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Thinking about the end of tobacco EPHA Conference - November 2011

Thinking about the end of tobacco EPHA Conference - November 2011. George Thomson, Richard Edwards, Nick Wilson, Tony Blakely Department of Public Health, University of Otago, Wellington, New Zealand. Aims. To briefly touch on:

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Thinking about the end of tobacco EPHA Conference - November 2011

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  1. Thinking about the end of tobaccoEPHA Conference - November 2011 George Thomson, Richard Edwards, Nick Wilson, Tony Blakely Department of Public Health, University of Otago, Wellington, New Zealand

  2. Aims To briefly touch on: • What a tobacco endgame is (definitions) • What may favour the adoption of endgame strategies (possible preconditions) • Where endgames might occur

  3. What isa ‘tobacco endgame’? • ‘the final stage of the process of ending tobacco use in a jurisdiction’

  4. Some possible elements of endgames • Having an explicit: • government intention • government plan • end prevalencetarget for tobacco use • ‘end’ target date

  5. Some tobacco endgame goals • Savuton Suomi vision (non-government 2009): Finland smokefree by 2040 • Finnish govt objective (2009): Ending ‘the use of tobacco products in Finland’ (no target date)

  6. A goal for the world • Beaglehole et al, 2011: ‘a world …where less than 5% of people use tobacco’ by 2040 Beaglehole et al. Lancet 2011; 377:1438-47 Robert Beaglehole

  7. Favourable conditions for real endgame planning by a jurisdiction • Prevalence under 15% • Rapid prevalence decrease • Wide public support for an end to tobacco use • Strong border control • Blunted industry • Strong leadership Uruguay's former president Vázquez

  8. Where might endgames happen? • California 2010: 11.9% adults smoke ‘some days’ Prevalence: California and U.S.A: 1984-2010 Q: ‘Do you now smoke cigarettes every day, some days, or not at all?’ US CDC Behavioral Risk Factor Surveillance System (BRFSS) 1984-2010

  9. Australia • 2010: 18% (14 yrs plus) smoke (Daily, weekly, less than weekly) 2010 National Drug Strategy Household Survey. AIHW 2011 • Tasmania: 2007-2010: 2+% drop/yr (22.6% to 15.9% - daily smokers) 2010 National Drug Strategy Household Survey. AIHW 2011 Health Minister Nicola Roxon

  10. Sweden • 2010: 13% (aged 16-84) smoke daily • 2010: 24% (aged 16-84) smoke currently

  11. But justified scepticism • Ending tobacco only feasible: ‘if smoking rates are below 5% and if the country’s borders can be easily controlled’ Joossens L. Tob Control 2009;18:5.

  12. Discussion • Endgames a paradigm shift in tobacco control • Thinking less incremental • Aims more ambitious • Ultimate aim articulated • International cooperation / stronger FCTC required • FCTC s.5.3 crucial

  13. Acknowledgements • Marsden Fund: Royal Society of New Zealand Further reading • Thomson et al. What are the elements of the tobacco endgame? Tob Control March 2012 • Thomson et al. Ending appreciable tobacco use in a nation Tob Control 2010; 19:431-5 Contact: george.thomson@otago.ac.nz

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