DOCSLIB.ORG

Antenatal and Early Life Tobacco Smoke Exposure in an African Birth Cohort Study

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Antenatal and Early Life Tobacco Smoke Exposure in an African Birth Cohort Study INT J TUBERC LUNG DIS 20(6):729–737 Q 2016 The Union http://dx.doi.org/10.5588/ijtld.15.0697 E-published ahead of print 12 April 2016 Antenatal and early life tobacco smoke exposure in an African birth cohort study A. Vanker,* W. Barnett,* K. Brittain,* R. P. Gie,† N. Koen,‡ B. Myers,§ D. J. Stein,‡ H. J. Zar* *Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, and Medical Research Council (MRC) Unit on Child & Adolescent Health, University of Cape Town, Cape Town, †Department of Paediatrics and Child Health, Tygerberg Children’s Hospital, Stellenbosch University, Cape Town, ‡Department of Psychiatry and Mental Health and MRC Unit on Anxiety & Stress Disorders, University of Cape Town, Cape Town, §Alcohol Tobacco and Other Drug Research Unit, South African Medical Research Council and Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa SUMMARY BACKGROUND: Exposure to tobacco smoke in African (32%) were active smokers on cotinine testing. At birth infants has not been well studied, despite the high burden and at 6–10 weeks of life, respectively 135/241 (56%) of childhood respiratory disease in these communities. and 154/291 (53%) infants had urine cotinine levels OBJECTIVE: To investigate the prevalence of antenatal indicating tobacco smoke exposure. Household smoking and early life tobacco smoke exposure and associations was prevalent and was associated with positive infant with infant birth outcomes in an African birth cohort, cotinine test results. Antenatal maternal smoking was the Drakenstein Child Health Study. associated with decreased infant birthweight-for-age Z- METHODS: Self-report questionnaires assessing mater- score (0.3, 95%CI 0.1–0.5). nal and household smoking were administered. Mater- CONCLUSION: Antenatal and early life tobacco smoke nal and infant urine cotinine testing was conducted exposure is highly prevalent in this community, and may antenatally, at birth and at 6–10 weeks of life to measure impact on birth outcomes and subsequent child health. tobacco smoke exposure. Multivariate regression mod- Smoking cessation interventions are urgently needed to els explored the associations between exposure to smoke reduce tobacco smoke exposure in African communities. and infant birth outcomes. KEY WORDS: tobacco smoke exposure; birth out- RESULTS: Of 789 pregnant women included, 250 comes; birth cohort; child health; maternal health EXPOSURE TO TOBACCO SMOKE is an impor- Cotinine, a biomarker of tobacco smoking and tant risk factor for childhood respiratory disease,1–3 exposure, has been used to both confirm and quantify and childhood morbidity and mortality worldwide.4,5 smoking and exposure in pregnant women.9,16,17 Infant Prenatal exposure is associated with an increased risk exposure during the first year of life has been assessed of pneumonia and of wheezing disorders,6–8 and may using blood, urine or hair cotinine measures.16,18–20 also lead to pre-term delivery and decreased birth- However, no studies have used infant cotinine mea- weight, predisposing infants to severe respiratory surements at birth to assess in utero tobacco smoke disease.9,10 Other maternal socio-economic and exposure, and few studies have used infant measures to psychosocial risk factors, including depression and evaluate early life exposure.16,18 Documenting exposure intimate partner violence (IPV), may also impact is especially relevant in low-and middle-income country infant birth outcomes.11–13 (LMIC) settings, which carry the highest burden of Tobacco smoke exposure often begins in utero with childhood respiratory illnesses. active or passive maternal smoking, and may We measured antenatal and early postnatal tobac- continue postnatally. Both prenatal and postnatal co smoke exposure, and investigated the association exposure adversely affect infant health. Nicotine between antenatal exposure and infant birth out- exposure may be directly toxic to the airways or comes in an African birth cohort study. may result in secondary impairment of lung growth due to decreased foetal breathing or cellular dam- METHODS age.14 Furthermore, adult smokers have a higher risk of respiratory infections, with increased risk of A prospective study of smoke exposure was under- pathogen transmission to child contacts.15 taken in pregnant women and infants enrolled in the Correspondence to: Aneesa Vanker, Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, Klipfontein Road, Rondebosch, Cape Town, South Africa. e-mail: [email protected] Article submitted 16 August 2015. Final version accepted 10 December 2015. 730 The International Journal of Tuberculosis and Lung Disease Drakenstein Child Health Study.21 The site of the Urine cotinine testing study is located 60 km outside Cape Town, South Maternal and infant urine cotinine tests were Africa, in a semi-rural area with a population of low performed using the IMMULITEw 1000 Nicotine socio-economic status (SES).21 More than 90% of the Metabolite Assay Kit (Siemens Medical Solutions population obtain health care in the public sector, Diagnostics, Glyn Rhonwy, UK). This provided a which has a strong primary health care system. quantitative test using a competitive chemilumines- cent immunoassay, which contained solid-phase Study population, participants and procedure beads coated with polyclonal rabbit anti-cotinine Pregnant women at between 20 and 28 weeks’ antibody. The test had a calibration range of 10–500 gestation were consecutively enrolled using conve- ng/ml, with an analytical sensitivity of 2 ng/ml. Urine nience sampling at one of two primary health care cotinine levels were classified as ,10 ng/ml (non- clinics serving different populations: Newman (pre- smoker), 10–499 ng/ml (passive smoker/exposed) or dominantly mixed race) and Mbekweni (predomi- 7500 ng/ml (active smoker), according to the nantly Black African). A second antenatal study visit manufacturer’s directions. was completed at 28–32 weeks’ gestation. All Maternal urine was collected and tested at the deliveries took place at a single central public second antenatal study visit and at birth, with the hospital, Paarl Hospital. Thereafter, mother-infant higher result used to classify smoking levels. Infant dyads attended follow-up visits, including at 6–10 urine was collected at birth and at 6–10 weeks, either weeks’ postpartum.21 via a urine bag or by placing a cotton-wool ball in the diaper from which urine could then be squeezed. Self-reported measures Urine samples were transferred to a clean, preserva- Sociodemographic data were collected at enrolment tive-free, plastic container and transported at tem- using a questionnaire adapted from the South African peratures of between 28 and 88C to the accredited Stress and Health Study.22 A composite SES score was medical laboratory for testing. developed as an internal comparison of SES for this sample, and participants were categorised as lowest, Ethics low–moderate, moderate–high or highest SES.13 The study was approved by the Faculty of Health Maternal tobacco smoking and exposure were Sciences Human Research Ethics Committees of the assessed using self-report questionnaires at enrolment. University of Cape Town and of Stellenbosch Maternal smoking was quantified as pack-years, University (Cape Town, South Africa), and by the whereby one pack-year was defined as 20 cigarettes Western Cape Provincial Health Research Committee smoked daily for one year. Maternal nicotine depen- (Cape Town, South Africa). Written informed con- dence was assessed using the Fagerstrom¨ test, a well- sent was provided by mothers at enrolment. validated questionnaire that scores tobacco depen- dence as low, low to moderate, moderate or high.23 Statistical analysis The Alcohol, Smoking and Substance Involvement Tobacco smoking and exposure were compared Screening Test (ASSIST) was administered to assess across the recruitment sites using the v2 or the Fisher’s substance use and substance-related risk.24 Partici- exact tests for categorical variables and Wilcoxon pants were categorised as being at low, moderate or rank-sum tests (Mann-Whitney tests) for non-nor- high risk of tobacco-related health problems, and any mally distributed continuous variables. The sensitiv- self-reported antenatal alcohol use was document- ity and specificity of self-reported maternal smoking ed.24 Women who reported antenatal substance use was calculated using maternal urine cotinine as the were counselled about cessation. gold standard. The associations between household Comprehensive psychosocial data were collected and maternal smoking (self-reported and based on antenatally, including an assessment for depression urine cotinine) and infant urine cotinine were using the Beck Depression Inventory (BDI-II) and a assessed using v2 tests, with cotinine levels of 710 questionnaire for any IPV in the past year.11,13 ng/ml used to categorise infants as being exposed to tobacco smoke. Risk ratios (RRs) with 95% confi- Birth outcomes dence intervals (CIs) were calculated to determine the All births were attended by a member of the study strength of these associations. Infant weight-for-age team. Birth outcomes included birth weight, gesta- (WfA) Z-scores were calculated using the revised tional age and presence of respiratory or other Fenton preterm growth charts, and infants with a disease. Gestational age at delivery (in completed WfA Z-score ,10th percentile were classified as small weeks) was calculated from
Load more

Recommended publications
  • Smokeless Tobacco and Public Health: a Global Perspective
    Chapter 12 Smokeless Tobacco Use in the African Region 353 Blank page. Smokeless Tobacco and Public Health: A Global Perspective Chapter Contents Description of the Region ........................................................................................................................357 Prevalence of Smokeless Tobacco Use....................................................................................................358 Types of Products and Patterns of Use ....................................................................................................362 Toxicity and Nicotine Profiles .................................................................................................................365 Health Problems Associated With Product Use.......................................................................................365 Marketing and Production Practices of Industry .....................................................................................367 Production ..........................................................................................................................................367 Distribution ........................................................................................................................................367 Marketing ...........................................................................................................................................368 Current Policy and Interventions .............................................................................................................369
    [Show full text]
  • Cigarette Smuggling and War Economies in Central and Eastern Africa Kristof Titeca,1 Luk Joossens,2 Martin Raw3
    Research paper Tob Control: first published as 10.1136/tc.2010.041574 on 3 February 2011. Downloaded from Blood cigarettes: cigarette smuggling and war economies in central and eastern Africa Kristof Titeca,1 Luk Joossens,2 Martin Raw3 1Research Foundation-Flanders, ABSTRACT Further, cigarette smuggling is detrimental to Institute of Development Policy Objective To analyse cigarette smuggling practices in health policy5 6 and the WHO Framework and Management, University of central and eastern Africa. Convention on Tobacco Control (FCTC) empha- Antwerp, Antwerp, Belgium 2International Expert on Illicit Methods Primary data were gathered during long-term sises the importance for tobacco control of 7 Trade in Tobacco, Framework qualitative field research in which about 400 interviews combating illicit trade. Smuggling undermines tax Convention Alliance, Brussels, were conducted. Analysis of secondary sources included revenue and promotes corruption8; by lowering Belgium academic literature and reports from non-government price, consumption is increased9; and smuggling 3UK Centre for Tobacco Control organisations, multilateral organisations and the press. promotes the development of new markets and Studies, Division of 10 Epidemiology and Public Health, Results Our research suggests that the following factors better exploitation of old ones. For example, University of Nottingham, play an important role in cigarette smuggling in eastern smuggling may lower the price of Western tobacco Nottingham, UK and central Africa: (1) government officials
    [Show full text]
  • Conference of the Parties to the Who Framework Convention on Tobacco Control
    FCTC/COP/8/VR CONFERENCE OF THE PARTIES TO THE WHO FRAMEWORK CONVENTION ON TOBACCO CONTROL Eighth session GENEVA, SWITZERLAND, 1–6 OCTOBER 2018 VERBATIM RECORDS OF PLENARY MEETINGS GENEVA 2019 FCTC/COP/8/VR CONFERENCE OF THE PARTIES TO THE WHO FRAMEWORK CONVENTION ON TOBACCO CONTROL Eighth session GENEVA, SWITZERLAND, 1–6 OCTOBER 2018 VERBATIM RECORDS OF PLENARY MEETINGS GENEVA 2019 4 EIGHTH CONFERENCE OF THE PARTIES PREFACE The Eighth session of the Conference of the Parties to the WHO Framework Convention on Tobacco Control was held in Geneva, Switzerland, from 01 to 06 October 2018. The report of proceedings (containing the decisions) was adopted by the COP at the end of the session, and is available at http://www.who.int/fctc/publications. In addition, the verbatim records of plenary meetings are issued in the current volume (FCTC/COP/8/VR). The documentation, including the list of participants, is also available at https://www.who.int/fctc/cop/sessions/cop8/documentation/en/. _______________ VERBATIM RECORDS 5 Contents FIRST PLENARY MEETING ............................................................................................................................. 6 1. OPENING OF THE SESSION (item 1) ......................................................................... 6 2. OPENING REMARKS BY DR TEDROS ADHANOM GHEBREYESUS, DIRECTOR-GENERAL OF THE WORLD HEALTH ORGANIZATION ................. 7 3. OPENING REMARKS DELIVERED, ON BEHALF OF MR MICHAEL MØELLER, DIRECTOR-GENERAL OF THE UNITED NATIONS OFFICE IN GENEVA, MR CHIKVAIDZE ...................................................................................... 8 4. OPENING REMARKS BY DR DA COSTA E SILVA, HEAD OF THE CONVENTION SECRETARIAT .................................................................................. 9 5. ADOPTION OF THE AGENDA AND ORGANIZATION OF WORK (ITEM 1.1) 11 6. KEYNOTE ADDRESS BY THE HEAD OF THE CONVENTION SECRETARIAT (Item 1.3.) ....................................................................................................................
    [Show full text]
  • Information Document Preparati
    Information Document for the preparation of guidelines to tackle single-use plastic items in the Mediterranean. Report for SCP/RAC 29 January 2021 1 Report for SCP/RAC Prepared by Chris Sherrington, Hara Xirou, Ayesha Bapasola, Hannah Gillie, Laurence Elliott, Tessa Lee, Eunomia Research & Consulting IKE Supervision: Pedro Fernández and Magali Outters, SCP/RAC Contributions: Ayman Rachid (Morocco), Fahmy AbdelRahman (Egypt), Marina Tomović, Azra Vucovic (Montenegro). Eunomia Research & Consulting IKE Tel: +30 210 7209614 Patroklou 1 & Paradeisou Web: www.eunomia.co.uk Athens 151 25 Greece This study and report was commissioned to Eunomia Research & Consulting IKE by the Regional Activity Centre for Sustainable Consumption and Production (SCP/RAC). SCP/RAC has an official mandate from the Contracting Parties to the Barcelona Convention to engage in international cooperation with Mediterranean countries on the prevention of plastic pollution, including marine litter and in the development and innovation in the business sector. This report serves as Information Document in the process of development regional guidelines to tackle single-use plastic items in the Mediterranean region, led by SCP/RAC, following the request of the Contracting Parties to the Barcelona Convention and as indicated in the MAP Programme of Work 2020-2021. Recommended citation Eunomia (2021). Information Document for the preparation of guidelines to tackle single-use plastic items in the Mediterranean. Report for SCP/RAC. Disclaimer Eunomia Research & Consulting has taken due care in the preparation of this report to ensure that all facts and analysis presented are as accurate as possible within the scope of the project. However no guarantee is provided in respect of the information presented, and Eunomia Research & Consulting, nor SCP/RAC, is not responsible for decisions or actions taken on the basis of the content of this report.
    [Show full text]
  • Oscar Levant: Pianist, Gershwinite, Middlebrow Media Star
    Washington University in St. Louis Washington University Open Scholarship Arts & Sciences Electronic Theses and Dissertations Arts & Sciences Spring 5-15-2020 Oscar Levant: Pianist, Gershwinite, Middlebrow Media Star Caleb Taylor Boyd Washington University in St. Louis Follow this and additional works at: https://openscholarship.wustl.edu/art_sci_etds Part of the Film and Media Studies Commons, Music Commons, and the Sociology Commons Recommended Citation Boyd, Caleb Taylor, "Oscar Levant: Pianist, Gershwinite, Middlebrow Media Star" (2020). Arts & Sciences Electronic Theses and Dissertations. 2169. https://openscholarship.wustl.edu/art_sci_etds/2169 This Dissertation is brought to you for free and open access by the Arts & Sciences at Washington University Open Scholarship. It has been accepted for inclusion in Arts & Sciences Electronic Theses and Dissertations by an authorized administrator of Washington University Open Scholarship. For more information, please contact [email protected]. WASHINGTON UNIVERSITY IN ST. LOUIS Department of Music Dissertation Examination Committee: Todd Decker, Chair Ben Duane Howard Pollack Alexander Stefaniak Gaylyn Studlar Oscar Levant: Pianist, Gershwinite, Middlebrow Media Star by Caleb T. Boyd A dissertation presented to The Graduate School of Washington University in partial fulfillment of the requirements for the degree of Doctor of Philosophy May 2020 St. Louis, Missouri © 2020, Caleb T. Boyd Table of Contents List of Figures ................................................................................................................................
    [Show full text]
  • Progress Report Duodenal Ulcer in Black Populations in Africa South Of
    Gut: first published as 10.1136/gut.16.7.564 on 1 July 1975. Downloaded from Gut, 1975, 16, 564-576 Progress report Duodenal ulcer in black populations in Africa south of the Sahara The Geographical Distribution of Duodenal Ulcer The geographical distribution of a disease may provide valuable clues with regard to its aetiology. Likewise any historical changes in prevalence, associated with changes in the mode of living, may give additional infor- mation. In this report the prevalence of duodenal ulcer in Africa, south of the Sahara, is reviewed and areas of high and low prevalence are identified. The information has been collected in several ways: by reviewing all the available literature; by extensive correspondence, personal interviews, and visits; and by replies to questionnaires sent out by Mr D. P. Burkitt of the Medical Research Council to a large number of mission hospitals, many of which have sent monthly returns over a period of three years. There are many difficult problems to overcome in trying to establish the prevalence of a disease with a low mortality such as duodenal ulcer. These problems are considerable in a developed country and much greater in developing countries. The authors have endeavoured only to establish whether duodenal ulcer is a common or a rare problem in a given area. It has not been for the most part to use any exact parameters. In making an possible http://gut.bmj.com/ assessment it was noted whether the diagnosis had been made on clinical findings, x-ray evidence, surgical experience, or necropsy examinations. Many hospitals are without x-ray facilities.
    [Show full text]
  • GROWTH Worldreginfo - 7017Cd3e-495C-4762-B1b1-3Bd868eb8567 Our Business Is Built on Great Brands and Great People
    ANNUAL REPORT AND ACCOUNTS 2017 INVESTING FOR GROWTH WorldReginfo - 7017cd3e-495c-4762-b1b1-3bd868eb8567 Our business is built on great brands and great people. Our brands are recognised and enjoyed by millions of people around the world. And our people are focused on creating the great moments that bring our business to life on a daily basis. 2017 has been an important year of progress for Imperial Brands. We’ve stepped up investment to support growth and created further value for our shareholders. See how we’re delivering against our strategy. CONTENTS STRATEGIC REPORT GOVERNANCE SUPPLEMENTARY INFORMATION OVERVIEW Chairman’s Introduction 33 Related Undertakings 130 Performance Overview 1 Board of Directors 34 Shareholder Information 144 Chairman’s Statement 2 The Board and its Committees 36 Our Brands and Markets 3 Directors’ Report 45 STRATEGY Directors’ Remuneration Report 52 How We Create Value 4 FINANCIAL STATEMENTS Key Performance Indicators 8 AND NOTES Our Operating Environment 10 Independent Auditors’ Report 75 Chief Executive’s Statement 11 Consolidated Income Statement 80 Investment Case 14 Consolidated Statement of Comprehensive Income 81 PERFORMANCE Consolidated Balance Sheet 82 Operating Review 15 Consolidated Statement of Changes Financial Review 20 in Equity 83 Principal Risks and Uncertainties 24 Consolidated Cash Flow Statement 84 Corporate Responsibility 29 Notes to the Financial Statements 85 Imperial Brands PLC Balance Sheet 126 Imperial Brands PLC Statement of Changes in Equity 126 For a more interactive experience
    [Show full text]
  • African Statistical Journal Journal Africain De Statistiques
    Éditorial African Statistical Journal Journal africain de statistiques 1. Quantification of Inflation Expectations from Business Tendency Survey Data in Uganda Kenneth Alpha Egesa 2. Cigarette Smoking in Tanzania-Prevalence and Determinants Asmerom Kidane, Aloyce Hepelwa, Kenneth Mdadila, Salvatory Macha, Anita Lee, Teh Wei Hu 3. Statistical Literacy for National Development Korter Grace, Olatunji Lateef, Omolehin Joseph, Olubusoye Olusanya 4. Statistical Indicators for Measuring Good Governance in Africa Dahud Kehinde Shangodoyin Volume 21 – September / septembre 2019 African Development Bank Group Groupe de la Banque africaine de développement Journal africain de statistiques, numéro 21, septembre 2019 1 Designations employed in this publication do not imply the expression of any opinion on the part of the African Development Bank or the Editorial Board concerning the legal status of any country or territory, or the delimitation of its frontiers. The African Development Bank accepts no responsibility whatsoever for any consequences of its use. African Development Bank Group Avenue Joseph Anoma 01 BP 1387 Abidjan 01 Côte d’Ivoire Tel: (+225) 20 26 10 20 Email: [email protected] Internet: http://www.afdb.org Les dénominations employées dans cette publication n’impliquent, de la part de la Banque africaine de développement ou du comité de rédaction, aucune prise de position quant au statut juridique ou au tracé des frontières des pays. La Banque africaine de développement se dégage de toute respon- sabilité de l’utilisation qui pourra être faite de ces données. Groupe de la Banque africaine de développement Avenue Joseph Anoma 001 BP 1387 Abidjan 01 Côte d’Ivoire Tel: (+225) 20 26 10 20 Courriel: [email protected] Internet: http://www.afdb.org @AfDB/BAD, 2019– Statistics Department / Département des statistiques African Statistical Journal Journal africain de statistiques Volume 21 September / septembre 2019 Contents Editorial ...............................................................................................................
    [Show full text]
  • Who Study Group on Tobacco Product Regulation
    WHO Technical Report Series 989 WHO STUDY GROUP ON TOBACCO PRODUCT REGULATION Report on the Scientific Basis of Tobacco Product Regulation: Fifth Report of a WHO Study Group WHO Technical Report Series 989 WHO STUDY GROUP ON TOBACCO PRODUCT REGULATION Report on the Scientific Basis of Tobacco Product Regulation: Fifth Report of a WHO Study Group WHO Library Cataloguing-in-Publication Data WHO study group on tobacco product regulation : report on the scientific basis of tobacco product regulation: fifth report of a WHO study group. (WHO Technical report series; 989) 1.Tobacco Use Disorder – prevention and control. 2.Tobacco Industry – legislation. 3.Tobacco Control Campaigns. 4.Tobacco – chemistry. 5.Metals, Heavy – adverse effects. 6.Metals, Heavy – toxicity. 7.Metals, Heavy – standards. I.World Health Organization. II.WHO Study Group on Tobacco Product Regulation. III.Series. ISBN 978 92 4 120989 2 (NLM classification: QV 137) ISBN (PDF) 978 92 4 069380 7 ISSN 0512-3054 © World Health Organization 2015 All rights reserved. Publications of the World Health Organization are available on the WHO website (www.who.int or can be purchased from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: [email protected]). Requests for permission to reproduce or translate WHO publications –whether for sale or for non-commercial distribution– should be addressed to WHO Press through the WHO website (www.who.int/about/licensing/copyright_form/en/index.html). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries.
    [Show full text]
  • Youth Employment in Sub-Saharan Africa
    Youth Employment in Sub-Saharan Africa Youth Employment in Sub-Saharan Africa Deon Filmer and Louise Fox with Karen Brooks, Aparajita Goyal, Taye Mengistae, Patrick Premand, Dena Ringold, Siddharth Sharma, and Sergiy Zorya A copublication of the Agence Française de Développement and the World Bank © 2014 International Bank for Reconstruction and Development / The World Bank 1818 H Street NW, Washington DC 20433 Telephone: 202-473-1000; Internet: www.worldbank.org Some rights reserved 1 2 3 4 17 16 15 14 This work is a product of the staff of The World Bank with external contributions. Note that The World Bank and the Agence Française de Développement do not necessarily own each component of the content included in the work. The World Bank and the Agence Française de Développement therefore do not warrant that the use of the content contained in the work will not infringe on the rights of third parties. The risk of claims resulting from such infringe- ment rests solely with you. The fi ndings, interpretations, and conclusions expressed in this work do not necessarily refl ect the views of The World Bank, its Board of Executive Directors, or the governments they represent, or the Agence Française de Développement. The World Bank does not guar- antee the accuracy of the data included in this work. The boundaries, colors, denominations, and other information shown on any map in this work do not imply any judgment on the part of The World Bank concerning the legal status of any territory or the endorsement or acceptance of such boundaries. Nothing herein shall constitute or be considered to be a limitation upon or waiver of the privileges and immunities of The World Bank, all of which are specifi cally reserved.
    [Show full text]
  • Annual Report and Accounts 2020 Our Business
    IMPERIAL BRANDS PLC IMPERIAL BRANDS ANNUAL REPORT AND ACCOUNTS 2020 AND ACCOUNTS REPORT ANNUAL ANNUAL REPORT AND ACCOUNTS 2020 OUR BUSINESS Our business is evolving. We appointed a new Chair and Chief Executive in the year and began to review our strategy with the aim of strengthening future performance and taking Imperial Brands into a new era of growth. CONTENTS HIGHLIGHTS Strategy Performance Overview 1 View from the top: Our New Chair Chair’s Statement 2 An introduction from our new Chair Chief Executive’s Q&A 5 Thérèse Esperdy. Our Regulatory Environment 10 Our Business Model and Strategy 11 See page 2 Key Performance Indicators 12 Our Stakeholders 14 Our People 16 Performance View from the top: Our New CEO ESG Review 20 Our new Chief Executive Officer Stefan Bomhard Operating Review 29 shares his thoughts on the future of the business. Financial Review 36 See page 5 Principal Risks and Uncertainties 42 Governance Chair’s Introduction 62 Board of Directors 64 Engaging with Stakeholders Board Engagement 68 We engaged with a broad range of stakeholders in The Board and its Committees 70 the year. Directors’ Report 86 See page 14 Directors’ Remuneration Report 96 Financials Independent Auditors’ Report 125 Consolidated Income Statement 136 Consolidated Statement Celebrating our People of Comprehensive Income 136 Our people worked tirelessly to keep the business Consolidated Balance Sheet 137 going in unprecedented circumstances. Consolidated Statement of Changes in Equity 138 See page 16 Consolidated Cash Flow Statement 139 Notes to the Financial Statements 140 Imperial Brands PLC Balance Sheet 191 Imperial Brands PLC Statement of Changes in Equity 191 Notes to the Financial Statements of Imperial Brands PLC 192 Managing our ESG Responsibilities We have a clear focus on our core environmental, Supplementary information social and governance responsibilities.
    [Show full text]
  • Bulletin Issue 101 Thursday
    ISSUE 101 THURSDAY, 18 MARCH 2010 GENEVA BULLETIN INSIDE THIS ISSUE TIME TO LOOK FOR West African situation 2 BAT’s complicity in smuggling 3 COMMON GROUND Tracking & tracing works in Kenya 4 Yesterday saw some welcome progress on s #LARIFY WHICH 0ARTIES ACTUALLY DISAGREE Les douanes doivent être davantage Part IV of the protocol - fruitful discussions with the core measures of the protocol, or impliquées en Afrique 5 that built upon and improved the work of fundamentally do not believe in a multilateral intersessional drafting group 2. It is highly approach to this issue. There may be a Il est temps d’interdire à l’échelle encouraging to see Parties reaching small minority that cannot be mondiale la vente de tabac par consensus on potentially delicate matters of accommodated, at least for now, and internet/à distance 6 search and seizure or proceeds of crime. Parties should neither tie themselves in knots to appease them nor waste their The big question is whether Parties can breath arguing with them keep this co-operative spirit going when we head back into the thornier issues of s &OCUS ON CORE PRINCIPLES Articles 5-7 - probably tomorrow in plenary, s #ONSIDER WHICH BITS OF TEXT 0ARTIES COULD likely today in corridor conversations. To cut without crippling a useful and realistic state the obvious, real progress on supply- international system of controls chain provisions will require a willingness to listen and to seek consensus on concepts s !DJUST EXPECTATIONS TO REALITIES NO before haggling about wording - as well as protocol can single-handedly solve all exceptionally hard work as we race to beat problems of illicit trade or substitute for the Sunday deadline of the end of INB-4.
    [Show full text]