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The Challenge of Eliminating Tobacco-induced Cancers in the Developing World
programmes, but can also serve as a communication tool to mobilise related to issues of specific interest to the patient. Oncologists are
political will and financial resources for tobacco control activities. probably more powerful than other health workers in helping smokers
to quit because cancer is a concern for many people and it has been
The Role of National Cancer Plans in Tobacco Control inextricably linked to the use of tobacco. In addition, oncologists who
For over a decade, the WHO has promoted comprehensive national cancer treat adult family members with cancer have a unique opportunity to
plans that encompass the full continuum from cancer prevention to early influence the family system, including adolescent children.
26
They can
detection to treatment to palliative care.
1
More and more countries have also influence peers and colleagues to quit using tobacco.
developed national cancer plans and are on the way to a paradigm shift
from cancer treatment-only approaches to comprehensive cancer As advocates, they can speak out to paint the true picture of the
prevention and control policies. Tobacco control is an essential element of disability, disease and death caused by tobacco, and encourage policy
any national cancer plan. Tobacco control within a cancer plan creates makers to take action. Every healthcare professional should be an
synergies between the cancer control and the tobacco control communities. advocate for MPOWER policies and interventions. Cancer care physicians
can become involved in local and national tobacco control activities.
Although the involvement of political leaders is of major importance for Oncologists and their associations can be strong advocates with decision-
the implementation of the WHO MPOWER policies, oncologists, as well makers for implementing smoke-free policies, including establishment of
as other health professionals, can play a key role as entry points for 100% smoke-free hospitals and healthcare settings. Through
translating the WHO FCTC into effective action at the national level, professional societies and associations, they can help to strengthen
implementing the practical, country-level actions. Oncologists and other networks, set examples and drive change of social norms, eventually
health professionals are in an excellent position that allows them to play implementing the WHO FCTC at large.
a prominent role in tobacco control.
25
They have knowledge of disease,
they reach a high percentage of the population, they have the In conclusion, a shifting tobacco epidemic, together with other factors, is
opportunity to help people change their behaviour and they can have likely to lead to a new epidemic of tobacco-induced cancers in developing
positions as public advisers and access to decision makers through countries. Tobacco is unique among today’s leading public health
professional societies. problems in that the means of curbing the epidemic are clear and within
our reach. If developing countries have the political commitment and
There should be no borders between cancer prevention and tobacco technical and logistical support to implement the WHO MPOWER policy
control. It is imperative that clinicians routinely screen for tobacco use package as a key component of the WHO action plan for the prevention
and assist in the efforts made by their patients to stop smoking. and control of non-communicable diseases, they can save millions of
Unfortunately, despite proven effectiveness, many practitioners are lives. Oncologists can play a key role in tobacco control as health role
reluctant to consistently identify tobacco users and offer assistance to models in order to take action to help patients, influence other health
their patients.
26
As healthcare providers, oncologists should quit professionals and advocate public policy. ■
smoking themselves and incorporate the identification of tobacco
users and provision of brief advice into their routine practice, because Disclaimer
this intervention is feasible, effective and efficient and will help to The authors are staff members of the WHO. The authors alone are
improve their health and allow them to live longer. As discussed responsible for the views expressed in this publication and they do not
previously, physician advice can be especially powerful when it is necessarily represent the decisions or policies of the WHO.
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ASIA-PACIFIC ONCOLOGY & HAEMATOLOGY 15
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