World Lung Foundation

New York City, New York, United States

World Lung Foundation

New York City, New York, United States

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Gruer L.,NHS Health Scotland | Tursan d'Espaignet E.,Tobacco free Initiative | Haw S.,University of Stirling | Fernandez E.,Tobacco Control Unit | Mackay J.,World Lung Foundation
Public Health | Year: 2012

Article 8 of the World Health Organization Framework Convention on Tobacco Control (2005) requires all signatory countries to adopt measures to protect people from tobacco smoke in indoor workplaces, indoor public places, public transport and other public places as appropriate. The aims of this symposium were to review progress across the world, to assess the evidence for the impact of legislation on health, and to identify the continuing challenges in making universal protection a reality. There was agreement that even in countries where strict legislation is enforced, many children continue to be dangerously exposed to parental second-hand smoke in the womb, the home and private cars. The importance of using accurate estimates of the burden of disease caused by second-hand smoke was agreed, in order to present an unassailable case for legislation and enforcement. © 2012 The Royal Society for Public Health.


Schluger N.W.,World Lung Foundation | Schluger N.W.,Columbia University | Koppaka R.,World Lung Foundation | Koppaka R.,Columbia University
Annals of the American Thoracic Society | Year: 2014

As described in a recently released report of the Forum of International Respiratory Societies, four of the leading causes of death in the world are chronic obstructive pulmonary disease, acute respiratory tract infections, lung cancer, and tuberculosis. A fi fth, asthma, causes enormous global morbidity. Not enough progress has been made in introducing new therapies and reducing disease burden for these illnesses in the last few decades, despite generous investments and some notable progress in biomedical research. Four external and modi fiable drivers are responsible for a substantial percentage of the disease burden represented by the major lung diseases: tobacco, outdoor air pollution, household air pollution, and occupational exposures to lung toxins. Especially in low- and middle-income countries, but in highly developed economies as well, pressures for economic development and lax regulation are contributing to the continued proliferation of these drivers. Public health approaches to themost common lung diseases could have enormous effects on reducing morbidity and mortality. There must be increased advocacy from and mobilization of civil society to bring attention to the drivers of lung diseases in the world. The World Health Organization should negotiate accords similar to the Framework Convention on Tobacco Control to address air pollution and occupational exposures. Large increases in funding by government agencies and nongovernmental organizations around the world are needed to identify technologies that will reduce health risks while allowing populations to enjoy the bene fi ts of economic development. This paradigm, focused more on public health than on individual medical treatment, has the best chance of substantial reduction in the burden of lung disease around the world in the next several years. Copyright © 2014 by the American Thoracic Society.


Wakefield M.,Center for Behavioural Research in Cancer | Bayly M.,Center for Behavioural Research in Cancer | Durkin S.,Center for Behavioural Research in Cancer | Cotter T.,Cancer Institute New South Wales | And 2 more authors.
Tobacco Control | Year: 2013

Background While television advertisements (ads) that communicate the serious harms of smoking are effective in prompting quitting-related thoughts and actions, little research has been conducted among smokers in low- to middle-income countries to guide public education efforts. Method 2399 smokers aged 18e34 years in 10 low- to middle-income countries (Bangladesh, China, Egypt, India, Indonesia, Mexico, Philippines, Russia, Turkey and Vietnam) viewed and individually rated the same five anti-smoking ads on a standard questionnaire and then engaged in a structured group discussion about each ad. Multivariate logistic regression analysis, with robust SEs to account for the same individual rating multiple ads, was performed to compare outcomes (message acceptance, perceived personalised effectiveness, feel uncomfortable, likelihood of discussing the ad) across ads and countries, adjusting for covariates. Ads by country interactions were examined to assess consistency of ratings across countries. Results Three ads with graphic imagery performed consistently highly across all countries. Two of these ads showed diseased human tissue or body parts, and a third used a disgust-provoking metaphor to demonstrate tar accumulation in smokers' lungs. A personal testimonial ad performed more variably, as many smokers did not appreciate that the featured woman's lung cancer was due to smoking or that her altered physical appearance was due to chemotherapy. An ad using a visual metaphor for lung disease was also more variable, mostly due to lack of understanding of the term 'emphysema'. Conclusion Television ads that graphically communicate the serious harms of tobacco use are likely to be effective with smokers in low- to middle-income countries and can be readily translated and adapted for local use. Ads with complex medical terms or metaphors, or those that feature personal testimonials, are more variable and at least require more careful pre-testing and adaptation to maximise their potential.


Beaglehole R.,University of Auckland | Bonita R.,University of Auckland | Yach D.,Vitality | Mackay J.,World Lung Foundation | Reddy K.S.,Public Health Foundation of India
The Lancet | Year: 2015

The time has come for the world to acknowledge the unacceptability of the damage being done by the tobacco industry and work towards a world essentially free from the sale (legal and illegal) of tobacco products. A tobacco-free world by 2040, where less than 5% of the world's adult population use tobacco, is socially desirable, technically feasible, and could become politically practical. Three possible ways forward exist: so-called business-as-usual, with most countries steadily implementing the WHO Framework Convention on Tobacco Control (FCTC) provisions; accelerated implementation of the FCTC by all countries; and a so-called turbo-charged approach that complements FCTC actions with strengthened UN leadership, full engagement of all sectors, and increased investment in tobacco control. Only the turbo-charged approach will achieve a tobacco-free world by 2040 where tobacco is out of sight, out of mind, and out of fashion - yet not prohibited. The first and most urgent priority is the inclusion of an ambitious tobacco target in the post-2015 sustainable development health goal. The second priority is accelerated implementation of the FCTC policies in all countries, with full engagement from all sectors including the private sector - from workplaces to pharmacies - and with increased national and global investment. The third priority is an amendment of the FCTC to include an ambitious global tobacco reduction goal. The fourth priority is a UN high-level meeting on tobacco use to galvanise global action towards the 2040 tobacco-free world goal on the basis of new strategies, new resources, and new players. Decisive and strategic action on this bold vision will prevent hundreds of millions of unnecessary deaths during the remainder of this century and safeguard future generations from the ravages of tobacco use. © 2015 Elsevier Ltd.


Dunlop S.,University of Sydney | Cotter T.,Cancer Institute | Cotter T.,World Lung Foundation | Perez D.,Cancer Institute | Wakefield M.,Center for Behavioural Research in Cancer
American Journal of Public Health | Year: 2013

Objectives. We assessed the effects of levels and duration of exposure to televised antismoking advertising on cognitive and behavioral changes. Methods. We used data from a serial cross-sectional telephone survey with weekly interviews of adult smokers and recent quitters in New South Wales, Australia (n = 13 301), between April 2005 and December 2010. We merged survey data with commercial TV ratings data to estimate individuals' exposure to antismoking advertising. Results. Logistic regression analyses indicated that after adjustment for a wide range of potential confounders, exposure to antismoking advertising at levels between 100 and 200 gross rating points per week on average over 6 to 9 weeks was associated with an increased likelihood of having (1) salient quitting thoughts and (2) recent quit attempts. Associations between exposure for shorter periods and these outcomes were not significant. Conclusions. Broadcasting schedules may affect the success of antismoking ads. Campaign planners should ensure advertising exposure at adequate frequency over relatively sustained periods to maximize impact. © 2013 American Journal of Public Health.


MacKay J.,World Lung Foundation | Ritthiphakdee B.,Southeast Asia Tobacco Control Alliance SEATCA | Reddy K.S.,Public Health Foundation of India
The Lancet | Year: 2013

For the purpose of this article, Asia refers to WHO's combined South-East Asia and Western Pacific regions and thus includes Australia and New Zealand. Asia has the highest number of tobacco users and is the prime target of transnational tobacco companies. The future of global tobacco control rests in this region and the challenges are clear. China, India, and Indonesia are key markets and Asia is a frontrunner in tobacco control measures, such as plain packaging of cigarettes. Some countries in Asia have a long history of tobacco control activities beginning in the 1970s, and WHO's Western Pacific Region is still the only region where all countries have ratified WHO's Framework Convention on Tobacco Control. We reviewed the history, research, epidemiology, tobacco control action, obstacles, and potential responses and solutions to the tobacco epidemic in this region. Levels of development, systems of government, and population size are very different between countries, with population size ranging from 1500 to 1·3 billion, but similarities exist in aspects of the tobacco epidemic, harms caused, obstacles faced, and tobacco control actions needed. © 2013 Elsevier Ltd.


The burden of tobacco-related morbidity and mortality in India is substantial, with smokeless tobacco being the predominant form of tobacco use. Use of smokeless tobacco (for example gutkha, paan, khaini, and pan masala) is linked to a host of socioeconomic and cultural factors including gender, regional differences, educational level, and income disparities. Given the scale of the problem, a national social marketing campaign was developed and implemented. The creative approach used testimonials from a surgeon and patients at Tata Memorial Hospital in Mumbai. The communication message approach was designed to reflect the realities of disfiguring, disabling, and fatal cancers caused by smokeless tobacco. Evaluation of the campaign identified significant differences across a range of campaign behavioral predictors by audience segments aware of the campaign versus those who were "campaign unaware". Significant findings were also identified regarding vulnerable groups by gender (female/male) and rural/urban disparities. Findings are discussed in relation to the powerful impact of using graphic, emotive, and testimonial imagery for tobacco control with socially disadvantaged groups.


Mackay J.,World Lung Foundation
Public Health | Year: 2012

A new paradigm is needed for the epidemics of the 21st century. The tobacco epidemic has shown that the curative-based medical model is insufficient to reduce the use of tobacco, and that this will only be achieved by prevention and public health measures. The magnitude of the health risks and the economic factors can only lead to one conclusion: there needs to be hard-hitting, well-funded campaigns in all countries and at all levels to avert initiation, decrease consumption, assist with cessation, and protect non-smokers. We must embrace the spirit of the Framework Convention on Tobacco Control by implementing robust, effective, cost-effective measures to protect people's health and the wealth of nations. We stand at a critical juncture in the unfolding pandemic. © 2012 The Royal Society for Public Health.


MacKay J.,World Lung Foundation | Schluger N.,World Lung Foundation
Progress in Respiratory Research | Year: 2015

This review covers global deaths, prevalence, consumption, tobacco economics, obstacles to tobacco control and tobacco control action in the tobacco epidemic. It highlights that 80% of smokers now live in low-and middle-income countries, and addresses the economic drain of tobacco on both national economies and smokers and their families. The tobacco epidemic, in spite of different populations and stages of development and different economic systems among countries, is comparable globally, with the same products, similar harm, identical obstacles and intervention measures needing to be taken. It shows that much progress has been made over the last half century, especially with the adoption of the World Health Organisation Framework Convention on Tobacco Control. Many millions are now covered by the WHO MPOWER measures, yet less than one in five of the world's population are covered by smoke-free areas, bans on all forms of advertising, promotion and sponsorship, optimum tobacco taxation, packet warning labels and cessation programmes at the highest, optimal level. There has been an increase in global funding for tobacco control, yet national funding remains woefully inadequate. © 2015 S. Karger AG, Basel.


MacKay J.,World Lung Foundation
British Medical Bulletin | Year: 2012

Introduction or background: Tobacco currently kills 6 million people each year, increasingly in the low-and middle-income countries, which will bear the economic brunt of this epidemic. Tobacco control takes health professionals to very new destinations, away from the traditional curative medical model to mastering the corridors of power, using the media, and political lobbying and advocacy. None of these skills is taught in medical schools.Areas of agreement: The magnitude and future expansion of the tobacco epidemic is beyond controversy, as is the fact that the economic costs of tobacco outweigh any benefits. The tools needed to reduce the epidemic are also known and accepted, and these are virtually identical in all countries. It only requires political will to implement these.Growing points: All countries should ratify and implement the WHO Framework Convention on Tobacco Control and commit adequate funding to counter this global pandemic.Areas timely for developing research: Action must be based on the science of epidemiology, prevalence, health effects, economic burden, success of action taken and tracking the tobacco industry. © 2012 The Author.

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