International Anti-Smoking Treaty to Take Effect Soon

18 December 2004

The global war on smoking passed a major milestone on 30 November 2004. On that date, Peru became the 40th country to ratify an international treaty to reduce smoking, thus triggering activation of the treaty in 90 days.

According to the World Health Organization's World Health Report 2003, tobacco consumption is the single leading preventable cause of death. It prematurely ends the lives of 5 million people a year, a figure which will double by 2020 if current trends are not reversed. Tobacco is the only legal product that causes the death of one half of its regular users, more than many illegal drugs. This means that of the current 1.3 billion smokers, 650 million people will die prematurely due to tobacco. Another way to look at the effect of smoking is to measure the average reduction in life expectancy among smokers. A study published in the British Medical Journal in June 2004 followed 34,439 male doctors since 1951 and showed that smokers died on average 10 years earlier than non-smokers.

Although the number of smokers has stabilized or fallen in developed areas, it is rising in developing or transitional regions, which contain more of the world's population and already 84% of the world's smokers. To fight this increasing health threat, the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) was unanimously adopted by the 56th World Health Assembly in May 2003 following almost three years of negotiations. The treaty aims to reduce both the demand for and the supply of tobacco by setting standards on tobacco price and tax increases, tobacco advertising and sponsorship, labelling, illicit trade and second-hand smoke.

Studies show that increasing prices through taxes on tobacco products is the most cost-effective way to reduce smoking. The World Bank estimated that a 10% increase in tobacco prices would, on average, result in a reduction of 4% of the demand in high-income countries and 8% in lower-income countries. Thus the treaty suggests tobacco taxes or price controls, although it neither suggests specific levels nor requires any taxes or price controls.

The treaty requires all countries adopting it to ban, to the extent allowed by their constitutions, all tobacco advertising, promotion and sponsorship within five years. Health warnings must occupy at least half of the principal display areas of a pack, but they must not be less than 30%. These health warnings must be changed regularly and may include pictures. Cigarette packages must contain information on ingredients and emissions.

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An anti-smoking ad (source: CDC Media Campaign Resource Center). View more here.

The treaty aims to reduce smuggling by requiring adopting nations to mark all tobacco packages for tracing purposes and to indicate their country of destination, as well as to cooperate with each other in monitoring and controlling the movement of tobacco products and investigating their diversion. The treaty bans tobacco sales to and by minors.

The idea for an international instrument for tobacco control was initiated in May 1995 at the 48th World Health Assembly. But it wasn’t until 1999, a year after the then WHO Director-General, Dr Gro Harlem Brundtland, made global tobacco control a priority, that work on the present treaty began. During the year after the FCTC was written, 167 countries signed and 23 countries ratified it, making it one of the most rapidly embraced UN treaties of all time. "The momentum growing around the WHO Framework Convention on Tobacco Control seems unstoppable. It demonstrates the importance placed by the international community on saving many of the millions of lives now lost to tobacco," said Dr Lee Jong-wook, WHO Director-General. "I look forward to more countries joining the 40 states that are making it possible for this Treaty to become law."

Of the countries ratifying the treaty, the largest are (in order of decreasing population) India, Pakistan, Bangladesh, Japan, Mexico, Thailand, France, and Burma. Nations that have signed but not yet ratified include China, USA, Brazil, Nigeria, Philippines, Viet Nam, Germany, and Egypt. The largest non-signers are Indonesia, Russia, Colombia, Tanzania, and Uzbekistan. The Himalayan kingdom of Bhutan went beyond the treaty requirements when on December 17 it became the first country in the world to completely ban the sale of tobacco.