World

No Tobacco Day 2013

Friday, 31 May 2013

Tobacco control briefing

National-level studies before and after advertising bans found a decline in tobacco consumption of up to 16% following prohibitions. (World Health Organization)

WNTD 2013 THEME: BAN TOBACCO ADVERTISING, PROMOTION AND SPONSORSHIP (TAPS) The theme of this years World No Tobacco Day is ban tobacco advertising, promotion and sponsorship or TAPS. The tobacco industry is renowned for its powerful and pervasive advertising in all media, as well as its sponsorship of events and organizations. These marketing tactics are designed to seduce smokers with positive associations that hide the deadly truth about tobacco use. Evidence shows that comprehensive TAPS bans lead to fewer people starting or continuing smoking and average overall declines of 7%. The tobacco industry spends tens of billions of US dollars worldwide each year on marketing. When countries implement partial advertising bans, tobacco companies simply divert resources to other types of marketing. For example, tobacco companies invest in sophisticated branding to promote their products. In many low- and middle-income countries, more than a third of young people own an object with a cigarette brand logo. Companies also engage in activities that they categorise as corporate social responsibility that are intended to improve their image as a socially acceptable economic contributors and persuade governments not to introduce policies that will reduce tobacco sales. 92 countries self-reported that they have adopted comprehensive bans on tobacco advertising promotion and sponsorship to the FCTC Conference of Parties in 2012. In fact, of the 176 countries that are Parties, to date only 19 countries have fully comprehensive bans. A comprehensive TAPS ban is required under Article 13 of the WHO Framework Convention for Tobacco Control (WHO FCTC) of all Parties to this treaty within five years of the entry into force of the Convention for that Party. 38% of countries still have minimal or no restrictions on TAPS. This years World No Tobacco Day highlights the need to implement bans at both subnational and national levels. GENERAL BACKGROUND INFORMATION Tobacco control is a public health priority because: Tobacco kills nearly 6 million people each year and accounts for 1 in 10 of all deaths. Included in this death toll are some 600,000 non-smokers who are exposed to second- hand smoke. In 2004, children accounted for 28% of these deaths. More than 40% of all children have at least one parent who smokes and are regularly exposed to second-hand smoke at home. There are more than 4,000 chemicals in tobacco smoke, of which at least 250 are known to be harmful, and more than 50 are known to cause cancer. Without urgent action, deaths from tobacco could reach 8 million by 2030. 63% of all deaths are caused by non-communicable diseases, for which tobacco use is one of the greatest risk factors. Tobacco is a risk factor for 6 of the 8 leading causes of death worldwide. It is the single

most preventable cause of death in the world today. 80% of tobacco deaths will occur in low- and middle-income countries.

Where is tobacco use the biggest problem: Globally there are around 1 billion smokers today. 80% of smokers live in low- and middle-income countries. 15 countries are home to approximately 2/3 of these smokers (in order by number of smokers): China, India, Indonesia, Russia, Bangladesh, Brazil, Mexico, Turkey, Pakistan, Egypt, Ukraine, Philippines, Thailand, Vietnam, Poland. Consumption of tobacco is increasing globally, although it has decreased in high- and upper-middle-income countries. Only half of the worlds population lives in a country offering protection through the key measures that significantly reduce tobacco use, such as ad bans. INTERNATIONAL ACTION FOR TOBACCO CONTROL The worlds first public health treaty, the WHO Framework Convention on Tobacco Control (FCTC), passed into law in February 2005. 176 countries, representing 88% of the worlds population, are now parties to the treaty, who are legally obligated to pass, implement and enforce tobacco control legislation. The Bloomberg Initiative to Reduce Tobacco Use was launched in 2006 with a US$ 125 million gift from US philanthropist Michael Bloomberg to provide support for tobacco control efforts aimed at fulfilling the requirements of the FCTC. Additional gifts in 2008 and 2012 have brought this total to $595 million in funding. The World Health Organization has developed the MPOWER package of measures that are aligned with FCTC requirements and are based on proven interventions: Monitor tobacco use and prevention policies Protect people from tobacco use Offer help to quit tobacco use Warn about the dangers of tobacco Enforce bans on tobacco advertising, promotion and sponsorship Raise taxes on tobacco. Progress: 19 countries representing 425 million people have comprehensive TAPS bans. In 2008 only 80 million people were protected by such bans. 101 countries have partial TAPS bans that cover national TV, radio and print. 42 countries mandate pictorial health warnings. 23 countries have implemented at least one strong anti-tobacco mass media campaign in the past two years. The number of people protected from second-hand smoke has more than doubled in two years: from 354 million in 2008 to 739 million in 2010. 59 countries are now monitoring tobacco use. 27 countries have raised tobacco taxes to more than 75% of the retail price. Challenges: Around 38% of countries have minimal or no restrictions on tobacco advertising, promotion and sponsorship (TAPS). The economic strength of the tobacco industry means that they can continue to block legislation through litigation. 92 countries self-reported that they have adopted comprehensive bans on tobacco

advertising promotion and sponsorship to the FCTC conference of parties. In reality, only 19 countries have fully comprehensive bans. Only 19 countries meet the best practice for pictorial warnings on tobacco packages (local language and covers at least half of the front and back). Less than 11% of the population is covered by comprehensive national smoke-free laws. 3 out of 4 smokers aware of the dangers of tobacco want to quit, but only 5% of the worlds population have access to comprehensive services to treat tobacco dependence.

WHAT THE UNION IS DOING: The International Union Against Tuberculosis and Lung Disease (The Union) has been working on tobacco control in low-income countries for 25 years. Today, as a partner in the Bloomberg Initiative to Reduce Tobacco Use (BI), The Union works to cut tobacco use and save lives by: Promoting effective tobacco control policy through technical training and resources Training a new generation of managers and practitioners Supporting effective programmes through grants Building knowledge for action through research Through the BI programme, The Union has worked with 43 low- and middle- income countries, supporting projects such as achieving 100% smokefree environments, improving tobacco control legislation, training close to 2,500 public health professionals in technical and management skills related to tobacco control, and giving technical and legal advice on a variety of tobacco control issues. Specific projects related to TAPS include: Indonesia: A Union workshop on graphic health warnings led to a declaration that these warnings should cover 50% of tobacco packages and a subsequent meeting with the President of Indonesia, who supported the idea. On 24 December 2012, a government regulation of the health law was passed requiring 40% pictorial warnings by June 2014. India: An Enforce TAPS workshop led to the drafting of compliance protocols that were finalised in early 2013 and are now being tested. Use of the protocols has intensified efforts to enforce TAPS bans in many states. Brazil: A law banning TAPS at point-of-sale came into effect in 2011. Two Union grantees were instrumental in this campaign and The Union provided legal and technical assistance throughout the process. Pakistan: Pakistan increased the size of its graphic warnings from 40 to 50% in 2011. Since a 2011 Union regional workshop on TAPS, the tobacco control cell (TCC) has registered numerous successful cases against the tobacco industry (TI) for violations. Lebanon: Lebanons National Tobacco Control Law went into effect in September 2012 and a total TAPS ban, which was challenged by local shop owners, was upheld. Nepal: Nepals comprehensive tobacco control law, which went into effect in May 2012, calls for 75% pictorial health warnings, but the TI sued the government, which has blocked implementation of this provision. The Union continues to support government efforts for full implementation. Chad and Niger: Both countries implemented a ban on all forms of direct advertising of tobacco products in 2011.

UNION EXPERTS TO CONTACT: Name and title Dr Ehsan Latif, Director of Tobacco Control

Expertise Contact BI grants elatif@theunion.org programme, Tobacco control in Pakistan and Bangladesh Prof Gihan El-Nahas Tobacco control in gelnahas@theunion.org Regional Coordinator Tobacco Control Egypt and the Middle East Dr Tara Singh Bam Technical Advisor, Tobacco Control Dr Lin Yan Director of The Union China Office Irina Berezhnova Director of The Union Russia Office
tsbam@theunion.org Tobacco control in Nepal and Indonesia Tobacco control in ylin@theunion.org China Tobacco control in iberezhnova@theunion.org Russia

Mirta Molinari Tobacco control in mmolinari@theunion.org Regional Coordinator Tobacco Control Latin America Dr Rana Jugdeep Singh Tobacco control in rjsingh@theunion.org Technical Advisor (Public Health) India Anne Jones Tobacco control in ajones@theunion.org Technical Advisor to The Union and Australia and South- CEO of ASH Australia East Asia Daouda Adam Tobacco control in dadam@theunion.org Technical Advisor of Africa to The Africa Union SOURCES AND LINKS TO MORE INFORMATION: The Unions Department of Tobacco Control www.tobaccofreeunion.org The Tobacco Atlas (4th edition) http://www.tobaccoatlas.org/ WHO Tobacco fact sheet (updated May 2013) http://www.who.int/mediacentre/factsheets/fs339/en/index.html WHO Tobacco Free Initiative www.tobacco.who.int Tobacco: A Global Threat by John Crofton, et al. http://www.theunion.org/index.php/en/resources/scientific-publications/tobacco- control/item/189-tobacco-a-global-threat Smoking cessation and smokefree environments for tuberculosis patients http://www.theunion.org/index.php/en/resources/scientific-publications/tobacco- control/item/43-smoking-cessation-and-smokefree-environments-for-tuberculosis-patients-