Towards a Global Tobacco Control Agenda: The WHO’s Framework Convention for Tobacco Control

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On May 31, 2007 tobacco control advocates and activists around the world recognized World No Tobacco Day. Through their actions, they drew attention to the fact that globally, tobacco products claim nearly 5 million lives per year and secondhand smoke has been proven to cause death and disease, and they challenged Big Tobacco’s continuing attempts to weaken national and international tobacco control measures.

Tobacco control is a global issue for several reasons. First, as Western nations implement stricter laws curbing secondhand smoke and tobacco industry practices, Big Tobacco increasingly looks to the global south – where there are often weaker tobacco control laws in place – to market its products. Second, in an era of globalized media, Big Tobacco’s marketing efforts reach beyond their country of origin and influence individuals, particularly youth, worldwide. Third, if current trends continue, by 2030 tobacco products will cause more than 10 million deaths per year with 70% of such deaths taking place in the global south. Thus, controlling tobacco has the potential to improve population health around the world. Finally, smuggling of tobacco products is an international issue and this practice is often coordinated by the tobacco industry itself.

As part of a global effort to fight Big Tobacco, 168 countries have signed the Framework Convention for Tobacco Control (FCTC) created by the World Health Organization. Of these, 147 have become Parties – members of the regulating body of the FCTC. More than 250 organizations from 90 countries have also joined the Framework Convention Alliance for Tobacco Control – an international group created to support the FCTC.

The FCTC is considered the world’s first public health treaty. The treaty is designed to address the growing crisis of tobacco-related death and disease and to reduce the health, social, environmental and economic impact of tobacco and secondhand smoke. It was adopted unanimously by the World Health Assembly (the governing body of the World Health Organization) in May 2003. In November 2004, Peru became the 40th country to ratify the treaty, thus meeting the minimum number of ratifications needed to enter the FCTC into force, an event that took place in February 2005. The FCTC is legally binding for those countries that ratify it. However, it is up to national governments to implement the agreement.

The main provisions of the FCTC require signatories to: 1) Ban the use of misleading tobacco advertising; 2) Enact and enforce comprehensive bans on tobacco marketing and sponsorship within five years of ratifying the treaty; 3) Increase tobacco taxes; 4) Require health warnings on tobacco packaging that cover a minimum of 30% of the display area but ideally cover 50% and 5) Implement comprehensive measures to protect citizens from the health hazards of secondhand smoke.

The FCTC also promotes research and the sharing of such research internationally, encourages legal action against the tobacco industry, suggests signatories support cessation services, and requires action against tobacco smuggling and for regulation and labeling of all ingredients in tobacco products. Countries that sign and ratify the FCTC are encouraged to look to these provisions as minimum measures and are encouraged to take a stronger stand against the tobacco industry practices that harm health.

The United States has been an international leader in tobacco control, particularly since the 1998 1998 Master Settlement Agreement, the provisions of which helped reduced already declining smoking rates in the United States. However, the Bush Administration has not been supportive of the FCTC. For more than a year the U.S. refused to sign the treaty and attempted to undermine it. In particular, the Bush Administration fought the provision which mandated a comprehensive ban on tobacco advertising, sponsorship and promotion, claiming that this would be unconstitutional in the United States as corporations are granted First Amendment rights to freedom of speech, which protects their right to advertise. The Bush Administration continued to fight this provision even when language was proposed that would have called for a ban of advertising “within constitutional limits.” The U.S. also fought the funding provisions within the treaty. Finally, in May 2004 the United States signed the FCTC but as of yet it has neither been ratified by Congress nor have its legislative mandates been passed . “Unfortunately,” Kathryn Mulvey of the advocacy group Infact told The Washington Post, “our government has a history of signing treaties, leveraging its power to weaken the treaties, and then never ratifying them. This is a stunning PR maneuver. We are not holding our breath for the U.S. to ratify the treaty.”

By July 2006, 131 countries representing more than 75% of the world’s population had ratified the FCTC. Thus, as other countries sign, ratify and implements its mandates, the United States is falling behind.

From June 30 to July 6, 2007, the Framework Convention for Tobacco Control’s “Conference of the Parties”, a group of countries that lead the effort to monitor implementation, will meet in Bangkok, Thailand. Their agenda is to develop guidelines to:

  • provide protection from exposure to tobacco smoke in indoor workplaces, public transport, indoor public places and, as appropriate, other public places.
  • eliminate of illicit trade in tobacco products.
  • move towards a comprehensive ban on tobacco advertising, promotion and sponsorship, covering both its within-country and cross-border elements.
  • establish standards for packaging and labeling of tobacco products.

The Framework Convention and its nongovernmental partners have the potential to match the global tobacco industry in advancing an international agenda on tobacco, an agenda that protects rather than harms health. Whether the decisions made in Bangkok can realize this potential remains to be seen.