Tobacco Control Litigation: Broader Impacts on Health Rights Adjudication

There is perhaps no area of law that so effectively protects human health and thereby advances the right to the highest attainable standard of health, as tobacco control. Globally, tobacco is responsible for 1 in 10 adult deaths, and is on track to kill 10 million people per year, mostly in developing countries, representing a US$200 billion drain on the global economy. Yet experience in recent decades has shown that a range of tobacco control measures, such as comprehensive bans on smoking in public places, tobacco taxes, and limits on tobacco advertising, can greatly reduce smoking prevalence. These measures have slowly curtailed the epidemic, despite strong opposition from various sectors led by the tobacco industry. It is fitting that tobacco control is the focus of a recent, widely ratified global treaty (the Framework Convention on Tobacco Control) and of increasing national litigation, often directly linked to countries’ human rights commitments.

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Tobacco control and Healthy China 2030

Tobacco Control ◽

10.1136/tobaccocontrol-2018-054372 ◽

2018 ◽

Vol 28 (4) ◽

pp. 409-413 ◽

Cited By ~ 13

Author(s):

Mark Goodchild ◽

Rong Zheng

Keyword(s):

Tobacco Control ◽

Control Measures ◽

Smoking Rate ◽

Policy Makers ◽

The Real ◽

The Third ◽

Full Implementation ◽

Tobacco Taxes ◽

Real Price ◽

Business As Usual

BackgroundThe Healthy China 2030 strategy sets ambitious targets for China’s policy-makers, including a decrease in the smoking rate from 27.7% in 2015 to 20% by 2030. China has made progress on tobacco control in recent years, but many key measures remain underused. This study explores the potential for full implementation of these measures to achieve the targeted reduction in smoking by 2030.MethodsFirst, a ‘business as usual’ scenario for China’s cigarette market was developed based only on underlying economic parameters. Second, non-price tobacco control measures were then added assuming they are fully implemented by 2030. Third, excise per pack was raised to a level that would increase the real price of cigarettes by 50% in 2030.FindingsUnder the business as usual scenario, the rate of smoking falls to around 26.6% in 2030. When non-price measures are included, the rate of smoking falls to 22.0% (20.9%~23.1%). Thus, non-price measures alone are unlikely to achieve the Healthy China target. Under the third scenario, excise per pack was roughly doubled in 2030 in order to increase real cigarette prices by 50%. The rate of smoking then falls to 19.7% (18.2%~21.3%), reflecting 78 million (59~97 million) fewer smokers compared with 2016. In addition, real excise revenue from cigarettes increases by 21% (−3%~47%) compared with 2016.ConclusionSignificantly higher tobacco taxes will be needed to achieve Healthy China 2030 target for reduced smoking even after the implementation of other tobacco control measures.

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Social differences in 20-year trends in daily smoking among Lithuanian adult population

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.1356 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

J Petkeviciene ◽

V Kriaucioniene ◽

A Raskiliene

Keyword(s):

Tobacco Control ◽

Smoking Prevalence ◽

Social Inequalities ◽

Control Measures ◽

University Education ◽

Daily Smoking ◽

Age Difference ◽

Consistent Difference ◽

Social Differences ◽

Men And Women

Abstract Background Tobacco control measures carried out in the countries can affect social inequalities in the smoking habit. This study aimed to examine the 20-year trends in social patterning of daily smoking in Lithuania. Methods The data were obtained from 11 biannual cross-sectional postal surveys of Lithuanian Health Behaviour Monitoring, beginning in 1994. Each survey used a randomly selected nationally representative independent sample of 3000-4000 inhabitants aged 20-64 drawn from the population register. In total, 8738 men and 11822 women participated in the surveys. The analysis of daily smoking involved the respondents who had smoked daily for at least one year. Results The prevalence of daily smoking was increasing up to the year 2000, especially among women, while a decreasing trend in men and levelling off a trend in women was observed afterwards. In the last survey, 33.3% of men and 12.5% of women were daily smokers. The proportion of daily smokers was higher among younger than older participants; however, the age difference in smoking decreased over time. The highly educated men and women smoked less than those with low education. The odds ratio (OR) of smoking in men with university versus lower education was 0.42 (95% CI 0.37-0.47) and in women - 0.68 (95% CI 0.60-0.78). The proportion of smoking men decreased in all educational groups; however, the differences in the smoking prevalence remained. Since 2000, the educational gradient in smoking among women was increasing due to a decline in smoking prevalence among women with university education. More women living in big cities than in non-urban areas were daily smokers (OR 1.29; 95% CI 1.15-1.44). Over 20 years, no consistent difference in the smoking trends by place of residence was found in both genders. Conclusions The 20-year trends in social patterning of daily smoking differed between men and women. Inequalities in daily smoking by age and education remained in both genders. Key messages In Lithuania, the trends and social differences in daily smoking were related to gender. Comprehensive tobacco control measures targeting young and lower educated groups should be implemented aiming to reduce social inequalities in smoking.

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Impact of the WHO FCTC on tobacco control: perspectives from stakeholders in 12 countries

Tobacco Control ◽

10.1136/tobaccocontrol-2019-054940 ◽

2019 ◽

Vol 28 (Suppl 2) ◽

pp. s129-s135 ◽

Cited By ~ 2

Author(s):

Lorraine Craig ◽

Geoffrey T Fong ◽

Janet Chung-Hall ◽

Pekka Puska

Keyword(s):

Tobacco Control ◽

World Bank ◽

Tobacco Industry ◽

Primary Objective ◽

Political Support ◽

Control Measures ◽

Stakeholder Perspectives ◽

Independent Expert ◽

Development Levels ◽

The Impact

BackgroundThe WHO Framework Convention on Tobacco Control (WHO FCTC), the first WHO treaty, entered into force in 2005. In April 2015, a seven-member independent expert group (EG) was established by a decision of the FCTC Conference of the Parties to assess the impact of the Treaty in its first decade.One component of the EG’s methodology was to gather evidence on WHO FCTC impact from Parties themselves. This paper presents findings from 12 country missions on how the FCTC impacted progress on tobacco control.MethodsBetween November 2015 and May 2016, EG members conducted missions in 12 countries representing each of the six WHO regions and the four World Bank economic development levels. In each country, the EG interviewed a broad range of stakeholders to assess the extent to which the FCTC had contributed to tobacco control. The primary objective was to assess whether tobacco control measures would have been developed or passed, or implemented at all, or as quickly, if there had been no FCTC. Through this counterfactual inquiry, the EG sought to determine the FCTC’s causal role.ConclusionThe FCTC was reported to have made contributions along the entire policy/regulation process: the development of a measure, building legislative and political support for a measure and its implementation. These stakeholder perspectives support the conclusion that the FCTC has played a pivotal role in accelerating and strengthening the implementation of tobacco control measures, although tobacco industry interference continues to be a significant obstacle to further advancement.

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Twenty-year health and economic impact of reducing cigarette use: Minnesota 1998–2017

Tobacco Control ◽

10.1136/tobaccocontrol-2018-054825 ◽

2019 ◽

pp. tobaccocontrol-2018-054825 ◽

Cited By ~ 2

Author(s):

Michael V Maciosek ◽

Amy B LaFrance ◽

Ann St Claire ◽

Zack Xu ◽

Morgan Brown ◽

...

Keyword(s):

Cigarette Smoking ◽

Medical Care ◽

Tobacco Control ◽

Smoking Prevalence ◽

Simulation Method ◽

Control Measures ◽

Productivity Costs ◽

Policy Model ◽

Medical Spending ◽

Lung Health

BackgroundAdult smoking prevalence in Minnesota fell from 21.8% in 1997 to 15.2% in 2016. This reduction improved heart and lung health, prevented cancers, extended life and reduced healthcare costs, but quantifying these benefits is difficult.Methods1.3 million individuals were simulated in a tobacco policy model to estimate the gains to Minnesotans from 1998 to 2017 in health, medical spending reductions and productivity gains due to reduced cigarette smoking. A constant prevalence scenario was created to simulate the tobacco harms that would have occurred had smoking prevalence stayed at 1997 levels. Those harms were compared with tobacco harms from a scenario of actual smoking prevalence in Minnesota from 1998 to 2017.ResultsThe simulation model predicts that reducing cigarette smoking from 1998 to 2017 has prevented 4560 cancers, 31 691 hospitalisations for cardiovascular disease and diabetes, 12 881 respiratory disease hospitalisations and 4118 smoking-attributable deaths. Minnesotans spent an estimated $2.7 billion less in medical care and gained $2.4 billion in paid and unpaid productivity, inflation adjusted to 2017 US$. In sensitivity analysis, medical care savings ranged from $1.7 to $3.6 billion.ConclusionsMinnesota’s investment in comprehensive tobacco control measures has driven down smoking rates, saved billions in medical care and productivity costs and prevented tobacco related diseases of its residents. The simulation method employed in this study can be adapted to other geographies and time periods to bring to light the invisible gains of tobacco control.

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Tobacco Control Legal System Based on Environmental Protection Law Under the Background of Framework Convention on Tobacco Control

Tobacco Regulatory Science ◽

10.18001/trs.7.4.23 ◽

2021 ◽

Vol 7 (4) ◽

pp. 457-468

Author(s):

Yang Liu

Keyword(s):

Control System ◽

Environmental Protection ◽

Tobacco Control ◽

Legal System ◽

Development Trend ◽

Public Places ◽

Tobacco Products ◽

Starting Point ◽

Administrative Rules ◽

Health Rights

Objectives: This paper studies the legal system of tobacco control based on environmental protection law under the background of the Framework Convention on tobacco control. Methods: Using the research methods of comparative analysis and literature analysis, and taking the tobacco control law as the starting point, this paper expounds the development of global tobacco control civilization and the historical process of tobacco control at home and abroad. By analyzing the problems existing in the production, sales and consumption of tobacco products in China, we can trace the source in the specific links of the life cycle of tobacco products. At the same time, this paper systematically analyzes the defects of China's tobacco control system in taxation and private rights, and summarizes the shortcomings of China's tobacco control system. Results: Many cities have begun to try to enact non-smoking regulations to control smoking in public places. China's deficiencies in this regard are mainly due to the low level of relevant laws and regulations, which are basically local laws and administrative rules. The second is the problem of implementation, resulting in the inadequate or virtual implementation of many laws. Conclusion: From the development trend of various countries, the view of respecting others' health rights and gradually banning smoking has gradually become everyone's consensus. The consolidation of this understanding needs the support of laws to form a set of nonsmoking system with national laws as the core and administrative rules and local regulations as the supplement. Rights and responsibilities are clear, and rewards and punishments are based on evidence. Only in this way can we ensure to reduce the smoking rate, protect everyone's health, and finally form a good atmosphere of no smoking and no respect for smoking in the whole society.

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Policy incoherence and tobacco control in Indonesia: an analysis of the national tobacco-related policy mix

Tobacco Control ◽

10.1136/tobaccocontrol-2021-056633 ◽

2021 ◽

pp. tobaccocontrol-2021-056633

Author(s):

Elisabeth Kramer ◽

Abdillah Ahsan ◽

Vaughan W Rees

Keyword(s):

Tobacco Control ◽

Smoking Prevalence ◽

Tobacco Industry ◽

Policy Mix ◽

Political Will ◽

News Reporting ◽

Health Finance ◽

Tobacco Control Policies ◽

High Smoking Prevalence ◽

Ministry Of Finance

IntroductionIndonesia has a high smoking prevalence that has not diminished significantly since 1990. Considering this, we aim to summarise the existing national tobacco-related policy mix and explore markers of policy incoherence in tobacco control between 2014 and 2020.MethodsWe conducted (1) a review and synthesis of Indonesian tobacco-related legislation and regulations; (2) a systematic search and synthesis of related literature and news reporting; and (3) interviews with tobacco control activists and academics to understand political will towards tobacco control regulations and the tobacco industry.ResultsIndonesia’s existing tobacco-related policy mix lies across the president’s office, six national ministries and one independent agency. However, current responsibility lies primarily with four government ministries: Ministries of Health, Finance, Communication and Information, and Trade and Industry, with the Ministry of Finance most active. Evidence demonstrates that official interministerial collaboration was lacking from 2014 to 2020 and suggests that institutional will to introduce more effective tobacco control varies considerably between different arms of government.DiscussionPolitical will differs according to ministerial mandates and priorities, fostering a fragmented policy approach and undermining the development of a coherent response. Without political will from the president or national parliament to create an overarching framework for tobacco control, either via ratification of the Framework Convention on Tobacco Control or another mechanism, there remains no formal impetus for intragovernmental cooperation. Nonetheless, this analysis reveals some government progress and ‘pressure points’ that advocates can focus on to promote tobacco control policies within the current policy mix.

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The taste of smoke: tobacco industry strategies to prevent the prohibition of additives in tobacco products in Brazil

Tobacco Control ◽

10.1136/tobaccocontrol-2018-054892 ◽

2019 ◽

Vol 28 (e2) ◽

pp. e92-e101 ◽

Cited By ~ 2

Author(s):

Andre Luiz Oliveira da Silva ◽

Stella Aguinaga Bialous ◽

Patrícia Gonçalves Duarte Albertassi ◽

Daniela Aparecida dos Reis Arquete ◽

Ana Marcia Messeder Sebrao Fernandes ◽

...

Keyword(s):

Tobacco Control ◽

Tobacco Industry ◽

Scientific Evidence ◽

Scientific Basis ◽

Control Measures ◽

Tobacco Products ◽

Political Interference ◽

The World ◽

Legislative Activity ◽

Smoke Tobacco

BackgroundThe tobacco industry (TI) uses several strategies to attract new consumers, including using additives in tobacco products, which makes tobacco especially attractive to youth. Based on scientific evidence and the principles of the WHO Framework Convention on Tobacco Control, the Brazilian Health Regulatory Agency (ANVISA, for the name in Portuguese), published the Collegiate Board Resolution (RDC, for the name in Portuguese) 14/2012 in 2012, prohibiting the addition of substances that enhance the flavour and taste of tobacco products in order to make them more attractive. In response, the TI used various strategies to prevent RDC 14/2012 from entering into force. At the time, the Brazilian additive ban was the most comprehensive in the world as it included a ban on menthol.ObjectivesThis paper analyses the arguments and strategies used by the TI to prevent the implementation of the additives ban.MethodsReview of published articles, reports, legislation and legislative activity, internal TI documents, media stories and other documents to describe TI’s reaction to the ban.ResultsThe results show that the TI used some well-known strategies to delay or cancel the entering into force of the resolution. For example, the TI attempted political interference, used litigation and commissioned studies with findings that questioned the resolution’s rationale. The TI strategies used in Brazil are similar to those used at the global level to oppose other tobacco control measures.ConclusionsTI successfully delayed the most comprehensive additive ban in the world using its usual tactics, despite the fact that none of the arguments presented by the TI had an acceptable scientific basis or evidence.

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Projecting the future impact of past accomplishments in tobacco control

Tobacco Control ◽

10.1136/tobaccocontrol-2019-055487 ◽

2020 ◽

pp. tobaccocontrol-2019-055487

Author(s):

Michael V Maciosek ◽

Ann W St Claire ◽

Paula A Keller ◽

Amy B LaFrance ◽

Zack Xu ◽

...

Keyword(s):

Tobacco Control ◽

Smoking Prevalence ◽

Control Measures ◽

Tobacco Prevention ◽

Quit Smoking ◽

Control Programmes ◽

And Control ◽

Productivity Gains ◽

Population Effects

BackgroundThe benefits to adults who quit smoking increase over time as former smokers live longer, healthier lives. Youth who never smoke will benefit for decades. Thus, the long-term population effects of tobacco prevention and control policies may be substantial. Yet they are rarely quantified in evaluations of state tobacco control programmes.MethodsUsing a microsimulation model, we predicted the benefits to Minnesotans from 2018 to 2037 of having reduced cigarette smoking prevalence from 1998 to 2017. We first simulated the health and economic harms of tobacco that would have occurred had smoking prevalence stayed at 1997 levels. The harms produced by that scenario were then compared with harms in scenarios with smoking declining at observed rates from 1998 to 2017 and either expected declines from 2018 to 2037 or a greater decline to 5% prevalence in 2037.ResultsWith expected smoking prevalence decreases from 2018 to 2037, Minnesotans will experience 12 298 fewer cancers, 72 208 fewer hospitalisations for cardiovascular disease and diabetes, 31 913 fewer respiratory disease hospitalisations, 14 063 fewer smoking-attributable deaths, $10.2 billion less in smoking-attributable medical expenditures and $9.4 billion in productivity gains than if prevalence had stayed at 1997 levels. These gains are two to four times greater than for the previous 20 years, and would be about 15% higher if Minnesota achieves a 5% adult prevalence rate by 2037.ConclusionsThe tobacco control measures implemented from 1998 to 2017 will produce accelerated benefits during 2018–2037 if modest progress in tobacco prevalence rates is maintained.

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Using market data to understand corporate behaviour

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.1304 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

R Hiscock

Keyword(s):

Tobacco Control ◽

Tobacco Industry ◽

National Level ◽

Control Policy ◽

Tobacco Product ◽

Tobacco Control Policy ◽

Market Data ◽

Tobacco Taxes ◽

Level Statistics ◽

Product Sales

Abstract Background Tobacco companies sell tobacco in order to invest in the business and make profits for shareholders. One element in creating profitability is via data driven marketing. Such data are also useful for public health because an understanding of pricing and sales patterns can help with the development of effective tobacco control methods by understanding how the tobacco industry is making profits. Methods Study 1) Public and commercial databases which provide free or paywalled access to market data were identified. Internet searches were conducted to understand more about their ownership, mission of the owners, funding and accessibility Study 2) University of Bath studies using such datasets to understand the tobacco industry were reviewed to synergise the ways in which corporate behaviour has undermined tobacco control policy. Results The United Nations provides freely accessible national level statistics on imports and exports of raw tobacco and manufactured tobacco products. Limited survey data may be available on the last product smoked. Proprietary databases are expensive, may have usage restrictions and links to the tobacco industry but can provide a detailed picture of tobacco product sales and prices. Research on such databases has illustrated how the tobacco industry kept cheap tobacco available despite tobacco taxes, used tax rises to increase their own revenue and used a standardised packaging sell through period to keep branded packs on the market for longer. Conclusions Governments should require the tobacco industry to provide market data in an easily publishable form Key messages The most detailed data on the tobacco market is proprietary. Proprietary databases are expensive, may have usage restrictions and links to the tobacco industry. Understanding of pricing and sales patterns can help with evaluating the effectiveness of tobacco control policy.

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Evidence on Article 5.3 of FCTC (Tobacco Industry Interference in tobacco control activities) in India- a Qualitative scoping study

10.21203/rs.3.rs-54074/v2 ◽

2020 ◽

Author(s):

Sonu Goel ◽

Sitanshu Sekhar Kar ◽

Madhur Verma ◽

Parthibane Sivanantham ◽

Bijay Nanda Naik

Keyword(s):

Tobacco Control ◽

Tobacco Industry ◽

Control Measures ◽

Socially Responsible ◽

Cross Sectional ◽

Control Laws ◽

Roles And Responsibilities ◽

Qualitative Research Design ◽

Depth Analysis ◽

Barriers And Challenges

Abstract Background: Tobacco Industry (TI) strives to portray itself as being “socially responsible” and contest for pertinent decision-making positions, which it uses to deter, delay or dilute tobacco control measures. There is little documented evidence of Tobacco Industry Interference (TII) from India, the scope of their interference and challenges faced by the experts for effective tobacco control.Methods: A cross-sectional qualitative research design, based upon in-depth interviews (N=26), was used to explore the opinion of key stakeholders regarding TII in India. The interview schedule collected information about the participant’s roles and responsibilities in tobacco control, the nature of TII faced by the participant, means of influence by TI, barriers and challenges to tobacco control efforts using a set of questions. Results: Most of the respondents were engaged in tobacco control, training, advocacy, and awareness generation activities from the last 5-10 years or more. The respondents defined the TI and its scope as per their experience with the help of power ranking methodology. Most of them perceived TI as ‘Manufacturers’ while others consider them as ‘advertisers’, ‘public relation companies’, ‘wholesalers’, ‘vendors’, and ‘Government firms having TI stocks’ as TI. We identified six major domains (Influencing the policy and administrative decisions, Interference with implementation of tobacco control laws and activities, False propaganda and hiding the truth, manipulating front action groups (FAG), Rampant tobacco advertising and promotion activities, and others) under which TII activities were classified. Most respondents were of opinion that TI players were interfering in the policy decisions, implementation of the tobacco control laws and activities, and manipulating the FAG. A detailed taxonomic classification of the TII strategies that emerged from our analysis were linked to article 5.3 of FCTC. Conclusions: The activity documented a significant level of TII in different domains with stakeholders acting at various hierarchical levels. The study provide insights about the nefarious tactics of TI, enable stakeholders to anticipate and pre-empt the kinds of alliances the TI may attempt to build, stimulate academicians and researchers to undertake in-depth analysis into various strategies and underscore the need for ensuring transparency in official interactions with the TI and their representatives.

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