What works in tobacco control
The WHO Framework Convention on Tobacco Control (WHO FCTC) provides a framework for evidence-based measures for tobacco control. On World No Tobacco Day 2011, WHO calls on countries to ratify and fully implement the treaty.
WHO FCTC measures can reverse the tobacco epidemic and prevent millions of tobacco-related deaths. The tobacco industry strongly opposes these measures because they work. Legislation is only the first step; enforcement is vital to effectiveness.
Within the WHO European Region, 46 countries and the European Community have ratified the Treaty.
The WHO FCTC calls on countries to take measures to reduce the demand for tobacco; these include:
- monitoring tobacco use and prevention policies
- protecting people from tobacco smoke
- offering help to stop using tobacco
- warning about the dangers of tobacco use
- banning tobacco advertising, promotion and sponsorship
- adopting price and tax measures to reduce demand.
Good monitoring provides important information about the extent of the tobacco epidemic and helps countries allocate tobacco control resources where they will be most effective. Monitoring also shows whether policies are working and how they should be tailored to the needs of different groups. Findings must be effectively disseminated so that they contribute to tobacco control policies and build capacity for effective policy implementation and enforcement.
Protection from smoke
Contrary to arguments from the tobacco industry, legislation banning smoking in public places does not harm businesses, and any country, regardless of income level, can implement effective smoke-free legislation.
Research clearly shows that there is no safe level of exposure to second-hand smoke. Only a total ban on smoking in indoor public places, including all indoor workplaces, protects people from the harm of second-hand smoke, helps smokers quit and reduces smoking among young people. In countries that have adopted such bans, public support is strong, contributing to successful implementation.
Help to quit
When informed of the risks, most tobacco users want to quit, but few get support to overcome their dependence. Health-care systems have primary responsibility for treating tobacco dependence. Programmes should include tobacco-cessation advice incorporated into primary health care services, easily accessible and free telephone help lines (quit lines) and access to low-cost cessation medication. Findings show that nicotine replacement therapies can double quit rates.
All health care workers should become advocates for tobacco control. Governments can use some tobacco-tax revenues to help generate funds to help tobacco users free themselves from addiction.
Health warnings on tobacco packages that combine text and pictures are one of the most cost-effective ways to increase public awareness of the serious health risks of tobacco use and to reduce consumption. Despite evidence of this, 9 out of 10 people worldwide live in countries that do not require warnings with pictures on tobacco packages.
Pictorial warnings convey a clear and immediate message, even to people who cannot read. They reduce the overall attractiveness of tobacco packages. This is important for a product whose new users are typically young and image and brand conscious.
Bans on advertising, promotion and sponsorship
A comprehensive ban on tobacco marketing can decrease consumption by about 7%. Banning tobacco advertising, promotion and sponsorship both reduces use and shifts the perception of tobacco use towards its not being perceived as the norm. Comprehensive bans work, and are in accordance with countries’ constitutional principles. Partial bans have little or no effect because the tobacco industry directs more efforts to areas that are not covered.
Price and tax measures
Increasing the price of tobacco is the most effective intervention to reduce smoking. It encourages tobacco users to quit and prevents children from starting to smoke. Taxes on inexpensive tobacco products should be equivalent to those on higher-priced products, such as premium-brand cigarettes, to prevent substitution in consumption.
Tobacco taxes need to be increased regularly to correct for inflation and consumer purchasing power. They are generally well accepted by the public, and raise government revenue. Allocating tax revenue for tobacco control and other important health and social programmes increases taxes’ popularity. Contrary to tobacco-industry claims, increased smuggling does not automatically follow tax increases; other factors are more important.
WHO FCTC in the European Region
- 46 countries (out of 53) and the European Community are parties to the treaty.
- 7 countries are not yet parties: Andorra, Czech Republic, Monaco, Switzerland, Tajikistan, Turkmenistan and Uzbekistan.
- Recent development: the President of Turkmenistan has signed the accession to the WHO FCTC, an important step towards becoming a party to the Treaty.