27.smoking and poverty,their interaction with tuberculosis in the developing world
Smoking and PovertyInteraction with TB in the Developing World Donald A Enarson The Union Asia Pacific Region 9 July 2011
Learning ObjectivesBy the end of the session you will be able to: Confirm the association of tobacco and TB; Outline the feasibility of smoking cessation for TB patients; Describe the plague of tobacco smoking and its toll; Explain how this impacts on health and economics; Identify the new directions of tobacco marketing.
Association of TB and Smoking Disease and Active Smoking; Sub-Saharan Africa Western Pacific Southeast Asia Latin America Disease and Passive Smoking; Southeast Asia.
Smoking Cessation for TB patients Smoking cessation services are feasible and do not negatively affect TB care: El Sony A, Slama K, Slieh M, Elhaj H, Adam K, Hassan A, Enarson DA. Feasibility of brief tobacco cessation advice for tuberculosis patients: a study from Sudan. Int J Tuberc Lung Dis 2007; 11: 150-155 There is a practical approach to smoking cessation for low-income countries Slama K, Chiang C-Y, Enarson DA. Tobacco Cessation Interventions for Tuberculosis Patients. A Guide for Low- Income Countries. Paris: International Union Against Tuberculoisis and Lung Disease. 2008, pp 57. ISBN 978-2- 914365-31-4
Association of TB and Poverty 100000 Norway G NI per capita Sweden 10000 Poland Thailand Romania 1000 Indonesia Pakistan 100 1 10 100 1000 Estimated cases per 100,000 - 2002WHO Global TB Report
Information on Smoking http://www.tobaccoatlas.org
Prevalence of Smoking by CountryProportion of Men who Smoke 60+ 40-59 20-39 <20 Afghanistan China France Sweden Yemen Turkey New Zealand Canada Russia Malaysia India Zambia Ukraine Austria Ireland Senegal Belarus Mongolia South Africa RD Congo Indonesia Chile Egypt Nigeria Portugal Brazil Ethiopia
Smoking by CountryFraction of Women to Men who SmokeAfghanistan .21 China .06 France .73 Sweden 1.25 Yemen .38 Turkey .37 New Zealand .93 Canada .92 Russia .38 Malaysia .05 India .04 Zambia .12 Ukraine .36 Austria .86 Ireland .98 Senegal .04 Belarus .33 Mongolia .14 South Africa .31 RD Congo .06 Indonesia .06 Chile .72 Egypt .04 Nigeria .02 Portugal .76 Brazil .63 Ethiopia .07
Burden to Health from SmokingProportion of Deaths in Men from Tobacco <10 10-19 20+ India Afghanistan Belarus New Zealand Ethiopia Brazil Austria Ukraine RD Congo Chile Sweden Turkey Zambia Malaysia France South Africa Indonesia Russia China Canada Egypt Portugal Yemen Ireland
Burden to the Individual Economy Cost of a Pack per $1,000 GNI Ethiopia RD Congo India China Indonesia MalaysiaNew Zealand Canada Russia Sweden 0 1 2 3 4 5 Cost of a Pack per $1,000 GNI
Costs to the General Economy Total Estimated Costs Sweden IndonesiaSouth Africa Egypt China France Canada 0 5000 10000 15000 20000 Total Estimated Costs ($ millions)
Existing Market for Tobacco Ukraine menRussia women Turkey men Brazil menChina women Russia menIndonesia men India men China men 0 100 200 300 400 500 Millions of Smokers
Future Market for Tobacco Russia women Nigeria men Brazil men Nigeria women Brazil womenIndonesia women China men India men India women China women 0 100 200 300 400 500 600 700 Millions of Potential Smokers
Effect of Cost on SmokingExcluding Industrialized Countries 10Cost of a Pack per $1,000 1 GNI 0.1 0.01 0 20 40 60 80 100 % of Men who Smoke
Smoking and PovertyKey points Tobacco smoking is facilitated by ‘relative’ wealth; It can be a burden to both health and wealth; Future markets for tobacco will target women and selected developing countries.
TB, Smoking and PovertyKey points Tobacco control is important everywhere; It should be a priority for TB patients; It is feasible; The highest dual burden is in middle-income countries.
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