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Tobacco control measures are working, but too slowly in less-developed countries: WHO

A man smokes a cigarette at a road side rest stop in rural Nepal.
World Bank/Aisha Faquir
A man smokes a cigarette at a road side rest stop in rural Nepal.

Tobacco control measures are working, but too slowly in less-developed countries: WHO

Health

“Great progress” has been made in tackling tobacco consumption and saving lives but more needs to be done to challenge the industry’s attempts to “bypass” international regulations, the World Health Organization (WHO) said on Monday.

At an international meeting on tobacco control in Geneva, the WHO reported that that nearly two-thirds of the 181 States parties to the WHO Framework Convention for Tobacco Control (WHO FCTC) have developed strategies “to prevent tobacco industry interference with tobacco control policies”. 

As a result of the treaty, countries have increased taxes on tobacco, established smoke-free spaces and made it obligatory for manufacturers to show graphic health warnings on their products, as well as using plain packaging.

Despite these advances, “this is not a time to be complacent,” said Dr Vera Luiza da Costa e Silva, head of the WHO FCTC Secretariat. “With astronomical budgets, the tobacco industry continues its furious efforts to undermine the implementation of our treaty.”

Smoking is a development problem because it hits the most vulnerable and strains already overstretched health systems, feeding a vicious cycle of poverty and inequality. -                          Michael Møller, UN Geneva Director-General

According to the WHO 2018 Global Progress Report, 85 per cent of the States parties have prohibited sales of tobacco products to minors and a growing number of countries have increased the minimum age to purchase tobacco products.

Health warnings on tobacco packs are also required in almost 90 per cent of States parties and at least 14 countries “are implementing or planning to implement” plain or standardized packaging.

In addition, tobacco-dependence diagnosis and treatment services are included in national tobacco control programmes in more than two-thirds of the Parties; significant progress, compared to just one half in 2016.

But there is still room for improvement, the report notes, particularly in banning self-service shelves for cigarettes, and vending machines, while also highlighting the emergence of new and novel tobacco products.

The WHO report - a publication based on national submissions to the Convention Secretariat – also indicates that implementation of tobacco control measures has consistently improved since the accord entered into force in 2005.

Nonetheless, progress towards implementation of the various articles remains uneven, with rates as low as 13 per cent in some countries, and as high as 88 per cent in others, the data shows.

To illustrate the scale of the challenge still facing States parties to the Convention, the head of the UN in Geneva, Michael Møller highlighted the fact that there are 1.1 billion smokers today; 80 per cent of whom, live in low- to middle-income countries.

The burden this creates is immense, in terms of health costs caused by tobacco-related sickness, the UN Geneva Director-General said, before calling for the need to link tobacco control measures with sustainable development strategies.

“Smoking is a development problem because it hits the most vulnerable and strains already overstretched health systems, feeding a vicious cycle of poverty and inequality,” Mr Møller said.

“Reaching the 2030 Agenda and lessening the burden of non-communicable diseases requires early, widespread action at every level.”

Also speaking at the Eighth Session of the WHO FCTC Conference of Parties in Geneva on Monday, UN health agency chief, Tedros Adhanom Ghebreyesus, hailed the tobacco control convention as “one of the greatest public health achievements of the past 20 years”.

Several countries including Kenya and Uganda have passed comprehensive tobacco control laws in recent years, he said, while Gabon and Gambia have increased tobacco taxes.

Elsewhere, India, Nepal, Sri Lanka and Thailand have introduced large graphic health warnings, the WHO Director-General continued, before highlighting that many countries have banned smoking in public places, from Afghanistan, to Cambodia and El Salvador.

Several cities in China have implemented smoke-free laws, Mr. Tedros said, adding: “We have made great progress. We have saved lives.”

In line with previous trends, the most successfully implemented tobacco control policies have been in protection from exposure to tobacco smoke (Article 8), Packaging and labelling of tobacco products (Article 11), public awareness (Article 12) and sales to and by minors (Article 16).

Implementation has been less successful on protecting the environment and the people’s health (Article 18), Liability (Article 19) and support for economically viable alternative activities (Article 17).

On the issue of increased tobacco taxation or over-the-counter price increases, the report also notes that significant advances have been observed among States parties, with more than 90 per cent now implementing the initiative.

The same percentage have also banned smoking in public all places, the report says, noting that “a considerable number” have also shared their experience with other States on extending smoking bans to outdoor environments, and on amending existing smoke-free legislation to incorporate new tobacco products.