Advocating Policies for Waterpipe and Cigarettes

Cynthia Callard's work in October 2013 focuses on advocating policies for waterpipe and cigarette use, emphasizing the importance of health rationale, legal structures, and societal impact. The graphics presented illustrate shifting trends in cigarette consumption globally, with a call for action through warnings, youth access control, pricing regulations, and more to combat smoking prevalence and protect public health.

• Advocacy
• Public health
• Tobacco regulation
• Smoking prevention
• Policy advocacy

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1. Advocating Policies for Waterpipe & Cigarettes Cynthia Callard October 2013

2. Adult per capita cigarette consumption, the United States, 19002006. USA annual adult per capita cigarette consumption Warner K E , Mendez D Nicotine Tob Res 2010;12:876-887

3. 1,800 1,600 1,400 1987 = 1,537 1,200 1960 = 1,129 2010 = 1,141 1,000 800 600 Global annual adult (15+) per capita cigarette consumption 400 200 - 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Sources: Averaged values, Maxwell, Euromonitor, USDA: population over 15 years from World Bank.

4. A shifting epidemic *new communities *new patterns of use

5. Health Rationale Political systems Legal structures (FCTC and related regulation) Societies Public health community Tobacco users

7. Warnings Youth Access Tax/Prices Advertising bans Smoke-free spaces Flavour bans Mass media Public education Clinical practice

8. Warnings Youth Access Tax/Prices Advertising bans Smoke-free spaces Flavour bans Mass media Public education Clinical practice *(Canada)

9. 25 21 21 20 19 19 19 20 18 18 17 17 16 16 14 15 12 9 9 10 7 6 5 4 4 5 3 0 2002 20032 2004 2005 2006 2007 2008 2009 2010 2011 2012 Smoking prevalence Children exposed at home Ever used waterpipe CTUMS

10. 25 21 21 Flavour ban 20 19 19 19 20 18 18 17 17 16 16 14 15 12 12 9 9 10 8 7 6 5 4 4 4 5 3 0 2002 20032 2004 2005 2006 2007 2008 2009 2010 2011 2012 Smoking prevalence Children exposed at home Ever used waterpipe CTUMS

11. Victory or Defeat? ? ?

12. Brazil: RESOLUTION - RDC N 14, OF MARCH 15, 2012 Additive ban covers all tobacco products. Art. 2 This Resolution applies to all tobacco products sold in Brazil, whether made in Brazil or imported. BUT Currently challenged at Supreme Court. http://www.tobaccocontrollaws.org/files/live/Brazil/Brazil%20- %20RDC%20No.%2014_2012.pdf

13. European Union Tobacco Directive original Considering the Directive's focus on young people, tobacco products other than cigarettes, roll-your-own tobacco and smokelesstobacco which are mainly consumed by older consumers, should be granted an exemption from

14. European Union Tobacco Directive as amended by EP. Considering the Directive's focus on young people, tobacco products other than cigarettes, roll-your-own tobacco and water-pipe tobacco which are mainly consumed by older consumers, should be granted an exemption from http://www.europarl.europa.eu/sides/getDoc.do?type=TA&reference=P7-TA-2013- 0398&language=EN&ring=A7-2013-0276

16. Widespread TC consensus: Science Policy Strategy Broad-based TC community Pan-partisan Multi-sectoral International

17. What do we want? Who can give it to us? What do they need to hear? Who do they need to hear it from? How can we get them to hear it?

18. #1: Get on the Agenda #2: Get Favourable Decisions #3: Protect gains/ address vulnerabilities (repeat as necessary)

19. Same Vulnerabilities

20. same, same Publish or Perish #1

21. Multisectoral Finance Health Education same, same Need Multiple Points of Contact Multi-jurisdictional International, National, subnational Corporate, CSO & home

22. same, same Need to under- stand the decision maker Canadian MPs: Live in the moment Are competitive and tribal Don t want to be disliked Barter policies Think locally Are not overly numerate Which side are you on?

23. same, same Need for sustained resources It s not a part-time job.

24. same, same Need to take risks There is a reason we are an unbranded movement.

25. Same Same Barriers The capacity of decision makers to: Deflect responsibility Deny the problem Discredit the evidence Delay action

26. Somewhat different Barriers Tobacco control is understood to mean cigarette control (perception is reality) Prevents instant adoption of Economic rationale, health rationale, cultural acceptance, priority over other health concerns.

27. Same same Mutable Problem Money is the root of all smoking! Suppliers are driven to adapt or overcome regulatory and other barriers.

28. same, same What do we want NOW? Challenge to find the right ask What will we want NEXT?

29. Tobacco Control is a changing game. Scott Sherman, October 21, 2013

30. We face the challenge of unimpeded emergence of new products. Cheryl Healton October 21, 2013

31. If we cant do it, no one can. Omniyat Al Hajeri October 21, 2013