National Cancer Prevention Policy - Tobacco Control Supersite

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Table 1.1 Cancer site and percentage of new cancers attributable to smoking in Australia in 2001 Site Males (%) Females (%) Lung 89 70 Larynx 69 60 Oral cancers 52 42 Renal (kidney) pelvis 51 43 Oesophagus 50 41 Anus 39 29 Bladder 38 28 Vulva – 32 Cervix – 19 Penis 21 – Pancreas 23 16 Kidney 17 12 Stomach 12 8 Colon/rectum 12 12 Sources AIHW & AACR 2004; Chao et al. 2000; USDHHS 2004 The economic consequences of tobacco use in Australia have been examined, with the total social costs in 1998−99 having been estimated at $21 billion (Collins & Lapsley 2002). It has also been estimated that the health system costs for lung cancer (85% of which is attributable to tobacco smoking) amounted to $107 million in 1993−94 (Mathers et al. 1998). Smoking causes very high levels of ill health and premature death among Aboriginal and Torres Strait Islander peoples, which adds to the social costs among these communities (Briggs, Lindorff & Ivers 2003). In Australia in 2001–02, smoking accounted for more than 291,000 hospital episodes per year, at a cost of $682 million (Hurley 2006). The challenge Adults The prevalence of smoking among Australian adults has been measured by a number of different surveys: the National Drug Strategy Household Survey conducted by the Australian Institute of Health and Welfare (AIHW 2005); Smoking and Health Surveys conducted by The Cancer Council Victoria (White, Hill et al. 2003); National Health Surveys (ABS 2006); and National Aboriginal and Torres Strait Islander Surveys conducted by the Australian Bureau of Statistics (ABS 1994). Consistent trends have been observed, despite minor variations in methods between the surveys, so trends over time rather than specific figures are important foci for policy development (White, Hill et al. 2003). In 2004 in Australia, 17.4% of people aged 14 years or older were daily smokers, with a further 3.9% of the population reporting weekly or less than weekly smoking (AIHW 2005). The recent decline in the number of daily smokers among men (18.6%) and women National Cancer Prevention Policy 2007 – 09 15 T o b a c c o
(16.3%) continues the trends observed over the last 25 years (White, Hill et al. 2003; AIHW 2005). It has been noted that those smokers who regard themselves as ‘occasional’ or ‘social smokers’ may make up 29% of all smokers. This segment of smokers holds different attitudes towards smoking and quitting from other smokers, which has implications for campaigns and messages for this group of smokers (Morley et al. 2006). There are specific populations for which smoking rates remain significantly higher than average, including populations that are socio-economically disadvantaged, Aboriginal and Torres Strait Islander peoples and male Australians born overseas in particular countries. Socio-economically disadvantaged populations The prevalence of smoking in Australia in 2001 among lower blue collar workers (36%) remained higher than among upper white collar workers (16%), despite the significant declines in all occupational groups since 1980 observed in surveys of people aged 18 years or older by The Cancer Council Victoria (White, Hill et al. 2003). Aboriginal and Torres Strait Islander peoples The prevalence of smoking remains very high among Aboriginal and Torres Strait Islander peoples. The National Aboriginal and Torres Strait Islander health survey of 2004–05 indicated that the prevalence of smoking in people aged 18 years and over has remained unchanged at 50% since 1995 (ABS 1994); however, the smoking rates among some remote Aboriginal and Torres Strait Islander communities are much higher (Ivers 2001). After adjusting for age differences, in 2004 Aboriginal and Torres Strait Islander people aged 18 years and over were more than twice as likely as non-Indigenous Australians to be smokers (AIHW 2006). A 2002 survey reported a smoking prevalence of 59% among Aboriginal health workers in New South Wales (Mark et al. 2005). Potential contributors to the higher prevalence of smoking among Aboriginal and Torres Strait Islander peoples include (Briggs, Lindorff & Ivers 2003; AGDHA 2005): • • • • • the effects of historical colonisation and dispossession (disruption and erosion of language and culture, creation of unhealthy living and social conditions, devaluation of cultural responses to health problems, general subordination due to racism) socio-economic disadvantage (the roles of lower levels of education, lower levels of employment and lower weekly income) cultural beliefs and strong links to a traditional lifestyle (recognition of homelands, believing in the important role of elders, and English not being a first language have been linked to higher prevalence of tobacco use) enjoyment and addiction (similar to their roles in the maintenance of smoking among non-Indigenous people) social contexts and pressures (role of smoking in becoming accepted as part of the social group, roles of boredom, stress and anxiety). A lack of knowledge on the health effects of tobacco does not appear to be a major factor in the higher prevalence of smoking among Aboriginal and Torres Strait Islander peoples (Briggs, Lindorff & Ivers 2003). 1 Section One: Preventable risk factors
Page 1 and 2: National Cancer Prevention Policy 2
Page 3 and 4: The Cancer Council Australia Member
Page 5 and 6: Overweight and obesity 86 Introduct
Page 7 and 8: A b b r e v i a t i o n s AACR Aust
Page 9 and 10: T h e N a t i o n a l C a n c e r P
Page 11 and 12: increase their understanding of man
Page 13 and 14: T o b a c c o Introduction 12 Secti
Page 15: Figure 1.1 Number of Australians wh
Page 19 and 20: in the longer-term future, when hea
Page 21 and 22: Tobacco products are among the top
Page 23 and 24: In 2007, given estimated costs of $
Page 25 and 26: improved regulation, by collectivel
Page 27 and 28: Tobacco control strategy for Aborig
Page 29 and 30: Australian National Tobacco Strateg
Page 31 and 32: Regulation of products Possible reg
Page 33 and 34: • • parents/carers and children
Page 35 and 36: Australia in partnership with a num
Page 37 and 38: What needs to be achieved How The C
Page 39 and 40: ——— 2005. 2004 National Drug
Page 41 and 42: Schofield PE, Borland R, Hill DJ, P
Page 43 and 44: In adult life, recreational (interm
Page 45 and 46: ehaviours as a result of public edu
Page 47 and 48: Screening for melanoma There is ins
Page 49 and 50: What needs to be achieved How The C
Page 51 and 52: Autier P 2004. Issues about solaria
Page 53 and 54: N u t r i t i o n Introduction 52 S
Page 55 and 56: Table 1.4 Conclusions of the major
Page 57 and 58: It may be possible that different t
Page 59 and 60: Table 1.5 Current trends in consump
Page 61 and 62: key stakeholders (Sorensen et al. 1
Page 63 and 64: A large scale randomised controlled
Page 65 and 66: • The International Union Against
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References Nutrition Agency for Hea
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Kushi L & Giovannucci E 2002. Dieta
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Strategic Inter-Governmental Nutrit
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How physical activity is measured U
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There is consistent epidemiological
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• • Moderate-intensity physical
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to help them achieve greater and mo
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Populations Aboriginal and Torres S
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An increased capacity to monitor be
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McTiernan A, Kooperberg C, White E,
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O v e r w e i g h t a n d o b e s i
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Table 1.9 Proportion of cancer attr
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were $107.3 million in 2005, with 7
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Obese children have a 25% to 50% ch
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Table 1.10 Summary of the strengths
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more than moderately effective. The
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a screening approach particularly f
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What needs to be achieved How The C
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References Overweight and obesity A
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Gebel K, King L, Bauman A, Vita P,
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——— 2004. SNAP: A population
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(the highest level of evidence in t
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How the amount of disease caused by
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The challenge Adults Alcohol is a s
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and healthy drinking cultures in Au
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ook’) (RACGP 2006) assists in dev
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English DR, Holman CDJ, Milne E, Hu
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Section Two: Screening to detect ca
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early detection improves health out
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false positive faecal occult blood
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1987, compared to 51.3 deaths per 1
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Breast self-examination Breast self
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a significant proportion of women a
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An Australian review of the benefit
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References Breast cancer Australian
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Semiglazov VF, Manikhas AG, Moiseen
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A vaccine to prevent HPV infection
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It is anticipated that the introduc
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Recruitment Women in the target age
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B o w e l ( c o l o r e c t a l ) c
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could focus on: how to use this tim
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Periodic testing is recommended, as
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participate in the initial phase; t
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likely to do so if reinvited, espec
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What we want to achieve How The Can
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P, Sivak MV & Butler H 2004. Comput
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Scholefield JH, Moss S, Sufi F, Man
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M e l a n o m a Melanoma in Austral
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Would screening be of benefit at th
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P r o s t a t e c a n c e r Cancer
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have lower levels of free PSA than
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• • a monitoring mechanism be p
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ecause surgical patients are usuall
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Klein EA 2004. Selenium and vitamin
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Section Three: Immunisation www.can
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epithelial carcinomas of the bladde
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The challenge Stigmatisation of cer
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The goals of a therapeutic vaccine
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Brinkman JA, Caffrey AS, Muderspach
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Victorian Cervical Cytology Registr
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Chronic hepatitis B infection occur
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Global Globally, an estimated two t
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The rise in HCC is thought to be as
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• • • • • • • • •
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The policy context The bleak outcom
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Aims What needs to be achieved How
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Chen DS 2005. Long-term protection
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Williams A 2002. Reduction in the h
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Authors Dr Cleola Anderiesz BSc (Ho
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Associate Professor John Kelly MDBS
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A alcohol 107 - 119 aims of The Can
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east cancer (post-menopause) 87, 88
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The National Cancer Prevention Poli
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