SLIDES 2-The Tobacco Epidemic

7/31/2019 SLIDES 2-The Tobacco Epidemic

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Dr Susan Mercado

Team Leader, Tobacco Free Initiative

Western Pacific Regional Office

The Tobacco Epidemic


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Cigarettes

Tobacco currently kills more than 6million/year but this will increase to over 8million/year in a few decades

If current smoking patterns continue, the

death toll from tobacco use will be:2000 2025 ~ 150 M2025 2050 ~ 300M2050 2100 > 500M

TOTAL for 21st Century 1 billion(half the deaths in middle age)


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5.0

3.9

3.0

1.8 1.71.2 1.0

0.6

0

1

2

3

4

5

6

Tobacco Lower

RespInfect

AIDS Diarrheal

Disease

TB Traffic

Injuries

Malaria Measles

GlobalDeathsperYe

(millions)

Unless urgent action is taken, tobacco will soon kill twice as

l d ill kill 1 billi l thi t

4


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Second hand smoke kills.


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We have a high tolerance for secondhand smoke exposure:

Of the 600 000 yearly deaths from

second hand smoke exposure---

167,000 or 28% are children

We have a high tolerance for secondhand smoke exposure:

Of the 600 000 yearly deaths from

second hand smoke exposure---

167,000 or 28% are children


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Image source: adapted by CTLT from U.S. Surgeon Generals Report. (2006).


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When you inhale, chemicals in tobacco smokecause damage immediately

Even the smallest amount of tobacco smoke canalso damage your DNA, which can lead to cancer

Even brief exposure to SHS can causecardiovascular disease and could trigger cardiacevents, such as a heart attack

Tobacco smoke can quickly damage blood vesselsand make blood more likely to clot.

Smoking makes it harder for diabetics to controltheir blood sugar

Quitting any time gives your body a change toheal the damage caused by smoking


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The following countries have classifiedSHS as a carcinogen:

GermanyFinlandUSA SHS is a group A carcinogen

with arsenic, asbestos, benzene,

radon and vinyl chloride


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Tobacco use is a

pediatric disease.

80-90% of smokers initiate use

before the age of 18.


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The tobacco industry

targets children andyouth.


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In Viet Nam2008:

FOR KIDS

Ice cream andcigarettes?

Ice cream or

cigarettes?

Point of sale advertising in Viet Nam


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Point of sale advertising. Again cigarettes beside

candies. Why not beside pesticides?


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The tobacco industry has deliberately made smoking glamorous and the norm.


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Deadly product packaged in candy colours


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Deadly product packaged in fruity flavours or with

misleading descriptors e.g. lite, mild


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Impulse control

Before adulthood the prefrontal cortex

is underdeveloped makingadolescents vulnerable to addictions.


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SMOKING CAUSED DISEASES


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DISEASES AND ADVERSE HEALTH

EFFECTS CAUSED BY SECOND HAND SMOKE


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TUBERCULOSIS AND SMOKING:

A STRONG ASSOCIATION

Smoking substantially increases the risk of tuberculosis and

death from TB.

More than 20% of global TB incidence may be attributable to

smoking.

Smoking is a risk factor for TB, independent of alcohol use

and

other socioeconomic risk factors.

Smoking increases the risk of TB disease by more than 2

times.

Source: WHO TB and Tobacco Control Monograph, 2007


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Chemicals in tobacco smoke reach lungs quickly every time

you inhale. Chemicals and toxicants in tobacco smoke damage DNA

which can lead to cancer. Exposure to tobacco smoke quickly damages blood vessels

throughout the body and makes blood more likely to clot.

This damage can cause heart attacks, strokes, and evensudden death. Chemicals in tobacco smoke inflame the delicate lining of the

lungs and can cause permanent damage that reduces theability of the lungs to exchange air efficiently and leads tochronic obstructive pulmonary disease which includes

emphysema and chronic bronchitis.

Source: US Surgeon-General Report 2010


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Health Advisory on Electronic NicotineDelivery Systems (ENDS)/E-Cigarettes

DOH warns the public on the use of these

products. There is insufficient evidence thatENDS are safe for human consumption.

Indicator light

Rechargeable battery

Vaporizing chamber Replaceable ingredients cartridge

tipAtomizer


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Nicotine is addictive.

Tobacco use is a chronic disease and is a gateway for use of alcohol and recreational

drugs among adolescents.


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10

Filipinosdie by the hour from

tobacco-related disease


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Number of current

smokers in the

Philippines:

17.3million

)28.3%(

Male smokers: 14.6 million (47.7%)

Female smokers: 2.7 million (8.9%)


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THE TOBACCO ATLAS, 2009


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THE TOBACCO ATLAS, 2009


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Youth Global Youth Tobacco Survey (GYTS)*

Adults Global School Personnel Survey (GSPS)*

Global Health Professions StudentsSurvey (GHPSS)*

Global Adult Tobacco Survey (GATS)+*School based survey+Household survey


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Prevalence of Students who NEVERSmoked But Likely Initiate Smoking Next

Year

23.9

12.8 12.9

30.2

14.3 15

20.612.2 11.6

0

20

40

60

80

100

1999 2003 2007

Total

Boy

Girl

Prevalence of Students who areCurrent Cigarette Smokers

11.5

17.516.6

23.4

12

18.2

26.2

12.4

7.80

10

20

30

40

50

1999 2003 2007

Total

Boy

Girl


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Percentage of Students whose

Best Friends Smoke

11.98.5 9.1

11.915.3

16.9

5.7 5.5 7.4

0

5

10

15

20

25

1999 2003 2007

Percentage of Students with

One or More Parents who Smoke

55.4 55.1 54.1

54.7 52.9 52.5

56.1 56.3 55.3

0

20

40

60

80

100

1999 2003 2007

TotalBoyGirl

Percentage of Students Exposed to

Smoke in Public Places

58.2 58.6 64.858.8 59.4 67.2

57.8 58.2 62.8

0

20

40

60

80

100

1999 2003 2007

TotalBoy

Girl


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Percentage of Current Smokers whoAlways Feel Like Having a Cigarette

First Thing in the Morning

3

5.4

0.8

4.7

0.8

3.2

5

0.7 0.30

2

4

6

8

10

1999 2003 2007

Total

Boy

Girl

Percentage of Current Smokers whoWant to Stop Smoking Now

85.2 8888.1

84.6

89.6

88

85.7

88.2

89.3

0

20

40

60

80

100

1999 2003 2007

Total

Boy

Girl


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Figure 4: Second Hand SmokeExposureat Home;Philippine

Global Adult TobaccoSurvey

(GATS), 2009

48.8

39.6

54.4

0

20

40

60

80

100

Smoking Allow ed inside

the Hom e

Expos ure Daily inside the

Home

Exposur e M onthly inside

the Hom e

Percent


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Figure 6: Second Hand Smoke Exposurein Public Places: Philippines

Global Adult Tobacco Survey

(GATS), 2009

25.5

55.3

33.6

7.6

0

20

40

60

80

100

Public

Transport

Restaurants Government

Offices

Health Care

Facilities

Percent


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Figure 7: Smoking CessationStatus of Adults

15 years andolder by Sex;

Philippines Global Adult Tobacco

Survey (GATS ), 2009

21.5

47.8

60.6

46.7

60.5

20.925.0

53.9

61.1

0

20

40

60

80

100

Quit Rate (Ever

Daily)

Quit Attempt

(Past Year)

Interested in

Quitting (Current

Cigarette

Smokers)

Percent

Total Men Women


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Cigarettes account for 97% of tobaccoexpenditures (FIES, 2003).

Average household expenditure on tobacco

V a r i a b l e M e a n N

A n n u a l h o u s e h o l d i n c o m e ( i n p e s o s ) 1 3 7 , 7 5 8 . 4 0 4 2 , 0 9 4

P r o p o r t i o n o f h o u s e h o l d s w i t h t o b a c c o e x p e n d i t u r e s0 . 6 9 4 2 , 0 9 4

H o u s e h o l d e x p e n d i t u r e s o n t o b a c c o p r o d u c t s ( i n p e s o s )1 , 9 3 1 . 9 0 2 8 , 8 3 6

H o u s e h o l d e x p e n d i t u r e s o n c i g a r e t t e s ( i n p e s o s )1 , 8 6 5 . 4 0 2 8 , 8 3 6

H o u s e h o l d e x p e n d i t u r e s o n c i g a r s ( i n p e s o s )9 . 5 2 8 , 8 3 6

H o u s e h o l d e x p e n d i t u r e s o n o t h e r t o b a c c o p r o d u c t s ( i n p e s o s )5 7 . 1 2 8 , 8 3 6

Source: Quimbo, S, et al, 6-Country Economics of Tobacco and Tobacco Taxation, PHL 2008;

Basic: FIES, 2003


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Source: Tobacco and Poverty Study in the Philippines, May 2006; Basic Data: FIES, 2003

2.8%

2.6%

2.2%

1.6%

0.8%

0.0%

0.5%

1.0%

1.5%

2.0%

2.5%

3.0%

Quintile 1 Quintile 2 Quintile 3 Quintile 4 Quintile 5


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1.3%

1.6%

13.1%

2.6%

6.3%

8.2%

3.3%

2.6%

61.1%

Food

Clothing

Housing

Health

Education

Utilities

Transport &

CommunicationTobacco

Other expenses

Source: Tobacco and Poverty Study in the Philippines, May 2006; Basic Data: FIES, 2003


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Smoking-relatedDiseases

Health Care Costs Productivity Lossesfrom Death

Productivity Lossesfrom Disease

Total Costs

Lung Cancer 9,188,871 189,709,987 3,407,151 202,306,009

CVD 507,315,052 2,930,533,343 38,910,556 3,476,758,951

CAD 236,888,476 1,312,836,695 88,922,515 1,638,647,686

COPD 104,561,119 569,530,925 54,043,648 728,135,692

All 4 Diseases 857,953,518 5,002,610,950 185,283,871 6,045,848,339

Summary of Economic Costs in US$)*

for Four Smoking-related Diseases

(2003,using SAMMEC methodology figures)

*$1=PhP 52.

Source: Tobacco and Poverty Study in the Philippines,2006.


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Tobacco Control Taxation Comprehensive

advertising bans Information

dissemination- Smoke-free public places

Cardiovascular riskreduction

Population-based saltlowering Health education on BP,

cholesterol, overweight Individual risk reduction

approach

SLIDES 2-The Tobacco Epidemic

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