Post on 16-Apr-2017
Protection from Second-hand Smoke in the Western Pacific Region
Dr Susan Mercado
Regional Adviser
Tobacco-Free Initiative
World Health Organization
Western Pacific Regional Office
Research clearly shows that there is no safe level of exposure to
second-hand smoke.
A third of the world’s smokersare in the Region.
2 peopledie each minute from a tobacco-related disease in the Region.
5
Most Recent Scientific Evidence: Exposure to SHS
Source: adapted by CTLT from U.S. Surgeon General’s Report. (2006).
Second-hand smoke increases the risk of coronary heart disease by 25–30% and the risk of
lung cancer in non-smokers by 20–30%.
Second-hand smoke exposure has been conclusively linked to breast cancer.
% OF STUDENTS (AGE 13 - 15 YEARS) EXPOSED TO SMOKE FROM OTHERS AT HOME (TOTAL)
11.5
35.1
37.3
38.3
40.3
42.1
47
47.1
47.6
48.3
54.4
54.5
57.6
58
58.5
59.1
59.3
59.4
60.7
61.9
73.9
76.6
0 10 20 30 40 50 60 70 80 90
MALAYSIA (2003)
SINGAPORE (2000)
NEW ZEALAND (2007)
REPUBLIC OF KOREA (2008)
LAO PEOPLE'S DEM REP (2007)
MACAO SAR (2005)
CAMBODIA (2003)
FIJI (2005)
PALAU (2005)
CHINA (2005)
MONGOLIA (2007)
PHILIPPINES (2007)
COOK ISLANDS (2003)
C.N. MARIANA IS. (2004)
VIET NAM (2007)
SAMOA (2007)
VANUATU (2007)
GUAM (2002)
MICRONESIA (2007)
AMERICAN SAMOA (2005)
PAPUA NEW GUINEA (2007)
TUVALU (2005)
%
Sub national data
Sub national data
% of students (age 13 - 15 years) exposed to smoke in public places (Total)
16.7
28.9
44.5
55.4
55.5
56.8
58.5
61.2
62.8
64.6
64.8
65.1
67.3
69.3
71.2
71.3
71.5
72.9
73
75.9
76.7
86.4
0 10 20 30 40 50 60 70 80 90 100
MALAYSIA (2003)
PALAU (2005)
CHINA (2005)
LAO PEOPLE'S DEM REP (2003)
MONGOLIA (2007)
FIJI (2005)
CAMBODIA (2003)
AMERICAN SAMOA (2005)
SAMOA (2007)
NEW ZEALAND (2007)
PHILIPPINES (2007)
SINGAPORE (2000)
MACAO SAR (2005)
REPUBLIC OF KOREA (2008)
VIET NAM (2007)
MICRONESIA (2007)
GUAM (2002)
C.N. MARIANA IS. (2004)
COOK ISLANDS (2003)
VANUATU (2007)
TUVALU (2006)
PAPUA NEW GUINEA (2007)
%
Sub national data
Sub national data
50% youth 13-15 years old are exposed to
second hand smoke at home.
% of current cigarette smoker students (age 13 - 15 years) usually smoke at home (Total)
6.1
8
11.1
11.8
14.5
15
15.3
18.3
19.3
20
20.7
22
22.1
22.5
24.2
28.1
56.5
0 10 20 30 40 50 60
MACAO [CHINA] (2005)
MONGOLIA (2007)
REPUBLIC OF KOREA (2008)
SINGAPORE (2000)
MALAYSIA (2003)
VIET NAM (2007)
PHILIPPINES (2007)
PAPUA NEW GUINEA (2006)
TUVALU (2006)
LAO PDR (2007)
FIJI (2005)
MICRONESIA (2007)
SAMOA (2007)
VANUATU (2007)
COOK ISLANDS (2003)
NEW ZEALAND (2007)
CHINA (1999)
%
Sub national data
Sub national data
Smoke-free environments help smokers who want to quit. Smoke-free policies in workplaces in several industrialized nations have reduced total tobacco consumption among workers by an average of 29%.
Smoke-free public places also encourage families to make their homes smoke-free, which protects children and other family members from the dangers of second-hand smoke.
13
Positive Health Impact of Smoke-Free Environments
Source: Navas, A. (2007).
DIRECT
INDIRECT
Reject the myths!
MPOWER: A Policy Package for Global Tobacco Control
The six demand reduction policies to support complete implementation of the
WHO Framework Convention on Tobacco Control
•Monitor tobacco use and prevention policies
•Protect people from tobacco smoke
•Offer help to quit tobacco use
•Warn about the dangers of tobacco
•Enforce bans on tobacco advertising, promotion and sponsorship
•Raise taxes on tobacco
WHO Regional Initiatives • Dissemination of the Guidelines for Article 8 of the WHO
FCTC• Development of tools and training on monitoring of
second-hand smoke• Promotion of tobacco-free sports• Development of guidance and awards for good practices
and best proposals for MPOWER and Healthy Cities• The Red Orchid Awards• Tobacco and gender• Healthy urban transport (smoke-free criteria)• Support for projects to use GYTS data for policies and
action
RESTAURANTS
PUBLIC TRANSPORT
INDOOR OFFICES
EDUCATIONAL FACILITIES
ALL OTHER PUBLIC PLACES
GOVERNMENT FACILITIES
PUBS AND BARS
HEALTH CARE FACILITIES
1
2
3
4SHS SPIDERGRAM
18
Indoor Air ConcentrationsThe concentration of secondhand smoke in the air can be determined by measuring the concentration of its components
Measurements of airborne nicotine, carbon dioxide, or particulate matter can indicate the extent of secondhand smoke exposure in a particular location
Passive air nicotine monitors are accurate, relatively inexpensive, and easy to use.
Nicotine
Particulate Matter
19Source: Navas-Acien, et al. (2004); Image source: New York City Department of Health and Mental Hygiene.
Air Nicotine Concentrations (µg/m3) in Restaurants in 10 Countries*
Smoking policy N Median (IQR)†
No policy 54 1.15 (0.32–2.44)
Smoking section 32 1.30 (0.43–2.31)
Nonsmoking 20 0.66 (0.20–1.10)
Smoking ban 7 0.07 (0.003–0.10)
* Countries: Argentina, Brazil, Chile, Costa Rica, Paraguay, Peru, Uruguay, Honduras, Mexico and Panama
† IQR: interquartile range
TRAINING ON SECOND-HAND SMOKE MONITORING
See next slide
TOBACCO FREE SPORTS
• Beijing, China• Viet Nam• Laos People’s
Democratic Republic• Viet Nam• Guangzhou, China• Cook Islands
Gender and tobacco
(Viet Nam and Palau)
2008 WHO Awards and the Alliance for Healthy Cities
COMPREHENSIVE TOBACCO CONTROL IN CITIES
• Singapore Health Promotion Board
• Taicang, China• Wonju, Republic of Korea
BEST PROPOSAL FOR COMPREHENSIVE TOBACCO CONTROL IN CITIES
• Chanwon, Republic of Korea
HEALTHY URBAN TRANSPORT
Lloyd Wright
Pilot on the Red Orchid Awards for Tobacco-Free Settings,
Philippines, 2009
Second-hand Smoke Busters!
Use of youth data to monitor tobacco control programme progress.
TOBACCO CONTROL DATA APPLICATION PROJECTS (GYTS)
Smoke-free schools in Seam Riap, Cambodia
Regional Action Plan (2010-2014) for the Tobacco Free Initiative in the Western Pacific
Moving Toward the Next Level: Complete implementation of the
WHO Framework Convention on Tobacco Control
Regional Action Plan (2010-2014) for the Tobacco Free Initiative in the Western Pacific
VISION: Tobacco free people, communities and environments
MISSION: To advocate, enable and support complete implementation of the WHO Framework Convention on Tobacco Control
GOAL: To attain the lowest possible tobacco use prevalence and the highest level of protection from second-hand smoke
Three Point Strategy1 Promote and advocate for complete
WHO FCTC Implementation
2 Mobilize for public action
3 Strengthen organizational capacity
•Legislation and policies
•Tobacco taxation
•Governance and local enforcement
•Alliance and partnerships
•Investment planning and resource management
•Leadership training and human resource development
•Surveillance, monitoring and knowledge management
•Public awareness, education, communication and advocacy
•Treatment of tobacco dependence
Approaches
• Development and/or updating of national action plans
• Establishment and/or strengthening of national coordinating mechanisms for tobacco control
• Adoption of targets and prevalence indicators to monitor progress
Overall indicators• By 2014- All countries have developed national action plans or
equivalents and established or strengthened national coordinating mechanisms
- All parties in the Region have ratified all WHO FCTC protocols
- Reliable adult and youth tobacco use data are available in all countries
- Prevalence of adults (men and women) and youth (boys and girls) current tobacco use (smoking and smokeless) is reduced by 10% from the most recent baseline
Regional programme targets relevant to protection from second-hand smoke exposure
• 100% of countries - have adopted measures compliant with Articles 5.3 & 8 - monitoring and enforcement of Article 5.3 & 8 - have a list of existing and potential partners - have multi-year human resource development plans - have reliable and comparable population level data - have implemented national communication plans - have national tobacco dependence treatment guidelines - have trained health workers giving brief cessation advice
• 50% of countries - convene meetings with multisectoral partners - publicly recognize outstanding contributions - have multi-year budget estimates
The Regional Action Plan (2010-2014) Tobacco Free Initiative for the Western
Pacific contains a menu of actions and indicators for
countries and WHO.
% of students (age 13 - 15 years) favored banning smoking in public places (Total)
32.5
36.3
39.1
41.2
41.3
52
62
63.1
63.5
75.7
79.1
81.2
82.9
83
88.4
89.5
90.9
0 10 20 30 40 50 60 70 80 90 100
MICRONESIA (2007)
VANUATU (2007)
FIJI (2005)
SAMOA (2007)
NEW ZEALAND (2007)
PAPUA NEW GUINEA (2007)
LAO PDR (2007)
MACAO [CHINA] (2005)
CHINA (2005)
COOK ISLANDS (2003)
MONGOLIA (2007)
MALAYSIA (2003)
CAMBODIA (2003)
REPUBLIC OF KOREA (2008)
VIET NAM (2007)
TUVALU (2006)
PHILIPPINES (2007)
%
Sub national data
Sub national data
Yuhta Ohishi, 15 years old, Japan
World No Tobacco Day Awardee, 2008
Recipient of Director General’s Special Recognition certificate