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Non-Communicable Diseases

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Call To Action

Reducing tobacco use must be a key component of any national or global plan to tackle non-communicable diseases.

Share of deaths due to non-communicable diseases (NCDs); 2010

Non-communicable diseases (NCDs) such as cardiovascular disease, stroke, diabetes and chronic lung disease have surpassed communicable diseases as the leading causes of death in all but the lowest-income nations. For all these major NCDs, tobacco use is arguably the most preventable risk factor. The 2011 UN summit on NCDs emphasized that essential fact, and necessarily included a reduction in tobacco use as part of the WHO Global NCD action plan. Besides the wide applicability of the many proven-effective tobacco control measures to addressing the risks of NCDs, at its most elemental level, tobacco control is NCD control.

Tobacco and NCDs

Risk factors for the leading non-communicable diseases worldwide

Tobacco use is a shared risk factor for the four leading non-communicable diseases in the world, causing 6.3 million deaths.

Resources

Sources

WHO. Note by the Secretary-General transmitting the report of the Director-General of the WHO on the progress achieved in realizing the commitments made in the Political Declaration of the High-level Meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases (NCDs). Geneva: WHO; 2013 [cited 2014 July 7].

Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2224-60.

Institute for Health Metrics and Evaluation. GBD 2010 Heat Map: University of Washington; 2013 [cited 2014 July 28].

Tsugane S, Sasazuki S, Kobayashi M, Sasaki S. Salt and salted food intake and subsequent risk of gastric cancer among middle-aged Japanese men and women. British journal of cancer. 2004 Jan 12;90(1):128-34. PubMed PMID: 14710219. Pubmed Central PMCID: PMC2395341. Epub 2004/01/08. eng.

Wang XQ, Terry PD, Yan H. Review of salt consumption and stomach cancer risk: epidemiological and biological evidence. World journal of gastroenterology : WJG. 2009 May 14;15(18):2204-13.

Aaron KJ, Sanders PW. Role of dietary salt and potassium intake in cardiovascular health and disease: a review of the evidence. Mayo Clinic proceedings. 2013 Sep;88(9):987-95. PubMed PMID: 24001491. Pubmed Central PMCID: PMC3833247. Epub 2013/09/05. eng.

Li XY, Cai XL, Bian PD, Hu LR. High salt intake and stroke: meta-analysis of the epidemiologic evidence. CNS neuroscience & therapeutics. 2012 Aug;18(8):691-701. PubMed PMID: 22742770. Epub 2012/06/30. eng.

Strazzullo P, D’Elia L, Kandala NB, Cappuccio FP. Salt intake, stroke, and cardiovascular disease: meta-analysis of prospective studies. BMJ (Clinical research ed). 2009;339:b4567. PubMed PMID: 19934192. Pubmed Central PMCID: PMC2782060. Epub 2009/11/26. eng.

Sharing the tools

Packaging regulations, a method employed to control tobacco use, can also serve to deter people from consuming other unhealthy products.

Existence of a global health treaty (WHO FCTC) as well as effective national and sub-national legislation make tobacco control a model for addressing other pressing NCD-related issues that require better regulations, including harmful use of alcohol and unhealthy diet.

Resources

Sources

Wipfli HL, Samet JM. Moving beyond global tobacco control to global disease control. Tobacco control. 2012;21(2):269-72.

“Mars is concerned that the introduction of mandatory plain packaging in the tobacco industry would also SET A KEY PRECEDENT for the application of similar legislation to other industries, including the food and non-alcoholic beverage industries in which Mars operates.” -The Mars Corporation to the UK government, 2012

“There are certain things that microbes don’t do: microbes do not lobby politicians to allow them to continue to spread; they don’t spend billions of dollars to convince people that it’s cool to be infected; they don’t fund scientists to say it’s not so bad to get that infection or re-brand themselves as ‘light’ bacteria that might be less harmful…” -Dr. Thomas R Frieden Director, Centers for Disease Control and Prevention, First Global Ministerial Conference on Healthy Lifestyles and NCD Control, Moscow, April 2011

“Today, many of the threats to health that contribute to noncommunicable diseases come from corporations that are big, rich and powerful, driven by commercial interests, and far less friendly to health. Forget collaboration with the tobacco industry. Never trust this industry on any count, in any deal. Implement the WHO Framework Convention on Tobacco Control. Doing so can avert around 5.5 million deaths each year at a cost, in a low-income setting, of less than 40 cents per person. There is no other “best buy” for the money on offer.”-Dr. Margaret Chan, Director-General of WHO, 2011

“NCDs are one of the MAJOR CHALLENGES to sustainable human development in the 21st century, and therefore must be central to the post-2015 development agenda.” -Tezer Kutluk, President-Elect, Union for International Cancer Control, 2014

One of the proposals for the 2011 UN NCD declaration included international restrictions on tobacco advertising. This point was rejected by delegates from some Western countries with strong tobacco industry presence and policies to protect their own citizenry.

Smoking and mental illness

Smoking prevalence among people with lifetime mental illnesses: USA, 2007

Current smoking prevalence increased with greater numbers of mental illness, ranging from 18.3% for people with no illness to 61.4% for people with three or more mental illnesses.

Cost-Benefit

Savings created by tobacco control interventions; in millions USD, 2013
 
MISSOURI, USA
TAIWAN, CHINA
UNITED KINGDOM
AUSTRALIA
GERMANY

 
Tobacco Prevention and Cessation Initiative: Smoke-free policy change
Outpatient Smoking Cessation Services program: Counseling and nicotine replacement therapy
Taxation: 5% increase in cigarette price
Australian National Tobacco Campaign: Intensive 6-month mass media
anti-smoking campaign
Smoke-free Class Competition: Reward non-smoking classes to
prevent students from becoming established smokers

NET SAVINGS
$62M
over remaining lifetime of 5761 quitters
$224M
over 15% years
$18,461M
over 50 years
$912M
over remaining lifetime of 190,000 quitters
$25M
over 1 year

EXAMPLES OF HOW THESE SAVINGS COULD BE SPENT
Annual budget for restoration and conservation of Missouri’s forests and wildlife.
Taiwan’s annual government budget for environmental protection.
Government annual spending on industry, agriculture and employment.
Australia’s annual governmental investment in early childhood education.
Government annual spending on helping ethnic Germans living in Eastern Europe.

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