Zubair Kabir

Zubair Kabir
Research Fellow
Institute for a Tobacco Free Society, Dublin

Principal Investigators:
Professor Luke Clancy, Research Institute for a Tobacco Free Society, Dublin
Professor Gregory N Connolly, Harvard School of Public Health, Boston

Duration of Project: September 2006-August 2008

Tobacco use is the greatest killer worldwide. In 2025 almost 10 million tobacco-related deaths are projected worldwide. Ireland alone reports 6,500 tobacco-related deaths annually mainly lung cancer, coronary heart diseases and chronic lung diseases. Ireland was the first country in the world to introduce a comprehensive nationwide workplace smoking ban in March 2004. The state of Massachusetts in the United States is also a global leader in anti-smoking policies. In July 2004, Massachusetts introduced the state-wide smoke-free policies. However, in January 1993 a comprehensive Massachusetts Tobacco Control Program (MTCP) was already in place and since then smoking ordinances were legislated in different towns and in cities across the state of Massachusetts. Through serious, science-based efforts the Tobacco Control Research Program in the Harvard School of Public Health is committed to understanding the dangers of smoking and second hand smoke exposure, so that "denormalization" of smoking in society can occur. Our joint research project is in accordance with the theory that the combination of scientific evidence with capable leadership and strong infrastructure is the best way to empower a country's national capacity to effectively fight the tobacco epidemic. This collaboration is a stepping stone to moving towards the Irish government's commitment to a Tobacco Free Society.

To date in this project, we have looked at the potential reductions in lung cancer deaths in the state of Massachusetts from 1931 to 2003. Almost 23,500 fewer lung cancer deaths were estimated between 1977 and 2003 because of some form of anti-smoking efforts in Massachusetts since the early 1960s. There has been 21% relative decline in adult smoking prevalence in Massachusetts from 1993 onwards, and such a decline has contributed to a total of 425 fewer coronary heart disease deaths between 1993 and 2003, which in turn has generated approximately 3,365 extra lives. If such a trend simply continues to 2010 then the US 2010 Healthy People Objective of an overall 12% smoking prevalence is most likely to be achieved. However, if the recent reductions in budgetary allowances for health promotional activities continue then the 2010 objective cannot be achieved in Massachusetts. Therefore, this collaboration not only attempts to evaluate the MTCP but also to project such tobacco-related health outcomes based on different scenarios (examples include, increased taxation, 100% indoor air policies, reduction in youth access to smoking products, and anti-smoking media advertisements) using simulation models. Similar studies can be undertaken in Ireland to come up with an evidence-based comprehensive national tobacco control program. The model will be adapted and replicated in year two for use in Ireland. Massachusetts is an ideal comparison site given the fact that the state has the highest proportions of residents claiming Irish heritage (25%) and that its tobacco campaign and decline in smoking predated that of Ireland by a decade and that Ireland's smoking rates are now fallen in a pattern similar to Massachusetts.