First Six Months Set Pace for Global Tobacco Fight

Initiative director Bill Parra reflects on the first six months of activity on the Bloomberg Initiative to Reduce Tobacco Use.

In the six months since we launched the CDC Foundation’s work related to the Bloomberg Initiative to Reduce Tobacco Use, our team has traveled to eight different countries, hosted an international group of tobacco experts at CDC and helped build consensus on how to best measure tobacco-related behaviors and attitudes in 15 different countries. We’ve set an aggressive pace, surprising many of our partners with substantial progress right out of the gate. And we’re just getting started.

As a partner in the Bloomberg Initiative, the CDC Foundation is working with experts at CDC and the World Health Organization (WHO) to develop a survey – called the Global Adult Tobacco Survey – that will monitor tobacco use and the effectiveness of tobacco control measures in 15 target countries that account for two-thirds of the world’s smokers. We want to learn more about smokers in these countries and their attitudes and behaviors related to tobacco use —  Do they want to quit? What kinds of cessation strategies do they have access to? Would they still buy cigarettes if they had to pay more for them? Our partners in the initiative will use data from the survey to help countries implement and evaluate tobacco control interventions, such as marketing restrictions, taxation, litigation, warning labels, education campaigns and smoking bans in public places. These efforts could potentially save millions of lives.

Tobacco Preys on Poor Countries, Poor People

When planning visits to our target countries, we presumed convincing officials of the health implications of tobacco use would be an easy sell. They were familiar with the data: By 2025, tobacco is projected to be the leading cause of death and disability worldwide, killing more than 10 million people every year. We realized that the major challenge would be economic; tobacco is a cash crop in many of these countries. In fact, three of the four countries that produced two-thirds of the world’s tobacco in 2004 – Brazil, China and India – are part of this initiative. And while cash-strapped governments have been lured by the economic benefits of growing and selling tobacco, poor residents of these countries have been drawn in by marketing campaigns and chemical dependence, resulting in higher rates of tobacco use among the poor worldwide. Despite these challenges, we were received enthusiastically by officials in all the countries we visited during the first six months.

Globe Trotting Builds Consensus, Network of Support

Working closely with a team of CDC experts led by Samira Asma, associate director of global tobacco control with CDC’s Office on Smoking and Health, we started in February by participating in a meeting of global experts convened by WHO in Geneva. The goal of the meeting was to develop the survey and agree on an implementation strategy. Many experts predicted that accomplishing this goal in just one week would be impossible, given the diversity of our target countries and the complexities of effectively measuring attitudes and behaviors. But, surprisingly, participants reached a consensus in the time allotted. Next we pilot tested the survey in the Philippines and India and then shared the results at a second meeting of experts that we hosted at CDC in Atlanta. We made a few additional modifications to the survey, and, by the end of July, the final version was ready to go.

In addition to the expert meetings, we also traveled to New Delhi and Moscow to meet with WHO regional officials to introduce them to the initiative and learn about potential challenges and opportunities in their regions. We also traveled to Brazil, Egypt and Bangladesh and returned to India to meet with their respective ministries of health to discuss how to best conduct the survey in their countries, all between May and July.

Hope for the Future

In these first six months, we’ve been delighted to witness and be a part of the emergence of an incredible global network of extremely dedicated individuals who understand the vital importance of taking action. Over the next six months, we hope to conduct the survey in four to six countries and begin planning visits to the remaining target countries.

Thus far, the project has revived my hope that international cooperation can bring about change and better health. We know what works. We now must work through programs like the Bloomberg Initiative to help tobacco control advocates of every nation implement tested strategies to prevent tobacco use, help smokers quit and save lives.