The role of the FCTC in implementing tobacco control measures

A literature review published by the Society for Research on Nicotine and Tobacco[1] assessed whether the ratification of the WHO Framework Convention on Tobacco Control (FCCLAT) was associated with tobacco demand reduction measures. The FCTC is the first and only global health treaty. It aims to reduce the demand for and supply of tobacco products by focusing on, among other things, tobacco taxes, smoking bans, health warnings, and advertising bans. The treaty has been ratified by 181 countries and the European Union.

The study's findings highlight that the FCTC has enabled the implementation of measures in several areas, which have had a measurable impact on reducing tobacco consumption in many countries. However, according to the authors, FCTC implementation should be accelerated, and Parties should comply with all their obligations under the Treaty, particularly regarding effective tax policies and a complete ban on tobacco advertising. Finally, tobacco industry interference in public policy remains a significant obstacle to the effective implementation of health measures.

The FCTC has catalyzed the creation of national tobacco control laws in countries

In several countries, particularly those that previously had virtually no tobacco control legislation, ratification of the FCTC has enabled them to adopt national tobacco control legislation. [2]-[3]. For example, the Kenyan government adopted the Tobacco Control Act (TCA) in 2007, 3 years after becoming a party to the FCTC, overcoming long-standing barriers of tobacco industry interference. Interference persisted in efforts to implement the law, but Kenya's status as a party to the FCTC provided a solid legal basis for the complete regulations of 2014 on tobacco control. Many stakeholders in Kenya reported that strict regulations would not have been put in place without ratification of the FCTC[4].

In Sri Lanka, the FCTC has guided the content and accelerated the enactment of the National Tobacco and Alcohol Authority in 2006, and provided the legal basis for national tobacco control legislation (tobacco advertising bans, policies, tax measures, and limiting youth access to tobacco products). Stakeholders in Madagascar stated that interministerial orders and decrees for the development and implementation of health warnings and a comprehensive tobacco control law would not have been introduced in the absence of the FCTC and its implementing guidelines. The FCTC has also guided strong tax policies (one of the highest tax rates in Africa[5]) and provided the appropriate legal framework to counter the tobacco industry's opposition to tax increases[6].

Several countries have also highlighted the importance of Article 5.3 and its implementing guidelines in raising awareness of the concept of tobacco industry interference, which remains the main obstacle to the implementation of tobacco reduction policies. To protect its public policies, Kenya has transposed the recommendations of the implementing guidelines of this measure into its domestic law. The country's 2014 tobacco control legislation is thus the most comprehensive in the African region.[7].

The WHO Framework Convention has strengthened existing tobacco control policies

In countries where tobacco control policies existed before the ratification of the FCTC, stakeholders described the important role of the Convention in strengthening existing policies based on good practices (health warnings on packages) and the adoption of new provisions (e.g. in the development of smoke-free spaces, tax policy, plain packaging, protection of public policies, etc.).

The United Kingdom ratified the FCTC in 2005. Tobacco control legislation and policies already existed. However, in Scotland, more recent measures aimed at ban smoking in private vehicles and campaigns to reduce smoking in the home have been justified in implementation by continued reference to implementing guidelines for Article 8 regarding protection from secondhand smoke. Key elements of the UK's tobacco control strategy are firmly anchored in the FCTC. The UK benefits from the treaty, notably through a reduction in the number of smokers, while also helping to facilitate and improve its implementation in other countries through shared experiences.

France also provides an example of this contribution. The country's experience in the field of advertising, as well as studies on health warnings and plain packaging, were used to support the adoption of implementing directives for the articles relating to product labelling and packaging, as well as the prohibitions on all advertising, for Articles 11 and 13 of the Treaty.

At European level, the 2014 EU Tobacco Products Directive is also in line with the European Union's obligations under the FCTC. These have thus allowed the expansion of health warnings in accordance with the recommendations of Article 11 or protection against exposure to tobacco smoke with bans on smoking in public places (Article 8). The most substantial progress has been made in countries where public decision-making was based on the Treaty, whether in terms of compliance with obligations, justifications for measures, or reference to good practices.[8]-[9].

Industry interference remains a continuing challenge to the proper implementation of the FCTC

The tobacco industry has long used direct and indirect tactics to hinder, delay, or weaken the implementation of public policies to reduce tobacco consumption. The effectiveness of the FCTC measures has reinforced the need for these steps for manufacturers. Although a growing number of countries have taken steps in recent years to protect their public policies, none of them has fully implemented all of the measures provided for in the texts. Moreover, these measures often remain limited to the sole sphere of health authorities, while tax increases, which are particularly effective, are the responsibility of budget and finance ministries, which often remain unaware of the best practices prescribed in relations with this industry.

For example, the industry continues to participate in events attended by government officials, to promote its interests through front groups, and to promote its image through so-called socially responsible business activities. In doing so, the industry continues to systematically oppose tax increases (Article 6) on tobacco by sponsoring research alleging the benefits of tobacco for a country's economy or announcing the development of illicit trade associated with tax increases.[10]. As a result, tobacco industry interference continues to be the biggest obstacle to FCTC implementation worldwide.

Keywords: FCTC, tobacco industry interference, taxes, health warnings, advertising

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[1] Heikki Hiilamo, PhD, Stanton Glantz, PhD, Global implementation of tobacco demand reduction measures specified in Framework Convention on Tobacco Control, Nicotine & Tobacco Research, 2021;, ntab216, https://doi.org/10.1093/ntr/ntab216 [2] McCabe Center for Law and CancerCampaign for Tobacco-Free Kids. Report on who FCTC in legislation and litigation, 2015. [3] Craig L, Fong GT, Chung-Hall J for the WHO FCTC Impact Assessment Expert Group, et al Impact of the WHO FCTC on tobacco control: perspectives from stakeholders in 12 countries Tobacco Control 2019;28:s129-s135. [4] Tobacco tactics, Kenya- BAT's Tactics to Undermine the Tobacco Control Regulations, last updated February 5, 2020, accessed October 20, 2021 [5] Husain, Muhammad Jami & English, Lorna & Ramanandreibe, Nivo. (2016). An overview of tobacco control and prevention policy status in Africa. Preventive Medicine. 91S. 10.1016/j.ypmed.2016.02.017. [6] van Walbeek C, Filby S Analysis of Article 6 (tax and price measures to reduce the demand for tobacco products) of the WHO Framework Convention on Tobacco Control Tobacco Control 2019;28:s97-s103. [7] Kenya Tobacco industry interference index 2020, Kenya Tobacco Control Alliance, August 14, 2020, accessed October 20, 2021 [8] Craig L, Fong GT, Chung-Hall J for the WHO FCTC Impact Assessment Expert Group, et alImpact of the WHO FCTC on tobacco control: perspectives from stakeholders in 12 countriesTobacco Control 2019;28:s129-s135. [9] Tobacco Control, EU Tobacco Products Directive Revision, last updated March 25, 2021, accessed October 20, 2021 [10] CNCT, Combating illicit trade and parallel markets, June 3, 2021, accessed October 20, 2021 National Committee Against Smoking |