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Effective Tobacco Control: Roles and Responsibilities for Filipino Physicians

Effective Tobacco Control: Roles and Responsibilities for Filipino Physicians. September 2009. COLD tobacco statistics:. 50% of all regular smokers die prematurely Currently 5.4 million deaths a year worldwide (more than TB, HIV/AIDS, and malaria combined)

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Effective Tobacco Control: Roles and Responsibilities for Filipino Physicians

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  1. Effective Tobacco Control:Roles and Responsibilities for Filipino Physicians September 2009

  2. COLD tobacco statistics: • 50% of all regular smokers die prematurely • Currently 5.4 million deaths a year worldwide (more than TB, HIV/AIDS, and malaria combined) • 100 million deaths in the 20th century Unless urgent action is taken: • By 2030, 8 million deaths per year • By 2030, 80% of deaths in developing countries • 1 billion deaths in the 21st century

  3. Tobacco-caused deaths: still climbing

  4. (by 2015)

  5. Distribution of deaths by leading cause groups, males and females, world, 2004 Health Statistics and Informatics

  6. Mortality rates among men and women aged 15–59 years, region and cause-of-death group, 2004 Health Statistics and Informatics

  7. Leading causes of death, global projections

  8. Global projections for selected causes, 2004 to 2030 Cancers Ischaemic HD Stroke Acute respiratoryinfections Road trafficaccidents Perinatal HIV/AIDS TB Malaria Updated from Mathers and Loncar, PLoS Medicine, 2006 Health Statistics and Informatics

  9. "Reversing this entirely preventable [tobacco] epidemic must now rank as a top priority for public health and for political leaders in every country of the world.” Dr. Margaret Chan WHO Director-General

  10. Is there hope? “The farther back you can look,the farther forward you are likely to see” Winston Churchill

  11. In Britain in 1962: • Tobacco generated 14% of government revenue • 70% of men were smokers • 43% of women were smokers

  12. 80 % smoked 70% 60 %at ages35-59 50% 40 % smoked 28% 20 26% 0 1950 1960 1970 1980 1990 2000 Decline in smoking in middle age in UK

  13. Why the Framework Convention on Tobacco Control (FCTC) Globalization of the epidemic • restricts the capacity of countries to regulate tobacco through domestic legislation alone • international coordination of policies is essential FCTC: a global response • first public health treaty under WHO

  14. History of the FCTC • 1996: 49th World Health Assembly adopts resolution WHA49.17 • requesting the WHO Director-General to initiate the development of a WHO Framework Convention on Tobacco Control. • 1998: WHO DG, Dr Gro Harlem Brundtland, makes global tobacco control a WHO priority • 1999: work on the WHO FCTC begins

  15. FCTC Timeline • 1999 Oct & 2000 Mar: • First and Second FCTC Working Group meetings - participants from 153 countries attend (representing 95% of the world’s population) • 2000 May: • Working Group report presented to Member States at WHO; • WHA resolution unanimously launches political negotiations towards FCTC • 2000 Oct 12-13: • Public Hearings on the FCTC • 2000 Oct to 2003 Feb: • Six sessions of Intergovernmental Negotiation Body (INB) - governments draft and finalize the FCTC text.

  16. FCTC Timeline • 2003 May 21: • Adoption of FCTC by WHA; treaty is opened for signatures. • 2004 June 29: • Treaty is closed for signatures. • 168 countries signed. 40 country ratifications are needed for the treaty to enter into force. • 2004 November 30: • 40th ratification of FCTC is achieved in record time. • The treaty entered into force on 27 February 2005.

  17. FCTC overview Treaty text available online: • WHO website - www.who.int/fctc • FCA website - www.fctc.org

  18. FCTC Preamble Refers to: • International Covenant on Economic, Social, and Cultural Rights (ICESCR) • Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW) • Convention on the Rights of the Child (CRC)

  19. FCTC text • Art. 3 - Objective • The objective of this Convention and its protocols is to protect present and future generations from the devastating health, social, environmental and economic consequences of tobacco consumption and exposure to tobacco smoke by providing a framework for tobacco control measures to be implemented by the Parties at the national, regional and international levels in order to reduce continually and substantially the prevalence of tobacco use and exposure to tobacco smoke.

  20. FCTC text • Art. 5(3) – General Obligations • to “protect these [public health] policies from commercial and other vested interests of the tobacco industry”

  21. FCTC text Demand reduction measures • Art. 6 – Price and tax measures • Art. 7 – (Non-price measures) • Art. 8 – Protection from exposure to tobacco smoke • Art. 9 – Regulation of the contents of tobacco products • Art. 10 – Regulation of tobacco product disclosures • Art. 11 – Packaging and labelling of tobacco products • Art. 12 – Education, communication, training and public awareness • Art. 13 – Tobacco advertising, promotion and sponsorship • Art. 14 – Demand reduction measures concerning tobacco dependence and cessation

  22. FCTC text Supply reduction measures • Art. 15 – Illicit trade in tobacco products • Art. 16 – Sales to and by minors • Art. 17 – Provision of support for economically viable alternative activities Protection of the environment • Art. 18 – Protection of the environment and the health of persons Questions pertaining to liability • Art. 19 – Liability Scientific and technical cooperation and communication of information • Art. 20 – Research, surveillance and exchange of information • Art. 21 – Reporting and exchange of information • Art. 22 – Cooperation in the scientific, technical, and legal fields and provision of related expertise

  23. FCTC global status (165 Parties, as of 22 May2009)

  24. Conference of the Parties (COP) • COP1: Geneva, 7-16 February 2006 • COP2: Bangkok, 30 June-6 July 2007 • Adoption of Art. 8 guidelines • COP3: South Africa, Nov 2008 • Adoption of Art. 5.3, 11, and 13 guidelines • Thereafter, regular sessions shall be held every two years • COP4: Uruguay, Q4 2010 • INB-3 on Illicit Trade Protocol: Geneva, June 2009

  25. Why physicians? • credibility • respectability • leadership

  26. Code of practice on tobacco control for health professional organizations • http://www.who.int/tobacco/communications/events/codeofpractice/en/index.html

  27. Role modeling: not like this!

  28. FCTC Article 14: cessation Provide brief counseling • dangers of smoking • importance of quitting • especially those with tobacco-related illness • very cost-effective

  29. The Impact of Physician Intervention and Tobacco Control Policies on Average Daily Cigarette Consumption Among Adult Smokers John A. Tauras and Lan Liang, 2003 • smokers that received advice from their physician to quit smoking will decrease their average daily consumption by between 5-6 cigarettes per dayas compared to smokers who do not receive advice • Other policies found to decrease average smoking by smokers include: the real price of cigarettes and clean indoor air laws.

  30. FCTC Article 8: 100% smoke-free Advocate for smoke-free public places • legislation • implementation • enforcement

  31. Smoke-free policies decrease cardiac hospital admissions • Colorado, USA: heart attack admissions decreased by 27%, 18 months after smoking ban • Scotland: acute coronary syndrome admissions decreased 17% after smoke-free law was passed

  32. FCTC Article 5.3: no TI partnerships

  33. 31 May 2009: World No Tobacco Day(FCTC Art. 11)

  34. Summary • Role modeling • Brief advice on cessation • Public health / tobacco control policy / FCTC • smoke-free environments • pictorial health warnings • high tobacco taxes • no tobacco industry partnerships • tobacco-free org events and agenda • coalition activities e.g. WNTD

  35. “Death in old age is inevitable, but death before old age is not.” Sir Richard Doll

  36. Thank you • dorotheou@fctc.org

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