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Presenter Disclosures

Presenter Disclosures. Hadii M. Mamudu, PhD, MPA. The following personal financial relationships with commercial interests relevant to this presentation existed during the past 12 months:. No relationships to disclose.

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Presenter Disclosures

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  1. Presenter Disclosures Hadii M. Mamudu, PhD, MPA The following personal financial relationships with commercial interests relevant to this presentation existed during the past 12 months: No relationships to disclose

  2. Implementation of the WHO FCTC in Africa: Article 8 –”Protection from Exposure to Tobacco Smoke” Mamudu HM, Ph.D.; Veeranki SP, DrPH; Ouma EO, PhD. American Public Health Association Annual Meeting Tuesday, October 30, 2012

  3. Background • Health Effects of Tobacco use • Leading preventable cause of NCDs • Cancers • Cardiovascular diseases • Chronic lung diseases • Diabetes • 36 million deaths/year • 6 million smoking-attributable deaths • 8 million deaths by 2030 • 80% in low- and middle-income countries • 1 billion deaths by the end of 21st century. • Socioeconomic/environmental effects

  4. Background Source: U.S. Surgeon General Report, 2010

  5. Background • Secondhand smoke (SHS) • >250 carcinogens • No safe level of exposure • Effects • Deaths • 600,000 people worldwide • Negative health effects on never smokers • Children • Developmental effects (e.g., low birth weight, SIDS, pre-term delivery) • Respiratory effects (e.g., decreased pulmonary function, cough, asthma) • Adults • Reproduction (e.g. male and female reproductive toxicity) • Respiratory effects • Cancer

  6. Tobacco Control • Smoke-free Policies (SPFs) • Origin • Began in the 1970s in the U.S. and diffused worldwide • Health benefits • Protection for nonsmokers • Improvement in health • Facilitation of smoking cessation • Economic benefits • Saves health care costs • Good for business • SFPs is part of the WHO Framework Convention on Tobacco Control (FCTC)

  7. The FCTC • International tobacco control treaty • 175 Members • Not including United States • Key provisions • Demand-side • Advertising ban • Health warnings • Tax increases • Smoke-free environments • Health campaigns • Supply-side • Ban on sale to minors • Control of illicit trade • Alternative sources of livelihood

  8. The FCTC: Art. 8 • Implementation: MPOWER 2009

  9. The FCTC: Art. 8

  10. Goals • Assess the adoption of components of smoke-free policies in Africa • Delineate key determinants of smoke-free policy adoption

  11. Methodology

  12. Methodology cont. • Policy Analysis • Smoke-free workplaces • Smoke-free indoor places • Smoke-free public transportation • Data Source • WHO MPOWER reports (2008, 2009, and 2011) • Tobacco control profiles (2000 and 2003) • Tobacco Atlas (2006, 2009, and 2012) • FCTC Implementation database (2-year & 5-year reports) • Tobaccocontrollaws.org • Measurements • Policy status (0=no, 1=partial, 2=full) • Analysis • Descriptive statistics • Regional comparisons over time.

  13. Preliminary Results • African countries and the FCTC • 46 countries • 89% has ratified the FCTC • November 12, 2003: First by Seychelles • August 12, 2010: Latest by Cote d’Ivoire • Non-ratified countries (Eritrea, Ethiopia, Malawi, Mozambique, and Zimbabwe) • Countries with national smoke-free policy • Comprehensive smoke-free legislation • Kenya, South Africa • Pending in the policy process • Ghana, Nigeria and Rwanda

  14. Preliminary Results • Central Africa • No clear trend or pattern

  15. Preliminary Results • Eastern Africa • Increasing full adoption for indoor workplaces and public transportation • Partial adoption for indoor public places

  16. Preliminary Results • Southern Africa • Increasing full adoption for indoor workplaces and public transportation • No policies for indoor public places

  17. Preliminary Results • Western Africa • Increasing full adoption for indoor workplaces and public transportation • Partial adoption for indoor public places

  18. Discussion • Identification of venues that need policy attention • The use of different legal mechanisms for SFPs • Countries with partial and full policies have increased since 2003 • Likely an FCTC effect • Indoor public places are least covered with policy • High-level of exposure to SHS • Countries in Central Africa merit attention • Fewer reported policies • Poorer data quality

  19. Future Research • Analysis the FCTC implementation reports • Cross-sectional to Identify key determinants

  20. Acknowledgement RafieBoghozian-Khoygani, MBA Research Data Manager College of Nursing East Tennessee State University David M. Kioko Department of Health Services Management & Policy College of Public Health East Tennessee State University Yi He, DrPH Department of Biostatistics and Epidemiology College of Public Health East Tennessee State University Yang Chen, MS Department of Biostatistics and Epidemiology College of Public Health East Tennessee State University

  21. Thank you!!

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