Global Implementation of Tobacco Demand Reduction Measures Specified in Framework Convention on Tobacco Control

Abstract

Objectives The world first global health treaty, WHO Framework Convention on Tobacco Control (FCTC) aims to reduce tobacco product demand by focusing on tobacco taxes, smoking bans, health warning labels and tobacco advertising bans. Previous studies almost unanimously suggest that FCTC has prompted countries to implement more effective tobacco demand reduction policies. By taking into account the pre-FCTC status, country income level and state capacity we studied if ratifying FCTC was associated with tobacco demand reduction measures in 2018/2019. Methods We used logistic regression to assess the association of FCTC ratification with adoption demand reduction measures, accounting for years since ratification, baseline status and other covariates. Results Except for taxes, state of tobacco policy implementation before FCTC ratification did not predict adoption of FCTC policies. Time since FCTC ratification was associated with implementing smoking bans and pictorial HWLs. In contrast, while the tax rate prior to FCTC ratification was positively associated with increased taxes after FCTC ratification, time since FCTC ratification was marginally negatively associated with increases in tobacco taxes. Conclusions While the FCTC was followed by implementation of compliant demand reduction policies, there are still many parties that have not implemented the FCTC, particularly increasing taxes and ending tobacco advertising and promotions. Implications We assessed changes in tobacco demand reductions measures over 22 years in 193 countries.By using internal tobacco industry documents, we were able establish a baseline before the FCTC negotiations.Unlike previous studies we included four tobacco demand reductions measures: tobacco taxes, smoking bans, health warning labels and tobacco advertising ban, The limitation of the study is that we do not have data to describe if demand reduction measures are actually enforced or what their effect on tobacco consumption is.

Testing Club Convergence in Female Smoking Prevalence

“…In equation ( 5 ), the dependent variable is an ordinal response variable, with C categories ranked in descending order (according to the different clubs identified by Phillips and Sul's methodology), and cigarette affordability is measured by its initial value. The model is thus defined by a set of C -1 equations, where the parameters α c are the thresholds (or cut-points) levels.…”

“…During the last two decades, progress has been made in implementing tobacco demand-reduction measures, such as reducing cigarette affordability through taxation, passing smoke-free laws, and banning advertising and sponsorship of tobacco products ( 4 , 5 ). These efforts have been associated with a substantial reduction in the prevalence of smoking in many world regions ( 6 ).…”

Framework Convention on Tobacco Control 2030—A Program to Accelerate the Implementation of World Health Organization Framework Convention for Tobacco Control in Low- and Middle-Income Countries: A Mixed-Methods Evaluation

“…Key demand measures require governments to raise taxes on tobacco, ban smoking in public, enforce warning labels on tobacco packs, ban tobacco advertising, and offer help in quitting tobacco. 4 When effectively implemented, several of these measures are strongly associated with reductions in smoking prevalence. 5 These measures can reduce the global tobacco-related disease burden substantially, and contribute toward advancing the United Nations Sustainable Development Goals (call for action by all countries—poor, rich, and middle income—to promote prosperity and address a range of social needs including education, health, social protection, and job opportunities, while tackling climate change and environmental protection).…”

“…Despite being parties to the WHO FCTC, only a few countries have fully implemented the FCTC demand measures. 4 , 7 For example, only 34% of countries, covering 24% of the world’s population, have implemented comprehensive smoke-free laws; and only 20% of countries, covering 13% of the world’s population, have tobacco taxes at significantly high levels to have achieved the highest-level of implementation, according to the WHO. 8 Policies to implement these measures are not in place in many countries; and even when enacted in law, are poorly enforced and implemented.…”

Trade Agreements and Tobacco Control Policy: Analysis of the Regulatory Patterns and the Influence of FCTC on Trade agreements from 2001 to 2019

“…FCTC has contributed to signi cant and rapid progress in implementing national tobacco control measures like regulating smoke-free public places and health warnings on cigarette package in many countries (7,8). The rates of adopting national tobacco control measures increased around 2 to 4 times from 1999 to 2019 (9). Furthermore, following FCTC rati cation, the global prevalence of tobacco smoking decreased from 24.3% in 2005 to 18.7% in 2020, some of which may be attributable to FCTC adoption (10).…”