WPC  2B R>T Z#|dPrestige Elite 12cpi (M)Times New RomanTimes New Roman BoldHP LaserJet 4HPLAS4.PRSdp@~rQ\ub@2\% 3'3'Standard6&6&StandardHPLAS4.PRSdp USUK"m^3ETggEEEgt3E39gggggggggg99ttt[~rEP~rr~•~E9E`gE[g[g[Egg99g9ggggEP9gggg[c)coE3EE"EEECEEEEEEdEg9YYYYYY~Y~Y~Y~YC8C8C8C8ddddddddddYggdddsd[[[[[[[g~[~[~[~[ggggggggE8E9E9E9oPg~9~9~9~8~9gvggggEEErPkNrPrP~9~9~9gggggg•g~[Y~[g~9gErP~9gggggNH3]gE[ggggg9@gFdddgF%C[[gEEggzzdddwrrE[dF"m^3ErggΫEEEgu3E39ggggggggggEEuuug~Pg•~rΕE9ExgEgr[r[Egr9Er9rgrr[PErggg[Q-QkE3EE"EEECEEEEEEdEr9dddddΕYYYYYN8N8N8N8oddddooooddrgdddzoggg[[[[r[[[[ggggggrrP8P9P9P9rgr999N9rrrggΕ[[[rPoNrPrPEEErrrrrrΕg[Y[r9r[rPEggrgrNH3ogEgggggg>DgFdddgF9CgggEEggzzddd~rrEgdF"m^>Re{{RRR{>R>E{{{{{{{{{{EEn㲥R`۲鲲RERt{Rn{n{nR{{EE{E{{{{R`E{{{{nv1vR>RR)RRRPRRRRRRxR{EkkkkkۥkkkkkPCPCPCPCxxxxxxxxxxk{{xxxxnnnnnnn{nnnn{{{{{{{{RCRERERE`{EEECE{{{{{۲RRR`]``EEE{{{{{{鲲{nkn{E{R`E{{{{{NV>p{Rn{{{{{DM{Txxx{T,Pnn{RR{{xxxȉRnxT2ZK  "m^>R{{RRR{>R>E{{{{{{{{{{RR{沥`{RER{R{nnR{EREΉ{n`R{{{na6aR>RR)RRRPRRRRRRxRExxxxxkkkkk]C]C]C]Cxxxxxx{xxx{{{nnnnnnnn{{{{{{`C`E`E`Eډ{EEE]E{{nnn`]``RRR{nknEn`R{{{NV>{R{{{{{{JQ{Txxx{TEP{{{RR{{xxxȉR{xT tTddd,dp@~rQ@ B7iC3,ƒXi\  P6XP C7nC3,)4Xn4  pX A~P>,B-~\  P6P AP>,)U`4  pxTR>RR)RRRPRRRRRRxR{E b #Xi\  P6ƒXP#      )  EXECUTIVE SUMMARY 1a    Each year, tobacco is responsible for the deaths of some three million people, one death every ten seconds. These numbers are increasing, and unless current trends are reversed, by the 2020s or early 2030s, tobacco will kill 10 million people each year, with 70% of these deaths occurring in developing countries. Since the early 1950s, scientific evidence has been accumulating, to the point where more than 25 diseases are now known or strongly suspected to be causally related to smoking. However, the costs of smoking extend well beyond the tragic health consequences, encompassing large economic and social costs as well.   Reflecting the concern of the international community, the World Health Assembly has adopted a number of resolutions on tobacco control, including a call for the implementation of comprehensive tobacco control strategies. These measures are urgently needed in countries with an already burgeoning tobacco epidemic, yet are just as important in countries where there is still potential to prevent what is a wholly avoidable tobacco epidemic.   In preparing action plans on comprehensive tobacco control, the overall goal is to reduce mortality and morbidity caused by tobacco products. This goal can be accomplished through: X  XaaHelping nontobacco users stay tobaccofree#a X  XaaPromoting and assisting cessation of tobacco use#a X  XaaProtecting the health and rights of children and adults by preventing involuntary exposure to environmental tobacco smoke. #a These objectives can be accomplished through activities such as: X  Xaahealth promotion activities;#a X  Xaamedia advocacy;#a X  Xaaencouragement of smoking cessation; #a X  Xaalegislative measures, including advertising bans and guarantees of smokefree public places and workplaces;#a X  Xaafiscal measures, including tobacco taxes that increase faster than inflation and income growth.#a X  #    Tobacco control initiatives may need to be modified quickly to adjust to inevitable opposition from tobacco interests. To convert tobacco control plans into action, some of the principles and strategies recommended include: X  XaaBe prepared, be flexible, be active, be persistent, seize opportunities;#a X  XaaTurn potential losses into gains;#a X  XaaIdentify and use arguments that will motivate others;#a X  XaaMake tobacco control selffinancing and a top public health priority.#a    Many people and institutions in all sectors of society, including governmental and nongovernmental realms can contribute to effective tobacco control efforts. All should be identified and their support obtained.*p-++Ԍ   Comprehensive, factual and credible information will be helpful in informing policy research, development and debate in favour of strengthened tobacco control policies. This information includes data on tobacco consumption and prevalence, tobaccorelated illness and death, attitudes and opinions on tobacco issues, and social, economic and political factors related to tobacco control. Sound knowledge of tobacco issues will be helpful in combatting arguments against tobacco control.   Health promotion policies and programmes should be based on internationallycomparable information. Standardized approaches facilitate global, regional, and national monitoring of the situation and the effectiveness of policies and programmes.   The complexity of the tobacco epidemic with the long delay between persistent smoking and its full health effects means that data need to be collected on current exposure as well as on diseases subsequently caused by smoking.   Tobacco consumption data, derived from tobacco production and sales information, are useful to indicate trends and the extent of tobacco use in a population. Consumption data, however, provide no information about the level of smoking among population subgroups.   For this, smoking prevalence information derived from sample surveys is needed. Updated WHO recommendations for standardized survey techniques to elicit core information on smoking prevalence are provided. Helpful suggestions are also given on how to obtain more extensive information on smoking behaviour, information on public opinions concerning tobacco control measures, and knowledge of the health consequences of tobacco use.   The serious health consequences of tobacco use begin to appear only two to four decades after tobacco use becomes widespread. Disease registries have been identified as a very promising source of data on tobaccorelated illness and death. Detailed methods for estimating the number of deaths attributed to tobacco are outlined. However, these methods should only be used when all the criteria for their use are met.   As useful as additional information on tobacco use and related health effects will be, it is already known that tobacco is the most important preventable cause of premature death in many countries, and that half of persistent smokers who start smoking in adolescence will die from their use of tobacco. Enough is already known for all countries to begin taking concrete action now to control tobacco use.   The need for effective global action against the tobacco epidemic is urgent. This book provides practical guidelines about how to do so. The sooner such action becomes truly global and effective, the earlier the epidemic will be overcome.