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F. Hawari



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    ED03 - Global Tobacco Control Policies: Advances & Challenges (ID 266)

    • Event: WCLC 2016
    • Type: Education Session
    • Track: Epidemiology/Tobacco Control and Cessation/Prevention
    • Presentations: 1
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      ED03.01 - Tobacco Control in the Middle East (ID 6437)

      14:30 - 14:50  |  Author(s): F. Hawari

      • Abstract
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      Abstract:
      Despite many countries signing and ratifying the Framework Convention on Tobacco Control (FCTC), the prevalence of tobacco continues to be on the rise in the Middle East. For example, in countries like Jordan and Tunisia, tobacco prevalence among males is close to 5o% and in Jordan specifically it is estimated to increase to 88% over the next 5 years according to the World Health Organization (WHO). In 2008 it was estimated that five million people died due to tobacco related illnesses. This number is expected to increase to eight million in the year 2030 with individuals from low- and middle-income countries making up approximately 80% of these deaths. Tobacco is a risk factor for all major non-communicable diseases (NCDs) such as cardiovascular diseases, cancer, pulmonary diseases and diabetes mellitus. The developing countries and the Middle East in particular is bracing for at least a 25% increase in such diseases over the next few years. The world economic forum estimates that the cost for such chronic disabling diseases will exceed USD 15 trillion with cancer costs specifically reaching close to USD 3 trillion. The WHO outlined six strategies that, when implemented simultaneously, will result in significant reduction in tobacco prevalence and its related morbidity and mortality. Those strategies known as MPOWER (Monitor tobacco use and prevention policies, Protect people from tobacco smoke, Offer help to quit tobacco use, Warn about the dangers of tobacco, Enforce bans on tobacco advertising, promotion and sponsorship, Raise taxes on tobacco) when implemented in a country like Jordan, for example, close to 180,000 deaths can be prevented over 5 years. Despite the documented benefits of these six strategies, compliance with implementing them across the Middle East remains low. Only few countries have pictorial warnings, exposure to second hand smoke (SHS) is high, tobacco prices remain low and smoking cessation services are scarce. As the population in the Middle East age and with the ongoing rise in tobacco prevalence and obesity, cancer is expected to be on top of the list of diseases causing death and disability in the region. For that reason, King Hussein Cancer Center (KHCC), one of the leading cancer centers in the region, took on the challenge of fighting tobacco across the region in collaboration with regional and international partners. KHCC became the regional host for Global Bridges (an international TDT healthcare alliance co-founded by the Mayo Clinic, the American Cancer Society, and the University of Arizona). The main mission of this collaboration is to address the implementation of article 14 of the FCTC agreement and design and implement effective programmes to promote the cessation of tobacco use and provide adequate treatment for tobacco dependence (TDT). This will also serve to address one of the six strategies recommended by the WHO; Offer help to quit tobacco use. Tobacco dependence in the region is severe. The high number of cigarettes smoked per capita and the significant exposure to SHS make people less capable of quitting on their own. Availing TDT across the region would respond to the high demand for such service (more than 65% of smokers are interested in quitting) and help curb the expected epidemic of NCDs. Long term, quitting tobacco generally reduces the risk of disease and premature death by 90% for those who quit before the age of 30 and by 50% for those who quit before the age of 50. In addition, TDT will optimize the management of certain NCDs such as cancer resulting in better treatment outcomes and long-term survivals. Over the past 5 years, KHCC developed partnership with countries across the Middle East and worked on training healthcare providers (HCPs) on how to treat tobacco dependence (figure 1). More than 2000 HCPS were trained to date (figure 2). Furthermore, 4 hubs designated for TDT training were established in Oman, Egypt, Tunisia and Morocco. In addition, an evidence-based TDT training curriculum specifically designed for the Middle East was developed and in the process of being made available in 3 languages; Arabic, English and French. In conclusion, tobacco dependence represents a major threat to the health and wellbeing of the people in the Middle East. Significant rise in NCDs including cancer is expected over the next few years. Many collaborative initiatives are underway to address this sever epidemic. Figure 1



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