Regional Strategies for NCD Prevention and Control

Introduction

The NCD burden, using any of the comparable measures available, is highly variable across south Asia (as noted in Chapter 1). However, by contrast, NCD risk factors are similar, especially for tobacco—which has the best data, and to a more limited degree with available data, for diet and alcohol use.

Thus, NCD prevention may benefit from harmonizing health policies and strategies at a regional level for tobacco control and healthy dietary practices. The centerpiece of tobacco control efforts include policies that restrict advertising to adults and marketing to children, and that increase tax rates of cigarettes and tobacco products to reduce consumption, especially among the poor, who tend to use more tobacco than the rich (Ross and

Chaloupka 2006).

The tobacco industry tends to target its marketing efforts at countries with fewer

restrictions, where tobacco is taxed less and is easier to buy. Media advertising for tobacco products in countries with fewer restrictions can therefore penetrate into countries with more restrictive policies. Also, low cigarette prices increase the risk of smuggling back into countries with restrictive policies, higher taxes, and higher tobacco prices.

Thus, harmonization of tobacco policy is not only important—its absence may cause harm. One response at a global level was the FCTC (Box 4.1 above), which has been adopted by all countries in South Asia. However, implementation worldwide has been slow or stalled because of several complexities, including weak international collaboration.

Food-exporting countries’ policies can heavily influence health dietary practices through the quality of food consumed in food-importing countries. For both tobacco use and food consumption, the poor are the most susceptible to domestic and international policies because they have higher smoking rates and make food purchases based on cost, not quality.