WHO Report Calls On Countries To Tackle Tobacco

Major WHO report calls on countries to tackle leading health risks such as tobacco

"Focussing on New Zealand's biggest health risks such as tobacco can reduce inequalities, adding life to years as well as years to life," according to Dr Anthony Rodgers, the New Zealand principal author of the World Health Organisation's (WHO) major annual report - World Health Report 2002: Reducing Risks to Health, Promoting Healthy Life - which was released today.

WHO broke new ground in the 1990s with the first-ever global analysis of disease and injury. This report goes one step further by assessing the risks that cause poor health globally, and what can be done about them.

"Tobacco is head and shoulders above our other risks to health. For countries like New Zealand, it's the leading cause of lost healthy life years by a wide margin," said Dr Rodgers.

The WHO report identifies two specific actions that could address these risks in New Zealand:

* Improving tobacco control, such as legislation to reduce harm from second-hand smoke;

* Gradually reducing salt levels in manufactured foods, like bread, breakfast cereals and processed meat, so that the whole population benefits from lower blood pressure.

Main findings of the World Health Report 2002

The report examines the impact of more than 25 major risks to health world-wide. It finds that the top 10 risks globally are: childhood and maternal underweight; unsafe sex; high blood pressure; tobacco; alcohol; unsafe water, sanitation and hygiene; high cholesterol; indoor smoke from solid fuels; iron deficiency and overweight/obesity.

"The report shows for the first time that 40 percent of global deaths are due to these 10 major risk factors, while the next 10 risk factors account for only about 5 percent more deaths. This means we need to concentrate on the major risks if we are to make big gains in healthy life expectancy," said Dr Rodgers.

Another New Zealander, Professor Christopher Murray who is a WHO Executive Director and director of the World Health Report 2002 said, "Globally, we need to achieve a much better balance between preventing disease and merely treating its consequences. This can only come about with concerted action to identify and reduce major risks to health. Although the report carries some ominous warnings, it also opens the door to a healthier future for all countries - if they're prepared to act boldly now."

The report also examines what can be done about these big risks by assessing the effectiveness and costs of relevant interventions.

The potential benefits from tackling known risks are much greater than commonly thought, and the risks can mostly be reversed within just a few years. Implications for NZ: big gains & reduced health inequalities from tobacco control The World Health Report shows how most of the lost healthy life years from tobacco occur in middle-aged people, often involving lost quality of life as well as premature death.

"A dozen people a day die from tobacco in New Zealand," said Dr Rodgers. "About 4,500 die every year. Smoking harms people of all ages - from stunting growth in the womb,cot death in babies, asthma in young adults through to life-threatening or disabling stroke, heart disease or cancer in middle aged and elderly."

The report also highlights how tobacco affects not only smokers but also others around them, most importantly young children who are not in a position to protect themselves.

Commenting on the report, Dr Diana North, Director of The Heart Foundation and the Chair of the Smokefree Coalition said, "Tobacco costs lives. Making smoking indoors less socially acceptable is a powerful tool to encourage quitting, often more powerful than fear of disease. Clearly, the Smokefree Environments Bill which denormalises smoking indoors and is being currently considered by The Health Select Committee, represents a great opportunity to improve the health of all New Zealanders."

The Smokefree Environments Bill aims to make all workplaces and schools smokefree, protect workers from second hand smoke and provide more consumer information to smokers.

Dr Tony Blakely at the University of Otago, led a team assessing the extent to which risks affect those living in poverty around the world for The World Health Report.

"Tobacco control is a powerful way to reduce health inequalities in New Zealand," said Dr Blakely. "A recent Ministry of Health Report 'Inhaling Inequality' concluded that tobacco causes about one-third of the gap in health between rich and poor in New Zealand." Implications for NZ: healthier nutrition and healthier lives Many of the leading risks identified in the report could be improved by healthier nutrition. Effective government-led changes can both improve public health overall, and reduce social inequalities in health. A good example in New Zealand would be encouraging food manufacturers to gradually reducing the very high salt levels in processed foods, said Dr Rodgers.

The Heart Foundation Pick the Tick programme has also achieved this goal in New Zealand. Research has shown the significant impact the programme has had on the salt content of everyday foods in New Zealand, with over 33 tonnes of salt being excluded from breads, breakfast cereals and margarines.

"The recent Hot Chips initiative is another good example in New Zealand. This involves promoting best-practice deep-frying techniques for producing lower fat chips, using a variety of improvements such as optimal cooking oil temperature and thickness of chips."

Dr Rodgers became involved in authoring the WHO report through groundbreaking international work on the causes of heart disease and stroke at The University of Auckland's Clinical Trials Research Unit, part of the Faculty of Medical and Health Sciences. Since its inception in 1989 the Unit has co-ordinated clinical trials involving tens of thousands of people in Australasia, Asia and Europe.

As the main annual report from WHO, the publication has huge global reach. The full World Health Report 2002 is available from 0100 Thursday NZ time at www.who.int/whr/

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