Tobacco, Obesity & Technology.
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1 Tobacco, Obesity & Technology. David Hammond, PhD June 21, 2011
2 Dramatic population level changes can happen over a short period of time.
3 Changes in tobacco consumption: 20 th Century
4 Smoking prevalence in Canada:
5 Prevalence: Obesity ~60% of Canadian adults overweight or obese. One quarter of children overweight or obese. Sources: 1. Statistics Canada. Canadian Health Measures Survey: 2007 to quotidien/100113/dq100113a eng.htm
6 Trends Obesity in Canada Source: Katzmarzyk PT. The Canadian obesity epidemic, CMAJ April 16; 166(8):
7 Trends Obesity in USA Source: US Centers for Disease Control & Prevntion.
8 Trends Health disparities Prevalence of smoking in many First Nation communities exceeds 70%.
9 Trends Obesity in Canada Obesity increasing among all SES groups, age groups, and geographic regions.
10 Individual level factors can not explain rise and fall in tobacco use.
11 Reductions in smoking are primarily the result of policy interventions.
12 Changes in tobacco consumption: 20 th Century
13 Price is among the most effective policy levers for reducing tobacco use.
14 Policy interventions Changing the environment
15 Policy interventions Changing environment
16 Policy interventions Marketing restrictions
17 Policy interventions Marketing restrictions
18 Policy interventions Marketing 18
19 Policy interventions Marketing 19
20 Technology Marketing 20
21 Policy interventions Marketing
22 Policy interventions Communicating risk
23 Policy interventions Communicating risk
24 Industry innovation and technology has done more to increase rather than decrease tobacco use.
25 Industry Consumer reassurance
26 Industry Consumer reassurance
27 Industry innovation Product Reformulation
28 Reductions in smoking were not driven by clinical interventions.
29 Abstinence rates for smokers trying to quit remain approximately 5 to 10%.
30 Individual level factors can not explain increase in obesity.
31 Technology Changing society & lifestyles
32 Advances in technology have made food more varied and convenient, so much so that our rather feeble will power is unable to cope with the temptation. Cutler D, Glaeser E, Shapiro J. Why Have Americans Become More Obese? NBER Working Paper No January
33 Marketing Food marketing to children
34 Marketing Toy Premiums
35 Food Industry Food industry & innovation
36 Industry Innovation & technology
37 Modern technology has done more to increase, rather than decrease obesity.
38 To what extent will technology be part of the solution in the future?
39 Monitoring & tracking Diabetes & geographic mapping bin/star_static.cgi?section=news&page=/flash/thursday diabetes.html
40 Monitoring & tracking Spread of obesity in social networks Source: Christakis NA, et al. The Spread of Obesity in a Large Social Network over 32 Years. N Engl J Med 2007; 357:370 37
41 Monitoring & tracking Monitoring retail environment
42 Monitoring & tracking Retail environment
43 Monitoring & tracking Monitoring school & work environments
44 Technology can help to increase the reach of interventions.
45 Interventions & Reach Smartphone Apps 33% of Canadians own a smartphone. Highest concentration among youth and young adults. More than 60 iphone apps to quit smoking. Source: comscore. Canada Digital Year in Review March 2011.
46 Interventions & Reach Online, Text & Apps Broad reach Personalize interventions Potential sources of social support Delivered at time of behaviour Source: comscore. Canada Digital Year in Review March 2011.
47 Apps & Web Interventions Content & Quality?
48 Public health community has been slow to adopt technology.
49 Can public health agencies design effective online interventions & apps?
50 Apps & Web Interventions Reach?
51 Apps & Web Interventions Quality
52 Apps & Web Interventions Quality
53 Apps & Web Interventions Quality
54 Technology has had very little impact on smoking cessation interventions..yet
55 Apps & Web Interventions Diet Source:
56 Apps & Web Interventions Diet Calorie Tracker
57 Apps & Web Interventions Diet & physical activity Lose it
58 Apps & Web Interventions New interventions?
59 Apps & Web Interventions New types of interventions?
60 Can technology increase consumer understanding of diet and nutrition?
61 Consumer education Tobacco control
62 Consumer education Tobacco: complexity
63 Nutrient quality and calorie levels are not intuitive. 540 calories 29g of fat 540 calories 37g of fat
64 Industry Healthy options?
65 Industry Healthy options?
66 Technology Sources of information Source: Goodman S, Hammond D, Pillo Blocka F, Glanville T, Jenkins R. Use of Nutritional Information in Canada: National trends between 2004 and (Submitted to Journal of Nutrition Education & Behavior.)
67 Consumer education Sources of information Source: Goodman S, Hammond D, Pillo Blocka F, Glanville T, Jenkins R. Use of Nutritional Information in Canada: National trends between 2004 and (Submitted to Journal of Nutrition Education & Behavior.)
68 Consumer education Nutrition labels: Reach
69 Consumer education Complexity of information
70 Consumer education Low tech
71 Consumer education Food content: high tech app for product info the challenge is in the content/
72 Consumer education There an app for that too!
73 Consumer education Food content: Low(er) tech
74 Consumer education Regulations, equity and reach Source: Center for Science in the Public Interest. Product Reformation: A Beneficial Outcome of Menu Labeling. Available at:
75 Warning Labels stopped you from having a cigarette. Wave 1 Wave 2 Canada Australia US UK Challenges Will high tech interventions increase inequities? Second level Third level Fourth level Fifth level Percentage 75 Source: Hammond (2007)
76 Challenges Government capacity Health Canada These medicines all taste pretty good let s approve them.
77 Warning Labels stopped you from having a cigarette. Wave 1 Wave 2 Canada Australia US UK Challenges Government innovation Second level Third level Fourth level Fifth level (Health Canada?) Percentage 77
78 Summary Modern technology has done more to increase rather than decrease obesity. Interventions that capitalize on technology have potential to increase reach and scope of interventions. Must be integrated with broader context of policy change to reduce prevalence of obesity.
79 Thank you. David Hammond, PhD Department of Health Studies & Gerontology University of Waterloo Tel. Web ext
80
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