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ESMO 2018

ESMO 2018: Tobacco Control: Saving Lives and Driving Development

Munich, Germany (UroToday.com) This talk in the advocacy session was by Gilberto Morgan, an American transplant to Sweden, who has a special interest in tobacco control. 

This may be the most important talk at a cancer conference – with the widest impact on cancer treatment and prevention! This topic needs greater attention. For all the effort and money put into drug development, smoking prevention can have a much greater impact on cancer prevention and treatment!

The first part of his talk included sobering facts about tobacco use – its effect on cancer, but also other common conditions that have a lasting international impact.
Tabacco_Statistics_ESMO.png

Everyone is affected, not just adults and not just smokers!
  • 88% of smokers start before age 18
  • Second-hand smoke affects children – up to 67% of African-American children, 30-36% of Caucasian and Hispanic children in the United States
  • SHS causes 600,000 premature deaths per year worldwide!
What else does smoking lead to, other than cancer?
  • Heart disease
  • Stroke
  • COPD
  • Diabetes
  • Asthma exacerbation in children
  • Birth defects in mothers who smoke while pregnant
  • Low birth weight
Worldwide, unfortunately, the average smoking age is getting younger!
  • In Indonesia, 41% of boys age 13-15 smoke!
For the next part of the talk, he highlights the importance of smoking prevention.

The WHO “Tobacco control vaccine” -  a program of changes that has been shown to reduce smoking uptake.
WHOTobaccoControlVaccine.png
He then provided an example: in Scotland – instituting a smoke-free legislation lead to a reduction of 18% in asthma exacerbation related admissions in children, 17% drop in heart attacks in the first year, 39% reduction in SHS exposure in children

Decreasing tobacco consumptions leads to a decrease in:
  1. Heart disease
  2. Stroke
  3. Diabetes
  4. Cancer
  5. Respiratory diseases
At this time, this affects all countries, not just high, middle or low-income countries. Unfortunately, though, smoking disproportionately affects low-income countries. 
  • 50% of smokers are in 5 countries: Russia, China, India, Brazil, and Indonesia
Cancer is not a priority in low-income countries – as the leading causes of death are heart disease, stroke, etc. As such, the focus on tobacco prevention cannot be just focused on cancer prevention! Many of these deaths are preventable – with one intervention!
TabaccoDeathRates.png
Reducing tobacco consumption also has other effects:
  1. It can help decrease poverty by helping poorer individuals break out of the cycle of poverty
  2. Can help reduce the exploitation of child workers and small-scale tobacco farmers
  3. Can help improve the environment 
Taxes on tobacco products – a soft measure.

I personally like a quote he used – “100% tax on something that costs nothing is still nothing!” The cost of the actual product must be increased for the tax to have any impact.

His summary slide:
Tobacco_ESMO_Summary.png

Presented by: Gilberto Morgan, MD, Department of Oncology, Skåne University Hospital, Lund, Sweden
Written by: Thenappan Chandrasekar, MD (Clinical Instructor, Thomas Jefferson University) (twitter: @tchandra_uromd, @TjuUrology) at the 2018 European Society for Medical Oncology Congress (#ESMO18), October 19-23,  2018, Munich Germany