who and sfe

Protection from Second-hand Smoke in the Western Pacific Region

Dr Susan Mercado

Regional Adviser

Tobacco-Free Initiative

World Health Organization

Western Pacific Regional Office

Research clearly shows that there is no safe level of exposure to

second-hand smoke.

A third of the world’s smokersare in the Region.

2 peopledie each minute from a tobacco-related disease in the Region.

5

Most Recent Scientific Evidence: Exposure to SHS

Source: adapted by CTLT from U.S. Surgeon General’s Report. (2006).

Second-hand smoke increases the risk of coronary heart disease by 25–30% and the risk of

lung cancer in non-smokers by 20–30%.

Second-hand smoke exposure has been conclusively linked to breast cancer.

% OF STUDENTS (AGE 13 - 15 YEARS) EXPOSED TO SMOKE FROM OTHERS AT HOME (TOTAL)

11.5

35.1

37.3

38.3

40.3

42.1

47

47.1

47.6

48.3

54.4

54.5

57.6

58

58.5

59.1

59.3

59.4

60.7

61.9

73.9

76.6

0 10 20 30 40 50 60 70 80 90

MALAYSIA (2003)

SINGAPORE (2000)

NEW ZEALAND (2007)

REPUBLIC OF KOREA (2008)

LAO PEOPLE'S DEM REP (2007)

MACAO SAR (2005)

CAMBODIA (2003)

FIJI (2005)

PALAU (2005)

CHINA (2005)

MONGOLIA (2007)

PHILIPPINES (2007)

COOK ISLANDS (2003)

C.N. MARIANA IS. (2004)

VIET NAM (2007)

SAMOA (2007)

VANUATU (2007)

GUAM (2002)

MICRONESIA (2007)

AMERICAN SAMOA (2005)

PAPUA NEW GUINEA (2007)

TUVALU (2005)

%

Sub national data

Sub national data

% of students (age 13 - 15 years) exposed to smoke in public places (Total)

16.7

28.9

44.5

55.4

55.5

56.8

58.5

61.2

62.8

64.6

64.8

65.1

67.3

69.3

71.2

71.3

71.5

72.9

73

75.9

76.7

86.4

0 10 20 30 40 50 60 70 80 90 100

MALAYSIA (2003)

PALAU (2005)

CHINA (2005)

LAO PEOPLE'S DEM REP (2003)

MONGOLIA (2007)

FIJI (2005)

CAMBODIA (2003)

AMERICAN SAMOA (2005)

SAMOA (2007)

NEW ZEALAND (2007)

PHILIPPINES (2007)

SINGAPORE (2000)

MACAO SAR (2005)

REPUBLIC OF KOREA (2008)

VIET NAM (2007)

MICRONESIA (2007)

GUAM (2002)

C.N. MARIANA IS. (2004)

COOK ISLANDS (2003)

VANUATU (2007)

TUVALU (2006)

PAPUA NEW GUINEA (2007)

%

Sub national data

Sub national data

50% youth 13-15 years old are exposed to

second hand smoke at home.

% of current cigarette smoker students (age 13 - 15 years) usually smoke at home (Total)

6.1

8

11.1

11.8

14.5

15

15.3

18.3

19.3

20

20.7

22

22.1

22.5

24.2

28.1

56.5

0 10 20 30 40 50 60

MACAO [CHINA] (2005)

MONGOLIA (2007)

REPUBLIC OF KOREA (2008)

SINGAPORE (2000)

MALAYSIA (2003)

VIET NAM (2007)

PHILIPPINES (2007)

PAPUA NEW GUINEA (2006)

TUVALU (2006)

LAO PDR (2007)

FIJI (2005)

MICRONESIA (2007)

SAMOA (2007)

VANUATU (2007)

COOK ISLANDS (2003)

NEW ZEALAND (2007)

CHINA (1999)

%

Sub national data

Sub national data

Smoke-free environments help smokers who want to quit. Smoke-free policies in workplaces in several industrialized nations have reduced total tobacco consumption among workers by an average of 29%.

Smoke-free public places also encourage families to make their homes smoke-free, which protects children and other family members from the dangers of second-hand smoke.

13

Positive Health Impact of Smoke-Free Environments

Source: Navas, A. (2007).

DIRECT

INDIRECT

Reject the myths!

MPOWER: A Policy Package for Global Tobacco Control

The six demand reduction policies to support complete implementation of the

WHO Framework Convention on Tobacco Control

•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

WHO Regional Initiatives • Dissemination of the Guidelines for Article 8 of the WHO

FCTC• Development of tools and training on monitoring of

second-hand smoke• Promotion of tobacco-free sports• Development of guidance and awards for good practices

and best proposals for MPOWER and Healthy Cities• The Red Orchid Awards• Tobacco and gender• Healthy urban transport (smoke-free criteria)• Support for projects to use GYTS data for policies and

action

RESTAURANTS

PUBLIC TRANSPORT

INDOOR OFFICES

EDUCATIONAL FACILITIES

ALL OTHER PUBLIC PLACES

GOVERNMENT FACILITIES

PUBS AND BARS

HEALTH CARE FACILITIES

1

2

3

4SHS SPIDERGRAM

18

Indoor Air ConcentrationsThe concentration of secondhand smoke in the air can be determined by measuring the concentration of its components

Measurements of airborne nicotine, carbon dioxide, or particulate matter can indicate the extent of secondhand smoke exposure in a particular location

Passive air nicotine monitors are accurate, relatively inexpensive, and easy to use.

Nicotine

Particulate Matter

19Source: Navas-Acien, et al. (2004); Image source: New York City Department of Health and Mental Hygiene.

Air Nicotine Concentrations (µg/m3) in Restaurants in 10 Countries*

Smoking policy N Median (IQR)†

No policy 54 1.15 (0.32–2.44)

Smoking section 32 1.30 (0.43–2.31)

Nonsmoking 20 0.66 (0.20–1.10)

Smoking ban 7 0.07 (0.003–0.10)

* Countries: Argentina, Brazil, Chile, Costa Rica, Paraguay, Peru, Uruguay, Honduras, Mexico and Panama

† IQR: interquartile range

TRAINING ON SECOND-HAND SMOKE MONITORING

See next slide

TOBACCO FREE SPORTS

• Beijing, China• Viet Nam• Laos People’s

Democratic Republic• Viet Nam• Guangzhou, China• Cook Islands

Gender and tobacco

(Viet Nam and Palau)

2008 WHO Awards and the Alliance for Healthy Cities

COMPREHENSIVE TOBACCO CONTROL IN CITIES

• Singapore Health Promotion Board

• Taicang, China• Wonju, Republic of Korea

BEST PROPOSAL FOR COMPREHENSIVE TOBACCO CONTROL IN CITIES

• Chanwon, Republic of Korea

HEALTHY URBAN TRANSPORT

Lloyd Wright

Pilot on the Red Orchid Awards for Tobacco-Free Settings,

Philippines, 2009

Second-hand Smoke Busters!

Use of youth data to monitor tobacco control programme progress.

TOBACCO CONTROL DATA APPLICATION PROJECTS (GYTS)

Smoke-free schools in Seam Riap, Cambodia

Regional Action Plan (2010-2014) for the Tobacco Free Initiative in the Western Pacific

Moving Toward the Next Level: Complete implementation of the

WHO Framework Convention on Tobacco Control

Regional Action Plan (2010-2014) for the Tobacco Free Initiative in the Western Pacific

VISION: Tobacco free people, communities and environments

MISSION: To advocate, enable and support complete implementation of the WHO Framework Convention on Tobacco Control

GOAL: To attain the lowest possible tobacco use prevalence and the highest level of protection from second-hand smoke

Three Point Strategy1 Promote and advocate for complete

WHO FCTC Implementation

2 Mobilize for public action

3 Strengthen organizational capacity

•Legislation and policies

•Tobacco taxation

•Governance and local enforcement

•Alliance and partnerships

•Investment planning and resource management

•Leadership training and human resource development

•Surveillance, monitoring and knowledge management

•Public awareness, education, communication and advocacy

•Treatment of tobacco dependence

Approaches

• Development and/or updating of national action plans

• Establishment and/or strengthening of national coordinating mechanisms for tobacco control

• Adoption of targets and prevalence indicators to monitor progress

Overall indicators• By 2014- All countries have developed national action plans or

equivalents and established or strengthened national coordinating mechanisms

- All parties in the Region have ratified all WHO FCTC protocols

- Reliable adult and youth tobacco use data are available in all countries

- Prevalence of adults (men and women) and youth (boys and girls) current tobacco use (smoking and smokeless) is reduced by 10% from the most recent baseline

Regional programme targets relevant to protection from second-hand smoke exposure

• 100% of countries - have adopted measures compliant with Articles 5.3 & 8 - monitoring and enforcement of Article 5.3 & 8 - have a list of existing and potential partners - have multi-year human resource development plans - have reliable and comparable population level data - have implemented national communication plans - have national tobacco dependence treatment guidelines - have trained health workers giving brief cessation advice

• 50% of countries - convene meetings with multisectoral partners - publicly recognize outstanding contributions - have multi-year budget estimates

The Regional Action Plan (2010-2014) Tobacco Free Initiative for the Western

Pacific contains a menu of actions and indicators for

countries and WHO.

% of students (age 13 - 15 years) favored banning smoking in public places (Total)

32.5

36.3

39.1

41.2

41.3

52

62

63.1

63.5

75.7

79.1

81.2

82.9

83

88.4

89.5

90.9

0 10 20 30 40 50 60 70 80 90 100

MICRONESIA (2007)

VANUATU (2007)

FIJI (2005)

SAMOA (2007)

NEW ZEALAND (2007)

PAPUA NEW GUINEA (2007)

LAO PDR (2007)

MACAO [CHINA] (2005)

CHINA (2005)

COOK ISLANDS (2003)

MONGOLIA (2007)

MALAYSIA (2003)

CAMBODIA (2003)

REPUBLIC OF KOREA (2008)

VIET NAM (2007)

TUVALU (2006)

PHILIPPINES (2007)

%

Sub national data

Sub national data

Yuhta Ohishi, 15 years old, Japan

World No Tobacco Day Awardee, 2008

Recipient of Director General’s Special Recognition certificate