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New Zealand diet causes premature deaths
MEDICINE AND HEALTH POLICY
Emphasising “quit” in the ubiquitous tobacco problem moking-cessation strategies are crucial to reducing the burden of tobacco-related disease, and governments implementing the Framework Convention on Tobacco Control must make treatment of tobacco dependence a cornerstone of their efforts. That was the message of the 12th World Conference on Tobacco or Health held Aug 3–8 in Helsinki, Finland. To support the plan, WHO is providing evidence-based guidelines in its new report, Policy Recommendations for Smoking Cessation and Treatment of Tobacco Dependence. “Governments, scientific agencies, [nongovernmental agencies], and other players will find a range of low-cost to high-cost measures for different social and political scenarios”, said Vera da Costa e Silva, project manager for the Tobacco Free Initiative at WHO. Prevention has been a main strategy to deal with tobaccorelated morbidity and mortality. “Yet evidence indicates that helping smokers quit results in earlier and greater benefits, specifically when measured by lives saved”, said Annette David (University of the Philippines). Methods for implementing cessation within clinical practice are well established. More difficult is addressing limited health resources or social environments that do not support cessation efforts. “It’s difficult to make tobacco a priority amid Brazil’s multiple health problems”, said Thais Corral, director of the Network for Human Development (Rio de Janeiro, Brazil). “But it would save thousands of lives.” “The background against which tobacco cessation therapies are applied is extraordinarily important”, said Thomas E Novotny (University of California, San Francisco, USA). He cites bans on tobacco advertising and smoke-free public spaces as important cues for smokers to quit.
S
544
AP
Rights were not granted to include this image in electronic media. Please refer to the printed journal.
Billboards like these are now history
At the conference, WHO reported that girls use tobacco as often as boys in most of the world, and women and other groups might benefit from tailored quit messages. As examples, David described innovative cessation programmes that draw on the respected influence of Buddhist monks in Cambodia. In China, the importance of tobacco-free parents and grandparents is emphasised to safeguard children’s health at home. As the conference closed, the 2000 participants remained split on the issue of smokeless tobacco. It does not cause lung cancer or create secondhand smoke, but it sustains nicotine addiction and increases the risk of other cancers. Many tobacco companies advertise low-tar or smokeless tobacco products, implying they are safer and providing an excuse not to quit, said Novotny. “Attempts to regulate tobacco products, increase taxes, and create a supportive environment is opposed by the tobacco industry at every moment”, said da Costa e Silva, while David added, “If public health programmes are compared to races, then tobacco control is the marathon.”
New Zealand diet causes premature deaths nhealthy diet and physical inactivity play a role in about 40% of all deaths in New Zealand, according to a joint study between the Ministry of Health and Auckland University, Nutrition and the Burden of Disease: New Zealand 1997–2011. The report estimates that more than 4500 premature deaths in 1997 could have been attributed to high cholesterol, 3700 to high blood pressure, 3200 to obesity and overweight, and 1600 to inadequate fruit and vegetable intake. Only tobacco consumption (5000 deaths in 1997) ranks higher. Anthony Rogers, one of the report’s authors, said the most striking finding was the huge effect of high cholesterol. “Our high saturated fat diets are causing thousands of deaths from heart attacks and strokes every year”, he said. The study used a comparative risk assessment method developed by WHO and used in the World Health Report 2002. It is the first study to provide reliable estimates of the mortality burden of nutrition-related risk factors in New Zealand. Although the report does not discuss policy options to address its findings, modelling showed that around 1300 projected deaths could be avoided by 2011 with specific intervention scenarios. The Ministry of Health has moved beyond believing that emphasising behavioural change can by itself substantially improve the health of populations: policies need to take into account the sociocultural context within which lifestyle choices are made. “We need to extend the idea of wider social change accepted around tobacco to nutritional practice”, said Colin Tukuitonga, the ministry’s Director of Public Health. The report floats some possible national policies to influence food supply and buying patterns, including taxes on unhealthy foods and subsidies for healthy foods. One option is to remove the 12·5% goods and service tax on fruit and vegetables to make healthy choices more affordable.
U
Sandra Coney Kathleen Nelson
THE LANCET • Vol 362 • August 16, 2003 • www.thelancet.com
For personal use. Only reproduce with permission from The Lancet
Emphasising “quit” in the ubiquitous tobacco problem moking-cessation strategies are crucial to reducing the burden of tobacco-related disease, and governments implementing the Framework Convention on Tobacco Control must make treatment of tobacco dependence a cornerstone of their efforts. That was the message of the 12th World Conference on Tobacco or Health held Aug 3–8 in Helsinki, Finland. To support the plan, WHO is providing evidence-based guidelines in its new report, Policy Recommendations for Smoking Cessation and Treatment of Tobacco Dependence. “Governments, scientific agencies, [nongovernmental agencies], and other players will find a range of low-cost to high-cost measures for different social and political scenarios”, said Vera da Costa e Silva, project manager for the Tobacco Free Initiative at WHO. Prevention has been a main strategy to deal with tobaccorelated morbidity and mortality. “Yet evidence indicates that helping smokers quit results in earlier and greater benefits, specifically when measured by lives saved”, said Annette David (University of the Philippines). Methods for implementing cessation within clinical practice are well established. More difficult is addressing limited health resources or social environments that do not support cessation efforts. “It’s difficult to make tobacco a priority amid Brazil’s multiple health problems”, said Thais Corral, director of the Network for Human Development (Rio de Janeiro, Brazil). “But it would save thousands of lives.” “The background against which tobacco cessation therapies are applied is extraordinarily important”, said Thomas E Novotny (University of California, San Francisco, USA). He cites bans on tobacco advertising and smoke-free public spaces as important cues for smokers to quit.
S
544
AP
Rights were not granted to include this image in electronic media. Please refer to the printed journal.
Billboards like these are now history
At the conference, WHO reported that girls use tobacco as often as boys in most of the world, and women and other groups might benefit from tailored quit messages. As examples, David described innovative cessation programmes that draw on the respected influence of Buddhist monks in Cambodia. In China, the importance of tobacco-free parents and grandparents is emphasised to safeguard children’s health at home. As the conference closed, the 2000 participants remained split on the issue of smokeless tobacco. It does not cause lung cancer or create secondhand smoke, but it sustains nicotine addiction and increases the risk of other cancers. Many tobacco companies advertise low-tar or smokeless tobacco products, implying they are safer and providing an excuse not to quit, said Novotny. “Attempts to regulate tobacco products, increase taxes, and create a supportive environment is opposed by the tobacco industry at every moment”, said da Costa e Silva, while David added, “If public health programmes are compared to races, then tobacco control is the marathon.”
New Zealand diet causes premature deaths nhealthy diet and physical inactivity play a role in about 40% of all deaths in New Zealand, according to a joint study between the Ministry of Health and Auckland University, Nutrition and the Burden of Disease: New Zealand 1997–2011. The report estimates that more than 4500 premature deaths in 1997 could have been attributed to high cholesterol, 3700 to high blood pressure, 3200 to obesity and overweight, and 1600 to inadequate fruit and vegetable intake. Only tobacco consumption (5000 deaths in 1997) ranks higher. Anthony Rogers, one of the report’s authors, said the most striking finding was the huge effect of high cholesterol. “Our high saturated fat diets are causing thousands of deaths from heart attacks and strokes every year”, he said. The study used a comparative risk assessment method developed by WHO and used in the World Health Report 2002. It is the first study to provide reliable estimates of the mortality burden of nutrition-related risk factors in New Zealand. Although the report does not discuss policy options to address its findings, modelling showed that around 1300 projected deaths could be avoided by 2011 with specific intervention scenarios. The Ministry of Health has moved beyond believing that emphasising behavioural change can by itself substantially improve the health of populations: policies need to take into account the sociocultural context within which lifestyle choices are made. “We need to extend the idea of wider social change accepted around tobacco to nutritional practice”, said Colin Tukuitonga, the ministry’s Director of Public Health. The report floats some possible national policies to influence food supply and buying patterns, including taxes on unhealthy foods and subsidies for healthy foods. One option is to remove the 12·5% goods and service tax on fruit and vegetables to make healthy choices more affordable.
U
Sandra Coney Kathleen Nelson
THE LANCET • Vol 362 • August 16, 2003 • www.thelancet.com
For personal use. Only reproduce with permission from The Lancet