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Youth Smoking

Trajectories of E-Cigarette and Conventional Cigarette Use Among Youth

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Teens, are you listening?Big Tobacco admits smoking is “highly addictive.”

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Singapore: Accidental tobacco sales to minors keep health officials on constant vigil

The Health Sciences Authority (HSA) has been actively dealing with the problem of tobacco being sold to underage buyers as it is seen as an increasing problem.

http://www.ibtimes.sg/singapore-accidental-tobacco-sales-minors-keep-health-officials-constant-vigil-public-health-18251

Cashiers at the respective shops were either new or judge the buyer based on their appearance, which has sometimes led to the shop’s tobacco license to be suspended.

HSA has been on their constant rounds to make sure this does not occur, by sending officials dressed in plain clothes.

They closely observe the situation which is going on inside the said shop, and if they find that the shop has sold it to someone who is underage, the shop’s license gets suspended or revoked.

A spokesperson for HSA told Channel NewsAsia that the penalty for selling tobacco products to under-aged buyers is a maximum fine of S$5,000, and S$10,000 for subsequent offenses. In addition, the tobacco retail licensee will also be suspended for the first offense and revoked for subsequent offenses, she said.

“If tobacco were sold to under-aged persons in school uniform or those below 12 years of age, the tobacco retail license will be revoked, even at the first offense,” the spokesperson added

A few months ago, Sally Ng, a minimart owner received a frantic call from her employee saying that a member of her staff had sold cigarettes to a student in uniform and that officers from the HSA saw it and revoked the shop’s tobacco licence.

In his defence, the employee who committed the offence said he did not see that the boy was in uniform, as he was holding his bag in front of him.

Sally Ng said the owner, though constantly reminded her employees to check the identity cards of customers who choose to buy tobacco products, failed to prevent the sale to minors.

In a major opeation Channel NewsAsia went to six of the shops to see what the underlying problem could possibly be regarding their offences, which revealed that the cashiers were new, foreign or judged the buyer based on their appearance instead of asking them for their identity cards.

Investors Demand Action from Hollywood on Smoking in Youth-Rated Films

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Getting to root of teen smoking

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Chain-smoking children: Indonesia’s ongoing tobacco epidemic

SOUTH SUMATRA, Indonesia — Surrounded by farmland and plantations in the small village of Teluk Kemang Sungai Lilin in South Sumatra, a boy, just 8 years old, sits smiling with his mother.

But this boy has a tumultuous past and a reputation that precedes him, having undergone a recovery most children will never face.

Six years ago, Aldi Suganda, also known as Aldi Rizal, was a 2-year-old chain smoker addicted to cigarettes, smoking packs each day. “It was hard for me to stop,” he said. “If I am not smoking, my mouth taste is sour and my head feel dizzy.

“I am happy now. I feel more enthusiastic, and my body is feeling fresh,” he said.

He became a global sensation as the “chain-smoking toddler,” with video clips of him puffing excessively on an endless cigarette supply watched by millions around the world.

His mother, Diana, thinks back to that period and recoils at the memory. Her son would get angry, she remembers, and throw tantrums if she withheld cigarettes from him or failed to give him money to obtain them. “He (would) start to smash his head to the wall. He was crazy, hurting himself if he didn’t get a cigarette,” she said.

People would accuse her of being a bad mother and regularly question her parenting skills, she said. “I am a weak mom. He always threaten me if I didn’t give him money. … I (was) afraid he (was) going to die.”

Aldi is the youngest of three boys born to Diana and her husband, who requested not to be named. But he is far from the only child who picked up the habit across the islands of Indonesia: More than 267,000 children there are estimated to use tobacco products every day.

A childhood habit

Diana believes Aldi’s addiction began with peer pressure and exposure to smokers. He accompanied her each morning to the market where she sells vegetables grown on their land. People there could have taught him to smoke, and he could easily get cigarettes by asking at the market, she said.

In many regions of the world, this might seem unrealistic and like an excuse, but in Indonesia, it’s highly likely. The country has the highest percentage of male smokers globally and among the highest rate of adolescent and child smokers in the world — fueled by lack of control over advertising, relaxed sales and low prices.

Today, Aldi is a healthy young boy who attends school and gets good grades, but to get here, it took years of rehabilitation with the country’s leading child psychologist, Dr. Seto Mulyadi, chairman of the nation’s National Commission for Child Protection. His road also didn’t end with his tobacco cravings. Soon after his recovery, he replaced tobacco with food and began to overeat as a means of compensation, eventually becoming obese.

But a second bout of rehabilitation to tackle this overeating created the healthy, stable young boy sitting beside his mother today.

Mulyadi believes the one benefit of working with children who have an addiction is their mental agility. In Aldi’s case, his age and intelligence meant he responded quickly to his treatment, in which Mulyadi distracted the 8-year-old with running, climbing and playing while slowly reducing the number of cigarettes he smoked each day. But treatment was intense and required Aldi to go to Jakarta for a few months to be with Mulyadi every day.

“He was just 3 years old, and he smoked four packs a day,” Mulyadi said. “(But) I was confident because he is still very young. Psychologically, as a child, he is very flexible and easier to be cured.”

And cured he is — at least for now.

“I don’t want to smoke anymore. I don’t want to get sick,” said Aldi, who now wants to help prevent other children going through a similar ordeal. “Please don’t smoke. Don’t even try it. It’s hard to quit.”

In 2013, more than 57% of men were reported to be smokers in Indonesia and more than 42% of teens ages 13 to 15, according to the Tobacco Atlas, compared with 17% and 8.2%, respectively, in the United States. It’s estimated that more than 217,000 people die from diseases linked to tobacco use each year in Indonesia, including heart disease and respiratory conditions such as emphysema and lung cancer.

With smoking so commonplace and numbers remaining steady or even rising among some groups in recent years, Aldi’s message could go unheard, believes Dr. Lily Sulistyowati, director of prevention and control of noncommunicable diseases at Indonesia’s Ministry of Health.

“I’m very worried about smoking in Indonesia,” she said, especially among teens ages 15 to 19.

No sign of decline

While rates in most countries fell between 2013 and 2016, the rate of smokers under 18 in Indonesia rose from 7.2% to 8.8%.

But more worryingly, among 10- to 14-year-olds, more than 3% were smokers in both 2013 and 2016 — the majority of them boys — and more than 18% of boys and more than 9% of girls 10 to 14 had tried a cigarette, according to Indonesia Basic Health Research data reported in 2013.

The research also found that 1.5% of boys and 1.4% of girls 5 to 9 years old had tried a cigarette.

Sulistyowati believes the problem is worse in rural areas and among poorer populations. “Poor people are spending their money on cigarettes,” she said.

In 2013, the richest fifth of the population used 7.1% of their monthly expenditures on tobacco and betel leaf to wrap tobacco, while the poorest fifth spent 12.5%, according to Indonesia’s Central Bureau of Statistics. The poorest fifth spent similar proportions of their wages on grains and tobacco — 15.5% and 12.5%, respectively — and spent six times more on tobacco than on dairy and egg products.

Rural regions also tend to be populated with people with lower incomes. There, parents’ priorities are working and earning money for their families, which can leave children vulnerable to influences such as smoking while parents are distracted. “(These areas) are a different situation. Parents focus on how to work and get money, not on the health of their children,” Sulistyowati said.

In addition, children begin working young to earn money that they can then spend on cigarettes, said Dr. Aman Pulungan, president of the Indonesian Pediatric Society, who has been monitoring and working on the issue of childhood smoking for decades. “It’s country life,” he said.

Smoking among children and teens is still a problem in the cities, highlights Silistyowati, but there, people know that the habit is bad for their health and children instead hide their addiction from their parents, she said. “They try it with friends,” she said.

This was the case for Icha, 16, in the capital, Jakarta, who began smoking when she was 13 after a friend offered a cigarette to smoke together. “The first time, I felt dizzy and coughed a lot,” she said. “But later on I (felt) the taste is good.”

Icha now smokes at least one pack of 12 cigarettes each day and says half of her classmates also smoke, some in front of their parents. Her own parents tried to ban her from smoking but after little success now just ask that she try to reduce her habit.

“There is no parental control,” Pulungan said.”They just do it, because no one says no.”

Pulungan added that many parents don’t fully understand the risks associated with smoking and that its prevalence among adults helps that ignorance persist, particularly in rural areas.

Part of the problem, Sulistyowati and other experts say, is the ease of access and pervasiveness of smoking in Indonesian culture.

Marketing and image invasion

“The problem is big,” Pulungan said, adding that smoking has been an issue in Indonesia for more than 40 years. “But it’s getting worse.”

He believes that in addition to peer influence, the root causes of the epidemic include advertising, lack of laws — or enforcement — in public spaces, sponsorship of venues by big tobacco companies and the way cigarettes are sold.

Nonsmoking sections in restaurants are very small, he said. In addition, tobacco companies are still sponsoring sporting and musical events as well as public buildings or clubs. This sponsorship has come down in recent years, he said, but he now believes that hidden advertising is growing — through TV and culture. “(Kids) think if you want to become a man, you have to smoke,” he said.

The issues of advertising and masculinity linked to smoking faced many other countries just a decade or two ago, but while rates across the West declined, companies and efforts to boost tobacco interest transferred to countries where bans and laws did not prohibit their existence, such as Indonesia, Pulungan believes.

In rural areas, “the small shops, grocery shops, are sponsored by cigarette companies, and they can put adverts anywhere,” he said. “No one controls this.” He also mentions sports clubs that have tobacco companies as part of their names.

“Advertising is of more interest to the youth,” Sulistyowati said, adding that companies entice adolescents by associating cigarettes with success and fame. “Schools can get sponsorship” from big companies, she said.

Again, while many countries have had bans against this for some time, Indonesia has no national laws in place — though some municipalities have introduced them, she said, including Western Sumatra.

Of the big six global tobacco companies, Phillip Morris International dominates the market in Indonesia, according to 2013 data from the Tobacco Atlas. The company did not respond to a request for comment.

The Ministry of Health is now working with the Ministries of Education and Communication to help prohibit sponsorship and advertising, as well as the Ministry of Transport to implement and enforce existing smoking bans on public transport.

Almost half of the country’s municipalities have regulations in place for smoke-free areas, said Sulistyowati, and universities have committed to having smoke-free campuses through the Ministry of Education. Graphic health warnings were also introduced on cigarette packets in 2014 to put people off the habit.

But “it all depends on the commitment of the local head, or mayor, of a district,” Sulistyowati said. “Indonesia is a big country,” at more than 1.9 million square kilometers (more than 740,000 square miles).

Easy access and affordability

The final hurdle is the cost and ease with which people can buy cigarettes: They can be bought individually — which makes them more affordable to people with lower incomes — and a pack of 12 can cost as little as $1 at most vendors and kiosks, said Sulitsyowati.

All 34 provinces have had regulations in place since 2012 to prohibit the sale of individual cigarettes, but enforcement has not been that effective.

“They buy one cigarette, not a pack usually … and everywhere you go, you can buy one cigarette, so it’s easy,” Pulungan said. “Shops easily sell them.”

One kiosk vendor in Jakarta, who did not provide his name, said most children buy individual cigarettes from him even though selling them in this form is breaking the law. “Everyone sells cigarettes to them,” he said.

Globally, experts agree that one of the strongest tobacco-control policies has been taxation. The rising cost of the habit, linked to higher taxes, has meant that many can no longer afford to smoke, and those who can smoke provide revenue for anti-smoking campaigns and quitting support services, to name a few options.

“The evidence suggests increasing pricing is the single most effective way to reduce demand,” said Vaughan Rees, director of the Center for Global Tobacco Control at the Harvard T.H. Chan School of Public Health, in a previous report by CNN.

“In states where we see the highest tax rates, we see the lowest prevalence,” he said, highlighting New York City, where former Mayor Michael Bloomberg introduced city taxes on top of state taxes in 2010.

In Indonesia, “the price of cigarettes is very cheap,” Sulistyowati said. “Everyone can buy them.”

Pushing for change

Now, the Ministry of Health is working to align with other ministries as well as international organizations, such as the World Health Organization, to tackle the appeal of cigarettes once and for all. This includes aligning with the WHO’s Tobacco Free Initiative and its strategy to reverse the global tobacco epidemic, known as MPOWER, which features six policies that have been proved to make an impact, such as protecting people from smoke, enforcing bans on advertising, and raising taxes.

The ministry also hopes to provide greater support for people trying to quit smoking and to increase public awareness about tobacco’s harms — as well as push harder for the country to join the Framework Convention on Tobacco Control, a global public health treaty formed in 2005 to tackle the global tobacco epidemic. Today, 181 states have signed the convention. Indonesia is not one of them.

With all this eventually in place, Aldi’s message may finally reach those who need to hear it: young children facing the allure of smoking tobacco.

Though cases like Aldi’s seem very rare on the surface, there are similar ones in Indonesia that don’t get serious attention, said Mulyadi, who treated Aldi.

“Aldi was very lucky because in his case, we get a fast response from the government and public. … Local and international media give him big attention,” he said. “Other children are not that lucky.”

The Indonesian government is not strict enough, he said. “As long as cigarette ads are spread out massively on TV, radio, newspapers, outdoor signage, everywhere, the problem of child smokers will get worse and worse.”

Association Between Initial Use of e-Cigarettes and Subsequent Cigarette Smoking Among Adolescents and Young Adults

A Systematic Review and Meta-analysis.

https://www.ncbi.nlm.nih.gov/pubmed?term=Association%20Between%20Initial%20Use%20of%20e-Cigarettes%20and%20Subsequent%20Cigarette%20Smoking%20Among%20Adolescents%20and%20Young%20Adults%3A%20A%20Systematic%20Review%20and%20Meta-analysis.&holding=ucsflib&otool=cdlotool&cmd=search

Abstract

IMPORTANCE:

The public health implications of e-cigarettes depend, in part, on whether e-cigarette use affects the risk of cigarette smoking.

OBJECTIVE:

To perform a systematic review and meta-analysis of longitudinal studies that assessed initial use of e-cigarettes and subsequent cigarette smoking.

DATA SOURCES:

PubMed, EMBASE, Cochrane Library, Web of Science, the 2016 Society for Research on Nicotine and Tobacco 22nd Annual Meeting abstracts, the 2016 Society of Behavioral Medicine 37th Annual Meeting & Scientific Sessions abstracts, and the 2016 National Institutes of Health Tobacco Regulatory Science Program Conference were searched between February 7 and February 17, 2017. The search included indexed terms and text words to capture concepts associated with e-cigarettes and traditional cigarettes in articles published from database inception to the date of the search.

STUDY SELECTION:

Longitudinal studies reporting odds ratios for cigarette smoking initiation associated with ever use of e-cigarettes or past 30-day cigarette smoking associated with past 30-day e-cigarette use. Searches yielded 6959 unique studies, of which 9 met inclusion criteria (comprising 17 389 adolescents and young adults).

DATA EXTRACTION AND SYNTHESIS:

Study quality and risk of bias were assessed using the Newcastle-Ottawa Scale and the Risk of Bias in Non-randomized Studies of Interventions tool, respectively. Data and estimates were pooled using random-effects meta-analysis.

MAIN OUTCOMES AND MEASURES:

Among baseline never cigarette smokers, cigarette smoking initiation between baseline and follow-up. Among baseline non-past 30-day cigarette smokers who were past 30-day e-cigarette users, past 30-day cigarette smoking at follow-up.

RESULTS:

Among 17 389 adolescents and young adults, the ages ranged between 14 and 30 years at baseline, and 56.0% were female. The pooled probabilities of cigarette smoking initiation were 30.4% for baseline ever e-cigarette users and 7.9% for baseline never e-cigarette users. The pooled probabilities of past 30-day cigarette smoking at follow-up were 21.5% for baseline past 30-day e-cigarette users and 4.6% for baseline non-past 30-day e-cigarette users. Adjusting for known demographic, psychosocial, and behavioral risk factors for cigarette smoking, the pooled odds ratio for subsequent cigarette smoking initiation was 3.62 (95% CI, 2.42-5.41) for ever vs never e-cigarette users, and the pooled odds ratio for past 30-day cigarette smoking at follow-up was 4.28 (95% CI, 2.52-7.27) for past 30-day e-cigarette vs non-past 30-day e-cigarette users at baseline. A moderate level of heterogeneity was observed among studies (I2 = 60.1%).

CONCLUSIONS AND RELEVANCE:

e-Cigarette use was associated with greater risk for subsequent cigarette smoking initiation and past 30-day cigarette smoking. Strong e-cigarette regulation could potentially curb use among youth and possibly limit the future population-level burden of cigarette smoking.

Why Smoking in Films Harms Children

We want to believe we’re raising our kids to think for themselves, and not to do dumb or unhealthy things just because the cool kids are doing them.

https://www.nytimes.com/2017/07/17/well/family/why-smoking-in-films-harms-children.html

But research shows that when it comes to smoking, children are heavily influenced by some of the folks they consider the coolest of the cool: actors in movies.

“There’s a dose-response relationship: The more smoking kids see onscreen, the more likely they are to smoke,” said Dr. Stanton Glantz, a professor and director of the University of California, San Francisco, Center for Tobacco Control Research and Education. He is one of the authors of a new study that found that popular movies are showing more tobacco use onscreen.

“The evidence shows it’s the largest single stimulus,” for smoking, he said; “it overpowers good parental role modeling, it’s more powerful than peer influence or even cigarette advertising.”

He said that epidemiological studies have shown that if you control for all the other risk factors of smoking (whether parents smoke, attitudes toward risk taking, socioeconomic status, and so on), younger adolescents who are more heavily exposed to smoking on film are two to three times as likely to start smoking, compared with the kids who are more lightly exposed.

Those whose parents smoke are more likely to smoke, he said, but exposure to smoking in movies can overcome the benefit of having nonsmoking parents. In one study, the children of nonsmoking parents with heavy exposure to movie smoking were as likely to smoke as the children of smoking parents with heavy movie exposure.

To Dr. Glantz, and the other people who study this topic, that makes smoking in movies an “environmental toxin,” a factor endangering children.

“There’s no excuse for continuing to have smoking in movies that are rated to be sold to kids, and so the policy objective we have is there should be no smoking in movies that are rated for kids,” said Dr. Glantz, who maintains a website called Smoke Free Movies. “The studios have it in their power to fix this with a phone call.” The rating system needs to start treating smoking like a proscribed obscenity, he said; if it’s in the movie, the movie gets an R rating.

The Centers for Disease Control and Prevention’s fact sheet on smoking in the movies estimates that taking smoking out of films rated for children would save 18 percent of the 5.6 million young people alive today who will otherwise die of tobacco-related diseases – a million lives. “There’s nothing you could do that would be so cheap and save so many lives,” Dr. Glantz said.

This has been studied in 17 different countries, he said, and though policies vary widely and cultures are very different, the results are remarkably similar. “You consistently see this two to three times risk in kids who are exposed to a lot of onscreen smoking, all over the world.”

Five years ago, the people who worry about the impact on the young of seeing smoking in the movies thought things were looking good. In movies rated for a young audience (that is, G or PG or PG-13), there had been a steady drop in the number of “onscreen tobacco incidents.” Not only that, but in 2012, convinced by a heavy array of scientific evidence, the Surgeon General issued a report saying explicitly that seeing people smoke in movies caused kids to start smoking: “longitudinal studies have found that adolescents whose favorite movie stars smoke on screen or who are exposed to a large number of movies portraying smokers are at a high risk of smoking initiation.”

But after 2010, despite the accumulating evidence, the rate of cinematic smoking started to rise in those youth-rated movies, according to the new study, published this month in the C.D.C.’s Morbidity and Mortality Weekly Report, which looked at incidents of tobacco use in top-grossing movies from 2010 to 2016.

As far as movies rated G, PG, and PG-13, “When we compared 2010 to 2016, there was a slight decrease in the number of movies, but an increase in the number of incidents,” said Michael Tynan, a public health analyst in the office on smoking and health at the C.D.C., and the lead author of the new study. Dr. Glantz is also an author, and he and two of the four other authors have received grants from the Truth Initiative, an antismoking group.

The number of times that an actor used a tobacco product in a top-grossing movie “increased 72 percent among all movies and 43 percent among PG-13 movies,” Mr. Tynan said. In other words, he said, by 2016 there were “more tobacco incidents concentrated in fewer movies.”

One out of every four movies rated for youth today continues to feature tobacco use, Mr. Tynan said, “and we know this is harmful to youth and causes youth to start using tobacco.”

And the policies that the studios have in place, which seemed to be working as of 2012, are clearly not sufficient, Mr. Tynan said. “The frequency of tobacco use in PG-13 movies is a public health concern.” So what should be done? “One change is to rate movies with tobacco use with an R rating,” he suggested. Other steps that might help would be to have studios certify that there was no paid product placement, and to end the use of any actual tobacco brands on the screen. All of these strategies are supported by the American Academy of Pediatrics, which has issued a statement calling the new study “alarming.”

In a study done back in the ’90s, researchers pointed to some of the differences between who smokes on screen and who smokes in the real world. In the real world, smokers are likely to be “poor people, people with mental illness,” Dr. Glantz said. “If you look at the power players, the rich people, people who are in control, they’re not smoking.” But in movies, it tends to be more desirable or powerful characters, even if they’re the bad guys, and in that way, movie images may reinforce images in cigarette advertising.

And movie images are powerful. In one experiment, young people who were smokers were shown montages of clips from recent movies; the participants were randomized so that some saw clips with smoking in them and some did not. Then they were given a 10-minute break, and the people who saw the smoking images were significantly more likely to smoke during the break than the smokers who had not seen the images.

“Keeping smoking onscreen is like putting arsenic in the popcorn,” Dr. Glantz said. The new study “shows they’ve taken half of the arsenic out,” he said. “Now they need to take the rest out.”

WHO China launches smoke-free campaign targeting youth

The World Health Organization (WHO) started a “smoke-free generation” media campaign in Beijing Thursday targeting young Chinese.

http://www.china.org.cn/china/2017-06/03/content_40957899.htm

China is in the grip of a national tobacco epidemic, and children are most susceptible with cigarettes portrayed as fashionable and alluring in popular culture, said Bernhard Schwartlander, WHO Representative in China at the launch event.

According to WHO, over half of Chinese adult men smoke, two thirds of whom started as young adults. By 2014, 72.9 percent Chinese students had been exposed to secondhand smoke.

“There is nothing cool about smoking, but there is something empowering about choosing to live a healthy, smoke-free life,” said Schwartlander.

Since China ratified the WHO Framework Convention on Tobacco Control in 2005, the country has made a number of tobacco control efforts, including banning tobacco advertisements, increasing tobacco taxes and putting forward regional smoking bans.

As of 2016, 18 cities, including Beijing, Shanghai and Shenzhen, had implemented regional smoking bans.

China has set a target to reduce the smoking rate among people aged 15 and older to 20 percent by 2030 from the current 27.7 percent, according to the “Healthy China 2030″ blueprint issued by the central authorities last October.

WHO urges government to control tobacco use

The World Health Organisation (WHO) has urged the government to introduce policies to control the use of tobacco because it is a leading risk factor for some serious non-communicable diseases.

The Country Representative of WHO, Dr Owen Kaluwa, who made the call suggested, for instance, the imposition of high taxes on tobacco companies to deter them from going into production.

http://www.graphic.com.gh/news/general-news/who-urges-government-to-control-tobacco-use.html

In the event of the companies paying such taxes, he said, the revenue generated should be used to finance health delivery.

He was speaking at a public forum to mark World No-Tobacco Day (WNTD) in Accra last Wednesday.

Avoid tobacco

Dr Kaluwa said globally, tobacco kills about 7.2 million people every year, over 80 per cent of whom are from low or middle-income countries.

“In Africa, about 146,000 adults aged 30 years and above die every year due to tobacco-related health diseases,” he added.

He said the use of tobacco was a leading preventable risk factor for non-communicable diseases such as cardiovascular diseases, cancer and chronic lung disease.

“Up to half of all tobacco users will die prematurely from tobacco-related causes, and on average, tobacco users lose 15 years of their lives,” he said.

Mr Kaluwa added that the growing of tobacco had affected agricultural lands in some areas.

Public education

At her turn, a Deputy Minister of Health, Mrs Tina Mensah, said adequate public education was important in dealing with the problem of tobacco use.

She reiterated the fact that tobacco use was dangerous to human health and damaging to national economic development.

“Tobacco-related illnesses and premature mortality impose direct and indirect cost to individuals and government,” she said.

She noted that tobacco production companies tried to influence the young generation to become addicted to smoking, which was a national threat.

She applauded the Food and Drugs Board (FDB) for its intervention in combating the use of tobacco by preventing tobacco companies from advertising their products.

Mrs Mensah said the ministry, for its part, would continue to support the fight against the use of tobacco in the country.

Preventive measures

Outlining some measures that had been put in place to check tobacco usage, the Chief Executive Officer (CEO) of the FDA, Mrs Delese A. Darko, mentioned the prohibition of smoking in public places, advertising prohibition and sponsorship as examples.

She added that packaging, labelling and health warnings on tobacco packages were other ways of preventing and discouraging tobacco consumers from patronising the product.

“These prohibitions have shown to be effective in reducing the demand for tobacco,” she said, adding that public sensitisation and education would, accordingly, be increased to meet the target groups.

“As we get funding, we will continue to do more to inform the public about the harmful effects of the use of tobacco,” Mrs Mensah said.

In connection with the celebration, Smoking Cessation Guidelines and a declaration on WNTD 2017 were launched.