La epidemia del cigarro

When I was a young smoker back in the mid 70s, attitudes about tobacco were a lot different than they are today in the United States. A person could light up just about anywhere, and while we all knew that cigarette smoking was hazardous to our health, we were in the dark ages about just how dangerous it really was. I could (and did) light up in movie theaters, on planes, and at my desk at work. I smoked in restaurants, cabs, and expected to smoke in any home I visited, whether my friends were smokers or not. I even smoked in my hospital room when my daughter was born (not while she was in the room, but smoking was allowed in maternity ward rooms -- can you imagine?!) That's how it was back then. Smokers were accepted by society and smoking was tolerated to a degree we can't fathom today.

The Advantage of Anti-Smoking Legislation

If you're fortunate enough to live in a country that aggressively works to protect its citizens from death by tobacco through anti-smoking legislation, the above scenarios probably seem bizarre. That is a good thing; a positive byproduct of the conditioning that years of increasing focus on tobacco control has done for us. Smoking is on the decline in countries that take the dangers of tobacco use seriously, and fewer innocent bystanders are poisoned by the effects of breathing in secondhand smoke. If, however, you live in a developing nation where there are no resources in place to educate people about the hazards of tobacco use, or to protect them from the marketing tactics of Big Tobacco, you are at a distinct disadvantage.

The Global Tobacco Crisis

The World Health Organization (WHO) recently published a startling report on the state of tobacco use around the world, along with some dire predictions about our future, should we continue on the path we're presently walking. Based on current trends in tobacco use worldwide, they tell us that we are poised on the brink of a global tobacco epidemic that could claim as many as one billion lives this century.

Mirriam-Webster defines an epidemic as something that affects a disproportionately large number of people within a population, community, or region at the same time. Typhoid fever was an epidemic, and tobacco use will be too, unless we do something drastic to change these trends, and do it soon.

Today, tobacco use is growing the fastest in low-income countries that are least equipped to deal with the disease and early death that accompanies smoking-related disease. Between population growth and tobacco marketing campaigns that target these areas with little or no legislation in place to restrict advertising, millions of new addicts are emerging every year. According to the WHO report, more than 80 percent of global tobacco-related deaths will be in low and middle-income countries by the year 2030.

Pertinent Tobacco Statistics

• There are 1.1 billion smokers in the world today, and if things continue as they have, that number is expected to increase to 1.6 billion by the year 2025.

• China is home to 300 million smokers who consume upwards of 1.7 trillion cigarettes a year, or 3 million cigarettes a minute.

• As many as 100 million Chinese men presently under the age of 30 will die from tobacco use.

• There are approximately 120 million smokers in India today, and it is estimated that in the year 2010 alone, there will be close to one million tobacco-related deaths among men and women age 30 to 69 in India.

• Worldwide, tobacco use will kill more than 175 million people between now and the year 2030.

• Current tobacco-related health care costs in the United States total US $81 billion annually. Germany spends an average of US $7 billion, and Australia, US $1 billion each year on health care directly related to tobacco use.

• Health care costs associated with secondhand smoke total US $5 billion a year in the U.S.

• It is estimated that as many as 500 million people alive today will be killed by tobacco use unless significant anti-smoking measures are adopted on a global level.

MPOWER

Six Policies to Reverse the Tobacco Epidemic

In an effort to raise global awareness about the dangers of tobacco use, WHO has put together a six-part plan of action that, if enacted worldwide, has the potential to alter the tobacco epidemic we face on this planet in the coming years.

The MPOWER strategies at a glance:

• Monitor tobacco use and prevention policies
• Protect people from tobacco smoke
• Offer help to quit tobacco use
• Warn about the dangers of tobacco
• Enforce bans on tobacco advertising, promotion and sponsorship
• Raise taxes on tobacco

Monitor tobacco use and prevention polices.

The first part of MPOWER focuses on the importance of monitoring global data collected regarding:

• the prevalence of tobacco use,
• the impact of tobacco control policies,
• and tobacco industry marketing, promotion and lobbying

Through careful attention to and reporting of this data, governments can create effective tobacco control policies that will best serve the public.

Protect people from tobacco smoke.

Research has shown that there is no safe level of exposure to secondhand smoke. Breathing in ETS contributes to a wide variety of diseases, including heart disease and many cancers. It is important to increase public awareness about the dangers of ETS. Legislating smoke-free environments encourages smokers to quit and nonsmokers to protect themselves and loved ones by choosing to live in smoke-free homes.

• Secondhand Smoke Facts

Offer help to quit tobacco use.

It's estimated that three-quarters of smokers want to quit, yet only 5 to 7 percent of those who do quit smoking without support are still smoke-free a year later. WHO suggests boosting assistance to smokers trying to quit in a number of ways:

• Incorporate cessation counseling more fully into the primary care setting. Advice and assistance from a trusted health care professional could help more people quit smoking
• Increase the availability of nation-wide toll-free telephone quit lines.
• Encourage the use of quit aids. Public health services can help reduce the cost for consumers.
• Provide governmental support for programs to help people quit smoking. It is important to first motivate citizens to quit through the other measures of MPOWER, such as raising taxes and aggressive anti-smoking legislation, before investing in these programs, however.

Ultimately, the more options available and easily accessed by smokers interested in quitting, the more lives saved.

• Smoking Cessation Support Forum

• Quit Smoking 101 -- a free email course

Warn about the dangers of tobacco.

Many people around the world still think of tobacco use as a bad habit rather than a life-threatening activity. It's important that we change the face of tobacco so that people begin to associate it with disease, addiction and death. Casting tobacco in a negative light will help us make the shift in consciousness that is needed.

• How Smoking Harms Us: Head to Toe

Enforce bans on tobacco advertising, promotion and sponsorship.

Tobacco manufacturers spend a lot of time and money on seductive ad campaigns to sell their deadly products.

From WHO:

"To sell a product that kills up to half of all its users requires some extraordinary marketing savvy."

Boy, isn't that the truth.

In the United States and other developed nations, tobacco companies have met with an increasing amount of resistance and stricter limits on how they are allowed to market their products. That translates to a reduction in cigarette consumption. It's no wonder that tobacco companies are currently setting their sights on marketing to countries where there are no restrictions on tobacco advertising. It is important that all countries take a proactive stance against tobacco by enacting strong measures of tobacco control.

Raise taxes on tobacco.

Perhaps the most effective way to cut tobacco use is to simply make tobacco products too expensive to buy. When faced with feeding the family or feeding a cigarette addiction, people are often quickly swayed to get serious about smoking cessation. Along with the personal incentive that raising taxes provides, cigarette taxes directly benefit governments through increased revenue that can then be used for tobacco-related programs. Tobacco taxes have the ability to ease the burden of health care for people sick with tobacco-related diseases and fund programs to help people quit smoking.

In summary...

When it comes to stemming the flow of death and destruction that tobacco use leaves in its wake, it takes a village to effect change -- a global village. If adopted by governments around the world, these simple, yet powerful MPOWER policies could be a life preserver that will save millions and millions of lives.

_Sources:

_{The Global Tobacco Crisis. 2008. The World Health Organization.}

_{MPOWER: six policies to reverse the tobacco epidemic. 2008. The World Health Organization.}

_{A Nationally Representative Case–Control Study of Smoking and Death in India. 13 February, 2008. New England Journal of Medicine.}

_{WHO Executive Summary: The Health of Adults. 2008. The World Health Organization.}

_{WHO/WPRO Smoking Statistics. 28 May, 2002. The World Health Organization.}