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Rapid urbanization as well as cultural habits explain Gulf states' rise in heart disease prevalence 

While the rapid improvement in socio-economic conditions is thought responsible for the high rates of cardiovascular disease in the Gulf states, deep-rooted cultural factors also play a part. "We're sitting on a time bomb," says Professor Hani Najm, Vice-President of the Saudi Heart Association, whose annual conference begins Friday 27 January. "We will see a lot of heart disease over the next 15 to 20 years. Already, services are saturated. We now have to direct our resources to the primary prevention of risk factors throughout the entire Middle East." . . .

And now there is further evidence that the cultural heritage of the Middle East may present yet another growing risk factor in the region's battle against heart disease. The waterpipe - also know as the hookah or shisha - is now said to be used by up to 34% of Middle Eastern adolescents. Despite a perception that the risk of the waterpipe may be less than those of cigarettes, a recent report suggests that its "harmful effects are similar to those of cigarettes", and that the waterpipe may offer "a bridge" to cigarette smoking.(1) The greatest prevalence of use - with up to 34% reported - is currently among adolescents and women.

A recent study from the Gulf Registry of Acute Coronary Events (GRACE), the region's largest, found that 38% of patients registered were cigarette smokers and 4.4% waterpipe smokers.(2) The study, which included 6,701 consecutive acute coronary patients in Bahrain, Kuwait, Qatar, Oman, United Arab Emirates, and Yemen, found that the waterpipe smokers were older than the cigarette smokers and more likely to be female.

However, despite the relatively low rate of waterpipe smoking among the patients in this registry study, other studies report more widespread use throughout the region, and especially among the younger age groups. A study from 2004 found that 22% of men in two villages of Egypt reported current or past use of waterpipes, and the habit is increasingly evident even among student communities in the USA, Canada and Germany.

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WHO: Resist tobacco firms' suits  

An official of the World Health Organization (WHO) has called on governments to be firm against efforts of big tobacco companies opposing new laws that may affect their sales.

"Tobacco is the only industry that produces products to make huge profits and at the same time damage the health and kill their consumers," said WHO director-general Margaret Chan during a public health meeting in Geneva earlier this week.

"How can we as an international community allow big tobacco to harass countries?" Chan said. . . .

Locally, two security guards filed a case against the Metropolitan Manila Development Authority (MMDA) after they were apprehended for smoking in public.

The two security guards were allegedly helped and encouraged by tobacco companies in filing the case.

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Study links smoking to millions of TB deaths 

The World Health Organization recently reported that the number of cases of tuberculosis has been falling since 2006. Also, fewer people are dying from TB. But a study by researchers at the University of California, San Francisco, says smoking could threaten this progress.

Nearly 20 percent of all people use tobacco, and millions of non-smokers get sick from breathing the smoke. The new study predicts that smoking will produce an additional 34 million TB deaths by 2050.

Efforts to control the spread of tuberculosis have mainly focused on finding and treating infections. Much less effort has been made to understand the causes. Dr Anthony Fauci is the director of the United States National Institute of Allergy and Infectious Diseases.

ANTHONY FAUCI: "Despite our control efforts, that you still have more than a million people each year, you know, dying from TB and millions and millions getting infected, we realize it's still a very important problem. So we have to do the practical thing and we have to do the fundamental research things at the same time."

Smoking does not cause tuberculosis; bacteria cause the infection. But the study says smoking affects the nervous system in a way that makes an inactive case of TB more likely to develop into an active one.

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• WHO chief slams tobacco firms that ‘harass’ governments to prevent anti-smoking measures  

The head of the World Health Organization has urged countries to stand together against tobacco companies that are trying to "harass" them into softening their anti-smoking stance.

"Tobacco is the only industry that produces products to make huge profits and at the same time damage the health and kill their consumers," WHO Director-General Margaret Chan told officials at a public health meeting in Geneva.

"How can we as an international community allow big tobacco to harass countries?" she asked. Chan said Australia, Uruguay, Norway and the United States were among the countries targeted by the tobacco industry over their measures to reduce smoking-related disease. . . .

A spokeswoman for Philip Morris said the company had been forced to act because the anti-tobacco measures were illegal.

"The laws that we have challenged in Uruguay and Norway have not reduced smoking but contravene numerous laws and treaties," said Anne Edwards, a spokeswoman for Philip Morris International, which is based in Lausanne, Switzerland.

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Tobacco is the only industry that produces products to make huge profits and at the same time damage the health and kill their consumers. How can we as an international community allow big tobacco to harass countries?
WHO Director-General Margaret Chan at a public health meeting in Geneva.

• FDA Statement on the International Tobacco Regulators' Conference 

This week, 65 representatives of health and regulatory agencies from 22 countries attended the International Tobacco Regulators' Conference, hosted by the U.S. Food and Drug Administration and the World Health Organization Tobacco Free Initiative.

During the conference, leaders from around the world engaged in open and frank discussions about their experiences in tobacco regulation to improve the public health of their nations. The leaders also identified opportunities for collaboration in tobacco control efforts and encouraged information-sharing between countries and established experts.

"The Obama Administration is committed to stopping children from smoking and reducing smoking rates and today, we saw a strong, global commitment to address this problem," said Commissioner of Food and Drugs Margaret A. Hamburg, M.D. "This conference underscores President Obama's commitment to close collaboration with our international counterparts to end the tobacco epidemic."

"This is the natural culmination of increasing our work to fight smoking that dates back to the adoption of the WHO Framework Convention on Tobacco Control in 2003," said Douglas Bettcher, M.D., M.P.H., Ph.D., director of WHO Tobacco Free Initiative.

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WHO urges fighting 'big tobacco's dirty tricks, immorality, bullying 

The World Health Organization's chief on Monday urged governments to unite against "big tobacco", as she accused the industry of dirty tricks, bullying and immorality in its quest to keep people smoking.

WHO director-general Margaret Chan accused cashed-up tobacco firms of using lawsuits to try and subvert national laws and international conventions aimed at curbing cigarette sales.

"It is horrific to think that an industry known for its dirty tricks and dirty laundry could be allowed to trump what is clearly in the public's best interests," Chan said at a WHO meeting in the Philippine capital on Monday.

Chan cited legal actions by the tobacco industry against anti-smoking measures in Australia and Uruguay, saying these were "scare tactics" intended to frighten other countries from following suit.

"It is hard for any country to bear the financial burden of this kind of litigation, but most especially so for small countries," she said.

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• WHO chief faces fight on reforms  

Tough-talking World Health Organization chief Margaret Chan Fung Fu-chun may be facing the toughest battle of her leadership as she launches a bid for unprecedented funding and management reform at the UN body.

The WHO director-general has begun governance reforms in the Geneva headquarters and has been traveling the world trying to convince the group's regional and country offices they should change the way they do business amid global financial austerity.

On the second day of the WHO regional meeting in Manila, Chan emphasized to the 194 member states the need for reform.

"We have to rethink given this financial austerity,"she said yesterday. . . .

In an interview with The Standard, Chan emphasized her determination to fight the tobacco companies.

She said big companies will go as far as character assassination to derail global efforts to combat smoking.

"Dr Judith Mackay [Hong Kong's pre-eminent anti-tobacco activist] was named and [the tobacco lobbyists] gave her a hard time,saying this and that."

Chan said it is unethical for scientists to be paid by the tobacco industry to do research to counter studies about the harmful effects of tobacco. . . .

Chan, 64, who ran as a representative of China for the leadership of the UN health body, said the mainland has one third of the world's smokers, and that every time she visits China, she takes up the tobacco issue with the nation's top leaders.

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Welcome funding to help in uphill battle  

South Korea has pledged more help for the World Health Organization's fight against noncommunicable diseases - an effort that lacks bite in much of Asia because of a lack of government support.

Seoul's vice minister for health and welfare, Choi Won Young, told the WHO Western Pacific regional meeting in Manila yesterday that his government is pledging an additional US$4.5 million (HK$35.1 million) over five years for prevention and control of noncommunicable diseases and for drugs needed after disasters.

The pledge was rare good news on a day that focused on cancer, heart disease, lung disease and diabetes, which claim about 30,000 lives every day in the Western Pacific region, which includes Greater China.

Regional director Shin Young Soo, wrapping up the session, said the issue of tackling noncommunicable diseases is an issue that has become "global and political" and the need is to work with partner agencies such as the Asian Development Bank, which can "squeeze the arms" of government ministers on matters such as increasing tax on tobacco.

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• WHO chief slams tobacco industry tactics 

THE World Health Organization's chief has urged governments to unite against "big tobacco", accusing the industry of dirty tricks, bullying and immorality in its quest to keep people smoking.

WHO director-general Margaret Chan accused cashed-up tobacco firms of using lawsuits to try and subvert national laws and international conventions aimed at curbing cigarette sales.

"It is horrific to think that an industry known for its dirty tricks and dirty laundry could be allowed to trump what is clearly in the public's best interests," Chan said at a WHO meeting in the Philippine capital today.

Chan cited legal actions by the tobacco industry against anti-smoking measures in Australia and Uruguay, saying these were "scare tactics" intended to frighten other countries from following suit.

"It is hard for any country to bear the financial burden of this kind of litigation, but most especially so for small countries," she said.

"Big tobacco can afford to hire the best lawyers and PR firms that money can buy. Big money can speak louder than any moral, ethical or public health argument and can trample even the most damning scientific evidence."

Chan called on the countries at the forum of Western Pacific nations to fight back.

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WHO report on the global tobacco epidemic, 2011: warning about the dangers of tobacco 

This report is the third in a series of WHO reports on the status of global tobacco control policy implementation.

All data on the level of countries’ achievement for the six MPOWER measures have been updated through 2010, and additional data have been collected on warning the public about the dangers of tobacco. The report examines in detail the two primary strategies to provide health warnings – labels on tobacco product packaging and anti-tobacco mass media campaigns. It provides a comprehensive overview of the evidence base for warning people about the harms of tobacco use as well as country-specific information on the status of these measures.

To continue the process of improving data analysis, categories of policy achievement have been refined and, where possible, made consistent with new and evolving guidelines for the implementation of the WHO Framework Convention on Tobacco Control. Data from the 2009 report have been re-analyzed to be consistent with these new categories, allowing for more direct comparisons of the data across both reports.

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• Tobacco industry relying on movies for brand promotion  

The tobacco industry is increasingly leaning on movies for the promotion of its business in India and several other countries following the ban on tobacco advertising, the WHO has warned.

Of late, the industry has also been denied the sponsorship of sports and music events, compelling it to shift its focus to films, the global health body observes in the report "Smokefree movies: From evidence to action".

Hollywood actor Sharon Stone in Basic Instinct glamourised smoking.

A survey of popular films has shown that tobacco brand displays exploded in Bollywood after its advertising was banned in the media in 2004. Of the 395 top grossers in 1990-2002, 76 per cent depicted the use of tobacco. The percentage of scenes showing lead actors or heroes using tobacco increased from 22 in 1991 to 54 in 2002. Of the 110 Hindi movies produced in 2004-2005, 89 per cent depicted tobacco use. The lead actors were shown smoking in 76 per cent of these movies.

The brand display was more or less even between premium cigarette brands belonging to the British American Tobacco, its Indian partner (the Indian Tobacco Company) and competing brands belonging to the Philip Morris International, whose entry into the Indian market coincided with the ban on tobacco advertising.

Using movies to promote smoking is a global phenomenon. In the UK, where almost all forms of tobacco advertising are prohibited, youth-rated films from the US contained 83 per cent of all tobacco visuals in 2001-2006.

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WHITMAN: Corporate Profits Trumping Public Health  

Responsible for 63 percent of deaths worldwide, or 36 million deaths per year, NCDs constitute a serious threat to global social and economic development.

Yet throughout events held on Monday and Tuesday, and in the political declaration agreed upon by member states outlining the steps they would take to address NCDs, a clear, persistent and pervasive challenge emerged: ensuring that profit-driven corporations and industry groups are not able to influence policies or other efforts aiming to improve public health.

Government and civil society leaders alike agreed that, as the political declaration stated, NCD prevention and control require "multisectoral approaches". But many also expressed concern that no clear boundaries exist to distinguish appropriate involvement of the private sector from the inappropriate and potentially unethical, or to ensure that profits do not trump public health. . . .

Bill Jeffery, national coordinator for Centre for Science in the Public Interest, Canada (CSPI-Canada), told IPS private sector engagement will "have no integrity" without a code of conduct. Nor was the "relationship between trade and health... squarely addressed in this political declaration," Jeffery pointed out.

CSPI-Canada is part of the Conflict of Interest Coalition calling for the creation of such a code.

Douglas Bettcher, director of the World Health Organisation's (WHO) Tobacco Free Initiative - WHO is considered the world's primary specialised health agency - told IPS that WHO had "very clear and strict guidelines vis-à-vis work with commercial enterprises to make sure that our... policy work is not deviated and not open to undue influence by the private sector."

He insisted that the political declaration did protect against such undue influence. "It says very strictly, 'where and as appropriate,'" he told IPS.

Nevertheless, there are "certain aspects of reducing risk factors where the cooperation of the industry can be beneficial," Bettcher said. Actually implementing policies by cutting down on sodium in foods and engaging in responsible marketing can help improve public health, for example.

But when industry groups participate in discussions or are involved in policy making decisions, their influence can run the gamut from directly opposing public health interests to emphasising control of NCDs, a more profitable aspect from the pharmaceutical perspective, for instance, over prevention.

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Scaling up action against noncommunicable diseases: How much will it cost? 

The report describes a financial planning tool for scaling up delivery of a set of cost-effective population-based and individual-level health care interventions in low- and middle-income countries. This tool can be used to forecast financial resource needs at national or sub-national level and also to generate a price tag at global level. It will enhance traditional budgeting mechanisms in countries and provide information to development agencies and international institutions on the resources needed to address the growing burden of NCDs.

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From burden to "best buys": Reducing the economic impact of NCDs in low- and middle-income countries 

Overview

There is growing awareness and concern about the large and escalating burden of chronic, noncommunicable diseases (NCDs) not just from the public health perspective but also from the economic one. The social burdens associated with the four diseases – cardiovascular disease, diabetes, cancer and chronic respiratory diseases – include prolonged disability, diminished resources within families and reduced productivity, in addition to tremendous demands on health systems.

This report addresses current information gaps in our understanding of how to mitigate these challenges by highlighting recent findings about the social costs of NCDs and the resource needs for managing these conditions. Specifically, the report brings together findings from two new studies aimed at equipping decision-makers in government, civil society and the private sector with key economic insights needed to help reduce the growing burden of NCDs.

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World Leaders Commit to Fighting Tobacco Use as Part of Global Battle Against Non-Communicable Diseases, But Words Must Be Backed Up By Action 

Meeting at the United Nations, world leaders today have made an unprecedented commitment to addressing the global public health crisis caused by non-communicable diseases (NCDs) and recognized that the battle against NCDs cannot be won without winning the fight against tobacco, the only risk factor shared by all major categories of NCDS -- cancer, heart disease, chronic lung disease and diabetes. NCDs are the world's biggest killers, accounting for nearly two out of every three deaths worldwide.

We are especially encouraged that the final declaration adopted today at the United Nations High-Level Meeting on Non-Communicable Diseases calls on nations to accelerate implementation of tobacco control policies such as those contained in the World Health Organization's Framework Convention on Tobacco Control, the world's only public health treaty. In particular, the declaration recognizes the effectiveness of raising taxes on tobacco products, stating that "price and tax measures are an effective and important means of reducing tobacco consumption."

The urgent challenge now is for nations to back up these commitments with concrete and aggressive actions. Only by putting in place the policies that we know work can nations reduce tobacco use, prevent the terrible diseases they cause and save millions of lives. In addition to higher taxes on tobacco products, the scientifically proven measures called for by the tobacco treaty include strong warning labels on tobacco products, smoke-free laws that protect against secondhand smoke and bans on tobacco advertising, promotion and sponsorship. To date, 174 countries have joined the treaty and committed to implementing these measures, including most of the countries participating in this week's UN meeting.

Today's declaration recognizes that NCDs create an unsustainable burden on the economy of every country, increase poverty and are a barrier to development, facts echoed by new reports from the World Economic Forum and World Health Organization. The report from the World Economic Forum and Harvard School of Public Health shows that without aggressive efforts to reduce NCDs, the global economic impact from the four leading non-communicable diseases could total over $30 trillion over the next 20 years.

Yet, the WHO report tells us that interventions for addressing high risk factors for NCDs would be eminently affordable

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