Sunday, 26 June 2011

Tobacco control aims to lead global fight against non-communicable diseases, claims evidence base of success

The World Lung Foundation, an advocacy group that endorses tobacco control, looks forward to the forthcoming global summit on non-communicative diseases (article from the European Society for Medical Oncology, or ESMO). This summit aims to consolidate further the aims of tobacco control, taking the rest of the agenda on tackling non-communicative diseases in its wake. An agenda proposed by the NCD Alliance in the Lancet proposes the following 'priority interventions', which are 'tobacco control, salt reduction, improved diets and physical activity, reduction in hazardous alcohol intake, and essential drugs and technologies' and a goal of a smoke-free world by 2040.

Is it not rather startling to find interventions in lifestyle factors at the heart of every one of these first five priorities except the one on drug development?

Discussing the events of a UN meeting earlier this week, Stephen Hamill of the World Lung Foundation says:
With so many issues on the table, there was a call to identify and prioritize cost-effective interventions with an evidence base of success. Tobacco control meets this criteria. Implementing the Framework Convention on Tobacco Control (FCTC), the world's only public health treaty, would save hundreds of millions of lives at very little cost. We heard numerous civil society groups testify that to combat NCDs, the UN Summit must accelerate implementation of the FCTC. As advocates, however, we should take nothing for granted, and we have hard work ahead to ensure that this remains an outcome of the Summit. [emphasis added]
What evidence base of success would that be? Smoking cessation rates are nothing to boast of. Evidence to support the tobacco display ban was 'inconclusive' (Christine Graham at col 19996). Arguments continue about the evidence that plain packaging will make any difference. A big fairy tale about a drop in heart attack admissions was used to boost the popularity of the smoking ban in Scotland, and elsewhere. Yet we are told that tobacco control has an evidence base of success. That looks like material for FOI if ever I saw it, but no doubt the World Lung Foundation is under no obligation to reveal anything.

On the basis of this 'success', civil society groups (whatever they are) now want more tobacco control on the agenda, including more steps taken to implement the FCTC.

Who knows what will come out of the forthcoming summit on non-communicable diseases next September, but it would appear that one result will be more commitments made by countries under pressure from international organisations that will bedevil democratic accountability to their electorates. This will effect laws on food content and alcohol regulation as well as tobacco. Policing global public health, with other environmental and genetic factors in ill health pushed down the priority list, promises to be a huge diversion of resources from vital health issues.

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