The Framework Convention on Tobacco Control (FCTC) was the first international public health treaty negotiated under the auspices of the World Health Organization (WHO), with the aim of providing a global strategy to address the global tobacco epidemic that cost an estimated 100 million lives in the 20th century. If trends continue, one billion people will die in the 21st century.
The FCTC came into force in 2005 and has been ratified by 182 Parties, covering more than 90% of the world population. It provides guidelines as well as requirements for countries to implement what are considered as the most cost-effective measures available to curb smoking and tobacco-related diseases, including cancer.
Required measures include a comprehensive ban on tobacco advertising, strong health warnings on tobacco packaging, protection from secondhand smoke in indoor areas and measures to reduce tobacco smuggling. Guidelines cover the regulation of ingredients in tobacco products, the sale of tobacco products by or to minors, treatment for tobacco addiction, research and exchange of information among countries and promoting public awareness. The FCTC also encourages price and tax measures as effective means to reduce the demand for tobacco.
To guide the implementation of these requirements and guidelines, the FCTC issued in 2018 a medium-term strategic framework, the Global Strategy to Accelerate Tobacco Control: Advancing Sustainable Development through Implementation of the WHO FCTC 2019–2025 or “Global Strategy 2025”.
“Overwhelming evidence tells us that the tobacco epidemic is not only a health issue, it is also a development issue. As the Global Strategy points out, implementing the WHO FCTC will not only help Parties combat tobacco use, it also will help them advance sustainable development.”
– Adriana Blanco Marquizo, Head of Secretariat of the WHO Framework Convention on Tobacco Control, “Fighting the tobacco epidemic”
A progress report issued in 2018 noted advances in the implementation of measures outlined in the FCTC and their effectiveness in reducing tobacco use. Some 90% of countries who ratified the treaty reported developing tax or price policies and the same percentage banned smoking in public places. Nearly two-thirds indicated that they had taken measures to prevent tobacco industry interference with control policies.
However, low prices and taxes, weak regulation, sociocultural factors as well as lobbying by the tobacco industry remain the determinants of tobacco consumption that constitute a barrier to implementing FCTC measures and reducing use. This is particularly true in low- and middle-income countries (LMICs), where 80% of the more than one billion smokers worldwide live and where effective regulation on tobacco is the most sorely needed. Interference by the tobacco industry in LMICs, in particular, remains strong, as exemplified by Jordan, which made headlines last year as the country with the highest smoking rates in the world – and second in the world for tobacco company interference.
Tobacco use is a risk factor for many cancers, not only lung and oral cancers, but for about 20 cancer types including cancers of the stomach, oesophagus, kidney, liver, bladder, pancreas, cervix and colon. In the US, the Center for Disease Control and Prevention estimates that up to 40% of diagnosed cancers can be attributed to tobacco consumption, while the International Agency for Research on Cancer estimates that about 20% of cases in Europe in 2018 are caused by tobacco.
According to WHO, 25% of all cancer deaths globally can be linked to tobacco. As there were an estimated 10 million deaths from cancer in 2020, this means that up to 2.5 million people could have avoided dying prematurely from cancer if they had never smoked or if they had quit.
For this reason, tobacco control constitutes a key area of work for UICC, which relies on a global network of some 1,200 member organisations in 173 countries, its close ties as founder to the NCD Alliance and the McCabe Centre for Law & Cancer, the WHO FCTC Knowledge Hub on Legal Challenges, and its status as an official NGO observer of the FCTC. As such, UICC is uniquely placed to support advocacy for more effective and cost-efficient tobacco regulation, and for raising awareness about tobacco prevention and cessation, as well as lifting the veil on tactics used by the tobacco industry to extend its influence and increase its customer base.
UICC collaborates closely with WHO on tobacco control and in the lead-up to World No Tobacco Day on 31st May and the year-long campaign “Commit to quit”, it will be supporting action with its own campaign to reduce the burden of cancer through tobacco cessation and prevention.
A ban on smoking in public areas, particularly closed environments, is to protect individuals by reducing their exposure to second-hand smoke, which contributes to 1.2 million deaths per year, including 65,000 among children. Taxation is a win-win measure for the economy as well as public health, since revenue can help fund health systems and prevention programmes, and studies have shown that a 10% increase in taxes leads to a 4-5% decrease in the demand for cigarettes. However, these and other effective measures are often undermined or made difficult to implement due to the massive financial and political weight of the tobacco industry, which spends an estimated USD 23 Million per day on marketing and actively spreads misinformation.
In the coming months, UICC aims to raise awareness on these issues through website blogs and news, articles in science journals and social media campaign videos. UICC will also be coordinating with its members and partners to relay messages and engaging at the international level with the FCTC and WHO as well as at the local level with stakeholders and advocates to reach policymakers. In particular, UICC is organising its first Virtual Dialogue series on tobacco control and cancer entitled “Aligning efforts, maximising impact“.
The overarching goal is to connect existing networks and partnerships, and help unite the cancer and tobacco control communities, in order to align efforts to support tobacco control around the world.