Smoking and Its Consequences in Pregnant Women in Ukraine

Smoking during pregnancy increases the risk of a number of complications of pregnancy and can have adverse effects on the child. This study provides data from Ukraine that are consistent with the international literature on the effects of smoking during pregnancy. The study of nearly 700 women in Ukraine examined the rate of smoking during pregnancy and factors related to continued smoking. It documents the outcomes of pregnancy in women who smoked prior to pregnancy, and who smoked during pregnancy compared to those who did not. It also looks at pregnancy outcomes with respect to the baby’s father smoking. Smoking during pregnancy is at low levels in Ukraine (<5% of pregnant women), but is associated with family structure, the baby’s father smoking, and the number of previous abortions. It is also associated with placental insufficiency, low birth weight, fetus hypotrophy, and hip joint dysphasia. The father’s smoking is associated with decreased fertility, late toxicosis, miscarriage threat in third trimester, small baby, and lower infant functional status. There was no evidence that information on the dangers of smoking while pregnant encouraged cessation.World Bank by the Swedish International Development Cooperation Agency (SIDA) and the US Centers for Disease Control, Office on Smoking and Healt

Tobacco use amongst out of school adolescents in a Local Government Area in Nigeria

Abstract Introduction Out-of-school adolescents are often neglected when planning for tobacco prevention programmes whereas they are more vulnerable. Few studies exist in Nigeria about their pattern of tobacco use to serve as the basis for effective policy formulation. Method A sub sample of 215 out of school adolescents was analyzed from a descriptive cross sectional study on psychoactive substance use amongst youths in two communities in a Local Government Area in Nigeria which used a multi-stage sampling technique. Results Males were 53% and females 47%. Only 20.5% had ever used tobacco while 11.6% were current users. Males accounted for 60% of current users compared to 40% amongst females. Of current users, 84% believed that tobacco is not harmful to health. In addition, the two important sources of introduction to tobacco use were friends 72% and relatives 20%. Use of tobacco amongst significant others were: friends 27%, fathers 8.0%, relatives 4.2% and mothers 0.5%. The most common sources of supply were motor parks 52% and friends 16%. Conclusion The study showed that peer influence is an important source of introduction to tobacco use while selling of tobacco to adolescents in youth aggregation areas is common. We advocate for a theory based approach to designing an appropriate health education intervention targeted at assisting adolescents in appreciating the harmful nature of tobacco use in this locality. A point-of-sale restriction to prevent adolescent access to tobacco in youth aggregation areas within the context of a comprehensive tobacco control policy is also suggested. However, more research would be needed for an in-depth understanding of the tobacco use vulnerability of this group of adolescents.Peer Reviewe

A critique of the WHO TobReg's "Advisory Note" report entitled: "Waterpipe tobacco smoking: health effects, research needs and recommended actions by regulators"

BACKGROUND AND AIM: The World Health Organisation Study Group on Tobacco Product Regulation (TobReg) has issued in 2005 an "Advisory Note" entitled: "Waterpipe Tobacco Smoking: Health Effects, Research Needs and Recommended Actions by Regulators". "Waterpipe" smoking is now considered a global public health threat and the corresponding artefact is actually known in the world under three main terms: hookah, narghile and shisha. This important report, the first ever prepared by WHO on the subject, poses two major problems. On one hand, its bibliographical references dismiss world chief relevant studies. On the other, it contains a certain number of errors of many orders: biomedical, sociological, anthropological and historical. The purpose of the present study is to highlight, one by one, where these weaknesses and errors lie and show how this official report can be considerably improved. RESULTS: We realise that widely advertised early anthropological studies were not taken into consideration whereas they shed a substantial light on this peculiar form of smoking and help understanding its high complexity. As for concrete errors to be found in this report, they deal with the chemistry of smoke, health-related effects, smoking patterns, description and history of the artefact and its use, gender and underage use aspects, prevention and research needs in this field. CONCLUSION: The scientific credibility of an international expert report may be at stake if its recommendations do not rely on sound objective research findings and a comprehensive review of the existing literature. The critical comments in this study will certainly help improve the present WHO report

Tobacco and poverty A Vicious Circle

Tobacco and poverty: a vicious circle The contribution of tobacco to premature death and disease is well documented. However,little attention has been paid to the link between tobacco and poverty. Tobacco tends to be consumed by those who are poorer. In turn, it contributes to poverty through loss of income,loss of productivity, disease and death. Together, tobacco and poverty form a vicious circle from which it is often difficult to escape

Recommendation Guiding Principles for the Development of Tobacco Product Research and Testing Capacity and Proposed Protocols for the Initiation of Tobacco Product Testing

This recommendation is the sixth in a series of recommendations formulated by the WHO Study Group on Tobacco Product Regulation (TobReg).1 The purpose of this recommendation is to promulgate the principles that should guide the development of the laboratory capacity required to enable implementation of Articles 9, 10 and 11 of the WHO Framework Convention on Tobacco Control and the initiation of tobacco product testing. Such laboratory capacity provides government regulatory authorities with the means to guide and validate tobacco product testing, including any testing that may be carried out by the tobacco industry itself. The considerations and principles discussed in this recommendation are intended to provide guidance for establishing laboratory capacity that meets the highest standards of excellence, transparency, reliability and credibility.2The WHO Framework Convention on Tobacco Control includes three articles that lay the groundwork for the regulation of the contents, disclosures, and packaging and labelling of tobacco products (1). They are:• Article 9: Regulation of the contents of tobacco products • Article 10: Regulation of tobacco product disclosures • Article 11: Packaging and labelling of tobacco products

The Tobacco Atlas

The Tobacco Atlas is intended for anyone concerned with personal or political health, governance, politics, economics, big business, corporate behaviour, smuggling, tax, religion, internet, allocation of resources, human development and the future. It will be useful for UN agencies, governments and politicians, health officials, the media, researchers, universities, schools, and the general public. The atlas includes full-colour world maps and graphics, revealing similarities and differences between countries, on the history of tobacco, different types of tobacco use, prevalence and consumption, youth smoking, the economics of tobacco, farming and manufacturing, smuggling, the tobacco industry, promotion, profits, trade, smokers' rights, legislative action such as smoke-free areas, bans on tobacco advertising, health warnings, quitting, the effect of price and taxation, litigation and the future of the epidemic. This book illustrates, in an accessible and creative format, how tobacco is not just a simple health issue, but involves economics, big business, politics, trade, litigation, deceit and crimes such as smuggling. The atlas also shows the importance of a multifaceted approach to reducing the epidemic by WHO, other UN agencies, NGOs, the private sector and, in fact, the whole of civil society

The Tobacco Industry and Scientific Groups ILSI: A Case Study

A July 2000 report of an independent committee of experts outlined a number of ways in which the tobacco industry had attempted to undermine WHO tobacco control efforts in recent decades. One such method of subverting tobacco control involved the industry’s funding of and involvement in seemingly unbiased scientific groups to manipulate political and scientific debate concerning tobacco and health. This paper presents a brief chronology of the industry’s relations with one such group, the International Life Sciences Institute (ILSI), between 1983 and 1998. Findings indicate that ILSI was used by certain tobacco companies to thwart tobacco control policies. Senior office bearers in ILSI were directly involved in these actions

Building blocks for tobacco control: a handbook

Background The tobacco epidemic is a global challenge demanding concerted global and national action. The WHO Framework Convention on Tobacco Control (WHO FCTC) contains the blueprint for coordinated global action to address one of the most significant risks to health. However, national action is critical in order to attain the vision embodied in the WHO FCTC. Building national capacity to carry out effective and sustainable national tobacco control programmes is an urgent priority, and one of the most important measures required to combat the tobacco epidemic. The idea of developing this Handbook arose from the awareness that while various official WHO documents called upon countries to develop national capacity for tobacco control, there was no comprehensive publication to guide them through the process of developing such capacity. Conceived as a “How to” manual, the approach is intentionally pragmatic, addressing ‘real world’ issues and providing practical advice for setting up viable national tobacco control programmes. Overview The Handbook contains three main sections. The Introduction presents the evolving definition of “national capacity”, identifies the types of capacities needed for effective tobacco control and outlines the key features of building capacity. Section 1 provides a descriptive overview of the tobacco epidemic. This section is divided into four chapters. These chapters address tobacco as a risk factor, presenting its health, social and economic costs; the global strategies of the tobacco industry to counteract public health measures; the scientific evidence for effective tobacco control interventions; and the WHO FCTC as a global solution to an epidemic with prominent politico-legal and socio-cultural attributes. Section 2 focuses on the fundamental capacities necessary to empower countries to control the tobacco epidemic successfully. These chapters apply the lessons learned from the experiences of different countries and offer advice and suggestions to enable countries to put the theories of tobacco control into practice. This section begins with the development of a national plan of action as the foundation for successful tobacco control at the country level. It addresses the other important elements in national capacity-building, including establishing an effective infrastructure for a national tobacco control programme, training and education, raising public awareness through effective communications and media advocacy, programming specific tobacco control activities, legislative measures for tobacco control and exploring economic interventions and funding initiatives. Finally, chapters on countering the tobacco industry, forming effective partnerships, monitoring and evaluating progress, and exchanging information and research provide valuable insights to improve tobacco control capacity. By sharing lessons learned from different countries and utilizing numerous examples, it is hoped that this Handbook will assist and inspire national governments to take on the challenge of reducing tobacco consumption and the related mortality and morbidity

Towards health with justice: Litigation and public inquiries as tools for tobacco control

This monograph has been developed by TFI in order to provide both countries and individuals at national, regional and global levels with information, support and technical assistance on litigation and public inquiries as tools for tobacco control. These two elements are key emerging techniques in the field of tobacco control. Therefore, it is crucial that public health workers seize this opportunity to step beyond the realm of science and medical statistics and embrace other techniques and tools for tobacco control. This monograph is based on the "Consultation on Litigation and Public Inquiries as Public Health Tools" organized and held by WHO Regional Office for the Eastern Mediterranean Region, in collaboration with WHO headquarters, from 5 to 7 February 2001, in Amman, Jordan. During this Consultation, more than 20 Member States expressed an urgent need to understand the scope and magnitude of litigation and public inquires as tools for tobacco control in order to determine the best ways to combine science and law in curbing the tobacco epidemic