Thinking about the end of tobacco EPHA Conference - November 2011
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Transcript of Thinking about the end of tobacco EPHA Conference - November 2011
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Thinking about the end of tobacco
EPHA Conference - November 2011
George Thomson, Richard Edwards, Nick Wilson, Tony Blakely
Department of Public Health, University of Otago, Wellington, New Zealand
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Aims
To briefly touch on:
1. What a tobacco endgame is (definitions)
2. What may favour the adoption of endgame strategies (possible preconditions)
3. Where endgames might occur
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What is a ‘tobacco endgame’?
‘the final stage of the process of ending tobacco use in a jurisdiction’
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Some possible elements of endgames
Having an explicit: government intention
government plan
end prevalence target for tobacco use
‘end’ target date
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Some tobacco endgame goals
Savuton Suomi vision (non-government 2009): Finland smokefree by 2040
Finnish govt objective (2009): Ending ‘the use of tobacco products in Finland’ (no target date)
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A goal for the world
Beaglehole et al, 2011: ‘a world …where less than 5% of people use tobacco’ by 2040
Beaglehole et al. Lancet 2011; 377:1438-47
Robert Beaglehole
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Favourable conditions for real endgame planning by a jurisdiction
Prevalence under 15%
Rapid prevalence decrease
Wide public support for an end to tobacco use
Strong border control
Blunted industry
Strong leadershipUruguay's former president Vázquez
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Where might endgames happen?
California 2010: 11.9% adults smoke ‘some days’
Prevalence: California and U.S.A: 1984-2010
Q: ‘Do you now smoke cigarettes every day, some days, or not at all?’
US CDC Behavioral Risk Factor
Surveillance System (BRFSS) 1984-2010
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Australia
2010: 18% (14 yrs plus) smoke (Daily, weekly, less than weekly)
2010 National Drug Strategy Household Survey. AIHW 2011
Tasmania: 2007-2010: 2+% drop/yr (22.6% to 15.9% - daily smokers)
2010 National Drug Strategy Household Survey. AIHW 2011
Health Minister Nicola Roxon
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Sweden
2010: 13% (aged 16-84) smoke daily
2010: 24% (aged 16-84) smoke currently
The National Survey on Public Health
http://www.who.int/tobacco/global_report/2011/en_tfi_global_report_2011_8.1_surveys_of_adult_tobacco_use.xls
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But justified scepticism
Ending tobacco only feasible:
‘if smoking rates are below 5% and if the
country’s borders can be easily controlled’Joossens L. Tob Control 2009;18:5.
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Discussion
Endgames a paradigm shift in tobacco control
Thinking less incremental Aims more ambitiousUltimate aim articulated
International cooperation / stronger FCTC required
FCTC s.5.3 crucial
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Acknowledgements Marsden Fund: Royal Society of New Zealand
Further reading Thomson et al. What are the elements of the tobacco
endgame? Tob Control March 2012 Thomson et al. Ending appreciable tobacco use in a nation
Tob Control 2010; 19:431-5
Contact: [email protected]