World No-Tobacco Day
May 31, 1995
- AN APPEAL FROM THE DIRECTOR-GENERAL OF THE WORLD HEALTH ORGANIZATION FOR WORLD NO-TOBACCO DAY 1995
- THE PUBLIC HEALTH IMPLICATIONS OF THE ECONOMICS OF TOBACCO
- TOBACCO AND HEALTH: THE FACTS
- SMOKERS HARM OTHERS AS WELL AS THEMSELVES
- HEALTH FACTS ABOUT TOBACCO
- SMOKING TRENDS
- COSTS OF TOBACCO USE
- THE CAUSES AND CONSEQUENCES OF A LUCRATIVE BUT DANGEROUS TRADE
- PUBLIC MONEY SUBSIDIZES THE TOBACCO INDUSTRY
- THE ECONOMIC AND HUMAN COSTS OF TOBACCO USE
- TOBACCO TAXATION: TURNING THE ECONOMIC TABLES IN FAVOUR OF HEALTH
- THE FARMING OF TOBACCO AND ITS ENVIRONMENTAL IMPACT THE ECONOMICS OF TOBACCO PRODUCTION
- THE ENVIRONMENTAL CONSEQUENCES OF TOBACCO PRODUCTION
- LIST OF WHO PUBLICATIONS ON TOBACCO OR HEALTH
- WHERE TO GET ADDITIONAL INFORMATION?
- WHO TO CONTACT IN WHO
World No-Tobacco Day
The increase in cigarette smoking worldwide since 1950 has been particularly dramatic in developing countries and has been associated with substantial morbidity, mortality, and economic costs (1,2). Each year, tobacco use accounts for at least 3 million deaths worldwide (1-3). Based on current smoking trends, in 30-40 years, tobacco use is projected to cause 10 million deaths annually, of which 70% will occur among persons in developing countries (1). The global health-care costs resulting from tobacco use exceed $200 billion per year--more than twice the current health budgets of all developing countries combined (4).
To increase global awareness of tobacco-attributable morbidity, mortality, and economic costs, the theme of the eighth World No-Tobacco Day, to be held May 31, 1995, is "Tobacco Costs More Than You Think." Additional information about World No-Tobacco Day 1995 is available from the Regional Office for the Americas, World Health Organization (telephone [202] 861-3200), or from CDC's Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion (telephone [404] 488-5705).
References
1. Peto R, Lopez AD, Boreham J, Thun M, Heath C. Mortality from smoking in developed countries, 1950-2000. Oxford, England: Oxford University Press, 1994.
2. World Health Organization. World No-Tobacco Day, 31 May 1995 [Advisory kit]. Geneva: World Health Organization, 1995.
3. World Health Organization. World No-Tobacco Day, 31 May 1995 [Press kit]. Geneva: World Health Organization, 1995. 4. Barnum H. The economic burden of the global trade in tobacco. Tobacco Control 1994;3:358-61.
* * *Inquiries about the MMWR Series, including material to be considered for publication, should be directed to: Editor, MMWR Series, Mailstop C-08, Centers for Disease Control and Prevention, Atlanta, GA 30333; telephone (404) 332-4555.
The MMWR is available on a paid subscription basis for paper copy and free of charge in electronic format. For information about paid subscriptions, contact the Superintendent of Documents, U.S. Government Printing Office, Washington, DC 20402; telephone (202) 783-3238. For electronic copy, send an e-mail message to lists@list.cdc.gov -- the body content should read subscribe mmwr-toc. Electronic copy also is available from CDC's World-Wide Web server at http://www.cdc.gov/ or CDC's file transfer protocol server at ftp.cdc.gov.
All material in the MMWR Series is in the public domain and may be used and reprinted without special permission; citation of source, however, is appreciated.
AN APPEAL FROM THE DIRECTOR-GENERAL OF THE WORLD HEALTH ORGANIZATION FOR WORLD NO-TOBACCO DAY 1995
On this World No-Tobacco Day 1995, there is an opportunity to make significant progress in the control of tobacco. There is a chance to reverse the growing tobacco epidemic - an epidemic that has been wreaking havoc with the health of the global population. Each year, tobacco is responsible for the death of 3 million people around the world, one death every ten seconds. Yet, this epidemic is not caused by any virus or bacterium. It is an epidemic created by the motive for profit, and perpetuated by those few who stand to earn so much while their products harm so many. The tobacco industry has turned a blind eye to the needless deaths and suffering caused by its products, by marketing a substance that has at least as much potential for causing dependence as heroin and cocaine.
World No-Tobacco Day is a time for the World Health Organization and its Member States to reaffirm their commitment to work towards a world free of tobacco. We also applaud those who have already broken free from tobacco use and encourage those who still use tobacco to make a special effort to finally free themselves from tobacco dependence.
The health risks of tobacco are mistakenly underestimated by many people. This is largely because of the 30 to 40 year time lag between the onset of smoking and the deaths that it causes. If the teenagers of today who smoke continue to do so, half of them will be killed by their habit, with one half of those dying during middle age. If current smoking trends persist, in 30-40 years, the tobacco epidemic will be responsible for 10 million deaths per year, with 70% of them occurring in developing countries.
The costs of tobacco go far beyond the tragic health consequences. Tobacco is devastating to the economic health of the world as well. With this realization firmly in mind, it is now time for the world's forces for economic development and public health improvement to join ranks to improve both health and wealth. It is for this reason that the slogan chosen for World No Tobacco Day 1995 is "Tobacco costs more than you think".
Even allowing for the short-term income it generates, it has been estimated that tobacco costs the world over US $ 200 billion per year. Were this money to become available, it would be enough to double the current health budget of all the developing countries. Six trillion cigarettes are smoked each year, and this number is growing, especially in developing countries, where, since 1970, per capita cigarette consumption increased by 67%. Tobacco companies have proven particularly adept at marketing cigarettes to emerging markets among youth, women and entire populations of newly developing countries.
We cannot just stand by and hope the situation will improve. It is now clear that government officials in the Finance sector have a concrete reason to ally themselves with those in the Health sector. There are proven measures that can be taken to reverse the tobacco epidemic and turn the economic environment against further growth in tobacco sales. These economic measures will complement health goals, while at the same time maximizing government revenue and reducing health costs.
There are many examples of measures that have been successfully adopted, such as those in Australia, Canada, Finland, Iceland and New Zealand, where some of the revenue raised from tobacco taxes is being used to offset the financing of other tobacco control measures and a wide variety of health promotion activities. Other notable examples from countries include developing economic alternatives to the farming of tobacco, increased tobacco taxes, banning tobacco promotion, requiring prominent health warnings on tobacco products, and eliminating the subsidization of tobacco.
A few developing countries derive a large part of their export earnings from tobacco, but even these countries could consider economic measures that will help to prevent further increases in domestic rates of tobacco consumption.
However, decision-making on matters concerning the economics of tobacco is not limited to government policy-makers. In deciding to purchase or not to purchase tobacco products, every single consumer is making a decision on tobacco economics every single day. Of course, the individual economic decision that will improve both health and wealth is the decision not to purchase tobacco products, but to use that money for other, more productive or worthwhile purposes. It is a decision on tobacco economics that I am happy to recommend to everyone. Policy- making in finance and health sectors can help to support this individual decision.
The global operating revenues from tobacco for just one tobacco company are more than double the amount spent on health care in China, the world's most populous country. This is yet more evidence that the tobacco industry is strong. Therefore, the forces of public health need to be stronger. Failure to act effectively to discourage tobacco consumption would amount to tacit approval of further unchecked growth of the tobacco epidemic. The point where half-hearted efforts would suffice has been passed. By working together to diminish the impact of the tobacco epidemic, public health and economic institutions can make the world both a healthier and a wealthier place to live.
Dr Hiroshi Nakajima Director-General
World No-Tobacco Day
THE PUBLIC HEALTH IMPLICATIONS OF THE ECONOMICS OF TOBACCO
World No-Tobacco Day 1995 focuses on the economics of tobacco for two simple reasons:
firstly, the driving force behind the spread of tobacco- related disease is not a virus or bacterium but the search for profit. This search for profit gives higher priority to the financial well-being of a few corporations than to the lives of hundreds of millions of people.
secondly, to the same extent as inoculations or antibiotics can change the environment to protect us from infectious diseases, there are a range of measures governments can take to turn the economic environment against the growing tobacco epidemic.
Traditionally, health ministries have looked at health policies, and finance ministries at economic policies. At best, there has been some dialogue. At worst, the two have pulled in opposite directions. In many countries, as health ministers have put out ever louder warnings about the risks of tobacco use, finance ministers have often allowed tobacco taxes to be eroded by inflation and rising incomes, making tobacco more affordable. As health ministers target domestic tobacco use, trade ministers can sometimes be found helping to promote tobacco use in other countries.
This lack of coordination of health and economic policies not only contributes to the tobacco epidemic but also undermines many of the revenue and economic policy goals of many of these countries. The fact is that economic measures which compliment health goals can also maximize government revenue and reduce health costs.
This year's focus is designed to make all those committed to reducing the threat to future world health from rising tobacco use aware of the power of economics and also aware of the need to get economic policies and health policies moving in the same direction. Getting this right has the potential to reduce the looming epidemic of tobacco-caused disease. The price of getting it wrong is that annual tobacco-caused deaths will more than triple in 30 to 40 years, and increase even more after that.
Tobacco products have no safe level of consumption, and are the only legal consumer products that kill when used exactly as the manufacturer intends. Researchers have rated nicotine as even more addictive than heroin, cocaine, marijuana, or alcohol. Unfortunately, efforts to convey these essential health messages to the public have been swamped by social, economic, and political factors that create an environment which promotes tobacco use.
World No-Tobacco Day
TOBACCO AND HEALTH: THE FACTS
How many smokers?
1.1 billion smokers worldwide. In developed countries, 41% of men and 21% of women regularly smoke cigarettes. In developing countries, 50% of men smoke, and 8% of women.
The number of women who smoke is increasing in many countries.
How many cigarettes?
6000 billion cigarettes are smoked every year. In developed countries annual consumption of cigarettes dropped from 2800 cigarettes per adult in the early 1980s to 2400 in the early 1990s. In developing countries, accounting for three-quarters of the world's population, per adult consumption rose from 1150 cigarettes per year to 1400, and is still increasing at 1.7% per year.
How many deaths are caused by tobacco?
About 3 million deaths a year now, with about one-third of them in developing countries. If current smoking trends persist, approximately 10 million a year in 30 to 40 years, with about 70% of them in developing countries. Cigarettes currently cause just under 20% of all deaths in developed countries.
SMOKERS HARM OTHERS AS WELL AS THEMSELVES
Environmental tobacco smoke
causes lung cancer and other diseases in individuals exposed to second-hand smoke; exacerbates allergies and asthma
.
Maternal smoking
is associated with a higher risk of miscarriage, lower birth- weight of babies, and inhibited child development; parental smoking is also a factor in sudden infant death syndrome and is associated with higher rates of respiratory illnesses including bronchitis, colds, and pneumonia in children.
HEALTH FACTS ABOUT TOBACCO
The facts speak for themselves. Every ten seconds, another person dies as a result of tobacco use. Currently, tobacco products kill about 3 million people a year, and this number is increasing. Unless current trends are reversed, that figure is expected to rise to 10 million per year by the 2020s or early 2030s, with 70% of those deaths occurring in developing countries. That means that a failure to take serious preventive action will result in approximately 100 million people per decade dying unnecessarily and prematurely by the decade of the 2030s, or perhaps a little earlier. Recent data confirm that the risks of smoking are considerably higher than previously thought, especially when smoking begins during adolescence. Persistent smokers have a one in two chance of eventually being killed by cigarettes.
Smoking, in fact, has been named as the single largest preventable factor in premature death, disability, and disease. How is it possible that we can ignore the reality of a grave public health crisis and not take serious action?
The negative health consequences of smoking are not as immediate as with other hazardous substances. There is a 30-40 year delay between the onset of smoking and the deaths that it causes. Therefore, the health risks of tobacco use are vastly underestimated by the public, and even by many of the authorities who are responsible for protecting and promoting public health. This is one of the reasons why tobacco products are still widely available and why lenient tobacco policies have been allowed to occur.
SMOKING TRENDS
Smoking rates have declined among adults in developed countries; however, the tobacco industry has been quick to shift their attention to other markets, and smoking prevalence has increased in many developing countries. In developed countries, an estimated 41% of men and 21% of women are smokers. In developing countries, the corresponding estimates are 50% of men and 8% of women. However, female smoking prevalence is on the rise, particularly in many developing countries. It has been proven that tobacco companies have been very successful in promoting smoking as a sign of women's increasing independence and equality. Unfortunately, that equality will be exhibited in mortality rates. As demonstrated by the developed countries, if women smoke at the same rates as men, they will die at the same rate as men.
The combination of increasing affordability and modern advertising and promotion plays an important part in recruiting children and adolescents into tobacco use.
The aggressive marketing of tobacco products along with their increasing affordability has been successful in enticing young people to begin smoking. At first, they are not concerned with the long-term health risks. However, by the time they realize the deadly repercussions of smoking, they are hooked on a highly addictive drug. If those teenagers continue smoking throughout their lives, then half will die from tobacco use. Of these, half will die in middle age and half will die in old age (over 70), losing about eight years of life expectancy. Those in the former category will lose 20-25 years of life expectancy. Tobacco is not just a cause of death in old age but in many countries, is the leading cause of premature death.
China, with an economy which has been one of the fastest growing in recent years, illustrates the challenge we face. From 1985 to 1992, cigarette consumption per adult dropped by 13% in highly developed countries, but at the same time increased by 20% in China. For every cigarette less smoked in highly developed countries, three cigarettes more were smoked in China. If current trends persist, two to three million annual tobacco-caused deaths are predicted for China by the 2020s. These trends also translate into approximately 50 million of the young people under twenty years of age alive today in China dying prematurely from the consequences of smoking.
World No-Tobacco Day
COSTS OF TOBACCO USE
THE CAUSES AND CONSEQUENCES OF A LUCRATIVE BUT DANGEROUS TRADE
It is now well established that tobacco usage is a major threat to global public health. But the damage resulting from tobacco extends far beyond the obvious health issues. Tobacco has been also proven to be detrimental to the economic health of the world as well. It is a major drain on the world's financial resources. A World Bank economist has estimated that the use of tobacco results in a net loss of US $ 200 billion per year, with half of these losses occurring in developing countries. Each 1000 additional tonnes of tobacco consumption translates into a net drain on the world economy of US $ 27.2 million. With annual global tobacco consumption now in excess of 7 000 000 tonnes - and growing - the magnitude of the economic losses is matched only by the extent of the staggering costs of human death and suffering.
These extraordinary losses to the world economy raises questions about what made it possible for the tobacco industry to grow to its present size. There is a combination of factors which create the economic environment that makes the tobacco industry a highly profitable business.
1. Tobacco products are inexpensive to manufacture
The cost of the tobacco leaf is almost inconsequential. Raw tobacco can be bought for less than US $ 2.00 per kilogram. That one kilogram can produce about 1400 cigarettes, which translates to a raw cost of only a few cents per pack for the manufacturer. Manufacturers' production costs are also kept down by highly automated factories requiring little human labour.
2. Tobacco products are highly addictive
Current smokers often find their cessation efforts futile, despite a sincere desire to quit coupled with strong public health messages. The tobacco companies are thus assured of asteady stream of existing, and new, users.
3. Rather than competing on price, the companies compete on brand images through advertising
The lack of serious price competition is what allows tobacco companies to maintain the high margins which rank them among the most profitable in the world, making billions of dollars each year. This extraordinary profitability is what drives the tobacco epidemic.
Without these profits, tobacco companies would not be able to launch such expensive advertising and public relations campaigns to ameliorate their image and improve the social acceptability of smoking.
PUBLIC MONEY SUBSIDIZES THE TOBACCO INDUSTRY
It is ironic that even though the tobacco companies are able to realize large profits each year, they have been effective at persuading governments to financially support the growing of tobacco. This has even included paying for research to develop tobacco with a higher nicotine level. In a certain African country, a tobacco research institute is heavily funded from government money set aside for science and technology. Members of the European Union puts more money into promoting tobacco production each day - US$ 3.8 million - than the total spent by the European Commission on tobacco control in a year. This is also by far the most costly crop subsidization programme in the European Union. If the European Union were simply to pay all tobacco farmers an amount equal to their entire net income and require them not to grow any more tobacco, subsidy expenditures would be reduced by 44%.
These kinds of policies are clearly not in line with government commitments to control tobacco. Not only do these policies add directly to future health tolls, they further reduce the cost of business for tobacco companies. Such policies are fertilizing, rather than attacking, the roots of the tobacco epidemic.
THE ECONOMIC AND HUMAN COSTS OF TOBACCO USE
Tobacco usage is far more costly than most people realize. Economists, such as those employed by the World Bank, can generate estimates of a global net drain on the world economy. But economists can only measure those things which can be measured.
In addition, there are substantial costs that, though quantifiable, are not as easily measured. For example, there is the work of caring for someone who becomes ill from tobacco usage, as well as the task of dealing with the responsibilities previously assumed by that person. In many countries this can be a significant burden for the entire family, one which may - among other things - prevent the tobacco user's children from getting an education, thereby inhibiting their chances of success. While the costs of such things are potentially measurable, the difficulty involved with such measurements mean they are seldom quantified.
Finally, there are the costs that are very real but cannot be measured. These include reduced quality of life for not only the smoker and those affected by secondhand smoke, but also the suffering that is brought upon those people whose lives are torn apart due to the loss or illness of a loved one. The value of human life, and of attaining human potential, cannot be adequately measured in pure economic terms. But difficulties in measurement should not leave us blind to these, for they are the biggest by far of the true costs of tobacco industry products.
World No-Tobacco Day
TOBACCO TAXATION: TURNING THE ECONOMIC TABLES IN FAVOUR OF HEALTH
Increases in tobacco taxes have clearly been one of the most significant weapons that public health advocates can use to change the economics of tobacco in a way that will reduce health problems. If the price of tobacco is high enough, many price-sensitive consumers will be prevented from taking up smoking. In fact, the very people who are traditionally least affected by health information appear to be the most affected by price changes. Research from the USA and the UK shows a strong effect of price increases in reducing tobacco use among young people and lower income groups.
Recent UK research indicates that a 10% increase in prices will cause overall tobacco use to fall by about 5%, and that women are more responsive to price than men, with the poorest fifth of the UK smoking population being the most responsive to increases in the price of cigarettes. Teenagers were also found to be price sensitive. As such, some of the groups which have been the hardest to reach through non- economic tobacco control strategies, are the most likely to experience the health benefits that flow from fiscal policies which complement public health goals.
If the price of tobacco products were made to rise regularly, and to increase at least as rapidly as incomes rise, this could significantly reduce the uptake, continued use, and eventual death toll of tobacco industry products.
There are different methods of tobacco taxation. The key thing is to ensure that the tax structure makes tobacco products less affordable. This can be done by ensuring that there is a high minimum price level for cigarettes. Simultaneously, there can be higher taxes imposed on particular forms of tobacco, or particular classes of cigarettes. This can be used to specifically discourage the use of some categories of tobacco products, or to place a greater price disincentive on products specifically targeted at particularly price-sensitive groups, such as young people.
There are, as with all public health measures, problems to be mindful of when raising tobacco taxes as part of an overall comprehensive strategyto reduce tobacco use. Foremost among the potential problems is the fact that - as with all effective tobacco control strategies - considerable opposition can be expected from pro-tobacco interests. Claims of near-insurmountable problems will be made, but all of them can be answered by recourse to the facts.
The most important aspect of increased tobacco taxes is the health gain resulting from reduced tobacco use. At the same time, it is worth noting that the increased taxes also result in increased tax revenue since the percentage increase in taxes will be greater than the percentage decline in tobacco use. As a result, governments can advance public health while raising revenue. The fact that tobacco taxation has been shown in many countries to be far more popular than other forms of taxation is a further gain for the world's governments. Seldom have national leaders had the opportunity to make decisions that will simultaneously prevent extraordinary human suffering, raise significant revenue, and be popular.
World No-Tobacco Day
THE FARMING OF TOBACCO AND ITS ENVIRONMENTAL IMPACT THE ECONOMICS OF TOBACCO PRODUCTION
Efforts to slow the spread of tobacco-caused disease sometimes run up against arguments about those who make a livelihood from the growing of tobacco. From a health standpoint, avoiding tobacco control efforts out of concern for the job security of tobacco farmers, makes no more sense than avoiding world peace out of concern for jobs in the armaments industry.
Any reduction in actual tobacco use is likely to be gradual, due to the addictiveness of tobacco products. There will be time for governments to help growers to adapt.
It is important to understand that the large majority of countries will realize strong net benefits from a reduction in tobacco use. In the majority of countries, either all, or at least a large percentage of the tobacco consumed is imported. For these countries, there is little local economic benefit while the country suffers all the human and economic costs of tobacco. In these nations, disposable income which would otherwise be spent on tobacco will, as tobacco use diminishes, go toward other goods and services. In many places this will include locally grown food.
Overall, the large majority of nations will have much more positive health outcomes from reducing tobacco use, while tending to create more local employment. As has been shown for non-tobacco-producing areas of the USA, the presence of a tobacco market in these countries is retarding the development of other areas of expenditure of disposable income, and reducing overall economic wellbeing.
In countries where a large amount of tobacco is grown and exported, the arguments against domestic tobacco control policies are also weak. In two African countries, for example, over 98% of all the tobacco produced is exported. Policies with the potential to control tobacco use within these countries will have negligible impact on the domestic tobacco growing industry and may even free up additional tobacco for export to nations which are currently uneconomic producers of tobacco.
Even in countries which produce and consume a lot of tobacco, the notion that national tobacco control policies will devastate tobacco producing areas lacks credibility. A study in the USA points out that even major tobacco growing areas of the tobacco-producing states have low levels of reliance on tobacco.
The net result is that the presence of tobacco agriculture need not be a significant impediment to the implementation of tobacco control measures.
THE ENVIRONMENTAL CONSEQUENCES OF TOBACCO PRODUCTION
If there is to be gradual movement towards a world free of the diseases, death and economic losses caused by tobacco use, the long- term future of tobacco production is in question. While this would be unquestionably good for health, there are also other reasons why tobacco farming may not be the blessing that it is frequently claimed to be.
Much of the tobacco produced in developing countries requires vast quantities of wood for the curing process. In some tobacco- growing regions, people now have to travel over 10 kilometres just to find wood for domestic cooking and heating.
Where tobacco companies engage in reforestation efforts, the promises are seldom matched by results. Even when tree planting is widespread the species favoured are frequently not the most appropriate for local environments.
The growing of tobacco often involves extensive use of fertilizers and pesticides. These can get into the local environment, including the water supply, and cause harm. At the same time, the unsafe use of pesticides is, like the threat of nicotine poisoning of tobacco workers, a threat to health.
The work necessary for tobacco growing is labour intensive. In many developing countries this means that the women and children do much of the work (and suffer the greatest risk of conditions such as nicotine poisoning). This need for labour has also been shown to interfere with the schooling of the children and may leave food crops neglected.
The prices paid to tobacco farmers are paid are often much less than they were led to believe, and the overhead is often much greater. The farmers are often left with little return for all their work. In a great many cases the farmers, like the local environment and global public health, are better off if other crops are grown.
World No-Tobacco Day
LIST OF WHO PUBLICATIONS ON TOBACCO OR HEALTH
CONTROLLING THE SMOKING EPIDEMIC
Report of the WHO Expert Committee on Smoking Control. Technical Report Series 636. World Health Organisation, Geneva, 1979. Available in English, French, Spanish and Russian.
SMOKING CONTROL STRATEGIES IN DEVELOPING COUNTRIES
Report of the WHO Expert Committee. Technical Report Series 695. World Health Organisation, Geneva, 1983. Available in English, French, and Spanish.
SMOKELESS TOBACCO CONTROL
Report of the WHO Study Group. Technical Report Series 773. World Health Organisation, Geneva, 1988. Available in English, French, Spanish and Russian.
WOMEN AND TOBACCO
World Health Organisation, Geneva, 1992. Available in English, French, Spanish and Japanese.
LEGISLATIVE ACTION TO COMBAT THE WORLD TOBACCO EPIDEMIC
Second edition. Ruth Roemer. World Health Organisation, Geneva, 1993. Available in English; French and Spanish in preparation.
SMOKE FREE EUROPE
A series of 10 booklets published 1988-91 covering all tobacco control elements. WHO Regional Office for Europe. Available in English, French, German and Russian.
IT CAN BE DONE. A SMOKE-FREE EUROPE. REPORT OF THE FIRST EUROPEAN CONFERENCE ON TOBACCO POLICY. MADRID, 7-11 NOVEMBER 1988
WHO Regional Office for Europe, 1990. Available in English.
TOBACCO HABITS OTHER THAN SMOKING:
BETEL-QUID AND ARECA-NUT CHEWING :
AND SOME RELATED NITROSAMINES
IARC Monographs on the evaluation of the carcinogenic risk of chemicals to humans. Volume 37. International Agency for Research on Cancer. World Health Organisation, Lyon, 1985. Available in English.
TOBACCO SMOKING
IARC Monographs on the evaluation of the carcinogenic risk of chemicals to humans. Volume 38. International Agency for Research on Cancer. World Health Organisation, Lyon, 1986. Available in English.
TOBACCO USE : A MAJOR INTERNATIONAL HEALTH HAZARD
Proceedings of an International Meeting, D.G. Zaridze and R. Peto (editors). IARC Scientific Publications No. 74. International Agency for Research on Cancer. World Health Organisation, Lyon, 1986. Available in English.
OVERALL EVALUATIONS OF CARCINOGENITY. AN UPDATING OF IARC MONOGRAPHS
IARC Monographs on the evaluation of the carcinogenic risk of chemicals to humans. Volume No. 1-42. Supplement 7. International Agency for Research on Cancer. World Health Organisation, Lyon, 1987. Available in English.
ENVIRONMENTAL CARCINOGENS. METHODS OF ANALYSIS AND EXPOSURE MEASUREMENT
.VOLUME 9 - PASSIVE SMOKING
I.K. O'Neill, K.D. Brunnemann, B. Dodet and D. Hoffmann (editors). International Agency for Research on Cancer, World Health Organisation, Lyon, 1987. Available in English.
WORLD HEALTH STATISTICS ANNUAL, 1990
World Health Organisation, Geneva, 1991. Available in English and French.
World No-Tobacco Day
WHERE TO GET ADDITIONAL INFORMATION?
There is a wealth of accumulated worldwide information on the economics of tobacco. For those wanting additional information we suggest that you seek out the World Health Organization 1995 World No-Tobacco Day "Advisory Kit", which has been distributed to health officials around the world. Copies of this kit can be obtained free of charge from your nearest WHO Regional Office. This kit will provide a more detailed analysis of the points covered in these press materials, as well as more in-depth information on other issues concerning the economics of tobacco.
WHO TO CONTACT IN WHO
For further information, please contact:
WHO headquarters
WHO Regional Office for Africa
WHO Regional Office for the Americas
WHO Regional Office for the Eastern Mediterranean
WHO Regional Office for Europe
WHO Regional Office for South-East Asia
WHO Regional Office for the Western Pacific
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