world cancer report - iarc
world cancer report - iarc
world cancer report - iarc
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such as bars and restaurants, who fear a<br />
decrease in business. In fact, the limited<br />
evidence from cities in the USA where this<br />
measure has been implemented speaks<br />
against a negative economic impact. In<br />
general, however, there has been little<br />
assessment of the effectiveness of promotion<br />
of tobacco-free environments. It<br />
should be stressed that fire prevention is<br />
an important positive side-effect of promotion<br />
of tobacco-free workplaces and<br />
public settings.<br />
Various forms of restrictions on advertising<br />
of tobacco products have been implemented<br />
in many countries. A recent survey<br />
of 22 countries with policies of either<br />
complete or partial ban on direct advertising<br />
concluded that a comprehensive set of<br />
tobacco advertising bans can reduce<br />
tobacco consumption, but that a limited<br />
set of advertising bans will have little or no<br />
effect [12]. However, tobacco companies<br />
have developed sophisticated forms of<br />
indirect advertising through subsidiaries.<br />
Sponsorship of cultural and sporting<br />
events can be seen as part of the same<br />
strategy of indirect advertising: several<br />
countries are currently discussing regulation<br />
of such sponsorship. Moreover,<br />
organizations involved in tobacco control<br />
(e.g. <strong>cancer</strong> societies) have developed a<br />
proactive advertising strategy, often using<br />
icons of tobacco advertisements such as<br />
cowboys and camels.<br />
A final form of tobacco control through<br />
health protection is the requirement that<br />
warnings are printed on tobacco products.<br />
Such health warnings are now widespread<br />
(a 1991 survey listed 77 countries where<br />
they were requested, although in most<br />
cases they consisted of “mild” statements<br />
about health without requirement of rotation<br />
[11]). In almost every respect, residents<br />
in developing countries are receiving inferior<br />
information about the hazards of smoking<br />
than residents of more developed countries<br />
[13]. There is no formal evidence that health<br />
warnings on cigarette boxes contribute to a<br />
decrease in tobacco consumption.<br />
Health promotion<br />
Discouraging smoking<br />
The epidemic of smoking-induced <strong>cancer</strong><br />
and other disease, both present and antic-<br />
Fig. 4.3 Cessation of smoking greatly reduces the risk of death from lung <strong>cancer</strong>, and is even effective<br />
at age 60 (UK men, 1990) From: R. Peto et al. (2000) BMJ 321: 323-329.<br />
Diseases associated with tobacco use<br />
Neoplastic diseases Lung <strong>cancer</strong><br />
Oral <strong>cancer</strong><br />
Laryngeal <strong>cancer</strong><br />
Pharyngeal <strong>cancer</strong><br />
Oesophageal <strong>cancer</strong><br />
Stomach <strong>cancer</strong><br />
Pancreatic <strong>cancer</strong><br />
Bladder <strong>cancer</strong><br />
Kidney <strong>cancer</strong><br />
Some leukaemias<br />
Liver <strong>cancer</strong><br />
Vascular diseases Ischaemic heart disease<br />
Pulmonary heart disease<br />
Myocardial degeneration<br />
Aortic aneurysm<br />
Peripheral vascular disease<br />
Cerebrovascular disease<br />
Respiratory diseases Chronic obstructive lung disease<br />
Pulmonary tuberculosis<br />
Pneumonia<br />
Asthma<br />
Other respiratory diseases<br />
Other Peptic ulcer<br />
Table 4.3 Diseases associated with tobacco use.<br />
Tobacco control 131