Reading 1: WHO - Facts about smoking.
Key facts - Tobacco kills up to half of its users. - Tobacco kills around 6 million people each year. More than 5 million of those deaths are the result of direct tobacco use while more than 600 000 are the result of non-smokers being exposed to second-hand smoke. - Nearly 80% of the world's 1 billion smokers live in low- and middle-income countries. Leading cause of death, illness and impoverishment The tobacco epidemic is one of the biggest public health threats the world has ever faced, killing around 6 million people a year. More than 5 million of those deaths are the result of direct tobacco use while more than 600 000 are the result of non-smokers being exposed to second-hand smoke. Nearly 80% of the more than 1 billion smokers worldwide live in low- and middle-income countries, where the burden of tobacco-related illness and death is heaviest. Tobacco users who die prematurely deprive their families of income, raise the cost of health care and hinder economic development. In some countries, children from poor households are frequently employed in tobacco farming to provide family income. These children are especially vulnerable to "green tobacco sickness", which is caused by the nicotine that is absorbed through the skin from the handling of wet tobacco leaves. Surveillance is key Good monitoring tracks the extent and character of the tobacco epidemic and indicates how best to tailor policies. Only 1 in 3 countries, representing one third of the world's population, monitors tobacco use by repeating nationally representative youth and adult surveys at least once every 5 years. Second-hand smoke kills Second-hand smoke is the smoke that fills restaurants, offices or other enclosed spaces when people burn tobacco products such as cigarettes, bidis and water-pipes. There are more than 4000 chemicals in tobacco smoke, of which at least 250 are known to be harmful and more than 50 are known to cause cancer. There is no safe level of exposure to second-hand tobacco smoke. - In adults, second-hand smoke causes serious cardiovascular and respiratory diseases, including coronary heart disease and lung cancer. In infants, it causes sudden death. In pregnant women, it causes low birth weight. - Almost half of children regularly breathe air polluted by tobacco smoke in public places. - Second-hand smoke causes more than 600 000 premature deaths per year. - In 2004, children accounted for 28% of the deaths attributable to second-hand smoke. Every person should be able to breathe tobacco-smoke-free air. Smoke-free laws protect the health of non-smokers, are popular, do not harm business and encourage smokers to quit. Over 1.3 billion people, or 18% of the world's population, are protected by comprehensive national smoke-free laws. Tobacco users need help to quit Studies show that few people understand the specific health risks of tobacco use. For example, a 2009 survey in China revealed that only 38% of smokers knew that smoking causes coronary heart disease and only 27% knew that it causes stroke. Among smokers who are aware of the dangers of tobacco, most want to quit. Counselling and medication can more than double the chance that a smoker who tries to quit will succeed. National comprehensive cessation services with full or partial cost-coverage are available to assist tobacco users to quit in only 24 countries, representing 15% of the world's population. There is no cessation assistance of any kind in one quarter of low-income countries. Picture warnings work Hard-hitting anti-tobacco advertisements and graphic pack warnings – especially those that include pictures – reduce the number of children who begin smoking and increase the number of smokers who quit. Graphic warnings can persuade smokers to protect the health of non-smokers by smoking less inside the home and avoiding smoking near children. Studies carried out after the implementation of pictorial package warnings in Brazil, Canada, Singapore and Thailand consistently show that pictorial warnings significantly increase people's awareness of the harms of tobacco use. Only 42 countries, representing 19% of the world's population, meet the best practice for pictorial warnings, which includes the warnings in the local language and cover an average of at least half of the front and back of cigarette packs. Most of these countries are low- or middle-income countries. Mass media campaigns can also reduce tobacco consumption by influencing people to protect non-smokers and convincing youths to stop using tobacco. Over half of the world's population live in the 39 countries that have aired at least 1 strong anti-tobacco mass media campaign within the last 2 years. Ad bans lower consumption Bans on tobacco advertising, promotion and sponsorship can reduce tobacco consumption. -A comprehensive ban on all tobacco advertising, promotion and sponsorship could decrease tobacco consumption by an average of about 7%, with some countries experiencing a decline in consumption of up to 16%. -Only 29 countries, representing 12% of the world’s population, have completely banned all forms of tobacco advertising, promotion and sponsorship. -Around 1 country in 3 has minimal or no restrictions at all on tobacco advertising, promotion and sponsorship. Taxes discourage tobacco use Tobacco taxes are the most cost-effective way to reduce tobacco use, especially among young and poor people. A tax increase that increases tobacco prices by 10% decreases tobacco consumption by about 4% in high-income countries and about 5% in low- and middle-income countries. Even so, high tobacco taxes is a measure that is rarely implemented. Only 33 countries, with 10% of the world's population, have introduced taxes on tobacco products so that more than 75% of the retail price is tax. Tobacco tax revenues are on average 269 times higher than spending on tobacco control, based on available data. Illicit trade of tobacco products must be stopped The illicit trade in tobacco products poses major health, economic and security concerns around the world. It is estimated that 1 in every 10 cigarettes and tobacco products consumed globally is illicit. The illicit market is supported by various players, ranging from petty peddlers to organized criminal networks involved in arms and human trafficking. Eliminating illicit trade in tobacco will reduce the harmful consumption of tobacco by restricting availability of cheap, unregulated alternatives and increasing overall tobacco prices. Critically, this will reduce premature deaths from tobacco use and raise tax revenue for governments. Stopping illicit trade in tobacco products is a health priority, and is achievable. But to do so requires improvement of national and sub-national tax administration systems and international collaboration, such as ratification and implementation of the Protocol to Eliminate the Illicit Trade in Tobacco Products, an international treaty in its own right, negotiated by parties to the WHO Framework Convention on Tobacco Control (WHO FCTC). While publicly stating its support for action against the illicit trade, the tobacco industry’s behind-the-scenes behaviour has been very different. Internal industry documents released as a result of court cases demonstrate that the tobacco industry has actively fostered the illicit trade globally. It also works to block implementation of tobacco control measures, such as tax increases and pictorial health warnings, by misleadingly arguing they will fuel the illicit trade. WHO response WHO is committed to fighting the global tobacco epidemic. The WHO Framework Convention on Tobacco Control entered into force in February 2005. Since then, it has become one of the most widely embraced treaties in the history of the United Nations with 180 Parties covering 90% of the world's population. The WHO Framework Convention is WHO's most important tobacco control tool and a milestone in the promotion of public health. It is an evidence-based treaty that reaffirms the right of people to the highest standard of health, provides legal dimensions for international health cooperation and sets high standards for compliance. In 2008, WHO introduced a practical, cost-effective way to scale up implementation of provisions of the WHO Framework Convention on the ground: MPOWER. Each MPOWER measure corresponds to at least 1 provision of the WHO Framework Convention on Tobacco Control. The 6 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. For more details on progress made for tobacco control at global, regional and country level, please refer to the series of WHO reports on the global tobacco epidemic. The WHO FCTC Protocol to Eliminate the Illicit Trade in Tobacco Products requires a wide range of measures relating to the tobacco supply chain, including the licensing of imports, exports and manufacture of tobacco products; the establishment of tracking and tracing systems and the imposition of penal sanctions on those responsible for illicit trade. It would also criminalize illicit production and cross-border smuggling.
Reading 2: WHO World No Tobacco Day
New release 28 MAY 2015 GENEVA - Eliminating the illicit trade in tobacco would generate an annual tax windfall of US$ 31 billion for governments, improve public health, help cut crime and curb an important revenue source for the tobacco industry. Those are the key themes of World No Tobacco Day on 31 May when WHO will urge Member States to sign the "Protocol to Eliminate the Illicit Trade in Tobacco Products". “The Protocol offers the world a unique legal instrument to counter and eventually eliminate a sophisticated criminal activity,” says Dr Margaret Chan, WHO Director-General. “Fully implemented, it will replenish government revenues and allow more spending on health.” So far, 8 countries have ratified the Protocol, short of the target of 40 needed for it to become international law. Once that happens, the Protocol’s provisions on securing the supply chain, enhanced international cooperation and other safeguards will come into force. The Protocol is an international treaty in its own right negotiated by parties to the WHO Framework Convention on Tobacco Control (WHO FCTC), which has been ratified by 180 Parties. Article 15 commits signatories to eliminate all forms of illicit trade in tobacco products. The Protocol requires a wide range of measures relating to the tobacco supply chain, including the licensing of imports, exports and manufacture of tobacco products; the establishment of tracking and tracing systems and the imposition of penal sanctions on those responsible for illicit trade. It would also criminalise illicit production and cross border smuggling. “The Protocol faces overt and covert resistance from the tobacco industry,” says Dr Vera da Costa e Silva, Head of the WHO FCTC Secretariat. “Manufacturers know that once implemented, it will become much harder to hook young people and the poor into tobacco addiction.” The illicit tobacco trade offers products at lower prices, primarily by avoiding government taxes through smuggling, illegal manufacturing and counterfeiting. Cheaper tobacco encourages younger tobacco users (who generally have lower incomes) and cuts government revenues, reducing the resources available for socioeconomic development, especially in low-income countries that depend heavily on consumption taxes. This money might otherwise be spent on the provision of public services, including health care. While publicly stating its support for action against the illicit trade, the tobacco industry’s behind-the-scenes behaviour has been very different. Internal industry documents released as a result of court cases demonstrate that the tobacco industry has actively fostered the illicit trade globally. It also works to block implementation of tobacco control measures, like tax increases and pictorial health warnings, by arguing they will fuel the illicit trade. “Public health is engaged in a pitched battle against a ruthless industry,” says Dr Douglas Bettcher, Director of the WHO’s Department for the Prevention of Noncommunicable Diseases. “On this World No Tobacco Day, WHO and its partners are showing the ends that the tobacco industry goes to in the search for profits, including on the black market, and by ensnaring new targets, including young children, to expand its deadly trade.” Policy makers should recognize that the illicit tobacco trade exacerbates the global health epidemic and has serious security implications. Ratification of the Protocol to Eliminate the Illicit Trade in Tobacco Products is a necessary step to combat these twin evils. Editor’s note Tobacco-related illness is one of the biggest public health threats the world has ever faced. Approximately one person dies from a tobacco-linked disease every six seconds, equivalent to almost 6 million people a year. That’s forecast to rise to more than 8 million people a year by 2030, with more than 80% of these preventable deaths occurring among people living in low-and middle-income countries. The WHO Framework Convention for Tobacco Control (WHO FCTC) entered into force in 2005. Parties are obliged over time to take a number of steps to reduce demand and supply for tobacco products including: protecting people from exposure to tobacco smoke, counteracting illicit trade, banning advertising, promotion and sponsorship, banning sales to minors, putting large health warnings on packages of tobacco, increasing tobacco taxes and creating a national coordinating mechanism for tobacco control. There are 180 Parties to the Convention.
Reading 3: WHO Global status report on alcohol and health 2014.
Global status report on alcohol and health 2014 The Global status report on alcohol and health 2014 presents a comprehensive perspective on the global, regional and country consumption of alcohol, patterns of drinking, health consequences and policy responses in Member States. It represents a continuing effort by the World Health Organization (WHO) to support Member States in collecting information in order to assist them in their efforts to reduce the harmful use of alcohol, and its health and social consequences. The report was launched in Geneva on Monday 12 May 2014 during the second meeting of the global network of WHO national counterparts for implementation of the global strategy to reduce the harmful use of alcohol. The report provides a global overview of alcohol consumption in relation to public health (Chapter 1) as well as information on: the consumption of alcohol in populations (Chapter 2); the health consequences of alcohol consumption (Chapter 3); and policy responses at national level (Chapter 4). In addition the report contains country profiles for WHO Member States and appendices with statistical annexes, a description of the data sources and methods used as well as references.
Reading 4: WHO reports on alcohol consumption.
WHO calls on governments to do more to prevent alcohol-related deaths and diseases News release 12 May 2014 GENEVA - Worldwide, 3.3 million deaths in 2012 were due to harmful use of alcohol, says a new report launched by WHO today. Alcohol consumption can not only lead to dependence but also increases people’s risk of developing more than 200 diseases including liver cirrhosis and some cancers. In addition, harmful drinking can lead to violence and injuries. The report also finds that harmful use of alcohol makes people more susceptible to infectious diseases such as tuberculosis and pneumonia. The "Global status report on alcohol and health 2014" provides country profiles for alcohol consumption in the 194 WHO Member States, the impact on public health and policy responses. “More needs to be done to protect populations from the negative health consequences of alcohol consumption,” says Dr Oleg Chestnov, WHO Assistant Director-General for Noncommunicable Diseases and Mental Health. “The report clearly shows that there is no room for complacency when it comes to reducing the harmful use of alcohol.” Some countries are already strengthening measures to protect people. These include increasing taxes on alcohol, limiting the availability of alcohol by raising the age limit, and regulating the marketing of alcoholic beverages. Report highlights The report also highlights the need for action by countries including: - national leadership to develop policies to reduce harmful use of alcohol (66 WHO Member States had written national alcohol policies in 2012); - national awareness-raising activities (nearly 140 countries reported at least one such activity in the past three years); - health services to deliver prevention and treatment services, in particular increasing prevention, treatment and care for patients and their families, and supporting initiatives for screening and brief interventions. In addition the report shows the need for communities to be engaged in reducing harmful use of alcohol. On average every person in the world aged 15 years or older drinks 6.2 litres of pure alcohol per year. But as less than half the population (38.3%) actually drinks alcohol, this means that those who do drink consume on average 17 litres of pure alcohol annually. The report also points to the fact that a higher percentage of deaths among men than among women are from alcohol-related causes - 7.6% of men’s deaths and 4% of women’s deaths – though there is evidence that women may be more vulnerable to some alcohol-related health conditions compared to men. In addition, the authors note that there is concern over the steady increase in alcohol use among women. “We found that worldwide about 16% of drinkers engage in heavy episodic drinking - often referred to as ‘binge-drinking’ - which is the most harmful to health,” explains Dr Shekhar Saxena, Director for Mental Health and Substance Abuse at WHO. "Lower-income groups are more affected by the social and health consequences of alcohol. They often lack quality health care and are less protected by functional family or community networks.” Globally, Europe is the region with the highest consumption of alcohol per capita, with some of its countries having particularly high consumption rates. Trend analysis shows that the consumption level is stable over the last 5 years in the region, as well as in Africa and the Americas, though increases have been reported in the South-East Asia and the Western Pacific regions. Through a global network, WHO is supporting countries in their development and implementation of policies to reduce the harmful use of alcohol. The need for intensified action was endorsed in the landmark 2011 United Nations General Assembly meeting, which identified alcohol as one of four common risk factors* contributing to the non-communicable diseases (NCDs) epidemic. *The rise of NCDs has been driven by primarily four major risk factors: tobacco use, physical inactivity, the harmful use of alcohol and unhealthy diets (“Noncommunicable diseases and their risk factors” in Programmes, WHO home page).
