Curb Tobacco Use Research Articles

A Health Economics Inquiry into Regulatory Constraints on the European Tobacco Market.

Despite the implementation of significant measures by European countries in recent years, smoking rates in Europe remain persistently high. TheEuropean Commission is currently undertaking a comprehensive review of itstobacco regulations. This article aims to address critical inquiries that arise during the amendment of the regulatory framework. We evaluate the effectiveness of existing tobacco control methods and observe a diminishing impact on promoting smoking cessation. Additionally, we explore how individuals of varying genders respond to the regulatory environment. We propose a comprehensive and evidence-based framework for implementing a taxation system in response to the proliferation of emerging products, including e-cigarettes and heated tobacco. This system is designed to align effectively with health policy objectives, providing a strategic approach to curbing tobacco use and promoting public health.

Tradition to Concern: Health Risks and Nicotine Dependence of Midwakh Use in Young Males in the UAE

Abstract Background Midwakh smoking, a traditional practice, poses a growing public health concern in the Middle East region. Despite global efforts to curb tobacco use, smoking rates, particularly among young men, remain high. This study explores nicotine dependency, assesses acute health effects, and measures carbon monoxide levels among midwakh smokers. Methods A quasi-experimental before-and-after study involved 103 young male midwakh smokers in the UAE. Data collection included surveys featuring the Hooked-on Nicotine checklist (HONC), clinical measurements, and pre/post-smoking saliva samples. Statistical analyses, including descriptive, paired samples, correlation, and regression, assessed associations between midwakh smoking, dependency, and health outcomes. Results Preliminary findings found that 33% of midwakh smokers were under 21 years, 68% had below undergrad education, and household incomes over 15,000 AED monthly. Smoking initiation was as early as 10 years. Smoking habits revealed 37% exclusive midwakh, 54% midwakh with e-cigarettes, 21% with shisha, and 34% with cigarettes. Post-smoking clinical measurements showed significant increases in blood pressure, heart, pulse and respiratory rates, and carbon monoxide levels (p ≤ 0.05). Significant differences in pre- (134.6 ng/ml) and post-smoking (154.4 ng/ml) saliva cotinine levels (p ≤ 0.05) were observed. Regression analysis identified predictors of nicotine dependency: initiation age (β= -.315; -0.579,0.0512), household income (β = 1.221; 0.297,2.146), multiple tobacco use (β = 0.576; 0.129,1.024), quit attempts (β = 1.555; 0.519,2.590) and smoking risk perception (β = 3.420; 1.950,4.890) Conclusions Midwakh smoking adversely affects clinical measurements, with early start correlating with higher nicotine dependency, worsened by using multiple tobacco products. Urgent action is needed, including tailored prevention campaigns and support systems to aid youth cessation and raise awareness of midwakh smoking’s harmful effects. Key messages • Midwakh smoking is deeply ingrained in UAE tradition but poses significant adverse health outcomes and nicotine dependency. • There is a need to establish specialized cessation programs offering support and resources to midwakh users, addressing both the health consequences and addictive nature of midwakh.

Modeling cigarette smoking exposure in subsets of the population

Modeling cigarette smoking exposure in subsets of the population Understanding and acknowledging various factors that impact cigarette smoking and exposure is critical when creating public health interventions to curb tobacco use. Here, Theodore R. Holford from Yale University discusses the impact of different approaches to tobacco control. The harmful effects of cigarette smoking have been widely recognized for more than 50 years (1), and the huge toll that it has taken in shortening lives has led to the recognition of an urgent need to reduce associated exposure. Because cigarette smoking is an addictive behavior, it has been a public health challenge to reduce the level of exposure in the population, even though alternative approaches have been used. These approaches include the introduction of taxes that increase cost to users, changing the legal age at which cigarettes can be purchased, introducing clean air laws that limit locations where individuals are allowed to smoke, and establishing resources that will assist those who wish to quit smoking. These efforts can be undertaken on a national level, but more often, such efforts are implemented at different times and in different ways in different regions. In the US, these laws are more commonly introduced by a state, county, or city. (2) This introduces geographic disparities in cigarette smoking exposure, and it is important to understand these differences when planning approaches to protect public health.

Response of legal and illegal cigarette prices to a tax increase in Ethiopia

BackgroundIn 2020, Ethiopia passed a landmark tax proclamation implementing an evidence-based mixed excise system aimed at curbing tobacco use. This study evaluates the impact of the tax increase of more...

IMPACTS OF TOBACCO USE AND EXPOSURE TO TOBACCO SMOKE ON HEALTH, SOCIETY, ECONOMY, AND ENVIRONMENT

Smoking represents a significant global public health challenge and is the primary preventable cause of disease and death. This problem is accentuated by the fact that a substantial 80% of adult smokers worldwide come from low- or middle-income countries. The aim of this paper is twofold: first, to highlight the health impacts associated with tobacco use, and second, to delineate the indirect damage caused to the environment during the life cycle of tobacco products - from production and distribution to consumption and waste generation. The reluctance of some countries to take decisive action, together with intense pressure from tobacco corporations, is hindering progress towards reducing the number of adult smokers and curbing tobacco use among minors. State interventions, supported by strict laws, are necessary to enforce the ban on indoor smoking, the ban on the sale of tobacco to minors, and the establishment of permanent interstate cooperation in the fight against cigarette smuggling. Educational initiatives aimed at raising awareness of the dangers of smoking and tobacco consumption are key to fostering a smoke-free culture. A strong media campaign, supported by state measures, could contribute to faster and more comprehensive targeting of target groups, especially younger age categories.

Prevalence of tobacco use among cancer patients in Iran: a systematic review and meta-analysis.

The prevalence of tobacco use among various cancer types in Iran remains a significant concern, necessitating a comprehensive analysis to understand the extent and patterns of consumption. This study aimed to systematically review and analyze existing literature to delineate the prevalence of tobacco use across different cancer types in Iran, thereby providing a robust basis for future interventions and policy formulations. Adhering to the PRISMA guidelines, we conducted a systematic review and meta-analysis of literature available in PubMed and Scopus databases. The initial search identified 351 records, out of which 44 studies were selected based on their relevance and design. These studies spanned various time frames, starting from the 2001s up until 2022, and encompassed diverse geographical locations and cancer types in Iran. To avoid bias and potential data overlap, we opted to incorporate a single comprehensive study from the Golestan Cohort, encompassing all data, while excluding 10 other studies. Our final analysis incorporated data from 34 studies, which accounted for 15,425 patients and 5,890 reported smokers. Statistical analyses were performed to calculate the overall proportion of tobacco consumption and to conduct subgroup analyses based on different variables such as cancer types, gender, geographical locations, and types of tobacco used. The analysis revealed a substantial prevalence of tobacco use among cancer patients in Iran, with an overall consumption rate of 43%. This rate varied significantly, ranging from 10 to 88% across individual studies. Subgroup analyses further highlighted disparities in tobacco consumption rates across different demographics, geographic areas, and cancer types. Notably, the 'ever' smokers category exhibited the highest prevalence of tobacco use. The study also identified a worrying trend of high cigarette smoking rates, along with variable consumption patterns of other forms of tobacco, including waterpipe, 'Naas', and 'Pipe'. This systematic review and meta-analysis underscores a significant association between tobacco consumption and various cancer types in Iran, with a prevalence rate among cancer patients being three times higher than the average Iranian population. The findings indicate substantial heterogeneity in tobacco use patterns, emphasizing the need for targeted interventions to address this pressing health issue. The study serves as a critical resource for shaping future policies and strategies aimed at curbing tobacco use and mitigating its adverse effects on cancer prevalence in Iran.

Youthful Choices: A Secondary Analysis of the NFHS-5 Data to Examine Tobacco Use in Indian Adolescent Girls and Young Women

Background and aim: Tobacco use among adolescents and young women is a global health concern. This study investigates the prevalence and determinants of tobacco use among adolescents and young women in India. Methods: Based on data from the National Family Health Survey-5, this study explored tobacco use among 241,180 young women aged 15–24 in India. The research investigated determinants of current tobacco use, encompassing any tobacco use in any form, smoked and smokeless tobacco (SLT). Independent variables include demographics, religion, caste, region, education, occupation, body mass index, wealth index, alcohol consumption, and media exposure. We used multivariable logistic regression models to estimate the adjusted odds ratio (OR) and 95% confidence intervals (95%CI). Results: Findings revealed that 1.3% of the population are current tobacco users, with 1.2% using SLT and 0.14% smoking. Significant determinants included age, urban residence, religion, scheduled tribe status, wealth index, education, alcohol co-use, region, and pregnancy/lactation status. Young women (young women, 3.5% > adolescents, 1.5%; OR 1.78, 95%CI 1.65, 1.92), urban dwellers (OR 1.38, 95%CI 1.32, 1.43), and alcohol users (OR 5.6, 95%CI 4.88, 6.33) exhibited higher odds of tobacco use. In contrast, education (higher education OR 0.15, 95%CI 0.13, 0.18) and higher socioeconomic status (richest OR 0.3, 95%CI 0.22, 0.31) were protective factors. Conclusion: Our research offered valuable insights into tobacco use among young Indian women. To effectively curb tobacco use in this population, it is imperative to address the identified determinants and vulnerabilities through tailored public health strategies and policies.

Policy Proposal for Integration of Tobacco Cessation Interventions into Oral Health Care in Dental Settings

Background: Due to the health consequences and economic losses associated with tobacco, the WHO Framework Convention on Tobacco Control, a worldwide effort to control the effects of tobacco smoking on human health enacted a set of policies to curb tobacco use. Smoking cessation services aim to ensure that every patient is screened for tobacco use, their tobacco use status is documented, and patients who use tobacco are advised to quit. Dental health professionals are strategically positioned to reach many tobacco users and this proposal provides a simple framework whereby dentistry could play a major role in smoking cessation efforts.
 Interventions: Strategies for incorporating Cessation Services into Oral Health Care Delivery include the School Oral Health programs through Public Health Dentistry, updating the Dental School Curriculum through dental education regarding tobacco use prevention and cessation; including Tobacco Treatment Specialists certification in Postgraduate Curriculum for Dental Public Health; Continuing Medical Education (CME) focused on cessation services for dental personnel; Clinical Smoking Cessation Interventions in Dental settings; Compensation of Dental personnel for tobacco use prevention and cessation services; and ongoing research, evaluation and monitoring.
 Conclusion: Incorporation of these evidence-based treatments into dental practice would result in more individuals achieving long-term abstinence and thus reduce tobacco-related death, disease, and economic loss worldwide.
 Author
 A Oyapero 1, O Erinoso 2, O Olatosi 3

India and the framework convention on tobacco control: the politics of rising power attitudes toward international rules

ABSTRACT This paper investigates why India actively negotiated and ratified the Framework Convention on Tobacco Control (FCTC), the first global health treaty to curb tobacco use worldwide. The World Health Organization’s (WHO) decision to conduct FCTC negotiations aligned with India’s shifting disease burden that was pivoting from infectious to non-communicable diseases, particularly cancer, which shot up due to surging tobacco use. The WHO’s decision to frame the agreement around constraining global tobacco commerce, particularly the might of multinational tobacco companies, meshed with the interests of New Delhi, which was concurrently seeking to curb surging tobacco consumption. This triggered a positive approach and attitude to FCTC negotiations, leading to India’s ratification. India’s negotiation and ratification of the FCTC shows that the literature(s) on rising powers and international organizations must consider how factors like the WHO’s institutional politics, specifically the intent to negotiate a focused global agreement to curb tobacco production and distribution worldwide, affects how countries perceive and seek to use that agreement to bolster domestic policy concerns like tobacco control.

Need for Gender Focused Policies Addressing Smokeless Tobacco Use among Women in India: A Review.

Nearly 8 million annual deaths occurring globally are attributable to tobacco use. Among more than 356 million smokeless tobacco (SLT) users in 140 countries, 82% reside in Southeast Asia with the vast majority being in India and Bangladesh. According to the Global Adult Tobacco Survey -2 data, 21.4% of adults in India consume SLT, among them 29.6% are men and 12.1% women. SLT has received less attention compared to its smoked counterparts in the public health measures to curb tobacco use. Though women are a sizable proportion of users, majority of the awareness building measures as well as governmental policies do not target them. This review aims to highlight these gaps objectively with constructive suggestions to enable a changed strategy to reduce tobacco consumption. (1) To critically review the gender sensitivity of tobacco control measures in India, (2) to conduct a comparative analysis of gender responsive strategies in India with those in smokeless tobacco high burden countries and (3) to make practical, feasible recommendations to enhance gender responsiveness of tobacco control measures in India in general and smokeless tobacco in particular. Following a comprehensive literature review to capture key information on gender responsiveness/sensitivity of strategies for tobacco control publications in English within the last 20 years, our search yielded 35 papers and reports from India describing policies relevant to SLT and women. Public health approach to tobacco control in general was found to be gender blind. It is evident that tobacco and smokeless tobacco related information and awareness activities need to focus more on women with improved messaging strategy to make it easily understandable and tailor the same to address the immediate and delayed health concerns. This much needed change would receive impetus with revisions in Governmental tobacco control policies, implementation and uptake.

Prevalence and pattern of tobacco consumption in urban community: a cross-sectional study in adults of Central India

Background: The emergence of tobacco related diseases is a burgeoning public health problem. Every year, more than 8 million people die from tobacco use worldwide. It is one of the major causes of death and disease in India and accounts for nearly 1.35 million deaths every year. India is also the second largest consumer and producer of tobacco. There is an urgent need to curb tobacco use and reduce the associated morbidities and mortalities. The present study was the first step in the process of generating strategies to control the use of tobacco by estimating the prevalence and pattern of tobacco use in an urban community.Methods: Study was conducted in the field practice area of an urban health training center of a tertiary care hospital. House to house survey was done. Houses were selected by systemic random sampling. All the people above 15 years of age were included in the study, with total subjects interviewed being 590.Results: 371 (62.88%) study subjects were males and 219 (37.19%) were females. The prevalence of tobacco consumption was found to be 34.06%, 28.81% used smokeless form of tobacco and 3.39% were smokers. About 1.86% consumed both forms of tobacco.Conclusions: Prevalence of tobacco consumption particularly of smokeless form was quite high. Identification of high-risk group and their pattern of tobacco consumption is crucial in developing innovative and effective strategies to curb the tobacco epidemic in India.

Computed Tomographic Screening for Lung Cancer

Lung cancer is the leading cause of cancer deaths worldwide. Although lung cancer screening has been advocated, for a long time level 1 evidence has been absent, leaving physicians with the challenge of treating patients with mostly incurable disease. Even in 2014, the 5-year survival for lung cancer will only be around 16% despite sophisticated imaging and diagnostic tools. Physicians are thus taking a more proactive route, including early screening for lung cancer and efforts to curb tobacco use. This review discusses lung cancer screening in the context of the National Lung Screening Trial, risk of overdiagnosis, cost-effectiveness, U.S. Preventive Services Task Force recommendations, lung cancer screening in the community, improving the specificity of lung cancer screening, and treatment options for early-stage lung cancer. Tables review key principles of computed tomographic screening, cost-effectiveness of computer tomographic screening, predictors of malignancy in the Pan-Canadian screening study model, and follow-up and management of newly detected indeterminate nodules. Figures show common causes of cancer death in the United States, estimated new cancer cases and cancer deaths in men and women, a four-stage system used in clinical and surgical evaluation of lung cancer, secondary prevention lung cancer screening goals, and a low-dose computer tomographic scan. This review contains 5 figures, 5 tables, and 31 references.

Family, lifestyles and new and old type of smoking in young adults: insights from an italian multiple-center study.

Tobacco smoke is the epidemic of modern times due to its tremendous burden of diseases and deaths, greater than that produced by alcohol, AIDS, drugs, road accidents, murders and suicides combined. In Italy, 26% of the population smokes and the high prevalence of smoking even among young people is crucial for the Tobacco Industry, because young people are the reservoir which replaces smokers who quit or die. The aim of this study is to investigate smoking habits and determinants of smoking among young adults. This cross-sectional study enrolled young people from three Italian regions: Latium (central Italy) Calabria (southern Italy) and Sicily (the largest Italian island). An anonymous, multiple-choice online questionnaire was distributed through social networks. Questions investigated individual habits and lifestyles (smoking, alcohol and coffee consumption, physical activity), the presence of smokers in the family and the use of electronic cigarettes. Descriptive and multivariate analyses were used to describe the characteristics of the sample and to evaluate factors associated with smoking status. All statistical analyses were conducted in SAS software version 9.4 (SAS Institute Inc., Cary, NC, USA). All hypothesis tests were 2-tailed and p values <0.05 were considered statistically significant. In a sample of 382 subjects between 18 and 34 years, the prevalence of smoking was 25%. A statistically significant higher percentage of smokers is observed among those who drink coffee and those who drink alcohol. Only 48% of smokers usually smoke classic cigarettes, while 45% roll their own cigarettes and 7% use electronic cigarettes. More than half of the smokers, smoke 1 to 5 cigarettes a day, while 17% smoke over 10 cigarettes a day. In families where there was at least 1 smoker, the percentage of smokers was 34% versus only 15% in families where nobody else smokes. The presence of at least 1 smoker in the family was strongly associated with young adults' smoking behavior: subjects with family members who smoke were more than three times as likely to be current smokers, compared to those with no family smokers (Odds Ratio [OR] = 3.14, 95% confidence interval [CI] 1.8-5.5, p=0.0001). Alcohol, coffee consumption, unemployment and being a student were also found to be independently and significantly associated with smoking of young adults (alcohol OR=2.96, 95%CI 1.64-5.34; coffee OR= 4.33, 95%CI 1.81-10.39; unemployment OR = 4.76, 95%CI 1.26-17.96; being a student OR = 3.21, 95%CI 1.25-8.27). Preventing young people from smoking is crucial in order to stop the Tobacco Epidemic. The Tobacco Industry is selling new products and is using new marketing tactics (i.e. the "influencers" in social media) which are hooking young people to addictive products and behaviors, thus threatening to wipe out decades of progress in curbing tobacco use. Effective action to drastically reduce new and old types of smoking or to pursue the "Tobacco Endgame" requires an increasing commitment not only towards young people, but also towards families, that play an important role in influencing young people.

Estimating the price elasticity for cigarette and chewed tobacco in Pakistan: evidence from microlevel data

While there is a large literature on the magnitude of price elasticity of cigarette demand, less is known about the same for chewed tobacco. Moreover, the studies on cigarette demand in Pakistan tend to ignore the heterogeneity in the smoking behaviour. This study estimates price elasticity for cigarette and chewed tobacco demand across different income groups, provinces and regions; and use these coefficients for simulating Pakistan's tax policy and its impact on revenue and health outcomes. Deaton model was applied on the 2015-2016 Household Integrated Income and Consumption Survey dataset to estimate price elasticities of different tobacco products. The demand for cigarettes is unitary elastic (-1.06), suggesting that a 1% increase in cigarette price would reduce its consumption by 1.06%. On the other hand, the demand for chewed tobacco is relatively inelastic (-0.55). Provincially, the own-price elasticity of cigarettes is negative and significant for all but Kyber Pakhtunkhwa (KP) province; whereas that of the chewed tobacco is negative and significant only for KP and Balochistan. Besides, the price elasticity of demand for both tobacco products is negative and significant only for lower income group and the rural region. The tax simulations favour a two-tiered tax system over the existing three-tiered system as the former will bring significantly better tax revenue and health outcomes. While confirming the effectiveness of tax policies in curbing tobacco use, this study concludes that higher tobacco taxes could increase tax revenue and improve public health in Pakistan.

Examining Student Perceptions of Tobacco Policy Enforcement on College Campuses in Texas.

Background. Colleges across the country are adopting tobacco-free policies to prevent and decrease tobacco use among college-aged young adults. Aims. This study examines differences between nontobacco, single-product, and polytobacco users' perceptions of the importance of enforcing tobacco-free policies, support for various enforcement strategies, and success of policy enforcement on campuses. Method. A Kruskal-Wallis test was conducted to examine group differences on the importance of enforcing polices, support for enforcement strategies, and success of policy enforcement among 10,351 students attending 10 Texas colleges. Results. Findings show significant group differences on all dependent variables. Post hoc tests indicated that nontobacco users reported the most favorable responses, followed by single-product users, then polytobacco users. Discussion. Despite group differences, findings show all students feel it is important to enforce tobacco policies and support enforcement strategies but believe current campus enforcement efforts are only moderately successful. Conclusions. Findings may prompt administrators to adopt policy enforcement strategies to curb tobacco use on campuses.

Evaluating the impact and equity of a tobacco-free pharmacy law on retailer density in New York City neighbourhoods

BackgroundIn 2018, New York City (NYC) implemented a tobacco-free pharmacy law as part of a comprehensive policy approach to curb tobacco use. This study models the reduction in tobacco retailer...

Prevalence, attitudes, behaviours and policy evaluation of midwakh smoking among young people in the United Arab Emirates: Cross-sectional analysis of the Global Youth Tobacco Survey.

IntroductionNon-cigarette tobacco products are an increasing public health concern globally. Little is known about midwakh, a pipe indigenous to the United Arab Emirates (UAE). This study aimed to assess the prevalence, attitudes, behaviours and policy evaluation of midwakh smoking among 13 to 15 year olds in the UAE.MethodsWe conducted secondary analyses of the 2013 UAE Global Youth Tobacco Survey. The main three outcomes were ever use, current use (past-30 days), and the number of midwakhs smoked per day. We assessed cessation, attitude, and policy measures. Regression models identified the association between each outcome measure and sex, school grade, nationality, weekly spending money, cigarette use, and parent and peer tobacco use.ResultsThe prevalence of ever and current midwakh use were 18.5% and 9.0%, respectively. Daily midwakh users smoked a median of 8.0 per day while non-daily users smoked 3.8 per month. Higher midwakh prevalence was reported among wealthier males, older age groups, concurrent cigarette users and among participants having peers or parents who use tobacco. There was also variation by nationality. Reduced harm perception was greater among midwakh users than non-users. About 39.6% reported being declined a midwakh purchase due to age, and 35.5% reported noticing health warnings on packages.ConclusionsMidwakh use is prevalent among 13 to 15 year olds in the UAE, and burden lies mainly with daily users. Further needed research should not delay implementation and evaluation of policies known to curb tobacco use among youth, including taxation, media campaigns, and provision of cessation services.

Country-specific costs of implementing the WHO FCTC tobacco control policies and potential financing sources.

BackgroundOne of the major obstacles to the full implementation of the World Health Organization (WHO) Framework Convention of Tobacco Control (FCTC) tobacco control measures is the lack of sustainable financing resources.GoalTo update and simulate country-specific indicators that are highly relevant to the costs and financial resources of the treaty policy implementation. We also developed an Excel tool for simulation and assessed the aggregated-level indicators by the 2016 World Bank income groups.ApproachesUsing mostly 2016 data or 2014–15 data if 2016 one are not available, we updated five indicators relevant to the treaty implementation, which are the gap between current and desirable policy implementation, cigarette affordability, the costs of implementing best- buy tobacco control policies, the number of smoking-attributable deaths, and the simulated tax revenue resulting from a $1 tax increase. We also aggregated indicators and simulation results by the World Bank income groups, encompassing the five indicators and the reduction in smoking and in attributable deaths due to a hypothetical 1I$ tax increase. Finally, the policy implementation cost was compared with tax revenue and revenue increases.FindingsAs of 2016, smoking remains one of the leading causes of premature deaths worldwide while the implementation of best-buy tobacco control policies was below the recommended levels. Meanwhile, there was room to further increase cigarette taxes and prices, as cigarettes remained affordable in many countries. The total costs of implementing best-buy policies in the next 15 years merely account for 8.3% of the 2016 excise tax revenue, indicating that a small proportion of annual tax revenue could fund the implementation of tobacco control policies recommended by the WHO FCTC.ConclusionsIncreasing taxes could have a multiplier impact on curbing tobacco use through aiding the implementation of the WHO FCTC.

Current strategies are inadequate to curb the rise of tobacco use in Africa.

Recently, there have been significant advances in the battle against tobacco use in Africa, with achievements including ratification of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) and the passing of tobacco control legislation in several countries. Many African countries have achieved measured success, while Uganda, South Africa and Mauritius have accomplished significantly more in their efforts to curb tobacco use. Nevertheless, few African countries meet the standards of the individual WHO FCTC articles with regard to comprehensive implementation. Africa has lower rates of tobacco taxation, weaker smoke-free policies and fewer restrictions on tobacco advertising compared with other world regions. These shortcomings have enabled the tobacco industry to expand its markets on the continent by capitalising on economic growth, changing social norms and population demographics. Consequently, tobacco use is increasing in Africa, with smoking prevalence having risen 57% between 1990 and 2009 compared with western Europe, where it decreased substantially during the same period. Rapid smoking uptake in Africa has led to tobacco-related conditions emerging as increasingly important public health problems. African nations are unlikely to meet the 2025 goal of a 30% relative reduction in tobacco use, as advocated by the World Health Assembly in 2013 and identified as the 'most urgent and immediate priority' intervention to reduce non-communicable diseases (NCDs). While there has been some progress, the current commitment of most African countries to the WHO FCTC has not translated into effective delivery of tobacco control policies and programmes. Strong tobacco control policies, which are among the most effective population-based strategies for NCD prevention, are needed. These include introducing higher tobacco excise taxes, stronger smoke-free policies, graphic warnings on cigarette packages, bans on tobacco advertising, promotion and sponsorship, and anti-smoking mass media campaigns. Furthermore, tobacco industry interference needs to be actively addressed by monitoring its activities and exposing misconducts, thereby changing attitudes to the industry. Technical support, capacity building and adequate financing are needed in Africa to enable countries to competently manage legal challenges to tobacco control and deal with the subversive tactics of the industry. Civil society and the media - major players in holding governments accountable for responsible stewardship - need to educate and pressurise African politicians and governments to implement and enforce effective tobacco control policies. Otherwise, if unchecked, the widespread uptake of tobacco use will be a threat not only to health but also to sustainable human development in Africa.

Chen Wang: new President of CAMS and PUMC

Professor Chen Wang, Director of the Centre for Respiratory Medicine at Beijing's China–Japan Friendship Hospital, is the new President of the Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC). Of the several reasons for welcoming the appointment, the most obvious is Wang's expertise in the respiratory diseases that are a leading cause of morbidity and mortality in his country and impose a great socioeconomic burden. Moreover, he makes no secret of his enthusiasm for curbing tobacco use, which, while now recognised by the Chinese Government as a key public health issue, remains high.