Ways to finance anti-smoking prevention and awareness actions

Lack of funding being one of the main obstacles to anti-smoking prevention and awareness actions, a webinar organized by Santé publique France suggested some avenues to explore.

Worldwide, more than half of the countries have not conducted a recent anti-smoking awareness campaign, and more than half of the population has never been exposed to such a campaign. Furthermore, due to a lack of adequate budget, more than half of these awareness campaigns, when evaluated, have proven ineffective. However, high-impact awareness campaigns, such as those conducted in Australia in 2013 and 2014, or public mobilization actions, such as Stoptober in the United Kingdom (the precursor to No Tobacco Month in France), have proven their relevance. These findings were the basis for an international webinar on financing anti-smoking prevention and awareness actions.

Actions to raise awareness among the population about the risks and dangers associated with smoking are provided for in Article 12 of the Framework Convention on Tobacco Control (FCTC) of the World Health Organization (WHO) as obligations for states that have ratified it. Organized by the Knowledge Center on Article 12 of the WHO FCTC, an offshoot of Santé publique France, this bilingual webinar was held on 1^er June 2023. This Knowledge Center aims in particular to assist the Parties by disseminating knowledge and expertise on the FCTC, while promoting international cooperation between the Parties.

Funding prevention through taxation of tobacco products

Several speakers took turns during this webinar :

• Zunda Chisha, FCTC Programme Manager in Cape Town, stressed the importance of increasing existing taxes on tobacco products and creating new ones to fund prevention efforts, as set out in the FCTC Article 6 Implementation Guidelines. The price sensitivity of tobacco, which is higher in low- and middle-income countries, is also an effective way to reduce tobacco prevalence.
• Claire du Merle and Anne-Charlotte Salavert (Ministry of Health), as well as Marie-Caroline Laï (Health Insurance), presented the many actions and activities financed by the Addictions Fund (FCLA). Formerly the Tobacco Control Fund, the FCLA is mainly funded by a portion of excise duties on tobacco products. Today, it covers all addictive behaviors and is the main source of funding for smoking prevention and denormalization actions in France.
• Sylviane Ratte (Vital Strategies) detailed multiple avenues for sustainably financing prevention actions[1]. In addition to creating and dedicating new taxes on tobacco products, fines and convictions, for example, allow the costs of prevention to be shifted to manufacturers. Obtaining free airtime in the media to broadcast awareness campaigns is also part of sustainable and low-cost solutions.
• Dudley Tarlton of the United Nations Development Programme (UNDP) suggested that a levy on tobacco products could be calculated based on the estimated per capita costs of tobacco to each country's health system.

Most of the options discussed therefore consist of taxing tobacco products or manufacturers more heavily in order to ensure not only the financing of prevention actions, but also the innumerable costs linked to smoking.

The FCTC, a wealth of resources for tobacco control

Several questions then focused on the implementation of targeted actions, whether they target adolescents, the prison population or the reduction of health inequalities. In most cases, the full implementation of the FCTC guidelines, and in particular the increase in taxes to increase the prices of tobacco products, make it possible to reduce the prevalence of smoking. The FCTC thus remains the reference toolbox in the fight against smoking.

Keywords: CCLAT, article 12, article 6, prevention, awareness, Public Health France.

M.F.

[1] Vital Strategies, Sustainable Funding Mechanisms for Population-Level Tobacco Control Communication Programs, plea, 2016, 33 p.