Health Minister: Programme coming to help smokers quit

Minister of Health Jerry Narace

Further, a rigorous smoking cessation programme is being designed to assist people to quit smoking. Encouragingly, many citizens have indicated their interest in quitting by registering for our cessation programme.

Address by the Minister of Health, Senator the Hon. Jerry Narace at the Tobacco Control Act Sensitization Seminar at Leon Agostini Conference Hall, Chamber Building, Columbus Circle, Westmoorings on Monday 8th March, 2010 at 8 am.  

 
SALUTATIONS
 Ms Catherine Kumar - Chief Executive Officer, Trinidad and Tobago Chamber of Industry and Commerce
 Mrs Angella Persad – President, Trinidad and Tobago Chamber of Industry and Commerce
 Chief Medical Officer, Dr. Anton Cumberbatch
 Dr Andrea Yearwood - Director Health Policy, Planning and Research - Ministry of Health
 Ms Bhabie Roopchand - Legal Advisor - Ministry of Health
 Ms Yvonne Lewis – Director, Health Education Division, Ministry of Health
 Ministry executives and staff
 Members of the Trinidad and Tobago Chamber of Industry and Commerce,
 Members of the media
 Ladies and gentlemen 
 
 
 Introduction
It is my distinct pleasure to be in the company of colleagues and friends from both the Ministry of Health and the Trinidad and Tobago Chamber of Industry and Commerce this morning and even more so for a cause as significant as this one.
 
Tobacco smoke has long been known to be detrimental to human health. In fact, the tobacco industry is the only industry in the world, whose products, if used as directed, will kill its customers. Not only do tobacco products kill their users, they also kill anyone who is exposed to second hand smoke.
 
According to the World Health Organisation (WHO), the world is facing a tobacco epidemic. Tobacco smoke currently kills 5.4 million people a year from lung cancer, heart disease, and other tobacco related illnesses. More than 80 per cent of these deaths occur in developing countries, leading to a less productive workforce and the inevitable rise of health care costs.
 
Tobacco Control Act
The Tobacco Control Act was designed especially to protect our children, young people, babies, born and unborn, from tobacco smoke. It is unquestionably true that tobacco control is essential for the protection of public health. Scientific research endorsed by the WHO has established that 100% smoke free environments are the only way to adequately protect the populace from the health-robbing effects of second hand tobacco smoke.
 
Although the passage of the Tobacco Control Act 2009 in the Parliament last December was a momentous victory for public health in Trinidad and Tobago, as the public finally won the right to enjoy smoke free public environments, true victory will rest with our appreciation and enforcement of the law.
 
The Act in its entirety has not yet been proclaimed, as the passage of the respective regulations in Parliament is still pending. However, Part Three and Sections 1 through 9 of the Act were proclaimed by the President on Ash Wednesday 2010, thus bringing the following prohibitions into effect:
 
  the prohibition against the sale of tobacco products to and by minors;
  [the prohibition against] self-service displays of tobacco products;
  [the prohibition against] public displays of tobacco products;
  [the prohibition against] self-service sales of tobacco products;
  [the prohibition against] sale of tobacco products in certain places;
  [the prohibition against] import, manufacture or sale of toy or candy cigarettes;
  [the prohibition against] tobacco advertising;
  [the prohibition against] incentive promotions and free supply of tobacco products;
  [the prohibition against] tobacco sponsorship;
  [the prohibition against] other forms of promotion and of course
  the prohibition of smoking in enclosed and semi- enclosed public spaces. These public spaces include, but are not limited to public conveyances, bars, restaurants, clubs and workplaces.
 
Ad Lib [This morning in our Q&A we will be more than happy to clarify how it works and I think that is the major part of this exercise; a sensitization to say to you things you may or may not have understood and I’m sure that the Chamber will continue to do more of these sensitization programmes on their own with some assistance from the MOH as we go through other parts of the country and interact with the other Chambers]
 
The remaining parts of the Act will be proclaimed when the Regulations, which are currently being developed and finalised, are introduced into the Parliament. We estimate that the time frame for this is approximately three months.
 
Ad lib; [I’ve listened very carefully to the Industry President saying that there are certain people, including the industry themselves who would like to assist us with enforcing and implementing Tobacco Control.  I want to suggest very respectfully that we are signatories to the FCTC, which is the Framework Convention For Tobacco Control, at that Treaty there are clearly established principles of how we conduct business and I want to suggest to the Industry that you are free to write to us and give us all the suggestions and all the information, all of that assistance that you may find useful.  It is not restricted to the Tobacco industry, any individual, any retailer, any association will also be free to write to us at the Ministry of Health, Corner Park and Edward Street.  I think we can address these letters to the Policy Director, Dr Andrea Yearwood or addressed to the Minister of Health, and we will work with that.  I want to know that I have heard what you have said.]
 
Enforcement of the Act
The government recognises and appreciates the fact that the enactment of Tobacco Control legislation represents a major cultural shift for our country. Nevertheless, it is an endeavour upon which the health, development and sustenance of our country rests.
 
My dear friends, I have always maintained that society should take on the responsibility for enforcing this law. Even though the police is indeed authorized to press charges and enforce this law by force, our wish and plan is to enforce this Act through citizen participation and moral suasion.
 
Ad lib: [In that all over the world this act is implemented and monitored by society itself.  In fact it’s had great success as the citizens at large sought to regulate themselves, and in fact I have been doing my own studies, and I want to congratulate the citizens of Trinidad and Tobago, certainly all of those establishments who have said to us through our investigation and enquiries, that we are meeting with a great response from the population.  I thank all those people and I want to congratulate them for that.  And clearly that is in its own right a cultural shift from what obtained in the past.]
 
Citizens are being encouraged to monitor smoking in enclosed public spaces and to report violations to the manager of the venue or file a complaint with the Ministry of Health.
 
I know many of you would have instituted your own company policies which regulated smoking in the workplace over the years and I want to commend you on your initiative in that regard. We are trusting now that all business owners and industry leaders will commit to assisting us with enforcing the law. On our part, we are committed to actively listening to your comments and working with you in meeting any challenges that might arise along the way.
 
It is well understood though that as leaders in business and industry, you have the power to effect change at your companies and businesses for smoke free environments and I am very pleased to see such a participation here today, which clearly indicates your interest in ensuring that your businesses abide by the law and assisting us in our efforts to promote the health of our nation.
 
Ad lib: [We have to remember if we are to remain successful in industry, trade and commerce, we need to have a healthy workforce.  And the only way we can have a healthy workforce is by adhering to some principles that will suggest that we are able to do exactly that.]
 
Since the enforcement of the Act, the Ministry of Health has been conducting its own internal monitoring of the public response to and compliance with the law. The general indication is that people, including the smokers themselves, are understanding and appreciative of smoke free environments. In fact, we are very encouraged by the response and grateful to civic society for their immediate observance and implementation of smoke free enclosed public places.
 
Ad lib: [So that we really want to underscore, that success we have been able to meet with, and I see the emails and cards being received all the time by MOH, as well as various messages all suggesting the same.] 
 
Further, a rigorous smoking cessation programme is being designed to assist people to quit smoking. Encouragingly, many citizens have indicated their interest in quitting by registering for our cessation programme. Additionally, we are currently implementing a public education and communication plan which encompasses the sensitisation of all stakeholders and the public at large using fora such as this one, while a new Tobacco Control Unit will be established to cater to the needs of this new legislation.
 
Ad lib: [As it stands now the Chief Medical Officer oversees all of the functions of that Unit.]
 
What is also important to highlight, ladies and gentlemen, is the significance of this Act at the regional and international levels. On March 3rd, 2010, the Ministry was paid a special visit by the General Manager of the Non-Smoker’s Rights Association of Canada (NSRA), Ms Lorraine Fry, and the Project Manager of the Caribbean Tobacco Control Project, Ms. Barbara Mc Gaw. The purpose of the meeting was to facilitate the exchange of learning experiences regarding tobacco control, including the achievements made by Trinidad and Tobago in implementing tobacco control legislation.
 
For those who might not be familiar with the NSRA, it is a Canadian voluntary non-profit health organisation that has worked exclusively in the field of tobacco control for over 30 years and has been awarded the World Health Organisation’s Gold Medal for tobacco control. It was therefore with great pride that I received Ms Fry’s comment that our country is ahead of many countries in putting things in place for tobacco control and her congratulations to the government of Trinidad and Tobago for being pioneers of tobacco control legislation in the Caribbean.
 
[And because I know that the media are present here today, I am advised that the footage from the interviews with the representatives of these international associations have been forwarded to you for your kind review and coverage].
 
CNCDs and policy on trans fats and sugars
Ladies and gentlemen, I also want to share with you another significant area that the government is about to undertake in its efforts to achieve its vision of a nation empowered to live long, healthy, happy and productive lives. Although tobacco is a major contributor to the development of chronic non communicable diseases, such as diabetes, cancer and heart disease, it is not the only contributing factor. Many of the dangers actually lurk in our diets – sugars, processed foods, foods with high sodium content and saturated and trans fats also contribute in less obvious ways to the development of CNCDs.
 
In Latin America and the Caribbean, chronic diseases continue to rise and are now the leading cause of premature mortality, accounting for nearly half the deaths of persons under 70 years, and for two out of three deaths overall.
 
CNCDs have accounted for four of the five leading causes of death in our country over the last two decades. In fact, heart disease, cancer, diabetes and strokes account for 60% of the total causes of death in Trinidad and Tobago.
 
What is both equally surprising and alarming also, is that the health of our children is being negatively impacted. Childhood obesity is on the rise, leading to the onset of diabetes and other chronic diseases much earlier in life. This epidemiological transition is undoubtedly due to a significant shift in their dietary patterns, characterised by decreased consumption of fibres, while simultaneously increasing the consumption of foods rich in saturated fats and salt, processed food, sugar rich soft drinks and physical inactivity.
 
According to the WHO, there is conclusive evidence indicating that the consumption of trans fatty acids increases the risk of coronary heart disease and possibly raises the risk of sudden cardiac death and diabetes.
 
Fortunately, most CNCDs are caused by modifiable risk factors and lifestyle choices. We can choose not to use tobacco, improve our diets and include physical activity in our lives. If we control the risk factors for CNCDs, we can prevent some 80 per cent of all heart attacks, strokes and Type 2 diabetes, as well as 40% of cancers.
 
Ad lib; [It is now well established all over the world, and I think teh United States has been at great pains saying, and made a major investment in trheir prevention programme, taht teh way to wellness is really through prevention and prevention programmes, and policy positions taht will facilitae that.]
 
So, several governments across the globe have already taken steps to eliminate industrially produced trans fats from their food supplies including Denmark, Chile, Argentina and Brazil. Many global food companies have also voluntarily taken steps towards eliminating trans fatty acids from their food products. 
 
The WHO recommends that trans fatty acids should be eliminated from the food supply and that while voluntary actions from the industry are welcome, they advise that regulatory action is needed to most rapidly and effectively protect population health.
 
Ad lib: [ But let me say, that I have been very well received by the Chamber of Industry, and I think the MOH shares a very good working relationship with them, and it is our interest that we collaboratively set about making this shift, and that it is our intention, that through collaboration and dialogue and working together that we are able to produce the policies that will ensure that we are able to treat with the issue of sugar, trans fats and sodium and in terms of our manufacturing  products and so forth.]
 
To that end, the Ministry of Health is working to develop a policy on trans fat and sugar and this represents a momentous stride in our efforts to achieve our Vision 2020 for Health. We are committed to working with industry leaders to identify common ground for action and to expedite the phasing out of trans fatty acids, and unnecessary sugars from the nation’s food supply and it is my sincere hope that you would cooperate with us in this venture.
 
Ad lib: [And sometimes, it is not so much mandating it.  Sometimes it is simply offering choice and educating people, and if people are appropriately educated and if they can find the choice, then it can even mean an expansion of business, the creation of new business opportunities, and can also provide citizens with an opportunity to lead healthier lifestyles, and for us not to be faced with that astronomical health bill or that problem we are faced with as a result of these diseases.
 
In fact, I think it was in New Zealand, there was a big shift to diet soft drinks, and the results that the MOH was able to record was phenomenon.  The evidence is there.  I spoke with the Minister of Health from New Zealand at a WHO conference who was explaining to me how well this worked.  As so if we are able to encourage all our manufacturers and our distributors to really follow this pattern, and the world is moving in that direction, so at any rate, Trinidad and Tobago will want to move in that direction, that is not just progressive, but a direction that seeks to produce the kind of results that we as a people would want not just for our children, but for selves.]
 
Closing
As I close, I want to reiterate my belief that the collaboration of government and industry can result in meaningful change in society. It took the joint efforts of industry, NGOs and government to have the tobacco legislation passed in the Parliament and it will take collaborative efforts to ensure that the legislation is enforced. 

Likewise, we can work together on this mission to protect and preserve the health of our nation through a national policy on trans fatty acids and sugars.
 
I want to again thank all of you who supported us in passing and now assist us in enforcing the tobacco control legislation; my gratitude is also extended to the Chamber for its continuous collaboration.
 
It is my sincere hope that you will continue to collaborate with us to improve and preserve the health of our nation. We are all mindful that a healthy nation provides for a healthier and more productive workforce.
 
I thank you.