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Best Practices in International Tobacco Control

Best Practices in International Tobacco Control. Annette David, MD, MPH, FACOEM Senior Partner for Health Consulting Services at Health Partners, L.L.C. (Guam). Learning Objectives. Identify key population strategies embodied in the WHO FCTC and MPOWER

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Best Practices in International Tobacco Control

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  1. Best Practices in International Tobacco Control Annette David, MD, MPH, FACOEM Senior Partner for Health Consulting Services at Health Partners, L.L.C. (Guam)

  2. Learning Objectives • Identify key population strategies embodied in the WHO FCTC and MPOWER • Delineate actions that health professionals can take to promote tobacco control

  3. World Cigarette Production Image source: Tobacco Atlas. (2012). www.tobaccoatlas.org

  4. A Global Solution to a Global Epidemic Image sources: (left) World Health Organization. (2000). Geneva public hearing; (right) World Health Organization. (2011).

  5. MPOWER • The six MPOWER measures are: • Monitor tobacco use and prevention policies • Protect people from tobacco use • Offer help to quit tobacco use • Warn about the dangers of tobacco • Enforce bans on tobacco advertising, promotion, and sponsorship • Raise taxes on tobacco Image source: World Health Organization.

  6. Monitor Tobacco Use and Prevention Policies

  7. Global Tobacco Surveillance System—GATS, GYTS, GHPSS Other global/regional surveys—WHO Steps, BRFSS, YRBSS National surveys Sources of Data

  8. Protect from Tobacco Smoke

  9. Smoke-Free Polices • Smoke-free policies decrease exposure to secondhand tobacco smoke by 80-90% in high-exposure settings

  10. Offer Help to Quit Tobacco Use • Three types of treatment should be included in any tobacco prevention effort: • Cessation advice in health care • Quit lines • Pharmacological therapy • Tobacco cessation interventions are effective

  11. Offer Help to Quit Tobacco Use • Studies show that even brief advice from health professionals can increase tobacco abstinence rates up to 30% • Interventions for smoking cessation led by nurses have shown to increase the chance of successfully quitting smoking by up to 50% • There also needs to be a systematic approach for incorporating brief tobacco interventions (the “5 A’s” and “5 R’s”) into primary health care services

  12. Warn about the Dangers of Tobacco

  13. Graphic Warnings Increase Smokers’ Intention to Quit Image source: iStockphoto.com

  14. Smokeless Tobacco Products and Warning Labels • Smokeless tobacco products are less likely to have health warning labels Images source: iStockphoto.com

  15. Enforce Bans

  16. Total Ad Bans Work Image source: Annette David.

  17. Only 19 Countries Have Total Ad Bans

  18. Raise Taxes on Tobacco

  19. Higher Taxes, Lower Consumption

  20. Optimal Tobacco Tax Rates • Less than 10% of middle- and low-income countries have optimal tobacco tax rates

  21. Average Retail Price and Taxation

  22. Impact on Consumption Source: Mendez et al. (2013). Tob Control, 22(1): 46-51.

  23. Why Health Professionals? • Witness to patients’ suffering from tobacco-related illnesses • Advocate for patients’ well-being • Key opinion leader—credibility • Expert—technical knowledge • Unique position to influence others • Professional and personal role model for the community

  24. Health Professionals’ Role in Tobacco Control • In 2004, a global meeting of medical organizations at the WHO headquarters in Geneva resulted in the publication of a code of practice for health professionals and health organizations • Individual actions: • Physician, heal thyself—become tobacco-free • Patient care—advise all smoking patients to quit • Personal policies—tobacco-free clinics/homes • Pursue skills and knowledge on tobacco cessation • Refuse tobacco industry support of any kind

  25. Health Professionals’ Role in Tobacco Control • Institutional actions: • Making all meetings and events tobacco-free • Including tobacco issues in conference agendas • Assessing and addressing tobacco consumption patterns among members of health associations • Refusing tobacco industry support • Promoting capacity building for tobacco cessation

  26. Health Professionals’ Role in Tobacco Control • Health system actions: • Integrating training on tobacco control and cessation into all health professionals curriculae • Incorporating at least brief tobacco cessation advice into primary health care • Building a strong cessation infrastructure and instituting cessation programs into all health care settings • Promoting tobacco-free policies in all health care settings and supporting all health professionals to become tobacco-free

  27. Health Professionals’ Role in Tobacco Control • National level: • Health professionals should support and advocate for effective tobacco control public policies as embodied by the MPOWER Package and full implementation of the WHO Framework Convention on Tobacco Control • Advise legislators on evidence-based tobacco-control policies and laws • As experts we should choose to be tobacco-free, recognize and treat tobacco dependence, advocate for and support tobacco-free policies and programs, and avoid tobacco sponsorship

  28. Thank You!

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