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  1. Saïd Business School 1-3 September 2004

  2. Tobacco Working Group Learning from tobacco to address diet and nutrition more effectively Professor Martin McKee 2 September 2004

  3. 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

  4. 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?

  5. The difficulty with epidemiological evidence for diet

  6. The difficulty with epidemiollogical evidence for diet • Varying intakes over lifetimes • Recall of consumption • Varying nutritional content of natural foodstuffs • Processing of food

  7. 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

  8. Litigation has been successful against tobacco in the US Investment banks are looking at the risks associated with food & drink companies Pressures for change

  9. 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

  10. 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?

  11. 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

  12. Agenda setters: 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

  13. Twelve lessons from tobacco • 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

  14. Twelve lessons from tobacco • 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

  15. Twelve lessons from tobacco • 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

  16. Twelve lessons from tobacco • 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!

  17. Tobacco Working Group Learning from tobacco to address diet and nutrition more effectively

  18. Saïd Business School 1-3 September 2004