Tobacco Control and

Global Health Challenge

Yamin Tauseef Jahangir, MPH

Department of Public Health
School of Health & Life Sciences
North South University
 Introduction
 In 2003, the smoking prevalence among
adults was 54.8% in males and 16.6% in
females.
 The prevalence was 1.6% in the age group
10-14, 2.8% among males and 0.1% among
females.  
 29% school going adolescent males practice
smoking and 55% males start smoking
during adolescence who do not go to school.
 Average number of cigarettes smoked: The
annual cigarette consumption per person:
245
National Geo, ACS:2003, WHO:2002
National Geo, ACS:2003, WHO:2002
 There are over 4,000 chemicals in tobacco
smoke

Each puff on a cigarette delivers nicotine to your brain within a few seconds.
However, the Nicotine levels in your blood drop quickly after your cigarette is done.
After 20 or 30 minutes you may feel the urge to smoke again.
 To know…
Each puff on a cigarette delivers
nicotine to your brain within a
few seconds.
However, the Nicotine levels in
your blood drop quickly after your
cigarette is done.
After 20 or 30 minutes you may
feel the urge to smoke again.
 Nicotine-The Poison
Poisonous
More addictive than cocaine and
heroine
So powerful that farmers can use it to
kill insects
Legal addiction
Use results in addiction
Mood leveler
Users rely on it to control emotional
responses to everyday life
 Tobacco Consumption
The compound is present in car
exhaust that can cause death.
Causes shortness of breath.
Reduces the amount of oxygen
carrying capacity of blood.
Sticky Residue that stains the
fingers and teeth.
Contains benzopyrene, one of the
deadliest cancer causing agent.
 Tobacco Consumption-
contd.
Acetone: fingernail polish
remover
Ammonia: floor/toilet cleaner
Cadmium: content of batteries
Arsenic: rat poison
Methane: content of cow manure
fumes
Formaldehyde: preserver of dead
bodies
 Nicotine Dependence
Central nervous system Pleasure
and arousal,
Improved short term memory,
Improved concentration and
Decreased anxiety
Cardiovascular system
Increased heart rate and blood
pressure and peripheral
vasoconstriction
 Nicotine Dependence-
contd.
Endocrine system: Increased
circulating catecholamines (eg.
adrenaline and noradrenalin) and
increased cortisol levels
Metabolic system: Increased
basal metabolic rate
Gastrointestinal system:
Decreased appetite, nausea
Skeletal muscle: Decreased tone
 Nicotine dependence-contd.
Central nervous system Pleasure and arousal,
Improved short term memory,
Improved concentration and
Decreased anxiety

Cardiovascular system Increased heart rate and blood pressure and peripheral
vasoconstriction

Endocrine system Increased circulating catecholamines (eg. adrenaline and

noradrenalin) and increased cortisol levels

Metabolic system Increased basal metabolic rate

Gastrointestinal system Decreased appetite, nausea

Skeletal muscle Decreased tone

Impact of Smoking
tobacco
 Effects of Tobacco
Consumption
Chronic bronchitis is a chronic
inflammatory condition in the lungs that
causes the respiratory passages to be
swollen and irritated, increases the
mucus production and may damage the
lungs.
Lung cancer kills more people than any
other type of cancer and at least 80% of
these deaths are caused by smoking.
It is the tar in the `cigarettes which
contains the carcinogenic “cancer
causing” substances
Effects of Tobacco
Consumption
 Effects of Tobacco
Consumption
Smoking increases blood cholesterol
level and hardens arteries. Thus nicotine
acts as a vessel constrictor and reduces
blood flow to different parts the body.
Diabetes increases cholesterol level and
the levels of some other fats in our
blood.
The combined cardiovascular risks of
smoking and diabetes is as high as 14
times those of either smoking or
diabetes alone.
Let’s Have a Break for 5 mins 
 Regulation on Tobacco
Control
Fiscal measures (taxes and subsidies)
Discouraging consumption by young people
(including access and appeal of tobacco)
Environmental tobacco smoke measures
Packaging and labeling of tobacco products
Measures to control advertising, promotion and
sponsorship
Mandatory health education
Measures to control smuggling
Treatment of tobacco dependence
Regulation of the tobacco product
 Transnational Dimensions of
Tobacco Control
 Taxes and prices  Tobacco and agricultural
 Smuggling policy
 Advertising and  Testing, reporting and

sponsorship regulation of toxic and

 Tobacco package design other constituents
 International cooperation
and labeling
and information sharing
 Duty free tobacco
products
 Controlling Promotion on
Tobacco
Cable and satellite
television
Movies and films
Foreign newspapers
and magazines
Internet
Product promotion
 Framework Conventions:
General Obligations
National measures
to combat the
problem
Education, training,
public awareness
Cooperation in
scientific research
Financial and
technical assistance
 WHA Resolution 49.17: A Framework
Convention for Tobacco Control (1996)
Initiatedevelopment of a framework
convention in accordance with Article
19 of the WHO Constitution to:
Deal with aspects of tobacco control
that transcend national boundaries

Includea strategy to encourage

member nations to move progressively
towards adoption of comprehensive
tobacco control policies
 The Tobacco Industry and Liberty
Smoking is a civil right,
Those who don’t should join the fight.
For if one right does disappear.
The loss of others may be near….
Too many calories can cause you to die,
So let’s have a ban on apple pie.
Once a government restricts a right,
The end will never be near in sight.
There is a lesson here and it is no joke, I once
had the right to smoke!
Philip Morris Magazine
 The 5 A Strategy
Ask—Systematically identify all
tobacco users at every visit
Advise—Strongly urge all tobacco
users to quit
Assess—Determine willingness to
make a quit attempt
Assist—Aid the patient in quitting
(provide counseling and
medication)
Arrange—Ensure follow-up
 Way Forward at National
Level
Be actively involved in tobacco use
control activities
Network between your own
institution and other national
institutions that are involved in
tobacco control to strengthen the
national tobacco control efforts
Be involved in developing and
maintaining a systematic approach
to treat tobacco dependence
Way Forward at National Level-
contd.
Raise awareness of high risk
groups about the dangers
associated with tobacco use and
dependency
Lobby for health policies that ban
tobacco use in public places
Participate in putting into
enforcement health policies that
are related to smoking
 Way Forward at International
Level
Participate in international
tobacco forums
Collaborate with international
scholars in developing new
venues in tobacco control in your
country
Exchange expertise with tobacco
use control activists form around
the world
Thank you