building geographic information systems capacity to ......building geographic information systems...

Building Geographic Information Systems Capacity to Monitor WHO FCTC Compliance

in East Asia

Pramil N. Singh, Dr.PHCenter for Health Research

Loma Linda University School of Public Health

Western Pacific Region: 1/3 of the World’s Smokers Live Here

Mongolia ratified 2004

Laos PDR ratified 2006

Cambodia ratified 2005

Proposed Intervention Efficacy Known?How do we evaluate efficacy

Tax Increase on tobacco Yes, in some areas. Pre-, post intervention assessments, PriceStudy, Illicit trade study.

Banning Tobacco Advertising

Contributes to De-normalization.

Pre-, post intervention assessments

Smoke Free Indoor Workplaces and Public Places.

Contributes to De-normalization.


Warning Labels on Packs Contributes to De-normalization.


WHO “Best Buy” Interventions for Implementing FCTC

BackgroundAsia Tobacco Control Leadership Training Program(R01 TW05964-05; R03 TW007345-03), 2002-2012

Sixteen Trainees from the Ministry of Health and National Institute of Statistics in Cambodia and Lao PDR underwent graduate certificate training in epidemiology to conduct their nation’s first national adult tobacco survey.


2006 TCLT Survey(n=13,988)

2011 National Adult Tobacco Survey of Cambodia(n=15,615)

2014 National Adult Tobacco Survey of Cambodia(n=17,642)

WHO FCTCRatification

Sub-decrees banningadvertising, increasingcigarette tax

NIHNIH/Gates Gates

2006 TCLTPrice per Pack: 0.20 USDSeen Tobacco Ad:86%

2011 NATSCPrice per Pack: 0.20 USDSeen Tobacco Ad:82%

2014 NATSCPrice per Pack: 0.45 USDSeen Tobacco Ad:44%

We need find the non-compliant advertising!

We need detailed Data on implementation of Tax Stamps!

We need find the illicit tobacco with no tax stamps sold in remoteregions, often near the border!

A B C

We need to find the smuggled cigarette packs!

We need to find the stores that sell single cigarettes to school children near their schools!

AIMS (2017-2022)Building Geographic Information System Capacity into the Tobacco Control Research (GIS-TOBCR) workforce of Cambodia, Lao, Mongolia

• Preliminary data indicate that the efficacy of WHO FCTC implementation exhibits marked spatial variation at a “fine-grain” community level.

– Low cost, illicit tobacco sales are occurring near schools, in hard-to-access rural communities (by ethnicity, religion, traditional medicine practice, geography), and in border regions.

– Our needs assessment indicates a gap in health sector capacity to use GIS applications that could be highly effective in identifying – for intervention purposes –community level, geographic targets where WHO FCTC policies are not being implemented.

SPECIFIC AIMS (2017-2022)

Aim 1. To use GIS applications to identify variables associated with points-of-sale of cigarettes that do not comply with WHO FCTC treaty articles on packaging (tax stamps, health warnings, brands targeting women, sale of single cigarettes) and pricing.

We hypothesize that there is a high density of vendors selling low cost cigarettes (i.e. untaxed, single cigarettes, local hand-rolled products) in hard-to-access rural communities (i.e. ethno-religious minorities, traditional medicine vendors, tobacco growing provinces), in border regions (illicit cross border trade), and to school children near their schools.

SPECIFIC AIMS (2017-2022)

Aim 2. To use GIS applications to identify variables associated with points-of-sale of loose tobacco (i.e. for smokeless quids, waterpipes/pipes, roll-your-own) that do not comply with WHO FCTC treaty articles on packaging (health warnings, tax stamps) and pricing.

We hypothesize that there is a high density of points-of-sale of unregulated loose tobacco in hard-to-access rural communities (i.e. ethno-religious minorities, traditional medicine vendors targeting women, tobacco growing provinces).

SPECIFIC AIMS 1-2 (2017-2022) are accomplished by:

1) Secondary GIS analysis of national tobacco databases with geocoded samples.

2) Developing and pilot testing a novel mobile GIS application for measuring GPS and picture data on the built environment of the tobacco user.

2006 TCLT,2011 NATSC

2014 NATSC

2017-2022 GIS-TOBCR: GIS and Mobile Apps

2017-2022 GIS-TOBCR co-I’s

Dr. Michael Jerrett GIS

Dr. Sudipto Banerjee Spatial Statistics

Dr. Jayakaran S JobEpidemiology

Dr. Jim Banta Health Policy

Dr. Daravuth Yel,WHO Cambodia

Dr. Chimedsuren OchirDean, Mongolian National Univ of Medical Sciences

Dr. Khamphithoun SomsamouthCIEH Ministry of HealthLaos PDR

UCLA

LLU

2017-2022 GIS-TOBCR: Training

Spatial EpidemiologyLeadership,

(Track I)3 MPH Degrees

GIS Certified Professional(Track II)

15 Online Certificates15 GISP Certifications

Cambodia Sub-award to Cambodia Movement for HealthCollaboration with National Institute of Statistics, Ministry of

PlanningWHO Cambodia

Lao PDR Sub-award to ADRA LaosCollaboration with Center for Information and Education on

Health (Ministry of Health)Lao Statistics Bureau

Mongolia Sub-award to MNUMS School of Public HealthCollaboration with Ministry of Health/Public Health Institute

National Statistical OfficeADRA Mongolia

GIS CertifiedTechnologist

(Track III)15 Esri

Enterprise Administrator Certifications

Sub-award: Jerrett,

Banerjee

Applicant:Singh, Job, Banta

Questions?

building geographic information systems capacity to ......building geographic information systems...

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