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Advocating Policies for Waterpipe & Cigarettes
Cynthia CallardOctober 2013
Adult per capita cigarette consumption, the United States, 1900–2006.
Warner K E , Mendez D Nicotine Tob Res 2010;12:876-887
Since 1962: A steady decline!!
USA annual adult per capita cigarette
consumption
1960
1962
1964
1966
1968
1970
1972
1974
1976
1978
1980
1982
1984
1986
1988
1990
1992
1994
1996
1998
2000
2002
2004
2006
2008
2010
-
200
400
600
800
1,000
1,200
1,400
1,600
1,800
After 50 years, we’re back where started
Sources: Averaged values, Maxwell, Euromonitor, USDA: population over 15 years from World Bank.
Global annual adult (15+) per capita cigarette consumption
1960 = 1,129
1987 = 1,537 2010 =
1,141
A shifting epidemic
*new communities*new patterns of use
So many similarities
Health Rationale Political systems Legal structures
(FCTC and related regulation) Societies Public health community Tobacco users
Same vector?
Same proven tools available Warnings Youth Access Tax/Prices Advertising bans Smoke-free spaces
Flavour bans Mass media Public education Clinical practice
Yet so many aren’t used *
Warnings Youth Access Tax/Prices Advertising bans Smoke-free spaces
Flavour bans Mass media Public education Clinical practice
*(Canada)
Different outcomesCigarette use & exposure go down
2002
2003
2
2004
2005
2006
2007
2008
2009
2010
2011
2012
0
5
10
15
20
2521 21 20 19 19 19 18 18 17 17 1616
1412
9 97 6 5 4 4 3
Smoking prevalence Children exposed at homeEver used waterpipe
CTUMS
Different outcomesWaterpipe trials increase
2002
2003
2
2004
2005
2006
2007
2008
2009
2010
2011
2012
0
5
10
15
20
2521 21 20 19 19 19 18 18 17 17 1616
1412
9 97 6 5 4 4 34
8
12
Smoking prevalence Children exposed at homeEver used waterpipe
Fla-vour ban
CTUMS
Victory or Defeat?
? ?
Brazil: RESOLUTION - RDC Nº 14, OF MARCH 15, 2012
Additive ban covers all tobacco products. “Art. 2 This Resolution
applies to all tobacco products sold in Brazil, whether made in Brazil or imported.”
BUT Currently challenged at Supreme Court.
http://www.tobaccocontrollaws.org/files/live/Brazil/Brazil%20-%20RDC%20No.%2014_2012.pdf
European Union Tobacco Directiveoriginal Considering the
Directive's focus on young people, tobacco products other than cigarettes, roll-your-own tobacco and smokeless tobacco which are mainly consumed by older consumers, should be granted an exemption from …
http://www.tobaccocontrollaws.org/files/live/Brazil/Brazil%20-%20RDC%20No.%2014_2012.pdf
European Union Tobacco Directiveas amended by EP. Considering the
Directive's focus on young people, tobacco products other than cigarettes, roll-your-own tobacco and water-pipe tobacco which are mainly consumed by older consumers, should be granted an exemption from …
http://www.europarl.europa.eu/sides/getDoc.do?type=TA&reference=P7-TA-2013-0398&language=EN&ring=A7-2013-0276
LOBBYIN
G
Same
UNITY
Widespread TC consensus: Science Policy Strategy
Broad-based TC community Pan-partisan Multi-sectoral International
Same
ORGANIZING PRINCIPLESWhat do we want?Who can give it to us?What do they need to hear?Who do they need to hear it from?
How can we get them to hear it?
Same
MODUS OPERANDI
#1:
Get on the Agenda
#2:
Get Favourable Decisions
#3:
Protect gains/ address vulnerabilities
(repeat as necessary)
SameVulnerabiliti
es
#1same, same
Publish or
Perish
Multisectoral• Finance• Health• Education
Multi-jurisdictional
• International, National, subnational
• Corporate, CSO & home
same, same
NeedMultiplePoints
ofContact
Canadian MPs:• Live in the moment• Are competitive and
tribal• Don’t want to be
disliked• Barter policies • Think locally• Are not overly numerate
“Which side are you on?”
same, same
Need to under-stand the
decision maker
It’s not a part-time job.
same, same
Need for
sustained
resources
There is a reason we are an unbranded movement.
same, same
Need to take risks
The capacity of decision makers to:Deflect responsibilityDeny the problemDiscredit the evidenceDelay action
Same Same
Barriers
Tobacco control is understood to mean “cigarette control”
Prevents instant adoption of Economic rationale, health rationale, cultural acceptance, priority over other health concerns.
Somewhat different
Barriers
(perception is reality)
Money is the root of all smoking!
Suppliers are driven to adapt or overcome regulatory and other barriers.
Same same
Mutable
Problem
What do we want NOW?
What will we want NEXT?
same, same
Challenge
to find the
right “ask”
“Tobacco Control is a changing game.”
Scott Sherman, October 21, 2013
“We face the challenge of … unimpeded
emergence of new products.”
Cheryl Healton October 21, 2013
“If we can’t do it, no one can.”
Omniyat Al Hajeri October 21, 2013