TOBACCO & NCDTOBACCO & NCD

Raúl MejíaCEDES

University of Buenos AiresArgentina

Tobacco caused deaths 2000-2030• Base-line scenario

– 2005 – 5.4 million– 2015 – 6.5 million– 2030 – 8.3 million

• Optimistic scenario– 2030 – 7.4 million

• Pessimistic scenario– 2030 – 9.4 million

• Change by income 2002-2030 – High – 9% decline– Medium/low – 2x

• 3.4 – 6.8 million

Mathers and Loncar. PLoS Medicine. 2006

CARDIOVASCULAR RISKS OF SMOKING

100% Increase in Risk

300% Increase in Risk

Stroke; CHD; Impotence

Death from undiagnosed CHD

> 300 % Increase in Risk

Peripheral Arterial Disease

400 % Increase in Risk

Aortic Aneurysm

What works on tobacco controlFramework Convention on Tobacco

Control– Comprehensive advertising bans– Rotating health warning (>30%)– Ban misleading terms “light”– Protect citizens from exposure to

secondhand smoke– Combat smuggling– Increase taxes

• Expose the tobacco industry (my own)

Copyright ©2004 BMJ Publishing Group Ltd.Sargent, R. P et al. BMJ 2004;328:977-980

Heart attack admissions during the 6 months (June-Nov) before, during (2002) and after smoke-free ordinance implementation.

2nd hand smoking is also important

WHO FCTC

• First global public health treaty

• Signed by 168 countries

• Ratified by 157 countries

• Went into force in February 2005

Objective

“To protect present and future generations from the devastating health, social, environmental and economic consequences of tobacco consumption and exposure to tobacco smoke...”

Ratification of FCTC: an example of KTE

• Policymakers (legislators) are not well informed about the consequences of tobacco smoking.

• Few legislatores interested in reducing tobacco consumption.

• Few “good quality” local information and most of it in English.

• Few experts in tobacco control research

Opportunities• Tobacco control research worldwide

– Epidemic

• Political pressure– Politicians like to look good

• Good things are happening already– Need critical evaluation– Be opened to criticism

Challenges

• Tobacco industry– Well organized

– Learned from the past

– 20 years ahead of us

What happened in Argentina

• We have got the information

• We have published it

• We have disseminated through the media

• Politicians were interested– Former Health Minister

But…..

Tobacco situation in Argentina

• 5 provinces produces tobacco

• We have not ratified the FCTC yet

• Almost 30% of Argentinean population smokes

• A 20 cigarettes pack cost 1 l. gas

• Partial bans for smoking in public spaces

• Partial bans for advertising

What could work?

• Alliances with committed legislators

• More “agresive” journalists

• Improvement in how research results are transmited to policymakers

• Civil society engagment

Civil coalition with the objetive of promote 100% free smoke

areas in Argentina