What We Need Is A Better Implementation Of The Global Tobacco Treaty

This year's World No Tobacco Day on 31 May 2011 highlights the importance of efforts to implement the Framework Convention on Tobacco Control (FCTC) initiated by the World Health Organization. FCTC is the world's first international public health treaty, which aims for a tobacco free healthy global society. "173 countries are now Parties to the FCTC, and that is a major achievement for public health that was almost unimaginable a decade ago", says Dr Nils E Billo, Executive Director of International Union Against Tuberculosis and Lung Disease (The Union).

"Implementation is the next big hurdle, though, and each country must cross it if we are truly committed to preventing the millions of deaths caused by tobacco-related diseases each year."

The urgency of this campaign against tobacco is compounded by the fact that tobacco is a risk factor for a host of non-communicable diseases (NCDs), including heart attacks and strokes, cancer and chronic respiratory diseases.  It jeopardizes the health of millions, and also places an unnecessary economic burden on the affected families, most of who live in low- and middle-income countries.

The Union has been in the fore front to provide technical assistance, training and other support to more than 30 of the world's heaviest tobacco-using countries, to help them fulfill their commitments under the World Health Organization - Framework Convention on Tobacco Control (WHO-FCTC).

It supports countries with the highest smoking rates, such as China, to meet the obligations laid down by the treaty, which range from passing smoke free legislation and raising tobacco taxes to warning people about the dangers of second-hand smoke. Funded by the Bloomberg Initiative to Reduce Tobacco Use, The Union and the Campaign for Tobacco-Free Kids (CTFK) have provided approximately US $77 million in support for 349 tobacco control projects in over 52 countries since 2006, with a view to tackle tobacco control and put the issue on the public health agenda in their respective countries. 

"We focus on the countries where tobacco use is highest, and they each face different obstacles", says Ehsan Latif, Director of The Union's Department of Tobacco Control. "For some, it might be a cultural tradition of using tobacco; for others, it might be an economic dependence on tobacco growing. Consequently, every obstacle overcome is to be celebrated, no matter how big or small."

All these efforts have borne some results, though a lot needs to be done still to wipe out the menace of tobacco completely from the face of the earth. Increasingly, the message about the harmful effect of tobacco on people's health - and on countries' overall economies - is being heard.

Several countries, such as Nepal, have passed legislation calling for 100% smoke free environments, and banned the sale of tobacco products to children under the age of 18.

Some of the world's largest cities like Buenos Aires, Argentina, Alexandria and Port Said in Egypt have gone smoke free. In Indonesia, seven cities are implementing 100% local smoke free regulations, setting a trend that is slowly spreading across the country.

In China, (which signed the FCTC in 2006), there have been major improvements during the last one year. Asian Games and the Shanghai Expo went smoke free. Guangzhou, a city of 12 million, has now implemented one of the strictest tobacco control laws in mainland China.  Recently, the Chinese Government has banned smoking in 28 different types of public spaces. 41 hospitals across China are now smoke- free and many of their staff has quit smoking.

Raising the taxes on tobacco products - and thereby raising the retail price - is one of the most effective ways of reducing consumption. Mexico and Egypt have also raised taxes to encourage smokers to quit and discourage newcomers from starting.

Last year, Russia's Prime Minister signed the National Concept on Tobacco Control, which calls for tax increases; 100% smoke free public places; a total ban on advertising, promotion and sponsorship; and graphic health warnings on tobacco packages. In Krasnoyarsk, many hospitals are also going smoke free.

In India, a Health Worker Guide was developed and widely disseminated in several languages to assist health workers in warning patients about the effects of tobacco use on their health and to help them quit.

Graphic health warnings have also proved an effective way to impress people with the need to quit or not start using tobacco. In Pakistan, pictorial health warnings now cover 40% of the back and front of tobacco packages.  As part of Nepal's new tobacco control legislation, 75% of tobacco products will be covered with a pictorial health warning. India, too has revised its current mild graphic warnings to scarier ones, with effect from December 2011.

With its scientific departments focusing on tuberculosis and HIV, lung health and non-communicable diseases, tobacco control and research, the Union is committed to support a healthier, smoke free, future for the world

"Each step forward is important", says Dr Billo, "and it's also important that World No Tobacco Day highlight the necessity of implementing the FCTC. Without strong tobacco control, WHO predicts the number of deaths per year will rise from 5 to 8 million by 2030. That is not a long way off."