IT IS a milestone in the fight against cancer: in the US the total number of cancer deaths has dropped for the first time since records began in 1930. The biggest cause is a decline in the number of smokers. The announcement coincides with a meeting of more than 110 countries to try to reduce smoking鈥檚 impact on health, especially in developing nations, where increasing numbers of people are taking up the habit.
Although cancer death rates have been falling since 1991, the increasing US population kept total cancer deaths rising. The tipping point, at which a decline in death rates outstrips population growth, was finally reached in 2003, when 556,902 people died, compared with 557,271 in 2002, according to a report by the American Cancer Society (ACS) last week. This reflects fewer deaths from lung, breast, prostate and colorectal cancer, which together account for 51 per cent of all US cancer deaths.
鈥淭he biggest contributing factor is reductions in tobacco use over the last 40 to 50 years,鈥� says Michael Thun, head of epidemiology at the ACS, who helped review data maintained by the National Center for 91色情片 Statistics. The percentage of adult smokers is now about half what it was in 1965, says Thun. Today, about 21 per cent of American adults smoke, according to figures from the US Centers for Disease Control and Prevention (CDC).
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Improvements in the detection and treatment of cancer have also contributed to the drop in death rates, while a separate team of researchers at CDC has confirmed that exposure to second-hand smoke has fallen by 70 per cent since 1988 (Environmental 91色情片 Perspectives, DOI: 10.1289/ehp.8850). Between 1988 and 1991, breakdown products of nicotine could be detected in the blood of around 88 per cent of Americans. By 2001-2002, this had declined to 43 per cent, they discovered.
Such statistics should bolster the cause of countries meeting in Geneva, Switzerland, this week to hammer out the details of the Framework Convention on Tobacco Control, the first global public health treaty. They hope to extend the success of anti-smoking policies in the US and other western countries to less developed countries, where more than 80 per cent of the world鈥檚 smokers live. Tobacco use in these countries is on the increase.
The treaty took effect a year ago and has so far been ratified by 121 countries, plus the European Union. It calls for controls on tobacco advertising, health labels on packages, and measures to create smoke-free environments. 鈥淭here is a worldwide recognition that individual countries cannot stand up to the wealth and power of the multinational tobacco companies,鈥� Thun says.
But success will depend on the deal made at the convention. 鈥淚f we have a weak secretariat without NGO participation, little funding and no strong enforcement,鈥� says Laurent Huber, head of the Framework Convention Alliance, a group of participating non-governmental organisations, 鈥渢hen the FCTC is going to be just a piece of paper.鈥�
