Hooked for life – How big tobacco companies seduce youth – CANSA

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Hooked for Life – How Big Tobacco Companies Seduce Youth

The Cancer Association of South Africa (CANSA) partners with the World Health Organization http://www.who.int/  to highlight risks associated with tobacco use as part of World No Tobacco Day (31 May).  The aim is to advocate for effective policies to lower tobacco use. #WorldNoTobaccoDay

Globally the focus is on the link between tobacco and heart and other cardiovascular diseases including stroke, which combined are the world’s leading causes of death. Says Elize Joubert, CANSA’s CEO, “In South Africa, we’re concerned about the burden of tobacco and especially about the tactics adopted by the tobacco industry to target youth. Research shows tobacco use is often initiated and established during adolescence and young adulthood.”

Smoking remains a major preventable cause of disease and premature death globally http://www.cansa.org.za/avoid-tobacco/ . Annually, the global tobacco epidemic kills over 7 million people.  South Africa’s comprehensive Tobacco Control strategy over the last 20 years has been effective in dropping smoking use per capita – according to the SA National Health and Nutrition Survey 2013.  It showed 32.8% of men had ever smoked compared to 10.1 % of females.

The initial success of legislation of the past 20 years such as the Tobacco Products Control Amendment Act No.12 (1999), hikes in excise duty on cigarettes, and health promotions to educate on risks of tobacco use have led to a 30 % decrease in smoking among school learners.

However, a recent increase in smoking has been noted among youth (particularly girls) in SA from 2008 to 2011, according to the Global Youth Tobacco Surveys.


Tobacco companies are engaged in systematic market research generating data on population trends, smoking patterns and attitudes towards smoking. Research revealed that 90% of smokers start the habit by age 18 and 99% start by age 26.

By altering the taste, smell and other sensory attributes of products, tobacco manufacturers entice new users, mostly youth, to start and continue smoking. They maximise the appeal of tobacco products in this age group, by means of introducing the following chemical additives:

  • Levulinic acid to reduce the harshness of nicotine; make smoke feel smoother and less irritating.
  • Flavourings, such as chocolate and liquorice, to boost sweetness of tobacco; mask the harshness of the smoke.
  • Bronchodilators to expand lungs’ airways, making it easier for tobacco smoke to pass into the lungs.
  • Menthol to cool and numb throat, reducing throat irritation; making smoke feel smoother.

“CANSA appeals to young people, be aware of these tactics and understand that these alterations to products while enhancing the experience, do nothing to reduce the long-term negative effects of smoking or the risk for several cancers,” added Joubert. #NoTobacco

Furthermore, CANSA warns against the use of hubbly bubbly, hookah pipes or water pipes http://www.cansa.org.za/hubbly-bubbly-or-hookah-smoking-increases-cancer-risk/. Popular among youth when socialising with friends, it’s important to note that tobacco is no less toxic in a hookah pipe than in other tobacco products. 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 inhaled in one smoking session. The sale of hookahs and products is prohibited by law to anyone under the age of 18.

Electronic cigarettes (e-cigarettes) http://www.cansa.org.za/legal-status-e-cigarettes-in-sa/ and similar devices are frequently marketed as aids to quit smoking or as ‘healthier’ alternatives to tobacco.

Joubert states, “However, this has not been proven. They contain nicotine, so they’re addictive and may encourage novice users to later switch to combustible cigarettes. They’re particularly harmful and addictive to people under the age of 25, as their brains are still developing. This makes it easier for them to get addicted to nicotine after using even small amounts of e-cigarettes, which also contain other harmful chemicals. It’s rather recommended to quit smoking by proven treatments.”

CANSA encourages young smokers who have started using any tobacco product to get support to quit. CANSA has a free online eKickButt programme that helps with quitting smoking (www.ekickbutt.org.za). Counselling and medication can more than double the chance of a smoker to succeed when attempting to quit.

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2556031/

Obesity: Is eating slap tjips as bad as smoking? – Bhekisisa

Written by: ADRI KOTZE
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.

The Big 5 Cancers Affecting Men in South Africa