Ratte Sylviane, Slama Karen
Institut National du Cancer (INCa), Paris, France.
Promot Educ. 2005;Suppl 4:17-22, 55. doi: 10.1177/10253823050120040105.
Given the mortality and morbidity attributed to tobacco worldwide, global funding for tobacco control research, is greatly insufficient If compared with the fight against other diseases, tobacco control remains grossly under-funded. Data necessary to monitor the tobacco epidemic is inadequate even in the richer countries. It is therefore hardly surprising that studies on the state of data in developing countries and especially in francophone Africa conclude that standardised and comparable data are missing in all fields of tobacco control. Data available is often old, incomplete and hardly representative. This can be explained by both the lack of adequate capacity to conduct research and the low priority given to tobacco control as a health problem. In poor countries and regions where other diseases such as malaria and AIDS seem more pressing, the tobacco industry has almost no difficulty in using unfounded arguments about its contribution to the economy. Public authorities are thus intimidated by the threats of economic loss or attracted by immediate economic gains. This too often weakens the political will to act on issues of tobacco control. The little data available for the region, however, is alarming. Tobacco consumption has rapidly increased in recent years. This trend is confirmed by tobacco industry projected expansion in the region. Consequently, research programmes for Francophone African countries need to take into account the emergency of the situation, the context of Francophone Africa and, as well as, the limited resources available. Recently global research programmes such as the "Global Youth Tobacco Survey" have begun helping low-income countries in addressing the need for comparable and standardised data. The subject of an appropriate research agenda for tobacco control for low income countries has been discussed by international, national agencies, as well as, the NGO community in the context of the development of the Framework Convention on Tobacco Control. Given that the most important factors as regards changing tobacco use in a population include changing its social acceptability, as well as, providing a legal framework for tobacco control, recommendations for appropriate research for low-income countries have highlighted the need to define research programmes able to support actions which will produce the largest impact on the population, will serve to accelerate the ratification of the FCTC, will hasten the adoption of low-cost evidence-based measures such as tax increases, complete bans on advertising, smoke-free legislation, and will stop the tobacco industry's offensive in these countries. Large international initiatives to support the development of tobacco control research in low-income countries and particularly Africa have been launched. However, because of the language barriers, African Francophone countries may not have the same access to them than their Anglophone counterparts. Special attention should, therefore, be given to strengthen recent initiatives in this field which take into consideration the important dimension of language for Francophone Africa.
鉴于烟草在全球造成的死亡率和发病率,全球用于烟草控制研究的资金严重不足。与抗击其他疾病相比,烟草控制的资金仍然严重短缺。即使在较富裕的国家,监测烟草流行所需的数据也不充分。因此,关于发展中国家尤其是非洲法语国家数据状况的研究得出结论,在烟草控制的各个领域都缺乏标准化和可比较的数据,这并不奇怪。现有的数据往往陈旧、不完整且缺乏代表性。这既可以归因于开展研究的能力不足,也可以归因于将烟草控制作为一个健康问题的优先级较低。在疟疾和艾滋病等其他疾病似乎更为紧迫的贫穷国家和地区,烟草行业几乎毫无困难地利用关于其对经济贡献的毫无根据的论点。公共当局因此受到经济损失威胁的恐吓,或被眼前的经济利益所吸引。这常常削弱了在烟草控制问题上采取行动的政治意愿。然而,该地区现有的少量数据令人担忧。近年来烟草消费迅速增加。烟草行业在该地区的预计扩张证实了这一趋势。因此,针对非洲法语国家的研究计划需要考虑到形势的紧迫性、非洲法语国家的背景以及可用资源的有限性。最近,诸如“全球青少年烟草调查”等全球研究计划已开始帮助低收入国家满足对可比较和标准化数据的需求。在《烟草控制框架公约》的制定背景下,国际、国家机构以及非政府组织界已讨论了针对低收入国家的适当烟草控制研究议程的问题。鉴于在人群中改变烟草使用的最重要因素包括改变其社会可接受性以及提供烟草控制的法律框架,针对低收入国家的适当研究建议强调需要确定能够支持对人群产生最大影响、有助于加速批准《烟草控制框架公约》、促使采取提高税收、全面禁止广告、无烟立法等低成本循证措施并阻止烟草行业在这些国家进攻的行动的研究计划。已经发起了支持低收入国家尤其是非洲烟草控制研究发展的大型国际倡议。然而,由于语言障碍,非洲法语国家可能无法像英语国家那样获得这些倡议。因此,应特别关注加强该领域最近的倡议,这些倡议考虑到了非洲法语国家语言这一重要因素。