using data to inform and evaluate tobacco control measures april 22, 2015 yogyakarta, indonesia...
TRANSCRIPT
Using Data to Inform and Evaluate Tobacco Control
Measures
April 22, 2015Yogyakarta, Indonesia
Kalina Duncan, MPHPublic Health Advisor
Center for Global [email protected]: @kalinaduncan
@NCIGlobalHealth
Overview• Definition of surveillance• Tobacco control surveillance systems• CDC Global tobacco surveillance systems
(GTSS) framework and components • Accessing and using GTSS data• MPOWER examples• Case studies and examples
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Surveillance
Timely, useful evidence to empower public & policy makers to lead & manage effectively. That’s where public health begins.
- US CDC
Ongoing, systematic collection, analysis, & interpretation of data essential to planning, implementation, & evaluation of public health practice, integrated with timely dissemination to those responsible for prevention & control.
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WHO FCTC Monitoring Protocol 20.2
“…integrate tobacco surveillance programs into national, regional, and global health surveillance programs so that data are comparable and can be analyzed at the
regional and international levels, as appropriate.”
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Purpose of a Tobacco-Related Surveillance System
To provide timely information from populations on:•Prevalence of use of tobacco-related products•Factors that influence their use•Incidence, prevalence, and mortality from tobacco-attributable diseases•Impact of tobacco control programs and policies on relevant outcomes
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Uses of Tobacco Surveillance Data
• Understand the natural history and trends of tobacco use and consequences of use
• Identify emerging issues and research needs (e.g. tobacco harm reduction, SHS exposure)
• Evaluate tobacco use prevention and control programs, policies, and legislation
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Using Existing Tobacco Control Data
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• CDC Global Tobacco Surveillance Data• GATS, GYTS
• National Datasets• RISKESDAS/Basic Health Survey/ Indonesia
Demographic and Health Survey (IDHS) • National Health Information System (HIS)• Disease registries• Posbindo NCD Risk Factor Screening Program
(Ministry of Health)• Others
GLOBAL YOUTH TOBACCO SURVEY
GLOBAL ADULT TOBACCO SURVEY
TOBACCO QUESTIONS FOR SURVEYS
CDC Global Tobacco Surveillance System
GYTS: Global Youth Tobacco Survey
• Global Youth Tobacco Survey (GYTS)– Global standard for systematically monitoring youth
tobacco use & key tobacco control indicators (WHO FCTC & MPOWER).
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• School-based survey of students aged 13-15• Anonymous and confidential self-administered data
collection• Core questionnaire with optional questions• Option for countries to add additional questions• Use of answer sheets that can be optically scanned
GYTS Methodology
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GYTS in Indonesia• 2006, 2009, in the field now• Dataset available at:
http://nccd.cdc.gov/GTSSData/Default/SelectSurveySite.aspx. (select Indonesia)
• Highlights:– 22.5% of students use tobacco– 2/3 of students live in homes where others smoke– 8/10 of students who smoke want to quit
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GATS: Global Adult Tobacco Survey• Global Adult Tobacco Survey (GATS)
– Household-based survey of adults that aims to collect data on adult tobacco use and key tobacco control measures by using a standard global protocol.
• Methodology– Nationally representative household survey of persons aged
15 years and older– Cross sectional estimates by gender and urban/rural– Core questionnaire with optional questions– Options for countries to add additional questions– Face-to-face personal interview survey– Electronic data collection using handheld devices
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TOBACCO QUESTIONS FOR SURVEYS
Tobacco Questions for Surveys (TQS)
• 22 Survey questions to collect data on tobacco use prevalence that can be used in national surveys.
• Currently TQS is integrated into:• World Bank Living Standards• WHO Stepwise• UNICEF National Surveys• USAID Demographic and Health Survey
• Available at: http://www.cdc.gov/tobacco/global/index.htm.
View one indicator for all locationsView one indicator for all locations
GTSS Data: Indicators by Tobacco Topic or MPOWER Objective
View results for one indicator for all countries and regions which have data available. Indicators are organized by tobacco topic or MPOWER objectives.
View results for one indicator for all countries and regions which have data available. Indicators are organized by tobacco topic or MPOWER objectives.
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Data Sharing & Dissemination
• Source data files• Publications• Public use datasets• Key Products
– Fact Sheets– Country Reports
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MPOWER: M - Monitor
• Monitor tobacco use and prevention policies• Obtain nationally representative data on
youth and adults• Critical to understanding and reversing the
epidemic and ensuring success of the other five MPOWER measures
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MPOWER: PProtect People from Tobacco Smoke
• Exposure to smoke at work (for people who work outside the home)
• Exposure to smoke in the home
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PROTECT:SHS Exposure at Workplace
Global Adult Tobacco Survey, 2008-2012
* In the past 30 days preceding the survey
MPOWER: OOffer Help with Quitting
• Quit attempts during the previous 12 months
• Receipt of advice to quit from a doctor or other health care provides
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* Among those who visited a Health Care Provider (HCP) in the last 12 months
OFFER: Advised to Quit by a Health Care Professional
Global Adult Tobacco Survey, 2008-2012
MPOWER: WWarn About the Dangers of
Tobacco• Noticing anti-cigarette information:
– In newspapers/magazines– On television– On cigarette packs
• Both noticing and thinking about quitting
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WARN: Thoughts About Quitting Smoking Because of Warning Labels on Cigarette Packages
* Among those who noticed health warning label (WL) on cigarette packages in the past 30 days preceding the survey
Global Adult Tobacco Survey, 2008-2012
MPOWER: EEnforce Bans on Tobacco Marketing• Noticing cigarette advertising in stores• Noticing cigarette promotions:
– Free samples– Sale prices– Coupons– Free gifts or discounts with purchase– Clothing or other items– Promotions in the mail
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ENFORCE: Percent Who Noticed Cigarette Marketing in Stores
* In the past 30 days preceding the survey
Global Adult Tobacco Survey, 2008-2012
RAISE: Cigarette Affordability
Global Adult Tobacco Survey, 2008-2012
* Affordability as the relative income price - median price paid per 2000 sticks as % of per capita GDP
International Tobacco Control Policy Evaluation Project (ITC)
The ITC Project has established a research platform to guide strong, evidence-based implementation of FCTC policies to:•Evaluate FCTC policies at the level of the individual smoker•Identify the determinants of effective tobacco control policies•Disseminate research findings to the global tobacco control community, including researchers, policy makers, and advocates.
Source: http://www.itcproject.org/about
International Tobacco Control Policy Evaluation Project (ITC)
The ITC measures the psychosocial and behavioral impact of national level policies of the FCTC, studying:
– Health warning labels and package descriptors
– Smoke-free legislation– Pricing and taxation of tobacco
products– Communication and education– Cessation– Tobacco advertising and
promotion
Source: http://www.itcproject.org/about
Global Adult Tobacco Survey Data as a Tool to Monitor the WHO Framework Convention on Tobacco Control(WHO FCTC) Implementation: The Brazilian Case
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• The Global Adult Tobacco Survey (GATS) was conducted in Brazil to provide data on tobacco use in order to monitor the WHO FCTC implementation in the country.
• Data in this report can be used as baseline for evaluation of new tobacco control approaches in Brazil, vis-à-vis WHO FCTC demand reduction measures.
Available at: http://www.mdpi.com/1660-4601/9/7/2520.
Using Data to Inform and Evaluate Tobacco Control Policies
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Linking Global Youth Tobacco Survey (GYTS) data to the WHO Framework Convention on Tobacco Control: the case for Indonesia.Aditama TY1, Pradono J, Rahman K, Warren CW, Jones NR, Asma S, Lee J.
RESULTS: This report shows that more than 1 in 10 students (12.6%) currently smoked cigarettes, with the prevalence among boys (24.5%) significantly higher than among girls (2.3%). Of the students who currently smoked, more than 7 in 10 (75.9%) reported that they desired to stop smoking now….CONCLUSIONS: Tobacco control in Indonesia will likely not move forward until the government evaluates and strengthens existing laws, considers passing new strong laws, and develops protocols for enforcing all laws…
Available at: http://www.ncbi.nlm.nih.gov/pubmed/18585772
Using Data to Inform Tobacco Control Policies
Examples from Indonesia…
Susi Ari Kristina, MPH, PhD
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