In December 1998, the World Health Organization’s Tobacco Free Initiative (WHO TFI) and the US Centers for Disease Control and Prevention’s Office on Smoking and Health (CDC OSH) convened a meeting to discuss the need for collecting data on tobacco use among adults and adolescents. In addition to WHO and CDC, at least one country representative from each of the six WHO Regions and other international agencies, such as UNICEF and the World Bank, attended the meeting. The groups reached consensus on several points.

First, consistent cross-country data did not exist regarding questionnaire content, sampling methodology, and data analysis. This was true for adults and adolescents. Many individual countries (especially developed countries) had good surveillance systems in place for adult data (see Tobacco Control Country Profiles, volumes I and II), some countries had systems in place for data on adolescents (for example, Australia, Canada, Thailand, and the United States), but only a very few cross-country systems were in place and most of these were in Western Europe (for example, Health Behaviour in School Aged Children [HBSC] and the European School Survey Project on Alcohol and Drugs [ESPAD]).

Second, cross-country data for adolescents was a top priority. WHO and CDC made the commitment to support the development of a Global Tobacco Surveillance System (GTSS) and launched the first component of the system, the Global Youth Tobacco Survey (GYTS).

Third, the GTSS surveys would include a “core” set of questions (with country-specific questions included where appropriate), identical sampling methodology, and consistent field procedures and data management.

The GYTS, a school-based survey of students aged 13–15, was initiated in 1999. By 2005, the GYTS had grown to include 140 countries across all six WHO Regions and more than 40 countries had conducted a second round of the GYTS. In 2000, WHO and CDC recognised the opportunity the GYTS offered to collect data from school personnel by introducing the Global School Personnel Survey (GSPS). The GSPS includes all school personnel in the schools selected to participate in the GYTS. By 2005, the GSPS had been completed in more than 50 countries.

In 2003, WHO, CDC, and the Canadian Public Health Association (CPHA) expanded the GTSS by initiating the Global Health Professionals Survey (GHPS). The GHPS is a survey of third-year students attending dental, medical, nursing, or pharmacy schools. The GHPS was successfully piloted in 10 countries in 2004 and will be expanded to more than 30 countries in 2006.

This special supplement to Tobacco Control includes a cross-country report from each of the three GTSS surveys—GYTS, GSPS, and GHPS. The GYTS article, “A cross-country comparison of exposure to secondhand smoke among youth”, focuses on exposure to secondhand smoke among students from 132 countries (page ii4). This report shows that more than half of all students were exposed to smoke in public places, nearly half were exposed to smoke at home, and nearly half reported that one or more parents smoke. The majority of students surveyed by the GYTS between 1999 and 2005 supported implementation of measures to reduce secondhand smoke exposure, including banning smoking in public areas.

The GSPS article, “The Global School Personnel Survey: a cross-country overview”, the first cross-country report using these data, covers 33 countries (page ii20). Data collected between 2000 and 2005 indicated an alarming proportion of school personnel smoked cigarettes and used other forms of tobacco. More than half of school personnel in the majority of sites supported prohibiting tobacco use on school property. Some teachers reported having access to tobacco control educational materials, but the majority of teachers in most sites reported that they do not have adequate teaching materials to support tobacco reduction and prevention curricula. The majority in most sites said they believe school personnel should set an example for students by not using tobacco.

The GHPS article, “Tobacco use and cessation counselling: Global Health Professionals Survey Pilot Study, 10 countries, 2005,” is a report from the 10 countries that conducted the pilot study in 2005 (page ii31).* The current cigarette smoking rate among third-year health-profession students was above 20% in seven of the 10 countries surveyed. Although most third-year health-profession students in the countries surveyed did not receive formal training in smoking cessation counselling, more than 90% said that such training should be included in their formal curricula.

In less than a decade, the GTSS has evolved into a leading public health surveillance system providing data on a variety of indicators important for tobacco control. We hope this supplement is an important milestone between recognising the need for a global system to monitor tobacco use and the development, implementation, and evaluation of effective comprehensive tobacco control programmes.

The articles in this supplement are authored by the Global Tobacco Surveillance System Collaborative Group (see Appendix below for complete list of names).

APPENDIX

GTSS COLLABORATIVE GROUP

Agencies supporting the Global Tobacco Surveillance System (GTSS) include:

World Health Organization Headquarters (WHO)

Yumiko Mochizuki-Kobayashi

Heide Richter-Airijoki

US Centers for Disease Control and Prevention (CDC)

Samira Asma

Rosemarie Henson

Corinne Husten

Nathan R. Jones

Juliette Lee

Melissa Lewis

Lela McKnight

Mark Tabladillo

Charles W Warren

Canadian Public Health Association (CPHA)

James Chauvin

Chris Rosene

National Cancer Institute (NCI)I

Cathy Backinger

Steve Marcus

Research Triangle Institute (RTI)

Donald Smith

Debbie Capps

Kim Watts

GTSS was coordinated through WHO Regions

Field work in each country was coordinated by the following persons:

African Region

Jean Pierre Baptiste, WHO/AFRO Regional Office

Algeria – Djamel Zoughailech

Angola – Filomena Wilson

Benin – Victor Hounkonnou

Botswana – Tebogo Maule

Burkina Faso – Maxime Drabo, Larba Theodore Kangoye, Arouna Ouedraogo

Burundi – Protais Baragasirika

Comores – Ahmed Ouledi

Congo – Rosalie Likibi-Bobo

Cote d’Ivoire – Pascal Bogui, Felisberto Moreira, and N’Guessan Kouame

Dem Republic of the Congo – Mifundi Bilongo

Eritrea – Asgodom Mosazghi

Ethiopia – Abdurahman Abdo

Gabon – Louma Eyougha

Ghana – Edith Wellington and S.O. Sackey

Kenya – Joyce Nato and Ezra Ouma Ogwell

Lesotho – Maletela Tuoane and Itumeleng Kimane

Madagascar – Nivo Ramanandraibe

Malawi – John Kapito, Patrick Kanyimbo, Esther Chaswa, and Adamson S Muula

Mali – Mahamane Ibrahima Cisse

Mauritius – Deowan Mohee

Mauritania – Diop Elhadj

Mozambique – Augusto Nunes

Namibia – Elizabeth Indongo and Taimi Amaambo

Niger – Daga Magagi

Nigeria – Ima-Obong A Ekanem

Sao Tome and Principe – Helena Costa Neto

Senegal – Cheikh Ibrahima Niang

Seychelles – Pascal Bovet and Bharati Viswanathan

South Africa – Dehran Swart and Priscilla Reddy

Swaziland – David Pritchard, Sydney Nkambule, and Africa Magongo

The Chad – Egip Bolsane and Mahamat Tahir Ali

The Gambia – Cherno Jallow and Momodou Fatajo

Togo – Osseni Tidjani

Uganda – Lillian Mpabulungi and Frederick Musoke

United Republic of Tanzania – Frida T Mokiti

Zambia – Mbiko Msoni and Richard Zulu

Zimbabwe – Christopher Zishiri, Edwin GV Sithole, and Pepukai Chikukwa

Region of the Americas

Armando Peruga, Heather Selin and Ana Luiza Curi Hallal, WHO/PAHO Regional Office

Antigua & Barbuda – Colin O’Keiffe and Joan A Moses

Argentina – Hugo A Miguez, Enrique Vazquez, and Raul Pitarque

Bahamas – Larrie Williams, Linda Campbell

Barbados – Sean Daniel, Glenda Maynard

Belize – Kimani Avila, Lorraine Thompson

Bolivia – Franklin Alcaraz de Castillo, Dora Caballero

Brazil – Liz Almeida, Luisa Goldfarb, Valeska Caralho Figueiredo, Adelemara Mattoso Allonzi, and Leticia Casado Costa, Miguel Malo

Chile – Claudia Gonzalez Wedmaier, Mildred Maisonet

Colombia – Carolina Wiesner Ceballos, Patricia Segurado

Costa Rica – Julio Bejarano, Miryan Cruz, and Hubert Blanco

Cuba – Luisa Lances Cotilla, José Gómez

Dominica – Joan Henry

Dominican Republic – Raquel Pimentel, Celia Riera, Rosario Cabrera

Ecuador – Silvia Corella Ramirez, Eduardo Ortiz

El Salvador – Carmen Elena Moreno, Maritza Romero

Grenada – A. Alister Antoine

Guatemala – Irma Perez, Maria Alicia Gracia, Maggie Fischer, Carlos Morales, Miguel Garces

Guyana – Shradhanand Hariprashad, Keith Burrows

Haiti – Gerald Lerebours, Rudolph Magloire

Honduras – Maria Gertrudis Ramos, Luis Amendola

Jamaica – Karen A Prendergast

Mexico – Mauricio Hernández, Luz Myriam Reynales, Maria Jesus Hoy Gutierrez, Pablo Kuri, Jesus Felipe Gonzalez Roldan, Raydel Valdes Salgado, Graciela León

Montserrat – Almae O’Garro

Nicaragua – Marcos Membreno Idiaquez and Silvia Narvaez Flores

Panama – Reina G Roa, Jorge Rodriguez

Paraguay – Graciela Gamarra de Caceres, Victor San Martin, Marcia Moreira

Peru – Alfonso Zavaleta, Fernando Rocabado

St Kitts and Nevis – Petronella Edwards

St Lucia – Elvina Lawrence and Edward L. Emmanuel

St Vincent and the Grenadines – Patsy Wyllie

Suriname – Kris Rambali, Gerold Vliet, Oscar Bhagwandin, Primnath Ritoe

Trinidad & Tobago – Diane Renaud, Leo Alleyne, Gina Watson

United States – American Legacy Foundation

Uruguay – Raquel Magri, Julio Gonzalez

Venezuela – Ricardo Granero and Natasha Herrera

Virgin Islands (Am.) – Julia Sheen-Aaron and Sharon Williams

Virgin Islands (Br.) – Ivy George and Sheila L Samiel

Eastern Mediterranean Region

Fatimah El Awa and Nisreen Abdul-Latif, WHO/EMRO Regional Office

Afghanistan – Sayed Ali Shah Alawie

Bahrain – Salah Ali Abdulrahman and Khadem Al-Halwaji

Djibouti – Abdulrahman Mohamed Abubaker and Samira Ali Higo

Egypt – Nevein Moneir Dous, Samy Ghanem, Mohamed Mehrez, Ehab Makram, and Nargis Albert Labib

Gaza Strip/West Bank – Salah Shaker Isa Soubani, Samah Eriqat, and Moein Al Kariri

Iran – Hassan Azaripour Masooleh

Iraq – Sarhang Jalal Saeed, Dilyara Barzani, and Mohammed El Hosani

Islamic Republic of Iran – Ali Asghar Farshad

Jordan – Heba Ayoub and Iman Al Jaghbeer

Kuwait – Sami Eissa Al-Nasser

Lebanon – Georges Saade

Libyan Arab Jamahiriya – Mohamed I Salah and Mohamed Ali Buni

Morocco – Noureddine Chaouki and Abdelkhalek Moujarrade

Oman – Tahira Mohammed Ali Juma, Issda Al-Shuaili and Sahar Abdou Helmi

Pakistan – Muhammad Yaqoob Qureshi and Shahzad Alan Khan

Qatar – Ahmed Al-Ibrahim and Ahmed Abdel Karim Al-Mulla

Saudi Arabia – Abdullah Mohammed Al-Bedah and Riyadh M Alsughaier

Somalia – Ali Sheikh Omar Kabil, Mohamed Said Mohamed, and Mohamed Hussein Abdi

Sudan – Ilham Abdalla Bashir and Ibrahim Ginawi

Syrian Arab Republic – Bassam Abou Alzahab

Tunisia – Mohamed Nabil Ben Salem, Alya Mahjoub Zarrouk, Radhouane Fakhfakh

United Arab Emirates – Bassam Abi Saab and Ayesha Almutawa

Yemen – Ahmed Ali-Bahaj and Tarek Salah Assad

European Region

Haik Nikogosian, Ionela Petrea, and Kerstin Schotte, WHO/EURO Regional Office

Albania – Roland Shuperka and Arta Lena

Armenia – Alexander Bazarjyan

Belarus – Irina Zastenskaya

Bosnia and Herzegovina

Federation of BiH – Aida Ramic-Catak

Republika Srpska – Zivana Gavric

Bulgaria – Antoineta Manolova

Croatia – Tanja Coric and Hrvoje Vrazic

Czech Republic – Hana Sovinova

Estonia – Kadi Lepp

FYR Macedonia – Elena Kosevska

Georgia – Akaki Gamkrelidze and Nana Nikolaishvili

Greece – Elipidoforos Soteriades

Hungary – Agnes Nemeth

Kazakhstan – Kazbek A Tulebaev and Alma Zhylkaidarova

Kyrgyzstan – Aisha S Tokobaeva

Latvia – Iveta Pudule

Lithuania – Antanas Gostautas and Aurelijus Veryga

Poland – Krzysztof Przewozniak and Witold Zatonski

Republic of Moldova – Vorfolomei Calmic

Russian Federation – Irina Parfenova, Andrei Demine, Konstantine Vitalievich Vyshinsky, Elena Skovortsova, and Galina Sakharova

Romania – Ileana Mirestean

Serbia and Montenegro

Serbia – Libija Dimitrijevic-Tanaskovic and Djordje Stojilkovic

Montenegro – Agima Ljaljevic

Slovakia – Tibor Baska

Slovenia – Mojca Juricic

Tajikistan – Zulfiya Nisanbaeva

Turkey – Toker Erguder

Ukraine – Konstantin Krasovsky and Tatiana Andreeva

Uzbekistan – Atabek Kutlumuratov

South East Asia Region

Khalilur Rahman and Sawat Ramaboot, WHO/SEARO Regional Office

Bangladesh – Zulfiqar Ali

Bhutan –Palden Lepcha and Sonam Phuntsho

East Timor – Nunik Kusumawardani

India – Prakash C Gupta, Urmi Sen, Surendra Shastri, Dhirendra N Sinha, Vendhan Gajalakshmi, Monika Arora, Mira Aghi, Rameshwar Sharma, M Prakasamma, G Gururaj, Arun Chaturvedi, Sanjeev Misra, Mihir N Shah, Rajesh Dixit, R Thulasidasan, and SK Jindal

Indonesia – Tjandra Yoga Aditama and Elisna Syahruddin

Maldives – Ahmed Waheed

Myanmar – Nyo Nyo Kyiang

Nepal – Mrigendra Raj Pandey, Ramjee Pd Pathak, and Gyanendra Sharma

Sri Lanka – PW Gunasekara

Thailand – Nithat Sirichotiratana

Western Pacific Region

Burke Fishburn and Jonathan Santos, WHO/WPRO Regional Office

Brunei Darussalam – Norhayati Kassim

Cambodia – Sin Sovann

China – Jiang Yuan

Cook Islands – Edwina Tangaroa

Federated States of Micronesia – Brenda Hadley Epenam

Fiji – Mosese Salusalu, Ilisapeci K Movono, Vasemaca Leweni Naulumatua, Raj Shalvindra, and Ifereimi Corerega

Guam – Joleen Almandres and Francis Victor Epres

Hong Kong (China) – Tham May Ked and, Vivian Chan, Chester Tsang

Japan – Akira Ushiyama

Lao People’s Democratic Republic – Ketkeo Boupha and Anothay Kongsayasak

Macao (China) – Tan Mui Chan, Veng Ian Uu, and Ka Wai Leong

Malaysia – Manimaran Krishnan

Marshall Islands – Marita Edwin

Mongolia – L Erdenebayar and Jargalsaikhan Dondog

Northern Mariana Islands – Isamu Abraham and Kevin Villagomez

New Zealand – Andrew Morehu Waa

Palau – Annabel Lyman, Valerie Whipps, and Debra Toribiong

Papua New Guinea – James Wangi and Jessica Yaipupu

Philippines – Marina Miguel-Baquilod

Republic of Korea – Sun Ha Jee and Ka Young Shin

Samoa – Herbert Peters and Taumafaimolealii Poleka

Solomon Islands – Josephine Watoto

Singapore – Chng Chee Yeong, Foo Ling Li and Karen Cheong

Tonga – Sunia Foliaki and Timaleti Nauna

Tuvalu – Teimana Avanitele

Vanuatu – Winch Garae

Viet Nam – Phan Thi Hai