Tobacco use is a major public health problem that kills over 5 million people worldwide each year. In Sudan, smoking prevalence among males is around 24% compared to only 2% among females. There are effective tobacco control strategies available through the WHO Framework Convention on Tobacco Control (FCTC) including tax increases, advertising bans, smoke-free laws, health warnings on packages, and cessation support. Quitting tobacco has significant health, economic, and social benefits for individuals and their families.

1. SMOKING
Presented by:
Eman Fathi
Msc. Public and
tropical health

2. Content
 Why tobacco is a public health priority
 The impact of tobacco use on tobacco users and
others
 Tobacco Control
 Quitting Tobacco

3. Why tobacco is a public health priority
 Tobacco use kills more than 5 million people/year.
Approximately one person dies every six seconds
due to tobacco, accounting for 1 in 10 adult deaths.
 Among the five greatest risk factors for mortality, it
is the single most preventable cause of death.
 11% of deaths from ischaemic heart disease, the
world's leading killer, are attributable to tobacco
use. More than 70% of deaths from lung, trachea
and bronchus cancers are attributable to tobacco
use.
 If current patterns continue, tobacco use will kill
more than 8 million people per year by 2030. Up to
half of the world's more than 1 billion smokers will
die prematurely of a tobacco-related disease

4. Sudan - Smoking prevalence
 Smoking prevalence, females (% of adults)
Year 2009 Value 2.07
 Smoking prevalence, males (% of adults)
Year 2009 Value 23.84
Source: WHO Report on the Global Tobacco
Epidemic.(http://www.indexmundi.com/facts/sudan/smoking-
prevalence)

5. The Prevalence of Tobacco use in
Sudanese adults ,n =60932

6. THE IMPACT OF TOBACCO USE ON TOBACCO
USERS AND OTHERS
 Tobacco use have both health and non-health
impacts on tobacco users and others.

7. HEALTH IMPACT
 This includes health risks to tobacco users and
their family.
 Tobacco products are made of extremely toxic
materials. Tobacco smoke contains more than
7000 chemicals, of which at least 250 are known
to be harmful and at least 69 are known to cause
cancer.

8.  All tobacco products are harmful. Tobacco
smoking can damage every part of the body,
causing many actual medical conditions such as
shortness of breath, exacerbation of asthma and
respiratory infections as well as many chronic
diseases including heart disease, strokes, cancer
and chronic respiratory diseases.

9. Figure 1: Tobacco is a risk factor for six of the eight
leading causes of death in the world

10. Smoking puts the smoker’s family at risk. Secondhand
smoke exposure increases the risks of having the
following diseases:
 Diseases in children
− sudden infant death
syndrome;
− acute respiratory
illnesses;
− middle ear disease;
− chronic respiratory
symptoms.
 Diseases in adults
− coronary heart
disease;
− nasal irritation;
− lung cancer;
− reproductive effects
in women (low birth
weight).

11. ECONOMIC IMPACT OF TOBACCO USE
 The economic costs of tobacco use are equally
devastating. In addition to the high public health
costs of treating tobacco-related diseases, tobacco
users are also less productive due to increased
sickness, and those who die prematurely deprive
their families of much-needed income.
 Tobacco use and poverty are linked. Many studies
have shown that in the poorest households in some
low- and middle-income countries, more than 10%
of total household expenses is on tobacco.

12. SOCIAL CONSEQUENCES OF TOBACCO
USE
 Smoking affects social interaction and
relationships negatively.
 There is a stigma attached to smoking (for
example, people may think the smoker is smelly,
disgusting/dirty, unhealthy…).
 As a smoker, their personal relationships may
be affected because many people don’t consider
being in a relationship with a smoker.
 As a smoker, their children are more likely to
smoke and to be heavier smokers at young ages.

13. Tobacco Control

14.  There are many cost-effective tobacco control
measures that can be used in different settings and
have a significant impact on tobacco consumption.
 The most cost-effective strategies are population-
wide public policies, like bans on advertising,
promotion and sponsorship of tobacco products;
tobacco tax and price increases; forbidding smoking
in all public and workplaces; and requiring large,
clear and visible graphic health messages on
tobacco packaging.
 All of these measures are outlined in the WHO
Framework Convention on Tobacco Control.

15. Conference of the Parties(COP) to the WHO
Framework Convention on Tobacco Control (WHO
FCTC)
 The COP is the governing body of the Convention
which meets regularly to review implementation of
the Convention and takes the decisions necessary to
promote its effective implementation.
 The agenda of COP6 covers many substantive
issues: price and tax measures, economically
sustainable alternatives to tobacco growing, trade
and investment issues, as well as measures in
relation to smokeless tobacco products, waterpipe,
and electronic nicotine delivery systems (ENDS).

16. Implementing tobacco control
 Governments use the tobacco control measures
in the WHO Framework Convention on Tobacco
Control (WHO FCTC) to reduce the prevalence of
tobacco use and exposure to tobacco smoke.
 By implementing these measures, governments
reduce the heavy burden of disease and death
that is attributable to tobacco use or exposure.

17. WHO Framework Convention on Tobacco Control
 Measures relating to the reduction of demand for tobacco:
 Price and tax measures to reduce the demand for tobacco
 Protection from exposure to tobacco smoke
 Regulation of the contents and disclosures of tobacco products
 Packaging and labeling of tobacco products
 Education, communication, training and public awareness
 Tobacco advertising, promotion and sponsorship
 Demand reduction measures concerning tobacco dependence and
cessation

18.  Measures relating to the reduction of the
supply of tobacco
 Illicit trade in tobacco products
 Sales to and by minor
 Provision of support for economically viable
alternative activities

19.  The WHO Framework Convention on Tobacco
Control (WHO FCTC) and its guidelines provide the
foundation for countries to implement and manage
tobacco control. To help make this a reality, WHO
introduced the MPOWER measures. These measures
are intended to assist in the country-level
implementation of effective interventions to reduce
the demand for tobacco, contained in the WHO
FCTC.
 Tobacco control is based upon an underlying ethical
framework that recognizes the rights of persons to
life, health and freedom.

20. The six components of MPOWER
 Monitor tobacco use and prevention policies
 Protect people from tobacco smoke
 Offer help to quit tobacco use
 Warn about the dangers of tobacco
 Enforce bans on tobacco advertising, promotion
and sponsorship
 Raise taxes on tobacco

21. Watching and countering the industry
 Understanding the tobacco industry's practices
is crucial for the success of tobacco control
policies. In this context, it's important also to
understand that tobacco products are the only
legally available products that can kill up to one
half of their regular users if consumed as
recommended by the manufacturer.

22. There are two significant components of this monitoring
process: surveillance and regulation.
 Under surveillance, WHO engages in ongoing
efforts to monitor, and to counter, as
appropriate, activities of the tobacco industry to
interfere with public health policy-making.
 It also publishes reports and maintains a
database of activities, efforts and campaigns by
the tobacco industry to undermine global
tobacco control.

23.  Under regulation, WHO, through its networks,
assists in efforts to regulate the contents and
emissions and the packaging and labelling of
tobacco products. Two of these networks are the
WHO Study Group on Tobacco Product
Regulation (TobReg), established in 2003, and
the WHO Tobacco Laboratory Network
(TobLabNet), established in 2005.

24. Quitting tobacco

25.  Quitting tobacco is not easy as tobacco
dependence is a cluster of behavioral, cognitive
and physiological phenomena. Very few tobacco
users can successfully quit the habit in their first
attempt. But the evidence is strong that it can be
done. From quit lines to counseling to
prescription medicines, there are numerous
effective ways to quit.

26. BENEFITS OF QUITTING

27. HEALTH BENEFITS

29.  ECONOMIC BENEFITS
Quitting also has very clear and tangible
financial benefits to smokers.
 SOCIAL BENEFITS

30. Algorithm for delivering brief tobacco
interventions

31. Quitting rates in Adults:
Source: Tobacco Problems in Sudan by Dr Kamal Hamed
Mohamed, Faculty of Medicine, Univ of
Khartoum(http://ucec.futureu.edu.sd/wp-
content/uploads/2013/02/The-Problem-of-Tobacco-Use-
in-Sudan.pdf)