How tobacco control advocates can contribute to NCD control

It is common knowledge within tobacco control that the only effective way to reduce tobacco use in populations is by changing the environment via policies. Targeting individual behaviour without policy changes has been proven in country after country to be ineffective at achieving sustained reductions in tobacco use at the population level.

We have come a long way in tobacco control, though of course there is much more to do. But the international attention to non-communicable diseases (NCDs) is new and there remains much to learn. Tobacco control advocates here have much to offer in terms of the types of policies that are likely to prove effective at reducing the risk of NCDs, including policies aimed at changing the food and physical activity environment, such as by banning advertising of soft drinks and sale of soft drinks and fast foods in schools, encouraging consumption of fresh produce including by protecting and expanding fresh markets and other inexpensive outlets for sale of fresh fruits and vegetables, and creation of better environments for walking and cycling. Knowledge gained in tobacco control of ways of monitoring and assisting with implementation of policies will also prove valuable in overall NCD prevention.

Although there remains much to learn about the correct policy mix to create a health-promoting environment for NCDs, there are many links to tobacco control that will make the learning easier. Designers exist to plan safe, convenient and attractive pathways for walking and cycling; much research has already been done on ways of encouraging healthier diets through environmental changes. What is important is to maintain a focus on policy and environmental factors so as to ensure effectiveness and a broad population reach; such an approach should come naturally to those experienced in tobacco control.

Our own experience in Bangladesh in partnership with HealthBridge shows that with some effort, one can gain access to policymakers and planners making decisions about such factors as national health policy and street design. Our input has included adding a focus on prevention to the national health policy, and working with transport planners to show how to improve the walking experience.

It is thus important to remember that while tobacco use is the main factor in NCDs, the next two are similarly susceptible to environmental changes: diet and physical activity. Our commitment to reducing NCDs should extend beyond continuing our efforts in tobacco control, to assist in efforts to ensure that health promoting policies for NCD reduction are widely passed and enforced. Finally, an integrated approach rather than separate vertical programming is far more likely to result in a comprehensive policy mix that leads to the health promoting environment needed to reduce the problems associated with tobacco use, unhealthy diets and lack of physical activity, and to increase the likelihood that future generations live long and healthy lives.