WHO FCTC Global Knowledge Hub on Smokeless Tobacco

Prof. RAVI MEHROTRA

MD, FRCPath, DPhil Director, WHO FCTC Global Knowledge Hub on Smokeless Tobacco

National Institute of Cancer Prevention & Research I-7, Sector-39, District Gautam Budh Nagar, NOIDA

www.untobaccocontrol.org/kh/smokeless-tobacco/

National Institute of Cancer Prevention and Research (NICPR)

Global burden of Smokeless Tobacco (SLT)

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241.5

30.8 16.6 9.4 4.1 3.3 3.2 2.5 2.4 2.4 2.4 2.4 2.4 2.0 1.9 1.9 1.8 1.8 1.6 1.5 1.4 1.3 1.2

0.0

50.0

100.0

150.0

200.0

250.0

SLT

user

s (m

illio

n)

•  Nearly 95% of Global SLT users are in top 23 high-

burden countries

•  Nearly 80% of Global SLT users are in SEAR

•  Nearly 67% of Global SLT users reside in India

Inauguration of the Global Knowledge Hub on Smokeless Tobacco at NICPR- 6th April, 2016

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Mandate

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§  Generate and share expertise, information and knowledge.

§  Assist Parties of the WHO FCTC in the area of SLT control.

§  Policy oriented additional project.

Website (http://untobaccocontrol.org/kh/smokeless-tobacco/)

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ACTIVITIES

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Publications so far.. (2016-17)

§  Sinha DN, Suliankatchi RA, Gupta PC, Thamarangsi T, Agarwal N, Parascandola M, Mehrotra R. Global burden of all-cause and cause-specific mortality due to smokeless tobacco use: systematic review and meta-analysis. Tob Control 2016; Nov 30. pii: tobaccocontrol-2016-053302. doi: 10.1136/tobaccocontrol-2016-053302.

§  Sinha DN, Kumar A, Bhartiya D, Sharma S, Gupta PC, Singh H, Mehrotra R. Smokeless Tobacco Use among Adolescents in Global Perspective. Nicotine Tob Res 2017; Jan 19. doi: 10.1093/ntr/ntx004.

§  Sinha DN, Bhartiya D, Kumar A, Singh H, Mehrotra R. Men in Myanmar Submerged in Tobacco: Women Following. Nicotine Tob Res 2016; Dec 7. pii: ntw314.

§  Sinha DN, Gupta PC, Kumar A, Bhartiya D, Agarwal N, Sharma S, Singh H, Parascandola M, Mehrotra R. The Poorest of Poor Suffer the Greatest Burden from Smokeless Tobacco Use: Study from 140 countries. Accepted in Nicotine Tob Res

§  Nethan S, Sinha DN, Mehrotra R. Non Communicable Disease Risk Factors and their Trends in India. Asian Pac J Cancer Prev 2017; 18(5):2005-2010

§  Bhatt D, Sharma S, Gupta R, Sinha DN, Mehrotra R. Predictors of hypertension among non-pregnant females attending health promotion clinic with special emphasis on smokeless tobacco: A cross-sectional study. Accepted in BioMed Research International 2017

Tobacco Control and Health Informatics Workshop (March 29-30, 2017)

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Inter-Country Meeting on Smokeless Tobacco Policy Control

(16-18 Aug, 2017, Le Meridian, New Delhi)

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Inter-Country Meeting on Smokeless Tobacco Policy Control

(16-18 Aug, 2017, Le Meridian, New Delhi)

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FACTSHEET

Available On: http://untobaccocontrol.org/kh/smokeless-tobacco/

Obscure definition

No definition

Express definition

General definition

SLT Hub in Media

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Research Work

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Submitted Papers

§  Smokeless tobacco use attributable oral cancer: A Systematic global review and

Meta-analysis: Nicotine Tobacco Research

§  Systematic review and Meta-analysis of the association between smokeless

tobacco use and coronary heart disease: A Global Perspective- Nicotine Tobacco

Research

§  Rising face of Risk Factors of Non-Communicable Diseases: Findings from the

Myanmar STEPS Surveys (2009 and 2014)

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Ongoing Research

§  Global progress on policies pertaining to health warnings on tobacco products as per

Article 11 of WHO FCTC.

§  Evaluation of global policies as per Article 12 of WHO FCTC: A global analysis

§  Global progress on policies pertaining to prohibition of sale of tobacco products to minors

§  Evaluation of global policies as per Article 13 of WHO FCTC: A global analysis

§  Future avenues of Oral cancer biomarkers through RNA-Seq technology

§  Global review on policy implementation status in Smokeless tobacco control

§  SLTChemDB: Database of Chemical Constituents of Smokeless Tobacco Products

§  Implementation of Article 20 of FCTC 16

Collaborative Ideas

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Objectives: ▰ Evaluate and strengthen domestic policies on SLT taxation in the region

▰ Evaluate and strengthen the national level policies on ban on TAPS in SEAR

▰ Encourage Parties to implement larger and stronger health warnings (HWs)

▰ Collect, compile and create evidence on SLT taxation, HWs and TAPS ban of SLT products in SEAR

▰ Capacity building.

Evaluating Global Policies on Taxation and TAPS

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▰ The current repository is for cigarette packages, SLT specific warnings are yet to be collated.

▰ Purpose: it will serve as a database for Parties to share and implement in their jurisdictions

Creating a repository for SLT relevant Health Warning

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▰ Parallel to second-hand smoke, the harmful effect of smokeless tobacco is assumed to be spread by spitting in public places.

▰ However, lack of evidence gives us no clear picture.

▰ Need for further research in this area

Providing evidence on effect of ban on spitting

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▰ Some Parties are practicing effective media campaigns against smokeless

tobacco use.

▰ Such campaigns need to be highlighted and their outcomes to be shared

in an inventory for Parties’ reference and support.

Developing an inventory of nations having appealing media campaigns against SLT use

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▰ Capacity building

▰ Training of health professionals

▰ Interaction among stakeholders and other knowledge hubs for research

Global webinars related to SLT policy

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▰ Standard Operating procedures (SOPs) for testing and analysis of Tobacco products are presently focused on smoked products.

▰ Such reference manuals, relevant to Smokeless products, are need of the hour.

Assisting NTTLs in developing standard protocols for tobacco testing

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NICPR Team

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