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| EDITORIAL |
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| Year : 2012 | Volume
: 49
| Issue : 4 | Page : 319-320 |
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Tobacco control in the WHO South-East Asia Region
PK Singh
Deputy Regional Director, World Health Organization, Regional Office for South-East Asia, New Delhi, India
| Date of Web Publication | 26-Feb-2013 |
Correspondence Address:
P K Singh
Deputy Regional Director, World Health Organization, Regional Office for South-East Asia, New Delhi
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0019-509X.107714
How to cite this article:
Singh P K. Tobacco control in the WHO South-East Asia Region. Indian J Cancer 2012;49:319-20 |
In 11 member states of the South-East Asia Region of the World Health Organization, diverse tobacco products are used in smoked and smokeless forms. Some products are similar across the region but are called by various names in different languages of the region. Commonly, smokeless tobacco is used as a component of betel quid. Smokeless tobacco use also exists in other forms e.g., for application to the gums and teeth and in combination with lime and areca nut for chewing. The most common forms of tobacco smoking is through indigenous smoking products such as bidi, cheroots, or kreteks.
The South-East Asia Region has 250 million smokers and almost the same number of smokeless tobacco users representing 90% of global SLT users. Many countries of this region are listed as highest prevalence countries of SLT use.
The morbidity and mortality attributable to tobacco use in this region is also high. The health of the people of the region needs to be protected from the serious health effects of tobacco use by instituting effective and practical tobacco control measures at national and subnational level.
WHO Regional Office for South-East Asia (SEARO) is making intense efforts to help member states implement the provisions of the WHO Framework Convention on Tobacco Control (FCTC). Ten of the 11 member states in the region have ratified the convention. SEARO is assisting member states in providing training on tobacco cessation, developing training manuals and modules, training on survey and research methodologies, helping in tobacco control leadership programme training, organizing regional meetings on developing regional and national strategies on tobacco control, and organizing expert group meetings on important topics such as revenue/tax/trade for strengthening capacity building for health and other sectors of member states.
Several member states have adopted legislative and administrative measures to curb the tobacco menace. Furthermore, many countries in the region have taken measures to ensure that tobacco products carry health warning labels, which have yielded a positive impact in some countries. A majority of the member states have adopted policies banning direct and indirect tobacco advertising and promotion. However, implementation of these provisions remains a challenge.
Many studies in the region, including some described in this special issue of the Journal, have shown that simple and cost-effective awareness raising interventions work in the region to reduce tobacco use. Awareness programmes need to be sustained as well as reach out to all
Monitoring of tobacco control has been one of the good practices in the region. To this end, member states have implemented various surveys under GTSS at periodic intervals. Global Youth Tobacco Surveys (GYTS) are being conducted in ten member states; Global School Personnel Surveys (GSPS) in nine member states; Global Health Professions Students Surveys (GHPSS) in seven member states; and Global Adult Tobacco Surveys (GATS) in Bangladesh, India, Indonesia, and Thailand.
WHO-SEARO works closely with the Centers for Disease Control and Prevention, of the United States Department of Health and Human Services, the CDC Foundation, Bloomberg Philanthropies, the Gates Foundation and various networks of voluntary organizations in the Region and internationally.
Several studies have revealed that most adult and adolescent tobacco users in the Region want to quit tobacco. Hence, it is essential to provide tobacco cessation support to them. WHO-SEARO has initiated tobacco cessation activities in communities in six member states provided training to trainers at the regional level and made available tobacco control manual in regional languages. In some member states, training has also been provided to teachers and other professional groups including health professionals.
Health professionals play a key and credible role in tobacco cessation programmes with respect to their patients and the public. They need to be sensitized, trained, and brought into the mainstream of tobacco control. Some health association groups are very active in this regard and health professional groups need to learn from them.
Governments in the region are committed to tobacco control provisions; however there are multiple challenges to tobacco control in the region. To begin with, there is the complexity of tobacco products used and the low level of health awareness among the general population. There are apparent conflicts between health and other sectors, including between the financial interests of the tobacco industry and the institutions responsible for the health of the people in the countries, especially the Ministries of Health. Other challenges include a lack of health education programs in schools and communities through which anti-tobacco education is imparted, a lack of tobacco cessation training among health professional students and health professionals, and a lack of health facilities dedicated to tobacco cessation support. Difficulties in implementing tobacco control laws, such as prohibitions of smoking in public places and labelling of tobacco packages have proved to be formidable. In addition there is an absence of unified taxation on tobacco products across products and across the member states, as well as rigorous marketing and promotion strategies of tobacco product manufacturers. While multi-pronged measures should be taken in tandem as a normative function, WHO is providing technical support and is sharing scientific information and public health materials with the member states. Bringing out a special issue of the Indian Journal of Cancer focusing on tobacco problem in South-East Asia is another link in the chain of these measures.
Although much work still needs to be done, the countries in the South-East Asia region have nevertheless implemented strong and often innovative tobacco control measures that can be classified as "best practices," with some setting global precedents. These measures include bans on gutka (in some States of India), reducing tobacco imagery in movies (in India), and media campaigns for warnings about the dangers of tobacco. With limited resources, countries in the region need to ensure that the most effective and cost-efficient measures are implemented. It is hoped that countries that have yet to introduce or implement strong tobacco control laws can learn from these examples and, as appropriate, adapt these measures to their own specific cultural, social, and political realities.
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