Comments of Prevention and health promotion

Primordial and Primary Prevention

• How could healthier communities be promoted, particularly in low to middleincome countries?
• What would motivate more countries, particularly the United States and Indonesia,to sign the Framework Convention on Tobacco Control?
• Is it possible to monitor, by country, research into tobacco control, surveys of smoking levels, global cigarette consumption, the economic effects on individual countries (tobacco leads to losses not gains as the costs of damage outweigh income from taxation), smoking costs to employers, the economic costs of fires and litter, costs to smokers, tobacco company documents, litigation, the tobacco industry and the recruitment of scientists to the tobacco company cause?
• What are the effects of MPOWER policies, particularly nicotine replacement therapy, on people living with multiple chronic diseases?
• What is the optimal diet and level of physical activity for people with multiple chronic conditions? How sustainable, cost-effective and safe are effective interventions?
• Which policies to improve diet and increase physical activity will be effective in patients with multiple chronic conditions?
• How might people in low and middle-income countries, who currently have healthy diets, be encouraged to keep to them rather than switch to unhealthier high fat, high salt, high calorie diets?
• How can we ensure that, with increasing urbanisation and urban poverty, the inhabitants of cities in low and middle-income countries are able to sustain levels of physical activity?
• How best to measure the risk of developing cardiovascular disease, particularly in places where laboratory tests are unavailable or unaffordable?
• Might age alone be used for risk assessment; if so, would the cut-off point be different in different countries?
• What is the right level of risk at which to begin pharmacological treatment?
• Will the polypill be more cost-effective than routine treatment in primary, secondary and tertiary prevention?
• What should the components of the polypill be?
• What is the best strategy for using the polypill in primary prevention: risk assessment followed by treatment or to offer the polypill to everyone above a certain age?
• If the polypill is cost-effective, how can its widespread use be encouraged?
• Might other polypills be useful in other forms of prevention, for example, smoking cessation or chronic lung disease?