New Study Calls Attention to Tobacco's Disproportionate Impact on Poor Nations

Latin America, Asia and Africa Suffer from Tobacco-Related Health Inequalities

WASHINGTON, March 21, 2012 /PRNewswire-USNewswire/ -- Tobacco is the world's number-one cause of preventable death – responsible for nearly 6 million deaths annually. A new supplement published in the journal Cancer Causes and Control calls attention to the burden of tobacco-related inequalities in low- and middle-income countries (LMIC) in Latin America, Asia, and Africa, many of which have been targeted by the tobacco industry's deceptive marketing practices. The supplement, funded by the National Cancer Institute, features 11 studies showing the disproportionate impact of tobacco use, secondhand smoke exposure, and tobacco-related cancer and disease among those of lower socioeconomic position (SEP) and, in some cases, by gender and race/ethnicity. 

(Logo: http://photos.prnewswire.com/prnh/20101101/DC86294LOGO)

"Tobacco's impact has reached epidemic proportions around the world," said Dr. Donna Vallone, Senior Vice President for Research and Evaluation at Legacy and co-editor of the special supplement. "This special issue confirms what we have known in public health for many years: tobacco is NOT an equal opportunity killer, and it impacts the health and economies of poor nations," she added.  According to the World Health Organization, nearly 80 percent of the world's one billion smokers live in low- and middle-income countries.

Findings from the special supplement add to our understanding of how global tobacco use affects low- and middle-income countries

• Studies conducted in Vietnam and China show how vulnerable populations-including women and children, racial/ethnic minorities and poor persons-are disproportionately affected by secondhand smoke exposure.
• Data from Southeast Asia show a five-fold mortality increase from oral cancers among tobacco chewers compared to never chewers with a strong and inverse association with education.  

"This is a critical opportunity for preventing the progression of tobacco use among women in many LMICs, particularly those in Sub-Saharan Africa and Asia," said Vallone. "The supplement allows us to take a look at where the burden lies, so that interventions can be tailored accordingly," she added.

Several studies also highlight the role of industry practices, mass media and social influences on tobacco use.  A study by Lee et al., shows that transnational tobacco companies are exploiting new vulnerable markets in low- and middle-income countries by using the same economic, political, and marketing practices that were successfully used in high-income countries – such as the United States – to promote smoking.

"People in most LMIC are being exposed to the sophisticated and unscrupulous marketing tactics of tobacco companies, and the results show that smoking rates are higher," said Sungkyu Lee, Ph.D., Post Doctoral Research Fellow at the Center for Tobacco Control Research and Education at the University of California San Francisco. "More importantly, the tobacco industry influences on the policy process, thus governments and policy makers should not carry out back room deals with the industry and counter their practices," Lee said.

In a study conducted in Mexico by Hammond et al., participants reported higher levels of overall effectiveness for graphic pictorial health warnings that featured graphic health effects and testimonials from "real" smokers compared to more abstract images with symbolic representations.  Furthermore, participants with lower levels of education reported even greater levels of effectiveness for graphic warning labels compared to their more educated counterparts.  

"Most people around the world are not fully aware of the range and severity of the health risks from smoking, and many are still confronted with marketing that undermines these risks. Health warnings can help to discourage tobacco use among young people and support efforts to quit among current smokers use," said David Hammond, Ph.D., Associate Professor at the School of Public Health & Health Systems for the University of Waterloo, Canada. "Health warnings are a relatively simple, cost-effective way to address the burden of tobacco on these low- and middle-income countries.  

Another study conducted in India by Turk et al., showed that a national awareness campaign on the harmful effects of smokeless tobacco can increase knowledge about the dangers of smokeless tobacco use, anti-tobacco attitudes and cessation intentions and behaviors among smokeless tobacco users—including among groups that suffer the greater burden, such as women and rural tobacco users who predominantly fall in the lower socioeconomic categories.

"A great challenge we face is changing the way public health policies address global health inequalities," said Vallone. "This extensive collection of manuscripts hopes to serve those who are in power to influence change that will make a difference."

The full supplement can be found online at: http://www.springerlink.com/content/0957-5243/23/s1/.

Legacy helps people live longer, healthier lives by building a world where young people reject tobacco and anyone can quit. Legacy's proven-effective and nationally recognized public education programs include truth®, the national youth smoking prevention campaign that has been cited as contributing to significant declines in youth smoking; EX®, an innovative public health program designed to speak to smokers in their own language and change the way they approach quitting; and research initiatives exploring the causes, consequences and approaches to reducing tobacco use. Located in Washington, D.C., the foundation was created as a result of the November 1998 Master Settlement Agreement (MSA) reached between attorneys general from 46 states, five U.S. territories and the tobacco industry. To learn more about Legacy's life-saving programs, visit www.LegacyForHealth.org.

Follow us on Twitter @legacyforhealth and Facebook www.Facebook.com/Legacy.

SOURCE Legacy