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Tobacco Breaks Hearts
Home > World No Tobacco Day 2018
Every year, on 31 May, WHO and its partners, including the World Heart Federation, mark World No Tobacco Day (WNTD) to highlight the health and other risks associated with tobacco use and advocate for effective policies to reduce tobacco consumption.
This year, World No Tobacco Day will focus on the important link between tobacco and heart disease, under the campaign theme “Tobacco Breaks Hearts”. The campaign aims to increase awareness on the link between tobacco and CVD and promote feasible actions and measures that governments and the public can take to reduce the risks to heart health posed by tobacco. World No Tobacco Day 2018 will also be an opportunity to bolster commitment and empower the cardiovascular community in the fight against tobacco.
Cardiovascular disease kills more people than any other cause of death worldwide, and tobacco use and second-hand smoke exposure contribute to approximately 12% of all heart disease deaths. Tobacco use is also the second leading cause of CVD, after high blood pressure. Despite the known harms of tobacco to heart health, and the availability of solutions to reduce related death and disease, knowledge among large sections of the public that tobacco is one of the leading causes of CVD is low.
World No Tobacco Day 2018 aims to:
Campaign materials to be available for WNTD:
Actions & events happening before and on WNTD:
For more information, visit the WHO World No Tobacco Day website, available in six languages:
Professor Fastone Mathew Goma, University of Zambia School of Medicine, Zambia
Prof Goma has been a pioneering champion and an ardent advocate for Tobacco Control in Zambia. He is the current Chairperson for the Zambia Tobacco Control Consortium which comprises Civil society Organizations involved with Tobacco Control, which has been extremely active in getting the Tobacco Control agenda to take priority on the government agenda. He was involved with the lobby to push for the Zambian government to accede to the FCTC, which happened on 28th August 2008.
Dr Eduardo Bianco, Coordinador Regional para las Americas de la Framework Convention Alliance (FCA), Oriental Republic of Uruguay
Dr Eduardo Bianco is a Medical Doctor based in Uruguay. Having obtained a postgraduate in Cardiology, he trained as a Tobacco Treatment Specialist and has a Master in Addictive Disorders Prevention and Treatment. He worked in clinical intensive care as staff in a Medical Emergency Mobile System for almost 20 years, and as a clinical cardiologist in a coronary care unit (CCU) until November 2015. In 1994 Dr Bianco started to work in smoking cessation and in 1997 initiated the first Tobacco Dependence Treatment (TDT) Program in a pre-paid institution of the Health Care System.
British Heart Foundation, United Kingdom
BHF has funded and participated in tobacco control in the United Kingdom for over 25 years. As a founder member of the Smokefree Action Coalition (SFAC) in the United Kingdom, the Foundation was instrumental in the campaign for comprehensive smoke-free legislation in England, and subsequently for the prohibition of tobacco displays and plain packaging. In addition to funding the SFAC, BHF has put its own considerable resources, its expertise and its well-known brand behind campaigning on tobacco control, running events for members of parliament, publishing reports, producing materials, and cofunding research, such as a recent evaluation of the impact of standardized packaging of tobacco products in the United Kingdom.
Mrs Susanne Løgstrup, Director of the European Heart Network, Belgium
Susanne has been with the EHN since 1995 and under her leadership EHN has become a strong advocate for tobacco control policies in the EU. Susanne was involved in lobbying for two EU Directives on advertising and sponsorship of tobacco products – the first was lost in court; but the second was successfully adopted in 2003. Equally, she was involved in lobbying for two tobacco products directives; her unflappable and professional commitment to the campaign to get the 2014 EU tobacco products directive adopted proved invaluable.
Professor Hu Dayi, Chinese Association on Tobacco Control, People’s Republic of China
Prof. Hu believes it is necessary to create an atmosphere of public opinion away from tobacco and tobacco control in the entire society. To let the public know that smoking addiction is a condition, it is a chronic disease. At the same time, we must vigorously publicize the concept of quitting smoking and train the public to consciously discourage illegal smoking behavior. For smokers in public places, people should be bold to stand up and say “no” to reduce the risk of secondhand smoke. He said that tobacco control should be regarded as a new subject, discipline construction will be well established, and a good platform will be set up to establish a large tobacco control database.
Early on in my career I realised that working with patients on a one-to-one basis didn’t deal with the wider issues – which is when I took the decision to study public health and start working in this field to make a bigger impact on society and population health.
Over the past 15 years my focus has been on NCDs, and specifically on CVD in the past five years. In my current role as CEO of Heart & Stroke Foundation South Africa and President of the African Heart Network, I am a passionate advocate of reducing the morbidity and mortality rates due to heart disease and stroke. One of the things I am pushing for is zero tolerance of tobacco smoking, and I’m working with the South African government and other relevant stakeholders to achieve this, given that tobacco smoking is one of the strongest risk factors for CVDs.
We are working closely with WHO and WHF towards these aims. In South Africa we don’t allow smoking indoors any more, but we are now seeking to introduce legislation to curb outdoor smoking – it’s about not endangering the public, and taking environmental smoking seriously. Outdoor smoking should be considered to be environmental pollution. We want to improve education – even people with a very healthy lifestyle are doing themselves a huge disservice by smoking.
A South African study has found that women and children are much more affected by environmental smoking, which is why we need to place a strong focus on reducing this. With respiratory illnesses a major factor in childhood morbidity, the study examined environmental risk factors on early life exposures – and smoke inhalation was one of these. It is crucial that we stop exposing pregnant women and vulnerable children to second-hand smoke, which is why we are campaigning for these changes.
We currently have a draft tobacco legislation out for public comment – the Control of Tobacco Products and Electronic Delivery Systems Bill is seeking to achieve a number of aims. Amongst other things, we want to provide control over smoking, regulate sales and advertising of tobacco products and electronic delivery systems, making sure they are not sold to anyone under 18 and to regulate their packaging and appearance.
We want to act as a ‘best practice’ model for the rest of Africa – the eyes of the continent are upon us as we demonstrate strong leadership, passionate advocacy and good practice in the medical field.
Between 1980 and 2016 we have seen a 52% increase in tobacco use in Sub-Saharan Africa. Through our work, we want to drive change in legislation and protect the most vulnerable in our society from the effects of second-hand smoking.
I began my nursing career more than 30 years ago in Brazil, working initially in medical-surgery floors and eventually moving into cancer prevention. This was where my tobacco knowledge began, and from here I developed a strong interest in smoking cessation and how nurses could take a more holistic approach with their patients to this end. A few years later I realized that nurses, if properly mobilized, could be a “formidable” opponent of the tobacco industry (as stated in an formerly secret industry document).
This was the start of a lifelong effort to mobilise nurses to become more engaged with their patients and to try to understand – and remove – some of the barriers preventing this. Lack of time is often cited as a reason, but to me, talking about smoking cessation is an integral part of nursing, not an add-on. We don’t say ‘take an extra minute to take this patient’s blood pressure’ and I feel that discussing smoking should be as fundamental as the other core duties we perform as nurses.
I began working with my collaborator Linda Sarna – now the dean at the UCLA School of Nursing – both of us on a determined mission to remove these barriers to nurses’ engagement. We discovered that leadership in nursing hasn’t really embraced tobacco dependence treatment, so we started to work with leaders to develop position statements and introduce content to conferences – always giving the message that tobacco control is a priority.
There isn’t much content in curricula for health professionals, either. We hear frequently that tobacco is bad for you and causes lung cancer, but the vast majority of those who die from smoking-related causes do so from cardiovascular disease. We need to educate our nursing students on how to address tobacco use.
Another big barrier we discovered is the myth that all health professionals smoke. While it is true in some countries that have high prevalence of tobacco use among nurses, it’s not so in others. But we need to look at helping our health professionals quit, no matter what the figures. If we say 15% of US nurses smoke (though I believe now it is closer to 10%) there is very little acknowledgement. If we said, for example, 15% of US nurses were HIV positive there would be a different reaction. What are we doing in medical and nursing schools to help our students become healthier? Until we start treating tobacco use as a condition for which there is help, it makes it harder to get leadership more engaged. And some nurses are avoiding the conversation with patients as they feel hypocritical if they smoke themselves. Of course they can still help patients to quit regardless – it’s about educating them to have the right conversations.
Through our work so far, we have moved the needle to a much higher understanding of the importance of addressing tobacco in the context of holistic care. We have provided education to thousands of nurses, written position statements with the context of you’ve got to do this, it isn’t a choice.
Occasionally, people apologise to me if they haven’t included smoking cessation in a programme, but to me that’s still awareness that it ought to be done. We are making progress, and we have changed perceptions about the role of nursing in making a difference, but we need to persist and do more.
My current work in the School of Nursing at UCSF includes a research programme capacity building nurses in around nine countries, including Eastern Europe and Japan – which are great champions as the level of nurses there who smoke is low. I am also involved with monitoring the tobacco industry, spreading the word that the tobacco industry cannot be creating health policy, that we need to implement 100% smoke-free environments. And I’m engaging with the International Council of Nurses (ICN) in Geneva to try to enhance their support for our tobacco control campaigns.
I’m delighted the word is getting out and that people are starting to realise the importance of nurses in this fight. I’ve been knocking on doors for years, and I know there is certainly demand for programmes and education – if we can find the resources to support this that will be a big step in the right direction. The 19 million nurses and midwives worldwide will indeed be formidable if engaged in tobacco control.
I’m passionate about the fight against tobacco, and through my organisation I work to try to improve the regulations in this industry. I’m an active participant in the debate on social media, which sometimes even means suffering online attacks due to my strong position. For me, it’s all about getting the message out as far and wide as possible – some of my letters have been published on one of Spain’s most-read newspapers.
As a cardiologist, I became interested in the association with tobacco and cardiovascular disease prevention. Interestingly – and unfortunately – there is very little interest in tobacco consultation among doctors in Spain, it is not a subject that’s particularly attractive to cardiologists.
To me, it was striking that a risk factor which has so much supporting evidence was given so little attention. I was interested in breaking through this inertia and filling this gap, bringing attention and dedication in place of apathy.
The subject is now at last beginning to arouse the interest of cardiologists. I have perservered, systematically bringing the risk factor of tobacco into all my talks. I believe this should be a multidisciplinary collaboration, a synergy of all professions – by dedicating time and effort we can work together to really make a difference.
New tobacco laws have begun to make an impact, but there is still a long way to go – there have been fewer recent regulatory efforts and this impact is starting to stagnate. We need to keep making the effort – for the most part, people are quite well informed and law abiding, but tobacco is still very accessible because of its price.
Bringing the subject of tobacco and its part in cardiovascular disease to the forefront of conversations is something I’m a dedicated advocate of, and I will continue to be. Seeing my fellow professionals turning around to the idea that there is a link between the two is reassuring, but we need to continue our campaigns to see real results.
During my time as Director General of the National Orientation Agency, (NOA), I worked with a number of public-spirited groups and NGOs, such as the Association of Public Health Workers and the NOA, to mount various campaigns against smoking in public places. Indeed, my work gave me the opportunity to act within very large communities, engaging the public on the importance of behaviour modification for health purposes nationwide.
Through our private company, Timbuktoo Media Solutions, which was established six years ago and managed by my dear wife two years before I left active government service, I’ve continued campaigning on healthy hearts, bringing people together from all walks of life to discuss critical health issues. I’m lucky that my previous work in government has given me access to influential, high-profile people in Nigeria to be part of this work.
One of my main focuses is on smoking cessation among young people. In Abuja, it’s common for young people to get together to watch football matches in beer parlours, salons and open spaces. Here, they share cigarettes and even those that don’t smoke are seriously exposed to secondhand smoke in this environment.
It’s the perfect opportunity for my team to get out there, handing out information, talking to young people about the dangers of smoking. We tell them if they want to smoke they can do it without subjecting non-smokers. But we also explain the risks the heart and other organs of the body are subjected to. We talk to youngsters who aren’t smoking, telling them about the dangers of passive smoking and encouraging them to move away from smokers within the group.
It’s interesting, as nobody has ever rejected us, or been resentful of us for talking to them. Initial apprehensions are overcome by our style and approach. What usually happens is they either put out their cigarettes or move away from the crowd if they wish to continue smoking in order to satisfy their deadly urge and social habit. On occasions, we get resistance from retailers and bar owners who sell cigarettes and tobacco because, to them, quitting means reduced sales and no income.
I can relate to smokers as I used to smoke myself – not heavily, just two or three a day. But I realized even this quantity is bad enough to cause system breakdown. In my case I developed a very serious heart condition and after reflecting on my health, future and young family, I decided to quit smoking. It was simple … if I wanted to save my heart, I needed to modify my behaviours. Now after quitting, one of the best feelings I have is when doctors ask me if I smoke I’m always proud to say I don’t. I’ve been free from medication for seven years, and my heart is much better.
I use the above anecdote as one way to encourage others to quit smoking, a habit that is a big part of social life among youths in Nigeria. I see it everywhere, not just in men but women and children too. It’s something of a status symbol for some and for others it’s cultural. What is more we’re also now seeing emergence of shisha smoking clubs where people gather to smoke cigarettes and cigars.
When I speak to young, I always ask what their reasons for smoking are. A common response is peer pressure and lifestyle. I hope my story will inspire young people, either to not take up smoking in the first place, or to quit for good.
Tobacco is a huge problem in Colombia. Unfortunately, our youth are smoking more and more, and there is now more nicotine in cigarettes.
I’m an ex-smoker myself – I used to smoke two packs a day – and decided to quit 20 years ago for the sake of my heart. It was a very hard challenge! In my role as President of the Colombian Society of Cardiology, I worked on initiatives aimed at promoting and disseminating information on smoking and cardiovascular risk for the Colombian population jointly with the Colombian Health Ministry and other health organizations.
Our campaign with the Ministry of Health aims to teach doctors how to better get the message across to their patients, at the same time helping the patient take responsibility for their own health looking for empowerment of the primary care physicians about a “self-caring culture” directed to smokers.
To me, this partnership between the doctor and patient is crucial. We want everyone to enjoy their old age in a healthy way, free of tobacco and smoke, and understanding the risks of smoking and changing mindsets, with the support of their doctor and the media. It’s a big step in the right direction.
General practitioners are key. They are usually the first clinicians to see the patient, and should therefore be the ones that ask for the necessary tests and medications – this is currently seen as an unnecessary expense. Thankfully, the law is changing, and we can begin to recover dignity and regain autonomy for prevention and prescription.
Doctors in Colombia are exceptionally well trained and more than capable of making the right decisions – which is why the new law is very welcome, giving them the opportunity to use their own professional judgement.
For the patient, it’s about taking responsibility for their health. Most people know their height, weight and shoe size, for example, but not the important things like their cholesterol levels or blood pressure. If it doesn’t hurt they don’t do any check-ups – for example, 25% of adults are hypertensive and don’t even know it.
We are also working to raise awareness amongst adolescents about what impacts their health. Too often young people think they are invincible, but they are the ones most exposed to risk, and during a long time. We want to educate teachers about the harmful effects of tobacco, so that in turn they can educate their students.
Currently I am helping with a guide on cardiovascular risks for patients with the Colombian Society of Cardiology and the Colombian Heart Foundation and one important part of it is related to tobacco abuse.
Hellenic Society of Cardiology
Students and schools from all over Greece were the central characters of the Panhellenic Short Film Student Competition organized by the Hellenic Society of Cardiology on the occasion of the No Tobacco Day.
The thematic scope of the competition concerned smoking and its harmful effects on active and passive smokers (especially in younger ages). Its aim was to focus, on behalf of pupils, on the special value of life without smoking, free from all kinds of addictions.
Participation of students and their schools with more than 100 films in the Competition, as well as the award ceremony in the center of Athens in a room full of excited students, educators and artists was the capstone of a competition that was met with great enthusiasm across Greece.
The President of the HSC, Associate Professor of Cardiology, Dr. Costas Tsioufis, highlighted through his presentation the multifaceted and adaptable project of HSC in the field of information and health prevention for citizens and advised against tobacco use.
A total of four films were awarded with a money prize, and special praises were given to all schools, pupils and teachers.
The Competition was held under the auspices of the Ministry of Education and the support of the Greek Academy of Cinematography.
Indonesian Heart Foundation
The Indonesian Heart Foundation held an event for World No Tobacco Day. The world’s second-largest market for tobacco after China, Indonesia is home to 100 million smokers – smoking kills more than 200,000 Indonesians a year.
Heart Foundation of Jamaica
The Heart Foundation of Jamaica (HFJ) recognized WNTD events with the following:
International Society of Cardiovascular Pharmacotherapy (ISCP)
On WNTD 2018 the ISCP held a Memorial Session at their Annual Scientific meeting and free consultation services for smoking cessation at the National Hospital Organization Kyoto Medical Center.
On May 27 2018, at the 23rd Annual Scientific meeting of the International Society of Cardiovascular Pharmacotherapy (ISCP) in Kyoto, they held a World No Tobacco Day Memorial Session “Tobacco and Heart Disease” and discussed the harmful impact on cardiovascular health of active and passive smoking, cost-benefit effectiveness of smoking cessation, and differences in anti-tobacco politics among countries and other hot topics.
At the National Hospital Organization Kyoto Medical Center on 30 May they provided smoking cessation consultation services free of charge for the general public who would like to quit smoking, but are unable to achieve this on their own. Nicotine dependency was checked, expired carbon monoxide levels were measured and counselling on how to quit smoking were performed. It was an extremely successful event.
Dutch Heart Foundation
The Dutch Heart Foundation engaged in a symposium on 50 years of tobacco control in the Netherlands. The Dutch state secretary of health prevention gave a speech and the Dutch professor of tobacco control Marc Willemsen launched his new book (free English download: Tobacco Control Policy in the Netherlands: Between Economy, Public Health, and Ideology). They also release an awareness video on tobacco consumption.
Philippine Heart Association
The Philippine Heart Association held a press conference last May 31 at the Department of Health. This was primarily initiated by Dr Francisco Duque III, Secretary of the Department of Health, Philippines. At the press conference, the detrimental effects of tobacco especially to the heart were discussed and the need to curtail tobacco use to minimize premature CVD deaths in line with the WHF mandate to decrease CVD mortality by 25% in 2025 was emphasized.
Left to right: Metropolitan Manila Development Authority Undersecretary, Mr. Frisco San Juan; Philippine Heart Association, Nannette Rey; WHO, Gundo Weiler; Department of Health Secretary, Dr Francisco Duque III; Lung Center of the Philippines, Dr. Vince Balanag; Philippine Heart Center, Dr Maria Encarnita Limpin
Rwanda Heart Foundation
For the World No Tobacco Day, the Rwanda Heart Fondation collaborated with the other members of Rwanda NCD Alliance, the City of Kigali Council and the Ministry of Health through the Rwanda Biomedical Center and its NCD Division. Together we organized an awareness week around the theme: “let us stop smoking and harmful use of alcohol, to fight NCDs”. During thecwhole week we organized free check up for NCDs risk factors and education at 3 sites in Kigali City and a media campaign including TV and Radio shows. The week culminated with the celebration of the WNTD during the bi-monthly “Car Free Day” activities with mass sports and screening for NCD risk factors, and an official message by the Minister of Health, in the presence of many other Ministers.
During the week, more than 8000 people were screened and educated.
Heart & Stroke Foundation of South Africa
On the occasion of World No Tobacco Day, The Weekly Mail, a Johannesburg paper conducted an interview with Pamela Naidoo, the CEO of the Heart & Stroke Foundation of South Africa. One of the key messages sent out on the occasion was: ‘Smoking not only burns your health, it burns your wealth too’. This is because while the use of tobacco increases the risk of heart diseases, strokes and other vascular conditions, smoking is also an expensive habit both to one’s health as well as the wallet. Sadly, this applies to both active and passive smokers.
Read the interview about some of the dangers associated with smoking and what people can do to alleviate them
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WHO World No Tobacco Day 2018 Awards – Region of the Americas: Dr Eduardo Bianco, Coordinador Regional para las Americas de la Framework Convention Alliance (FCA), Oriental Republic of Uruguay