2011-12-31-世界卫生组织-2012_STEPS_Country_report_Tonga_144页_3mb

Kingdom of Tonga NCD STEPS Report (2014)

1. Introduction

Tonga faces a high burden of noncommunicable diseases (NCDs) such as cardiovascular diseases, diabetes, cancer, and respiratory illnesses. The STEPS survey of 2012 assessed modifiable risk factors (tobacco use, alcohol consumption, diet, physical inactivity, overweight/obesity, hypertension, high cholesterol, and diabetes) to provide data for prevention and control strategies.

2. Key Findings by Risk Factor

Tobacco Use

• Prevalence: 26.7% adults are current smokers, with men (42.1%) nearly twice as likely as women (13.4%).
• Daily Smokers: 26.7% smoke daily; high use among youth needs attention.
• Trends: Slight decrease from 2004 (29.8%), but high rates persist.

Alcohol Consumption

• 9.3% of adults reported drinking in the past 30 days.
• Heavy drinking is concentrated among men (youngest age group: ~1 in 5 consumed 20+ drinks).
• Decline in consumption from the 2004 survey.

Fruit and Vegetable Intake

• Only 73.1% consume less than five servings per day (recommended).
• Minimal improvement over the 2004 survey.

Physical Activity

• 23.7% of adults are physically inactive (<600 MET-minutes/week).
• Slight improvement compared to 2004 (43.9% inactive), but low overall levels.

Overweight and Obesity

• Over 90% are overweight or obese (BMI ≥ 25 kg/m²).
• Obesity prevalence (BMI ≥ 30 kg/m²) is 67.6%. Rates are higher among women (77.6% vs 57.2%).
• Obesity rising with age.

Hypertension and Diabetes

• Hypertension: 27.6% (lowers with age).
• Diabetes: 34.4% prevalence. Higher in older age groups.

3. Chronic Disease Risk

• 57.1% of the population is at "High Risk" for NCDs (3–5 risk factors).
• Common risk factor combination: smoking, low fruit/vegetable intake, inactivity, and overweight.

4. Comparisons with 2004 STEPS Survey

• Positive Trends:
  • Fruit/vegetable intake ↑ (73.1% vs. 92.2% in 2004).
  • Physical activity ↓ (23.7% vs. 43.9% inactive).
• Unchanged Issues:
  • Smoking prevalence stable at ~29–30%.
  • Heavy alcohol use among men remains a challenge.
  • Overweight and obesity rates saw minor declines, but remain elevated.

5. Conclusions

NCDs are a major public health concern in Tonga. While some progress has been made (e.g., reduced inactivity), challenges remain for tobacco, alcohol, diet, and weight management. Efforts need to be sustained and expanded to prioritize whole-of-government and community-based approaches.

6. Recommendations

1. Strengthen Tobacco Control:
   • Ban smoking in public places and increase tobacco taxes.
2. Alcohol Regulation:
   • Tax increases, marketing restrictions, and youth-focused prevention.
3. Healthy Diets:
   • Promote fruit and vegetable intake, ban unhealthy foods/sugary drinks in schools.
4. Physical Activity:
   • Encourage walking/cycling, culturally appropriate programs.
5. Clinical Management:
   • Conduct cardiovascular risk assessments and manage hypertension/diabetes.
6. Surveillance:
   • Repeat STEPS surveys to track progress and inform interventions.