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WHO convention launches project to strengthen tobacco control

Nov 8th, 2016
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http://www.business-standard.com/article/pti-stories/who-convention-launches-project-to-strengthen-tobacco-control-116110801400_1.html

Developing countries are all set to get a boost in their tobacco control efforts with the the WHO Framework Convention on Tobacco Control today launching a project to strengthen implementation of the global tobacco control treaty.

Through the project, countries will be offered support to create and strengthen coordination mechanisms and action across sectors to implement the WHO FCTC, including treaty obligations to ban tobacco advertising and promotion, ensure tobacco packaging has health warnings, end smoking in enclosed public and workplaces, and increase tobacco taxes among others.

The five-year project will open call for expressions of interest inviting LMIC governments wishing to join implementation from 2017 and will be delivered with the generous development funding from the United Kingdom.

“Developing countries will receive dedicated support to implement the WHO FCTC, the best instrument to ensure tobacco control worldwide that has 179 countries plus the European Union as its Parties.

“Through the new project, to be delivered by the WHO FCTC Secretariat in collaboration with UNDP and other partners, a number of low and middle-income countries (LMICs) will be eligible to receive direct support to implement tobacco control strategies and policies,” an official FCTC statement said.

This emerged on the second day of the Seventh Session of the Conference of Parties (COP7) to World Health Organisation (WHO) Framework Convention on Tobacco Control (FCTC) which India is hosting for the first time.

The statement said that if current tobacco use patterns persist, tobacco will kill about 1 billion people in the 21st Century and by 2030, over 80 per cent of the world’s tobacco-related mortality will be in LMICs.

“The treaty is an evidence-based blueprint for tobacco control policies. Tobacco use will be reduced if a country has a high level of WHO FCTC implementation,” the statement said.

The significant harms of tobacco use on developing countries are usually understood primarily as health issue and this overlooks the extensive impact of tobacco on social, economic and environmental progress.

Tobacco control is a development issue and its success

relies on the work of other sectors such as commerce, trade, finance, justice and education. That is why the international community agreed to include the implementation of the WHO FCTC in the UN’s new Sustainable Development Goals (SDGs), it said.

In promoting the new project, the Head of the FCTC Secretariat Vera Luiza da Costa e Silva said that the implementation of the WHO FCTC is critical in advancing sustainable development.

“Through the new project, we will take implementation of the WHO FCTC to a new level by providing support and guidance to developing country parties,” Silva said.

Douglas Webb, Team Leader on Health and Innovative Financing at the UN Development Programme said that there is growing recognition that current tobacco trends and sustainable development cannot coexist.

“As a committed partner, UNDP welcomes this opportunity to advance tobacco control through better support to national planning, good governance and protection against tobacco industry interference in policy making,” he said.

The statement said that the full implementation of the WHO FCTC in low-and middle-income countries is “impeded” without the integration of tobacco control into broader development agendas such as food and water security, environment, the right to education and human rights.

Joint UN work at country level has also revealed a demand from Parties to the Convention for support in a number of areas related to social and economic development.

“Although well represented with two targets under Sustainable Development Goal 3 on health and wellbeing (reduction by one-third of premature mortality from NCDs and full implementation of the WHO FCTC)…,

“The overall success of Agenda 2030 depends on successful tobacco control – and thus integrating tobacco control into the other SDGs and their targets,” the statement said

Developing countries to be supported on FCTC policies

Nov 8th, 2016
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http://www.business-standard.com/article/news-ians/developing-countries-to-be-supported-on-fctc-policies-116110801261_1.html

The WHO Framework Convention on Tobacco Control (WHO FCTC) on Tuesday said developing countries will receive dedicated support to implement its policies.

The WHO FCTC called it (the policies) best instrument to ensure tobacco control worldwide that has 179 countries plus the European Union as its parties.

In the new project, to be delivered by the WHO FCTC Secretariat in collaboration with UNDP and other partners, a number of low-and middle-income countries (LMICs) will be eligible to receive direct support to implement tobacco control strategies and policies.

“The project will bring together support from across the UN to accelerate the implementation of the Convention,” said a statement issued by the FCTC on the second day of the Convention.

According to WHO, if current tobacco use patterns persist, it would kill about 1 billion people in the 21st century.

By 2030, over 80 per cent of the world’s tobacco-related mortality will be in Low and Middle Income Countries(LMIC).

“The treaty is an evidence-based “blueprint” for tobacco control policies. Tobacco use will be reduced if a country has a high level of WHO FCTC implementation,” said the statement.

Under the project, the countries will be offered support to create and strengthen coordination mechanisms and action across sectors to implement the WHO FCTC, including treaty obligations to ban tobacco advertising and promotion, ensure tobacco packaging has health warnings, end smoking in enclosed public and workplaces, increase tobacco taxes and protect public health policies from tobacco industry interference.

“The five-year project will open call for expressions of interest inviting LMIC governments wishing to join implementation from 2017,” said the statement.

The project will be delivered with the generous development funding from Britain.

FCTC on Monday had said Britain is ready to fund $90 million to the FCTC to curb smokeless tobacco consumption.

Promoting the project, Head of the FCTC Secretariat Vera Luiza da Costa e Silva said: “The implementation of the WHO FCTC is critical in advancing sustainable development. Through the new project, we will take implementation of the WHO FCTC to a new level by providing support and guidance to developing country parties.”

The significant harms of tobacco use on developing countries are usually understood primarily as health issue. This overlooks the extensive impact of tobacco on social, economic and environmental progress.

Tobacco control is a development issue and its success relies on the work of other sectors such as commerce, trade, finance, justice and education. This is why the international community agreed to include the implementation of the WHO FCTC in the UN’s new Sustainable Development Goals (SDGs).

“There is a growing recognition that current tobacco trends and sustainable development cannot coexist. As a committed partner, UNDP welcomes this opportunity to advance tobacco control through better support to national planning, good governance and protection against tobacco industry interference in policy making,” Douglas Webb, Team Leader on Health and Innovative Financing at the UN Development Programme.

‘Stop tobacco industry interference in health legislation’

Nov 8th, 2016
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“We have an ethical responsibility to prioritize people’s health over the industry’s interests.”

http://www.newvision.co.ug/new_vision/news/1439632/-stop-tobacco-industry-interference-health-legislation

“The tobacco industry is the single-largest threat to public health in the world,” says Dr. Sheila Ndyanabangi, Principal Medical Officer, Mental Health and Substance Abuse Control/ Tobacco Control, for the Ugandan Ministry of Health.

Ndyanabangi is one of the delegates from up for 179 countries convening at the seventh session of the World Health Organization (WHO) Framework Convention on Tobacco Control (WHO FCTC) in India.

The high-level meeting seeks to stop tobacco industry interference in public health policymaking.

“As delegates to the global tobacco treaty, we have an ethical responsibility to prioritize people’s health over the industry’s interests. Today, we recognize that the most urgent task before us is to protect policymaking from the corrosive influence of big tobacco,” said Ndyanabangi.

A 2012 study from the Global Youth Tobacco Survey (GYTS) showed that the prevalence rate of smoking among Ugandan adults aged 15-54 stood at about 25%.

The 2010 Tobacco Atlas also estimated that every year, more than 5, 000 Ugandans are killed by tobacco-caused disease such as include lung cancer, chronic bronchitis and tuberculosis among others.

Against this background, Uganda passed the Tobacco Control Bill on July 28, 2015.

The law among other requirements prohibits smoking in public places including hotels, bars, taxi parks, public transportation vehicles and other outdoor spaces within 50 metres of a public place.

Despite the legal steps to control tobacco use, there have been reports that the industry is still aggressively marketing its products, putting millions of lives at risk.
A November 2015 BCC investigation revealed that the industry was exploiting loopholes to infiltrate treaty meetings and block, weaken and delay outcomes of public health legislation.

“This is decision time. Tobacco industry intimidation of champions of tobacco control in Uganda is just an example of how far the industry will go to thwart life-saving policies in developing countries. At the international level the industry is doing same,” says Hellen Neima, a tobacco control activist from Uganda.

At the ongoing FCTC negotiations in India, governments seek to advance life-saving tobacco control measures such as plain packaging and graphic health warnings on tobacco control products.

“With recent wins against Big Tobacco’s legal bullying in Uruguay and Australia, we stand at a tipping point for public health,” said John Stewart, deputy director with Corporate Accountability International and an accredited observer to the global tobacco treaty proceedings.

“Given the industry’s widespread lying, cheating, and outright bribery, governments are ready to act. The global tobacco control community is poised to protect decisions about people’s health from narrow corporate interests, and pave the way for a future where Big Tobacco and its bullying are a thing of the past.”

Delegates also plan to advance tools to hold the tobacco industry liable such that governments to, among other recommendations, can utilize legal systems to recoup the enormous costs of tobacco-related healthcare coverage.

The global tobacco treaty, known formally as the World Health Organization Framework Convention on Tobacco Control (FCTC) entered into force in 2005. Uganda ratified the WHO FCTC on 20th June 2007 becoming a party to the convention.

To-date, 179 countries and the European Union have become Parties to the treaty. It contains the world’s most effective tobacco control and corporate accountability measures—estimated to save more than 200 million lives by 2050 if fully implemented.

Seventh session of the Conference of the Parties (COP7) – Address by Dr Vera da Costa e Silva

Nov 7th, 2016
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Conference of the Parties to the WHO Framework Convention on Tobacco Control Meets in New Delhi for the Seventh Time

Nov 7th, 2016
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The seventh session of the Conference of the Parties (COP7) to the WHO Framework Convention on Tobacco Control (WHO FCTC) began today.

http://allafrica.com/stories/201611081206.html

The COP is the governing body of the Convention, which meets regularly to review its implementation and take decisions necessary to promote its effective implementation. During the opening day it was announced that Mozambique is to become the 181st Party to the Convention and Zimbabwe was welcome as the most recent Party to accede to the Convention.

Parties highlighted the progress they have made in implementation of the Convention and it shows there is increasing compliance with the provisions of the treaty. The report by the Secretariat of the WHO Framework Convention on Tobacco Control Global Progress in Implementation of the WHO FCTC also notes the incredible advances made in implementing the measures of the treaty.

Key note address by President of Sri Lanka and opening ceremony

Dr Oleg Salagay of the Russian Federation chaired the session in his capacity as President of the COP and H.E. Mr Jagat Prakash Nadda, the Indian Minister of Health and Family Welfare, delivered an opening speech welcoming delegates and observers to the country.

Sri Lanka’s President Maithripala Sirisena addressed COP7 on the inaugural day. The Sri Lankan President, who has also served as the Minister of Health is a strong advocate of tobacco control and successfully implemented laws to display pictorial warnings up to 80% on both sides of cigarette packets.

A statement on behalf of Dr Margaret Chan, Director-General of WHO, was conveyed to the delegates stressing the growing success of the Convention, and stating that, “In a world full of so many new and old threats, we turn to tobacco control as unquestionably our biggest, surest, and best opportunity to save millions of lives.”

The session is being attended by 136 Parties, as well as representatives of four States non-Parties. Staff from WHO and UNDP are attending, along with representatives from four intergovernmental and 13 nongovernmental organizations, accredited as observers. More than 1,300 participants are attending COP7.

The WHO FCTC successes

Delegates have heard how the Parties have overcome legal challenges from the tobacco industry and its front groups when implementing tobacco control measures, in some cases by opposing domestic legislation, and in others by using international trade and investment agreements to challenge Parties’ initiatives in curbing the tobacco epidemic.

The Head of the Convention Secretariat, Dr Vera Luiza da Costa e Silva, noted that the period since COP6 in 2014 has seen significant success, saying, “We must applaud the bold action taken by many Parties during the last two years and it’s reassuring that the treaty and the standards adopted by COP have helped you protect your decisions against legal challenges.”

Interaction with the Parties has reached an all-time high with around three-quarters of Parties delivering implementation reports. As the treaty matures it has been establishing relationships beyond the health sector as its role in development and human rights has become more obvious. The Secretariat has engaged with the UN Interagency Task Force on Noncommunicable Diseases and recently has become a participant of the WHO Global Coordination Mechanism on prevention and control of NCDs.

Excluding the tobacco industry

Dr Vera Luiza da Costa e Silva asked for Parties to consider Article 5.3 dealing with tobacco industry interference. For the first time, under the guidance of the Bureau, note verbales had been sent requesting Parties to exclude representatives of partially or wholly state-owned tobacco companies from their delegations. This has helped the Secretariat adhere to its mandate and Dr Vera Luiza da Costa e Silva said, “We do not question the right of sovereign states to choose national representatives but we must be reminded that there is a fundamental and irreconcilable conflict of interests between the tobacco industry and public health policy.”

The conference was warned that while delegates made decisions about the future implementation of the Convention there were malign forces close at hand. Dr Vera Luiza da Costa e Silva said, “There is another observer here, although its representatives may not always wear badges. The tobacco industry takes a very keen interest in COP meetings and makes every effort to insinuate itself into delegations and proceedings. If anyone doubts the importance of what we do here, always remember the industry’s malevolent presence and the strong need for transparency. “

The facts that drive tobacco control measures

Tobacco kills around 6 million people each year. This epidemic is one of the biggest public health threats the world has ever faced. The gathering this week in India is the most important global anti-tobacco conference. The WHO FCTC was adopted in 2003 and has quickly become one of the most widely embraced treaties in the history of the United Nations. To date a total of 180 Parties have committed to implementing the treaty’s articles and obligations. It provides a united legal means of challenging a deadly addiction.

Concluding her remarks, Dr Vera Luiza da Costa e Silva encouraged the delegates, “I am certain that COP7 will mark a significant moment in our march towards a tobacco-free world.”

Note to Editors

COP7 is being held at the Expo Mart, Greater Noida in India, 7 – 12 November 2016. There will be daily press releases distributed from the conference.

Experts urge WHO to back tobacco harm-reduction strategies at CoP7

Nov 7th, 2016
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The seventh Conference of the Parties (CoP7) of the WHO’s Framework Convention on Tobacco Control (FCTC) — the world’s first public health treaty — kicked off here Monday with a coalition of experts seeking a focus on policy for new nicotine products like e-cigarettes.

http://www.newkerala.com/news/2016/fullnews-139597.html

The FCTC entered into force in 2005 and establishes requirements and recommendations for reducing demand-supply of tobacco products to reduce preventable diseases and premature death caused by tobacco use. As many as 180 countries are now parties to the convention.

Slated to run till November 12, CoP7 is expected to play a crucial role in shaping global policy in the field of tobacco harm reduction.

Ahead of the conference, a coalition of top tobacco harm-reduction experts warned that “one in two life-long smokers will die prematurely from a smoking-related disease”.

The coalition, established to provide balanced, evidence-based information on harm reduction, observed that “if current smoking patterns and trends continue, a billion people might die from smoking-related diseases in the 21st century”.

“Despite the availability of smoking-cessation medications, many smokers do not want to try them. Of those who use them, the majority either fail or relapse within a year,” the coalition pointed out in a Mission Statement.

It explains how “public health experts have recommended that smokers be encouraged… to switch completely to less harmful substitutes”.

The World Health Organization (WHO) has identified harm-reduction strategies as a core principle of tobacco control, and recently stated: “If the great majority of tobacco smokers who are unable or unwilling to quit would switch… to using an alternative source of nicotine with lower health risks… this would represent a significant contemporary public health benefit.”

According to the Mission Statement, there are new technologies that comply with this principle. One such is the “electronic cigarette” — or, as WHO calls it, Electronic Nicotine Delivery Systems, ENDS — which delivers nicotine without burning tobacco. The vapor from e-cigarettes and personal vaporisers contains very low levels of potentially-harmful chemicals”.

According to the experts, Public Health England recently concluded vaping is at least 95 per cent safer than smoking and acknowledged that e-cigarettes can be an effective aid to quitting smoking. The experts said they support “government policies that seek to remove barriers to the availability of better, safer, non-combustible nicotine delivery products, with appropriate quality standards and regulations”. They added that disproportionate restrictions — regulation of e-cigarettes as medical products, restrictions similar to tobacco cigarettes, advertising bans — will make such products expensive and create misconceptions that they are as harmful as smoking. The coalition called such measures “counter-productive”.

The Tobacco Harm Reduction Expert Group includes Konstantinos E. Farsalinos of the Onassis Cardiac Surgery Center in Athens; Prof. Riccardo Polosa of the Institute for Internal and Emergency Medicine, University of Catania; Christopher Russell of the Centre for Substance Use Research, Glasgow; Amir Ullah Khan, member of the Telangana government’s Commission of Inquiry on Socioeconomic Conditions; Julian Morris, Vice President of Research at Reason Foundation; and Prof. Rajesh N. Sharan of the Department of Biochemistry, North-Eastern Hill University.

Need to take multi-sectoral action to tackle tobacco challenge: J P Nadda

Nov 7th, 2016
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The Union Health Minister said there are nearly 275 million current users in the country and close to one million lives are lost every year due to tobacco use.

http://indianexpress.com/article/india/india-news-india/need-to-take-multi-sectoral-action-to-tackle-tobacco-challenge-j-p-nadda-3741862/

Health Minister J P Nadda on Monday termed the challenge of tobacco control as “formidable” and said there is need to take multi-sectoral action and integrated approaches to health goals, especially as the country is facing the dual burden of infectious and non-communicable diseases. He was speaking during the inauguration of the Seventh Session of the Conference of Parties (COP7) to World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) which India is hosting for the first time.

Sri Lankan President Maithripala Sirisena gave a special address during the inaugural session of the conference.

Nadda said there are nearly 275 million current users in the country and close to one million lives are lost every year due to tobacco use, either directly or indirectly.

He said the economic cost to India or the healthcare cost to treat tobacco-related diseases is a whopping USD 22 billion and the target of achieving relative reduction of tobacco use by 30 per cent is no longer a choice but a necessity.

“The challenges faced by India in the realm of tobacco control are formidable, both in their number and in their complexity. However, despite our vast complexity, substantial investments for implementation of WHO FCTC are slowly improving the situation,” he said at the conference where more than 1500 delegates from all over the world are taking part.

He said India has to go a long way in preventing millions of avoidable deaths resulting from the habit of tobacco use and there are many challenges like new products which are emerging and the existing products are profilerating locally and internationally to newer areas.

“The prevalence of tobacco use is still unacceptably high. Morbidity and mortality due to its use is also very high. There is a huge economic burden on people and governments due to adverse health consequences of tobacco use. Certain parts of the world, including India, have a myriad of tobacco products.

“We cannot do this alone. Along with national will and resources, we also need the strength of international collaboration to mitigate the rising burden of health, social and economic costs of tobacco,” Nadda said.

He said this is a landmark year for tobacco control activities as the country has successfully implemented, from April, large pictorial health warnings occupying 85 per cent of the principal display area of tobacco packs and on all forms of tobacco.

Terming WHO FCTC as India’s strongest tool to curb the emerging non-communicable diseases, Nadda said India cannot tackle these diseases only by making more hospitals, cancer institutes and producing more doctors and allied health professionals.

“Today, India and other developing countries in the south east Asian, African and Latin American regions face the dual burden of infectious diseases like malaria and TB, and emergent conditions like zika and dengue, along with non-communicable diseases like cancer, cardiovascular diseases, diabetes etc.

“All countries are gearing up and making efforts to strengthen their health systems to tackle these challenges. For this to happen, we need multi-sectoral action along with integrated approaches to health programmes and health goals,” he said.

“We need to prevent the risk factors, tobacco being the biggest of them, since today’s risk factors are tomorrow’s diseases,” he said.

He said India is committed to strengthening non- communicable disease programmes and interventions and implementation of the WHO FCTC as an integral part of the post 2015 sustainable development goals.

“Tobacco use is detrimental to all aspects of life and grips users in the most productive years. We must reverse this tide. We must, for this purpose, target our young children, catch them young, and indoctrinate their minds against the harms of tobacco use,” he said.

Reporters Banned From Global Anti-Tobacco Conference

Nov 7th, 2016
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http://dailycaller.com/2016/11/07/reporters-banned-from-global-anti-tobacco-conference/

A United Nations legislative body has voted to kick journalists out of its meeting Monday.

Delegates voted unanimously to ban journalists from the remaining sessions of the biennial legislative conference of World Health Organization’s Framework Convention on Tobacco Control (FCTC).

Journalists called the decision “outrageous” and “shocking,” while delegates refused to address concerns about denying press freedom.

The FCTC’s legislative body, known as the COP, or Conference of the Parties, is meeting this week in a Delhi, India suburb to discuss and vote on policy proposals that impact more than 90 percent of the world’s population. Global taxpayers spend approximately $13 million a year funding the FCTC and its conference. Every major nation has signed on to the UN tobacco control treaty except the United States, Switzerland and Indonesia.

At the event, delegates representing 180 nations set international guidelines for tobacco taxes, regulations on e-cigarettes, advertising bans, graphic health warnings and other efforts to reduce tobacco consumption. The delegates are generally high-ranking public health, finance and trade officials, such as finance ministers and secretaries of health.

During the closing minutes of Monday’s opening session of the conference, a delegate from Thailand proposed banning the media and the public from the remainder of the 6-day event in order to “have discussions in private.”

The proposal passed with no objections, meaning that each of the 180 nations, unanimously agreed to bar reporters from the taxpayer-funded legislative session, leaving journalists stunned.

“I, for one, was shocked,” said Faith Goldy, a reporter for The Rebel, a Canadian political news site. “I’ve covered a lot of conventions and this was totally unprecedented for me.”

When Golby asked a Canadian delegate why they supported banning the media despite Canada’s strong tradition of freedom of the press, the delegate refused to offer a comment.

Yaël Ossowski, a columnist covering the COP for the PanAm Post called the decision “outrageous.”

“Journalists are responsible for informing the public about the decisions such large international bureaucracies make,” Ossowski said. “How can this be done if the media is kicked out the second the real issues are discussed?”

“Every citizen should be concerned about what the WHO is up to.”

Delegates from Italy, Madagascar, Mexico and the Philippines all declined to speak to reporters after they voted to ban journalists.

One delegate from Mali expressed concern after his country went along with the decision to eject the media.

“Reporters should be allowed to stay,” said the Malian delegate who preferred not to be identified. “Without the media, the public doesn’t know what has happened.”

This is not the first time the COP has come under scrutiny for restraining press freedom. During the WHO’s most recent anti-tobacco convention in Moscow, journalists were physically removed from the COP meeting hall moments before a controversial vote regarding a minimum 70 percent tax increase on the retail price of tobacco products.

Reporters covering the conference now face the task of reporting on the meeting without access to the proceedings.

“For a conference with such a sweeping impact on every global citizen, it’s frankly an outrage that journalists are not allowed to freely report and do their jobs,” said a frustrated Ossowski

CANCER ORGANISATIONS LAUNCH TOBACCO TAX INITIATIVE

Nov 7th, 2016
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Cancer organisations have launched a new initiative to build a vigorous global coalition to support governments seeking to increase tobacco taxes.

The American Cancer Society’s Economic and Health Policy Research (EHPR) programme – the technical lead for the initiative – has developed a portfolio of easy-to- understand fact sheets and tools to support governments and civil society.

The EHPR team’s main tool is a dynamic model that can predict the tax increase necessary for a country to reach the WHO target of a 30-percent reduction in smoking prevalence by 2025 (with 2010 as the base year).

The team has already used publicly available data to model tobacco tax increases for 72 countries. For example, for Albania to reach the target, cigarette prices would need to be increased to 542.61 Albanian Lek per pack by 2025, which is a 4-fold tax increase. (See figure.)

The WHO target was adopted at the Sixth Conference of FCTC Parties in 2014. Achieving it would help countries reach the United Nations Sustainable Development Goal (SDG) of reducing premature mortality from noncommunicable disease (NCD) by one-third by 2030, but a recent report from WHO indicates that most countries aren’t on track to meet that target.

The cancer community has a vested interest in this issue. Around 20 percent of global cancer deaths are related to tobacco. As Harpal Kumar, Chief Executive Officer of Cancer Research UK, said at the World Cancer Congress last week:

“Global tobacco use remains, by far, the most important modifiable risk factor for cancer, and an area where cancer organizations could make a meaningful difference if we
worked together.”

According to Gary M. Reedy, Chief Executive Officer of the American Cancer Society (ACS): “The time is right for this campaign. There is an urgency for governments around the world to respond to the WHO’s call for a 30 percent relative reduction in adult smoking prevalence by 2025. The most plausible way for governments to reach this target is by raising tobacco taxes.”

Article 6 of the WHO FCTC commits governments to raising tobacco excise taxes in order to reduce the affordability of tobacco products. This is one of the most effective tools to prevent initiation and promote cessation of tobacco use, with studies proving that it is particularly effective among the young and the poor. As detailed in the Addis Ababa Action Agenda last year, it is also a recommended means of generating millions of dollars annually in sustainable government revenue that can be reinvested in health and development priorities – including cancer screening, diagnosis and treatment. These revenues could easily fund the implementation of the WHO FCTC’s provisions, too, and the strategy could deliver significant savings in future health care costs, thanks to a reduction in tobacco related disease.

In spite of these clear benefits, many countries have been slow to implement effective tax and price measures. Barriers to high tobacco taxes include a lack of information in clear, non-technical language that can help potential proponents of tobacco tax reform to effectively make their case – particularly in the face of misinformation promoted by the tobacco industry. Moreover, governments and their nongovernmental allies sometimes lack the technical capacity to implement a successful tobacco
taxation programe.

The cancer community’s tobacco tax initiative aims to increase understanding within the global public health community – and within Ministries of Finance and Ministries of Health – of the power of tobacco taxation as an effective measure for reducing tobacco use, preventing NCDs, such as cancer, and raising sustainable revenues for national governments. Assistance is available to support stakeholders wishing to be part of the campaign, especially for those who have not worked in the field of tobacco taxation before.

The dynamic model can also be adjusted for country-specific needs to use data provided by in-country experts and to reflect other, perhaps more ambitious, scenarios for tobacco tax increases. The model also accounts for changes in the affordability of tobacco products, changing price elasticities, and any country’s tax structure.

Cancer organisations are ready to take a lead in raising the prominence of tobacco taxation as an essential intervention for cancer prevention, but ultimately it is only through a true partnership among motivated governments and nongovernmental stakeholders – the people attending COP7 this week – that an effective tobacco tax strategy can be realised.

The EHPR team attending COP7 – Jeff Drope, Michal Stoklosa and Jacqui Drope – are available to discuss this initiative and provide advice on tobacco taxation. Fact sheets for 72 countries are available upon request and at the FCA booth. To arrange a discussion with an EHPR representative, or to be kept up-to-date with developments, please email tobaccotax@cancer.org.

CESSATION SUPPORT (ARTICLE 14) IS NOT COSTLY OR COMPLICATED – AND IT IS EFFECTIVE!

Nov 7th, 2016
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• CONDUCT A NATIONAL SITUATION ANALYSIS, AS RECOMMENDED IN THE FCTC ARTICLE 14 GUIDELINES;
• DEVELOP A NATIONAL CESSATION STRATEGY;
• MANDATE RECORDING TOBACCO USE IN ALL MEDICAL NOTES;
• OFFER MOBILE PHONE TEXT MESSAGING SYSTEMS;
• INTEGRATE BRIEF ADVICE TO ALL TOBACCO USERS INTO THE HEALTHCARE SYSTEM.

There is strong international support to strengthen and accelerate full implementation of Article 14 of the WHO Framework Convention on Tobacco Control (FCTC), as evidenced by the World Conference on Tobacco or Health Declaration in 2015 that “By 2018, at least 50% of FCTC Parties will have developed and published an official national tobacco dependence treatment strategy, in accordance with Article 14 Guideline recommendations”.

Most of the substantive FCTC Articles, especially 6, 8, 11, 12, 13 and 14, promote tobacco cessation (as opposed to discouraging young people from starting) in one way or another. It is important to note that only effective cessation will have a sufficient effect on mortality in the 9 years left to reach the UN/ WHO goal of a 25 percent reduction in premature mortality from NCDs by 2025.

The 2014 WHO Global Progress Report on FCTC implementation suggests good progress in FCTC implementation but notes that some treaty articles are being implemented more quickly than others. The report adds that only half of Parties said they were implementing Article 14 by 2014.

Evidence from MR’s group’s survey (at Nottingham University, UK) suggests perceived cost to be one concern about tobacco cessation support, another may be lack of clarity about the role of such support, including about its effectiveness and cost effectiveness.

Helping tobacco users stop is a cost effective healthcare intervention, which saves lives and improves population health.

Every day that smokers over 35 years old continue to smoke they lose about 3–6 hours of life, thus for the estimated 500 million current adult smokers, 62 million days of life are lost every day.

Some of these tobacco users will stop unaided, others will stop only after repeated attempts over time, and many more will die before they can stop, principally because
tobacco use is so addictive. The unaided population tobacco cessation rate after 1 year is very low, only about 3–5 percent, meaning that the majority of smokers who try to
stop without help fail. Adding comprehensive cessation support can be up to about four times more effective, at about 20 percent after a year, but even brief advice has a
worthwhile effect.

One key reason why the majority of ex-smokers stopped without help is because the majority do not have access to help.

According to WHO, just 15 percent of the world’s population have access to appropriate cessation support.

Arguably, cessation support should be provided alongside measures that prompt cessation attempts, like those in Articles 6, 8, 11, 12 and 13.

Given a genuine need for cessation support, the fact that globally most tobacco users don’t have access to it, and that providing it implies at least some basic infrastructure, can anything be done quickly to improve the situation, something that low and middle income countries can afford?

I think countries could consider the following relatively low-cost measures to build core infrastructure:

1. Conduct a national situation analysis, as recommended in the FCTC Article 14 guidelines;
2. Develop a national cessation strategy;
3. Mandate recording tobacco use in all medical notes;
4. Offer mobile phone text messaging systems;
5. Integrate brief advice to all tobacco users into the healthcare system.

As resources become available countries can consider adding the following:

6. Develop and disseminate national cessation guidelines;
7. Make affordable medicines available;
8. Establish mass communication and education programmes that encourage cessation and encourage tobacco users to use cessation support;
9. Offer specialist tobacco cessation support.

The availability of new, low-cost interventions and methods to help countries select affordable treatments (will remove significant barriers to the development of tobacco cessation support and make Article 14 implementation both feasible and a significant contributor to global health.

Martin Raw, Director, International Centre for Tobacco Cessation, London, UK; Visiting Scholar, New York University Medical School, New York, USA and Thomas Glynn, Consulting Professor, Stanford University Preveniton research Center, School of Medicine, Palo Alto, California, USA

This article draws extensively on a comment published in the Lancet in January: Raw M, Mackay J, Reddy S. Time to take tobacco dependence treatment seriously. Lancet, 30 January 2016. Further references and sources can be obtained from MR at martin@martinraw.com

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