Dr. Limpin- Epidemiology of Smoking

8/6/2019 Dr. Limpin- Epidemiology of Smoking

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Ma. Encarnita C. BlancoMa. Encarnita C. Blanco--Limpin, MDLimpin, MDFramework Convention on Tobacco Control Alliance,Framework Convention on Tobacco Control Alliance,

Philippines (FCAP)Philippines (FCAP)Council on Tobacco or Health, Philippine College of ChestCouncil on Tobacco or Health, Philippine College of Chest

Physicians (PCCP)Physicians (PCCP)

Philippine Heart CenterPhilippine Heart Center


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1.1 billion or 1 in 3 adults smoke1.1 billion or 1 in 3 adults smoke

about 80% live in lowabout 80% live in low-- and middleand middle--income countriesincome countries

total number of smokers is expected to reach abouttotal number of smokers is expected to reach about1.6 billion by 20251.6 billion by 2025

G

lobal Trends in Tobacco UseG

lobal Trends in Tobacco Use

World Bank, 1999World Bank, 1999

WHO, 2001WHO, 2001

1.2 billion smokers over the age of 15 years1.2 billion smokers over the age of 15 years300 million are in China300 million are in China


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Smoking already kills one in 10Smoking already kills one in 10

adults worldwideadults worldwide

By 2030, the proportion will be oneBy 2030, the proportion will be one

in six, or 10 million deaths per yearin six, or 10 million deaths per year

Until recently, this epidemic ofUntil recently, this epidemic of

chronic disease and premature deathchronic disease and premature deathmainly affected the rich countries, itmainly affected the rich countries, it

is now rapidly shifting to theis now rapidly shifting to the

developing worlddeveloping world

By 2020, seven of every 10 peopleBy 2020, seven of every 10 peoplekilled by smoking will be in lowkilled by smoking will be in low--

and middleand middle--income nationsincome nations

World Bank, 1999World Bank, 1999


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Tobacco Production andTobacco Production and

ConsumptionConsumption


ConsumptionConsumption Manufactured CigarettesManufactured Cigarettes

Philippines has manufactured 73Philippines has manufactured 73

billion cigarettes in 1994, occupyingbillion cigarettes in 1994, occupying

the 15the 15thth

leading producer ofleading producer ofcigarettescigarettes

Manufactured Cigar

ettesManufactured Cigarettes

Philippines has manufactured 73Philippines has manufactured 73

billion cigarettes in 1994, occupyingbillion cigarettes in 1994, occupying

the 15the 15thth

leading producer ofleading producer ofcigarettescigarettes


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Imported CigarettesImported Cigarettes

Philippines has imported some 13.98Philippines has imported some 13.98

billion cigarettes, occupying the 12billion cigarettes, occupying the 12thth

place among worlds leadingplace among worlds leading

importersimporters

Imp

orted CigarettesImported Cigarettes

Philippines has imported some 13.98Philippines has imported some 13.98

billion cigarettes, occupying the 12billion cigarettes, occupying the 12thth

place among worlds leadingplace among worlds leading

importersimporters






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ConsumptionConsumption Tobacco ConsumptionTobacco Consumption

Among 25 leading countries in 1994,Among 25 leading countries in 1994,

Philippines ranked 15Philippines ranked 15thth on apparenton apparent

tobacco consumption with sometobacco consumption with some

85.36 billion cigarettes or about 1.6%85.36 billion cigarettes or about 1.6%

of the worlds total (WHO 1997)of the worlds total (WHO 1997)

Tobacco Consump

tionTobacco Consumption

Among 25 leading countries in 1994,Among 25 leading countries in 1994,

Philippines ranked 15Philippines ranked 15thth on apparenton apparent

tobacco consumption with sometobacco consumption with some

85.36 billion cigarettes or about 1.6%85.36 billion cigarettes or about 1.6%

of the worlds total (WHO 1997)of the worlds total (WHO 1997)


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S

moking PrevalenceS

moking PrevalenceS

moking PrevalenceS

moking Prevalence In terms of tobacco consumption, WHOIn terms of tobacco consumption, WHO

estimated in 1998 that 1/3estimated in 1998 that 1/3rdrd

of the globalof the globalpopulation, or 1.1 billion people aged 15population, or 1.1 billion people aged 15

years and over are smokersyears and over are smokers

800 million of these are in developing800 million of these are in developingcountries like the Philippinescountries like the Philippines

In terms of tobacco consumption, WHOIn terms of tobacco consumption, WHO

estimated in 1998 that 1/3estimated in 1998 that 1/3rdrd

of the globalof the globalpopulation, or 1.1 billion people aged 15population, or 1.1 billion people aged 15

years and over are smokersyears and over are smokers

800 million of these are in developing800 million of these are in developingcountries like the Philippinescountries like the Philippines


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S

moking PrevalenceS

moking PrevalenceS

moking PrevalenceS

moking Prevalence In 4,541 individuals aged 20 yearsn 4,541 individuals aged 20 years

and over :and over : 33% of adult Filipinos are current33% of adult Filipinos are current

smokerssmokers

13% are ex13% are ex--smokerssmokers

In 4,541 individuals aged 20 yearsn 4,541 individuals aged 20 years

and over :and over : 33% of adult Filipinos are current33% of adult Filipinos are current

smokerssmokers

13% are ex13% are ex--smokerssmokers

Monograph of Cigarette SmokingMonograph of Cigarette SmokingDans et. al., 1999Dans et. al., 1999Monograph of Cigarette SmokingMonograph of Cigarette SmokingDans et. al., 1999Dans et. al., 1999


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S

mokingS

moking single most preventable health crisis of allsingle most preventable health crisis of all

Kills nearly 5 million people each yearKills nearly 5 million people each year

20,000 Filipinos die every year due to20,000 Filipinos die every year due to

tobaccotobacco--related diseaserelated disease

-- that's 2 or 3 every hour.that's 2 or 3 every hour.


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What Are You Smoking?What Are You Smoking?

There are 4,000 chemicals in cigaretteThere are 4,000 chemicals in cigarettesmokesmoke -- 60 of which are cancer60 of which are cancer--inducinginducingsubstancessubstances

NicotineNicotine an intake off 60 mg can kill;an intake off 60 mg can kill;each stick has 15each stick has 15--20 mg20 mg TarTar an irritating & canceran irritating & cancer--causingcausing

substancesubstance AmmoniaAmmonia makes smokers addictedmakes smokers addicted Carbon monoxideCarbon monoxide also found in car smokealso found in car smoke

CadmiumCadmium highly toxic, found in carhighly toxic, found in carbatteries that causes liver, kidney &batteries that causes liver, kidney &brain damagebrain damage

LeadLead stunts growth & causes brain damagestunts growth & causes brain damage ArsenicArsenic wellwell--known poisonknown poison


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Hair loss, wrinkling, discolored fingers and

bad breath are just some of the side effects of

smoking

Smoking makes bones brittle, making you prone toinjuries

Smoking for more than 20 years will reduce your

lifespan by 20 to 25 years

Hair loss, wrinkling, discolored fingers and

bad breath are just some of the side effects of

smoking

Smoking makes bones brittle, making you prone toinjuries

Smoking for more than 20 years will reduce your

lifespan by 20 to 25 years

S

mokeG

ets in yourS

mokeG

ets in yourS

mokeG

ets in yourS

mokeG

ets in your


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W

hat YouS

hould Know AboutW

hat YouS

hould Know About

Mainstream smoke is smoke that is inhaledthrough a smokers mouth

Sidestream smoke is smoke that drifts off at

the end of cigarettes

A secondhand smoke or passive smokerA secondhand smoke or passive smokeris one who inhales sidestream smokeis one who inhales sidestream smoke


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nonnon--smokers who live with smokers are:smokers who live with smokers are: at 20at 20--30% increased risk of developing cancer,30% increased risk of developing cancer,

particularly lung cancerparticularly lung cancer

At 20At 20--30% increased risk of developing heart30% increased risk of developing heartdiseasedisease

-- Major International reviews on Cancer andMajor International reviews on Cancer andHeart DiseaseHeart Disease

Passive Evidence ofPassive Evidence of

secondsecond--hand smoke kills 35,000 to 65,000hand smoke kills 35,000 to 65,000adult nonadult non--smokers from heart disease andsmokers from heart disease and3,000 non3,000 non--smokers from lung cancer everysmokers from lung cancer everyin USA alonein USA alone

-- USand California EnvironmentalUSand California Environmental

Protection AgenciesProtection Agencies


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In children, passive smoking is known tocause fetal growth impairment, cot death

(SIDS), asthma, bronchitis, pneumonia andmiddle ear disease

Childrens exposure to tobacco smoke isresponsible for up to 13% of asthma cases,

13% of ear infections and 20% of all lunginfections in children under 5

-- 1996USAnalysis of over100 reports on1996USAnalysis of over100 reports on

Pediatric DiseasesPediatric Diseases

Passive Evidence ofPassive Evidence of


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Tobacco Smoke is also anImportant Source of Air Pollution

Tobacco Smoke is also anImportant Source of Air Pollution

Contributes to a noxiousenvironment

It causes wheezing, coughing,

colds, earaches, and asthmaattacks in passive smokers


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Economic IssuesEconomic Issues The Philippine government earns aboutThe Philippine government earns about 2121

billion pesosbillion pesos from the sale and manufacturefrom the sale and manufacture

of tobacco and tobacco products each year.of tobacco and tobacco products each year.

But it loses aboutBut it loses about 46 billion pesos46 billion pesos toto

tobaccotobacco--related healthcare and lost ofrelated healthcare and lost of

productivity.productivity.

Monograph of Cigarette SmokingMonograph of Cigarette SmokingDans et. al., 1999Dans et. al., 1999Monograph of Cigarette SmokingMonograph of Cigarette SmokingDans et. al., 1999Dans et. al., 1999


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Health Consequences ofHealth Consequences of

Smoking are TwoSmoking are Two--FoldFold AddictionAddiction

The addictive properties of nicotine are wellThe addictive properties of nicotine are welldocumented but often underestimated by thedocumented but often underestimated by the

consumerconsumer

Fatal and disabling diseasesFatal and disabling diseases

The diseases associated with smoking are wellThe diseases associated with smoking are welldocumented & include:documented & include:

Cancers of the lungs and other organsCancers of the lungs and other organs Ischemic heart diseaseIschemic heart disease

StrokesStrokes

Respiratory diseases such as emphysema, frequentRespiratory diseases such as emphysema, frequentasthma attacksasthma attacks


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What is FCTC?What is FCTC? FFrameworkrameworkCConvention ononvention on TTobaccoobacco CControlontrol

International treaty initiated by the World HealthInternational treaty initiated by the World HealthAssemblyAssembly

A governing body of the World Health OrganizationA governing body of the World Health Organization worlds first global public health agreement devotedworlds first global public health agreement devoted

entirely to tobacco control.entirely to tobacco control.

Participated by 192 countriesParticipated by 192 countries

Negotiations began in October 1999 & concluded onNegotiations began in October 1999 & concluded onMarch 1March 1stst 20032003

Signing & ratification is onSigning & ratification is on--going (May 18going (May 18--28, 2003)28, 2003)


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People who smoke may notPeople who smoke may not

realize how noxious smoke is torealize how noxious smoke is to

nonnon--smokers. Passive smoking issmokers. Passive smoking is

damaging, not just disagreeable,damaging, not just disagreeable,

and can actually be lethal toand can actually be lethal to

people with severe asthma. people with severe asthma. -- Claire Rayner, writer andClaire Rayner, writer and

health campaignerhealth campaigner


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"It is important to know as much as possible about"It is important to know as much as possible about

teenage smoking patterns and attitudes. Today's teenteenage smoking patterns and attitudes. Today's teen--agerager

is tomorrow's potential regular customer, and theis tomorrow's potential regular customer, and the

overwhelming majority of smokers first begin to smokeoverwhelming majority of smokers first begin to smoke

while in their teens. . . .The smoking patterns of teenwhile in their teens. . . .The smoking patterns of teen--agersagers

are particularly important to Philip Morris. . . the shareare particularly important to Philip Morris. . . the share

index is highest in the youngest group for allMarlboroindex is highest in the youngest group for allMarlboro

and Virginia Slims packings. At least a part of the successand Virginia Slims packings. At least a part of the success

ofMarlboro Red during its most rapid growth period wasofMarlboro Red during its most rapid growth period was

because it became the brand of choice among teenagersbecause it became the brand of choice among teenagers

who then stuck with it as they grew older."who then stuck with it as they grew older."

March 31, 1981 market research report on young smokers titled"YoungMarch 31, 1981 market research report on young smokers titled"Young

Smokers Prevalence, Trends,Implications, and Related DemographicSmokers Prevalence, Trends,Implications, and Related Demographic

Trends,Trends,

written by Philip Morris researcherMyron E. Johnston and approved bywritten by Philip Morris researcherMyron E. Johnston and approved by

Carolyn Levy and Harry Daniel. Bates No. 000390803Carolyn Levy and Harry Daniel. Bates No. 000390803


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Ma. Encarnita C. Blanco-Limpin, MDCouncil on Tobacco or Health & Air Pollution, Philippine

College of Chest Physicians (PCCP)Framework Convention on Tobacco Control Alliance,

Philippines (FCAP)


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What Happens to our body whenWhat Happens to our body when

you quit smoking . . .you quit smoking . . .

What Happens to our body whenWhat Happens to our body when

you quit smoking . . .you quit smoking . . .20 minutes20 minutes BP & pulse rate drops to normalBP & pulse rate drops to normal

Body temp of hands & feetBody temp of hands & feet

increases to normalincreases to normal

8 hours8 hours CO level in your blood drops toCO level in your blood drops to

normalnormal

O2 in our blood increases toO2 in our blood increases to

normalnormal

24 hours24 hours chance of heart attack chance of heart attack

decreasesdecreases

20 minutes20 minutes BP & pulse rate drops to normalBP & pulse rate drops to normal

Body temp of hands & feetBody temp of hands & feet

increases to normalincreases to normal

8 hours8 hours CO level in your blood drops toCO level in your blood drops to

normalnormal

O2 in our blood increases toO2 in our blood increases to

normalnormal

24 hours24 hours chance of heart attack chance of heart attack

decreasesdecreases


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What happens to our body whenWhat happens to our body when



you quit smoking . . .you quit smoking . . .48 hours48 hours nerve endings start growing againnerve endings start growing again

ability to smell & taste is enhancedability to smell & taste is enhanced

nicotine is no longer detectable innicotine is no longer detectable inthe bodythe body

2 wks to2 wks to circulation improvescirculation improves

3 months3 months walking becomes easierwalking becomes easierlung function increase up to 30%lung function increase up to 30%

48 hours48 hours nerve endings start growing againnerve endings start growing again

ability to smell & taste is enhancedability to smell & taste is enhanced

nicotine is no longer detectable innicotine is no longer detectable inthe bodythe body

2 wks to2 wks to circulation improvescirculation improves

3 months3 months walking becomes easierwalking becomes easierlung function increase up to 30%lung function increase up to 30%


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you quit smoking . . .you quit smoking . . .1 to 9 months1 to 9 months cough, sinus congestion,cough, sinus congestion,

fatigue & shortness of breathfatigue & shortness of breath

decreasedecreasecilia grow again in your lungs,cilia grow again in your lungs,

increasing ability to handleincreasing ability to handle

mucus, clean the lungs &mucus, clean the lungs &

reduce infectionreduce infection

1 year1 year risk of coronary heart diseaserisk of coronary heart disease

is that of a smokeris that of a smoker

1 to 9 months1 to 9 months cough, sinus congestion,cough, sinus congestion,

fatigue & shortness of breathfatigue & shortness of breath

decreasedecreasecilia grow again in your lungs,cilia grow again in your lungs,

increasing ability to handleincreasing ability to handle

mucus, clean the lungs &mucus, clean the lungs &

reduce infectionreduce infection

1 year1 year risk of coronary heart diseaserisk of coronary heart disease

is that of a smokeris that of a smoker


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you quit smoking . . .you quit smoking . . .5 years5 years lung cancer death ratelung cancer death rate

decreases by almost decreases by almost stroke risk is reduced tostroke risk is reduced to

that of nonthat of non--smoker 5smoker 5--1515

years after quittingyears after quitting

risk of cancer of the mouth,risk of cancer of the mouth,

throat & esophagus is throat & esophagus is

that of a smokers riskthat of a smokers risk

5 years5 years lung cancer death ratelung cancer death rate

decreases by almost decreases by almost stroke risk is reduced tostroke risk is reduced to

that of nonthat of non--smoker 5smoker 5--1515

years after quittingyears after quitting

risk of cancer of the mouth,risk of cancer of the mouth,

throat & esophagus is throat & esophagus is

that of a smokers riskthat of a smokers risk


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What happens to our body when

you quit smoking . . .

What happens to our body when

you quit smoking . . .10 years lung cancer death rate is

similar to that of a non-smoker

risk of all cigarette-related

cancers continues to decrease

15 years risk of coronary heart disease

is that of a non-smoker

10 years lung cancer death rate is

similar to that of a non-smoker

risk of all cigarette-related

cancers continues to decrease

15 years risk of coronary heart disease

is that of a non-smoker


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QUIT NOW!


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Dr. Limpin- Epidemiology of Smoking

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