A Global Tobacco Epidemic Tobacco use is the worlds leading cause of preventable death, according to the World Health

Organization. Increasingly, the burden of tobacco use is greatest in low and middleincome countries that have been targeted by the tobacco industry with its deadly products and deceptive marketing practices. A global tobacco epidemic of preventable death, disease and economic harm to countries and families. Tobacco use killed 100 million people in the 20th century. If current trends continue, tobacco will kill one billion people in the 21st century.Tobacco kills more than 5 million people a year and accounts for one in 10 deaths among adults. If current trends persist, tobacco will kill more than 8 million people worldwide annually by the year 2030, with 80 percent of these deaths in low and middleincome countries. Almost a billion men in the world including half of men in low and middleincome countries and 250 million women smoke. If no action is taken, 650 million smokers alive today will eventually die from tobaccorelated diseases.Tobacco kills prematurely. On average, smokers lose 15 years of life, and up to half of all smokers will die of tobaccorelated causes. Every day, 80,000 to 100,000 young people around the world become addicted to tobacco. If current trends continue, 250 million children and young people alive today will die from tobaccorelated diseases. Secondhand smoke kills more than 600,000 people worldwide each year, including 165,000 children. Tobaccos Economic Toll Tobacco use costs the world an estimated $500 billion each year in health care expenditures, productivity losses, fire damage and other costs. Health care costs associated with tobacco related illnesses are extremely high. In the United States, annual tobaccorelated health care costs amount to 96 billion USD10; in Germany, 7 billion USD; in Australia, 1 billion USD. Tobaccorelated illnesses and premature mortality impose high productivity costs to the economy because of sick workers and those who die prematurely during their working years. Lost economic opportunities in highlypopulated developing countries will be particularly severe as tobacco use is high and growing in those areas. Countries that are net importers of tobacco leaf and tobacco products lose millions of dollars a year in foreign exchanges. Fire damage and the related costs are significant. In 2000, about 300,000 or 10 percent of all fire deaths worldwide were caused by smoking and the estimated total cost of fires caused by smoking was 27 billionUSD. Tobacco production and use damage the environment and divert agricultural land that could be used to grow food. The top five cigaretteconsuming countries are China, Russia, United States, Japan and Indonesia. China consumes more than 35 percent of the worlds cigarettes,17 with 53 percent of males smoking.Philip Morris International, British American Tobacco, Japan Tobacco International and Imperial Tobacco are the worlds four largest multinational tobacco companies. The largest state tobacco monopoly is the China National Tobacco Corporation, which has the largest share of the global market among all companies.

Hazards of Tobacco Smoking is a hazard to not only the people who smoke, but the people around them. Smoking doesn't only make people look bad, but it effects their bodies internally in negative ways. First of all, smoking can cause many life-threatening diseases. When you smoke, the effects on your body are immediate. Your pulse increases and your breathing becomes faster and more shallow. Plus your circulation begins to drop. Before you know it, you will have heart disease. Also, cigarettes contain many cancer-causing substances, which hits your lungs and will leave you with lung cancer, another life-threatening disease. Along with harming yourself, you harm many others. Just like smokers, a non-smoker breathing second-hand smoke is exposed to roughly 3, 700 different chemicals. Many of them can be poisonous; others are powerful cancer-causing substances, such as formaldehyde. The more second-hand smoke you breath, the greater risk of a heart attack or stroke, and the greater risk of lung cancer. Although smoking effects people's health, it also effects the way they look. The skin is effected in at least two ways. Firstly, tobacco smoke has a drying effect on the skin's surface. Secondly, since smoking restricts blood vessels, it reduces the amount of blood flowing to the skin which decreases the skin of oxygen and essential nutrients. Since these two things happen, the skin gets damaged which makes it have a grayish, wasted appearance. Besides smoking effecting the appearance of skin, it also effects the color of your teeth and the smell of your breath. Your teeth gradually change to an icky gray color and your breath wreaks of odor which could lead people away from you. People who smoke are increasing their chances for death, bad looks, and to harm the health of others. Today, many people are beginning to realize the hazards of smoking and make the wise decision to quit. Every one who smokes is like Ill stop tomorrow. But they never do. Even if youre not the smoker you are still in danger. I dont think you should smoke because it is unhealthy, it is addicting and it affects people around you. Smoking is extremely unhealthy because of the tar in the cigarette. The tar settles in your lungs every time you smoke. It will fill your lungs leaving less room for air. It gets harder and harder to breathe every time you exercise. The more you smoke the worse it will get. Some people get so frail from smoking. More than 7000 toxic chemicals are present in tobacco? You breathe in the tobacco every time you smoke. This will cause lung cancer. Most people that smoke die from lung cancer. The longer you smoke the more of a chance you have of getting cancer. If you are a smoker and you stop at the age of 60 you will have a high chance of getting cancer. If you stop at 40 the chance drops. If you stop at 30 or lower you completely eliminate or have little chance of getting cancer.

'World No Tobacco Day' 'World No Tobacco Day' is observed on May 31 every year, the world observes World No Tobacco Day (WNTD) that is promoted by the World Health Organization (WHO). The objective of observing World No Tobacco Day is to reduce tobacco consumption which can lead to deadly diseases like cancer and early death. Project Quit Tobacco International University of Arizona anthropologists Mark Nichter and Mimi Nichter with colleagues from centers of medical research in India and Indonesia have initiated Project Quit Tobacco International in 2003, with funding from the Fogarty International Center at the National Institutes of Health. They began with ethnographic research on tobacco use as a basis for developing culturally appropriate tobacco cessation activities in India and Indonesia, two countries where smoking is deeply embedded as cultural practice. "We recognized as anthropologists that we could not simply take cessation programs developed in the U.S. and introduce them off-the-shelf in other countries," said Mimi Nichter, professor ofanthropology, public health and family studies and human development. Instead, the Nichters and their colleagues approached the issue of tobacco use from an anthropological perspective, concerned first with understanding the role of smoking in both cultures. "We began by looking at smoking as a consumption event and the role of smoking in everyday life, recognizing that asking people to quit means more than just giving up nicotine," said Mark Nichter, Regents' Professor of Anthropology and professor of public health and family and community medicine."Smoking is a form of pleasure, a source of self-medication, and a shared experience that enables social interaction," he said. "Asking people to quit in the name of health in countries where people only associate smoking with lung cancer, and not scores of other health problems like TB, diabetes and heart problems, and where there is little appreciation for the harm of secondhand smoke was going to be challenging." Project Quit Tobacco International focuses on three key areas. The first is medical education, and the Nichters have helped develop a tobacco curriculum in India and Indonesia that educates medical students on how tobacco use affects all parts of the body not just lung health.The comprehensive curriculum, which is fully integrated into students' four years of medical school, emphasizes that doctors must ask patients about their smoking and must inform them about the harm of smoking, not just for health in general but for their specific medical condition. The curriculum has been piloted in five medical colleges in each country and is freely available on the Project Quit Tobacco International website.The project's second component involves developing tobacco cessation clinics that employ culturally sensitive approaches for counseling individuals about how to quit. Cessation training courses and videos modeling how to counsel different types of patients at different stages of readiness to quit have

been introduced in both countries. Cessation clinics also have been set up specifically for patients with diabetes and TB, diseases gravely affected by smoking. The third project component is a smoke-free homes initiative, a community-based movement to create nonsmoking residences in order to reduce women's and children's exposure to secondhand smoke. In both India and Indonesia, smoking is strongly tied to masculinity and is extremely common amongst men. About 70 percent of men in Indonesia and between 50 and 60 percent of men in India use tobacco. While smoking is very rare among women in both countries, the Nichters' research showed that about 70 percent of women, often along with their children, were frequently exposed to secondhand smoke in their homes. And while women in both countries said they didn't want their husbands to smoke indoors, the vast majority felt powerless to ask their husbands to smoke outside the house. One of the things that we learned early on is that people don't respond real well to international statistics or even national statistics," Mark Nichter said. "If you talk about smoking in general being bad for your health, people don't pay much attention. They want information from doctors who they respect, and they want to know about the dangers of smoking to people like themselves, who doctors see in their practice." The Nichters found that having community leaders sign contracts declaring their households as smoke-free zones led men to agree to comply with this new normative practice. In addition, providing people with stickers or signage, indicating a home or community's intent to be smokefree, was an effective way of spreading the word and reminding men not to smoke."Women liked the fact that they don't even have to say 'no smoking' to men who visit their home; they can just point to a sticker," Mimi Nichter said.While the initial idea of smoke-free homes was simply to keep men from smoking in their households, it has inspired some to quit altogether. "Even though we weren't telling men to quit, some men did so once they weren't smoking in the house. They began smoking less and some of them did quit," Mimi Nichter said. "And there's a great deal of pride among those men who quit. They see quitting as a show of will power, not a loss of masculinity." The Nichters' work is not without its challenges. India and Indonesia are among the countries with the highest rates of tobacco use in the world. Both countries grow their own tobacco and have their own brands of cigarettes, and Indonesia has some of the world's most aggressive cigarette ads, targeting young men and, more recently, women they hope will take up the habit. But this hasn't discouraged the Nichters, who spend a couple of months each year working on the ground in India and Indonesia in addition to maintaining regular contact year-round with project teams in the two countries."The future of tobacco control is in the hands of our colleagues in India and Indonesia, but we feel good about helping build a strong foundation upon which to build a tobacco cessation community of practice in both countries," said Mark Nichter.Since Project Quit Tobacco International's inception a decade ago, medical professionals, including doctors and health workers from many communities in both countries have received training in tobacco cessation and implementation of smoke-free home community interventions.The smokefree homes initiative continues to spread and was recently been adopted by the Ministry of Health in the Indian state of Kerala, where much of the project's work has been centered. The

Nichters also hope that Project Quit Tobacco International might also serve as an inspiration for other medical schools, clinics and community-based tobacco cessation efforts globally."We have developed a website where anyone interested can go to see our educational materials, videos for training doctors on how to counsel patients for cessation, videos on the smoke free homes initiatives, and the medical school curriculum. We encourage others from around the globe to look at the materials and adapt them to their cultural context," Mark Nichter said."We emphasize that this is not a one-size-fits-all set of resources that you can just transplant to a different country," he added. "As engaged medical anthropologists, we want others to do the formative research necessary to come up with programs that make sense in their own cultural settings."

Towards a tobacco-free world Considering the fact that tobacco use is a major cause of preventable death and disease worldwide and kills nearly 6 million people globally every year a global initiative towards an endgame for tobacco is of utmost importance . A global campaign should be launched focusing on advocating strong tobacco control policies from a youth perspective, including measures to prevent youth access to tobacco, and countering tobacco industry interference in national policymaking. Individuals, non-profit organisations and public health organisations should actively participate in the campaign by distributing placards and displaying posters with the latest information on the ill-effects of consuming tobacco and smoking. Users should be encouraged to quit tobacco consumption and its related products and a public boycott of companies that sell cigarettes and other tobacco products should be organized . Efforts should be made to draw public and government attention on the need to take effective measures to prevent tobacco consumption which contaminates the air we live in. The government, individuals and public health organisations should organize health camps and rallies to create a tobacco-free society .

Turkey a model of success in tobacco control Today, people in Turkey breathe more easily than they did just a few years ago, said DirectorGeneral of the World Health Organization Dr Margaret Chan, marking World No Tobacco Day, 31 May, in Istanbul, Turkey. She went on to point out that in the year 2000, 20% of patients hospitalized in Turkey had a smoking-induced disease and that such diseases accounted for more than half of all hospital deaths. More than half of all Turkish men were daily smokers. By 2008, however, Turkey benefited from some of the most stringent tobacco control measures in the world making indoor spaces 100% smoke free. The impact on health has been clear with a 20%

drop in the smoking related hospital admissions and smoking prevalence down to 27%.Dr Chan noted that this was a particularly remarkable achievement given Turkeys strong associations with tobacco. Its world famous oriental tobacco dates back to the Ottoman Empire and for 400 years tobacco was an important part of Turkeys political and cultural identity, as well as a major driver of the economy. Referring to the advances as true Turkish delight, Dr Chan summed up with the words: If it can work in a country like Turkey, with such a long history and entrenched culture of tobacco production and use, it can work anywhere. Turkey has been a shining and inspiring model of success.The Prime Minister Recep Erdogan was presented with the WHO Director-Generals World No Tobacco Day special recognition certificate. Turkey is the only country in the world to have received three WHO awards for achievements in tobacco control.