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FCTC cut smoking 2.5 per cent over 10 years; study

A decade of tobacco control efforts by the Framework Convention on Tobacco Control (FCTC) has reduced the global smoking rate by 2.5 per cent, according to an evaluation by the International Tobacco Control Policy Evaluation Project.

http://www.tobaccojournal.com/FCTC_cut_smoking_2_5_per_cent_over_10_years_study.54157.0.html

Although the international treaty, an adjunct of the World Health Organisation, has made substantial progress in combatting use of tobacco products, implementation of FCTC measures has fallen short of its objectives, according to the study. “While the progress of WHO Framework Convention on Tobacco Control has been remarkable, there are still far too many countries where domestication of the treaty and its implementation has fallen short,” said Dr Geoffrey Fong, a study author from the University of Waterloo, Canada. “One important cause of this is the tobacco industry’s influence, particularly in low- and middle-income countries.”

Conducted with assistance from WHO, the study analysed data from 126 countries and determined the smoking rate in those countries declined on average from 24.7 per cent in 2005 to 22 per cent in 2015. FCTC obligates 180 signatory countries to raise tax on tobacco products, create smoke-free public spaces, implement warning labels on packaging, ban advertising and support stop-smoking services.

WHO Letter to HK Government on Tobacco Control Efforts

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Addressing the tobacco industry vector

The tobacco industry’s escalating attacks on public health are replicated across the world, as is the harm caused by its products.

http://www.jpost.com/Opinion/Addressing-the-tobacco-industry-vector-482330

‘THE TOBACCO industry attempts to impede tobacco regulation have changed over the years, but have not abated – they have instead mutated, and on a global scale.’

I was privileged recently to deliver the keynote address to the annual meeting of the Israel Society for Smoking Cessation and Prevention. The title was “Advocacy efforts in countering tobacco industry tactics.”

In the address I quoted Dr. Margaret Chan, director- general of the World Health Organization, who in 2008 said, “I want to remind governments in every country of the range and force of counter-tactics used by the tobacco industry – an industry that has much money and no qualms about using it in the most devious ways imaginable.”

Just as the primary vector for malaria is the mosquito, the primary vector for the tobacco epidemic is the tobacco industry. The industry attempts to impede tobacco regulation have changed over the years, but have not abated – they have instead mutated, and on a global scale.

When the WHO’s first and only internationally binding treaty – the Framework Convention on Tobacco Control (WHO FCTC) – entered into force (Israel became a signatory in 2005), there was a dramatic increase in the number of countries implementing tobacco control policies. The industry determined to adapt to the new situation.

According to WHO, the tobacco industry has continued to use advertising, promotion and sponsorship to undermine tobacco control efforts. In addition, it has sought to interfere with tobacco control on a global scale using a variety of tactics. For example, it lobbies and funds politicians and political parties to hijack the political and legislative process. It exaggerates the economic importance of the industry, while remaining silent on the massive health and economic costs of tobacco use. It manipulates public opinion to gain the appearance of respectability, often under the guise of corporate social responsibility, while irresponsibly playing down or denying the real harms its products.

It fabricates support by developing and resourcing front groups who advocate on the industry’s behalf. It continues to attempt to discredit proven scientific and economic evidence – often erroneously claiming that evidence from one country isn’t applicable in another.

And, increasingly, it intimidates governments with litigation or the threat of litigation, or trade threats.

Tobacco companies have recently launched a spate of international legal challenges to oppose the implementation of legitimate and robust tobacco control measures. Bilateral investment treaties have been used as the premise for international commercial arbitration challenges against Uruguay and Australia. This typifies the tobacco industry’s response to countries exercising their regulatory autonomy in the tobacco space: one of untenable intimidation.

This intimidation of governments is important because only governments can ratify and implement UN treaties, such as the WHO FCTC, mandate public health legislation and implement taxation policies that increase the price and reduce the affordability of tobacco products – the single most effective way of reducing tobacco use.

Legal and trade challenges typically have a delaying effect upon the country concerned – the implementation of tobacco control measures is paused until the case is resolved, they are expensive for governments (typically costing millions of US dollars) and have a regulatory chill effect on other countries that might be contemplating similar measures. However, these challenges have been repeatedly dismissed by high courts, constitutional courts and courts of justice in jurisdictions including Australia, the UK, Kenya, France, the European Union, South Africa, Thailand and Uruguay.

In addition, more and more countries are dismissing tobacco industry opposition, and introducing plain packaging. Responding to the industry’s increased use of trade law, Bloomberg Philanthropies and the Gates Foundation announced an $ 4 million fund to support countries against such threats – but we need to adopt other strategies too.

For example, research is often directed toward establishing the rates of smoking prevalence, health and mortality, and the economic impact of tobacco. This research is invaluable, but more effort also should be directed at tracking tobacco industry behavior so we can more efficiently monitor and resist the tobacco industry vector. Many advocates do not even know whether the tobacco industry donates to front groups or politicians in their country; whether the International Tax and Investment Center (funded by the tobacco industry) has visited their Finance Ministry with the mantra of not raising tobacco taxes; or whether the industry has met with government (and under WHO FCTC Article 5.3, the tobacco industry should have no part in formulating tobacco control policy).

This is perhaps why recent allegations regarding tobacco industry bribes to the Israeli government came as such a shock.

The tobacco industry’s escalating attacks on public health are replicated across the world, as is the harm caused by its products. The global tobacco epidemic, which will kill six million people this year, cannot be addressed unless we are equipped to counter all the industry’s tactics and all governments – including Israel’s – stand firm in stopping the tobacco industry from influencing health policy development and implementation.

The current prevalence of smoking in Israel is about 20%. Israel’s next step could be, as many countries have already done, to announce a target of 5% prevalence rate by 2028, and work annually to achieve this target. This is an ambitious target, but challenging rather than impossible.

Jamaica to evaluate WHO’s call for heavy taxation on tobacco industry

Health Minister, Dr Christopher Tufton says he along with stakeholders will be evaluating the call by the World Health Organisation (WHO) for heavy taxation on the tobacco industry.

http://jamaica-gleaner.com/article/news/20170124/jamaica-evaluate-whos-call-heavy-taxation-tobacco-industry

Addressing the WHO’s Executive Board in Geneva, Switzerland, yesterday Director-General, Dr Margaret Chan, said heavy taxation is one way of controlling tobacco use.

According to Tufton, Jamaica, which is a member of the WHO board, shares the concerns about the financial costs to treat tobacco-related illnesses and the associated cost to public health, globally and nationally.

He says any measure to discourage smoking and support public health is worth considering.

In a landmark report on the economics of tobacco and tobacco control, the WHO and the US National Cancer Institute concluded that smoking costs the global economy more than $1 trillion yearly.

The researchers also said smoking will soon kill more than six million people worldwide each year.

They show how tobacco control, through heavy taxation can save lives while generating revenues for health and development.

Global tobacco control

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Smoking kills, so stop protecting it

http://www.nst.com.my/news/2017/01/204184/smoking-kills-so-stop-protecting-it

JAMES Bond isn’t the only one with a licence to kill. The World Health Organisation reports that smoking costs the global economy RM4.5 trillion a year, and will take eight million lives annually by 2030.

For a species that has invented fire, travelled to space and split the atom, we are still paying an industry to kill us. Mankind is indeed strange.

Decades of research have shown that smoking can be fatal. So, we are often asked: if cigarettes cause such harm, why are they allowed to exist?

One challenge is the separation of the problem — the health industry sees tobacco as a health issue, while businesses and governments see it as an economic driver.

But the same WHO report also states that the cost of smoking far outweighs the revenue from tobacco taxes.

Treating smoking-related diseases drives up the cost of healthcare. In 2005, Malaysia’s Health Ministry spent 26 per cent of its budget to treat those diseases, which accounted for 0.74 per cent of its gross domestic product.

There are also the environment, productivity and human development — smoking pollutes our air and water, and smokers are 30 per cent more likely to miss work (for longer periods, too). In some families, money for cigarettes is taken from household essentials.

No other industry causes as much damage to its users and non-users alike — and remains legal.

Instead of protecting this industry, we urge the nation to support tobacco control efforts in Malaysia.

Tobacco control can work. A study published in the United States this month reports that efforts since 1964 had resulted in eight million fewer smoking deaths.

We should want the same for our fellow Malaysians.

MANDY THOO

National Cancer Society Malaysia

Tobacco control measures found to be cost-effective, says WHO report

A report (link is external) from the National Cancer Institute in the US and the World Health Organisation has found that tobacco control measures are highly cost-effective, but under-used in some countries.

http://www.cancerresearchuk.org/about-us/cancer-news/news-report/2017-01-13-tobacco-control-measures-found-to-be-cost-effective-says-who-report

The report also states that tobacco control doesn’t harm economies, and reduces the impact smoking has on poorer communities.

“Smoking is the single most preventable cause of death in the world” – George Butterworth, Cancer Research UK

Tobacco control measures include tax increases, bans on advertising, including health warnings on packages, policies to restrict where people can smoke and programmes to help them quit.

“This valuable report highlights the substantial financial cost of tobacco,” said George Butterworth, tobacco policy manager at Cancer Research UK. “It’s good to see that the most cost effective measures – tobacco tax and price increases – are being called for as part of comprehensive tobacco control strategies.”

Smoking accounts for 1 in 4 UK cancer deaths and nearly 1 in 5 of all cancer cases.

“The human cost of the tobacco industry is enormous,” said Butterworth. “Smoking is the single most preventable cause of death in the world, killing almost 6 million people worldwide and 100,000 people in the UK each year.”

The report states that, while effective measures to reduce smoking rates are available, they don’t yet cover the vast majority of the world’s population. And where taxes are used, the money is rarely invested in health programmes.

The report also finds that people in poorer communities stand to benefit most from tobacco control measures, due to the proportion of income spent on tobacco and negative health effects it causes in these areas.

In the UK, a ban on smoking in public places as well as tobacco advertising restrictions, including picture warnings of health issues and standardised packaging, are all in place.

“Cancer Research UK’s ambition to see a Tobacco-Free country by 2035, where less than 5 per cent of adults smoke, is in line with the UK’s commitment to the World Health Organization’s Framework Convention on Tobacco Control,” Butterworth added.

But Stop Smoking Services across England are facing ongoing budget cuts after 6 in 10 local authorities were forced to reduce their funding in the last year.

Illegal trade, and the fact that 5 tobacco companies account for 85% of the global cigarette market, were both highlighted by the report as challenges for future control efforts.

The report also warns against relaxing the progress made across the world in controlling tobacco, and calls for continued research and use of evidence-based policies.

Dr Robert Croyle, Director of the National Cancer Institute’s Division of Cancer Control and Population Sciences, said: “The global scale of suffering, death, and disease from tobacco use is staggering. Millions of early deaths can be prevented if nations adopt evidence-based tobacco control policies.”

Smoking costs global economy over US$1 trillion a year: study

http://www.ejinsight.com/20170110-smoking-costs-global-economy-over-us1-trln-a-year-says-new-study/

Smoking costs the global economy more than US$1 trillion a year, and will kill one third more people by 2030 than it does now, according to a new report released on Tuesday.

The World Health Organization and the US National Cancer Institute said in a study that the costs from smoking far outweigh global revenues from tobacco taxes, Reuters reports.

“The number of tobacco-related deaths is projected to increase from about 6 million deaths annually to about 8 million annually by 2030, with more than 80 percent of these occurring in LMICs (low- and middle-income countries),” the study said.

Around 80 percent of smokers live in such countries, and although smoking prevalence was falling among the global population, the total number of smokers worldwide is rising, it said.

Health experts say tobacco use is the single biggest preventable cause of death globally.

“It is responsible for… likely over $1 trillion in health care costs and lost productivity each year,” said the study, peer-reviewed by more than 70 scientific experts.

The economic costs are expected to continue to rise. Although governments have the tools to reduce tobacco use and associated deaths, most have fallen far short of using those tools effectively, WHO said in the report.

“Government fears that tobacco control will have an adverse economic impact are not justified by the evidence. The science is clear; the time for action is now.”

Cheap and effective policies include hiking tobacco taxes and prices, comprehensive smoke-free policies, complete bans on tobacco company marketing, and prominent pictorial warning labels.

Tobacco taxes could also be used to fund more expensive interventions such as anti-tobacco mass media campaigns and support for cessation services and treatments, it said.

Governments spent less than US$1 billion on tobacco control in 2013-2014, according to a WHO estimate.

– Contact us at english@hkej.com

Tobacco control can save billions of dollars and millions of lives

http://www.who.int/mediacentre/news/releases/2017/tobacco-control-lives/en/

Policies to control tobacco use, including tobacco tax and price increases, can generate significant government revenues for health and development work, according to a new landmark global report from WHO and the National Cancer Institute of the United States of America. Such measures can also greatly reduce tobacco use and protect people’s health from the world’s leading killers, such as cancers and heart disease.

But left unchecked, the tobacco industry and the deadly impact of its products cost the world’s economies more than US$ 1 trillion annually in healthcare expenditures and lost productivity, according to findings published in The economics of tobacco and tobacco control. Currently, around 6 million people die annually as a result of tobacco use, with most living in developing countries.

The almost 700-page monograph examines existing evidence on two broad areas:

• The economics of tobacco control, including tobacco use and growing, manufacturing and trade, taxes and prices, control policies and other interventions to reduce tobacco use and its consequences; and
• The economic implications of global tobacco control efforts.

“The economic impact of tobacco on countries, and the general public, is huge, as this new report shows,” says Dr Oleg Chestnov, WHO’s Assistant Director-General for Noncommunicable Diseases (NCDs) and mental health. “The tobacco industry produces and markets products that kill millions of people prematurely, rob households of finances that could have been used for food and education, and impose immense healthcare costs on families, communities and countries.”

Globally, there are 1.1 billion tobacco smokers aged 15 or older, with around 80% living in low- and middle-income countries. Approximately 226 million smokers live in poverty.

The monograph, citing a 2016 study, states that annual excise revenues from cigarettes globally could increase by 47%, or US$ 140 billion, if all countries raised excise taxes by about US$ 0.80 per pack. Additionally, this tax increase would raise cigarette retail prices on average by 42%, leading to a 9% decline in smoking rates and up to 66 million fewer adult smokers.

“The research summarized in this monograph confirms that evidence-based tobacco control interventions make sense from an economic as well as a public health standpoint,” says the monograph’s co-editor, Distinguished Professor Frank Chaloupka, of the Department of Economics at the University of Illinois at Chicago.

The monograph’s major conclusions include:

• The global health and economic burden of tobacco use is enormous and is increasingly borne by low- and middle-income countries (LMICs). Around 80% of the world’s smokers live in LMICs.

• Effective policy and programmatic interventions exist to reduce demand for tobacco products and the death, disease, and economic costs resulting from their use, but these interventions are underused. The WHO Framework Convention on Tobacco Control (WHO FCTC) provides an evidence-based framework for government action to reduce tobacco use.

• Demand reduction policies and programmes for tobacco products are highly cost-effective. Such interventions include significant tobacco tax and price increases; bans on tobacco industry marketing activities; prominent pictorial health warning labels; smoke-free policies and population-wide tobacco cessation programmes to help people stop smoking. In 2013-2014, global tobacco excise taxes generated nearly US$ 269 billion in government revenues. Of this, less than US$ 1 billion was invested in tobacco control.

• Control of illicit trade in tobacco products is the key supply-side policy to reduce tobacco use and its health and economic consequences. In many countries, high levels of corruption, lack of commitment to addressing illicit trade, and ineffective customs and tax administration, have an equal or greater role in driving tax evasion than do product tax and pricing. The WHO FCTC Protocol to Eliminate Illicit Trade in Tobacco Products applies tools, like an international tracking and tracing system, to secure the tobacco supply chain. Experience from many countries shows illicit trade can be successfully addressed, even when tobacco taxes and prices are raised, resulting in increased tax revenues and reduced tobacco use.

• Tobacco control does not harm economies: The number of jobs dependent on tobacco has been falling in most countries, largely due to technological innovation and privatization of once state-owned manufacturing. Tobacco control measures will, therefore, have a modest impact on related employment, and not cause net job losses in the vast majority of countries. Programmes substituting tobacco for other crops offer growers alternative farming options.

• Tobacco control reduces the disproportionate health and economic burden that tobacco use imposes on the poor. Tobacco use is increasingly concentrated among the poor and other vulnerable groups.

• Progress is being made in controlling the global tobacco epidemic, but concerted efforts are needed to ensure progress is maintained or accelerated. In most regions, tobacco use prevalence is stagnant or falling. But increasing tobacco use in some regions, and the potential for increase in others, threatens to undermine global progress in tobacco control.

• The market power of tobacco companies has increased in recent years, creating new challenges for tobacco control efforts. As of 2014, 5 tobacco companies accounted for 85% of the global cigarette market. Policies aimed at limiting the market power of tobacco companies are largely untested but hold promise for reducing tobacco use.

Dr Douglas Bettcher, WHO Director for the Prevention of NCDs, says the new report gives governments a powerful tool to combat tobacco industry claims that controls on tobacco products adversely impact economies. “This report shows how lives can be saved and economies can prosper when governments implement cost-effective, proven measures, like significantly increasing taxes and prices on tobacco products, and banning tobacco marketing and smoking in public,” he adds.

Tobacco control is a key component of WHO’s global response to the epidemic of NCDs, primarily cardiovascular disease, cancers, chronic obstructed pulmonary disease and diabetes. NCDs account for the deaths of around 16 million people prematurely (before their 70th birthdays) every year. Reducing tobacco use plays a major role in global efforts to achieve the Sustainable Development Goal of reducing premature deaths from NCDs by one-third by 2030.

Working Together Around The World To Kick The Big Tobacco Habit

http://healthaffairs.org/blog/2017/01/05/working-together-around-the-world-to-kick-the-big-tobacco-habit/

Ten years ago, the world was a different place when it came to tobacco. Fewer than twenty developing countries in the world had even one strong tobacco control policy in place. The tobacco industry was beginning an aggressive ramping up of nefarious activities to grow their market share in vulnerable developing countries. And although advocates for tobacco control measures had a major public health victory in passing the Framework Convention on Tobacco Control, the world’s first public health treaty, little financial or technical help was available to support countries that wanted to put life-saving, proven tobacco control policies in place.

Early in 2007, the tobacco control landscape was changed dramatically when Michael R. Bloomberg, then in his second term as mayor of the City of New York, donated $125 million through his foundation, Bloomberg Philanthropies, for a two-year commitment to reducing global tobacco use. Now ten years and a total of $600 million later, Bloomberg recently committed another $360 million over six years to this life-saving work, bringing his total financial commitment to nearly $1 billion.

In the ten years since Bloomberg’s first commitment, Bloomberg Philanthropies has been pleased to partner with more than 110 countries and five international partner organizations to tirelessly fight to end the global tobacco epidemic. The decade-long fight has shown that progress is indeed possible. In that time, nearly 100 countries worldwide with a total of more than four billion people have passed at least one strong tobacco control law—and fifty-nine of these countries with nearly 3.5 billion people have received Bloomberg support.

Urgent Need

The need for these tobacco control policies is urgent: tobacco is among the leading public health scourges. Noncommunicable diseases (NCDs) are persistent killers, representing 80 percent of deaths in middle- and lower-income countries. Tobacco contributes to six of the ten leading causes of death globally, including heart attack; stroke; chronic lower respiratory disease; lower respiratory infections; lung, bronchial, and throat cancers; and diabetes.

NCDs are preventable, but together they receive a mere 1 percent of global health funding. As the WHO works to achieve the United Nations’ goal of reducing premature NCD deaths by one-third, Big Tobacco spends heavily to fight against effective regulation of its products.

Here’s one way tobacco companies do it: litigation. In 2010, Philip Morris International filed a challenge to prevent Uruguay from enforcing its tobacco laws—which mandate large, graphic health warning labels on cigarette packs and restrict what is known as “brand usage to a single presentation.” In other words, this means no longer allowing tobacco companies to market a cigarette with various representations such a “light,” “red,” “blue,” and so forth. On July 8, 2016, after a six-year lawsuit, the International Centre for the Settlement of Investment Disputes, a World Bank arbitration panel, determined that Philip Morris’s suit had no merit. Uruguay’s laws were designed according to evidence demonstrating that strong warning labels spur smokers to quit, and they stop nonsmokers—especially youth—from starting. In 2014 youth smoking in Uruguay was at 8 percent, down from 23 percent in 2006, according to the Uruguay Ministry of Public Health.

Uruguay won, as did the rest of the world. Many groups rallied around Uruguay in its fight, including the Campaign for Tobacco-Free Kids, the CDC Foundation, Johns Hopkins Bloomberg School of Public Health, the International Union Against Tuberculosis and Lung Disease, the WHO, Vital Strategies, and others.

The Bloomberg partner network has worked closely with country-level advocates and governments in low- and middle-income countries, where nearly 80 percent of the world’s smokers live and where smoking is ingrained in the culture. Of the 110 countries that have received support from the Bloomberg network, fifty-nine countries—with nearly 3.5 billion people—have passed a strong tobacco control law, saving an estimated 30 million lives. Just in the past two years, Bloomberg Philanthropies and our partners collaborated with the city governments of Beijing and Shanghai, China, to provide technical support aimed at achieving new smoke-free laws. Together, smoke-free laws in those cities now protect more than 30 million residents.

WHO Creates MPOWER

To further support countries and public health officials in their battle against the tobacco epidemic, WHO created the technical package called MPOWER. The acronym stands for a group of policies proven to reduce tobacco use: Monitor tobacco use; Protect people from second-hand smoke; Offer help to quit; Warn about dangers of tobacco use; Enforce advertising bans; and Raise tobacco taxes. MPOWER has, since 2007, spurred action to improve tobacco-control policies through strategies completely in line with the guidelines of the Framework Convention on Tobacco Control.

Bloomberg Philanthropies has provided support for the country-level implementation of MPOWER, for instance, by supporting thirty-four countries representing nearly four billion people to conduct household surveys to track tobacco use—the M in MPOWER. Similarly, the Bloomberg Initiative to Reduce Tobacco Use has supported, through our partners, 168 hard-hitting mass-media campaigns in thirty-one countries. The campaigns were created and adapted for global use—the W in MPOWER.

In Turkey—a country that has made a strong commitment to reducing tobacco use—the establishment of tobacco pack warnings, smoke-free zones, tobacco taxes, and tobacco advertising bans have had a huge impact. From 2008 to 2012, the number of smokers in Turkey declined by 1.2 million. Exposure to second-hand smoke in restaurants there declined from 55.9 percent in 2008 to 12.9 percent in 2012. And Turkey is on track to save 5.2 million lives by 2030.

To continue the momentum, we must build on MPOWER and the work of the global partnership, boldly communicate the importance of tobacco control to keep it on the global public health agenda, deepen support for tobacco taxes in vulnerable countries, ensure long-term funding for tobacco control as well as NCDs, and hold Big Tobacco accountable for its actions and the impact of its products. By remaining focused on programs proven to reduce use of tobacco and expanding successful programs, we can reach the Bloomberg Philanthropies initiative’s ambitious goal of saving 100 million lives by 2050.