Bulletin of the World Health Organization

Tobacco Convention: countries “changed history”

Representatives from more than 110 countries gathered in Geneva to decide in detail how to implement the WHO Framework Convention on Tobacco Control (WHO FCTC), the first ever legally binding global public health treaty.

Director-General LEE Jong-wook praised countries for adopting the treaty in May 2003, saying they had “changed history”.

Since then, the WHO FCTC has become one of the most widely embraced treaties in the history of the United Nations. It came into force in February 2005 after 40 countries ratified it or followed equivalent legal procedures. By November 2005, it had a further 60 parties.

“This group of countries represents 69% of the world’s cigarette consumption,” LEE told the 6–17 February conference, referring to more than 100 parties to the treaty. “It might seem astonishing that this group is also preparing to put into action the roadmap for countries to control tobacco”.

Tobacco kills about five million people every year, and these deaths are increasing. By adopting, signing and ratifying the treaty, countries commit themselves to changing their laws to implement its provisions.

Many have started. For example, Ireland, Norway and Spain have banned smoking in indoor public places; India has imposed a comprehensive ban on tobacco advertising; and Australia, Brazil, Canada, Singapore and Thailand print highly visible graphic warnings on cigarette packets. Many other countries have implemented these and other measures.

At the conference, countries reported progress and plotted out the next steps. Some are uncertain about how to implement parts of the treaty, such as the ban on smoking in public places and the comprehensive ban on tobacco advertising, and how to track progress in this.

Countries discussed the possibility of WHO developing legally binding protocols, which would supplement the Convention, outlining action governments could take to deal with cross-border advertising and illicit trade, as well as developing guidelines for issues such as smoking bans and tobacco product regulation.

WHO may also develop guidelines to help countries ward off attempts by the tobacco industry to interfere in their tobacco control efforts. Concerns have been raised that agreements Mexico and Uzbekistan reached with the tobacco industry threaten to dilute their tobacco control efforts, according to articles published in the BMJ [2006;332:313-4, 355-8].

“WHO monitors the industry and issues publications to raise awareness about tobacco industry activities that can undermine tobacco control efforts,” said Marta Seoane, spokeswoman for the Tobacco Free Initiative at WHO.

Countries that are implementing the Convention face major challenges. For example, although Spain has raised taxes on cigarettes, tobacco companies are waging a price war to weaken their effect.