An international group of health and policy experts writing in The Lancet has called for the United Nations to lead a “turbo-charged” effort toward a world essentially free from tobacco products.
The article is part of a new series in The Lancet and will be launched at the 2015 World Conference on Tobacco or Health in Abu Dhabi, United Arab Emirates. The conference is the world’s largest gathering of public health experts and tobacco control advocates.
“The time has come for the world to acknowledge the unacceptability of the damage being done by the tobacco industry and work towards a world essentially free from the legal and illegal sale of tobacco products,” states Prof. Robert Beaglehole, one of the series’ lead authors from the University of Auckland in New Zealand.
“A world where tobacco is out of sight, out of mind, and out of fashion – yet not prohibited – is achievable in less than 3 decades from now, but only with full commitment from governments, international agencies, such as UN [United Nations] and WHO [World Health Organization], and civil society.”
It has been 10 years now since the WHO introduced the Framework Convention on Tobacco Control (FCTC) – an international treaty designed “in response to the globalization of the tobacco epidemic,” with the aim of reducing tobacco use.
Success has been mixed. During the past decade, an estimated 50 million deaths have been caused by tobacco, suggesting that the FCTC is not enough to achieve the desired reductions in tobacco use.
According to the authors, only 15% of the world’s population have access to smoking cessation programs, and less than 1 in 10 people are covered by FCTC-recommended tobacco tax levels. This comes despite evidence demonstrating that increasing the cost of tobacco through taxation is one of the best ways to reduce the use of tobacco.
An accompanying research article also suggests that although overall rates of smoking are declining worldwide, in some countries, tobacco usage is expected to increase over the next decade. When combined with the fact that the global population is increasing, as things stand, the authors predict there could be over 1 billion smokers by 2025.
The authors of the series believe that global tobacco regulation needs to be “turbo-charged.” Their suggestion entails accelerating the FCTC in certain countries where implementation has so far proven slow or incomplete, and for the UN to take a major role in instigating global action toward eliminating the sale and use of tobacco.
Until now, the authors argue, FCTC regulations have focused on reducing demand for tobacco rather than targeting the very supply of tobacco – dominated by four major international corporations and the state-owned Chinese National Tobacco Company.
Due to falling rates of tobacco consumption in high-income countries, tobacco companies have turned their attention to low- and middle-income countries, particularly in Africa and Asia where rates of tobacco usage are now increasing.
The authors report that the “big four” tobacco companies utilize a range of tactics to promote their products, including lobbying, covertly maintaining political pressure and through publicity events aimed at women or young people. “Contrary to industry claims, tobacco marketing deliberately targets women and young people,” says series author Prof. Anna Gilmore.
“The tobacco industry continues to interfere with governments’ efforts to implement effective tobacco control policies. If the world is to become tobacco free, it’s vital that the industry’s appalling conduct receives far closer scrutiny and countries which stand up to the industry’s bullying tactics receive better global support,” she adds.
Regulation in China is more complicated, given that tobacco production is controlled by the state-owned Chinese National Tobacco Company. Effective tobacco regulations are impaired by the fact that production, sales and regulation are, in effect, all controlled by the same body.
“China has the potential to be successful in tackling the pandemic of tobacco use among Chinese people,” states Prof. Gonghuan Yang, from the Peking Union Medical College in Beijing, China, “but only if the governmental structure is changed to allow tobacco regulations to be implemented independently from the tobacco industry.”
Currently, China is believed to have 300 million smokers. This prevalence is reported to be rising, and in 2010, 1-4 million deaths were attributed to tobacco use.
The series suggests that, if tobacco usage is to be reduced to levels that the WHO are happy with, greater levels of intervention will be required. Appealing to the UN, world governments and other international agencies could be a necessary step if the goal of a tobacco-free world is ever to be achieved.
Recently, Medical News Today reported on a study suggesting that the introduction of new regulations that could modify cigarettes is unlikely to significantly affect the present demand for illicit tobacco.