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Number of deaths (’000s) in 1998 attributable to tobacco use WHO Region Males Females World Health Report 1999. All member states 3,241 782 Africa 112 13 The Americas 472 300 Eastern Mediterranean 160 22 Europe 1,066 207 South-East Asia 505 75
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All member states 3,241 782
Africa 112 13
The Americas 472 300
Eastern Mediterranean 160 22
Europe 1,066 207
South-East Asia 505 75
Western Pacific 927 166
Source: Murray CJL, Lopez AD. 1996.DALYs attributable to tobacco use% of total inRegion 1990 2020World 2.6 8.9
Developed Regions 12.1 18.2
Developing Regions 1.4 7.7
Source: Murray CJL, Lopez AD. 1996DALYs attributable to tobacco use% of total inRegion 1990 2020Est. Market Economies 11.7 17.0
Former Socialist Econ. of Europe 12.5 19.9
India 0.6 10.2
China 3.9 16.1
Sub-Saharan Africa 0.4 1.7
Latin America & Carib. 1.4 6.8
”By 2020, tobacco is expected to cause more premature death and disability than any single disease.”
Signs of addiction include
F10 Disorders resulting from use of alcohol
F11 Disorders resulting from use of opiods
F12 Disorders resulting from use of cannabinoids
F13 Disorders resulting from use of sedatives or hypnotics
F14 Disorders resulting from use of cocaine
F15 Disorders resulting from use of other stimulants
F16 Disorders resulting from use of hallucinogens
F17 Disorders resulting from use of tobacco
F18 Disorders resulting from use of volatile solvents
F19 Disorders resulting from multiplw drug use and use of other psychoactive substances
”Light” cigarettes ?
Generally no benefit. Low nicotine yield may even increase health risks unless tar/nicotine ratio is kept extra low
Smokeless tobacco ?
Most kinds of smokeless tobacco involve severe health risks.
However, Swedish ”snus” (a special kind of moist oral snuff) has been recognized as substantially less harmful than smoking
In principle it represents a long term solution
It cannot yield an appreciable reduction of mortality during the nearest 40 years - only later, when today’s young people reach ages >55
Social pressure to smoke can be very strong and intervention programmes have limited success
Mortality reduction occurs quite rapidly after successful intervention
Widespread cessation contributes to a social climate that favours prevention of onset
Smokers must be given both:
- motivation to quit, and
- support to overcome their dependence