1. Public health policies and approaches for reducing prevalence of tobacco use
E Tursan d’Espaignet
Comprehensive Information Systems for Tobacco Control Tobacco Free Initiative Prevention of Noncommunicable Diseases WHO Geneva

2. Regional Comparison Smoking prevalence in WHO Member States, Adults 15+ years, 2011
Recent regional estimates on Smoking any tobacco products including shisha among adults in the region shows high rate among males , the GAP between men and women smoking estimates is very wide . average regional estimate for men is 38%, compared to 4% among women.
Source: WHO Report on the Global Tobacco Epidemic Geneva, World Health Organization, 2014, in print.
Definition: Smoking at the time of the survey any form of tobacco including cigarettes, cigars, pipes, bidis, shisha , etc

3. Regional Comparison Tobacco Use Among Youth, 13-15 GYTS

5. Global voluntary tobacco target under adopted by Member States
Indicator: Prevalence of current tobacco use among persons aged 15+ years
Target: 30% relative reduction in prevalence of current tobacco Use between 2010 and 2025
Example: Prevalence for country X in 2010 = 20% Absolute reduction by 2025 = 30% of 20% = 6% Target for 2025 = = 14%
Monitor change (simple assumption) of 6%/15 = -0.4%p.a.

6. Tobacco Use
Smoking
Smokeless

7. Analysis exercise to set the tobacco target
Mostly pre-FCTC
Post-FCTC
Ratio of post FCTC to pre FCTC annual change
Initial, End year
Prevalence level (%)
Average annual change
Average annual change
Australia
30%
21%
- 0.7%
2004
2010
18%
- 0.5%
0.7
Iran
1993
2005
20%
14%
-0.5%
2009
12%
1.0
Ireland
33%
29%
- 0.4%
2007
24%
- 1.7%
4.0
New Zealand
26%
- 0.1%
2006
- 1.0%
10.0
Thailand
1991
32%
-0.7%
2011
21% 24%
+1.5%
0.0% --
Turkey
34%
31%
2008
2012
27%
-1.0%
2.0
Uruguay
2000
35% 0%
-1.2%
? ∞
United Kingdom
25%
- 0.2%
5.0

8. Analysis exercise to set the tobacco target
Mostly pre-FCTC
Post-FCTC
Ratio post to pre FCTC change
Initial, End year
Prevalence level (%)
Average annual change
Average annual change
Australia
30%
21%
- 0.7%
2004
2010
18%
- 0.5%
0.7
Ireland
33%
29%
- 0.4%
2007
24%
- 1.7%
4.0
New Zealand
26%
- 0.1%
2006
2009
- 1.0%
10.0
Thailand
1991
32%
-0.7%
2011
21% 24%
+1.5%
0.0% --
Turkey
34%
31%
-0.5%
2008
2012
27%
-1.0%
2.0
United Kingdom
25%
- 0.2%
2005
5.0

9. New Zealand, observed and projected current smoking, women, 2000-2040
Projected
current smoking (%)
YEAR
Women
2000 23
2005 21
2010 18
2015 16
2020 14
2025 12
TARGET
12.7
2040 8

10. Country B, observed and projected current smoking, women, 2000-2040
Projected
current smoking (%)
YEAR
Women
2000 25
2005 22
2010 20
2015 18
2020 16
2025 15
TARGET
12.7
2040 11

11. Country C, observed and projected current smoking, men, 2000-2025
Projected
current smoking (%)
YEAR
Men
2000 37
2005 36
2010 34
2015 33
2020 32
2025 30
TARGET
23.9
2040 28

12. Analysis of changes over time and projected estimates to 2025.
2010
2014
2025
Region
Men
Women
Both sexes
AFRO
23.2
2.5
12.8
25.3
2.2
13.7
34.7
1.6
18.1
AMRO
23.8
14.0
18.7
21.3
12.2
16.7
16.1
8.5
EMRO
35.1
3.0
19.6
37.4
2.8
20.6
45.2
2.4
24.5
EURO
39.8
19.5
29.2
37.2
18.4
27.4
31.0
15.7
23.0
SEARO
33.1
2.9
18.2
31.3
2.3
17.0
27.5
1.2
14.5
WPRO
49.0
3.5
26.6
47.4
3.1
25.6
43.1
GLOBAL
36.7
7.2
21.9
35.2
6.3
20.8
33.0
4.6
18.8

13. The WHO FCTC
Carefully constructed comprehensive antidote aimed at controlling demand for and supply of tobacco products
The target to be achieved through full implementation of the WHO FCTC and, (in particular, demand reduction measures including high tobacco product tax, large pictorial health warning labels, comprehensive smoke-free legislation, and bans on all forms of tobacco advertising, promotion and sponsorship).

14. Protect people from tobacco smoke through smokefree environments 14
TFI current focus: MPOWER, a package of measures each reflecting one or more provisions of the WHO FCTC
Articles
Description 20
Monitoring 8
Protect people from tobacco smoke through smokefree environments 14
Offering help to quit
11 & 12
Warning about dangers of tobacco 13
Enforcing bans on promotion, sponsorship and advertising 6
Raising taxes on tobacco

15. Potential impact of tax on prevalence rates
Policy
Description
Potential relative effect sizes on prevalence
Tax – short term effects
For each 10% tax increase :
High income countries
- 1.5%
Middle income countries
- 2.0%
Low income countries
- 2.5%
Impact appears to hold for about 1-3 years and then require a new tax injection
Source: WHO draft estimates *work in progress

16. Potential impact of smokefree public places on prevalence rates
Policy
Description
Potential relative effect size on prevalence
Smokefree effects
No ban in place
- 0.0%
Partial bans
- 1.5%
Comprehensive ban
- 6.0%
Source: Levy et al., SimSmoke model

17. Potential impact of marketing bans on prevalence rates
Policy
Description
Potential relative effect size on prevalence
Comprehensive bans
Applied to tv, radio, print, billboard, in-store displays, no sponsorships, no free samples
- 5% in prevalence
Strong advertising bans
Applied to all media: television, radio, print and billboards
- 3% in prevalence
Weak advertising bans
Applied to some but not all of television, radio, print and billboards
- 1% in prevalence
Source: Levy et al., SimSmoke model

18. Potential impact of warnings on packets of cigarettes on prevalence rates
Policy
Description
Potential relative effect size on prevalence
Strong health warnings
Covers at least 50% of package and pictorial
- 1.0%
Moderate health warnings
Covers at least 1/3 but no pictorial
- 0.5%
Weak health warnings
Covers less than 1/3 and no pictorial
- 0.1%
Source: Levy et al., SimSmoke model

19. Tobacco questions for surveys

20. Thank you tursandespaignet@who.int37 20