Tobacco policy (in)coherence in Mozambique: an examination of national and subnational stakeholder perspectives.

Mozambique ranks fifth on the list of tobacco producing countries in Africa, while also being a Party to the WHO Framework Convention on Tobacco Control (FCTC). Tobacco farming is regarded by some governments as a strategic economic commodity for export and remains deeply entrenched within Mozambique's political and economic landscape. This study uses a qualitative description methodology to identify tensions, conflicts and alignment or misalignment in policy on tobacco across government sectors and levels in Mozambique. We conducted semi-structured qualitative interviews with 33 key informants from sectors across national and subnational levels including health, agriculture, economic and commercial sectors, as well as non-state actors from civil society organizations, the tobacco industry, farmers unions and associations and individual farmers. Incoherence was present across sectoral mandates, perspectives on industry's presence in the country and regions and between FCTC provisions and informant perceptions of tobacco production as a development strategy. Despite tobacco being viewed as an important economic commodity by many informants, there was also widespread dissatisfaction with tobacco from both farmers and some government officials. There were indications of an openness to shifting to a policy that emphasizes alternatives to tobacco growing. The findings also illustrate where points of convergence exist across sectors and where opportunities for aligning tobacco policy with the provisions of the FCTC can occur.

Seguir avanzando en las Américas: el control del tabaco fomenta el desarrollo sostenible*

[EXTRACTO]. el presente número especial de la Revista Panamericana de Salud Pública aporta datos relevantes y actuali- zados de la Región de las Américas, abriendo camino por una senda en la que aún queda mucho trabajo por hacer para mejo- rar las medidas de control del tabaco. Además, las múltiples iniciativas de investigación descritas en este número demues- tran la enorme capacidad y colaboración presentes en la Región. Este número especial ha sido posible gracias a la cooperación de investigadores, organizaciones nacionales e internacionales, organismos intergubernamentales, puntos focales de control del tabaco en los ministerios de salud y diferentes especialistas en el control del tabaco que colaboran de forma continua para lograr los objetivos de salud.

Using MPOWER policies to address tobacco impact on the environment

[EXTRACT]. Beyond the call to governments and policymakers, World No Tobacco Day 2022 established an opportunity to create, or strengthen, partnerships between academics, advo- cates, youth and others in tobacco control and environmental protection, mobilizing a wider group of stakeholders in advo- cacy for a healthier planet. Strengthening the implementation of the WHO FCTC, including Article 18, will provide additional momentum to address the environmental harms of tobacco.

Moving forward in the Americas: tobacco control fosters sustainable development

[EXTRACT]. This special issue applies this lens, bringing an equity focus to tobacco control measures, with particular attention paid to vulnerable groups (e.g., youth and low-income quintiles) and including a gender perspective. Further, one analysis empha- sizes the extent of environmental damage posed across the tobacco production chain, including the economic cost of tobacco products waste, and proposes policies to address this.

Climate Change, Public Health, Health Policy, and Nurses Training.

There are few educational programs in the United States that have a primary focus on preparing nurses to engage in all levels of public health, health policy, and climate change. The United Nations sustainability development goals (SDG) and the Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity (2021) report underscored the importance of key stakeholders, including nurses, engaging in advocacy and policy to promote health equity. We discuss the role of nursing at the intersection of public health, policy, climate change, and the SDG. We also discuss the history and merger of the University of California San Francisco (UCSF) School of Nursing public health and health policy specialties, a significant innovation in our effort to promote health equity. We provide a brief overview of the redesigning of our curriculum that meets the needs of today's learners by including content on climate change, data analytics, and racial, social, and environmental justice. Finally, we emphasize the need to train the next cadre of nurses interested in careers in public health and health policy for us to meet the challenges facing our communities. (Am J Public Health. 2022;112(S3):S321-S327. https://doi.org/10.2105/AJPH.2022.306826).

Is It Possible to Solve the Conflicts Over Conflict of Interest? Comment on "Towards Preventing and Managing Conflict of Interest in Nutrition Policy? An Analysis of Submissions to a Consultation on a Draft WHO Tool".

Addressing conflicts of interest (COIs) when developing and implementing policies to address commercial determinants of health is pivotal to ensure that these policies are free from commercial and other vested interests of unhealthy commodities industry. As a concept, this is well accepted within the tobacco control community, and supported by the existence of an international treaty, the WHO Framework Convention on Tobacco Control (FCTC). But in nutrition policy the engagement of the food industry appears to remain controversial, as efforts to create partnerships are still underway. There is a need to undertake evaluation of existing COI policies to assess their implementation and outcomes, creating best practice models that can be replicated, and understanding how to change norms within governments. Additionally, a review of existing norms, codes of conduct, and ethics to determine their impact on preventing COI would guide future implementation of these measures. Finally, governments, academics, and advocates should consider how existing tools, guidelines or other instruments could help frame the COI discussion to ensure its political feasibility. There is a need for a discussion on whether the current approach of separate policies for distinct industries is preferable than a broader COI policy that would be applicable to a wide range of unhealthy commodities and across governmental sectors.

Seguir avanzando en las Américas: el control del tabaco fomenta el desarrollo sostenible

es

Health without filters: the health and environmental impacts of cigarette filters. / Saúde sem filtro: os impactos dos filtros dos cigarros na saúde e no meio ambiente.

Tobacco-related diseases kill eight million people worldwide ever year and are responsible for thousands of cases of cancer, cardiovascular disease and other illnesses in Brazil. Cigarette filters are believed by many to reduce the health risks of smoking. This article outlines the history of the technology of filters and discusses the impacts of these cigarette design features and their regulation. We conducted a literature review to assess the impacts of this technology. The results show that filters were initially developed for aesthetic purposes and later improved and marketed as a harm reduction technology. The most widely-used filters are those made of cellulose acetate with or without activated carbon. Despite smokers' beliefs and advertising claims, filters have no health benefits and filter tip ventilation can increase the health risks of smoking. Filters can also make cigarettes more appealing and cause significant environmental impacts. Cigarette filters have no health benefits and lull smokers into a false sense of security and should therefore be banned.

As doenças relacionadas ao tabaco matam oito milhões de pessoas anualmente no mundo e, no Brasil, são responsáveis por milhares de casos de cânceres, doenças cardiovasculares e outras enfermidades. Os filtros nos cigarros são percebidos como uma tecnologia que reduziria os danos à saúde. O objetivo deste artigo é descrever a tecnologia dos filtros, seu histórico, seus impactos e discutir formas de regulação. Foi feita uma busca na literatura para avaliar os impactos desta tecnologia. Os resultados mostram que os filtros foram inicialmente desenvolvidos para fins estéticos, e posteriomente aprimorados e promovidos como uma tecnologia para redução de danos. O filtro de cigarro mais utilizado é o de acetato de celulose, combinado ou não com carvão ativado. Apesar das propagandas e da percepção dos fumantes, os filtros não trazem nenhum benefício à saúde, e sua associação com tecnologias como a perfuração nas ponteiras podem trazer mais riscos à saúde. Os filtros também podem tornar os cigarros mais atrativos e causam impactos ao meio ambiente. Por proporcionarem uma falsa percepção de riscos e nenhum benefício, os filtros deveriam ser uma tecnologia proibida.

Saúde sem filtro: os impactos dos filtros dos cigarros na saúde e no meio ambiente / Health without filters: the health and environmental impacts of cigarette filters

Resumo As doenças relacionadas ao tabaco matam oito milhões de pessoas anualmente no mundo e, no Brasil, são responsáveis por milhares de casos de cânceres, doenças cardiovasculares e outras enfermidades. Os filtros nos cigarros são percebidos como uma tecnologia que reduziria os danos à saúde. O objetivo deste artigo é descrever a tecnologia dos filtros, seu histórico, seus impactos e discutir formas de regulação. Foi feita uma busca na literatura para avaliar os impactos desta tecnologia. Os resultados mostram que os filtros foram inicialmente desenvolvidos para fins estéticos, e posteriomente aprimorados e promovidos como uma tecnologia para redução de danos. O filtro de cigarro mais utilizado é o de acetato de celulose, combinado ou não com carvão ativado. Apesar das propagandas e da percepção dos fumantes, os filtros não trazem nenhum benefício à saúde, e sua associação com tecnologias como a perfuração nas ponteiras podem trazer mais riscos à saúde. Os filtros também podem tornar os cigarros mais atrativos e causam impactos ao meio ambiente. Por proporcionarem uma falsa percepção de riscos e nenhum benefício, os filtros deveriam ser uma tecnologia proibida.

Abstract Tobacco-related diseases kill eight million people worldwide ever year and are responsible for thousands of cases of cancer, cardiovascular disease and other illnesses in Brazil. Cigarette filters are believed by many to reduce the health risks of smoking. This article outlines the history of the technology of filters and discusses the impacts of these cigarette design features and their regulation. We conducted a literature review to assess the impacts of this technology. The results show that filters were initially developed for aesthetic purposes and later improved and marketed as a harm reduction technology. The most widely-used filters are those made of cellulose acetate with or without activated carbon. Despite smokers' beliefs and advertising claims, filters have no health benefits and filter tip ventilation can increase the health risks of smoking. Filters can also make cigarettes more appealing and cause significant environmental impacts. Cigarette filters have no health benefits and lull smokers into a false sense of security and should therefore be banned.

Assessing sector representation of non-state actors within the World Health Organisation Framework Convention on Tobacco Control.

The WHO Framework Convention on Tobacco Control (WHO FCTC) has accomplished much in advancing tobacco control. Non-governmental organisations (NGOs) were critical to the development of the Convention, who aided in mobilising stakeholders and advocated for core provisions of the treaty. NGOs and intergovernmental organisation are well recognised within the Convention and deemed essential to its continued implementation and evolution. Further, the treaty has been understood to be multidisciplinary in its aspiration to improve public health, and the role of both health sector and non-health sector stakeholders is an important component for describing the reach and potential for the Convention. In 15 years, however, non-state actors' participation in the WHO FCTC Conference of the Parties (COP) - where Parties to the treaty engage in discussions that shape the treaty's implementation and evolution - has been underrepresented in terms of sectoral diversity. We reviewed COP documents and assessed non-state actors' participation in the COPs since the Convention's entry into force. We conclude that greater inclusion in COPs from health and non-health sector NGOs, intergovernmental organisations and UN Special Agencies would strengthen the global reach and full implementation of the WHO FCTC.

How Should Global Tobacco Control Efforts Be Prioritized to Protect Children in Resource-Poor Regions?

The tobacco industry's aggressive marketing of tobacco products and electronic (e-)cigarettes is well documented. Yet existing restrictions on tobacco and e-cigarette marketing are poorly implemented in most low- and middle-income countries. Ongoing challenges include weak implementation and enforcement of some aspects of the WHO Framework Convention on Tobacco Control and a lack of consensus among health professionals on how to address the tobacco industry's health claims related to e-cigarettes and other novel tobacco products. We argue that, despite these challenges, countries must prioritize the implementation and enforcement of restrictions on tobacco and e-cigarette marketing as these products represent not only a serious public health threat but also a violation of children's rights.

Increased adoption of smoke-free policies on campuses with schools of nursing.

BACKGROUND: In 2015, the majority of U.S. American Association of Colleges of Nursing (AACN)-accredited schools of nursing resided on campuses without smoke-free policies. PURPOSE: To determine the presence of smoke-free policies at AACN-accredited after resolutions from AACN and the American Academy of Nursing, and the creation of online resources. METHODS: Smoke-free policies (2015-2017) were determined through listings on the ANRF College Campus Policy Database© and survey responses from nursing deans. RESULTS: Smoke-free policies for 689 schools of nursing increased from 36% in 2015 to 91% in 2017. There were no significant differences by nursing program types or geographic area. Twenty percent of deans reported using the resources, with over 1700-page views. CONCLUSION: Smoke-free policies increased after support from two national nursing organizations. Learning in a smoke-free environment should be an expectation for nursing students to protect their own health, and to support their future critical role in tobacco control.

The taste of smoke: tobacco industry strategies to prevent the prohibition of additives in tobacco products in Brazil.

BACKGROUND: The tobacco industry (TI) uses several strategies to attract new consumers, including using additives in tobacco products, which makes tobacco especially attractive to youth. Based on scientific evidence and the principles of the WHO Framework Convention on Tobacco Control, the Brazilian Health Regulatory Agency (ANVISA, for the name in Portuguese), published the Collegiate Board Resolution (RDC, for the name in Portuguese) 14/2012 in 2012, prohibiting the addition of substances that enhance the flavour and taste of tobacco products in order to make them more attractive. In response, the TI used various strategies to prevent RDC 14/2012 from entering into force. At the time, the Brazilian additive ban was the most comprehensive in the world as it included a ban on menthol. OBJECTIVES: This paper analyses the arguments and strategies used by the TI to prevent the implementation of the additives ban. METHODS: Review of published articles, reports, legislation and legislative activity, internal TI documents, media stories and other documents to describe TI's reaction to the ban. RESULTS: The results show that the TI used some well-known strategies to delay or cancel the entering into force of the resolution. For example, the TI attempted political interference, used litigation and commissioned studies with findings that questioned the resolution's rationale. The TI strategies used in Brazil are similar to those used at the global level to oppose other tobacco control measures. CONCLUSIONS: TI successfully delayed the most comprehensive additive ban in the world using its usual tactics, despite the fact that none of the arguments presented by the TI had an acceptable scientific basis or evidence.