Addressing the tobacco epidemic in low and middle income countries
English, Lorna McLeod
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Tobacco use is leading cause of preventable death in the world. The World Health Organization (WHO) projects that by 2030 tobacco use will kill over 8 million people annually. Eighty percent of the world’s smokers now live in low and middle income countries (LMIC) compared to 20 percent in developed countries. A primary reason for increased smoking in these countries is the tobacco industry’s targeted and aggressive marketing of cigarettes; billions of dollars are spent annually on tobacco advertising, promotion and sponsorship (TAPS). In 2003, the WHO negotiated the Framework Convention on Tobacco Control (FCTC) to prevent the death and disease associated with tobacco use. The FCTC treaty calls for countries to enact comprehensive policies that ban TAPS and inform their populations about dangers of tobacco use. The treaty is founded on proven interventions that countries can implement to protect their population from the epidemic. The objective of this research is to examine tobacco-related policies in LMIC to assess their impact on smoking behaviors. The first study reviewed the impact of TAPS exposure and anti-TAPS policies on students’ smoking behavior in African LMIC. The second study examined the impact of anti-TAPS policies and counter-tobacco messages on male smoking behavior in Thailand and Turkey. The findings suggest that there is an association between TAPS exposure and increased smoking and susceptibility in the youth studied. It was determined that strong anti-TAPS laws are associated with decreased student exposure to advertising and sponsorship, while weak anti-TAPS laws had no impact on exposure level. Further, weak anti-TAPS policies were associated with increased smoking behavior while strong-anti-TAPS policies were suggestive of decrease smoking. Finally, the findings demonstrate that effective enforcement of strong anti-TAPS policies over time can result in improved tobacco control outcomes in middle-income countries where smoking rates are high and tobacco use ingrained in the culture. These findings provide recommendations to improve the effectiveness of tobacco control policies in LMIC. The global effort to regulate tobacco marketing and warn populations about the dangers of smoking is a vital and effective component of tobacco control that must be adopted by LMIC governments.
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