Linking data to tobacco control program action among students aged 13-15 in Association of Southeast Asian Nations (ASEAN) member states, 2000-2006.

BACKGROUND: The Association of Southeast Asian Nations (ASEAN) has made tobacco use prevention a primary health issue. All ASEAN countries except Indonesia have ratified the World Health Organization Framework Convention on Tobacco Control (WHO FCTC), the world's first public health treaty on tobacco control. METHODS: Global Youth Tobacco Survey (GYTS) data were collected from representative samples of students in school grades associated with ages 13-15 in Cambodia, Indonesia, Laos (Vientiane), Malaysia, Myanmar, Philippines, Singapore, Thailand and Vietnam (Hanoi). RESULTS: Current cigarette smoking ranged from less than 5% (Vietnam and Cambodia) to 20.2% in Malaysia. Current use of tobacco products other than cigarettes was less than 10% in all countries. Boys were significantly more likely than girls to smoke cigarettes or use other tobacco products. Exposure to second-hand smoke in public places was greater than 50%, direct pro-tobacco advertising exposure was greater than 75% and over 10% of students were exposed to indirect advertising. Over 60% of students who currently smoked cigarettes wanted to stop, but 80% who tried to quit in the year prior to the survey failed. CONCLUSIONS: Efforts to reduce the current and projected harm caused by tobacco use in the ASEAN countries are urgently needed. ASEAN countries need to expand their national comprehensive tobacco prevention and control programs and enforce those laws already passed. Without this effort little reduction can be expected in the burden of chronic diseases and tobacco-related mortality.

Alternative forms of tobacco use.

BACKGROUND: A review of the available scientific literature concerning forms of tobacco use other than regular cigarettes, cigars and pipes, the nature of such products, prevalence data and trends, health effects, regulatory issues and preventive measures. RESULTS: Narghile (water pipe), bidis, kreteks and other forms of oral tobacco are traditionally used in many low-income countries, and some of these are currently spreading to the Western countries. They are all linked to negative effects similar to, and often greater than, those associated with common cigarette smoking. Various potentially reduced exposure products (PREPs), including snus, targeted at smokers aware of the health risks of regular cigarettes, have recently been developed by the tobacco industry. Their pathogenic potential varies widely and is not fully known; it is in any case greater than that of pure nicotine forms (such as medicinal nicotine). Their use as cigarette substitutes should not be considered even by inveterate smokers who are unable or unwilling to quit nicotine before further independent evaluation and control. CONCLUSIONS: There is no such thing as a safe tobacco product. Like cigarettes, alternative forms of tobacco use need regulatory measures that are adapted to local situations and supplemented by preventive measures within the World Health Organization's Framework Convention for Tobacco Control.

A survey of TB services in hospitals in seven large cities in Asia and North Africa.

SETTING: Hospitals in Bangkok, Cairo, Dhaka, Jakarta, Karachi, Kathmandu and Manila. OBJECTIVES: To evaluate tuberculosis (TB) services provided in public and private hospitals in big cities. DESIGN: A survey on TB services in hospitals was carried out in 2005 by visiting hospitals and face-to-face interviews. Selection criteria were determined for each city. All hospitals were included if feasible. RESULTS: The number of hospitals included in the survey ranged from 52 in Bangkok to 106 in Jakarta. The proportion of private hospitals with access to a National Tuberculosis Programme (NTP) manual ranged from 8% in Jakarta to 89% in Bangkok. Private hospitals rarely functioned as a basic management unit (BMU) of the NTP, except in Bangkok. TB treatment was not always free of charge in BMU hospitals. The proportion of non-BMU hospitals that never referred/reported TB patients to the NTP was substantial in Bangkok, Dhaka, Jakarta, Karachi and Manila. Non-BMU hospitals did not routinely use standard NTP regimens, especially in Jakarta, Karachi and Manila. In non-BMU hospitals, patient tracing mechanisms were generally lacking and treatment outcome was not known. CONCLUSION: TB services provided in non-BMU hospitals were not satisfactory. NTPs need to involve non-BMU hospitals in TB control.

Impact of haze from forest fire to respiratory health: Indonesian experience.

OBJECTIVE: This paper will describe the impact on the human lung of haze from forest fires in Indonesia based on data collected from different provinces. METHODOLOGY: Data were collected from personal reports from pulmonologists working in the area as well as from province/district health offices and hospitals. RESULTS: These data show that there was a significant impact of haze to the human lung. There was a significant increase in respiratory conditions, lung function complaints and other related impacts. CONCLUSION: Further studies, especially cohort studies, should be undertaken so that the long-term' impact of pollution from forest fires can be known.

Prevalence of tuberculosis in Indonesia, Singapore, Brunei Darussalam and the Philippines.

Tuberculosis remains a major health problem in South-East Asia and ranks high in the list of causes of morbidity and mortality. There are still many smear-positive cases, about half a million in Indonesia and almost 400,000 in the Philippines, and these are a reservoir of infection. Cooperation between countries in this region is required for the control of tuberculosis.