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The sixth session of the conference of the 179 Parties to the WHO Framework Convention on Tobacco Control (FCTC) concluded in Moscow on Oct 18. The 6-day long meeting saw decisions on taxation (Article 6 of the FCTC), with new guidelines, at present being drafted, emphasising the importance of ensuring tobacco products are comparably taxed, otherwise users could simply decide to switch to a cheaper product. “We have to bring regulation of smokeless tobacco and water pipes to the same level of importance that cigarettes have”, added Vera da Costa e Silva, head of the Convention Secretariat. The Protocol to Eliminate Illicit Trade in Tobacco Products came under discussion. Thus far, only five Parties have signed up to this agreement. “We are making a strong call for Parties to approve the protocol—for it to go into
force we need forty Parties”, da Costa e Silva told The Lancet Oncology. The conference also decided to regulate electronic cigarettes (e-cigarettes) in a similar manner to tobacco products. “Views on e-cigarettes continue to be a bone of contention between member states with some (ironically in countries with very weak tobacco control measures) wanting outright bans and others, such as the UK, going for a more evidencebased approach”, explains Robert West, University College London. “Much of the concern stems from the fact that the tobacco industry is perceived to be behind the e-cigarette revolution”. Some countries expressed concerns that the tobacco industry, which owns a large share of the e-cigarette market, will use the products as a means to re-normalise smoking. The conference Parties’ decision to regulate
e-cigarettes was an attempt to find a compromise between stringent regulation and outright endorsement. “Parties have taken a stand in the direction of regulation, but without closing the door on future scientific evidence”, stressed da Costa e Silva. This approach from the FCTC has its critics. “The FCTC is essential because it sets the foundations of most countries’ approach to policy”, said Nottingham University’s John Britton, “But it has to keep many different constituencies happy so where there is disagreement, it will opt for a fudge.” Guidance for e-cigarettes will allow those who are in favour to exploit their potential, and those against to prohibit them. “That method keeps everyone happy, but it is hardly good for world health,” concluded Britton.
Shutterstock/Ecelop
WHO Framework Convention on Tobacco Control conference
Published Online October 27, 2014 http://dx.doi.org/10.1016/ S1470-2045(14)71037-X For more about WHO’s Tobacco Control conference see http:// www.who.int/fctc/en/
Talha Khan Burki
CRC risk knowledge does not affect screening compliance New research suggests that individualised genetic and environmental risk assessment (GERA) for colorectal cancer (CRC) susceptibility does not improve screening adherence in people with an average risk for this cancer. David Weinberg (Fox Chase Cancer Center, Philadelphia, USA) and colleagues postulated that providing patients who had an average risk of CRC with a personalised GERA would increase the uptake of screening compared with the numbers screened with the usual care. The researchers did a prospective, randomised controlled trial with 783 patients of average risk for colorectal cancer (eg, asymptomatic, no family history of CRC). Weinberg and colleagues assessed the effect of GERA feedback on uptake of CRC screening in these patients who had not previously adhered to screening recommendations at study entry. Participants were randomly assigned to either have a GERA (n=514) or to
receive usual care (control group; n=269). GERA-associated risk for CRC was characterised by the particular combinations of age-specific serum folate concentrations and methylenetetrahydrofolate reductase polymorphisms. Participants were told that their GERA results would classify their CRC risk as increased or average. Weinberg and colleagues reported at 6 months after study entry, the uptake for CRC screening was similar for GERA (170 of 514 [33·1%]) and usual care (96 of 269 [35·7%]) groups. After adjustment for baseline participant factors, the odds ratio (OR) estimate for CRC screening in the GERA group versus the usual care group was 0·88 (95% CI 0·64–1·22). In an analysis of the 437 participants in the GERA group, those with an average risk for CRC (according to the GERA feedback) had higher screening rates than for those who had an elevated risk for CRC (141 [38·1%] vs 18 [26·9%]);
www.thelancet.com/oncology Vol 15 December 2014
however, the OR estimate between the two risk types of 0·60 (95% CI 0·33–1·07) was not significant. Knowledge about a patient’s genetics is assumed to be able to change their health behaviours. “Presumably this belief forms the basis for many companies beginning to directly offer consumers genetic testing”, but “very little experimental data exists to support this belief” says Weinberg. “Our study is, we believe, the largest and most methodologically robust trial to date”. “Findings from this research have tried to dispel a common belief that better knowledge about individual genetic makeup can substantially effect health behaviours,” commented Swapan Jana (Midnapore Medical College, West Bengal, India). “However, we should look forward to further research in this discipline to validate such findings”.
Published Online October 27, 2014 http://dx.doi.org/10.1016/ S1470-2045(14)71038-1 For the study by Weinberg and colleagues see Ann Intern Med 2014; 161: 537–45
Sanjeet Bagcchi e588
The sixth session of the conference of the 179 Parties to the WHO Framework Convention on Tobacco Control (FCTC) concluded in Moscow on Oct 18. The 6-day long meeting saw decisions on taxation (Article 6 of the FCTC), with new guidelines, at present being drafted, emphasising the importance of ensuring tobacco products are comparably taxed, otherwise users could simply decide to switch to a cheaper product. “We have to bring regulation of smokeless tobacco and water pipes to the same level of importance that cigarettes have”, added Vera da Costa e Silva, head of the Convention Secretariat. The Protocol to Eliminate Illicit Trade in Tobacco Products came under discussion. Thus far, only five Parties have signed up to this agreement. “We are making a strong call for Parties to approve the protocol—for it to go into
force we need forty Parties”, da Costa e Silva told The Lancet Oncology. The conference also decided to regulate electronic cigarettes (e-cigarettes) in a similar manner to tobacco products. “Views on e-cigarettes continue to be a bone of contention between member states with some (ironically in countries with very weak tobacco control measures) wanting outright bans and others, such as the UK, going for a more evidencebased approach”, explains Robert West, University College London. “Much of the concern stems from the fact that the tobacco industry is perceived to be behind the e-cigarette revolution”. Some countries expressed concerns that the tobacco industry, which owns a large share of the e-cigarette market, will use the products as a means to re-normalise smoking. The conference Parties’ decision to regulate
e-cigarettes was an attempt to find a compromise between stringent regulation and outright endorsement. “Parties have taken a stand in the direction of regulation, but without closing the door on future scientific evidence”, stressed da Costa e Silva. This approach from the FCTC has its critics. “The FCTC is essential because it sets the foundations of most countries’ approach to policy”, said Nottingham University’s John Britton, “But it has to keep many different constituencies happy so where there is disagreement, it will opt for a fudge.” Guidance for e-cigarettes will allow those who are in favour to exploit their potential, and those against to prohibit them. “That method keeps everyone happy, but it is hardly good for world health,” concluded Britton.
Shutterstock/Ecelop
WHO Framework Convention on Tobacco Control conference
Published Online October 27, 2014 http://dx.doi.org/10.1016/ S1470-2045(14)71037-X For more about WHO’s Tobacco Control conference see http:// www.who.int/fctc/en/
Talha Khan Burki
CRC risk knowledge does not affect screening compliance New research suggests that individualised genetic and environmental risk assessment (GERA) for colorectal cancer (CRC) susceptibility does not improve screening adherence in people with an average risk for this cancer. David Weinberg (Fox Chase Cancer Center, Philadelphia, USA) and colleagues postulated that providing patients who had an average risk of CRC with a personalised GERA would increase the uptake of screening compared with the numbers screened with the usual care. The researchers did a prospective, randomised controlled trial with 783 patients of average risk for colorectal cancer (eg, asymptomatic, no family history of CRC). Weinberg and colleagues assessed the effect of GERA feedback on uptake of CRC screening in these patients who had not previously adhered to screening recommendations at study entry. Participants were randomly assigned to either have a GERA (n=514) or to
receive usual care (control group; n=269). GERA-associated risk for CRC was characterised by the particular combinations of age-specific serum folate concentrations and methylenetetrahydrofolate reductase polymorphisms. Participants were told that their GERA results would classify their CRC risk as increased or average. Weinberg and colleagues reported at 6 months after study entry, the uptake for CRC screening was similar for GERA (170 of 514 [33·1%]) and usual care (96 of 269 [35·7%]) groups. After adjustment for baseline participant factors, the odds ratio (OR) estimate for CRC screening in the GERA group versus the usual care group was 0·88 (95% CI 0·64–1·22). In an analysis of the 437 participants in the GERA group, those with an average risk for CRC (according to the GERA feedback) had higher screening rates than for those who had an elevated risk for CRC (141 [38·1%] vs 18 [26·9%]);
www.thelancet.com/oncology Vol 15 December 2014
however, the OR estimate between the two risk types of 0·60 (95% CI 0·33–1·07) was not significant. Knowledge about a patient’s genetics is assumed to be able to change their health behaviours. “Presumably this belief forms the basis for many companies beginning to directly offer consumers genetic testing”, but “very little experimental data exists to support this belief” says Weinberg. “Our study is, we believe, the largest and most methodologically robust trial to date”. “Findings from this research have tried to dispel a common belief that better knowledge about individual genetic makeup can substantially effect health behaviours,” commented Swapan Jana (Midnapore Medical College, West Bengal, India). “However, we should look forward to further research in this discipline to validate such findings”.
Published Online October 27, 2014 http://dx.doi.org/10.1016/ S1470-2045(14)71038-1 For the study by Weinberg and colleagues see Ann Intern Med 2014; 161: 537–45
Sanjeet Bagcchi e588
![[WHO Framework Convention on Tobacco Control (FCTC) Article 8: protection from exposure to tobacco smoke].](/assets/img/hold.png)
