world cancer report - iarc

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