TOBACCO CONTROL. Presented by Dr. Eva Lewis-Fuller

Transcription

1 TOBACCO CONTROL Presented by Dr. Eva Lewis-Fuller

2 TOBACCO FARM

3 TOBACCO SMOKE Consists of approximately 4000 compounds - 40 of these cause cancer

4 Some Contents of Cigarette Smoke Nicotine Tar-containing polycyclic aromatic hydrocarbons Carbon monoxide & dioxide Nitrosamines (tobacco-specific) Ammonia Acetone Butane Hydrogen cyanide DDT Polonium 210 Cadmium Methanol Sulphuric acid Arsenic Radon Naphthalene

5 TOBACCO SMOKING IS MAJOR CONTRIBUTOR TO PREMATURE DEATHS: - Smokers have an overall mortality of 20-50% greater than non-smokers - Excess of deaths greatest in year age-group - At least 50% of chronic smokers die from tobaccorelated diseases, loosing years of life

6 MISCELLANEOUS DATA ON USE OF TOBACCO (cont d) Approximately one-third of all cancers in the world are attributable to use of tobacco Cigarette smoking is major contributor to cardiovascular deaths Passive smokers are at risk for smokingrelated diseases

7 MISCELLANEOUS DATA ON USE OF TOBACCO (cont d) Use of tobacco is second leading cause of worldwide mortality Risk from smoking-related diseases decreases steadily after cessation of smoking Tobacco use is the greatest single preventable cause of death.

8 TOBACCO PRODUCTS Cigarette - contains hundreds of chemical additives, highly engineered, exquisitely designed nicotine delivery device Bidis Cigars Kreteks Pipes Sticks Chewing tobacco Moist snuff Dry snuff

9 Examples:

10 ILLNESSES CAUSED BY CIGARETTE SMOKING

11 Youth Global Tobacco Survey ( ) Prevalence of smoking among year olds WPRO WHO Regions SEARO PAHO EURO EMRO AFRO Prevalence %

12 Smoking prevalence in the Caribbean GYTS Prevalence % among Year olds COUNTRY % Antigua/Barbuda Bahamas Barbados 17.6 Dominic a 20.5 Grenada 16.4 Guy ana 16.9 Jamaic a 19 Mons terrat 13.9 St. Vinc ent 24.2 St. Luc ia 14.3 Suriname 20.5 Trinidad/Tobago 16.3 Cuba 17.6 Hait i 18.5 USA 23.1

13 THE TOBACCO INDUSTRY Tobacco industry has remained stable over the years, as subsidiaries of transnational companies e.g. British American Tobacco Very little tobacco farming in Jamaica since Hurricane Gilbert 1988 Most of the raw materials used in cigarette manufacturing are now imported Employs 130 persons directly??30,000 small business and micro- enterprises involved in cigarette retail trade Contributes tax revenue and foreign exchange to the Jamaican economy

14 Quanity Total Import / Annual Average Prices of Cigarettes for Jamaica Ann. Avg. Price per pack

15 TOBACCO CONSUMPTION Prevalence of Smoking - % YEAR GYTS MOH ADULT -% 14.6 NA YOUTH 29 % NA

16 RESPONSE TO THE TOBACCO PROBLEM Levels of Response: Global Regional Local

17 Global Response The Framework Convention on Tobacco Control (FCTC) was adopted by the 192 Member States at the 56 th World Health Assembly on May 21, The FCTC was later came into force February 27, 2005, after 40 countries ratified it.

18 GLOBAL RESPONSE (Cont.) Objective of the FCTC to provide a framework for the integrated tobacco-control measures to be implemented through the engagement of the Parties in order, continually and substantially, to reduce the prevalence of tobacco use and thus protect present and future generations from the devastating health, social, environmental and economic consequences of tobacco consumption and exposure to tobacco smoke.

19 GLOBAL RESPONSE the FCTC The 38 Articles of the FCTC presents a preamble, introduction, objective, guiding principle and general obligations, then main headings of the convention are: 1. Measures relating to the reduction of demand for tobacco 2. Measures relating to the reduction of the supply of tobacco 3. Protection of the Environment 4. Questions related to liability 5. Scientific and Technical Cooperation and Communication of information 6. Institutional Arrangements and Financial Resources 7. Settlements of Disputes 8. Development of the Convention 9. Final Provisions

20 GLOBAL RESPONSE the FCTC Measures relating to the reduction of demand for tobacco: Price and tax measures to reduce demand for tobacco Non-price measures to reduce the demand for tobacco Protection from exposure to tobacco smoke Regulation of the content of tobacco products Regulation of tobacco product disclosures Packaging and labeling of tobacco products Education communication, training and public awareness Tobacco advertising, promotion and sponsorship Demand reduction measures concerning tobacco dependence and cessation

21 GLOBAL RESPONSE the FCTC Reduction of Demand Rationale for price and tax measures: - increasing real price of cigarettes by 10% through taxation will reduce consumption by 8% in middle and low income countries. - although consumption is reduced, increased taxation increases revenue to government which can be used for health promotion programmes.

22 GLOBAL RESPONSE the FCTC The Laffer Curve Tax Revenue Tax Rate %

23 GLOBAL RESPONSE the FCTC Reduction of Demand Non-Price Measures: - Legislation - executive/administrative measures - Policies - Public education, involvement of civil society, NGOs

24 GLOBAL RESPONSE the FCTC Reduction of Demand Rationale for Protection from Exposure to tobacco smoke: - Unequivocal link between exposure to passive or environmental tobacco smoke (ETS) and an increased risk of disease and death in nonsmokers - ETS in the workplace results in increased work days lost form smoking related illness. - Decreasing smoking in various environments increases the rate at which smokers quit smoking

25 GLOBAL RESPONSE the FCTC Reduction of Demand Rationale regulating packaging and labeling tobacco products: - Packaging is a means of promotion of the product through false, misleading or deceptive portrayal e.g. use of terms: low tar, light, ultra-light, or mild - Health warnings on packages are effective educational tools, and should be large, visible, legible and clear ( 30% - 50% of the display areas on packages);

26 GLOBAL RESPONSE the FCTC Reduction of Demand Rationale regulating packaging and labeling tobacco products (Cont d): - Labeling specifications should apply to each unit packet or package and any outside packaging - Health warnings should be varied and rotating, in principal language of country - Warnings may be in the form of pictures or pictograms - The main constituents of the tobacco/cigarette and the smoke should be displayed on the packet or packages.

27 GLOBAL RESPONSE the FCTC SMOKING CAUSES IMPTOTENCE

28 GLOBAL RESPONSE the FCTC Reduction of Demand Rationale for regulating Tobacco Advertising, promotion and sponsorship: - Promotion creates a friendly familiarity and increases demand for the product, thus sustaining a market. - Comprehensive ban on advertising, including cross-border advertising, prevents initiation of the tobacco habit and is effective in weakening the development of brand loyalty, reducing consumption. - Partial bans have been shown to be ineffective.

29 GLOBAL RESPONSE the FCTC Reduction of Demand Education, communication, training and public awareness - implication for educators - mandate to implement effective and appropriate training or sensitization and awareness programmes on tobacco control addressed to educators (Article 12) - Design and implement effective programmes aimed at promoting the cessation of tobacco use in such locations as educational institutions sporting environments (Art. 14.2)

30 GLOBAL RESPONSE the FCTC Reduction of supply Elimination of illicit trade in tobacco products Prohibition of sale to minors Support for economically viable alternative tobacco workers, growers and individual sellers.

31 GLOBAL RESPONSE the FCTC Reduction of Supply Sale to Minors (Article 16) - Prohibition of sale of tobacco products to persons under the legal age (18 years old) - indication of prohibition to be placed inside shops (with signs) - tobacco products not to be displayed in shops so as to be accessible to minors. - prohibition of manufacture of sweets, snacks, toys etc. in the form of tobacco/cigarettes - Ensure that Tobacco vending machines not accessible to minors - Prohibit distribution of free cigarette etc., sale of single sticks - Prohibit sale of all tobacco products to minors

32

33 LOCAL RESPONSE - MOH General Measures Health education and promotion of healthy lifestyles are integrated into strategy to prevent chronic diseases Designation of a Focal Point for Tobacco Control Development of communication materials to discourage smoking.

34 LOCAL RESPONSE - MOH Existing Measures: mandatory health warning on tobacco packages - Chief Medical Officer s warning: cigarettes can be dangerous to your health

35 LOCAL RESPONSE - MOH Existing Measures: Prohibition of tobacco advertising on the electronic media (television, radio and cinemas) The Broadcasting and Re-Diffusion Act

36 LOCAL RESPONSE Existing Measures: Ban on smoking in health institutions No smoking in the national carrier Air Jamaica Some Private companies restrict smoking within their buildings Insurance companies provide more favourable terms for non-smokers Prohibition of ads. In printed material intended for minors under 18 years.

37 LOCAL RESPONSE MOH Endorsement and participation (along with 192 other countries) in formulation of international Treaty: - Framework Convention on Tobacco Control (FCTC) initiated by the World Health Organization (WHO) FCTC formally adopted September 24, 2003, signed by the the Minister of Foreign Affairs Jamaica ratified the FCTC on July 7, 2005.

38 LOCAL RESPONSE MOH Proposal for New / Amended LEGISLATION Product Price Packaging and labeling Advertising and promotion Smoke free environment Restricting distribution of tobacco products.

39 LOCAL RESPONSE LEGISLATION PROPOSED Review of taxation policy as it applies to tobacco products with a view to increasing taxation and the price of the products. Additional revenues raised to be channeled into National Health Fund to finance specific health programmes and conditions. - Excise duty recently increased by 23% - Increase in special consumption tax (to produce $300 million) - Cabinet approval of ratification and domestic legislation

40 LOCAL RESPONSE - -MOH Legislation Proposed. Vary the Chief Medical Officer s message and rotate health warnings with graphics illustrations on the cigarette boxes. Recover the cost of smoking-related illnesses from the tobacco companies Registration of tobacco products coming into the country, under the Food and Drug Act.

41 LOCAL RESPONSE Legislation Proposed. Licensing of wholesalers of tobacco products; payment of fees Prohibition of sale or distribution of tobacco, including free samples) to minors less that 18 years old. Review current anti-smuggling legislation with the Customs Act to reduce smuggling of tobacco.

42 LOCAL RESPONSE Legislation Proposed. Ban on smoking in : Workplaces schools Health institutions and other Government buildings airports and seaports Ban on smoking in public places e.g. restaurants, clubs, recreational facilities, workplaces, auditoriums, educational institutions conference/meeting rooms. Total ban on all tobacco advertising, promotion, and sponsorship

43 CABINET S RESPONSE November 26, 2001 Proposal for a Joint Select Committee to examine issue MOH to: - collaborate with other relevant ministries, agencies - calculate the impact of tobacco control on economy - examine alternative employment measures - examine strategies to address immediate revenue inflows Support the initiative to encourage reduced tobacco use Planned to asked the Legislative Committee to examine fines for offences and make recommendations.

44 ACTION TAKEN BY MOH First phase of economic analysis completed Second phase completed Study A third, very technical phase to be embarked on Education of public Collaboration globally, regionally and locally - with many partners

45 STUDY: THE ECONOMICS OF TOBACCO CONTROL IN JAMAICA: Will the Pursuit of Public Health Place A Fiscal Burden on the Government? Increase in taxation on cigarettes = win-win situation ( increase in revenues and decrease in consumption of tobacco products)

46 FURTHER ACTION TAKEN Adopted the FCTC in September 2003 Ratified the FCTC - July 7, became Party to the Convention 90 days after Represented at the first session of the Conference of the Parties February Draft legislation at the office of the Chief Parliamentary Council

47 BUILDING SUPPORT FOR TOBACCO CONTROL LEGISLATION Non-governmental organizations Jamaica Coalition for Tobacco Control National Council on Drug Abuse Smoke Free Advocacy Group Medical / Health Professional NOGs Churches Others.To work along with Government agencies.

48 TOBACCO CONTROL MEASURES Clinical Interventions Smoking Cessation: Tell smokers to stop smoking help them to quit nicotine replacement therapy (NRT) Provide support and counseling Consider nicotine replacement therapy Discourage youth from commencing smoking

49 We want to make these museum items

50 The health of the public is the foundation upon which rests the happiness of the people and the welfare of the state - Benjamin Disraeli

51 STOP Thank you for not smoking