May 31 is marked by the encouragement of anti-smoking information. The date was created by the WHO – World Health Organization in 1987, and aims to combat smoking and its harmful consequences to health, society and the environment.
According to ANVISA, the consumption of the substance is responsible for approximately 7 million annual deaths worldwide and up to 200 thousand in Brazil, being the main cause of preventable death.
Consuming tobacco derivatives causes chemical, emotional and behavioral dependence, bringing risks to the individual and collective quality of life.
Up to 50 diseases are associated with smoking, mainly involving heart attacks, cancer and obstructive respiratory diseases, which make up the most recurrent causes of death from illness in Brazil.
In addition, studies indicate that up to 90% of lung cancer cases are related to tobacco consumption, and lung cancer is the type of disease that kills the most in Brazil.
Gradual measures are taken to reduce tobacco consumption, such as the ban on cigarette advertising in the media and the obligation to warn about the risks of cigarettes in packaging.
In recent years, the reduction in consumption of the product has stagnated in most countries with medium and high HDI (Human Development Index). Brazil has one of the biggest decreases in the rate of smokers, but it is still in 8th position in the ranking of inhabitants who smoke.
One of the main concerns is the increase in tobacco consumption by young people, especially in countries with low HDI.
Studies observe the resumption of tobacco consumption in countries such as sub-Saharan Africa, which has a low HDI, as a possible trend in other low-developed countries.
With regard to national figures, despite studies showing that more than 52% of Brazilians who smoke intend to quit smoking, the percentage is still low, considering the impacts on health and the environment.
Contents
What is World No Tobacco Day?
In recent years, May 31 is marked by actions aimed at stimulating the reduction of tobacco consumption worldwide.
The campaign aims to bring information to smokers and tobacco addicts, as well as raise awareness about the harmful effects of the substance.
By means of actions that aim to put political initiatives into practice and make public policies for the reduction of smoking accessible, the campaign aims to reach not only the society that consumes tobacco or not, but also farmers and traders.
The idea is that, at the time, the whole society does not use any tobacco-derived substance. But the 24 hours of abstinence act as a first action for the total abandonment of the drug.
Among the actions promoted by World No Tobacco Day, are the campaign’s dissemination in different media – such as TV, radio, institutional website and social networks – distribution of information about the harmful effects of consumption and where to seek treatment to quit addiction, mobilizations , free lectures and assistance to the community.
What is tobacco?
Tobacco has very old historical records, and its consumption – smoked or chewed – is part of some traditions. There are historical indications that the plant was used in indigenous practices and was introduced to Europeans as early as 1492.
The surveys indicate that tobacco was one of the plants that had the most widespread consumption, both in temporal and geographical issues.
The presence of the plant in the historical trajectory of societies may have favored the current consumption rates, which, even with the various studies on the risks that the substances bring to health, still remain high.
On average, tobacco can produce up to 500 different substances when it is burned. However, due to industrial processes that aim to enhance the commercialization of the drug, other substances are added to cigarettes, making consumption more pleasurable.
Nicotine is considered a psychoactive substance because it is capable of altering the person’s state of consciousness, sensations or emotional state. Among the components present in tobacco, it is the most active and is also responsible for dependence.
As or tobacco age no organism?
The way of using tobacco can have different effects on the body. There are several ways to consume the plant, but damage to health is present in all.
Industrialized Cigarette
The lung quickly absorbs nicotine. On average, it takes just 8 seconds for the substance to start acting on the brain and trigger a series of responses, such as:
- Increased blood pressure;
- Increased heart rate;
- Decreased skin temperature;
- Dizziness;
- Change in respiratory rate.
Cigarette smoke contains 5315 substances. On average, 4,700 of them are harmful to health and 69 are proven to be carcinogenic.
But it doesn’t stop there, if you consider the substances present in tobacco and industrial additives, the number can reach 8622 elements present in a single cigarette.
In general, components are added to flavor, soothe mucous membrane irritation and regulate the action of nicotine.
In contact with the body, nicotine can act both as a stimulant, when the smoker is sleepy, and as a relaxant, promoting an immediate reduction of anxiety .
Cigarettes are added with several carcinogenic substances that are harmful to health, but smoking rates are still high.
Straw Cigarette
The product is produced by hand, being present in older Brazilian habits and traditions.
Although it is not added with other toxic substances, the straw cigarette does not have a filter, making the inhaled smoke more concentrated and, therefore, more harmful to health.
Tobacco leaf
The plant can be eaten through chewing as well. Despite being free of industrialized toxics, the plant leaf has high concentrations of zinc, lead and polonium, which affect health risks.
In addition, nicotine comes in direct contact with the lining of the mouth, which may accentuate the risks to the tissue and increase the rates of severe gingivitis, reduced taste and cancer of the mouth.
What is nicotine?
Nicotine is the main substance present in tobacco. Its absorption by the organism occurs regardless of the way in which the plant is consumed – it can be through smoking, chewing and even through the skin.
Chemically, the component is a basic alkaloid. When extracted or isolated, the substance has a liquid aspect and has a yellow tint, which can present concentrations between 0.6% and 3.0% of dry tobacco.
She is primarily responsible for the chemical addiction to tobacco. When inhaled or in contact with mucous membranes, nicotine quickly reaches the brain and initiates changes in the body. So it is called a psychoactive drug.
Among the changes it can promote are relaxation or mental stimulation, changes in the perception of the senses (increasing or decreasing), increased heart and respiratory rate, for example.
This is because, upon entering the brain, nicotine begins to act like acetylcholine, a natural neurotransmitter responsible for several functions throughout the body, mainly in the cardiovascular system, excretory system, respiratory system, muscular system and in the brain.
Nicotine also increases levels of dopamine, which is a neurotransmitter hormone related to feelings of pleasure and well-being. The reward system causes the brain to re-use the drug to obtain a feeling of well-being.
Many people think that the harm is only in the consumption of cigarettes, due to the dozens of toxic substances added.
However, nicotine causes reduced appetite, increased heart rate, increased blood pressure and respiratory rate, in addition to promoting the formation of clots.
So, even though the tradition of chewing tobacco leaves is old, it is dangerous and harms health.
Electronic cigarette and e-cigarettes
Electronic cigarettes have emerged as an alternative for those who want to quit smoking. Since the product does not burn tobacco and offers the body controlled doses of nicotine, its use would help to gradually reduce smoking.
However, nicotine itself is already responsible for harm to the body and is present in electronic cigarettes.
Invented in 2003 by Hon Lik, a Chinese pharmacist, the product aims to imitate ordinary cigarettes, but in a less toxic way. Thus, it would be an alternative especially for people who have behavioral dependence on cigarettes.
There are several options that include flavors, such as mint and chocolate, which, controversially, can encourage and stimulate consumption according to experts against consumption.
Studies published by the scientific journal PLoS One, in 2013, show that the substance can modify the expression of cellular genes, favoring the appearance of cancer.
Tobacco use
The American NGO Vital Strategies, in partnership with the American Cancer Society, carried out a worldwide study on tobacco consumption. The data resulted in the Tobacco Atlas, which brings information from different countries and habits of planting, consumption and marketing of the plant.
The results show that in 2016 approximately 5.7 trillion cigarettes were consumed worldwide.
However, considering the most recent figures, there has been a worldwide reduction in tobacco consumption in recent decades.
Although the absolute numbers are more favorable, countries with low HDI (Human Development Index) are showing an increase in consumption, associating smoking with precarious social conditions.
The Tobacco Atlas shows that approximately 80% of people addicted to tobacco are concentrated in 24 countries, and two thirds of them have low and medium income.
It is estimated that, worldwide, 1 in 4 men smoke and, among women, this proportion is 1 in 20.
Although education policies are quite comprehensive and access to information is even more intense in the upper social strata, almost half of women smokers live in countries with a high or very high HDI.
The data that can be indicated by the historical association of cigarettes with status and glamor.
In the last 25 years, Brazil has shown a reduction in smoking rates. Anti-smoking laws, the price of cigarettes and intervention policies help to compose a reduction of 17% of male smokers and 9% of female smokers.
Even though it is considered a country with high anti-smoking and preventive information policies, Brazil ranks as the eighth country in the ranking of numbers of smokers.
Smoking in pregnancy
The English newspaper Addiction published a survey that points out very worrying data: 87% of women do not stop smoking during pregnancy.
In addition to those who remain smoking for 9 months, about 7% stop using the drug, but return after giving birth.
The main harms occur in the baby’s exposure to nicotine, as soon as the blood circulation of mother and child is shared. The substance favors congenital malformation and respiratory and digestive complications.
Cigarettes can still result in difficulties in maintaining pregnancy and abortion.
In addition, after birth, the baby who is exposed to smoke, becoming a passive smoker, is more sensitive to infections in the airways, reduced breathing capacity and increased risks of sudden death.
The popularization of tobacco
Around 1498, with the discovery of the plant by the Europeans, tobacco began to rise worldwide. In 1542, tobacco was already spreading to Arab countries, where the rigidity was quite great (even alcohol was not allowed at the time).
Historically, tobacco was one of the first products distributed under commercial brands.
When launched in the market with logos, personalized packaging and attractive slogans, the product began to be perceived with different eyes by the population. Along with the advertisements, cigarettes became fashionable and won over customers.
It didn’t take long for advertising to see the promising tobacco market and invest in personalized packaging and slogans.
It is as if, today, the person had to choose between a white T-shirt, simple, without major differences, and another one produced and stylized by Nike. Although the two are clothes with the same purpose (dressing and person), the brand sounds more interesting to most.
This is because it is not only the fabric, the labor and the piece itself that the consumer chooses, but also the status linked to it. At the time, advertising and cinema built quite seductive, elegant and sophisticated images for tobacco, making the consumer want to buy that too.
In 1880, James Buck Duke, an American tobacco seller, took advantage of the recent invention of the cigarette making machine and dominated the market, causing the plant’s consumption to increase by 50% in the late 19th century.
After the first world war, the consumer public gained a new profile, also composed of women.
As women started to have purchasing power due to their insertion in the job market, the industry started to assign advertising to them. Around 1924, the cigarette industry saw a promising market for women.
In 1924, Phillip Morris launched Marlboro for women, a product that, according to advertisements at the time, was softer and lighter. In addition to the slogan, the launch’s advertisements were all aimed at women, aiming to attract more consumers.
In addition, notions of sensuality, glamor and seduction were strongly linked to people who smoked, making consumption continue to grow.
The manufacturer of Lucky Strike, a cigarette brand, saw the opportunity initiated by Marlboro and invested in the same way, conquering 38% of the market for women smokers.
Then came the cinema and a great chance for the cigarette industry to gain even more visibility.
At a time when cinema was still a novelty, everything the films showed had great chances of being well accepted by the public. Then the tobacco brands partnered and showed the products in the films.
The result was that the film industry became very responsible for reinforcing the elegant status that cigarettes had at the time.
To promote the sale, the cigarette manufacturers have invested large amounts in films, actresses and actors to make the scenes stamp their brands.
Old Cigarette Advertisements
Several campaigns, which today would sound quite absurd, circulated at the time. More than promoting tobacco and promoting drug use, the advertisements printed phrases that could deceive consumers about the effects of cigarettes, such as the famous case of Camel and its slogan “Doctors smoke Camel”.
In addition, packages with children, Santa Claus and even the Flintstones characters circulated encouraging and promoting the consumption of the drug.
Winston e Os Flintstones
The Winston brand was a sponsor of the design and featured scenes in which Barney and Fred smoked cigarettes. Even though, at first, The Flintstones was produced for the adult audience, the association with the drawings and animations was very attractive to children and adolescents.
Camel and the Christmas spirit
“Merry Christmas to all smokers” was just one of the advertisements distributed by cigarette brands. Several others stamped Santa Claus, Christmas dinner, gifts and get-togethers.
Philip Morris and the conquest of the youth market
Announcing that the brand is “popular with young smokers”, the advertising promises that the cigarette is “Smooth, more delicate in flavor … for those with young and appetizing tastes”.
Even the children!
Marlboro stamped packages with babies and children approving the consumption of cigarettes. The campaign released different posters featuring dialogues between mother and baby, such as:
“Our mommy, you really like your Marlboro.” And the mother replies: “Yes, you never feel that you have smoked too much. It is the miracle of Marlboro! ”.
Or, “Yes, you never feel like you’ve smoked too much … that’s the miracle of Marlboro.”
The famous Marlboro cowboys
The Marlboro brand launched the character of the smoking cowboy. Created by Leo Burnett Worldwide, the campaign is one of the most recognized and famous cigarette advertisements.
The fall of tobacco
With the realization of studies indicating the damage to health caused by tobacco, especially tobacco, which is widely marketed, health organizations began to intervene with information actions.
As there was a lot of positive publicity for the drug, without warning about the damage to health, there are several lawsuits filed against the tobacco industry, due to the physical and emotional damage that the drug has caused.
But the economic power was so great that the lawsuits went on for years or, when resolved, compensation was never received by smoking patients.
The withdrawal of advertising, the obligation of companies to report on the harmfulness and toxicity of the substance, in addition to high taxes help to reduce smoking rates.
In addition, the search for more quality of life, associated with the dissemination of information and studies on tobacco consumption, has reduced consumption or, at least, increased awareness of the harm of smoking. This is reflected in the increased desire to quit smoking.
Measures to reduce tobacco consumption have started to be implemented worldwide. In Brazil, on July 15, 1996, Law No. 9,294, in its Article 3, determined the prohibition of commercial advertising of cigarettes, cigars, pipes or products associated with smoking, derived or not from tobacco.
However, advertising at points of sale was still permitted, for example, with the placement of branded displays in the commercial environment.
The situation was changed in 2014, when any and all advertising was prohibited, in addition to the obligation to have visible information about the harm of cigarettes.
In 2011, the income of tobacco producers grew by about 33%. In 2013, growth was more moderate, but remained high, at 9%.
But in 2015 the Association of Tobacco Growers of Brazil (AFUBRA), which represents tobacco and tobacco producers, recorded a reduction of almost 20% in revenues.
Smoking
The physical and mental need for tobacco is classified as a disease, listed by ICD 10 with code F17.2 – Mental and behavioral disorders due to the use of tobacco – dependence syndrome.
Whether by chewing the leaf or smoking a cigarette, nicotine has the same effect on the brain, as it is an organic substance contained in the tobacco leaf.
When inhaled, the component reaches the lungs and diffuses through the blood vessels until it reaches the brain. If chewed, nicotine is carried by the blood.
Upon reaching the brain, the substance activates reward systems. That is, there is a manifestation of well-being and relaxation promoted by tobacco. In addition, hormones are released that reduce and inhibit pain sensations.
On average, 80% of nicotine is metabolized in 15 minutes by the liver. By reducing the perception of well-being, the body tends to activate the pleasure mechanisms again, that is, the desire to smoke returns quickly.
Dependency types
Currently, it is said that there are 3 ways to classify tobacco dependence:
Physics
The continued use of nicotine produces chemical changes in the body. The stimulus of well-being promotes addiction due to the effect of the substance.
Psychological
Well-being is caused more by the emotional effect and reduced anxiety. As smoking can also decrease aspects of agitation, the habit becomes an alternative measure to emotional control.
In addition, the association and reinforcement of the product with self-esteem , elegance and charm can impact emotional perceptions, making the person feel more confident.
Behavioral
In that case, there is a need created and reinforced habitually with the cigarette. For example, a person gets used to smoking when he consumes alcohol or coffee, developing a behavioral pattern.
Therefore, every time you drink coffee, the habit will naturally awaken the craving for cigarettes.
Effects and consequences of tobacco
It is not only the health of the patient who smokes and that of those close to him that is compromised.
In addition to the various substances harmful to health, tobacco causes economic and environmental imbalances.
Health
Respiratory, cardiovascular, hypertension, cerebral and aortic aneurysms, strokes, gastric ulcers, skin problems, thrombosis , impotence, vision problems and premature aging are just some of the problems associated with smoking.
In addition to the various direct manifestations caused by exposure and consumption of tobacco and other toxic substances, there are higher rates of early retirement and absence from work.
The habit can still affect the health of those who live with the smoker. In this case, passive smokers are at the same health risk due to smoke inhalation.
When released by the lit cigarette, the smoke has 3 times more nicotine and carbon monoxide, and up to 50 times more carcinogens. This is due to the activation of properties by heat.
The numbers are also quite alarming, since, according to the Institute of Collective Health Studies (INCA), about 2655 non-smokers, that is, passive smokers die due to smoke damage every year in Brazil alone.
The main disease related to smoking is lung cancer, with 90% of diagnoses related. In general, it is one of the first consequences attributed to tobacco consumption.
Up to 30% of deaths from other types of cancer, such as mouth, larynx, pharynx, esophagus, pancreas, liver, kidney, bladder and cervix, are related to smoking.
About 25% of vascular diseases and also 25% of cases of angina and myocardial infarction are associated with tobacco consumption.
But the list of smoking-related illnesses is huge:
- Brain aneurysm;
- Rheumatoid arthritis;
- Bronchial asthma;
- AVC (derrame cerebral);
- Cancer of the bladder, mouth, cervix, colon, esophagus, stomach, larynx, tongue, pancreas, prostate, lung and kidney;
- Macular degeneration (loss of vision);
- Premature aging;
- Fracture of the femoral neck;
- Gangrene and amputations;
- Gastritis;
- Arterial hypertension;
- Sexual impotence;
- Urinary incontinence;
- Heart attack;
- Infertility;
- Renal insufficiency;
- Leukemia;
- Early menopause;
- Optical neuropathy;
- Osteoporosis;
- Pneumonia;
- Intestinal polyps;
- Psoriasis;
- Reduced taste and smell;
- Allergic rhinitis;
- Deep vein thrombosis;
- Stomach ulcers;
- Ulcers on the skin;
Economy
The harms and damage to the organism are long term, causing a reduction in the life span of patients, the need for interventions and more frequent medical care and absence from work due to poor health conditions.
The Ministry of Health reported that the average national expenditure on expenses related to tobacco consumption is R $ 57 billion.
Of this amount, almost R $ 35 billion comes from direct medical costs, the remainder being caused by reduced productivity at work, death or disability of the smoking worker.
On average, 80% of the total value of cigarettes is the result of taxes. This gives the government an average revenue of 12.9 billion reais.
Therefore, the economic balance results negatively, bringing delays and deficiencies to the economy and social development as a whole.
Atmosphere
The environment does not come out unscathed either. Environmental organizations claim that cigarettes contain toxic substances that harm the atmosphere, in addition to filters and packaging that are thrown on the ground, manholes and rivers, favoring floods and environmental destruction.
But it is not only the incorrect disposal that must be evaluated. Studies have shown that environmental damage already begins in the cultivation and manufacture of the substance, which favors the poisoning of soils, water and pollutes the air.
The data show that up to 680 million kilograms of tobacco waste are generated annually. In large cities, adding to packaging, these remains represent up to 40% of the total garbage collected.
In plant cultivation, it is necessary to use agrochemicals and growth regulating substances, which harm and alter the soil, helping in deforestation.
Energy and water consumption is also quite high, as soon as large amounts of water and energy have to be used for tobacco production and harvesting.
Finally, the emission of smoke releases toxic and carcinogenic substances, in addition to greenhouse gases, harmful to health and the environment.
Social impact
The tobacco industry also interferes in social development, leaving women and children above all to the margins of vulnerability.
About 860 million adult smokers are concentrated in low and middle income countries. In these cases, it is estimated that the amount allocated to the purchase of tobacco can reach 10% of the economic total of the families.
Often, consumption results in educational and even food abstinence, as addiction causes spending on food or education to be cut to maintain the purchase of the drug.
With regard to tobacco cultivation, studies show that low-income families use their children’s work as a resource.
The result is that about 14% of children miss classes due to work in the fields. There is also a large participation of women in the cultivation work, reaching 70% of the tobacco harvesting tasks.
Due to the need to use highly toxic chemical compounds, the health risks are quite high.
Public policy
The government applies public policies to reduce smoking rates, as well as tobacco production. The producer who wants to change his type of plantation, exchanging tobacco for other crops, receives encouragement from the government.
According to the Secretariat of Family Agriculture and Agrarian Development, between 2009 and 2015, there was a reduction in the planting area of the plant, going from 374 thousand hectares to 308.2 thousand hectares (reduction of 17.6%).
In addition, high taxes on cigarettes aim to discourage buying. However, some recent surveys have pointed out the relationship between high taxation and smuggling and consumption of counterfeit cigarettes.
Health and awareness campaigns, such as World No Tobacco Day, also act as preventive measures, disseminating information and providing assistance to those interested in quitting smoking.
These measures are the result of health investment to promote social well-being, aiming to reduce tobacco-related illnesses and, consequently, the costs to the Unified Health System (SUS).
In addition, on 29 August it is dated as the National Day to Combat Tobacco. Another date that is intended to bring information and assistance to society.
Created in 1986 by Federal Law 7,488, the date intends to reinforce the need to combat smoking, reducing the harm to health, the environment and society and the economy.
She anti-smoking
Anti-Smoking Law No. 12,546 / 2011 prohibits smoking in places that are totally or partially closed.
This means that any environment that has one side of the wall closed, with partitions, awnings or a ceiling is included. Common areas such as marquees, condominiums and clubs are also included.
Establishments that do not comply with the rules can be warned, fined and interdicted. The amount of the punishment can reach R $ 1.5 million.
Why stop smoking?
The campaign brings impressive numbers of the effects of cigarettes in the social, family and health spheres.
On average, 428 people lose their lives a day in Brazil due to direct or indirect causes related to smoking. This number represents 12.6% of the total deaths that occur in the country.
In Brazil, more than 156 thousand deaths per year could be prevented without cigarettes. INCA also shows that smoking reduces, on average, 6.71 years of life for women and 6.12 years for men.
The harms are so great that, even giving up the cigarette, an ex-smoker has 2.45 years of life less than the average, while a man reduces 2.66 years.
Benefits of quitting smoking now
- After 20 minutes, blood pressure and pulse return to normal;
- After 2 hours, there is no more nicotine circulating in the blood;
- After 8 hours, the oxygen level in the blood returns to normal;
- After 12 to 24 hours, the lungs are already working better;
- After 2 days, the perception of smells and flavors is improved;
- After 3 weeks, breathing difficulties are eased and the blood circulates better;
- After 1 year, the risk of death from myocardial infarction is halved;
- After 10 years, the risk of suffering a heart attack will be the same as that of people who have never smoked.
The benefits extend throughout life. Routine activities are facilitated, for example, walks, runs and trips to the gym become less tiring due to improved breathing.
The skin suffers less from dryness, especially in cold periods. In addition, hair and nails look healthier.
What to do on May 31?
Stay away from situations that arouse the desire to smoke and avoid having wallets or cigarettes at home.
The first moments are always more delicate. The body misses nicotine and can start anxious processes. Therefore, keeping busy, performing pleasurable activities is the most suitable.
Practicing some physical activity can reduce tension, release endorphins and ease the urge to smoke.
Those who smoke for a long time, in general, may present habits that are associated with cigarettes. For example, smoking after drinking coffee or drinking alcohol. So, it is necessary to take care and, if possible, avoid activities that trigger behavioral dependence.
Alcoholic beverages also have a negative effect on those who are quitting smoking. This is because alcohol has a depressive effect on the nervous system and nicotine acts as a stimulant.
That is, drinking can wake up or refer more easily to cigarettes. So the ideal is to avoid activities that are linked to tobacco.
Use the date as well for information. Several measures and initiatives take place on the day, providing information and assistance to those who wish to quit smoking.
Since 2002, the Ministry of Health together with the state and municipal Health Secretariats has offered free treatment to those interested in quitting tobacco.
The patient who wants to quit smoking does not necessarily need to go through the process alone, because in addition to the various interventions, there are help groups in order to provide the exchange of experiences and mutual support between the participants.
It may also be indicated to combine antidepressant drugs, to reduce anxiety, and nicotine replenishers, when there are symptoms of withdrawal crisis. In addition, it is necessary to monitor and receive help from friends and family.
Strategies to quit smoking
Some experts suggest that stopping gradually may be a less difficult alternative for those with high levels of addiction. However, studies published in the Annals of Internal Medicine , suggest that the gradual reduction does not always yield such promising results.
Among the participants evaluated, those who stopped drastically were 25% more successful in staying away from the drug after 6 months of starting treatment.
Regardless of the adopted measure – drastic or gradual -, some changes can help in the good results:
- Keep yourself busy with pleasurable activities;
- Invest in physical activities;
- Seek assistance from specialists and professionals;
- Make family and friends aware of your decision;
- Avoid situations associated with smoking;
- Avoid consumption of other drugs, such as alcohol;
- Improve nutrition;
- Reduce stress levels.
May 31 encourages you to stay away from tobacco for 24 hours. But this is just a loophole for drug abandonment to take effect.
Smoking is offered free of charge by SUS and can promote changes in different spheres of patient life. In addition, decreasing tobacco consumption reflects several social, economic, political and environmental changes.
Join this campaign and share more health!
