Supporting Pacific Island Countries to Strengthen Their Resistance to Tobacco Industry Interference in Tobacco Control: A Case Study of Papua New Guinea and Solomon Islands

Tobacco use is the biggest single preventable cause of non-communicable diseases (NCDs) in the Western Pacific region. Currently, 14 Pacific Island countries have ratified the WHO Framework Convention on Tobacco Control (FCTC) and, in having done so, are committed to implementing tobacco control measures aligned with the FCTC. Progressing strong and effective tobacco control legislation is essential to achieving long term gains in public health in small island countries. However, survey evidence suggests that pervasive tobacco industry interference serves to undermine tobacco control and public policy in several Pacific countries. An initiative was developed to provide dedicated, in-country technical support for developing legislation and policy to support implementation of Article 5.3 of the FCTC in the Solomon Islands and Papua New Guinea. This paper examines the factors that have assisted the two Pacific countries to make progress in implementing Article 5.3 and what this might mean for supporting progress in other Pacific settings. A document analysis was undertaken to identify the process and outcome of the intervention. Two significant outputs from the project including having identified and documented specific examples of TII and the development of draft legislation for Article 5.3 and other key resources for public servants both within and outside the health sector. Key determinants of progress included a motivated and engaged Ministry of Health, active civil society group or champion and access to media to prepare tobacco industry related material to stimulate public and policy sector debate

Environmental tobacco smoke in homes, motor vehicles and licensed premises: community attitudes and practices

Abstract Objective: To assess community knowledge, attitudes and practices in relation to environmental tobacco smoke (ETS) especially in homes, private motor vehicles and licensed premises, and to document levels of support for further government legislation. Methods: 656 persons aged 18 years and over, a sub‐sample in a computer‐assisted telephone survey of 2,087 randomly selected respondents across NSW, answered 12 ETS‐specific questions The whole sample was asked demographic, smoking status and household membership questions. The overall response rate was 61.4% (consent rate 75.4%). Results: Overall, 32.8% (95% CI 27.8–37.8) of children aged 0–4 years in the households surveyed were reported to live with at least one smoker. Agreement about ETS hazards was lowest in relation to child ear problems (31.2%) and sudden infant death syndrome (50.6%). Complete bans on smoking were reported in 69.9% of homes and 77.1% of private motor vehicles The percentages favouring total bans in homes (p<0.001) and private motor vehicles (p<0.001) were significantly lower among smokers than non‐smokers. Overall, 55.8% supported legislation to ban smoking in private vehicles carrying children. The majority support restrictions on smoking in non‐eating areas of licensed clubs (88.7%) and hotels (84.8%). Overall, the data indicate a ban on smoking in licensed premises is likely to increase business. Conclusion: Smoking is banned in most NSW homes and private motor vehicles Acceptance of ETS risks is high but there are important knowledge gaps. Considerable support exists for further government regulation of ETS. Media campaigns are likely to reinforce a public environment already receptive of the need for more government ETS restrictions

Tobacco smoking in islands of the Pacific region, 2001-2013

We provide an overview of tobacco smoking patterns in Pacific island countries and territories to facilitate monitoring progress toward the goal of a Tobacco-Free Pacific by 2025. We examined data from 4 surveys conducted in the region between 2001 and 2013, including the STEPwise approach to surveillance for adults (25–64 years); the Global School-Based Student Health Survey and the Global Youth Tobacco Survey (students 13–15 years); and the Youth Risk Behavior Surveillance System (grade 9–12 students) in United States affiliated Pacific Islands (USAPIs). Adult smoking prevalence ranged from less than 5% of women in Vanuatu to almost 75% of men in Kiribati. Smoking prevalence among students (13–15 years) ranged between 5.6% and 52.1%. There were declines in smoking among youths in many USAPIs. To achieve the tobacco-free goal and reduce disease burden, accelerated action is needed to align national legislation with international agreements and build capacity for tobacco control at all levels

Australians' use of fake tanning lotions: another piece of the puzzle

Abstract Objective: To assess community attitudes and practices in relation to fake tanning lotions. Methods: 1,509 New South Wales residents aged 15 years and over, selected at random, completed a computer‐assisted telephone survey. Results: Thirty‐three per cent of respondents thought fake tanning lotions were unsafe. In relation to The Cancer Council marketing fake tanning lotions, more than three‐fifths thought The Cancer Council would be promoting tans, although 62% thought it would be a good thing as fake tans are safer than tanning in the sun. Nine per cent of respondents had used fake tanning lotions in the past 12 months. Almost half (48%) of female current users used fake tanning lotions occasionally or only for special occasions during the past summer. In particular settings, the sunscreen and hat‐wearing practices of female users and non‐users of fake tanning lotions differed significantly. Conclusion: There appears to be no consistent data to suggest that fake tanning lotions may be used as a safer alternative to sun tanning. However, there is a responsibility to at least disseminate accurate information on these products

Noncommunicable diseases and risk factors in adult populations of several Pacific Islands: results from the WHO STEPwise approach to surveillance

To provide an overview of the prevalence of noncommunicable diseases (NCDs) and their risk factors in several Pacific island countries and territories (PICTs), in accordance with global NCD targets.For six risk factors, data for adults (aged 25-64 years) from published reports of the World Health Organization STEPwise approach to NCD surveillance, or methodologically similar surveys, were collated, age standardised and compared across fifteen PICTs.In the majority of PICT populations, more than half of male current drinkers drank heavily and more than 40% of men and 20% of women were current smokers. In 10 populations, about 50% or more of women were insufficiently physically active. Prevalence of hypertension and diabetes exceeded 20% and 25%, respectively, in several populations. Near or more than half of men and women in all populations were overweight; in most, more than one-third of both sexes were obese.The prevalence of NCDs and risk factors varies widely between PICTs and by sex. The evidence shows the high and alarming present and future burden of NCDs in the region.Strengthened political commitment and increased investment are urgently required to tackle the NCD crisis, successfully achieve targets and ensure continuing sustainable development in the Pacific islands

Alcohol use in the Pacific region: results from the STEPwise approach to surveillance, global school-based student health survey and youth risk behavior surveillance system

Little is known about frailty and its impact on health-care systems. Using large-scale population health surveillance data, this study determined the prevalence of frailty, its associated factors, and the impact it places on health care services

Battling tuberculosis in an island context with a high burden of communicable and non-communicable diseases: epidemiology, progress, and lessons learned in Kiribati, 2000 to 2012

Objectives: To examine the epidemiology of tuberculosis (TB) in Kiribati from 2000 to 2012, document lessons learned, and recommend ways to mitigate the burden of TB in Kiribati. Methods: A descriptive study was performed using data on TB case notifications, prevalence, incidence, mortality, and treatment outcomes from global reports and data files. Progress towards meeting the Millennium Development Goal TB target (to reduce TB incidence by 2015) and the Regional Strategy to Stop Tuberculosis in the Western Pacific 2011–2015 targets (to reduce TB prevalence and mortality by half by 2015 relative to the level in 2000) was examined. Results: TB case notifications and the estimated incidence and prevalence have increased in Kiribati since 2000. From 2000 to 2012, Kiribati reported a total of 3863 TB notifications; in 2012, the case notification rate was 343/100 000 population. The majority (89%) of TB patients complete treatment and/or are cured, and the estimated TB mortality rate has remained relatively stable at around 16/100 000 population. HIV testing of TB patients has increased over recent years from 8% of notifications tested in 2003 to 43% tested in 2012. Of all 818 tests, only four (0.5%) patients were confirmed HIV-positive. Drug-resistant TB has been detected in a small number of cases. Conclusions: TB rates continue to increase in Kiribati and the 2015 goals for TB control are unlikely to be met. This is probably due to the complex mix of risk factors present in Kiribati, including smoking, diabetes, alcohol use, crowded living, and poverty. A comprehensive approach to address these risk factors is needed to mitigate the burden of TB in Kiribati