the risks associated with food & drink companies

Pressures for change


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What doesn’t

Education in schools

Voluntary agreements on ad bans

Voluntary agreements on smoke-free areas

Tobacco control

What works

€£$¥

Taxes

Ad bans

Smoke-free

Litigation


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Make fruit & vegetables more affordable; research effect of taxation

€£$¥

Restrict advertising to children; discourage unhealthy lifestyles

Health warnings and disclosure of nutritional information; labelling guidelines, health claims

How might FCTC policies be relevant to diet and physical activity?


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How might FCTC policies be relevant to diet and physical activity?

  • Product content: Regulation of harmful of ingredients; food safety regulations

  • Education campaigns: in schools, workplaces and sites reaching the general public

  • Clinical interventions: based on collaborative goal-setting, skill-building, self-monitoring, personalized feedback, planned follow-up & links to community resources


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Agenda setters: activity?

Researchers

NGOs

Globalink, Framework Convention Alliance

Governments:

Health Ministries

Treasuries

International:

UN

WHO

World Bank

IMF

Private sector:

Pharmaceutical companies

Tobacco companies

Many key players in tobacco control


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Twelve lessons from tobacco activity?

  • Address the issue of individual responsibility versus collective/environmental action early and often

  • Evidence of harm is necessary but not sufficient to motivate policy change

  • Decisions to act need not wait for evidence of the effectiveness of interventions


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Twelve lessons from tobacco activity?

  • The real and perceived needs and concerns of developing countries need to be addressed even if they involve going beyond the initial scope of the risk being addressed

  • The more comprehensive the package of measures considered, the greater the impact

  • Broad-based, vertical and horizontal coalitions, well networked, are key


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Twelve lessons from tobacco activity?

  • Media-savvy individual and institutional leadership matters

  • Change in support for tobacco control took decades of dedicated effort by all

  • Modest, well-spent funds can have a massive impact. But without clear goals they may not be sustainable


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Twelve lessons from tobacco activity?

  • Complacency that past actions will serve well in future may retard future progress

  • Rules of engagement with the tobacco and food industries need to be different and continually under review

  • Risk factor envy is harmful!


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Tobacco Working Group activity?

Learning from tobacco to address diet and nutrition more effectively


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Sa activity?ïd Business School

1-3 September 2004


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