I’ll Huff and Puff and Blow Us All Down

Only ten days before the World Health Organization (WHO) celebrates this year's World No-Tobacco Day, the World Health Assembly unanimously adopted the Framework Convention on Tobacco Control (FCTC).

The Convention, adopted by the 192 members of the Assembly, is the world's first-ever attempt to promote a tobacco-free environment within a legislative framework.

Four years in the making, the FCTC has been a priority in the WHO's global work to stem the tobacco epidemic. While smoking rates are declining in some industrialized countries, they are increasing, especially among the young, in many developing countries. These will account for over seventy percent of the projected death toll resulting from tobacco (WHO).

To come into force, the Convention must be signed by at least 40 countries. The Convention's main focuses are:

• Imposing restrictions on tobacco advertising, sponsorship and promotion.
• Establishing new labeling controls.
• Establishing new clean indoor air controls.
• Strengthening legislation to clamp down on tobacco smuggling.

Contrary to the popular misconception that placing curbs on tobacco smoking will have a negative impact on economies depending on the product, recent economic analyses done by the World Bank show that the social and health costs of tobacco far outweigh the direct economic benefits that may result from tobacco cultivation and manufacture (WHO).

World No-Tobacco Day

This year, the theme for World No-Tobacco Day is tobacco-free film and fashion. “The WHO is calling on the entertainment industry, in particular the world of film and fashion, to stop promoting a product that has devastating effects on public health and to start promoting a tobacco-free society” (WHO).

The influence actors who smoke in films have on teenagers has been shown by a study carried out by researchers at Dartmouth Medical  College  in  Hanover , New England . The study, which analyzed 178 films, revealed that fans of actors who play characters who smoke on screen are much more likely to smoke themselves or be pro-tobacco than fans of non-smoking actors.

The study showed that teenage fans were up to three times more likely to smoke or be pro-tobacco if their favorite actors smoked in at least three films. After concluding the study the researchers said:"We believe this evidence strongly suggests that media portrayals of tobacco use by popular movie stars contribute to adolescent smoking."

An estimated 80% of adult smokers began smoking before the age of 18. Each day, approximately 5,000 youngsters under the age of 18 smoke their first cigarette.

Smoking: A Worldwide Epidemic

According to the WHO, there are 1.1 billion smokers around the world. That makes up around one third of the adult global population. Smoking causes more death and disability than any other single disease, accounting for 7% of all deaths, with about 13,700 people dying each day of tobacco-related illnesses.

The WHO's projection that states that tobacco will result in more than 10 million deaths annually by the year 2020 would make it the leading cause of death and disability, thus becoming more lethal than HIV, tuberculosis, car accidents, maternal mortality, suicide and homicide combined.

There is an estimated 42% of men and 24% of women that smoke in developed countries, while in developing countries 48% of men and 7% of women smoke. There are 800,000 smokers and an estimated one million people who die annually from tobacco in developing countries.

In the  United States, smoking is the leading cause of preventable death leading to more than 440,000 deaths annually. The health care costs associated with tobacco-related illnesses in the U.S are more than $75 billion.

In developing countries cigarette sales have increased by 80% since 1990. In Africa the annual rise in the rate of smoking is estimated to be 2.5% higher than in other developing countries. It is anticipated in the next 20 years that tobacco-related diseases will become the number one cause of death in Africa.

Exposure to Second Hand Smoke

One of the most sordid facts about smoking is that not only does it affect the person who chooses to smoke, exposure to second hand smoke can and does affect non-smokers, especially children whose bodies are still developing. Parents who smoke around their children increase their risk of occurrence of sudden infant death syndrome (SIDS), middle ear infections and cause an increased incidence of respiratory diseases, such as bronchitis, pneumonia, asthma and lower respiratory tract infections.

Parents who smoke around their children increase their risk of respiratory diseases

Second hand smoke is also a cause of lung cancer and coronary heart disease in adults who are lifetime non-smokers. Environmental tobacco smoke (ETS) is listed by the National Institutes of Health as a human carcinogen. Therefore exposure to ETS is a causative factor of human cancer. Around 3,000 deaths caused by lung cancer occur each year among adult non-smokers. Studies also show that ETS is the cause of 35,000 deaths from ischemic heart disease in the U.S each year.

Smoking in Children

The global tobacco epidemic is predicted to prematurely claim the lives of some 250 million children and adolescents, a third of who are in developing countries (WNTD). Over 6.4 million children living today will die prematurely due to smoking. Studies have shown that children can become addicted to tobacco after smoking only a few cigarettes.

Over 6.4 million children will die prematurely due to smoking

According to a report in the journal Tobacco Control, a study performed on nearly 700 schoolchildren in the U.S with an average age of 12 showed that a quarter of the children who smoked had cravings within two weeks of beginning to smoke, some even had symptoms of addiction within days of starting to smoke.

Women who smoke during pregnancy place their babies at an increased risk of miscarriage, low birth weight, and intrauterine growth retardation.

Smoking is a worldwide epidemic and all possible measures should be taken to raise awareness of the international impact of tobacco use and to promote a tobacco-free environment. World No-Tobacco Day is an excellent opportunity to do so.

Sources:

• WHO, 2003: World No Tobacco Day.
• Derbyshire, David, 2001: Teenagers are influenced by smoking idols on the screen. Telegraph.
• Hall, Celia, 2000: A few cigarettes 'enough to make children addicts'. Telegraph.
• Weissman, Robert, 2000: Intl-tobacco Smoking - Africa's lurking killer.
• American Lung Association, 2003: Tobacco Control.
• BBC News. 2003: Smoking.
• CDC, 2002: Exposure to Environmental Tobacco Smoke and Cotinine Levels - Fact Sheet
• CDC. Women and Smoking
• World No Tobacco Day. Tobacco Use Facts.
• Foulkes, Imogen, 2003: Anti-tobacco treaty agreed. BBC News.
• Aetna InteliHealth, 2003: Smoking.
• ACK Cheng, CP Pang, ATS Leung, JKH Chua, DSP Fan, DSC Lam, The association between cigarette smoking and ocular diseases. HKMJ 2000; 6(2): 195-202
• CDHA. Smoking and Your Oral Health.
• Health and age, 2001: The Negative Effects of Smoking on Bones, Joints and Healing.
• WHO, 2003. The Framework Convention on Tobacco Control: A Primer

Aisha El-Awady M.D is an editor at the Health and Science section of IslamOnline.net. She is currently working as Lecturer of Parasitology at the Faculty of Medicine, Cairo University. She may be contacted at sciencetech@islamonline.net