Smoking cessation, a human right whose access must be facilitated

In anticipation of the World No Tobacco Day (JMST), on May 31, whose theme is "commit to quitting", the International Center for Smoking Cessation (ICTC) and Action on Smoking and Health (ASH) published a report[1] which calls for facilitating access to smoking cessation for all tobacco users to reduce the overall prevalence of tobacco and to consider this access to treatment for tobacco dependence as a human right.

Legally binding human rights texts require governments to provide their citizens with the highest attainable standard of physical and mental health as specified in Article 12 of the International Covenant on Economic, Social and Cultural Rights (ICESCR). In the context of tobacco, governments have a duty to protect their citizens by implementing tobacco control laws and strategies to end the tobacco epidemic.

Over the past few decades, progress has been made in combating the tobacco epidemic, particularly since the adoption and implementation of the WHO Framework Convention on Tobacco Control (FCTC). However, progress has been limited, with over a billion people using tobacco worldwide and 8 million people dying prematurely each year from tobacco use. Many countries still lack comprehensive tobacco control programmes. While some FCTC measures have been well implemented, others have been seriously neglected, including treatment for smoking cessation.[2].

A right enshrined in the WHO Framework Convention

Article 14 of the Framework Convention is devoted to tobacco dependence and smoking cessation. It stresses the importance of reducing the number of current smokers by using validated treatments that are made available. In 2010, the Conference of the Parties adopted guidelines detailed to assist Parties in implementing Article 14. It recommended best practices for cessation treatment, but according to WHO, only 23 countries offer comprehensive cessation services with full or partial cost coverage to help tobacco users quit. This represents only 32% of the world's population[3].

Furthermore, Article 12 of the Treaty, devoted to Education, communication, training and public awareness, includes a number of references to raising awareness of the dangers of smoking and the benefits of quitting smoking.

Support during weaning increases the chances of success

The success of tobacco control policies has increased consumer demand for smoking cessation support. On average, in countries where the Global Adult Tobacco Survey was conducted[4], more than 60% of smokers indicated that they intended to quit and more than 40% had attempted to quit in the 12 months preceding the survey. Without appropriate support, only 4% of attempts to quit smoking are successful[5]. Proven cessation treatments and professional support can double a smoker's chances of quitting. According to WHO, health professionals are the key players in promoting information and support on quitting smoking.

The WHO target of a 25% reduction in premature mortality from noncommunicable diseases (NCDs) by 2025 and the United Nations target of reducing the risk of premature death in middle age from NCDs by 2030 (SDG indicator 3.4.1) will likely not be achieved without urgent action on the provision of tobacco cessation care.[6].

E-cigarettes are not proven quitting aids

Over the last decade, the tobacco industry has expanded its range of nicotine products to position itself on the e-cigarette market, while launching new products such as heated tobacco/grilled tobacco. Behind a harm reduction discourse, the objective through these products is to develop new markets likely to reverse the downward trend in consumption of traditional cigarettes.

Health professionals warn that e-cigarette users who continue to smoke, even in smaller amounts, are not reducing their risks.

Furthermore, WHO points out that the scientific evidence on e-cigarettes as smoking cessation aids is not conclusive to date and it is difficult to say whether these products have a role to play in quitting smoking. Furthermore, while e-cigarettes, in the event of complete cessation of smoking, induce a reduction in risks for the person, these products are not harmless. E-cigarettes generate toxic chemicals, which have been linked to adverse health effects such as cardiovascular disease and lung disorders.

Dr Tedros Adhanom Ghebreyesus, Director-General of WHO, said: “We must be guided by science and evidence, not the marketing campaigns of the tobacco industry – the same industry that has engaged in decades of lies and deception to sell products that have killed hundreds of millions of people.”[7]

Keywords: Smoking cessation, World No Tobacco Day, JMST, WHO, CCLAT, smoking cessation ©Tobacco Free Generation

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[1] Access to Smoking Cessation Support is a Human Right ASH and ICTC Release a Report in Advance of World No Tobacco Day, May 31st, ASH, May 19, 2021, accessed May 21, 2021 [2] WHO Global report on trends in prevalence of tobacco smoking 2000-2025, Second edition. Geneva: World Health Organization 2018 (https://www.who.int/tobacco/publications/surveillance/trends-tobacco-smoking-secondedition/en/). [3] WHO report on the global tobacco epidemic 2017. Geneva: World Health Organization; 2017 (https://apps.who.int/iris/bitstream/handle/10665/255874/9789241512824-eng.pdf?sequence=1). [4] Asma S, Mackay J, Song SY, Zhao L, Morton J, Palipudi KM, et al. The GATS Atlas. Atlanta, GA: CDC Foundation; 2015 [5] WHO Report on the Global Tobacco Epidemic, 2019. Geneva: World Health Organization; 2019. License: CC BY-NC-SA 3.0 IGO. [6] Communicated, Non-communicable diseases: States adopt an “ambitious and balanced” political declaration on these diseases responsible for 71% of deaths worldwide, AG/12069, WHO, September 27, 2018, accessed May 21, 2021 [7] Dr. Ruediger Krech, World No Tobacco Day 2021 campaign - Commit to Quit, World Health Organization, May 19, 2021, accessed May 21, 2021 National Committee Against Smoking |