For millennials, it ain’t looking good, but are hard-hitting campaigns just fat-shaming and counterproductive?
The video features a small white box that looks like a cigarette packet. No pictures, just stark lettering.
People on the street are shown the box and asked a question: “What is the biggest preventable cause of cancer after smoking?”
They guess. Drinking? Sunbeds? No. The packet is opened. It is stuffed with greasy, plump slap chips.
On bleak white posters and billboards splashed across London and the United Kingdom and a barrage of social media messages the question is repeated.
Some letters to the answer are left out, in an easy game of hangman. OB_S__Y.
Yes, Cancer Research UK wants to tell the British public in a hard-hitting advertising campaign, being overweight or obese could be the new smoking: as smoking rates fall, obesity levels have crept up. If the trend continues, obesity may eventually overtake smoking as the biggest cause of cancer.
The message is SC_RY.
The country’s millennials — the supposedly quinoa-loving, juicing, detoxing generation born between the early 1980s and the mid-1990s — are likely to be the most overweight since records began, Cancer Research UK calculates, based on Health Survey for Englanddata from 2015.
More than seven in 10 millennials will be overweight by 2026-2028, the organisation predicts. This compares with around half of all baby boomers — those born between 1945-55 — who were overweight or obese at the same age.
In South Africa, obesity figures are equally alarming. South African women have the highest overweight and obesity rate in sub-Saharan Africa, according to a 2014 study published in the medical journal The Lancet.
The country’s 2016 demographic and health national survey reveals that two out of every three women (68.5%) and just over a third of men 15 years and older are overweight or obese. The Lancet study’s results were similar: 69.3% for women and 39% for men.
South African women’s obesity and overweight rate is almost double the global rate of about 30%, according to The Lancet study, for which researchers collected data from 188 countries.
For adults, overweight and obesity ranges are determined using weight and height to calculate a person’s body mass index (BMI), which for most people correlates with the amount of body fat. Overweight is defined as a BMI of 25 to 29.9 and obesity as a BMI of 30 or more, according to the United States government’s Centers for Disease Control (CDC).
A woman who is 1.65m tall and weighs 69kg, for example, has a BMI of 25.3 and is therefore overweight. If a woman of 1.73m weighs 90kg, her BMI is 30 and she is obese. (There are some exceptions, such as sportspeople.)
“While obesity groups tend to increase in the older age groups, South African millennials are also affected, with three out of five women and one in five men between the ages of 20 and 34 years estimated to be overweight or obese,” says Jessica Byrne, a registered dietician and spokesperson of the Association for Dietetics in South Africa (Adsa), referring to statistics in the 2016 demographic and health survey.
“South Africa faces a massive and growing burden of obesity.”
Lifestyle changes may prevent 4 in 10 cancers
Being overweight or obese is linked to 13 different types of cancer, research published in the New England Journal of Medicine in 2016 shows. This includes cancers of the breast in postmenopausal women, says Lorraine Govender, national advocacy co-ordinator of the Cancer Association of South Africa (Cansa), as well as cancer of the colon and rectum, endometrium, kidney and pancreas. It may also be associated with an increased risk of cancer of the liver, cervix, ovary and aggressive prostate cancer.
Statistics from the South African National Cancer Registry reveal a steady increase in the incidence of both lung and colorectal cancers from 2009 to 2013 among men, Govender points out.
The incidence is the rate at which new cases of a condition in a population increases over a specified period of time, according to the CDC.
“From 2011 the figures show that colorectal cancer incidence has increased in comparison to lung cancers,” Govender explains. “This could be the start of the impact of the obesity epidemic in South Africa.”
Among women in South Africa, Cancer Registry statistics show an increase in reported new cases of breast cancer and colorectal cancer. Govender says this is “possibly resulting” from the growing obesity epidemic.
Linda Bauld, Cancer Research UK’s prevention expert, explains that “extra fat doesn’t just sit there. It sends messages around the body that can cause damage to cells. This damage can build up over time and increase the risk of cancer in the same way that damage from smoking causes cancer.”
But only 15% of people in the UK know that obesity is a cause of cancer, Cancer Research estimates.
A 2015 study in the British Journal of Cancer confirms smoking is still responsible for a huge 54 300 cases of cancer in the UK every year but being overweight or obese causes nearly half as many (22 800 cases or 6.3%). The results suggest that more than 1 in 20 cancer cases would be prevented by maintaining a healthy weight, Cancer Research UK argues.
In South Africa, Govender explains, there is not sufficient research to show the actual percentage of cancers that are lifestyle-related. But, apart from obesity, preventable cancers include those linked to tobacco, alcohol consumption, exposure to the sun and ultraviolet-emitting tanning devices, pollution and lack of physical activity.
“Cancer is not inevitable,” says Govender. “It is possible that many cancers related to overweight and obesity could be prevented.”
Will blunt messaging convince millennials to shake off the kilos or is it fat shaming?
“Fat shaming!” and “Damaging!” — a chorus of protest met Cancer Research UK’s awareness campaign.
Sofie Hagan, a London-based Danish comedian, did not tactfully omit a single letter when she took to Twitter to vent how P_SS_D off she was: “Right, is anyone currently working on getting this piece of shit Cancer Research UK advert removed from everywhere? Is there something I can sign? How the fucking fuck is this okay?”
But Cancer Research says the campaign was never about fat shaming or blaming someone for their cancer.
“It’s not about anybody’s personal eating habits or blaming the individual,” says Malcolm Clark, policy manager for obesity at Cancer Research UK. “Yes, we wanted to raise the fact that there is a link between obesity and cancer, but the aim was to get action across the population to tackle this; to get policymakers and regulators to do more and to show where government should focus its efforts. The purpose was to have a public health campaign.”
The campaign was based on science, Clark emphasises. And although these figures make for grim analysis, they also show that positive changes can decrease the risk of cancer.
In South Africa, Govender says, nongovernmental organisations such as Cansa play a vital role in creating awareness — especially in the absence of a functional and well-resourced national cancer control plan.
But Cansa’s language is considerably more measured. Obesity is a highly stigmatised condition, Govender points out, and even clinicians may use alienating language when they try to talk to patients about their weight.
Adsa’s Jessica Byrne says that, although shock tactics may raise awareness, as has been successfully done in highlighting the dangers of smoking, there is a delicate balance between educating the public about the dangers of obesity and stigmatising or creating a negative body image in those who are overweight.
“Perhaps supportive messages should also focus on the importance of healthy lifestyle choices to prevent cancer, rather than singling out obesity,” she explains.
Cancer Research UK is still awaiting the results of the impact its campaign has had.
There will be considerably more than 15% of people who know about the link between excess weight and cancer, Clark predicts, especially given the level of response, coverage — and outrage.
Originally published For Health-e News
Witten by Kerry Cullinan
Regulations to ban smoking in all public spaces, remove branding from cigarettes packs and control electronic cigarettes will be published within two weeks.
The 17th World Conference on Tobacco or Health (WCTOH), Cape Town, South Africa,
Jose Luis Castro, WCTOH co-chair; Dr Aaron Motsoaledi, Minister of Health, South Africa.
Photo©The Union/Steve Forrest/Workers’ Photos
This is according to Health Director General Precious Matsoso, who was speaking on the sidelines of the World Conference on Tobacco or Health, which opened for the first time in Africa yesterday.
“I had hoped they would be published this week to coincide with the conference, but they are still being discussed by the Cabinet sub-committee,” said Matsoso.
Two years ago, Health Minister Dr Aaron Motsoaledi indicated that government wanted to introduce the new regulations but admitted yesterday that South Africa had “lagged behind” in its fight against tobacco control.
“In 2005, we compromised and allowed smoking in 25 percent of public spaces but we are going to take that space away to protect everyone,” said Motsoaledi, addressing the opening the conference.
“We are also committed to plain packaging,” he added. “We are looking at regulating all nicotine delivery systems including electronic systems because we need to control those.”
Fighting back
“All the signs are there that the tobacco industry is staging a fight-back after a slew of tobacco control legislation in the past two decades,” said Motsoaledi. “They are targeting young people in Africa. In the US, they are targeting African American people, the homeless and mentally ill. They are targeting young, working class and the most vulnerable people. We need activism against this onslaught.”
The tobacco industry and the food industry used job creation to defend themselves against government regulation “but are we creating these jobs for corpses?” asked the minister.
Meanwhile, World Health Organisation (WHO) Director General Dr Tedros Adhanom Ghebreyesus warned that Africa was “ground zero” for tobacco companies, who had identified it as a major growth market.
But, said Tedros, six out of 10 people in the world were now protected by some of the measures developed by the WHO against smoking, and that eight African countries had introduced picture warnings of he effects of smoking on cigarette packs.
No co-operation
Tedros appealed to all governments not to co-operate with the tobacco industry, including the recently formed Foundation for a Smoke-free World, financed by Marlboro manufacturer Philip Morris, and headed by former WHO official Derek Yach.
Billionaire philanthropist and former New York mayor Michael Bloomberg warned that “one billion people will die this century from smoking despite our efforts”.
“The tobacco industry is doing everything to circumvent our efforts to control tobacco to sell a product that is deadly and kills the people who use it,” said Bloomberg, who has donated over $1-billion to tobacco control.
However, Bloomberg said there had been remarkable gains: “In the US, you cannot go into a restaurant and smoke. In Shanghai, the government owns the tobacco companies but it no longer allows smoking in public.”
The crackdown on smoking for SKouth Africans is about to become much tougher as government gets ready to tighten the regulations. The change in the tobacco control act of 1993 comes under further change as South Africa falls in line with international standards after joining WHO Framework Convention on Tobacco Control on July 18, 2005. These changes are still up for comment and discussion in parliament at the beginning of this year.
Information Originally appeared on Tobaccocontrollaws.org
Smoke Free Places: Designated smoking areas in indoor workplaces, public places, and public transport are allowed. For workplaces and specified public places, up to 25 percent of floor space may be set aside for smoking. Specified public places include: smoking establishments, bars, pubs, taverns, night clubs, casinos, restaurants, hotels, guesthouses, Bed & Breakfasts, game lodges, and airports. In passenger ships and passenger trains with more than 10 cars, up to 25 percent of the space may be designated as smoking areas. Passenger trains with fewer than 10 cars may designate only one car as a smoking area. Sub-national jurisdictions can enact smoke free laws that are more stringent than the national law.
Tobacco Advertising, Promotion and Sponsorship: Nearly all forms of tobacco advertising and promotion are prohibited, with certain exceptions including that tobacco products may be visible at point of sale but must be displayed in such a manner that customers may not handle tobacco products prior to purchase. Although sponsorship by the tobacco industry is not completely prohibited, publicity of the sponsorship is prohibited.
Tobacco Packaging and Labeling: Rotating text-only health warnings covering 15 percent of the front of the package and 25 percent of the back of the package are required on cigarette packaging. Misleading packaging and labeling, including terms such as “light” and “low tar,” is prohibited.
Roadmap to Tobacco Control Legislation: The Tobacco Products Control Act 83 of 1993 is the primary tobacco control law in South Africa and governs many aspects of tobacco control, including, but not limited to, public smoking restrictions; packaging and labeling of tobacco products; and tobacco advertising, promotion and sponsorship. Several tobacco control regulations have been issued under this law including: 1) Regulations Relating to the Labeling, Advertising, and Sale of Tobacco Products (which regulates packaging and labeling); 2) Notice Relating to Smoking of Tobacco Products in Public Places (which regulates public smoking); 3) Regulations Relating to the Point of Sale of Tobacco Products (which regulates signs at point of sale and product display); and 4) Regulations Relating to Provisions for Exemption For Unintended Consequences and the Phasing out of Existing Sponsorship or Contractual Obligations (which exempts cross-border advertising from the ban on advertising, promotion and sponsorship).
Tobacco use is a threat to any person, regardless of gender, age, and race, cultural or educational background that causes over 18 types of cancer, and accounts for over 20% of cancer deaths worldwide. CANSA advocates stopping the use of any and all tobacco products.
Tobacco can be found in many forms, and all tobacco use is harmful. “People only think of cigarette smoking when you talk about tobacco, but it goes beyond that. They need to be aware that hubbly bubbly and e-cigarettes are just as harmful to your health and the health of those around you. It’s not just the smoker who has increased risk of disease, but also people exposed to second-hand smoke,” says CANSA Health Specialist, Prof Michael Herbst.
Tobacco Products Expensive
On top of the health implications, tobacco products are getting more expensive and are creating a huge negative impact on the economy.
“The tobacco industry produces and markets products that kill millions of people prematurely, rob households of finances that could have been used for food and education, and impose immense healthcare costs on families, communities and countries,” says Dr Oleg Chestnov, World Health Organisation’s (WHO) Assistant Director-General for Non-communicable Diseases (NCDs) and Mental Health.
“There is so much more you can do with an average R30 a day, instead of buying a pack of cigarettes. Have you thought about that? Giving up smoking one pack a day, will free up close to R1 000 a month, which can be used in better ways than harming your health, and the health of those around you. The financial impact is huge,” adds Herbst.
Hookah, or hubbly bubbly use is especially concerning among the youth. The tobacco is no less toxic in a hookah pipe and the water in the hookah does not filter out the toxic ingredients in the tobacco smoke. Hookah smokers may actually inhale more tobacco smoke than cigarette smokers do, because of the large volume of smoke they inhale in one smoking session. In South Africa, hubbly and their related tobacco products, fall under the definition of ‘tobacco product’ as indicated in the Tobacco Products Control Amendment Act (2007). This means that its use and sale have to comply with the regulations that apply to a tobacco product in the country. This includes the prohibition of the sale of hookahs and their products to anyone under the age of eighteen.
“Electronic cigarettes and similar devices are frequently marketed as aids to quit smoking, or as healthier alternatives to tobacco. This has not been proven, and e-cigarettes are not a better alternative to cigarettes. They still contain harmful chemicals, and it’s rather recommended to quit smoking by proven treatments. CANSA has a e-Kick Butt programme, which assists with quitting smoking (www.ekickbutt.org.za),” continues Herbst.
Know the law – it’s Your Right to a Smoke-free World
CANSA has played a significant role in contributing to tobacco control legislation in South Africa. Every person should be able to breathe tobacco-smoke-free air. Smoke-free laws protect the health of non-smokers. Report offenses here…
- Legislation is very clear about where people may smoke and where smoking is prohibited
- It’s your right to complain when someone smokes in your presence
- It’s also your right to take remedial steps if someone smokes in any area where smoking is prohibited
- Adults may not smoke in a car when a passenger under 12 years is present
- Smoking is not allowed in premises (including private homes) used for commercial childcare activities, such as crèches, or for schooling or tutoring
- No person under 18 may be allowed into a designated smoking area
- No smoking in partially enclosed public places such as balconies, covered patios, verandas, walkways, parking areas, etc.
- The fine for the owner of a restaurant, pub, bar and workplace that breaks the smoking law is a maximum of R50 000 and for the individual smoker R500
- The tobacco industry can no longer use ‘viral’ marketing like parties to target young people
- The sale of tobacco products to and by persons under the age of 18 years is prohibited
- Cigarette vending machines that sell tobacco products cannot be used to sell other products like crisps, chocolates etc.
Download all the materials and infographics here
