WHO scaling up tobacco control strategies

Bobby Ramakant ,  Singapore   |  Thu, 05/29/2008 10:38 AM  |  Opinion

Indonesia and other countries in the world need to scale up the cost-effective, proven and WHO recommended strategies to reduce the number of deaths attributed to tobacco use.

The World Health Statistics Report (2008) of WHO released 10 days before this year's World No Tobacco Day (May 31) ups the urgency to scale up quality interventions to control tobacco use.

About half of all countries in the world implement none of the recommended tobacco control policies, despite the fact that tobacco control measures are cost-effective and proven. Moreover, not more than 5 percent of the world's population is fully covered by any one of these measures.

World Health Statistics Report (2008) had further confirmed that heart disease, obesity, and tobacco use were among the leading causes of deaths worldwide. The number of deaths from non-communicable chronic conditions, the risk to which is exacerbated by tobacco use, is alarmingly rising far more than the number of deaths from communicable diseases like HIV, TB or Malaria.

The single most preventable cause of death world wide, the report stated, is tobacco use. Tobacco use has been found to kill one-third to one-half of its users, according to this report.

Earlier in February 2008, WHO had released the World Tobacco Epidemic Report which underlines not only the evidence-based fact that tobacco epidemic is worsening but also recommends a comprehensive package of six-effective tobacco control policies - clubbed as "MPOWER" that have demonstrated results in helping countries stop the diseases, deaths and economic damages caused by tobacco use.

The MPOWER package includes:

M: stands for "monitor" tobacco use and prevention policies. Assessment of tobacco use and its impact must be strengthened.

P: stands for "protect" people from tobacco smoke. All people have a fundamental right to breathe clean air. Smoke-free places are essential to protect non-smokers and also to encourage smokers to quit.

O: stands for "offer" help to quit tobacco use. Services to treat tobacco dependence are fully available in only nine countries with 5 percent of the world's population. Countries must establish programs providing low-cost, effective interventions for tobacco users who want to quit.

W: stands for "warn" about the dangers of tobacco use. Despite conclusive evidence, relatively few tobacco users understand the full extent of their health risk. Graphic warnings on tobacco packaging deter tobacco use, yet only 15 countries, representing 6 percent of the world's population, mandate pictorial warnings (covering at least 30 percent of the principal surface area) and just five countries with a little over 4 percent of the world's people, meet the highest standards for pack warnings. More than 40 percent of the world's population lives in countries that do not prevent use of misleading and deceptive terms such as "light" and "low tar".

E: stands for "enforce" bans on tobacco advertising, promotion and sponsorship. Partial bans on tobacco advertising, promotion and sponsorship, do not work because the industry merely redirects its resources to other non-regulated marketing channels. Only a total ban can reduce tobacco consumption and protect people, particularly youth, from industry marketing tactics. Only 5 percent of the world's population currently lives in countries with comprehensive bans on tobacco advertising, promotion and sponsorship.

R: stands for "raised" taxes on tobacco. Raising taxes and therefore prices, is the most effective way to reduce tobacco use, and especially to discourage young people from using tobacco. Only 4 countries, representing 2 percent of the world's population, have tax rates greater than 75 percent of retail price.

"Reversing this entirely preventable epidemic must now rank as a top priority for public health and for political leaders in every country of the world" said Margaret Chan, Director-General of the WHO in the summary.

However the global tobacco epidemic stands starkly apart from other conventional disease control programs because of an aggressive tobacco industry that is hell-bent on protecting and expanding its markets globally, particularly in the developing countries of Asia and Africa. Tobacco corporations across the world have not only been aggressively protecting and promoting their tobacco markets, particularly in the developing countries, but also trying their best to either abort or weaken the public health policies that begin to take shape in countries around the world.

The alert monitoring of tobacco corporations in Indonesia and holding them accountable for violating existing health policies will further boost the impact of the WHO's recommended MPOWER package in reducing tobacco use globally.

The writer is a regional correspondent and a member of Network for Accountability of Tobacco Transnationals (NATT). He can be contacted at bobbyramakant@yahoo.com

Comments (2)  |   Post comment
A  |   A  |   A  |   Mail to a friend  |  Printer Friendly Version |  Digg it!  |  Add to Del.icio.us!  |  Add to Reddit!  |  Stumble it!

Regarding WHO and tobacco control strategies: In the war on nicotine addiction, the health of the Indonesian citizens is clearly losing as Indonesian politicians continue to side with the tobacco lobby. Banning advertising would be an important step in protecting children from the temptations of smoking. Increasing tobacco excise taxes in periodic steps would reduce the affordability to all but the coddled rich. Some tobacco farmers may have to find substitute crops, but with the prices of food now rising everywhere, there should be plenty of opportunities. The government could take the increased taxes to create a fund to retrain displaced tobacco industry workers or to provide for their unemployment insurance.

There are several creative ways to reduce nicotine addiction which have been fully tested in other countries. It is a blight on this country that its politicians hold the health of its children in such low esteem, while claiming to be so concerned by the dangers of their exposure to internet pornography.

All these cool UN acronyms mean nothing. As long as it is allowed for the tobacco death merchants to erect their huge display advertisements appealing to the virility of the youth no amount of health messages will have any effect whatsoever. As long as children can buy single cigarettes openly and the deadly product is promoted by pop concerts; what is the point of any committee drawing up plans for campaigns?

The other day I saw a little wayside government poster saying "Narcoba Haram." Tobacco kills - horribly - many many more millions than any illicit drug. Without tobacco people would never "graduate" to other substances. Yet mile upon mile of cigarette advertising and acres upon acres of poster space proclaims the message that tobacco is the most heavily promoted product in Indonesia.

These are mass murderers and destroyers of the youth of the nation. Tobacco advertising must be prohibited completely and sales to children rigorously denied.

It is one of the three stupidities of life in Indonesia - tobacco promotion, children on overloaded motorcycles and noisy religious practices. It is time for Indonesia to start to wise up.