The impact of the WHO Framework Convention on Tobacco Control in defending legal challenges to tobacco control measures

BackgroundSince the WHO Framework Convention on Tobacco Control’s (FCTC) entry into force, the tobacco industry has initiated litigation challenging tobacco control measures implemented by governments around the world, or supported others to initiate such litigation on its behalf. In defending their tobacco control measures against such litigation, governments have invoked their obligations and rights under the WHO FCTC. We assess the extent to which the WHO FCTC has provided legal weight to governments’ defences against legal challenge.MethodsWe reviewed 96 court decisions concerning legal challenges to tobacco control measures, determining whether or not they cited the WHO FCTC and their outcomes. We then reviewed the cases where the WHO FCTC was cited, analysing how the WHO FCTC contributed to the resolution of the case.ResultsThe WHO FCTC was cited in 45 decisions. Decisions both citing and not citing the WHO FCTC were largely decided in favour of governments, with 80% of WHO-FCTC-citing and 67% of non-WHO-FCTC-citing cases upholding the measure in its entirety and on every ground of challenge. In cases where it was cited, the WHO FCTC contributed to the resolution of the case in favour of governments by providing a legal basis for measures, demonstrating the measure’s public health purpose, demonstrating the evidence in favour of a measure, demonstrating international consensus, demonstrating that a measure promotes or protects health-related human rights and demonstrating whether or not a measure is reasonable, proportionate or justifiable.ConclusionsThe way the WHO FCTC has been cited in court decisions suggests that it has made a substantial contribution to courts’ reasoning in tobacco control legal challenges and has strengthened governments’ arguments in defending litigation.

Download Full-text

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.

Download Full-text

A Magic Bullet? The Potential Impact of E-Cigarettes on the Toll of Cigarette Smoking

Nicotine & Tobacco Research ◽

10.1093/ntr/ntaa160 ◽

2020 ◽

Cited By ~ 1

Author(s):

David Mendez ◽

Kenneth E Warner

Keyword(s):

Harm Reduction ◽

Tobacco Control ◽

Smoking Status ◽

Vital Statistics ◽

Control Measures ◽

Magic Bullet ◽

Health Crisis ◽

Life Years ◽

Quitting Smoking ◽

The Impact

Abstract Introduction We examine the proportion of US smoking-produced mortality that e-cigarettes might eliminate under assumptions regarding vaping’s ability to increase smoking cessation, vaping’s health risks, and the possibility that vaping will increase smoking among young people. Methods We employ a dynamic population simulation model that tracks individuals from ages 0 to 110, differentiated by gender and smoking status. Using data from the US Census, the National Vital Statistics Reports, Cancer Prevention Study II, and the National Health Interview Survey, we estimate the number of smoking-related life-years lost (LYL) from 2018 to 2100 in a no-vaping scenario. We then compare results for model runs that assess the impact of vaping under a variety of assumptions. Results The combination of assumptions produces 360 possible scenarios. 357 (99%) yield positive estimates of life-years saved (LYS) due to vaping by 2100, from 143 000 to 65 million. Most scenarios result in millions of individuals quitting smoking due to vaping. On average, vaping-induced quitters gain an extra 1.2–2.0 years of life compared to smokers who quit without vaping. The impact of vaping is greatest when it most helps smokers who otherwise have the greatest difficulty quitting smoking. While the numbers of LYS are generally large across all scenarios, they often represent a small fraction of the toll of smoking. Conclusions Vaping is highly likely to reduce smoking-produced mortality. Still, vaping is not “the” answer to the public health crisis created by smoking. Rather, it may well be a tool to add to the armamentarium of effective tobacco control measures. Implications E-cigarettes hold the potential to reduce cigarette smoking’s enormous toll. By itself, however, tobacco harm reduction, as embodied in vaping, is no magic bullet. Going forward, tobacco control will require vigilant application of the evidence-based measures that have brought us so much success in combatting smoking. It will require, as well, the search for and adoption of novel means of attacking the remaining problem. Harm reduction can, and many would say should, be a part of the complex formula that will eventually bring about the demise of smoking.

Download Full-text

The World Trade Organization

10.1093/oso/9780190672676.003.0018 ◽

2018 ◽

Author(s):

Suerie Moon ◽

Thirukumaran Balasubramaniam

Keyword(s):

Human Rights ◽

World Trade Organization ◽

Tobacco Control ◽

World Trade ◽

Access To Medicines ◽

Control Measures ◽

Public Health Services ◽

Major Power ◽

The World ◽

Health Related

The ability of governments to protect and promote health-related human rights can be constrained by international trade rules, including those of the World Trade Organization (WTO). The WTO rules can increase medicine prices, challenge tobacco control measures, restrict national food safety policies, and facilitate brain drain from public health services. This chapter offers a brief history of the WTO’s origins, a high-level overview of the health implications of various WTO agreements, and a closer look at how two key issues—access to medicines and tobacco control—have created greater policy space for health within the WTO. It then identifies the institutional factors that promote or hinder human rights protection and offers conclusions on the prospects for institutionalization of health-related human rights. This chapter concludes that protecting health within the WTO and broader global trade regime is possible, but remains a significant challenge due to major power asymmetries.

Download Full-text

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.

Download Full-text

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.

Download Full-text

FCTC Ratification, Smoking Prevalence and GDP per Capita : Lesson Learn for Indonesia

10.21203/rs.3.rs-369151/v1 ◽

2021 ◽

Author(s):

Abdillah Ahsan ◽

Rifai Afin ◽

Nadira Amalia ◽

Martha Hindriyani ◽

Ardhini Risfa Jacinda

Keyword(s):

Tobacco Control ◽

Smoking Prevalence ◽

Tobacco Industry ◽

Well Being ◽

Least Square ◽

Gdp Per Capita ◽

Country Level ◽

Per Capita ◽

The Government ◽

The Impact

Abstract Background The stagnated tobacco control progress in Indonesia needs to be accelerated through a more comprehensive implementation of Framework Convention of Tobacco Control (FCTC) measurement. Nevertheless, the tobacco industry argument concerning the negative economic impacts of tobacco control still hinders the government to ratify or even sign the FCTC, which has been ratified by more than 180 countries. This study aims to bring the empirical evidence on the tobacco industry argument concerning FCTC. This study applied two stage least square estimation strategy to unbalanced panel data at country level. On the first stage we estimate the impact FCTC ratification on smoking activity, and on the second step, estimating the influence of smoking activities on macroeconomic performance.Results The result of this study shows that FCTC ratification is negatively related to a country’s smoking prevalence, in which the ratifying party of FCTC has lower smoking prevalence. Moreover, country who ratifies FCTC longer is also associated with lower smoking prevalence. Whereas FCTC ratification is beneficial in reducing smoking prevalence, the declining smoking prevalence is not related to the decline in GDP per capita.Conclusions The result of this study shows the decrease in smoking prevalence has nothing to do with the macroeconomic indicator. Hence, FCTC ratification, which is an important driver for tobacco control actions acceleration, should not be seen as a backfire to the economy. Instead, FCTC ratification could be mutually beneficial for the health and economic aspects as it provides comprehensive guidance and protocols by taking into account the well-being states of both aspects.

Download Full-text

The lead up to tobacco plain packaging policy in Turkey

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.078 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

M Selamoğlu ◽

S Fawkes ◽

A E Önal ◽

D Gleeson

Keyword(s):

Tobacco Control ◽

Tobacco Industry ◽

Single Case ◽

Public Awareness ◽

Political Agenda ◽

Plain Packaging ◽

Study Approach ◽

Turkish Government ◽

The Government ◽

The Impact

Abstract Background Research shows tobacco plain packaging (TPP) is effective in reducing the attractiveness of tobacco products, effectiveness of tobacco packaging and increases the impact of health warnings. Since Australia introduced TPP in 2012, several other countries have adopted similar legislation, and more have begun preparations for introducing it. Turkey first announced its intention to proceed with TPP in 2011, however prior to the eventual passage of legislation in December 2018 there were many false starts and delays. This study (conducted in 2018 before TPP legislation was passed in Turkey) explored the barriers and facilitators to introducing legislation. Methods A qualitative study design was employed using a single case study approach. Publicly available documents relevant to TPP in Turkey were analysed and interviews with key informants from academics, bureaucrats in government ministries and non-government organisations (NGOs) were conducted in 2018. Results Barriers such as changes to the government, tobacco industry opposition and the economic crisis appeared to contribute most to the delays in introducing TPP. Despite the barriers Turkey had faced, TPP legislation managed to reach the political agenda primarily through the collaborative advocacy efforts of NGOs, academics and the leadership of particular tobacco control advocates. Conclusions TPP legislation was approved by the Turkish government on the 5th December 2018 and has been in force since the 5th January 2020. Implications for the wider uptake of TPP include the importance of building effective coalitions and raising public awareness. Key messages The tobacco industry opposition can be defeated by tobacco control advocates working together. Turkey’s experience should be considered by other countries who are willing to implement TPP.

Download Full-text

Diverse and competing interests around tobacco: qualitative analysis of two decades of parliamentary questions in India

BMJ Global Health ◽

10.1136/bmjgh-2020-004093 ◽

2021 ◽

Vol 6 (4) ◽

pp. e004093

Author(s):

Amiti Varma ◽

Latha Chilgod ◽

Upendra Bhojani

Keyword(s):

Political Parties ◽

Tobacco Control ◽

Tobacco Industry ◽

State Level ◽

The Political ◽

The Public ◽

Competing Interests ◽

Health Related ◽

The Government ◽

Important State

IntroductionIndia continues to enhance tobacco control regulations protecting the public health while housing a widespread tobacco industry. This implies complexities in regulating tobacco. As part of a broader inquiry on the political economy of tobacco, we aimed to understand the concerns of Indian parliamentarians around tobacco.MethodsWe sourced transcripts of tobacco-related questions asked by parliamentarians between the years 1999 and 2019 from the electronic archives of both the houses of Indian parliament. We analysed the frequency of questions during different regimens, segregated by the states and the political parties that parliamentarians belonged to, as well as by the government ministries to which these questions were posed. We also conducted thematic content analysis of these questions, identifying specific themes defining parliamentarians’ concerns.Results729 unique parliamentarians asked 1315 questions about tobacco, conveying varied concerns related to health, commerce, labour and agriculture sectors. Over time, the focus of the questions shifted from majorly trade to majorly health-related concerns. We show how the tobacco regulations in India are multi-institutional and are a result of negotiations of several legitimate and competing, interests. We found important state-level differences in the number and nature of these questions.ConclusionParliamentary questions constitute a useful resource in studying tobacco politics. Tobacco regulations are a product of complex negotiation of varied and competing concerns. We identify core arguments in favour and against tobacco control that would help tobacco control advocates and agencies to better prepare and engage with diverse political voices around tobacco.

Download Full-text

Tobacco Control Litigation: Broader Impacts on Health Rights Adjudication

The Journal of Law Medicine & Ethics ◽

10.1111/jlme.12011 ◽

2013 ◽

Vol 41 (1) ◽

pp. 147-162 ◽

Cited By ~ 3

Author(s):

Oscar A. Cabrera ◽

Juan Carballo

Keyword(s):

Tobacco Control ◽

Global Economy ◽

Smoking Prevalence ◽

Tobacco Industry ◽

Control Measures ◽

Public Places ◽

Tobacco Taxes ◽

Broader Impacts ◽

The Right ◽

Health Rights

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.

Download Full-text

Implementation of tobacco control measures in the Gulf Cooperation Council countries, 2008–2020

Substance Abuse Treatment Prevention and Policy ◽

10.1186/s13011-021-00393-8 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Sarah S. Monshi ◽

Jennifer Ibrahim

Keyword(s):

Tobacco Control ◽

Tobacco Use ◽

Tobacco Industry ◽

National Level ◽

Gulf Cooperation Council ◽

Control Measures ◽

World Health ◽

Careful Examination ◽

Gulf Region ◽

Gcc Countries

Abstract Background The World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) was developed to assist nations in reducing the demand and supply of tobacco. As of 2020, 182 nations joined the FCTC, agreeing to implement the recommended tobacco control measures. The Gulf Cooperation Council (GCC) countries, including Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and United Arab Emirates (UAE) ratified the WHO FCTC by August 2006. Given the unique political, cultural, and religious context – and known tobacco industry efforts to influence tobacco use- in these nations, a careful examination of the translation of FCTC measures into policy is needed. This study aimed to assess the implementation of FCTC tobacco control measures at the national level within the six GCC countries. Method We collected and coded the FCTC measures that were implemented in the GCC countries. We examined trends and variations of the implementation between 2008 and 2020. Results GCC countries implemented most FCTC measures targeting the demand for and supply of tobacco, with some variation among countries. Bahrain and Qatar were more comprehensively implementing FCTC measures while Kuwait and Oman implemented the least number of the FCTC measures. Implementing measures related to tobacco prices and eliminating the illicit tobacco trade has slowly progressed in GCC countries. All GCC countries entirely banned smoking in workplaces while three countries implemented a partial ban in restaurants. Only Oman has restrictions on tobacco ads shown in media. There is progress in implementing FCTC measures related to tobacco packaging, cessation, and sale to minors in most GCC countries. Conclusions Given the influence of the tobacco industry in the Gulf region, the findings suggest a need for ongoing surveillance to monitor the proliferation of tobacco control measures and evaluate their effectiveness. Efforts required to address tobacco use should correspond to the unique political and cultural background of the GCC countries.

Download Full-text