SEA-Tobacco-9 Distribution: General
Regional Strategy for Utilization of Global Youth Tobacco Survey Data
WHO Project: ICP TOB 002 XK 04 1
World Health Organization Regional Office for South-East Asia New Delhi April 2005
© World Health Organization (2005) This document is not a formal publication of the World Health Organization (WHO), and all rights are reserved by the Organization. The document may, however, be freely reviewed, abstracted, reproduced or translated, in part or in whole, but not for sale or for use in conjunction with commercial purposes. The views expressed in documents by named authors are solely the responsibility of those authors.
CONTENTS Page 1. BACKGROUND ..............................................................................................1 2. GENERAL OBJECTIVES ....................................................................................2 3. SPECIFIC OBJECTIVES .....................................................................................2 4. TARGETS ........................................................................................................3 5. STRATEGIES....................................................................................................4 5.1 5.2 5.3 5.4 5.5 5.6 5.7 5.8 5.9 Support to Formulation of National Tobacco Control Policy and Plan of Action and Enforcement of National Legislation ......................4 Increasing the Knowledge on Hazards of Tobacco among Schoolchildren.............................................................................5 Protection from Second-hand Smoke .......................................................5 Ban on Advertisement of Tobacco Products..............................................6 Limiting Access to Tobacco Products ........................................................6 Tax Policies ............................................................................................8 Cessation of Tobacco Use........................................................................8 Surveillance and Monitoring of Youth Tobacco Control Activities ...............8 Identification and Mobilization of Financial Resources ..............................8
5.10 Promoting Partnerships for Tobacco Control.............................................9
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1.
BACKGROUND Recent trends indicate that utilization of research data is not a simple linear process but is a very dynamic and interactive process between stakeholders and researchers. Three groups of users/stakeholders are distinguishable in the literature, each with a different position in the research and innovation process: policy-makers, professional users and end-users; that is, the public at large or specific target groups. In any kind of research/study including Global Youth Tobacco Survey (GYTS), various stages could be identified as problem identification or identification of the research question, design, implementation of research, analysis of findings, and interpretation of findings and utilization of findings. It is vital that potential users/stakeholders and researchers get fully involved from the very beginning of the research process such as in problem identification or identification of the research question. They also need to cooperate in the study design although the researchers are more involved than the potential users in the actual implementation of research and analysis of findings whereas both should be involved to the same degree in the interpretation of findings. The potential users are the ones who should utilize the research findings to the greatest extent. In the area of tobacco control, governments as a whole, are the most important and vital users of research data. Unfortunately, despite GYTS data being available, the same is not being utilized in a coordinated manner for national tobacco control programmes due to poor coordination between researchers and governments, inadequate knowledge of policy makers about the data and due to the absence of policy for proper utilization. Research findings should be incorporated into existing programmes to improve the programmes or to form a baseline for the programmes.
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Regional Strategy for Utilization of Global Youth Tobacco Survey Data
The strategy for utilization of GYTS data by the Member States in their policy formulation and implementation, should be incorporated into the WHO South-East Asia Regional Plan of Action for Tobacco Control so that comprehensive tobacco control objectives are well achieved in the Region. This document provides an indicator of WHO Regional Office for South-East Asia’s possible support, technical and financial, to Member States.
2.
GENERAL OBJECTIVES To provide a Regional Strategy for Member Countries of WHO’s South-East Asia Region for implementing tobacco control measures to reduce initiation of tobacco use among the youth, to protect the youth from second hand smoke and to protect present and future generations from the devastating health, social, environmental and economic consequences of tobacco consumption and exposure to tobacco smoke through utilization of GYTS data.
3.
SPECIFIC OBJECTIVES The South-East Asia Regional Strategy for utilization of GYTS data aims to provide guidance, coordination and support to Member Countries to: (1) Formulate, promote and implement their national tobacco control policy and plan of action which incorporates GYTS and utilization of GYTS data as its component; (2) Enhance awareness on the dangers of tobacco use among the youth by enhancing education, training, communication and advocacy through wider media coverage; (3) Support training of health care personnel in tobacco control; (4) Incorporate hazards of tobacco in the basic school curriculum so as to prevent initiation and to promote cessation of tobacco use; (5) Promote awareness on the dangers of exposure to second-hand smoke and to protect the youth from exposure to second-hand smoke by taking measures to ban smoking within educational facilities, in public places and in public transport;
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(6) Ban all forms sponsorship;
of
tobacco
advertisement,
promotion
and
(7) Implement counter-marketing measures against the tobacco industry to prevent the youth from falling prey to the lure of the industry; (8) Prohibit access of minors to all forms of tobacco products; (9) Protect the youth from being used for labour in the cultivation, production and sale of all forms of tobacco products; (10) Establish appropriate tax and price measures which aim at prevention of initiation of tobacco use by the youth; (11) Implement measures to promote cessation of tobacco use for the youth who have already fallen prey to the habit, and (12) Develop, enact, promulgate, implement and enforce comprehensive national tobacco control legislations, as appropriate, in all Member States in line with the WHO Framework Convention on Tobacco Control (FCTC).
4.
TARGETS The targets of the Regional Strategy would be to support Member Stares to: (1) Have comprehensive, sustainable and accountable national policies and strategies for utilization of GYTS data for tobacco control in all Member States; (2) Ban sale to and by minors of tobacco products in all Member States within a timeframe to be determined by WHO/SEARO after consultation with Member States; (3) Have national tobacco control legislation in all countries of the Region within a timeframe to be determined by WHO/SEARO after consultation with Member States based on the provisions of WHO FCTC. The legislation will include measures to protect the youth from the lure of the tobacco industry;
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(4) Have all health and education facilities, workplaces, public places and public transport in all Member States declared tobacco-free within a timeframe to be determined by WHO/SEARO after consultation with Member States, and (5) Establish on-line database for tobacco surveillance and to establish Tobacco Free Initiative (TFI) websites in all Member States within a timeframe to be determined by WHO/SEARO after consultation with Member States linked to Regional Online Database System.
5. 5.1
STRATEGIES Support to Formulation of National Tobacco Control Policy and Plan of Action and Enforcement of National Legislation The Regional office should provide technical assistance to Member States for the development of their national tobacco control policy and plan of action. All countries should have a clearly stated, comprehensive, accountable and sustainable National Tobacco Control Policy and Plan of Action. Existing plans and policies should be reviewed and amended, as appropriate, to reflect the provisions of FCTC. Implementation of GYTS and utilization of GYTS data should be incorporated in the regional and national plans of action for tobacco control including the following: (1) Advocacy campaigns for policy makers and responsible personnel in the Ministry of Education and Ministry of Health on the situation of tobacco use, exposure to second-hand smoke and advertisement among the youth and the aims and objectives of conducting GYTS in the country; (2) Co-ordination within related ministries for planning the GYTS, including problem identification, development of the questionnaire and getting information for school enrollment; (3) Co-ordination with related ministries and authorities for conducting the GYTS;
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(4) Co-ordination with personnel in related ministries for the preparation of the report; (5) Dissemination of GYTS data through press releases, dissemination workshops, advocacy workshops, publications, formal distribution to departments etc. and through the TFI website, and (6) National policy for utilization of GYTS data for national tobacco control programmes.
5.2
Increasing the Knowledge on Hazards of Tobacco among Schoolchildren GYTS data should be used to emphasize the need to increase the knowledge on hazards of tobacco among schoolchildren. The Regional Office should provide technical assistance to Member States by: (1) Providing guidelines for development of training curricula on hazards of tobacco to be incorporated in the curricula of all basic education schools including medical, nurses, paramedical schools and teachers’ training institutions; (2) Providing technical assistance to countries to conduct advocacy/training workshops for media personnel on the hazards of tobacco, and (3) Providing technical assistance for counter-marketing activities as a proactive measure against the lure of the tobacco industry with active involvement of the youth.
5.3
Protection from Second-hand Smoke GYTS data showed that a very high percentage of students were exposed to second-hand smoke at home and in public places. WHO could help countries to use this information for the development of plans which should include: (1) Promoting public awareness about the dangers of second-hand smoke; (2) Introducing or strengthening legislation to make all public places smoke-free, including public transport and workplaces; Page 5
Regional Strategy for Utilization of Global Youth Tobacco Survey Data
(3) Ban both indoor and outdoor smoking in the premises of all educational institutions; libraries, nurseries, day-care centres etc., and (4) Ban smoking in the premises of all health institutions.
5.4
Ban on Advertisement of Tobacco Products GYTS reports showed that a high percentage of schoolchildren were exposed to tobacco advertisements; a considerable percentage had been something with a tobacco product brand on it and many had seen tobacco promotion and sponsorships through various forms of sports and social entertainment. The WHO Regional Office could help countries to develop strategic plans for prohibition of tobacco advertisement, promotion and sponsorship that should include: (1) Ban on all forms of direct and indirect advertising of tobacco products, in all media (including electronic media, print media, folk media, the internet etc.); (2) Ban on promotion, brand stretching and sponsorship of sports and social events including international events, activities and/or participation therein; (3) Ban on cross-border advertising, promotion and sponsorship originating from its territory, subject to the legal environment and the technical means available to the Member Country. Member Countries should cooperate in the development of technologies and other means necessary to facilitate the cessation of cross-border advertising; (4) Discontinuation of direct or indirect incentives that encourage the purchase of tobacco products.
5.5
Limiting Access to Tobacco Products GYTS data could be used to advocate with decision makers and to inform the public on the easy availability of cigarettes and other tobacco products by schoolchildren. This should highlight the urgent need to limit access to tobacco products by minors. The Regional Office could provide technical
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assistance and guidance to Member Countries to adopt and implement effective legislative, executive, administrative and other measures to prohibit the sale of tobacco products to and by persons under the age set by national law or eighteen years. Youth access laws are most effective comprehensively. These measures should include: when administered
(1) Requiring that all sellers of tobacco products place a clear and prominent indicator inside their point of sale regarding prohibition of sales to minors; (2) Requiring that all sellers of tobacco products, in case of doubt, request young purchasers to provide appropriate evidence of having reached the age of majority as determined by domestic law; (3) Ban on the sale of tobacco products in any manner by which they are directly accessible, such as store shelves, vending machines, selfservice displays, mail order and electronic sales; (4) Ban on distribution of free samples of tobacco products to the public and especially minors; (5) Ban on the sale of cigarettes and other smoking tobacco products stick wise, piece wise, or in small packets which increase the affordability of such products to minors and to the low-income group; (6) Ban on manufacture and sale of snacks, toys, toothpaste, toothpowder or any other objects in the form of tobacco products which appeal to minors; imposing penalties (such as graduated fines) against sellers and distributors, in order to ensure compliance with the regulations; (7) All Member Countries shall adopt and implement effective measures to prohibit the sale of tobacco products by persons under the age set by national law or eighteen years. They should also identify measures that prohibit child labour in the cultivation, manufacturing and sale of tobacco products.
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5.6
Tax Policies GYTS data also revealed that cigarettes and other tobacco products are easily affordable by schoolchildren. Appropriate tax policies should be formulated to bring about an increase in the real price of tobacco products that is greater than the effect of inflation in order to prevent initiation as youth are sensitive to price hikes. Measures to bring all tobacco products under the tax and price net should be sought for, in order to avoid substitution of one tobacco product by another. Member States should be encouraged and assisted to earmark a certain portion of the tobacco revenue for implementation of national tobacco control activities.
5.7
Cessation of Tobacco Use GYTS reports showed that a very high percentage of students who were current smokers wanted to quit; they also revealed that these students were not receiving adequate support or guidance they needed to quit tobacco. The Regional Office should provide appropriate guidelines for comprehensive and integrated programmes on cessation, based on scientific evidence and best practices. Effective programmes should be designed and implemented in different settings such as educational and health institutions, health care facilities and sporting environments, community settings etc. to provide support for cessation.
5.8
Surveillance and Monitoring of Youth Tobacco Control Activities The on-line data base on tobacco at WHO/SEARO should be updated regularly with GYTS data from countries. SEARO should regularly monitor youth tobacco use, their knowledge and attitude and their exposure to second-hand smoke. SEARO should assist countries to implement GYTS along with sentinel prevalence surveys periodically. SEARO should also provide technical assistance to countries to develop TFI websites including information from GYTS.
5.9
Identification and Mobilization of Financial Resources Financial resources are crucial to achieve the objectives of the Regional Strategy for Utilization of GYTS data. Each Member State should provide
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financial support in respect of its national activities and promote, as appropriate, the utilization of bilateral, regional, sub-regional and other multilateral channels to provide funding for the implementation and strengthening of comprehensive multisectoral tobacco control programmes including utilization of GYTS data. WHO should assist Member States in identifying sources of funding and mobilizing financial resources to implement and sustain national tobacco control programmes; e.g. funds from the European Union and the World Bank. The World Health Organization is well positioned to play a role in providing institutional funding and channeling funding from public and private sources to tobacco control activities. WHO should mobilize extra-budgetary funds to support and further strengthen programmes related to tobacco control. WHO encourages Member States to cooperate with international and regional intergovernmental organizations and with financial and development organizations of which they are members. WHO should strengthen its collaboration with CDC, Atlanta for sustaining the GYTS process in the interest of comprehensive tobacco control programmes at the country level. Given the high level commitment to the tobacco control agenda by governments and given the entry into force of the WHO FCTC, it is time for countries to allocate national resources for tobacco control activities. Earmarking tax from tobacco revenues should also be used for tobacco control activities/ programmes. Government support for tobacco control activities should also be provided as part of the public health infrastructure by directly creating and promoting tobacco control programmes or by offering assistance to health delivery and research institutions.
5.10
Promoting Partnerships for Tobacco Control WHO should provide technical support to promote cooperation among countries to strengthen current capacity building initiatives to encompass both government and nongovernmental sectors for multisectoral involvement in tobacco control. WHO should strengthen collaboration among the health, finance, trade, law, home and other related departments and international relations sectors at the regional and country levels in order to improve Page 9
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technical capabilities relating to non-health aspects of the FCTC, included in WTO regulations. The GYTS data could be used to bring the problem of tobacco into the broad purview of relevant noncommunicable disease control programmes, health promotion programme, tuberculosis control programme and other programmes for poverty reduction and environmental protection. As tobacco production and consumption exacerbate poverty and undermine sustainable development, tobacco control should also be a key component of national development assistance programmes. WHO should identify measures to enhance regional and country level co-cooperation and coordination with UN and other international organizations under the UN Adhoc task-force mechanism. Partnerships should be enhanced with regional and national NGOs; WHO collaborating centres; the US Centers for Disease Control and Prevention (CDC), with research and academic institutions to build capacity and to channel resources and expertise for tobacco control at the country level.
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