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May 7th, 2016:

The Framework Convention on Tobacco Control

The unconditional support for WHO’s Framework Convention on Tobacco Control (FCTC) shown by Martin Raw, Judith MacKay, and Srinath Reddy warrants discussion.1

The World Oncology Forum ranked tobacco control first among its ten priorities,2 but the Convention is one more failure to add to the record of WHO’s bureaucracy.3,4

First, from 1980 to 2004, the annual decrease in the prevalence of daily smoking was on a fast track, reaching 2% in 2004, the year of the Convention.

Since then it has levelled off , and the 2012 annual rate of change in prevalence of daily smoking was almost zero.5

Second, WHO claims the FCTC has 180 parties, but exhibits little concern for implementation of the Convention.

The sixth session of the Conference of the Convention was held in Moscow in 2014, with 179 countries, 46 of which were essentially tourists as they failed to produce their self-assessment report. WHO took no action. Such soft diplomacy is hardly acceptable when parties such as Indonesia, Dominican Republic, Honduras, Ukraine, and Cuba challenged Australia’s plain tobacco packaging law before the World Trade Organization (WTO), acting in support of tobacco manufacturer Philip Morris.

In October, 2015, European Ombudsman Emily O’Reilly criticised the Commission’s failure to comply with FCTC rules regarding tobacco industry lobbying. The Commission has responded by repeating that it “complies in full” with the rules.6

Again, the WHO remains blind and silent, making the Convention worth no more than the paper on which it is written.

I declare no competing interests.

Alain Braillon

University Hospital, 80000 Amiens, France.

1 Raw M, Mackay J, Reddy S. Time to take tobacco dependence treatment seriously. Lancet 2016; 387: 412–13.
2 Cavelli F. Stop cancer now! Lancet 2013; 381: 426–27.
3 Braillon A. Global health challenges facing bureaucracy: democratization or revolution? Public Health 2014; 128: 1134–35.
4 Lancet. 1 year on—lessons from the Ebola outbreak for WHO. Lancet 2015; 385: 1152.
5 Ng M, Freeman MK, Fleming TD, et al. Smoking prevalence and cigarette consumption in 187 countries, 1980–2012. JAMA 2014; 311: 183–92.
6 Corporate Europe Observatory. European Commission complacent on tobacco industry infl uence. Feb 8, 2016. (accessed April 11, 2016).