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1. Why is tobacco
control a public health priority and necessity?
Currently, 1.3 billion persons use tobacco in the world.
Tobacco continues to be the second major cause of death in the world. Half of
today's tobacco users will eventually be killed by tobacco, and most of them
will be in developing countries. Currently 4.9 million people die every year
globally from tobacco use; out of the number 1.1 million people die from SEA
Region. By 2030, if present smoking trends continue, this number will rise to
10 million deaths per year globally.
While epidemiological research continues to connect
tobacco use to numerous serious health problems, economic research also shows
that tobacco con exacerbate poverty among users, grows, workers and nations.
In order to counter the ill effects of tobacco use, especially among the poor
and in low-income countries, development agencies should use policy dialogue
coupled with technical and financial cooperation to support policy change.
2. What is the WHO
Framework Convention on Tobacco Control?
Negotiations on the WHO FCTC
started as a way to combat the globalization of the tobacco epidemic. The WHO
FCTC is the first public health treaty negotiated
under the auspices of WHO.
The Treaty was adopted by all WHO’s Member States and it sets an
international minimum standard for tobacco control with provisions on issues
such as tobacco advertising and sponsorship, tax and price increases, labelling, illicit trade and
second-hand smoke among others. Ultimately the WHO FCTC
is aimed at reducing tobacco consumption and the health and economic burden
it brings with it.
3. What is the
importance of the WHO FCTC ?
The WHO FCTC set the roadmap for
a minimum set of comprehensive tobacco control measures. But the most
important dimension of the WHO FCTC is the
transnational one. A country can be successful in implementing its own
smoking bans or price increases, but if people can easily have access to
cheaper tobacco coming from a neighbouring
country that has very different standards on price and tax measures, the
objective is not achieved. The Treaty deals with this transnational problems,
illicit trade and contraband, and when it enters into force, the countries
will have some basic standards to follow.
The treaty also sets up a mechanism for international cooperation,
with its own governance system.
4. What is the
difference between a treaty, a convention, a protocol and a resolution?
A treaty is an
international legal agreement concluded between States in written form, and
governed by international law;
A convention (and
also a framework convention) is a different name for a treaty;
A protocol is
also a form of treaty. It typically
supplements, clarifies, amends or qualifies an existing international
agreement, for example, a framework convention;
A resolution is
an expression of common interest of numerous states in specific areas of
international cooperation.
5. Does this mean that the WHO FCTC
will have the same laws for all parties?
No. The WHO FCTC sets only some minimum standards and some aspirational or ideal goals for
countries to go beyond these minimum standards. Countries are free to legislate
at higher thresholds, according to their needs.
6. Why was FCTC developed?
The FCTC was developed in response to the globalization of
the tobacco epidemic. The spread of
the tobacco epidemic is facilitated through a variety of complex factors with
cross-border effects, including trade liberalization and direct foreign
investment. Other factors such as
global marketing, transnational tobacco advertising, promotion and
sponsorship, and the international movement of contraband and cunterfeit cigarettes have also
contributed to the increase in tobacco use.
7. When was FCTC adopted?
The WHO Framework Convention on Tobacco Control was adopted
unanimously by the 56th World Health Assembly on 21 May 2003.
8. Is the Treaty
going to harm tobacco growers and countries growers of tobacco?
The WHO FCTC in its preamble recognizes the need to develop
appropriate mechanisms to address the long-term social and economic
implications of successful tobacco demand reduction strategies.
Even with strong
tobacco control programmes, consumption will not
fall immediately and thus it will not affect tobacco growing countries. It
will take a few generations, time that can help a very smooth transition for
those countries that are more dependant.
The WHO and the World Bank concluded after several studies that even assuming
the more optimistic of scenarios of a reduction on smoking prevalence (% of
people who smoke), there would be an increase of tobacco demand, due to the
increase in the population. For the country's economy, it is estimated that a
reduction of money spent on tobacco would direct the money to other goods,
creating other jobs in other industries. The governments should also ensure
(and the WHO FCTC recommends) that alternative
sources of employment are devised to compensate the job that could be lost in
the tobacco fields and factories.
Currently, a very
big percentage of the people growing the tobacco crop live very precariously
and in poverty, due in part to the policies that the very same industry has
in place, like the fixing of the tobacco leave prices which leaves farmers
with no decision power of who to and for how much to sell their products.
9. How can a
country become a party to the WHO FCTC ?
After the closure
of signature to the WHO FCTC on 29 June 2004, a
country that has not signed the WHO FCTC can become
party to the Convention only by Accession/Acceptance to the Convention. The instrument of Accession/Acceptance
should be deposited to the UN Treaty Section at UN headquarters in New York.
The countries
that have signed the WHO FCTC can become parties to
the Convention by submitting the Instrument of Ratification to the UN Treaty
Section at UN headquarters in New
York.
10. Why is reaching
40 Contracting Parties such an important point?
As stated on the Treaty itself, 90 days after the
deposit of the 40th instrument of ratification or legal
equivalent, the Treaty will enter into force, and become international
binding law by which countries that are Parties to it are bound by it. These
countries are legally bound to implement the provisions in the Treaty
accordingly. Reaching 40 Contracting Parties unleashes the next step in the
process of the WHO FCTC. This sets forth the
mechanism for establishing the supreme body of the Convention the COPS, which
will oversee the implementation of the WHO FCTC.
11. How will the
WHO FCTC be implemented?
After the entry
into force of the WHO FCTC, a Conference of Parties
(COP) to the consultation will be set up.
It will have a secretariat which will oversee the implementation of
the Convention.
12. What is the
Conference of the Parties? Who will regulate the process of the Treaty?
The first session of the Conference of the Parties
(COP) will take place within a year of the entry into force. The COP
will be the regulating body in charge of deciding in detail procedural and
financial matters relating to the implementation of the Treaty at country
level.
13. If a country
has not ratified or become a party to the Treaty, yet, can it do it at a
later date?Is there a deadline for ratification?
No, the Treaty
will continue from now on to be open to ratification, acceptance or approval
for those countries that have signed, and is open for accession for those
that have not. There is no deadline for countries to become Contracting
Parties to the WHO FCTC.
14. What advantages
have countries that are already Parties to the Treaty?
The first 40
countries are making history by being the first Parties to the first WHO
Global Public Health Treaty. The Parties to the Treaty will decide in
depth the mechanisms by which the Conference of the Parties (COP) --governing
body to the Treaty-- will be guided. In this regard, the first session of the
COP will be crucial for determining how the Treaty body will function. The
COP will also be a forum to share and exchange technical and scientific
information that will be very valuable during the implementation of the
national tobacco control programmes.
15. What are the
disadvantages for countries that are not Parties to the Treaty yet ?
They will be left
out of the Conference of the Parties (COP) while they are not Parties to the
Treaty, and so they will not be able to decide on governing or procedural
issues. The Treaty also establishes that the COP shall devise funding and aid
mechanisms for those Parties that are less developed and more needed.
Countries that are not Parties will not be considered for these mechanisms of
help.
Countries not
Parties will be missing an opportunity to improve the health of their people.
16. Do the countries
that have signed the Treaty have an obligation to implement it?
No. Signing the
Treaty shows the government’s interest or intention to become a party at
a later stage. Once a country has signed it is also expected that its
government will act in good faith not to undermine the provisions set out in
the Treaty.
17. Do countries
need to sign/become a Party in order to implement tobacco control measures?
No. Many
countries have in place important and effective tobacco control programmes, but it is important, especially with the
current globalization of trade and communications, that some transnational
standards prevailing across the borders are established to prevent the
tobacco industry from circumventing national restrictions.
18. Can the
European Community (or European Union) ratify the WHO FCTC?
The EC can become
a Party to the treaty by means of formal confirmation, which has the same
effect as ratification.
19. When the EC
becomes a Party to the WHO FCTC, does this mean
that all of its 25 Member States will automatically become parties?
No. The European
Community and its member countries have competence
that are mutually exclusive. The member countries of the
European Union and the European Community as a regional economic integration
organization will become WHO FCTC Contracting
Parties as separate and distinct entities.
20. When will the FCTC come into force ?
The Convention
will enter into force on the ninetieth day following the date of deposit of
the fortieth instrument of ratification, acceptance, approval, formal
confirmation or accession with the Depository.
21. How will the FCTC help international tobacco control
?
The FCTC and related protocols will improve transnational
tobacco control and cooperation through the following avenues
:
The guiding
principles of the Convention encompass both national and transnational
measures making it clear that : tobacco is an important contributor to
inequity in health in all societies; as a result of the addictive nature and
health damage associated with tobacco use it must be considered as a harmful
commodity; the public has a right to be fully informed about the health
consequences of using tobacco products; and the health sector has a leading
responsibility to combat the tobacco epidemic, but success cannot be achieved
without the full contribution of all sectors of society.
Under the
Convention, State Parties would take appropriate measures to fulfil, through coordinated
actions, the general objectives that they had jointly agreed to. In this respect, the FCTC
includes the following general objectives : protecting children and
adolescents from exposure to and use of tobacco products and their promotion;
preventing and treating tobacco dependence; promoting smoke-free
environments; promoting healthy tobacco-free economies, especially stopping
smuggling; strengthening women’s leadership role in tobacco control;
enhancing the capacity of all Member States in tobacco control and improving
knowledge and exchange of information at national and international levels;
and protecting vulnerable communities, including indigenous peoples.
The protocols
include specific obligations to address inter alia:
prices, smuggling, tax-free tobacco products, advertising/sponsorships,
internet advertising/trade, testing methods, package design/labeling, environmental tobacco
smoke, protection of children and adolescents, product regulation, cessation
and agricultural diversification.
The process of
developing and adopting the FCTC and related
protocols will also help to :
mobilize national and global technical and financial support for tobacco
control; raise awareness among several ministries likely to come into the
loop of global tobacco control, as well as various sectors of society
directly concerned with the public health aspects of tobacco; strengthen
national legislation and action; and mobilize NGOs and other members of civil
society in support of tobacco control.
22. Where and how
resources can be mobilized for implementation of the WHO FCTC ?
After entry into
force of the FCTC, the Parties to the Convention
shall promote, as appropriate, the utilization of bilateral, regional, sub
regional and other multilateral channels to provide funding for the
development and strengthening of multisectoral
comprehensive tobacco control programmes of
developing country Parties and Parties with economies in transition. Accordingly, economically viable
alternatives to tobacco production, including crop diversification should be
addressed and supported in the context of nationally developed strategies of
sustainable development.
There are a
number of donors who can provide assistance to countries in implementing the
WHO FCTC.
However, most of these donors are contributing funds to WHO
headquarters. A portion of that fund
is coming to the Regional Office and Regional Office is spending this fund
for intercountry programmes that can facilitate the implementation of the
WHO FCTC by our Member States.
There are also
donors like European Union and World Bank who are ready to fund country
specific programmes on a bilateral basis if tobacco
control programmes are integrated into the overall
development agenda and policy of the country.
In this case, country has to take the lead and WHO Regional Office and
headquarters will help countries in this respect.
However,
countries also need to allocate their own money for tobacco control programmes. This
can encourage donors to come forward to the support of the tobacco control programmes at the country level.
23. How WHO/SEARO
is helping countries to implement the FCTC and
overall tobacco control programme?
WHO has been helping countries in building their national
capacity to implement the provision of the FCTC;
Support has also been provided to countries to formulate
national Tobacco Control Law in line with FCTC;
WHO organized Awareness Raising Workshop on FCTC;
National NGOs have been supported to facilitate signing,
ratification and implementation of FCTC;
Seed grants have been provided to countries (Bangladesh,
DPR Korea and Timor Leste) to build national
capacity and formulate National Plan of Action;
A number of researches (comprehensive tobacco control
measures, economics of tobacco control, tobacco and poverty, women and
tobacco, oral tobacco use etc.) have been undertaken in countries to generate
evidence for appropriate tobacco control interventions;
Surveillance on tobacco has been strengthened in the
Region through Global Youth Tobacco Survey (GYTS),
Sentinel Survey, Regional Survey Template etc.;
Dissemination of tobacco control information is being done
through Regional Online Database System
Countries have been supported to participate in the First
Session of Inter-Governmental Working Group on FCTC
in June 2004.
24. Do
internationally binding conventions/treaties lead to action and tangible
results?
Adopting an
international agreement can make a significant difference. For example:
 Production and consumption of substances that
deplete the stratospheric ozone layer have declined dramatically over the
last decade, as a result of the Montreal Ozone Protocol.
The General Agreement on Tariffs and Trade has
brought down trade barriers and promoted the expansion of international
trade.
Arms control agreements have limited nuclear
weapons proliferation and have led to a substantial reduction in the arsenals
of the nuclear powers.
25. Why should the FCTC be developed and negotiated under the auspices of
the World Health Organization, rather than, for example, under the umbrella
of the United Nations?
The World Health
Organization is the only international multilateral organization that brings
together the technical and public health expertise necessary to serve as a
platform for the negotiation and effective implementation of the Framework
Convention of Tobacco Control. Although
the United Nations also has the legal authority to sponsor the creation of
international instruments on tobacco control, the UN has neither the
specialized technical expertise nor the time to engage in negotiating complex
standards on tobacco control, particularly if extensive negotiation of the
Convention is required.
26. Which countries
are doing the best job on tobacco control?
Countries that
implement and enforce effective tobacco control measures in line with the
provisions of the WHO FCTC, like price and tax
increases, bans on advertising, or bans on tobacco use in public places.
27. What countries
are the worst ones?
Some countries
are more prepared and have more resources to fight against the tobacco
epidemic. For other countries, either for lack of resources or economic
dependency, it takes longer to react to this threat. But in general, the
world is becoming more aware about the negative effect that tobacco has on
people’s health and economies, and the vast majority of governments have it
as a high priority on their health agendas.
28. Will the US, China, ratify ?
The US and China have so
far signed the treaty. This indicates the intention to take the necessary
steps to become a party at a later date. It also means that they should refrain
in good faith from acts that would defeat the purpose and object of the
Convention. They need to go through the respective process of ratification or
equivalent instrument before the become parties to the Treaty.
29. How does
tobacco consumption affect individuals and families?
At the individual
and household level, money spent on tobacco can have a very high opportunity
cost. For the poor, money spent on
tobacco is not money spent on basic necessities, such as food, shelter,
education and health care. Also
tobacco users are at much higher risk of falling ill and dying prematurely of
cancers, heart attacks, respiratory diseases or other tobacco related
diseases, thus depriving families of much-needed income and imposing
additional health-care costs.
30. How does
tobacco contribute to child labour?
The use of child labour in the tobacco fields is
common practice in many tobacco-producing countries. Among poor families who depend on tobacco,
children work on tobacco farms or factories at a very early age, missing out
on vital educational opportunities that could help lift them out of poverty.
31. How does
tobacco increase poverty of countries?
Tobacco not only
impoverishes many of those who use it, it puts an enormous financial burden
on countries. The countries suffer
huge economic losses as a result of increased health-care costs,
lost productivity due to tobacco-related illnesses and premature deaths,
foreign-exchange losses by importing tobacco leaf and tobacco products,
reduced government tax revenue due to smuggling of cigarettes and
environmental damage by tobacco cultivation and curing.
32. What are the
diseases that can be caused by tobacco ?
Increased
risk of cancer and heart disease, respiratory illnesses including Chronic
Obstructive Pulmonary Diseases (COPD),
tuberculosis. A recent study showed that smoking is the
cause of half of all male TB deaths in India.
33. What are the
health hazards of tobacco cultivation?
Children and
adults working with tobacco frequently suffer from green tobacco sickness (GTS). Large and frequent application of pesticides to
protect the plant from insects and disease is a common cause of pesticide
poisonings, with symptoms encompassing nausea, muscle twitching and
convulsions. These pesticides often
have neuro-psychiatric
effects with preliminary studies indicating increased rates of depression and
suicides.
34. How does
growing tobacco harm the environment?
In many
developing countries wood is used as fuel to cure tobacco leaves and to
construct curing barns. According to a study which assessed the amount of
forest and woodland consumed annually for curing tobacco, nearly 5% of all
deforestation in developing countries where tobacco is grown was due to
tobacco cultivation. Environmental
degradation is also caused the tobacco plant, which leaches nutrients from
the soil as well as pollution from pesticides and fertilizers applied to
tobacco fields. Also tobacco
manufacturing produces immense amounts of chemical and manufacturing wastes.
35. Who benefits
from tobacco cultivation?
The tobacco
multinationals! In 2002, the combined tobacco revenues of the world’s three
largest tobacco multinationals was greater than the total combined GDPs of 27
developing countries of the world put together.
36. Is it true that
tobacco industry generates employment?
The manufacturing
side of the tobacco industry is only a small source of jobs, since it is
usually highly mechanized. In most
countries tobacco manufacturing jobs account for well below 1% of the total
manufacturing employment. And, with
the exception of a few heavily dependent countries, tobacco farming in most
countries makes up a tiny proportion of employment in the agricultural
sector.
37. Is revenue
generated from tobacco industry more than the money spent to treat tobacco
related diseases ?
Tobacco’s so called contributions to the economy
are far less than its costs to households, to public health, to the
environment and to national economy.
38. What will
happen to economies that depend on tobacco ?
It is a
perception that tobacco control will lead to loss of revenues. The economic analysis show that the social and health costs of
tobacco far outweigh the direct economic benefits that may be possible
because of tobacco cultivation.
The tobacco
industry relies on the argument that there are no real crop or other substitution
options. It is reasonable to assume
that consumers who stop smoking will reallocate their tobacco expenditure to
other goods and services in the economy.
Therefore, falling employment in the tobacco industry will be offset
by increases in employment in other industries. However, in the medium-term, for countries
which rely heavily on tobacco exports (i.e., the economy is a net exporter of
tobacco),
economic/agricultural diversification will likely entail employment losses.
The FCTC takes a long-term view of agricultural
diversification. The
framework-protocol approach provides for an evolutionary approach to
developing an international legal regime for tobacco control, and thus all
issues will not need to be addressed at the same time. Further, the need for a multilateral fund
to assist those countries which will bear the highest adjustment cost needs
to be established. The FCTC will probably be the first instrument seeking global
support for tobacco farmers.
Also, it is worth
noting that if the prevalence of tobacco use remains the same, the current
1.1 billion smokers in the world are predicted to rise to 1.64 billion by
2025, mainly due to population increases in developing countries. Therefore, tobacco growing countries are
extremely unlikely (over the next several decades) to suffer economically
from any tobacco control measures such as the FCTC. Even if global tobacco control efforts are
highly successful the world will likely have 1 to 1.2 billion tobacco users
by 2030.
39. Among which
section of the population tobacco use is the highest?
Tobacco use is
the highest among the poor and illiterate people.
40. What is the
single most effective way to control tobacco use?
Tax increase on
tobacco products is the single most effective way to control tobacco, in
particular among the most vulnerable and prevalent groups like poor and
youth.
10% increase in
price of tobacco products would decrease consumption by 3.6% among users and
7.5% among the population of low and middle-income countries.
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