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The global epidemiology of tobacco and related chronic diseases

The global epidemiology of tobacco and related chronic diseases. Professor Judith Mackay Plenary Session 4 - Chronic Disease World Congress of Epidemiology Edinburgh, Scotland; 9 August 2011. Smoking prevalence. Male. Female. Same key. Female smoking numbers: Top 20.

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The global epidemiology of tobacco and related chronic diseases

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  1. The global epidemiology of tobacco and related chronic diseases Professor Judith Mackay Plenary Session 4 - Chronic Disease World Congress of Epidemiology Edinburgh, Scotland; 9 August 2011

  2. Smoking prevalence Male Female Same key

  3. Female smoking numbers: Top 20

  4. Youth smoking prevalence, 2000-2007, GYTS Boys Girls Same key

  5. Health professionals

  6. ↑ Tobacco epidemic (~ other NCD) Smoking prevalence Tobacco consumption Tobacco deaths 6m->8m p.a. by 2030

  7. Global Cigarette Consumption, 1880-2020

  8. Health risks known, but always moree.g. link with TB

  9. Deaths caused by tobacco 2015

  10. Deaths caused by Secondhand smoke

  11. Cumulative deaths from tobacco, global, 2005-2030

  12. Tobacco Costs

  13. Costs to smoker: cig v. rice

  14. Obstacles to Tobacco Control • Lack of awareness of risk factors • Preoccupation with other diseases • Tobacco may not yet cause many deaths • Focus on curative medicine, not prevention • Smoking, alcohol, diet seen as personal behaviour • Tobacco industry: promotion, distortion of health and economic evidence, financial might, challenge/threats to governments  other industries not far behind • Tobacco tax revenue (but not debit) seen • Misperceived economic costs • Lack of funds for research and intervention

  15. HK resident smoking through SARS mask

  16. The tobacco industry: Not changed its spots… Acknowledgement to http://www.wildlife-pictures-online.com/leopard-pictures-1.html

  17. Neo-libertarian groups – now gone global “Nanny state” “Less government” “Personal freedom”

  18. Medical Model Not Enough

  19. Tobacco Control:WHO FCTC • WHO FCTC into effect 2005 • Parties ratified: 174/ 192

  20. Tobacco Control:FCTC Main Provisions

  21. Tobacco Control:Ban Tobacco Promotion People’s Republic of China Las Palmas Philippines

  22. Tobacco Control:Smoke-Free Laws Hong Kong RestaurantTax Receipts Before ban and2 years later:  31% Example: Hong Kong

  23. Tobacco Control:Pack Warnings Example: Hong Kong • 27 Oct 2006: Smoking (Public Health) Ordinance 2006 in effect • 6 pictorial health warnings – all cigarettes to display 50% health warning messages in both Chinese & English

  24. Tobacco Control:Media Campaigns worldlungfoundation.org/mmr

  25. Tobacco Control:Quitting Reduces NCD Risk For Smoker:Quitting Works

  26. Tobacco Control:Raising Taxes Key Economic Messages • Tobacco is debit to the economy • Tobacco control is cost-effective • Price increases most effective •  tobacco tax does not govt revenue •  tobacco tax does not smuggling • tax on other NCD risk factors (e.g. alcohol, certain foods); tax on vegetables??

  27. Tobacco Control:Raising Taxes, consumption

  28. Tobacco Control:Raising Taxes: revenues up

  29. Tobacco Control:Earmarked Tax for Health Example: Thailand • 2% of tobacco and alcohol tax used for health promotion

  30. And now: Major private donors Michael Bloomberg But funding from governments completely inadequate… Bill Gates

  31. NCDs: 60% Global Deaths Source: WHO, 2010

  32. Deaths fromCardiovascular Disease Coronary heart disease Stroke * Different keys

  33. Cancer: Major Risk Factors

  34. Cancer Registries % of the population covered by cancer registration 67.0 85.0 7.1 19.0 7.9 13.0 82.0 17.0% total IARC, 2011

  35. Physicians Working in NCD

  36. C21 Epidemics:New Paradigm Needed

  37. Source: WHO, 2010

  38. UN Summit on NCDs 19-20 Sep 2011 • 28 such meetings at UN sinceend-WWII  only 1 on health (AIDS) • This one: 135 co-sponsoring countries and unanimous approval • Outcome Document is critical • Call for addition of all NCDs into next round of UN MDGs in 2015

  39. Public health come of age

  40. The fight for tobacco control will continue!Thank You Professor Judith Mackay Senior Advisor jmackay@worldlungfoundation.org

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