Tobacco and Public Health - TCSC Indonesia

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EFFECTIVE INTERVENTIONS TO REDUCE SMOKING
price elasticity for low- and middle-income countries are about double those estimated
for high-income countries, implying that significant increases in tobacco taxes in these
countries would be very effective in reducing tobacco use.
In summary, the empirical evidence indicates that increases in tobacco taxes reduce
tobacco use by preventing initiation (and subsequent addiction), increasing the likelihood
of cessation among current users, reducing relapse among former users, and
reducing consumption among continuing users. Thus, higher tobacco taxes will lead
to substantial improvements in public health and to lower social costs attributable to
smoking.
Restrictions on smoking
Increased awareness of the health consequences of passive smoking exposure, particularly
among children, has led many governments as well as private entities to adopt
restrictions on smoking. While the rationale for these restrictions is to reduce nonsmokers’
exposure to environmental tobacco smoke, the policies also reduce smokers’
opportunities to smoke. In Western populations, comprehensive restrictions on smoking
lead to 5–15 per cent reductions in population smoking rates (Evans et al. 1999;
Emont et al. 1992; Ohsfeldt et al. 1998; Hopkins et al. 2001; Levy and Friend 2003) and
to the changes in social norms regarding smoking behavior, especially among youth
(Woolery et al. 2000). Smoking bans in workplaces generally reduce quantity smoked
by 5–25 per cent, and prevalence rates up to 20 per cent (Fichtenberg and Glantz 2002;
Levy and Friend 2002). The no-smoking policies seem to be most effective when strong
social norms against smoking help to make smoking restrictions self-enforcing
(Jacobson and Wasserman 1997).
Health information and counter advertising
The first reports linking smoking to lung cancer released in the US and the UK in the
1960s, followed by publicity about the health consequences of smoking led to significant
reductions in cigarette smoking, with initial declines between 4 and 9 per cent,
and longer-term cumulative declines of 15–30 per cent (Townsend 1993; Kenkel and
Chen 2000). Similar declines accompanied information dissemination on tobacco
harm in low- and middle-income countries several years later (Kenkel and Chen 2000).
Even after the initial information shock, mass media antismoking campaigns still have
potential to reduce smoking prevalence by 4–12 per cent if sufficiently funded and
combined with other tobacco control policies, and school- or community-based programme
(Hopkins et al. 2001; Farrelly et al. 2002; Friend and Levy 2002). The
continuing discovery of new evidence about the harmful effects of tobacco use and
inadequate understanding of these risks among members of the public (Weinstein
1998), particularly in the lowest, income countries implies, however, that there is still
much to be done in terms of health education.