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10 octobre 2017
Le 10 Octobre 2017
Préparées par Jean-François Etter
• La Campagne UK Stoptober inclut les e-cigarettes pour la première fois
• Notre société néglige de plus en plus le sommeil, rythme fondamental de l'individu
• I foresee serious criminal liability problems for the tobacco industry
• New report is a must read for those charged with protecting the public health
La Campagne UK Stoptober inclut les e-cigarettes pour la première fois
La campagne annuelle Stoptober en Angleterre inclut les cigarettes électroniques pour la première fois - et considère qu'elle peut aider les gens à arrêter de fumer. Les experts en santé ont eu tendance à éviter de promouvoir explicitement les e-cigarettes. Mais la campagne du gouvernement UK en octobre inclura pour la première fois les e-cigarettes dans ses publicités télévisées. ... Read more:
New report is a must read for those charged with protecting the public health
A new publication, The Economics of Tobacco and Tobacco Control,1 reminds us that tobacco use remains the single largest preventable cause of death in the world.
The Economics of Tobacco and Tobacco Control
Major C onclusions
Nine broad conclusions that emerge from the volume are as follows:
1. Th e global health and economic burden of tobacco use is enormous and is increasingly borne by low- and middle-income countries. Already, around 80% of smokers live in LMICs. While smoking prevalence is falling at the global level, the total number of smokers worldwid e is not decreasing, largely due to population growth. There is a strong possibility that the global target of a 30% relative reduction in tobacco use by 2025 agreed to by WHO Member States will not be met. The number of tobacco-related deaths is projected to increase from about 6 million deaths annually to about 8 million annually by 2030, with more than 80% of these occurring in LMICs.
2. Fail ures in the markets for tobacco products provide an economic rationale for governments to intervene in these markets. These market failures include (1) the public's imperfect and asymmetric information about the health and economic consequences of consuming tobacco products, particularly in LMICs, which is further complicated by the time- inconsistency of individual preferences for tobacco and the uptake of tobacco use during youth and adolescence; and (2) the externalities of tobacco use for nonusers. These externalities include the fact that nonsmokers, both children and adults, experience adverse health consequences when exposed to secondhand smoke (SHS) and that the cost of treating diseases caused by tobacco use and SHS exposure is borne, in part, by the public. The external costs of tobacco use are greater in countries where public funds are used to pay for a greater share of health care costs, given public spending to treat the diseases caused by tobacco use.
3. Eff ective policy and programmatic interventions are available to reduce the demand for tobacco products and the death, disease, and economic costs that result from their use, but these interventions are underutilized. The WHO FCTC and its implementation guidelines provide an evidence-based framework for governmental action to reduce tobacco use. Technical resources included in the MPOWER package in line with the WHO FCTC can support the implementation of tobacco control demand-reduction provisions on the ground. In addition, numerous other documents including U.S. Surgeon General's reports, NCI monographs, and reports of the Institute of Medicine (U.S.), the WHO Tobacco Free Initiative, and the WHO International Agency for Research on Cancer summarize the science and provide guidance on effective policy and program interventions. However, the vast majority of the world's population is still not adequately covered by the most effective of these interventions, including sufficiently high levels of tobacco taxation, comprehensive smoke-free policies, complete bans on tobacco marketing, information interventions, and cessation support.
4. Policies and programs that work to reduce the demand for tobacco products are highly cost-effective. Significant tobacco tax and price increases, comprehensive bans on tobacco industry marketing activities, and prominent pictorial health warning labels are generally the least costly tobacco control interventions, followed by the implementation and enforcement of smoke-free policies and the provision of population-wide tobacco cessation programs. Significant tobacco tax and price increases are the most cost-effective of these interventions. Despite the considerable revenues generated by tobacco taxes, few governments are investing more than a fraction of these revenues in tobacco control or in other health programs. WHO estimated that in 2013 2014, global tobacco excise taxes generated nearly 2 69 billion U.S. dollars (US$) in government revenues, but governments spent a combined total of less than US$ 1 billion on tobacco control. 10
5. Control of illicit trade in tobacco products, now the subject of its own international treaty, is the key supply-side policy to reduce tobacco use and its health and economic consequences. There is broad agreement that control of illicit trade will benefit tobacco control and public health and result in broader benefits for governments. Other supply-side policies, such as support for economically viable alternatives to tobacco production and restrictions on youth access to tobacco products, can be effective, especially as part of a comprehensive strategy to reduce tobacco use.
6. Th e market power of tobacco companies has increased in recent years, creating new challenges for tobacco control efforts. The global tobacco market has become increasingly concentrated over the past 25 years and is being driven by the same forces that have contributed to globalization in other industries, including reductions in barriers to trade and foreign direct investment, privatization of state-owned tobacco enterprises, and a wave of mergers and acquisitions. Policies aimed at limiting the market power of tobacco companies are largely untested but hold promise for reducing tobacco use.
7. Tob acco control does not harm economies. The number of jobs that depend on tobacco has been falling in most countries, largely thanks to technological innovations, the shift from state- owned to private ownership of tobacco manufacturing, and globalization, which have facilitated efficiencies in tobacco growing and manufacturing. For the vast majority of countries, implementation of tobacco control measures will have only a modest impact on tobacco-related employment, and will not lead to net job losses. For the few countries particularly dependent on tobacco growing and tobacco leaf exports, job losses due to global tobacco control efforts are likely to be gradual, predictable, and far enough in the future to have little effect on the current generation of tobacco farmers, and programs could be implemented that help tobacco farmers make the transition to alternative livelihoods. Evidence from high-income countries and LMICs shows that smoke-free policies do not adversely affect the hospitality sector.
8. Tob acco control reduces the disproportionate burden that tobacco use imposes on the poor. Tobacco use is concentrated among the poor and other vulnerable groups, and tobacco use accounts for a significant share of the health disparities between the rich and poor. These disparities are exacerbated by a lack of access to health care and the diversion of household spending from other basic needs, such as food and shelter, to tobacco use. Moreover, tobacco use contributes to poverty, as illnesses caused by tobacco lead to increased health care spending and reduced income. Research indicates that tobacco control interventions lead to reductions in tobacco use among all population groups. Additionally, significant increases in tax and price lead to greater reductions in tobacco use among the poor than among the rich, and thus contribute to reducing health disparities. Tobacco taxes also provide the opportunity to dedicate tax revenues specifically to health programs that benefit the poor, thus increasing their ability to reduce health disparities between population subgroups.
9. Progress is now being made in controlling the global tobacco epidemic, but concerted efforts will be required to ensure that progress is maintained or accelerated. In most world regions and country income groups, the prevalence of tobacco use is stagnant or falling. In HICs, progress in tobacco control has been ongoing over several decades; in LMICs, progress has generally been more recent and has sometimes been more rapid. Factors contributing to recent progress include the galvanizing effort of the WHO FCTC, research documenting the health and economic burden of tobacco use and evidence-based tobacco control interventions, the contributions of private funders and civil societies in promoting tobacco control policies, and broad recognition of the tobacco industry's role in promoting tobacco use a round the world. Despite this progress, many threats remain, including increasing tobacco use in some world regions and the potential for tobacco use to increase in regions that are still at an early stage of the tobacco epidemic. Maintaining and increasing progress will require continued research and surveillance of the epidemic and implementation of the evidence-based strategies set forth in the WHO FCTC, as well as vigilant monitoring of the tobacco industry's tactics and strategies to undermine or subvert tobacco control efforts.
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