Reduction de la consommation du tabac conduit a la reduction des crises d'asthme chez les enfants

Une étude révèle que, suite à la mise en œuvre de la loi antitabac, le nombre d'hospitalisations d'enfants pour asthme a diminué

Depuis le 26 mars 2006, le Smoking, Health and Social Care Act, la loi écossaise sur le tabac, la santé et la protection sociale, interdit de fumer dans tous les lieux publics et de travail. Des études menées précédemment ont montré que, suite à l’adoption de la loi d’interdiction totale de fumer, les troubles respiratoires chez les employés de bars ont diminué. Une étude publiée récemment dans le New England Journal of Medicine a étudié d’impact de cette législation sur les enfants en examinant la tendance, avant et après l'entrée en vigueur de la loi, en matière d'hospitalisations d’enfants pour asthme. Pour cela, l’étude a utilisé les registres d’admissions entre janvier 2000 et octobre 2009 afin de déterminer les taux d’hospitalisation pour asthme des enfants âgés de moins de 15 ans.

Les principaux résultats:

·Avant la mise en œuvre de la loi antitabac, le taux d’hospitalisation pour asthme augmentait en moyenne de 4,4 % par an. Après son entrée en vigueur, on a observé une réduction moyenne du taux d’hospitalisation de 15,1 % par an.

·La baisse du nombre d’hospitalisations d’enfants pour asthme est survenue aussi bien chez les enfants d’âge préscolaire que d’âge scolaire.

Avant l'adoption de la loi écossaise, on craignait que celle-ci n'augmente le tabagisme à la maison, ce qui aurait augmenté de fait l’exposition des enfants à la fumée de tabac environnementale. Les études relatives à l’exposition des adultes et des enfants n’ont apporté aucune preuve que le tabagisme ne se soit déplacé dans les foyers. Au contraire, la législation s’est accompagnée d’une augmentation des restrictions volontaires à la maison. Ces dernières réduisent l’exposition des enfants à la fumée de tabac environnementale. D’ailleurs, depuis l’entrée en vigueur de la loi écossaise, l’exposition globale des enfants à la fumée secondaire a diminué.

Messages clés :
·Depuis la mise en œuvre de la loi écossaise, l'exposition des enfants à la fumée de tabac environnementale a diminué, ce qui s’est traduit par une baisse du nombre d’hospitalisations pour asthme.

·Les lois d’interdiction totale de fumer, qui permettent de réduire l'exposition à la fumée secondaire, ne bénéficient pas uniquement aux travailleurs mais également aux enfants.

Le résumé [en anglais uniquement] de ce rapport est disponible à l’adresse suivante :http://www.nejm.org/doi/pdf/10.1056/NEJMoa1002861

Autres ressources:

·Pour accéder aux directives pour l'application de l'article 8 de la CCLAT sur la protection contre l'exposition à la fumée du tabac :

[français] : http://www.who.int/fctc/cop/art%208%20guidelines_french.pdf

·Pour accéder aux Points sur les faits relatifs aux lois antitabac

[français], notamment un Point sur les faits relatif aux effets sanitaires de la fumée secondaire, allez à : http://tobaccofreecenter.org/fr/resources/smoke_free_laws/fact_sheets

Citation complète : Mackay D, Haw S, Ayres J, Fischbacher C, Pell J. Smoke-free Legislation and Hospitalizations for Childhood Asthma. New England Journal of Medicine Vol. 363:1139-45, 2010.

Le New England Journal of Medicine est la plus ancienne revue médicale publiée sans interruption. Fondée en 1811, elle a recours à processus d’évaluation par les pairs et de révision afin de déterminer l’exactitude, l’innovation et l’importance scientifiques des manuscrits.

Pour toute question concernant ces documents ou la façon dont vous pouvez les utiliser dans le cadre de vos efforts de lutte antitabac, n’hésitez pas à contacter research@tobaccofreecenter.org.

Study Finds Decreases in Childhood Asthma Hospitalizations after Smoke-free Law Implementation

Scotland’s Smoking, Health and Social Care Act banned smoking in all public places and workplaces as of March 26, 2006. Previous studies have shown that adoption of the comprehensive smoke-free law has been associated with reduced respiratory symptoms among workers in bars. A recent study published in the New England Journal of Medicine examines the impact of the legislation on children by looking at trends in childhood asthma hospitalization admissions before and after the law went into effect. The study used hospital admissions records between January 2000 and October 2009 to determine asthma hospitalization rates for children under the age of 15 years.

Key findings:

·Admissions for asthma before the implementation of the smoke-free legislation increased at an average rate of 4.4% per year. After implementation, there was an average reduction in admission rates of 15.1% per year.

·The reduction in childhood asthma hospitalization admissions occurred for both preschool and school-age children.

Before implementation of the Scottish legislation, there was concern that it might increase smoking activity to homes, leading to an increase in exposure to environmental tobacco smoke among children. Studies of exposure among both adults and children have shown no evidence of displacement of smoking to the home. Instead, the legislation has been followed by an increase in voluntary restrictions in the home. Household smoking restrictions reduce the exposure of children to environmental tobacco smoke, and the overall exposure of children to environmental tobacco smoke has fallen since the implementation of the Scottish legislation.

Key messages:

·The exposure of children to environmental tobacco smoke has fallen since the implementation of the Scottish legislation, resulting in fewer hospital admissions for asthma.

·In addition to workers, children also benefit from comprehensive smoke-free legislation through reduced exposure to environmental tobacco smoke.

A link to the abstract [English only] can be found at: http://www.nejm.org/doi/pdf/10.1056/NEJMoa1002861

Additional Resources:

·To access FCTC Article 8 Guidelines on protection from exposure to secondhand smoke [English]: http://www.who.int/fctc/cop/art%208%20guidelines_english.pdf

·To access fact sheets on smoke-free policies [English] including a fact sheet on health effects of secondhand smoke, go to: http://tobaccofreecenter.org/resources/smoke_free_laws/fact_sheets

Full Citation: Mackay D, Haw S, Ayres J, Fischbacher C, Pell J. Smoke-free Legislation and Hospitalizations for Childhood Asthma. New England Journal of Medicine Vol. 363:1139-45, 2010.

The New England Journal of Medicine is the oldest continuously published medical periodical. Established in 1811, it employs a rigorous peer-review and editing process to evaluate manuscripts for scientific accuracy, novelty, and importance.

If you have any questions about the materials or how you may use them in your advocacy efforts, please e-mail research@tobaccofreecenter.org

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Campaign for Tobacco-Free Kids

1400 Eye Street, NW, Suite 1200

Washington, DC 20005

(202) 296-5469

(202) 296-5427 fax

www.tobaccofreecenter.org

www.tobaccofreekids.org

Agir Ensemble will be implenting new program for cervical cancer prevention

AGIR ENSEMBLE, in its efforts to prevent cancer, will be implementing a new program for cervical cancer prevention. It is a campaign for cervical cancer prevention during 6 months from January 2011 which includes a training of doctors and nurses in cervical cancer screening. This program is financially supported by UICC Cancer Campaign.

Thank you.

Dr Sahani.

Capacity Building Workshop Training of UICC in Cape Town

A workshop training in cancer prevention including social marketing for Tobacco control has been held by UICC in Cape Town/South Africa in March 2010. AGIR ENSEMBLE has been represented as a member of UICC by Dr Mateus Kambale Sahani.

Thank you.

Capacity of health professionals in cervical cancer screening in Goma/DRC M. Kambale Sahani1,2, M.M. Mutumwa3, P.K. Mukama4

This article has been published in the 2010 IGCS biennual meeting held in Prague/Czech Republic:

Capacity of health professionals in cervical cancer screening in Goma/DRC
M. Kambale Sahani1,2, M.M. Mutumwa3, P.K. Mukama4

1Health Department, AGIR ENSEMBLE, 2Virunga General Hospital-GOMA, 3Clinic Chaine de l'Espoire-GOMA, 4Centre Medical Belle vue, GOMA, The Democratic Republic of the Congo

Overview
Cancer is now the leading cause of death worldwide, 28 million of people live with cancer in the world and 8 million die each year by the disease. In DRC, cancer killed approximately 33,000 people in 2005 and cervical cancer was the killer no 1 among women and prostate cancer among men. If nothing is done now, this figure will reach 65,000 in 2030. Source: WHO infobase
In DRC no woman has access to cervical cancer screening in all the life (service not available in all the country, a country of more than 70,000,000 people).

Objectives
This research project aims to know the degree of understanding and competency of health professionals (doctors and nurses) in screening methods (VIA and VILI) to make sure that the screening can be initiated without any difficulty in the city of Goma and, if there are difficulties, how they can be solved to this services being accessible to people. To measure also their capacity of using cryotherapy for treatment of precancerous lesions.

Method
We used the STEPS Method of the WHO, especially Step 1 using questionnaire and interview of 50 doctors (general practitioners) and 500 nurses in the city of Goma. Sample was constituted from all public and private hospitals and health centers of the city. We used comparative statistic test among people who know the method and those who don’t know it.

Hypothesis
Our study was focused on the following hypothesis:
- Health professionals know well the usage of VIA and VILI methods,
- Health professionals usually educate their patients on prevention of cervical cancer,
- Health professionals know how to use cryotherapy to treat precancerous lesions.

Results
At the end of our study, we found that:
1. 85% of doctors (43) never understand about VIA and VILI methods and 98% of nurses (490) are too.
2. 10% of doctors (5) have understood about the methods but don’t know how to proceed and 1% of nurses (5) are too.
3. 5% of doctors (3) know the substances used for VIA and for VILI but don’t know how they are used and 1% of nurses (5) are too.
4. 10% of doctors (5) give an education message to their patients (avoid genital infections) and 2% of nurses (10) do too.
5. 10% of doctors (5) are aware of HVP vaccine to prevent cervical cancer and no nurses (0) know that.
6. No health professional (doctors or nurses) knows that precancerous lesions can be treated and no one knows how to use cryotherapy.
7. No health professional (doctors or nurses) has participated in a campaign for cervical cancer prevention.
8. No health institution in Goma has a screening service.

Conclusions
Health professionals in the city of Goma don’t have sufficient skills in cervical cancer screening and HPV vaccine. This constitutes a need for training in this area and it is also a big challenge to the availability of the service.

1. Introduction

On April 24th, 2010, AGIR ENSEMBLE has organized a Raising Awareness Session (RAS) on tobacco control for youth in the church community (CBCA KESHERO) in the city of Goma. We had planned to join together 50 young people of the community church and inform them that tobacco is dangerous for their health and explain them the strategies used by the industry to grow its clients.

This session took place normally as expected and got the audience of 59 young people joining the meeting.
The duration of the event was 2 hours from 2:00 pm to 4:00 pm.

2. Objective of the session

AGIR ENSEMBLE, in its commitment of spreading information which can save lives and maintain the health of population in the community, settled following objectives for this session:
- Bring together a group of 50 young people from KESHERO CBCA community church, who can receive the message that tobacco is a global priority of public health,
- To teach to the group how to protect himself and to protect others against tobacco smoking, the reason of not begin smoking and at the end of the session at least 95 % of participants will know correctly the importance of not to begin smoking.

3. Context of organization

Considering the financial difficulty, the event was held in the worship hall of KESHERO CBCA CHURCH from 2:00 pm till 4:00 pm. The event has been attended by 59 persons among whom 38 females and 21 males. We didn’t find possibility to make T-SHIRTS for participants.

4. Progress of the event

The event took place around the subject:
"Tobacco and youth", the role of youth in tackling tobacco usage.
The moderator of the session was Mr. Alphonse KAVWIRWA, president of the Board of AGIR ENSEMBLE and the speaker was Dr Mateus KAMBALE SAHANI, the director of the Health Department of AGIR ENSEMBLE.
The session began with the allocution of the president of AGIR ENSEMBLE, Mr. Alphonse KAVWIRWA who welcomed all participants to the session of the day and presented the missions of AGIR ENSEMBLE.
Then Dr Mateus SAHANI began explaining the background of the event and presented the relevance of acting against tobacco. “Most importantly, our collective voice must show our commitment to fight tobacco in our community and worldwide and it must be a global priority for the public health” he said.
After this, the speaker began the session “Tobacco and Youth, the role of young people in the fight against tobacco” in which he gave the place held by tobacco as a big public health threat. “Tobacco is the first Risk factor of cancer and kills each year 5.4 million people worldwide and cancer is becoming the leading cause of death worldwide. We know that cancer kills 8 million people each year and if nothing is done by now cancer will kill 12 million of people. Every one may act by now if you want to save the 28 million of people living with cancer in the world and if you want to address the cancer burden worldwide. The voice of each one is needed for the fight”, he said.
Then some questions were asked and answered by the speaker. All participants were interested by the session of the day and 15 questions have been received. Almost all questions were well answered. After this a cocktail was offered to participants.

5. Participants

In total 59 people attended the meeting among whom 38 females and 21 males and were interested by the theme of the day.

6. Evaluation of the session.

We expected 50 people for the meeting and brought together 59. This objective was reached in 118%. The second objective was reached in 90%. In all our performance was 104%. The main barriers for us to reach our maximum of goals were the background of the organization of the event, and missing financial support and we didn’t be able to organize transport for participants.

7. Questions and recommendations

Some pertinent Questions
- What is the importance of tobacco for community and for smokers?
- If tobacco kills 5.4 million of people each year, why is it allowed to be selled?
- Are governments aware that tobacco kills people and cause diseases? What are they doing to protect people?
- What can be our attitude as young people towards our parents who smoke?
- What is the good strategy we can use to sensitizer our parents who smoke?
- What can be the attitude of a wife towards her husband who is smoking?
- Why industry targets young for its activities?

Recommendations

At the end of the event, participants have recommended:
- To organize multiple sessions like this one to allow spreading the message that can save lives of population.
- To choose a place and a moment which allow more people to attend the event for the next time.
- Such events need financial support for a real success: media campaigns, advocacy with politicians, etc. Can LAF help us?

8. Conclusions

Generally the activities of the planned were well realized and it was a real success even if there were some difficulties. All was done as planed and our objectives were reached. Participants were satisfied by the event and the message was new for almost 97% of them. They recommend us to them more information and strategies to allow them to sensitizer their parents who are smoking and they ask us to give them some posters to be used in their living rooms.
Goma, April 24th, 2010.
Dr Mateus KAMBALE SAHANI
AGIR ENSEMBLE/DRC

AGIR ENSEMBLE a celebre la journee internationale contre le cancer 2010

AGIR ENSEMBLE has organized a public debate on cancer focusing on the campaign slogan: “cancer can be prevented too”. The target people were teachers of Visoke institute.
The event took place in one of the classrooms of the school (Visoke Institute) on February 4th, 2010 directly after courses from 12:45 – 16:00.
The official langage of the event was French.
The event has begun with presentation of participants and a little presentation on mission of AGIR ENSEMBLE. The moderator was Mr Paul and was in charge of taking picture.
The speaker was Dr Mateus Kambale Sahani (in yellow T-SHIRT). After presentation, the speaker begun with the topic: “Cancer, a global priority” and after he continued by giving the key messages of the campaign through the topic: “Cancer can be prevented too”. The speaker has insisted on some simple measures to prevent cancer and this was received by participants as good news because all of them didn’t know that it could be possible to prevent cancer.
Then, the moderator opened the debate and 15 questions have been received and all found responses.
At the end, Dr Mateus gave the press release, key messages and the Diary notes to the headmaster of the school (Visoke institute).
After this, some recommendations were given by participants:
1. for next time, to invite more people and look for a common moment and sufficient time to allow people to understand better the matter of cancer, screening for cervical cancer, breast cancer, tobacco control, etc.
2. the headmaster has asked to AGIR ENSEMBLE to do more sessions of raising awareness for their pupils and said that they need more posters for their classrooms and the public room of teachers.

Some key outcomes:
At the end of the day activities:
1. All participants have understood and convinced that cancer can be prevented too (this was the first time for them to understand that cancer is also preventable),
2. All participants have made commitment to sign the world cancer declaration,
3. All participants have made commitment to spread this message to their pupils but they need some materials as posters and some modules.

Thank you,

Dr Mateus Sahani.

World Cancer day, 4 February 2010: Press release

AGIR ENSEMBLE

Address: AGIR ENSEMBLE, Avenue LUSAKA, Commune de Goma
Q. KESHERO, GOMA/RDC
Date: Le 30/01/2010.


Request for your support for World Cancer Day 2010

Dear Sir(s)/Madam(s)

On behalf of AGIR ENSEMBLE, NGO OF DRC, I would like to ask for your support of World Cancer Day 2010 which takes place on 4th February and is led by the International Union Against Cancer, the leading international NGO which unites 300 member organizations in more than 100 countries including AGIR ENSEMBLE in the global fight against cancer through the implementation of the World Cancer Declaration. By working together our goal is to eliminate cancer as a life-threatening disease for future generations.

This is an ambitious target as globally one in eight deaths are due to cancer. If no action is taken, the worldwide burden is projected to reach 26 million new cancers in the year 2030 and 17 million deaths with the most rapid increases occurring in those countries lease prepared to deal with them.

Approximately 40% of cancers are potentially preventable and the good news is that we now have more knowledge than ever on how to bring cancer under control.

Under the slogan “Cancer can be prevented too”, the 2010 World Cancer Day campaign will focus on how the risk of developing cancers related to tobacco use, heavy alcohol consumption, excessive sun exposure and obesity can be significantly reduced by avoiding these risk factors and encouraging healthy behaviour such as regular exercise and eating healthily.

In this light, we would be very grateful for your support for this year’s campaign. This could be by taking part in a photocall or public event that we are organizing, by signing the World Cancer Declaration (see www.uicc.org), by putting your name to a quote that we use in media materials, or in any other way that you’d like to discuss. Example quotes that could be tailored and attributed to you in World Cancer Day 2010 media materials:

“I know that one third of all cancers can be prevented through simple steps. I am reducing my risk and my family’s risk by not smoking”.

“I know that regular exercise and eating healthily reduces my risk of developing cancer.”

“I know that one third of all cancers can be prevented through simple steps. My young daughter has been vaccinated against HPV”.

We very much hope you will support us and look forward to hearing from you.

Yours sincerely,

Dr Mateus KAMBALE SAHANI
AGIR ENSEMBLE/UICC-DRC

World Cancer day, 4 February 2010: key messages

AGIR ENSEMBLE




WORLD CANCER DAY 2010
KEY MESSAGES FOR MEDIA MATERIALS AND SPOKESPEOPLE
Message one (painting the picture)
Each year, 12 million people receive a cancer diagnosis and 7.6 million people die of cancer. If no action is taken, the worldwide cancer burden is projected to reach 26 million[1] new diagnoses in the year 2030 and 17 million[2] deaths, with the most rapid increases occurring in low- and middle-income countries.
Message two (insight and umbrella message)
The good news is that experts estimate that approximately 40% of cancers are potentially preventable. You can significantly reduce the risk of you or your family developing cancers related to tobacco use, heavy alcohol consumption, excessive sun exposure and obesity by avoiding these risk factors and encouraging healthy behaviour such as regular exercise and eating healthily.
Message three (preventing cancers caused by infections - the focus for World Cancer Day 2010)
In addition, some cancers such as cervical, liver and stomach cancers are known to be caused by chronic infections. Prevention of these infections is possible through interventions such as vaccination, antibiotics, improved sanitation and learning simple avoidance strategies.
Message four (the vehicle)
World Cancer Day, under the campaign slogan “Cancer can be prevented too”, is led by the International Union Against Cancer (UICC), the leading international NGO which unites over 300 member organisations in more than 100 countries in the global fight against cancer through the implementation of the World Cancer Declaration.

Support World Cancer Day 2010 - February 4th. Visit www.uicc.org

World Cancer day, 4 February 2010: diarry note

DIARY NOTICE FOR FORWARD PLANNING DESKS

WORLD CANCER DAY – 4th FEBRUARY 2010

Each year, 12 million people are diagnosed with cancer and 7.6 million people die of cancer. If no action is taken, the worldwide cancer burden is projected to reach 26 million new diagnoses by 2030 and 17 million deaths, with the most rapid increases occurring in low- and middle-income countries.

The good news is that approximately 40% of cancers are potentially preventable. The risk of developing cancers related to tobacco use, heavy alcohol consumption, excessive sun exposure and obesity can be significantly reduced by avoiding these risk factors and encouraging healthy behaviour, such as regular exercise and eating healthily.

World Cancer Day, under the campaign slogan “Cancer can be prevented too”, is led by the International Union Against Cancer (UICC), the leading international NGO which unites over 300 member organisations in more than 100 countries in the global fight against cancer through the implementation of the World Cancer Declaration.

Launched on World Cancer Day the 2010 report will focus on preventing cancers caused by persistent viral and bacterial infections through measures such as vaccination, antibiotics, improved sanitation and learning simple avoidance strategies.

Activities run by International Union Against Cancer members for World Cancer Day will include educational events, walks, runs, public talks, scientific forums, exhibitions, concerts, sporting events and much more.

Support World Cancer Day - February 4th. Visit www.uicc.org.

For information on activities planned on World Cancer Day by UICC members in your country, please contact Aline Ingwersen:

Direct line: +41 22 809 1811
Mobile: +41 79 568 5070
Email: ingwersen@uicc.org

Press contact:
Sophie Laird, Cohn & Wolfe Public Relations
Tel: +41 22 908 40 73 / email: Sophie.laird@cohnwolfe.com