A Comment published online Friday June 29 assesses the impact of 10 years of Tony Blair's Labour Government in the UK concerning public-health measures to reduce the harmful effects of tobacco, just two days before a ban on smoking in public places is introduced in England. This week's lead Editorial also discusses tobacco control, with reference to the 2005 WHO Framework Convention on Tobacco Control (FCTC).

John Britton, co-author of the Comment, states: "Labour has achieved more in terms of tobacco control than any other UK government, establishing the UK as a world leader in this respect, and deserves credit for doing so. However, it has taken 10 years to deliver results that could have been achieved in 5 or even 3, indicating that Blair's government has lacked either the courage or the commitment to implement its policies. Smoking was the biggest avoidable public-health problem when Labour came to power in 1964, it still was in 1997, and it still is now. Smoking is the leading cause of health inequalities, and rates of smoking in the most deprived groups in society have changed little over recent decades. There is a great deal more that could and should be done to reduce the harm caused by smoking, but implementation of the necessary new strategies and sustaining existing policies requires strong leadership. Similar resolve will be needed to address some of the other major public-health challenges the government now faces, particularly obesity and rising consumption of alcohol, both of which also involve dealing with powerful and influential industries."

The Comment concludes: "Blair promised much for tobacco control but required considerable pressure before he delivered. Let us hope that Gordon Brown, the new Labour Prime Minister, is able to act on the radical advice on long term planning and promotion of public health he commissioned in 2004, and responds to the nation's major public health problems with timely and powerful solutions."

The Editorial says: "The FCTC undoubtedly represents a milestone for the promotion of public health worldwide. But there is a long way to go to achieve full implementation of the treaty and to reduce the prevalence of smoking. One in four adults currently smokes. As Thomas Frieden, New York City's Health Commissioner, and Michael Bloomberg, Mayor of New York City, point out, "if global adult smoking prevalence declines to 20% by 2020, at least 100 million fewer people currently alive will be killed prematurely by tobacco".

The Editorial concludes: "The Bloomberg initiative helps to translate the principles of the FCTC into action, with particular focus on the 15 countries where two-thirds of the world's smokers live (which include China, India, Indonesia, and Russia). But as the sorry delays in the UK illustrate, signing up to the FCTC was the easy bit. Implementation of all effective tobacco control policies requires sustained unwavering governmental commitment. The short-term political costs may seem substantial, but the potential health gains are huge."

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