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Importance of Research on Tobacco control From research to action

Importance of Research on Tobacco control From research to action. Prof. Gonghuan Yang China CDC/PUMC. Outline. Importance of Research on Tobacco control Research proved the risk of tobacco use Research proved the effective of strategy of tobacco control

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Importance of Research on Tobacco control From research to action

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  1. Importance of Research on Tobacco control From research to action Prof. Gonghuan Yang China CDC/PUMC

  2. Outline • Importance of Research on Tobacco control • Research proved the risk of tobacco use • Research proved the effective of strategy of tobacco control • From research to action on tobacco control • Research on tobacco control has translated to global action on tobacco control • Evidence-based research to support tobacco control in China

  3. The Importance of Research on Tobacco Control • Established the relationship between tobacco use and disease; • Estimated disease burden and economic cost quantitatively; • Verified the efficiency of strategies on tobacco control

  4. MPOWER POLICIES • Protect people from tobacco smoke; • Offer help to quit tobacco use; • Warn about the dangers of tobacco; • Enforce bans on tobacco advertising, promotion and sponsorship; • Raise taxes on tobacco）

  5. Early Indications that Tobacco Causes Disease: German Research • 1929: Fritz Lickint publishes statistical evidence linking lung cancer and cigarettes • 1939: Lickint publishes ‘Tabak und Organismus’ a 1,100 page volume, “the most comprehensive scholarly indictment of tobacco ever published” • 1939: Muller presents the world’s first controlled epidemiological study of the tobacco–lung cancer relationship Borio G. Tobacco Timeline, 1998

  6. 100 Non-users 90 Moderate smokers 80 70 Heavy smokers 60 Thousands of survivors 50 40 30 20 10 0 40 50 60 70 80 90 100 30 Age in years Pearl, 1938 Early Indications that Tobacco Causes Disease Survivorship of white males after 30 years of age according to smoking habits • 1938: Raymond Pearl reports smokers do not live as long as non-smokers • 1950: Three key case-control studies link smoking with lung cancer • 1953: Ernst Wynder’s study showed that tobacco painted on the backs of mice produced tumors Borio G. Tobacco Timeline, 1998

  7. Early Indications of Tobacco-related Disease • 1954: Richard Doll and Bradford Hill’s study of British doctors published in the British Medical Journal • 1962: Royal College of Physicians Report • 1964: First Surgeon General’s Report on tobacco and health • 1981: First major study on passive smoking and lung cancer by Takeshi Hirayama (Japan) Surgeon General Luther Terry holding the 1964 Report Borio G. Tobacco Timeline. 1998

  8. Pattern on tobacco control & Health

  9. Epidemilogical Study on tobacco & Health in China • Smoking and lung cancer in Shanghai，Gao YT,. IARC Sci. Rubi.1986;(74):115-21. • Early health effects of the emerging tobacco epidemic in China,（Chen ZMJAMA, 1997, 278(18):1500-4) • Retrospective proportional mortality study of one million deaths（Liu BQ et al，BMJ, 1998; 317:1411-1422) • Early mortality results from a prospective study（Niu SR et al BMJ, 1998; 317:1423-1424 • Mortality attributable to smoking in China(Gu DF，N Engl J Med 2009 Jan 8;360(2):150-9. ， • Body mass index and mortality from lung cancer in smokers and nonsmokers(Yang L, Int J Cancer. 2009 Nov 1;125(9):2136-43.

  10. Death numbers of Attributed tobacco use/Total Death, 1990 (1000)

  11. JAMA，1999，282：1247-53 Tobacco Control，1999，282：1247-53 BMJ，1999，282：1247-53

  12. Cohort Study on Tobacco & Health in Chinese （1991-95） • 5年死亡追踪研究结果

  13. Alan Lopez’ comments in BMJ • These studies are important both for their concordance conclusions about tobacco and for their epidemiological methods. • This system could be extended to other countries and is particularly useful for prospective studies • These two new studies provide the first nationwide evidence of tobacco's effects in a developing country. BMJ 1998；317：1423-24

  14. Disease Burden attributed to tobacco use

  15. The health consequences of the tobacco epidemic are very serious

  16. Minus Net Benefits on Integrated Tobacco Social Costs and Benefits Assessment 2010年负效应已达600亿。

  17. Report of the Surgeon General • How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for smoking Attributable Disease • Conclusion: • The evidence on the mechanisms by which smoking causes disease indicates that there is no risk-free level of exposure to tobacco smoke.

  18. Real cigarette prices and cigarette smoking prevalence among Canadians aged 15–19 years 270 48 Teenage smoking 45 250 Real tobacco price index 42 230 39 210 36 190 33 170 Real cigarette price index Smoking prevalence (%) 30 150 27 24 130 21 110 18 90 15 1979 1983 1980 1981 1982 1984 1985 1986 1987 1988 1989 1990 1991 Year Impact of Increasing Price on Smoking Among Canadian Teenagers Health and Welfare Canada

  19. Estimated Impact of Increasing Price on Prevalence and Mortality Potential number of smokers persuaded to quit, and lives saved, by a price increase of 10% Change in number of smokers (millions) Change in number of deaths (millions) Region East Asia and Pacific - 16 - 4 Eastern Europe and Central Asia - 6 - 1.5 Latin America and the Caribbean - 4 - 1.0 Middle East and North Africa - 2 - 0.4 South Asia (cigarettes) - 3 - 0.7 South Asia (bidis) - 2 - 0.4 Sub-Saharan Africa - 3 - 0.7 Low/middle Income countries - 36 - 9 High Income countries - 4 - 1 World - 40 - 10 Note: Numbers have been rounded World Bank, 1999

  20. From Research to Action • Research results has been translated to global action of tobacco control • Need to strengthen research on tobacco control in China.

  21. The State of selected tobacco control policies in the World, 2010

  22. Prevalence of NCD in China need to active tobacco control • Proportion of NCD in total death rates is increasing: 82% in 2005, Daly in 2005: 72% • The age-standard death rates of the major NCDs were increasing; • The NCDs prevalence in rural was still increasing; • Aging will blow up the diseases burden of NCD.

  23. Increasing trend of standard death rates of 6 chronic diseases Stroke CHD Lung Cancer Liver cancer Traffic injury Diabetes Breast cancer

  24. NCD Control & Economy in China • While China has had an enviable economic growth and development performance for more than 30 years, its human development has lagged behind the most advanced economies. • China ranked 89th in the 2010 human development index prepared by the United Nations Development Program(UNDP). • The Chinese population’s healthy life expectancy(HALE) at birth is about 10 years shorter than in some of the leading G-20 countries . • China could narrow these gaps in human development by identifying the priority health issues affecting its population, mustering political support to overcome them, and implementing appropriate interventions, as described below. • China’s 12th Five-year Plan (2011–2015) aims to promote inclusive, equitable growth and development by placing an increased emphasis on human development .

  25. Political declaration on the Prevention and Control of NCD • The global burden and threat of non-communicable diseases constitutes one of the major challenges for development in the twenty-first century, which undermines social and economic development throughout the world, and threatens the achievement of internationally agreed development goals; • Non-communicable diseases are a threat to the economies of many Member States, and may lead to increasing inequalities between countries and populations; • The primary role and responsibility of Governments in responding to the challenge of non-communicable diseases and the essential need for the efforts and engagement of all sectors of society to generate effective responses for the prevention and control of non-communicable diseases; • …….

  26. Completely promote banning smoking in Public Places in National “12.5” Social Economic Development Plan has been approved by NPC in March 2011. MOH issued the detailed rules and regulations of banning smoking in public places in March, 22, 2011.

  27. Research on TC in China • Search: tobacco use, prevalence, China • 627 article, Key words: tobacco use, prevalence, China

  28. CNTC supports academic research • A research and education-oriented institute with the goals of promoting the use of technology in tobacco farming, manufacturing and research and training tobacco researchers. • Number of Paper is as 20 times as one of tobacco control. • Increasing paper on the research on less harmful and low-tar cigarettes besides the traditional research paper ;

  29. Research Fund • Tobacco control: • A few • NIH Fogarty international center • CMB • National Ministry of Science & Technology • Tobacco Industry • Unclear • But for museum of tobacco: 180 million RBM

  30. THANKS

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