Washington, D.C., 5 June 2013 (PAHO/WHO) – Tobacco consumption increases the risk of death of people who have high blood pressure. Within the framework of World No Tobacco Day, held every 31 May, the Pan American Health Organization / World Health Organization (PAHO/WHO) urges total bans on tobacco advertising, promotion, and sponsorship in the Americas to help reduce tobacco consumption, and calls for further efforts toward blood pressure control.

In the Americas, 30% of the population over the age of 18 suffers from hypertension, and 21% of those over the age of 15 are smokers. Combined, these two risk factors increase the risk of cardiovascular disease, which is responsible for 30% of all deaths in the Americas.

“Many of the risks of hypertension can be reduced by controlling blood pressure. If smoking cessation is also pursued, the risk of cardiovascular disease can be reduced even further”, noted Adriana Blanco, PAHO/WHO’s regional tobacco control advisor.

Smoking is responsible for 16% of all deaths of people over the age of 30 in the Americas, which corresponds to 1 million deaths each year. Alongside Europe, the region has the highest percentage of deaths attributable to tobacco—12% above the global average.

“It is essential that countries implement all measures contained in the WHO Framework Convention on Tobacco Control. This year, we are stressing one such measure in particular: a total ban on tobacco advertising, promotion, and sponsorship, which is one of the most effective ways to reduce consumption of tobacco,” said Blanco. To date, only five countries in the Americas have implemented such measures: Panama (2008), Colombia (2009), Brazil (2011, but regulations are pending), Chile (2013), and Suriname (in June 2013). Others have broad restrictions, and the rest have minimal or no restrictions at all.

High blood pressure, in turn, increases the risk of myocardial infarction, stroke, and chronic kidney failure. In the Americas, cardiovascular diseases cause 1.9 million deaths each year and are the leading cause of death in the majority of the countries of the region.

“Tobacco and hypertension make for a lethal combination. Tobacco cessation contributes to a significant reduction in the number of deaths from heart attack and stroke”, said Pedro Ordúñez, PAHO/WHO advisor on noncommunicable diseases.

“People who are diagnosed with hypertension can be treated and controlled long-term, which significantly improves the likelihood of a long, healthy, and productive life”, added Ordúñez. “Everyone has a role to play in helping prevent and control this disease. Measures that help reduce tobacco consumption are also measures that help reduce and control high pressure”, he stressed.

In addition to avoiding tobacco consumption, hypertension can also be prevented by eating less salt (particularly in processed foods), following a balanced and healthy diet, engaging in physical activity regularly, and avoiding harmful alcohol consumption.

This year’s World Health Day—which is held every 7 April—was dedicated to the risks of hypertension. PAHO/WHO issued a call for people to know their blood pressure numbers and adopt measures to prevent and control hypertension.

LINKS:

• ·         World No Tobacco Day 2013 (PAHO)
• ·         World Health Day—Hypertension (PAHO) 
• ·         http://www.paho.org
• ·         http:/www.facebook.com/PAHOWHO
• ·         http:/www.youtube.com/pahopin
• ·         http://twitter.com/pahoeoc
• ·         http://twitter.com/pahowho
• ·         http://twitter.com/opsoms

Tobacco is a Deadly Product

-         Tobacco kills up to half of its users.

-         Tobacco kills nearly 6 million people each year, of whom more than 5 million are from direct tobacco use and more than 600 000 are nonsmokers exposed to second-hand smoke. Unless urgent action is taken, the annual death toll could rise to more than eight million by 2030.

-         Tobacco caused 100 million deaths in the 20th century. If current trends continue, it may cause about one billion deaths in the 21st century.

-         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.

The World Lacks Protection from Tobacco

-         Under 11% of the world’s population are protected by comprehensive national smoke-free laws.

-         National comprehensive health-care services supporting cessation are available in only 19 countries, representing 14% of the world’s population.

-         Just 19 countries, representing 15% 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. No low-income country meets this best-practice level. Forty-two countries, representing 42% of the world’s population, mandate pictorial warnings.

-         Only 19 countries, representing 6% of the world’s population, have reached the highest level of achievement in banning tobacco advertising, promotion and sponsorship.

-         Around 38% of countries have minimal or no restrictions at all on tobacco advertising, promotion and sponsorship.

-         Only 27 countries, representing less than 8% of the world’s population, have tobacco tax rates greater than 75% of the retail price.

-         Tobacco tax revenues are on average 154 times higher than spending on tobacco control, based on available data.

The Tobacco Epidemic is Widespread

-         Nearly 80% of the world’s one billion smokers live in low- and middle-income countries.

-         Consumption of tobacco products is increasing globally, though it is decreasing in some high-income and upper middle-income countries.

THERE IS A SOLUTION!

Implement the WHO Framework Convention Alliance: 

MORE INFORMATION:

- Why ban tobacco advertisements?

- Best Practices for Banning Tobacco Marketing

The researchers, led by Stanton Glantz from the Center for Tobacco Control Research and Education at the University of California, San Francisco, reached these conclusions by analysing previously secret documents from the tobacco industry and the Institute of Medicine related to the Institute’s landmark 2001 report, Clearing the smoke — a report that set the tone for the development and regulation of tobacco products in the US, particularly those claiming to be less dangerous.

The authors found that tobacco companies developed and implemented strategies with consulting and legal firms to access the IOM proceedings (that led to the FDA-commissioned Institute of Medicine report on tobacco products) and that the companies used this access to deliver specific, carefully formulated messages designed to serve their business interests.

Although the authors found no evidence that the efforts of tobacco companies exerted direct influence on the IOM committee, the analysis shows that tobacco companies were pleased with the final report, particularly its recommendation that tobacco products can be marketed with exposure or risk reduction claims provided the products substantially reduce exposure and provided the behavioral and health consequences of these products are determined in post-marketing surveillance and epidemiological studies (“tiered testing”). Recommendations within the report have policy implications that were continuing to reverberate in 2012.

The authors say: “There was a lack of clear policy on tobacco industry engagement by the [Institute of Medicine] which, combined with the general presumption of honesty upon which all scientific discourse is based, created an opportunity for the tobacco companies to advocate positions that supported their interests.”

They continue: “The presence of tobacco industry representatives on the FDA’s Tobacco Products Scientific Advisory Committee, combined with the FDA’s official consideration of the tobacco industry as a “stakeholder,” increase the likelihood that the tobacco companies will continue to successfully manipulate the scientific discourse around tobacco product regulation, to the companies’ benefit and to the detriment of public health.”

The authors conclude: “To prevent such an outcome, the FDA and counterpart organizations in other countries need to remain cognizant of the guidelines for implementing FCTC Article 5.3* and that they are dealing with companies with a history of more than 50 years of intentionally misleading the public and who were found by two federal courts to have participated in ”a pattern of racketeering activity” in violation of the RICO Act** when assessing the role of the tobacco companies and the information they present as part of the regulatory process.”

In an accompanying Perspective, Thomas Novotny (uninvolved in the study) from the University California, San Diego says: “[The tobacco industry] should never be treated as a stakeholder because it is unlikely that the industry will ever be part of the solution to the public health challenge of tobacco use.”

Novotny continues: “The profits from selling cigarettes and alternative tobacco products are simply too great for the tobacco industry to simply fade into history. Thus, the public health community needs to do what it does best: to rally popular support for strong, science-based approaches to prevention of tobacco use, to expose the truths about the harms of tobacco use to current users, and to support government agencies in carrying out their legislatively mandated duties to protect public health.”

Notes:

*The World Health Organization’s Framework Convention on Tobacco Control, developed in response to the globalization of the tobacco epidemic. Article 5.3 relates to the protection of public health policies with respect from tobacco control from commercial and other vested interests of the tobacco industry.

**Racketeer Influenced and Corrupt Organizations Act is a US federal law that provides for extended criminal penalties and a civil cause of action for acts performed as part of an ongoing criminal organization.

Funding: This work was supported by National Cancer Institute grant CA-087472. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

See Original Here

May 20, 2013, ASH’s Chris Bostic testified about tobacco, urging the U.S. to exclude it from the treaty.

The text of his verbal comments is below.

To read ASH’s written comments, click here.

I am here today to urge the United States government to exempt tobacco products from the Transatlantic Trade and Investment Partnership, in order to retain policy space for all TTIP partners to address this most destructive cause of preventable disease. This is not an anti-trade message, but the goals and benefits of trade are not compatible with tobacco. Trade has the potential to improve lives, while tobacco devastates lives, providing no benefit whatsoever to its addicted consumers. Let me quickly lay out the arguments for a full exemption.

First, tobacco is the world’s leading killer. Nearly 6 million people die every year, and that number is rising. By the end of the century, we risk a billion premature deaths, ten times the toll of the 20^th century.

Second, there is a global consensus on how to deal with the tobacco epidemic, the WHO Framework Convention on Tobacco Control. The U.S. has signed this treaty, and every member state of the European Union, as well as the European Commission, has ratified it.

Third, the tobacco industry has consistently abused international trade and investment rules to stall, block or roll-back implementation of the tobacco treaty. Trade is the strongest arrow in their litigation quiver, and TTIP as it is currently envisioned is a dream come true for an industry that kills half of its customers.

Fourth, while health exceptions are built in to many trade systems, those systems did not envision an industry that would use trade rules to create legal chill. It is clear from past trade and investment disputes that the tobacco industry need not win trade disputes to achieve their goal. The cost of litigation is a barrier unto itself, and many small governments simply cannot afford to win these disputes. We already have examples of countries that have delayed or discarded plans to advance tobacco control legislation due to the threat of trade litigation.

Fifth, the incompatibility of trade liberalization and tobacco is already recognized under U.S. law. The Doggett and Durbin Amendments, as well as Presidential Executive Order 13913, prohibit federal agencies from promoting the sale or export of tobacco products. These laws have been ignored in recent trade negotiations.

Sixth, the U.S. has joined the world on a path to addressing the growing problem of non-communicable diseases, or NCDs. The leading risk factor for NCDs is tobacco use, and the UN Political Declaration on NCDs, which the U.S. joined, calls for accelerated implementation of the tobacco treaty. By giving the tobacco industry new tools to block meaningful tobacco regulation, the U.S. undermines the NCD initiative and reneges on its promises.

Seventh, the slippery slope argument is a red herring. The tobacco exception that the U.S. has drafted – but not tabled – for the Trans-Pacific Partnership recognizes the uniqueness of tobacco in international trade.

Finally, half measures or weak exceptions will not address the core problem. Complicated legal tests and chapter exclusions invite litigation and increase legal chill. The easiest and most elegant solution is a blanket exclusion for tobacco products.

“It is with great pleasure that I announce, ahead of World No Tobacco Day on Friday, that I have received Government approval to begin the process of introducing standardised/plain packaging of tobacco products in Ireland. While many arguments will be made against such an introduction, I am confident that this legislation will be justified and supported purely by the fact that it will save lives” stated Minister Reilly today.

As you are aware, smoking places an enormous burden of illness and mortality on our society with over 5,200 people dying every year from tobacco related diseases – one in two of all smokers will die from their addiction.

To replace the smokers who quit, the tobacco industry needs to recruit fifty new smokers in Ireland every day just to maintain smoking rates at their current level. Given that 78% of smokers in a survey said they started smoking under the age of 18, it’s clear that the tobacco industry focuses on children to replace those customers who die or quit.

The theme of World No Tobacco Day is “Ban tobacco advertising, promotion and sponsorship”. “The introduction of standardised packaging will remove the final way for tobacco companies to promote their deadly product in Ireland.” the Minister said. Cigarette packets will no longer be a mobile advertisement for the tobacco industry. Research has shown that packaging has been used effectively to reassure consumers about the risks of smoking for example with the use of the words “mild” or “light” on packs in the past. Research has also shown that imagery and colours are also used to influence consumers. Pack shape and design are also key measures with packets available that resemble a lipstick box.

Standardised packaging of tobacco products will remove all form of branding – trademarks, logos, colours and graphics. The brand name would be presented in a uniform typeface for all brands and the packs would all be in one plain neutral colour.

There is strong evidence that standardised packaging will:

• Increase the effectiveness of health warnings;
• Reduce false health beliefs about cigarettes; and
• Reduce brand appeal particularly among youth and young adults.

Minister Reilly concluded “plain packaging is one of a number of measures that are required to effectively denormalise smoking in our society. As such this initiative should not be looked at in isolation. Education and awareness, cessation services and extending the smoking ban to other areas are just some of the other measures which I am currently progressing.”

NOTES FOR EDITOR:

An informative video by Cancer Research UK on the power that cigarette packaging has on children is available online at: www.youtube.com/watch?v=c_z-4S8iicc