Framework Convention on Tobacco Control

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Tobacco Issues Committee, The Cancer Council Australia


Historic global tobacco control treaty welcomed
And now the real work begins…

Tobacco use is estimated to have killed 100 million people in the 20th century and is expected to claim the lives of ten times that number – one billion people – in this century, based on current trends. The burden of death and disease caused by tobacco is shifting rapidly to low income nations as most high income nations are implementing effective tobacco control policies.

J MacKay, M Eriksen “The Tobacco Atlas”, WHO, 2002

Health and medical organisations and governments throughout the world hailed the adoption of the Framework Convention on Tobacco Control (FCTC) by the World Health Assembly (WHA) on 21 May 2003. The world’s first-ever public health treaty, it represents an important global response to the tobacco epidemic.

Created under the auspices of the World Health Organisation (WHO), the treaty sets down a comprehensive range of measures for reducing the harm caused by tobacco.

‘The world now stands united on the need for strong action to reduce tobacco use. This treaty represents a triumph of public health over the concerted efforts of the world’s largest tobacco companies. It is a monumental achievement by the World Health Organisation under the leadership of Director-General Dr Gro Harlem Brundtland, and by nations of the world.’

Dr John R Seffrin, President of the UICC

Key obligations under the treaty include:

  • Price and tax measures: Governments shall implement tax policies, and where appropriate, price policies “so as to contribute to the health objectives aimed at reducing tobacco consumption”, and prohibit or restrict duty-free sales to international travellers. 
  • Exposure to tobacco smoke: Recognising that “scientific evidence has unequivocally established that exposure to tobacco smoke causes death, disease and disability”, governments shall take measures “providing protection from exposure to tobacco smoke in indoor workplaces, public transport, indoor public planes, and, as appropriate, other public places.” 
  • Regulation of the contents of tobacco: Governments shall implement “effective legislative, executive and administrative or other measures” for testing and measuring the contents and emissions of tobacco products following the development of guidelines by competent international bodies.
  • Regulation of tobacco product disclosures: Governments shall require manufacturers and importers of tobacco products to disclose information about the contents and emissions of tobacco products. Governments shall implement effective measures for public disclosure of information about the toxic constituents of the products and their emissions.
  • Packaging and labelling: Within three years of entry into force of the convention, signatories shall adopt national measures to ensure that product packaging and labelling “do not promote a tobacco product by any means that are false, misleading, deceptive” or give the impression that a particular product is less harmful than others. “These may include terms such as ‘low-tar’, ‘light’, ‘ultra-light’, or ‘mild’” – although there is no total ban on such terms. Each pack must carry health warnings that should ideally be 50% – but no less than 30% – of the principal display areas and may include pictures or pictograms. 
  • Advertising, promotion, and sponsorship: “Each party shall, in accordance with its constitution or constitutional principles, undertake a comprehensive ban of all tobacco advertising, promotion, and sponsorship”. This should be within five years and include sponsorship of international events and – subject to technical constraints – cross-border advertising. Radio, television, print media, and as appropriate, other media such as the Internet, should be covered. Countries unable to impose a ban for constitutional reasons (including the US) shall apply restrictions. 
  • Demand reduction: Governments shall increase public awareness and education activities and develop effective cessation and counselling programs. 
  • Illicit trade: Governments shall implement measures to ensure that all unit packets and outside packaging are marked to help determine the origin of the product and carry wording such as “sales only allowed in xx country”. There should be more international exchange of information between tax and customs authorities and cooperation between enforcement agencies. 
  • Sales to minors: Governments shall prohibit the sale of cigarettes to minors, require vendors to place prominent signs and ask for proof of age; ban sales from accessible store shelves; ban the manufacture and sale of sweets, snacks, toys or other objects in the form of tobacco products which appeal to minors; and restrict the sale of individual or small quantities of cigarettes. Governments shall restrict the placement and display of vending machines, but may implement a total ban on vending machines as a codicil to the treaty.
  • Liability: “For the purpose of tobacco control, the Parties shall consider taking legislative action or promoting their existing laws, where necessary, to deal with criminal and civil liability, including compensation where appropriate.” This is the first time an international treaty has introduced the concept of manufacturer liability, although the provisions are deliberately vague.

‘This treaty will be as important in reducing deaths from tobacco use as the sanitary laws of the 19th Century were in controlling cholera and infectious disease. However, the greatest challenges now lie before us. The treaty will only be effective if it is quickly ratified and implemented by the nations of the world.’

Dr Yussuf Saloojee, UICC Strategic Leader for Tobacco Control

Tobacco smoking remains the single largest preventable cause of premature death and disease. Worldwide each year, five million people die prematurely as a result of tobacco-caused diseases. Many of the factors affecting tobacco consumption – such as tobacco smuggling, and the portrayal of smoking and promotion of tobacco through films and other popular forms of entertainment – are international in nature and need to be tackled at a global level. It is also disturbing that the developing countries are being increasingly targeted by the tobacco industry in its quest for new and less regulated markets for its deadly products.

‘Today, we are acting to save billions of lives and protect people’s health for generations to come. This is an historic moment in global public health, demonstrating the international will to tackle a threat to health head on.’

Dr Gro Harlem Brundtland, Director-General of the WHO to the 56th World Health Assembly, 21 May 2003

Current trends indicate that by 2020, tobacco use will cause 10 million deaths per annum worldwide. This makes it particularly critical that the international community supports global and comprehensive approaches to tobacco control.

Adoption of the FCTC was an historic moment for tobacco control, and brought to an end over four years of protracted and taxing negotiations with the tobacco industry an all-pervasive, undermining presence. It also sent a clear signal to the tobacco industry that the world stands united in the fight to curb the human toll of death, disease and suffering caused by tobacco. Adoption of the treaty, however, is but the start to even greater challenges: the ratification and effective implementation of the treaty by all nations. Much will depend on political will and the might and vigilance of civil society.

Both the Australian government and civil society have important and ongoing roles to play in ensuring that the treaty comes into force. It is vital that the Australian government ratify the treaty, and that this is done soon. As a community we should be urging the Government’s early ratification of the treaty. It should also be recognised that the treaty outlines minimum standards in some areas, but encourages countries to go further. We need to call for the strongest interpretation possible of obligations under the treaty, and continuing progress.

Australia has been a lead nation in tobacco control, and its ratification of the treaty offers the prospect of revitalising tobacco control policy in this country. While we have come a long way in tobacco control in this country, over 19,000 Australians die each year from diseases caused by smoking, and the social costs of smoking to the community have blown out to over $21 billion. Clearly, there is still much work to be done.

The Government continues to reaffirm its commitment to tobacco control, but there has been a noticeable complacency in more recent times that is reflected in low investment in tobacco control and a lack of action in terms of legislative reforms. The treaty provides an opportunity to lift tobacco control on the Government’s health agenda and to leverage increased funds and resources for tobacco control.

As well as stepping up domestic tobacco control activity, we should urge the Australian government to support developing countries who are trying to boost their tobacco control efforts. Around 70 per cent of the worldwide tobacco-related deaths occur in developing countries, where education campaigns about smoking are almost non-existent. Developed countries, such as Australia, have a moral obligation to help those countries that are facing the biggest challenges in tobacco control, and which are really just starting to address the tobacco epidemic. We should be encouraging the Australian government’s support of developing countries within the Western Pacific region in building capacity in tobacco control in particular.

‘More people smoke today than at any other time in human history. One person dies every ten seconds due to smoking-related diseases. Research evidence in the past five years shows a bleaker picture of the health danger of smoking than previously realised. Tobacco is the biggest killer, much bigger in dimension than all other forms of pollution.’

Dr Gro Harlem Brundtland, Director General of the WHO

The FCTC will be open for signature at the UN headquarters (New York) from 30 June 2003 to 29 June 2004. The treaty becomes a legal document once 40 nations have ratified it. The FCTC will result in unprecedented global action by countries to reduce tobacco use, but we all share responsibility for ensuring that it truly delivers on all that it promises.

The treaty can be viewed online at http://tobacco.who.int/

Acknowledgements

I would like to acknowledge the support of The Cancer Council Australia, the National Heart Foundation of Australia, and the Cancer Foundation of Western Australia Inc in enabling my attendance at international meetings to represent Australian NGOs during the negotiations. I am grateful for their funding support, expert advice, and time allowed for preparation and participation in meetings. I would also like to thank Action on Smoking and Health and the Vic Health Centre for Tobacco Control for their expert advice and support, which helped significantly in the preparation of submissions, comment on drafts of FCA papers, and media advocacy on the FCTC. The priority to tobacco control given by these agencies is recognised and much appreciated, particularly by the international NGO community which valued the participation of Australian NGOs in the FCTC negotiations.

* Denise Sullivan attended the negotiations on the FCTC as a representative of The Cancer Council Australia and National Heart Foundation of Australia, and co-convenor of the International Union Against Cancer delegation.

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