GIS Project “Tobacco Free World”
By Viktoriya Yakymenko
GIS680 Class Professor: Dr. Sergei Andronikov
Winter Quarter, 2014
Tobacco use is the world’s leading cause of preventable death, according to the World Health Organization. In the Western Pacific Region, it is estimated that at least two people die each minute from a tobacco-related disease. Apart from the harm smoking causes to smokers, exposure to second-hand smoke is a major public health hazard. In 2010, it was estimated that globally more than 600 000 people die each year from exposure to second-hand smoke; 28% of these deaths were among children. In Asia and the Pacific, more than half of women and children are regularly exposed to cigarette smoke in public places and at home. 
Cancer is a leading cause of death worldwide, accounting for 8.2 million deaths in 2012. Among all cancer types lung cancer is the cause of 1.59 million deaths. 
Lung cancer kills more people globally than any other cancer, and by far the biggest cause of the disease is cigarettes. The lag time between when a person starts smoking and when cancer develops can be 30 years. High rates of lung cancer in countries such as the United States reflect high rates of smoking several decades ago.
Tobacco use is the single most important risk factor for cancer causing about 22% of global cancer deaths and about 71% of global lung cancer deaths in many low-income countries. 
Smoking has declined in many industrialized countries, but it is increasing in developing nations. Today, China consumes more than a third of the world’s cigarettes, and an estimated two thirds of men in Indonesia smoke. Experts predict sharp increases in lung cancer deaths in the developing world in the years ahead. 
Tobacco kills almost six million of its users each year. The tobacco industry needs to attract new customers to replace those who die or manage to quit maintaining and increasing tobacco sales and profits. At the core of the industry strategy to sell its products are tobacco advertising, promotion and sponsorship (TAPS). 
There is a causal relationship between advertising and promotional efforts of the tobacco companies and the initiation and progression of tobacco use among young people. 
I would like to dedicate this project to a bright memory of my loving father who tragically passed away after he lost his battle with lung cancer on November 25th, 2011. My family and I will always love and cherish him. Nobody in the world deserves to go through what my father and my family did.
I would like to thank my GIS professor Dr.Sergei Andronikov for the education he provided, for his support and encouragement, for sharing his depth of knowledge, enthusiasm, and enormous experience in GIS field.
Goals and Objectives
The goal of “Tobacco-Free World” project is to perform global analysis to determine top countries which require more help with lung cancer awareness and enforcing tobacco use laws and policies to improve and save human lives.
- Analyze men currently smoking any tobacco product by country
- Analyze women currently smoking any tobacco product by country
- Analyze youth (ages 13-15) exposed to secondhand smoke at home
- Analyze smoke-free educational facilities worldwide
- Identify countries which need to enforce smoking policies at schools
- Analyze boys and girls ages 13-15 who are current cigarette smokers
- Consumption, cigarettes per person, per capita 
- Analyze death from lung cancer by countries
- Analyze tobacco billboard and outdoor advertising by country
- Analyze international magazines and newspapers tobacco advertising by country
- Analyze international television and radio tobacco advertising by country
- Analyze Internet tobacco advertising by country
- Analyze local magazines and newspapers tobacco advertising by country
- Analyze national television and radio tobacco advertising by country
- Analyze points of sale tobacco advertising by country
- Analyze sub national bans on tobacco advertising, promotion and sponsorship
- Identify countries that need to enforce tobacco advertising bans
Some world spatial data was downloaded in a form of a layer for ArcMap from ESRI website. The most of my data I collected throughout the Internet (view the reference list) in a form of .xls, .xlsx, .csv, .pdf files. The attributive data was the most challenging part of the project. I performed a lot of data and file conversions, but the most trouble I had with the attribute country names. Different sources use different country names (some use shot some use full names) for example In my spatial data layer from ESRI the geodatabase is using country name “United States”, where the World Health Organization is using name “United States of America”. Because of the mismatches in the primary key field the output of joining spatial layer with WHO data table would always result in <Null>. The solution for it was manually changing most country names in WHO data table so they would be exact matches of ESRI country names. This process was very time consuming.
Analyze men currently smoking any tobacco product by country 
Analyze women currently smoking any tobacco product by country 
Countries where more than 30% Men and Women Smoking ANY Tobacco (%), 2009
Consumption, cigarettes per person, per capita 
Analyze youth (ages 13-15) exposed to secondhand smoke at home 
Top countries where youth is exposed to secondhand smoke at home, (%) (ages 13-15)
Secondhand smoke is the combination of smoke from the burning end of a cigarette and the smoke breathed out by smokers. Secondhand smoke contains more than 7,000 chemicals. Hundreds are toxic and about 70 can cause cancer. 
Analyze boys and girls ages 13-15 who are current cigarette smokers 
Countries where more than 20% of boys & girls ages 13-15 are current cigarette users 
Despite the ads and warning that cigarette smoking is bad for the health, a lot of people are still smoking and find it hard to quit the habit. What would you do if you found out that there is a link between smoking and lung cancer?
Smoking can cause cancer and then block your body from fighting it:
•Poisons in cigarette smoke can weaken the body’s immune system, making it harder to kill cancer cells. When this happens, cancer cells keep growing without being stopped.
•Poisons in tobacco smoke can damage or change a cell’s DNA. DNA is the cell’s “instruction manual” that controls a cell’s normal growth and function. When DNA is damaged, a cell can begin growing out of control and create a cancer tumor.
Doctors have known for years that smoking causes most lung cancer. Nearly 9 out of 10 men who die from lung cancer are smokers. And about 3,000 nonsmokers die each year from lung cancer caused by secondhand smoke. 
Worldwide, lung cancer is the leading cause of cancer death in men and the second leading cause of cancer death in women, with an estimated 951,000 deaths in men and 427,400 deaths in women in 2008. 
International variations in lung cancer rates and trends largely reflect differences in the stage and degree of the tobacco epidemic. 57-58, 59-60 In several Western countries, where the tobacco epidemic peaked by the middle of the past century, such as the United States, the United Kingdom, and Finland, lung cancer rates have been decreasing in men and plateauing in women 61-62 (Figure 8). In contrast, in countries where the epidemic has been established more recently and smoking has just peaked or continues to increase, such as China, Korea, and several countries in Africa, lung cancer rates are increasing and are likely to continue to increase at least for the next few decades, barring interventions to accelerate smoking cessation and reduce initiation. 
Cigarette smoking is the most important risk factor for lung cancer, accounting for about 80% of lung cancer cases in men and 50% in women worldwide. Risk increases with quantity and duration of cigarette consumption. Cigar and pipe smoking also increase risk. Other risk factors include secondhand smoke, occupational or environmental exposures to radon and asbestos (particularly among smokers), certain metals (chromium, cadmium, and arsenic), some organic chemicals, radiation, air pollution, coal smoke, and indoor emissions from burning other fuels. Genetic susceptibility contributes to risk, especially in those who develop the disease at a younger age. 
Prevention and early detection:
Lung cancer is one of the most preventable cancers. Most lung cancers could be prevented by reducing smoking initiation among adolescents and increasing smoking cessation among adults. This requires a comprehensive tobacco control program that includes raising the price of tobacco products through excise taxes, banning smoking in public places, restricting tobacco advertising and promotion, counter-advertising, and providing treatment and counseling for tobacco dependence. In the United States, comprehensive tobacco control programs in many states have markedly decreased smoking rates and accelerated the reduction in lung cancer occurrence, particularly in California. In the developing world, there is a striking difference in smoking prevalence between men (50%) and women (9%).
As women have not yet begun to smoke in large numbers in developing countries, preventing increases in smoking prevalence among women could have a major impact on future lung cancer rates and would provide an opportunity to avoid the mistakes made in developed countries where lung cancer rates skyrocketed as a result of the tobacco epidemic.
Screening for early lung cancer detection has not yet been proven to reduce mortality. Chest x-ray, analysis of cells in sputum, and fiber-optic examination of the bronchial passages have shown limited effectiveness in reducing lung cancer mortality. Newer tests, such as low-dose spiral computed tomography (CT) scans and molecular markers in sputum, have produced promising results in detecting lung cancers at earlier, more operable stages, and preliminary results from a randomized clinical trial have shown reduced lung cancer deaths in high-risk patients. However, there are considerable risks associated with lung biopsy and surgery, and the net benefit of screening in the general population has not been established. 
Analyze death from lung cancer by countries 
Top 40 Countries with the highest deaths from Lung Cancer, Rate 
The highest rate of deaths from Lung Cancer in countries where more than 30% men and women are currently smoking 
Secondhand Smoke Causes Lung Cancer
Secondhand smoke causes lung cancer in adults who have never smoked.
- Nonsmokers who are exposed to secondhand smoke at home or at work increase their risk of developing lung cancer by 20–30%.
- Secondhand smoke causes more than 7,300 lung cancer deaths among U.S. nonsmokers each year.
- Nonsmokers who are exposed to secondhand smoke are inhaling many of the same cancer-causing substances and poisons as smokers.
- Even brief secondhand smoke exposure can damage cells in ways that set the cancer process in motion.
- As with active smoking, the longer the duration and the higher the level of exposure to secondhand smoke, the greater the risk of developing lung cancer. 
Smoke-free educational facilities except Universities 
Smoke Free Universities 
By combination last two analyses we can identify countries that don’t have smoke free educational facilities 
Countries that need to enforce smoking policies at schools 
TOBACCO ADVERTISING BANS
Advertising affects Tobacco Use
The tobacco industry spends billions of dollars each year to market its products. The industry uses a mix of advertising, promotion and sponsorship tactics to directly affect tobacco use and attitudes related to tobacco. Tobacco advertising, promotion and sponsorship:
- Promote tobacco use as customary and glamorous.
- Are deceptive and misleading.
- Weaken public health campaigns.
- Target specific populations such as women, youth, and minority groups.
- Increase tobacco consumption by:
- Attracting new tobacco users.
- Increasing the amount of consumption among current smokers.
- Reducing a smoker’s willingness to quit.
- Encouraging former smokers to start smoking again.
Through advertising of its products, the tobacco industry tries to create an environment in which tobacco use is familiar and socially acceptable, and the warnings about its health consequences are undermined. 
The tobacco industry uses all possible promotional channels
The pervasiveness of TAPS influences the population’s exposure to marketing messages and images. The tobacco industry uses all the communication channels it can reach. The public perceives the traditional mass media to be the most common promotional channels used by the tobacco industry. Whenever possible, tobacco companies do advertise their products on TV, radio and in print media such as newspapers, magazines, billboards and posters. However, as governments clamp down on tobacco advertising in traditional mass media, tobacco companies have turned to new media, including stealth marketing, with a viral effect to create a “buzz” about their products and brands. To prevent more people being lured into nicotine addiction by the tobacco industry’s new promotional tactics, policy-makers and, ultimately, the public need to be aware of the diversity of promotional tactics employed by the industry and of their tragic consequences. 
International Magazines and Newspapers Tobacco Advertising by Country 
Internet Tobacco Advertising by Country 
Local Magazines and Newspapers Tobacco Advertising by Country 
National Television and Radio Tobacco Advertising by Country 
Point of Sale Tobacco Advertising by Country 
Tobacco Billboard and Outdoor Advertising by Country 
Stop tobacco industry manipulation. Ban TAPS!
Bans on tobacco advertising, promotion and sponsorship are effective at reducing smoking
A comprehensive ban on all TAPS activities significantly reduces exposure to smoking cues resulting from tobacco advertising and promotion. This, in turn, significantly reduces the industry’s ability to continue promoting and selling its products, both to young people who have not yet started to use tobacco and to adult tobacco users who want to quit. Protecting people by restricting TAPS activities can substantially reduce tobacco consumption but only when such restrictions are comprehensive, and it does so regardless of the income level of the country. In high-income countries, such a ban decreases tobacco consumption by about 7%.
A comprehensive ban on tobacco advertising, promotion and sponsorship will raise the opposition of the tobacco industry, including court challenges. In February 2013, the Russian Federation approved a new law that included a ban on advertising, promotion and sponsorship. The tobacco industry tried unsuccessfully to stop its approval. In August 2012, a Government agency charged with vetting legislation and whose board of trustees is headed by the speaker of the lower house of Parliament reversed its initial support of the law, after having accepted a contract with a tobacco company. 
Countries that need more tobacco advertising bans 
Tobacco is the only legal drug that kills many of its users when used as intended by manufacturers. Direct tobacco smoking is currently responsible for the death of about 6 million people across the world each year with many of these deaths occurring prematurely. Tobacco kills more than tuberculosis, HIV/AIDS and malaria combined. In the next two decades, the annual death toll from tobacco is expected to rise to over 8 million, with more than 80% of those deaths projected to occur in low- and middle-income countries. Unless we act, the epidemic, in the 21st century, could kill over 1 billion people. 
How Can Smoking-Related Cancers Be Prevented?
Quitting smoking lowers the risks for cancers of the lung, mouth, throat, esophagus, and larynx.
• Within 5 years of quitting, your chance of cancer of the mouth, throat, esophagus, and bladder is cut in half. 
• Ten years after you quit smoking, your risk of dying from lung cancer drops by half.
If nobody smoked, one of every three cancer deaths in the United States would not happen.
According to my analysis conducted in this project many countries must ban all forms of tobacco advertising, promotion and sponsorship in order to improve and save human lives.
Comprehensive bans, which prohibit the use of all marketing strategies by the tobacco industry, reduce tobacco use among people of all income and educational levels. Partial advertising bans are less effective, in part, because the tobacco industry switches its marketing efforts to unrestricted outlets when bans are not comprehensive.
• A study of 22 developed countries found that comprehensive bans reduced tobacco consumption by 6.3%.
• A study of 102 countries showed that in countries with partial bans consumption only decreased by 1% compared with almost 9% in countries with comprehensive bans.
A study of 30 developing countries found partial bans were associated with a 13.6% reduction in per capita consumption, compared to 23.5% in countries with comprehensive bans. 
Analysis Methods and Programs Used
I have used Microsoft Excel, Microsoft Word, and ESRI ArcMap version 10.2.1 as my software to perform analysis.
I used overlay analysis because it was mostly suitable to perform global analysis on countries since they are polygons.
In ArcMap I mostly conducted these types of tasks and analysis:
- Spatial Joins (Polygon to Polygon)
- Table Joins
- Polygons to table joins
- Table modification
- Analysis of tabular data
- Overlay analysis
- Performing an intersection
- Classification of numeric data
- Creating unique category values
- Conducting quantities analysis
- Using union operation
- Creating new layers
- Selecting by attributes/constructing SQL expressions
- Isolating of features to perform more analysis
- Importing Excel data tables into ArcMap
- Composing the data frames
- Labeling features
- Customizing legend
- Creating choropleth maps
- Analyze most sold brand of cigarettes by country
- Identify which countries raise taxes on tobacco
- Analyze health warnings on cigarette packaging by country
- Identify which countries have fines for violations in smoke-free public places
- Identify which countries have fines on the establishment that sell tobacco illegally
- Analyze if government objectives on tobacco control exist by country
- Analyze if national agency for tobacco control exists by country
- Analyze if annual budget for tobacco control in currency reported by country
- Analyze if annual budget for tobacco control in US$ at official exchange rate by country
- Identify which countries have nicotine replacement therapy – legally sold
- Identify which countries have nicotine replacement therapy – place available
- Identify which countries have access to a toll-free quit line
- Identify which countries have smoking cessation support is available in hospitals
- Identify which countries have smoking cessation support is available in health clinics or other primary care facilities
- Identify which countries have smoking cessation support is available in offices of health professionals
- Identify which countries have smoking cessation support is available in the community
- Identify which countries have anti-tobacco mass media campaigns
- Identify which countries have national tobacco control programs
- Analyze which countries have national legislation on smoke-free health-care facilities
- Analyze which countries have national legislation on smoke-free government facilities
- Analyze which countries have national legislation on smoke-free indoor offices
- Analyze which countries have national legislation on smoke-free restaurants
- Analyze which countries have national legislation on smoke-free pubs and bars
- Analyze which countries have national legislation on smoke-free public transport
- Analyze which countries have national legislation on compliance with regulations on smoke-free environments
- Analyze which countries have sub national smoke-free legislation authority exists