2012 Johns Hopkins Bloomberg School of Public Health Annette David, MD, MPH, FACOEM Senior Partner...

2012 Johns Hopkins Bloomberg School of Public Health

Annette David, MD, MPH, FACOEMSenior Partner for Health Consulting Services at Health Partners, L.L.C. (Guam)

Best Practices in International Tobacco ControlBest Practices in International Tobacco Control


Learning Objectives

Identify key population strategies embodied in the WHO FCTC and MPOWER

Delineate actions that health professionals can take to promote tobacco control

2


World Cigarette Production

3

Image source: Tobacco Atlas. (2012). www.tobaccoatlas.org


A Global Solution to a Global Epidemic

4

Image sources: (left) World Health Organization. (2000). Geneva public hearing; (right) World Health Organization. (2011).


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.

5


Monitor Tobacco Use and Prevention Policies

6


Sources of Data

Global Tobacco Surveillance System—GATS, GYTS, GHPSS

Other global/regional surveys—WHO Steps, BRFSS, YRBSS

National surveys

7


Protect from Tobacco Smoke

8


Smoke-Free Polices

Smoke-free policies decrease exposure to secondhand tobacco smoke by 80-90% in high-exposure settings

9


Offer Help to Quit Tobacco Use

Three types of treatment should be included in any tobacco prevention effort:

1. Cessation advice in health care

2. Quit lines

3. Pharmacological therapy

Tobacco cessation interventions are effective

10


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

11


Warn about the Dangers of Tobacco

12


Graphic Warnings Increase Smokers’ Intention to Quit

13

Image source: iStockphoto.com


Smokeless Tobacco Products and Warning Labels

Smokeless tobacco products are less likely to have health warning labels

14

Images source: iStockphoto.com


Enforce Bans

15


Total Ad Bans Work

Image source: Annette David.

16


Only 19 Countries Have Total Ad Bans

17


Raise Taxes on Tobacco

18


Higher Taxes, Lower Consumption

19


Optimal Tobacco Tax Rates

Less than 10% of middle- and low-income countries have optimal tobacco tax rates

20


Average Retail Price and Taxation

21


Impact on Consumption

22

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


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

23


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:

1. Physician, heal thyself—become tobacco-free

2. Patient care—advise all smoking patients to quit

3. Personal policies—tobacco-free clinics/homes

4. Pursue skills and knowledge on tobacco cessation

5. Refuse tobacco industry support of any kind

24



Institutional actions:

1. Making all meetings and events tobacco-free

2. Including tobacco issues in conference agendas

3. Assessing and addressing tobacco consumption patterns among members of health associations

4. Refusing tobacco industry support

5. Promoting capacity building for tobacco cessation

25



Health system actions:

1. Integrating training on tobacco control and cessation into all health professionals curriculae

2. Incorporating at least brief tobacco cessation advice into primary health care

3. Building a strong cessation infrastructure and instituting cessation programs into all health care settings

4. Promoting tobacco-free policies in all health care settings and supporting all health professionals to become tobacco-free

26



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

27

2012 Johns Hopkins Bloomberg School of Public Health 28

Thank You!

2012 Johns Hopkins Bloomberg School of Public Health Annette David, MD, MPH, FACOEM Senior Partner...

Documents

Transcript of 2012 Johns Hopkins Bloomberg School of Public Health Annette David, MD, MPH, FACOEM Senior Partner...