CNS: May 2012

The Union Defends Governments From Tobacco Industry Interference On World No Tobacco Day

With the theme “Stop Tobacco Industry Interference”, World No Tobacco Day 2012 highlights the critical need to meet head on the aggressive strategies and tactics used by the tobacco industry to dilute, delay and prevent tobacco control policies and measures. To assist governments and other agencies involved in tobacco control, The International Union Against Tuberculosis and Lung Disease (the Union) has developed a free FCTC Article 5.3 Toolkit: Guidance for Governments on Preventing Tobacco Industry Interference, which will be launched at an event at the University of Edinburgh today on the occasion of World No Tobacco Day 2012.

[हिन्दी][English report card] [हिन्दी रिपोर्ट कार्ड] Youth participants of Rights and Responsibilities Summer Training Camp currently underway released a REPORT CARD on implementation of tobacco control, other health and development policies in Lucknow city. The report card monitors and analyzes neighbourhood localities in Lucknow on four priority areas: 1) tobacco control laws, 2) alcohol advertising, 3) sanitation, hygiene and waste management, 4) chewing gums.

On this World No Tobacco Day (WNDT 2012) it would be worthwhile to remember that ‘tobacco products are the only legally available products that can kill up to one half of their regular users if consumed as recommended by the manufacturer.’ The International Union Against Tuberculosis and Lung Disease (the Union), recognizes that, “With its formidable economic and political resources, the tobacco industry is fighting to prevent passage of new tobacco control laws and policies around the world. Article 5.3 of the Framework Convention on Tobacco Control calls for parties to the treaty to resist these efforts to undermine public health and continue the spiralling pandemic of tobacco-related disease.”

The Cloud Of Tobacco Smoke Is Choking The World

Tobacco is the single most preventable cause of death in the world today. Yet it kills nearly 6 million people each year, which includes some 600,000 non-smokers who die due to exposure to second-hand smoke. In 2004, children accounted for 31% of these deaths. Almost half of the world’s children (through no fault of theirs) regularly breathe air polluted by tobacco smoke which is said to carry more than 4,000 chemicals, of which at least 250 are known to be harmful, and more than 50 are known to cause cancer. Tobacco is one of the greatest risk factors for Non Communicable Diseases which are responsible for 63% of all deaths globally. Also 50% of all deaths from lung disease are linked to tobacco.

[RTI applications] [हिन्दी] The Lucknow youth participants of the ongoing Rights and Responsibilities Summer Training Camp at Professor (Dr) Rama Kant’s Centre in C-block crossing, Indira Nagar, filed applications under the Right to Information (RTI) Act, 2005, demanding information pertaining to poor implementation of development programmes in the city including tobacco control. The youth, Ankur Verma, Diya Pandey, Sanjay Kumar Verma, Shikha Srivastava, Shikhar Agarwal, Shubham Dwivedi, and Udita Chandra, filed many RTI applications on tobacco control and other development schemes.

Photo credit: Shobha Shukla-CNS

Jyoti (name changed) hails from rural Uttar Pradesh which has a high prevalence rate of smokeless tobacco. Two years ago she became addicted to paan masala (a popular form of chewing tobacco) of a particular brand, under the influence of her friends. She began with one or two pouches a day, but the number quickly increased to 25. With one pouch costing one rupee (less than 2 cents) she had to cook stories to get money from her parents for this. She says, “I would ask them for money to buy eats and spend it on tobacco. I would eat outside the house, never in front of my parents. Then I would brush my teeth.” Eating tobacco put her on a high giving her momentary respite from the perpetual tension in the family. Her own marriage had broken and her father ill treated her mother. At the end of one year she started having difficulty in opening her mouth fully—‘It was difficult for me to open my mouth to put my three fingers inside it.’

Prof Rama Kant to be awarded honorary FCS by College of Surgeons, Sri Lanka

[हिंदी] Renowned Lucknow Surgeon Professor (Dr) Rama Kant will be conferred upon the honorary Fellowship of the College of Surgeons of Sri Lanka in their convocation on 15th August 2012. The Council of College of Surgeons of Sri Lanka informed Prof Rama Kant of the honorary fellowship award on Saturday, 16 June 2012. Prof Rama Kant will also deliver a lecture on ano-rectal surgery at the annual convention of SAARC Surgical Care Society in Colombo, Sri Lanka.

I am alive because of my children: Story Of Vani

This is the story of Vani (name changed), a 43 years old mother of two bubbly kids—Kajal and Tarun (names changed) aged 13 years and 10 years respectively. She is one of the lucky few who could eventually manage to access and successfully complete her treatment of MDR TB, outside the woefully inadequate government DOTS Plus programme. It is the story of the grit and determination of a mother who conquered all odds for the sake of her children. Her concern and love for them gave her strength to not only grapple with her infection of HIV/AIDS and drug resistant TB (MDR TB) but also to face singlehandedly the stigma and discrimination at the hands of her apathetic family and society.

Tobacco - a threat to human health

Tobacco, the age old slow poison, takes a human life every eight seconds, which means approximately 6 million deaths annually. It is consumed in many forms, all of which are equally harmful. It could be smoked as cigarettes and cigars, or used in smokeless forms such as chewing tobacco or inhaling tobacco such as hookah/sheesha. Globally approximately 10 million cigarettes are purchased a minute, 15 billion are sold each day, and an upward of 5 trillion are produced and used on an annual basis. It is estimated that worldwide, one in five teenagers in the age group 13-15 years smoke cigarettes. Youth and kids are still picking up smoking at the alarming rate of about 80,000 to 100,000 a day worldwide. Tobacco poses a serious danger to public health despite the fact that it is a preventable cause of death.

A study titled Lost in Transition: Transgender People, Rights and HIV Vulnerability in the Asia-Pacific Region was released in Bangkok today (17th May, 2012) to mark the International Day Against Homophobia and Transphobia. According to this research, which was jointly released by the United Nations Development Programme (UNDP) and the Asia Pacific Transgender Network (APTN), transgender persons are among the most socially ostracized in this region and lack fundamental rights, including basic access to health care and social protection schemes. So there is need for concerted action by governments, civil society, development partners and the transgender community itself to design and conduct further research to fill the lack of information about transgender people and their environments.

A beautiful healthy smile is an enviable asset one can possess but, despite longing for pearly white teeth, we willingly fall prey to some habits which not only trap us in their dangerous clutches but also deprive us of our health and happiness and sometimes even our life. Commonly, tobacco is consumed in two forms-smoking and smokeless. There is a strong scientific evidence that tobacco causes cancer and the commonest association of ‘spit’, ‘chew’ or ‘snuff’ forms of smokeless tobacco is with oral cancer.

India currently holds the dubious distinction of being the second largest producer and the second largest consumer of tobacco in the world. Not a particularly dignified title, considering that tobacco kills half of its dedicated users prematurely in their productive years! According to the Global Adult Tobacco Survey-2010, 47.9% of males and 20.3% of females currently use tobacco in some form in India. Globally, smoking prevalence is declining in developed nations while it is on the rise in developing countries. India is currently on an upward swing both in terms of tobacco use and mortality thereof.

By Jittima Jantanamalaka, CNS Thailand

Part 2: Take Control of Asthma - Assure Access to Quality Affordable Medicines [Thai version]

Special thanks:

International Union Against Tuberculosis and Lung Disease (The Union); Prof Nadia Ait-Khaled, Union advisor on asthma, ISAAC Steering Committee and ISAAC Africa Regional Coordinator, Executive Committee, BOLD (Burden of Lung Disease) study. Co-author of asthma management chapter, GAR, Muthita Trakultivakorn, MD, Associate Professor. Division of Allergy & Clinical Immunology, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Thailand, and The Asthma Foundation of Thailand.

Part 1: Taking Control - Understand Asthma and Its Triggers [Thai version]

What does making TB a notifiable disease mean to us?

[हिंदी] On one hand the Indian Revised National TB Control Programme (RNTCP) needs to be complimented for making tuberculosis (TB) a notifiable disease (read the government order issued on 7th May 2012 here), but on the other hand there are words of caution and oft-repeated list of actions RNTCP should consider to reach the unreached populations who need TB services. Probably in response to the alarm bells that went ringing when Mumbai reported ‘total drug-resistant TB cases’ the government has taken the step to make TB a notifiable disease.

The key to fighting the tobacco menace is engaging youth at the forefront of the battle, with both youth focused tobacco control programs and policies and youth-led health advocacy. According to the World Health Organization, nearly 80 percent of the all adult smokers begin before 18 years of age. In India, 5500 youth initiate smoking every day. Of the 1000 teenagers smoking today, 500 will eventually die of tobacco related diseases - 250 in their middle age and 250 in their old age. The most susceptible time for initiating and experimenting with tobacco use in India is during adolescence and young adulthood, between 15-24 years of age. Estimates from the Global Tobacco Youth Survey (GYTS) show the growing concern of tobacco use by youth in both developed and developing countries. Nearly 15 % of Indian youth use tobacco in one form or the other – smoking or smokeless forms.

Tobacco is the only legal consumer product that kills when used exactly as indicated by the manufacturer. This catastrophe called tobacco gives out a scary factsheet. According to the estimates of the World Health Organization (WHO) about 1 billion people around the world will die from smoking in the 21st century, which is ten times the numbers killed throughout the 20th century. The World Health Organisation's 2012 Global Report on Mortality attributable to tobacco shows that seven percent of all deaths for age 30 years and over in India are attributable to tobacco.

Chewing Tobacco Chews Away Your Life

Tobacco was considered as an alien product in India and was not welcome to begin with. However, the widespread uptake of tobacco habit as we see it today marks a huge victory for the tobacco promoters. In a milieu of social changes in India, fuelled by foreign news media, influence of foreign films and global economic players, a tug of war is going on in the women’s minds between the tobacco pushers on one hand and societal values on the other. In a country where smoking is generally not socially acceptable for women, it is increasing among certain social groups. The aspirations of some independent and so called liberated women match with what the tobacco companies are promoting and they are getting hooked to smoking cigarettes.

According to the The Global Asthma Report 2011, published by The International Union Against Tuberculosis and Lung Disease (The Union) and the International Study of Asthma and Allergies in Childhood (ISAAC): Asthma is the most common chronic disease among children and also affects millions of adults. The burden of asthma has been growing over the past 30 years, particularly in low- and middle-income countries, where a large majority of asthma patients are treated only on an emergency basis – when they arrive at a health care facility with an acute attack of asthma. Part of the problem is that quality-assured asthma inhalers, that are essential to well-managed asthma, are either not available or are prohibitively expensive. Another barrier is that the health services lack the strategy, systems and trained staff for providing good asthma care. The Union urges the international community and countries to make sources of funding rapidly available, so that access to quality-assured essential asthma medicines and asthma care can be scaled up and improve the patients’ quality of life, significantly reducing costs for patients and health systems.