#Tobacco compliance Brazil

[freyrnigeria]

Tobacco product registration in Brazil is a complex regulatory landscape that manufacturers and importers must comprehend and ensure compliance with as Brazil strengthens its tobacco control policies. This blog provides a summary of the main points made in the infographics about Brazil's compliance with tobacco products.

Overview of Brazil's Tobacco Control Policies Brazil has taken strong measures to cut down on tobacco use and protect public health. These are some:

Brazil's ban on tobacco flavors and additives: Tobacco products cannot contain any additives, including flavors like menthol. Restrictions on tobacco advertising in Brazil: Although there are exceptions for specific circumstances, tobacco advertising and promotion are strictly prohibited. Smoking Bans: In order to promote a healthier environment for all citizens, smoking is outlawed in nearly all enclosed public spaces and workplaces with more than one employee. Products That Can Be Smoked In Brazil, the following products can be smoked:

To be able to legally sell their products in the country, manufacturers must ensure that they fall into one of these categories.

Administrative Methodology for Tobacco Item Enrollment in Brazil The enrollment cycle for tobacco items in Brazil includes a few basic advances:

The manufacturer or importer of tobacco products submits an application to the Brazilian Health Regulatory Agency (ANVISA) for registration in accordance with Brazilian tobacco control policies. The application is then evaluated by ANVISA to ensure compliance with regulations. If the application is approved, ANVISA issues a registration certificate to the manufacturer or importer. Labeling and Packaging: The registered tobacco product must adhere to Brazilian labeling and packaging regulations, which include rotating nine (9) pictorial health warnings that cover 100 percent of the back of the packages every Sale and Distribution Brazil permits the sale and distribution of the registered tobacco product. Regulations for Sale, Labeling, and Packaging All tobacco products sold in Brazil must be packaged and labeled properly. Important tobacco laws in Brazil include:

Tobacco packaging from Brazil: Tobacco items should be bundled in a manner that doesn't misdirect shoppers about the wellbeing dangers of smoking. On packaging, misleading terms are not allowed, but other elements like colors and numbers are not. Labeling of tobacco products Brazil: Every five months, tobacco products must rotate through nine (9) pictorial health warnings that cover the entire back of the package. An extra text cautioning should cover 30% of the front lower part, and a subjective constituents and outflows explanation should cover 75% of one parallel side. Brazil's restrictions on tobacco sales: Only licensed retail establishments can sell tobacco products. The offer of single cigarettes, little parcels of cigarettes, and tobacco items through the web and in instructive and medical care establishments is denied. Brazil's tobacco promotion and advertising: The only exception granted for tobacco advertising and promotion is the display of the products at the point of sale. Sponsorship of tobacco products as well as sponsorship-related publicity are subject to some restrictions. Taxation: Merchants should enroll for charge stamps alongside different prerequisites like confirmation of installment of Monetary Expense for Sterile Cautiousness, a Cd ROM with the electronic mark record, and duplicates of vital reports. Conclusion It can be difficult to comprehend Brazil's regulatory landscape for tobacco products. Notwithstanding, understanding the key consistence prerequisites is significant for producers and shippers meaning to enter or keep up with their presence in this market. Consultations with regulatory affairs specialists can provide valuable insights into ensuring compliance with Brazilian laws for additional assistance. Businesses can not only comply with Brazil's tobacco regulations by following these guidelines, but they can also help public health efforts to reduce tobacco use in Brazil.

[lalsingh228-blog]

Adult Ventilators Market Projected to Show Strong Growth

Global Adult Ventilators Market Report from AMA Research highlights deep analysis on market characteristics, sizing, estimates and growth by segmentation, regional breakdowns & country along with competitive landscape, player’s market shares, and strategies that are key in the market. The exploration provides a 360° view and insights, highlighting major outcomes of the industry. These insights help the business decision-makers to formulate better business plans and make informed decisions to improved profitability. In addition, the study helps venture or private players in understanding the companies in more detail to make better informed decisions. Some are the key & emerging players that are part of coverage and have being profiled are Philips Healthcare (Netherlands), ResMed (United States), Medtronic (Ireland), Becton, Dickinson and Company (United States), Getinge (Sweden), Dräger (Germany), Smiths Group (United Kingdom), Hamilton Medical (Switzerland), GE Healthcare (United States), Fisher & Paykel (New Zealand),. Get Free Exclusive PDF Sample Copy of This Research @ https://www.advancemarketanalytics.com/sample-report/51343-global-adult-ventilators-market The upsurging advancements in the medical industry have helped global adult ventilator manufacturers to improve business growth. An adult ventilator is a machine that supports patients with chronic respiratory disease or insufficient breathing while inhaling and exhaling air into and out of the lungs. It is also a diagnostic tool to measure the static compliance of airway resistance and irregular functioning of the respiratory system. A rapid growth in the geriatric population who are more prone to respiratory disorders and high prevalence of chronic respiratory diseases primarily contribute towards the growth of the Adult Ventilators market.

The titled segments and sub-section of the market are illuminated below:

by Type (Intensive Care Ventilators (High-end ICU Ventilators, Mid-end ICU Ventilators, Basic ICU Ventilators), Portable/Transportable Ventilators), Application (Hospitals and Clinics, Home Care, Ambulatory Care Centers, Emergency Medical Services (EMS)), Mode (Combined Mode Ventilation, Volume Mode Ventilation, Pressure Mode Ventilation, Others), Interface (Invasive Ventilation, Non-invasive Ventilation), End User (Hospitals and Clinics, Home Care, Ambulatory Care Centers, Emergency Medical Services (EMS))

Market Trends:

High Prevalence of Tobacco Smoking

Urbanization and Growing Pollution Levels

Opportunities:

High Adoption of Home Care Therapeutic Devices

Growth Opportunities in Emerging Countries

Market Drivers:

Rapid Growth in the Geriatric Population

Rising Number of ICU Beds

Global Adult Ventilators market report highlights information regarding the current and future industry trends, growth patterns, as well as it offers business strategies to help the stakeholders in making sound decisions that may help to ensure the profit trajectory over the forecast years. Region Included are: North America, Europe, Asia Pacific, Oceania, South America, Middle East & AfricaCountry Level Break-Up: United States, Canada, Mexico, Brazil, Argentina, Colombia, Chile, South Africa, Nigeria, Tunisia, Morocco, Germany, United Kingdom (UK), the Netherlands, Spain, Italy, Belgium, Austria, Turkey, Russia, France, Poland, Israel, United Arab Emirates, Qatar, Saudi Arabia, China, Japan, Taiwan, South Korea, Singapore, India, Australia and New Zealand etc. Have Any Questions Regarding Global Adult Ventilators Market Report, Ask Our Experts@ https://www.advancemarketanalytics.com/enquiry-before-buy/51343-global-adult-ventilators-market Points Covered in Table of Content of Global Adult Ventilators Market:

Chapter 01 – Adult Ventilators Executive Summary

Chapter 02 – Market Overview

Chapter 03 – Key Success Factors

Chapter 04 – Global Adult Ventilators Market - Pricing Analysis

Chapter 05 – Global Adult Ventilators Market Background

Chapter 06 -- Global Adult Ventilators Market Segmentation

Chapter 07 – Key and Emerging Countries Analysis in Global Adult Ventilators Market

Chapter 08 – Global Adult Ventilators Market Structure Analysis

Chapter 09 – Global Adult Ventilators Market Competitive Analysis

Chapter 10 – Assumptions and Acronyms Chapter 11 – Research Methodology Read Detailed Index of full Research Study at @https://www.advancemarketanalytics.com/reports/51343-global-adult-ventilators-market Thanks for reading this article; you can also get individual chapter wise section or region wise report version like North America, Middle East, Africa, Europe or LATAM, Southeast Asia. Contact US : Craig Francis (PR & Marketing Manager) AMA Research & Media LLP Unit No. 429, Parsonage Road Edison, NJ New Jersey USA – 08837 Phone: +1 201 565 3262, +44 161 818 8166 sales@advancemarketanalytics.com

[wemarketresearchreport]

Air Sterilizer Market Latest Trends and Analysis, Future Growth Study by 2030

Global Air Sterilizer Market size was $ 9702.41 million in 2019, $ 12742.0 million, and is anticipated to grow to a value of more than $12,946 million in 2030, registering a growing CAGR (Compound annual growth rate) of over 9% from 2022 to 2030.

By removing contaminated and polluted particles including pollen, dust, and contagious bacteria, air sterilisers are the tools used to filter the air for industrial and home usage.

It helps maintain the highest level of air quality and prevents the spread of dangerous contaminants. Additionally, it has the power to prevent various air pollution, which contributes to illnesses including respiratory and neurological conditions.

Additionally helpful to asthmatic and allergy sufferers is the air steriliser. These gadgets can occasionally be employed to purge the space of undesirable smoke, such as tobacco smoke and offensive odours.

Global Air Sterilizer Market- Overview

Air sterilisers are machines that clean air through the standards of filtration, purification, and cleansing. As well as killing microbes, infections, molds, spores and other alleged cleansing and sterilization, a few models can likewise eliminate formaldehyde, phenol and other natural contaminations in indoor air, and can likewise kill or channel dust and different allergens.

Simultaneously, it can actually eliminate the smoke and smoke smell created by smoking, the awful stench in the restroom, and the stench of individuals. The sterilization impact is solid, and the sanitization can be performed under the state of human activities, to understand the concurrence of man and machine.

Air Sterilizer Market: Key Trends Market Drivers: Rising Urbanization and Indoor Air Pollution Level: The rapid surge in the population, urbanization, and industrialization across the globe have raised the emission of toxic gases, volatile chemicals, biological components and fine particulate matter (PM), consequently increasing the air pollution level. The upsurge in the carbon emission is more notable in developing countries (such as India, China, Mexico and Brazil) due to their rapid industrialization and limited compliance with pollution monitoring and control rules and regulations. Urbanization has doubled the number of vehicles, which expels many polluted & toxic gases. Even home appliances also contribute to pollution since they are prominent emitters of chlorofluorocarbons (CFCs).

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Segmentation Analysis of Global Air Sterilizer Market

Based on product type –

· High Temperature Sterilizer

· Low Temperature Sterilizer

· Radiation Sterilizer

Based on type –

· Static-Air Type Sterilizer

· Forced-Air Type Sterilizer

Based on technology –

· HEPA

· Electrostatic precipitators

· Plasma disinfection

· UV Disinfection

· Photocatalysts

· Lionizes and Ozon generators

Based on mode –

· Portable

· Stationary

Based on application –

· Commercial

· Industrial

· Pharmaceutical and biotechnology facilities

· Healthcare facilities

· Laboratory and academic research institutes

North America is anticipated to hold the highest market share

North America, Europe, Latin America, Asia Pacific, and Middle East and Africa are the major regions constituting the geographical landscape of Global Air Sterilizer Market. North America is supposed to stand firm on a predominant foothold in the air steriliser market, inferable from expanding utilization of air sterilisers by clinics with most recent highlights like enacted carbons, and U.V. lights.

Major development

Modern Alchemy Air Purifiers of U.S. are equipped for treating a wide scope of airborne impurities, including allergens, chemicals, unstable natural compounds, microscopic organisms, mycotoxins, and scents by medical-grade High Efficiency Particulate Air (HEPA) channels, initiated carbons, and germicidal U.V. lights.

Table of Contents

1. Global Air Sterilizer Market Introduction and Market Overview

2. Global Air Sterilizer Market — Executive Summary

3. Air Sterilizer Market Trends, Outlook, and Factors Analysis

4. Global Air Sterilizer Market: Estimates & Historic Trend Analysis (2018 to 2021)

5. Global Air Sterilizer Market Estimates & Forecast Trend Analysis, by Deployment

6. Global Air Sterilizer Market Estimates & Forecast Trend Analysis, by Component

7. Global Air Sterilizer Market Estimates & Forecast Trend Analysis, by Content Type

8. Global Air Sterilizer Market Estimates & Forecast Trend Analysis, by End Use

9. Global Air Sterilizer Market Analysis and Forecast, by Region

10. North America Air Sterilizer Market: Estimates & Forecast Trend Analysis

11. Europe Air Sterilizer Market: Estimates & Forecast Trend Analysis

12. Asia Pacific Air Sterilizer Market: Estimates & Forecast Trend Analysis

13. Middle East & Africa Air Sterilizer Market: Estimates & Forecast Trend Analysis

14. Latin America Air Sterilizer Market: Estimates & Forecast Trend Analysis

15. Competitive Landscape

16. Company Profiles

17. Assumptions and Research Methodology

18. Conclusions and Recommendations

For More Details, Visit Our Report Page:https://wemarketresearch.com/reports/air-sterilizer-market/156/

Major questions answered in this report

· What is the growth rate of this Market?

· What are the primary growth determinants of this Market?

· Which are the major regions constituting the geographical landscape of Global Air Sterilizer Market?

· Which are the prominent companies operating in Global Air Sterilizer Market?

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Our strategic market analysis and capability to comprehend deep cultural, conceptual and social aspects of various tangled markets has helped us make a mark for ourselves in the industry. WE MARKET RESEARCH is a frontrunner in helping numerous companies; both regional and international to successfully achieve their business goals based on our in-depth market analysis. Moreover, we are also capable of devising market strategies that ensure guaranteed customer bases for our clients.

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[babymilkaction]

No ‘sunset clause’ please! NGOs call for vigilance on harmful marketing

Press Release PDF

No ‘sunset clause’ please!

NGOs call for vigilance on harmful marketing

WHO Executive Board meeting, Geneva, 7th February 2020

Civil society NGOs attending WHO’s Executive Board meeting ahead of the May World Health Assembly are protesting against a new Decision – drafted by WHO and to be debated today – proposing that in an effort to take pressure off the agenda and ‘streamline’ – biennial reporting of controls on marketing of baby formulas and foods should end in 2026.  The NGOs warn that WHO must keep a close watch on all commercial promotion that has the potential to harm health – whether on baby foods, tobacco, junk foods, alcohol or drugs.

The International Baby Food Action Network (IBFAN), the 40-year-old global network that protects breastfeeding and infant and young child health, has worked alongside WHO for perhaps the longest. A major achievement of IBFAN’s work was the adoption of the International Code of Marketing of Breast-milk Substitutes in 1981 in response to the evidence that 1.5 million babies were dying every year because they are not breastfed and that marketing was a major contributory factor. Over 800,000 babies continue to die each year because they are not breastfed [1]

The International Code was the first global consumer protection code of its kind and made strong recommendations to its Member States to end the commercial promotion of these products. One of its key requirements was that Member States report back to WHO on its implementation every two years. Because of this, the Assembly regularly heard about marketing tactics that threaten children’s health and survival – despite the industry’s claims of code compliance.  As a consequence, 19 Resolutions were adopted that clarified, strengthened and updated the original Code.  Although 85% of the 198 countries have taken some action to implement the Code, under pressure from industry and trade bodies to weaken safeguards,  far too many of these laws are too weak or rely on the voluntary cooperation of the companies.

The producer countries and corporations that profit from the fast-growing baby food market such as Swiss Nestlé, French Danone, US Mead Johnson and Abbott Ross, have always wanted this troublesome issue taken off WHO’s agenda referred to as hibut have dared not say so openly.

Speaking for IBFAN, Patti Rundall:

“We know that harmful marketing will not stop until every country has strong laws that are independently monitored and enforced. The multi-stakeholder partnership ideology that WHO is now embracing is making things much worse, with corporations being given unprecedented access to policy framing and setting spaces.  We know there are many important issues on WHO’s agenda, but this attempt to sunset of one of its most effective and essential safeguards can only be the result of private sector influence on WHO’s governance. To describe it as ’streamlining’ is disingenuous.  If WHO is going to sunset its decisions, then please start with ones that are doing little or nothing to protect health. ”

For more information contact: Patti Rundall, Baby Milk Action/ IBFAN Global Council: prundall@babymilkaction.org +447786523493 Alison Linnecar, IBFAN WG convenor on Climate and Contaminant issues­­­­­­: alinnecar@gmail.com Dr Marina Rea, IBFAN Brazil/IBFAN Global Council: marifrea@usp.br

[1] (Lancet 2016)

WHO Executive Board Meeting: Biennial Reporting on the International Code under threat

  No ‘sunset clause’ please! NGOs call for vigilance on harmful marketing was originally published on Baby Milk Action

[theygotboxesandnurfguns-blog]

How To MAKE YOUR Intel Design Card's Performance In Gaming With GMABooster And Modded Drivers

How to get free CSGO skins?

Martial art already is available into this world for almost 4000 years. They have been the most greatly played out online first-person shooters for days gone by several years. As counter strike of August 2011, the series has sold over 25 million systems because the original release of Counter-Strike. Beretta 92FS with wood grips (US made gun with black handles), for comparison.

New version of the vintage. Looks great. Frequently updated. Filled up with trolls and annoying people, but that is to be expected on any video game. They have a good competitive system where you get ranked by skill after receiving a certain amount of games and you will continually ranking up by being successful more than you lose. It's presently the most frequent first person shooter in competitive competitions.

https://theygotboxesandnurfguns.tumblr.com/post/164819600155/warts-related-articles

Counter-Strike is one of the most popular game titles among network and solo one. A lot of people worldwide are well doing with it. They`re not merely having fun, but treat it as professional game for e-sport. Someone counter strike prefers to view. So, cs gamble looks more appealing for these people. Either play or watch, but Counter-Strike game is keeping famous and popular for a long time.

This game brings back most, if not absolutely all, the old maps, all rendered with an modified engine. Needless to say, along with the old gameplay of CS 1.6, CS:GO offers a couple of new maps and of course one or two more game modes. Is there times where you don't have friends to experience with or have lost access to Xbox Live? No issue. The game's local variant allows you to play with Bots instead! Unfortunately if you get this on the unit, their is not a couch co-op action (split-screen).

15 Great Websites To Consider Counter Strike

Ce report intitulé « Serveur Counter-Strike: Source - Les Anti-Triche » issu de CommentCaMarche () est mis à disposition sous les termes de la licence Creative Commons Vous pouvez copier, modifier des copies de cette webpage counter strike, dans les conditions fixésera par la licence, tant que cette be aware apparaît clairement.

In fact, the largest drawback this mod has is the fact that its creator hasn't updated it in years. Fortunately, according from what we've read in talk forums, Counter Hit 1.6 Z-Bot doesn't have serious problems. CS: GO features new maps, people, and weapons and delivers updated variations of the traditional CS content (de_dust, etc.). In addition, CS: GO will present new gameplay modes, matchmaking, leader boards, and more.

The best Counter-Strike 1.6 players originated from all over the world: MiBr from Brazil, multi-game teams WeMade FOX and eSTRO from Korea, North America's Team 3D and Evil Geniuses , but counter strike review the top talent centered around European countries, with Swedish groups being the most dominant at the game.

The program's goal is to lessen youth usage of tobacco in retail outlets by systematically monitoring store compliance with talk about lawful restrictions which prohibit the sales of tobacco products to minors. This program also serves to organize and encourage local enforcement with those laws. Over 23,000 retail inspections have been performed since the program's inception.

[kickoffme-blog]

PM Narendra Modi\'s GST Challenge Makes Donald Trump\'s Tax Overhaul Look Easy

NEW DELHI: The challenge is daunting: Convert an economy of more than 1 billion consumers, 29 states, 22 official languages, 9 million businesses all operating under a spider's web of taxes, arcane regulations and competing political ambitions into a unified common market. But that's the goal as India gets ready to roll out a goods-and-services tax after a 10-year battle to win over the country's powerful states and fractious federal parties. Designed to free up trade, foster tax compliance and make it easier to do business in the world's fastest growing major economy, the GST is scheduled to go into effect on July 1. "It has been a huge challenge with countless man hours," said Anita Rastogi, Partner, indirect taxes at PricewaterhouseCoopers LLP, New Delhi, in a telephone interview. "The July 1 target is looking feasible. And the effort that has been put in is worth it because this will lead to greater tax compliance and better efficiency." Until now, a product or service in India is taxed multiple times at different rates as components are added and shipped between states. Everyday more than 20,000 truck divers wait in queues up to three kilometers long to pay an entry fee at 122 New Delhi checkpoints, food rotting, tempers fraying, costs rising. The new levy will apply at the final point of consumption, reducing the cascading effect of taxes on tax, allowing producers to easily claim credits and minimizing the opportunity for corruption. Those trucks at the New Delhi border? They'll see their waiting time at check points drop by half, according to economists at Nomura Holdings Inc. Prime Minister Narendra Modi's government says introduction of the tax may bolster growth by as much as 2 percentage points. Below we look at the challenges and potential rewards from the country's biggest ever tax reform. Scale A GST for India will in effect create one of the world's biggest free trade areas. Its population of 1.3 billion is more than that of U.S., Europe, Canada and Australia combined and more states than the European Union's 28 members. The tax will replace at least 17 state and federal levies on everything from electricity to Gucci handbags to border crossings. From the powerful Uttar Pradesh with a population the size of Brazil, to the tiny seaside region of Goa, India's states currently set their own taxes and charge duties. The GST will sweep those away and harmonize the indirect tax system across the nation. Effort President Donald Trump is girding for a political battle to overhaul the U.S. tax system. It took India 10 years to get the GST through. Modi had opposed the tax as chief minister of the western state of Gujarat but changed his view after becoming premier in 2014. His ruling BJP party had to win over all opposition parties, including the Indian National Congress, which had originally proposed the tax a decade ago. Then there's the logistical mountain to climb. The government is setting aside about 28 billion rupees ($435 million) over five years to set up a network that can handle invoices worth 36 billion rupees a year and is training more than 61,000 government officials to operate it. Indian software giant Infosys Ltd., will provide the digital backbone to handle 55,000 users concurrently. The roll out, which is expected to encourage compliance in a country notorious for tax evasion and hoarding of cash, has missed its April 1 deadline. Rates India's tax will comprise four basic rates: 5 percent, 12 percent, 18 percent and 28 percent. While officials are yet to reveal final details of what will fall into each bracket, Finance Minister Arun Jaitley has said 50 percent of items in the retail inflation basket won't be taxed to protect consumers. Other mass consumption items like spices are likely to attract a 5 percent rate while processed foods will be charged 12 percent. Household goods like soaps, toothpaste, and smartphones are likely to be in the 18 percent bracket while other durable goods such as air conditioners will attract 28 percent duties. Luxury goods such as tobacco will be taxed at a higher rate. Collections at the higher rate, or in excess, will go to a fund, which will be used by the federal government to compensate states for any loss in revenues. Critics have argued that the multi-layered tax system is too complex but compromises had be be struck to get the GST accepted in India's large and diverse country. India will be joining 160 countries that have a value-added tax, including Poland, Canada and Japan. At the top rate, India's GST will be among the highest. The U.S. has always resisted a national sales tax. Inflation While some fear the GST could pressure inflation as some goods get taxed at higher rates and businesses sneak in cost increases, economists say countries like Australia and New Zealand experienced a fleeting increase in inflation after GST implementation, which normalized in a year. Indian inflation is expected to rise by less than 20 basis points in the near term, Sonal Varma, chief India economist at Nomura Holdings Inc. in Singapore, said in a report last month. The central bank is unlikely to react to any rise in inflation, in the same way it called the impact from India's cash ban in November on inflation and growth as temporary. Impact Companies will face one-time costs in switching to new systems and there could be some disruption of activity when the tax is introduced but many analysts expect the benefits from a single market to bolster the economy over the longer run. While designed to be revenue neutral, increased compliance could boost remittances to government coffers over time. The promise of such a huge single market, along with a simplified tax structure, will likely attract more foreign direct investment into capital-starved India. The country is ranked 130 out of 190 in the ease of doing business by the World Bank and Modi wants to push Asia's third-largest economy higher up the ladder. Meanwhile, companies are racing to capitalize on the introduction with accounting firms such as Ernst & Young LLP pitching packages to manage the new system. Logistics companies stand to be among the biggest winners as it becomes easier to ferry goods across India while the country's poorest states could also benefit as the removal of border levies make their low-cost regions even more attractive. Competition to attract business is set to intensify. "Over time, we expect the elimination of cascading taxes and its simplified tax structure to boost productivity, lower costs, aid in the formalization of the economy and result in large revenue benefits for the government," Varma said. Read more Click to Post

[type2diabetestreatments-blog]

Smoking still kills more than 1 in 10 people around the globe

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Smoking still kills more than 1 in 10 people around the globe

Smoking still kills more than 1 in 10 people around the globe Figures show need for renewed and sustained efforts on tobacco control

Carline White

Thursday, 06 April 2017

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More than 1 in 10 deaths worldwide (6.4 million) are still caused by smoking, and just four countries—China, India, USA, and Russia— account for half of these deaths, show the latest estimates from the Global Burden of Disease study* published in The Lancet today.

The new estimates, which are based on smoking habits in 195 countries and territories between 1990 and 2015, show that smoking remains a leading risk factor for death and disability. With growing and ageing populations already boosting the impact of tobacco, it will be crucial to support more smokers to quit and stop people from starting, say the researchers.

Since the implementation of the WHO Framework Convention on Tobacco Control in 2005, many countries have adopted tobacco control policies, but the war against tobacco is far from won, warn the researchers who argue that policy makers must renew and sustain their efforts to tackle the epidemic.

Worldwide, between 1990 and 2015, smoking prevalence fell by almost a third (29.4%) to 15.3% in 2015. Today, one in four men (25%) smoke, as do one in 20 women (5.4%). Despite these improvements, population growth has led to an increase in the overall number of smokers, from 870.4 million in 1990 to 933.1 million in 2015.

Deaths attributable to smoking increased by 4.7% in 2015 compared with 2005, and smoking was rated as a bigger burden on health – moving up from the third to the second highest cause of disability.

“Despite more than half a century of unequivocal evidence of the harmful effects of tobacco on health, today, one in every four men in the world is a daily smoker,” said senior author Dr Emmanuela Gakidou, Institute for Health Metrics and Evaluation at the University of Washington, USA.

“Smoking remains the second largest risk factor for early death and disability, and so to further reduce its impact we must intensify tobacco control to further reduce smoking prevalence and attributable burden,” she said.

The 10 countries with the largest number of smokers in 2015 were China, India, Indonesia, USA, Russia, Bangladesh, Japan, Brazil, Germany and the Philippines – who together accounted for nearly two-thirds of the world’s smokers (63.6%).

There were no significant reductions in the prevalence of smoking among men in Indonesia, Bangladesh or the Philippines between 1990 and 2015 (smoking rates were 46.7%, 38.0%, and 34.5%, respectively), and in Russia, smoking prevalence among women has increased from 7.9% in 1990 to 12.3% in 2015).

In contrast, Brazil, which has been a leader in tobacco control, had one of the largest reductions in smoking prevalence for men and women between 1990 and 2015— halving from 28.9% to 12.6% in men and 18.6% to 8.2% in women.

The increases in smoking prevalence among women since 1990 and consistently high levels of male smokers in Eastern Europe are associated with the tobacco industry’s targeting of the area in the 1990s, say the researchers.

They warn that a similar picture could emerge in sub-Saharan Africa, as the tobacco industry now seeks to expand its market by exploiting the region’s patchy tobacco control regulations and its limited resources to combat the industry’s marketing tactics.

“There have been some success stories, but smoking remains the leading cause of death and disability in 100 countries in 2015,” said Dr Gakidou.

“Its toll will remain substantial without more concerted policy initiatives, policy compliance and enforcement, and sustained political will to offset commercial interests.

“Despite progress in some settings, the war against tobacco is far from won, especially in countries with the highest numbers of smokers. The staggering toll of smoking on health echoes well beyond the individual, especially as tobacco threatens to exact long-term financial and operational burdens on already resource-constrained health systems.

“To markedly bend the global tobacco epidemic’s trajectory, a renewed and sustained focus is needed on comprehensive tobacco control policies around the world. Success is possible, but requires effective and aggressively enforced policies and laws,” she emphasised.

In a linked comment,** Professor John Britton, University of Nottingham, said: “Today, the smoking epidemic is being exported from the rich world to low-income and middle-income countries, slipping under the radar while apparently more immediate priorities occupy and absorb scarce available human and financial resources.

The epidemic of tobacco deaths will progress inexorably throughout the world until and unless tobacco control is recognised as an immediate priority for development, investment, and research.”

* GBD 2015 Tobacco Collaborators. Smoking prevalence and attributable disease burden in 195 countries and territories, 1990–2015: a systematic analysis from the Global Burden of Disease Study 2015. The Lancet, published 05 April 2017. DOI: 10.1016/S0140-6736(17)30819-X

** Britton J. Death, disease, and tobacco. The Lancet, published 05 April 2017. DOI: 10.1016/S0140-6736(17)30867-X

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