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Tobacco use remains the indisputably leading preventable cause of cancer

This Tuesday, February 4, marked World Cancer Day.  In honor of the occasion, the World Health Organization (WHO) and the International Agency for Research on Cancer (IARC) released coordinated reports on the status of cancer prevention research and recommendations for combatting the disease worldwide.  IARC’s World Cancer Report: Cancer Research for Cancer Prevention provides a comprehensive overview of current research on cancer prevention and how it can be used to implement effective strategies for cancer prevention and early detection, including in low- and middle-income countries.  WHO’s Report on Cancer: Setting Priorities, Investing Wisely and Providing Care for Allprovides a global agenda for helping countries set priorities for investment in cancer control and mobilization of stakeholders.

IARC’s report highlights the indisputable fact that tobacco use is the leading preventable cause of cancer worldwide.  Globally, cigarettes are the most common – and most deadly – type of tobacco used – causing at least 20 types or subtypes of cancer.  According to the report, smokers are more than 20 times as likely to get cancer of the lung, trachea, or bronchus than nonsmokers.   There is also considerably elevated risk for other cancer types, such as head and neck cancers, and other serious health conditions, such as cardiovascular disease.

While another recent WHO report identified that global tobacco use was declining, including among males for first time ever, WHO’s newest report finds that tobacco use is responsible for 25 percent of cancer deaths – an increase from prior estimates.  While smoking rates are declining, population growth and aging of long-term smokers have led to increased disease rates.  With 1.3 billion people using tobacco products worldwide, and 80 percent of smokers living in low- or middle-income countries where tobacco use rates remain high in many countries, the global burden of tobacco-caused cancers is likely to remain high.  In fact, WHO notes that the number of cancer cases worldwide is expected to nearly double by 2040, with people in low- and middle-income countries and lower socioeconomic groups in higher-income countries being most affected.  IARC projects that tobacco use will cause a billion deaths this century if more is not done to combat the issue.

Complementing IARC’s report, WHO report provides a blueprint for effective cancer control, which includes implementing feasible and evidence-based policies like the WHO’s “Best Buys” of tobacco tax increases, smoke-free indoor workplaces and public places, health information and warnings, and bans on tobacco advertising, promotion and sponsorship.  WHO’s Framework Convention on Tobacco Control (FCTC), signed by 181 Parties, and the FCTC Protocol to Eliminate Illicit Trade in Tobacco Products are international treaties that help to support implementation of effective tobacco control strategies and reduce tobacco smuggling around the world.  However, WHO notes that progress is inadequate, and tobacco control remains the main cancer prevention priority in nearly every country, as its use causes 2.4 million cancer deaths each year.  In particular, greater action is needed in restricting tobacco advertising and promotion.  WHO also recommends regulation of e-cigarettes and strategies to keep them away from children.

WHO member states have pledged to work towards a target of 30% relative reduction in the rate of tobacco use by 2025, a benchmark many countries are unlikely to meet.  Increased action is particularly needed in three countries – ChinaIndia, and Indonesia – which comprise more than half of the world’s male smokers.  WHO highlights that enablers of successful cancer control include collaboration with non-government organizations that can engage in political advocacy and convene key stakeholders, and prioritization of research and innovation.  Doubling down on what we know works is the best strategy for reducing tobacco-caused disease and death across the globe.

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