Survivors of tobacco-related diseases and advocacy for tobacco control

Need for accelerating tobacco control in India: findings from the national cancer registry programme

OBJECTIVE

To describe the epidemiology of cancer in sites associated with tobacco use in India, according to recent findings from the National Cancer Registry Programme.

METHODS

The data on cancers in sites associated with tobacco use has been sourced from 28 population-based and 58 hospital-based cancer registries of the National Cancer Registry Programme in India. The data covering a period of 5 years (2012-2016) was taken up for analysis.

RESULTS

The highest age-adjusted incidence rate (AAR) among males was reported in the Aizawl district in Mizoram (197.3 per 100 000). The AAR was the highest (121.1 per 100 000) in the Papumpare district in females. The top five leading sites were cancers of the lung (10.7%), mouth (8.7%), oesophagus (6%), tongue (6%) and stomach (5%) among males and cancer of the cervix (10.3%), lung (4.3%), oesophagus (3.3%), mouth (3.3%) and tongue (2.7%) in females. The highest significant increase in AAR, indicated by the annual percentage change was seen among males in Aurangabad (3.4) and females in Kamrup urban (2.4). Except for lung cancer, most patients with other cancer types among both genders presented to the health facility with a locoregional (spread to nearby lymph nodes) disease spread. It is projected that in 2025, there will be 694367 cases of cancers in the sites associated with tobacco use.

CONCLUSION

Tobacco uses in either form and cancer in sites associated with tobacco use are an important matter of public health concern in India. Cancer registries play a crucial role in identifying populations with high cancer incidence in sites associated with tobacco use, monitoring the trends over time, and evaluating the impact of tobacco control measures.

Communicating program outcomes to encourage policymaker support for evidence-based state tobacco control

Tobacco use, the leading cause of preventable death in the U.S., can be reduced through state-level tobacco prevention and cessation programs. In the absence of research about how to communicate the need for these programs to policymakers, this qualitative study aimed to understand the motivations and priorities of policymakers in North Carolina, a state that enacted a strong tobacco control program from 2003–2011, but drastically reduced funding in recent years. Six former legislators (three Democrats, three Republicans) and three lobbyists for health organizations were interviewed about their attitudes towards tobacco use, support of state-funded programs, and reactions to two policy briefs. Five themes emerged: (1) high awareness of tobacco-related health concerns but limited awareness of program impacts and funding, (2) the primacy of economic concerns in making policy decisions, (3) ideological differences in views of the state’s role in tobacco control, (4) the impact of lobbyist and constituent in-person appeals, and (5) the utility of concise, contextualized data. These findings suggest that building relationships with policymakers to communicate ongoing program outcomes, emphasizing economic data, and developing a constituent advocacy group would be valuable to encourage continued support of state tobacco control programs.