Healthcare professionals can add their voice to this campaign but can also have an impact closer to home by encouraging parents to quit.
It is vital that doctors talk to their patients, particularly those who are parents, about the benefits of quitting smoking - not only for the sake of their own health but for their children's health too. It's not just advertising that can have a detrimental effect on the smoking habits of today's younger generation. Adolescents with both parents smoking are four times more likely to start smoking than those whose parents had never smoked. Sadly, almost half of all children worldwide live in a home with at least one smoker.
Parents play a critical role in influencing their child's smoking habits, as research shows children in the pre-initiation phase of smoking who receive anti-smoking messages from their parents are less likely to start smoking - even if their parents smoke. However, as Dr Nirvana Raghubir, Medical Director at Pfizer South Africa notes, “It is much more effective if parents lead by example and don't smoke themselves. If smokers really want to protect their children from the serious health consequences of smoking and minimise the chances of them starting, they should ask their doctor for help.”
It isn't easy to give up smoking. It is not a lifestyle choice; tobacco dependence is a chronic relapsing condition[v]a. Smokers suffer from a physical addiction to nicotine as powerful as that of “hard” drugs such as heroin and cocaine. Smokers need support as at least 95% of unaided quit attempts each year are unsuccessful5b, whereas behavioural support and effective medication can achieve long-term quit rates of about 30%.
Dr Raghubir also notes that lung cancer is the most common cancer worldwide and the biggest cancer killer of South African men. “By the time it is diagnosed, the disease is usually already advanced, with the result that survival rates are low. But because most of these deaths - about 60% - are smoking related, this also makes it the most preventable form of cancer, providing a strong rationale for tobacco control. The key to addressing the problem is to prevent people from starting to smoke and encouraging those who do to quit. Studies have shown that those who quit experience health benefits”, she said.
Lung cancer is only one aspect of the burden of disease associated with tobacco products. Tobacco use is also associated with increased risk for other cancers, such as mouth, throat and oesophagus, as well as heart disease, stroke and emphysema. Dr Raghubir points out that 42 000 South Africans die every year from tobacco-related illnesses. And this isn't limited to smoking. “Chewing tobacco is equally hazardous to health and is associated with cancers of the lip, tongue, palate and pharynx.”
In South Africa and the SADC, Pfizer is working at mobilising non-governmental organisations (NGO) and the media to create public awareness on the risk of tobacco use and also to try and get tobacco control onto the government's health agendas.
Notes Dr Raghubir, “The developed world has, in recent years, introduced many restrictions on tobacco products, and tobacco use in these countries has been declining steadily. This trend has forced the tobacco industry to seek new markets, and much of its promotional efforts have shifted to the developing world, including Africa where legislation is weak”.
“Consequently, smoking is on the increase. “If left unchecked, it'll have a devastating negative public health impact on a continent already overwhelmed by diseases like HIV/AIDS, tuberculosis and malaria,” Dr Raghubir said.
Dr Raghubir feels that South Africa, which has taken the lead in anti-tobacco legislation in Africa, is well placed to be an example to the rest of the continent. “The government has placed restrictions on advertising, required warnings on cigarette packaging and banned smoking in public places. It has also signed the WHO Framework Convention on Tobacco Control, committing itself to strengthen these measures.”
The effectiveness of such measures has been seen around the world and South Africa is no exception. Since the 1990s the number of South Africans who smoke has declined due to the introduction of legislative measures such as a steep increase in tobacco taxation, which has had with a knock-on effect to population health. In 2003 South Africa became one of the first signatories to the Framework Convention on Tobacco Control and it is anticipated that further strengthening of tobacco legislation will take place. Dr Raghubir is optimistic that with the appropriate legislative interventions, other African countries will follow suit - especially given the support of the Pfizer Foundation's Tobacco Control Initiative.
The Foundation already has a strong presence in Europe, the USA, Asia and Latin America, where it works with a diverse group of local NGO experts towards improving the diagnosis and treatment of cancer and reducing the disease's incidence and burden. It has now expanded its reach to Africa and, together with the American Cancer Society, is currently spearheading a smoke-free workplace initiative in a number of North African countries. This is due to take effect in June.
In all, the World Health Organization estimates that almost half of all children worldwide live in a home with at least one smoker. World No Tobacco Day is an ideal time for parents who smoke to start protecting their children and youth from this lethal addiction.
“With political will, support and efficacious treatments available, it's vital that doctors take action by opening a dialogue about the benefits of quitting smoking and what support is available to help smokers quit. Only with these united actions can we expect to protect our children and youth from the lethal addiction that is smoking”, Dr Raghubir concluded.
