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Global tobacco treaty cuts smoking rates by 2.5%

Only fifth of countries have begun most effective tobacco reduction measure

Adrian O'Dowd

Thursday, 23 March 2017

Smoking rates have fallen by around 2.5% globally over the past decade since the introduction of the World Health Organization’s Framework Convention on Tobacco Control (WHO-FCTC).

A study* published in The Lancet Public Health found progress had been made since the treaty was implemented in 2005 as an agreement signed by 180 countries to commit to putting in place strong policies, including five measures:

  • high tobacco taxes
  • smoke-free public spaces
  • warning labels
  • comprehensive advertising bans
  • support for stop smoking services

A team of researchers from the International Tobacco Control Policy Evaluation Project, based at the University of Waterloo, Canada and WHO’s headquarters in Switzerland set out to analysed WHO data from 126 countries.

They tracked strong implementation of the five measures from 2007 to 2014, and examined the association between the number of measures fully implemented and country’s smoking rates from 2005 to 2015.

The countries which had fully implemented more of the measures experienced significantly greater reductions in smoking rates.

On average, smoking rates across the 126 countries fell from 24.7% in 2005 to 22.2% in 2015 – a 2.5% reduction.

However, the trends varied across countries, with smoking rates decreasing in 90 countries, but increasing in 24 and remaining static in 12 countries.

The most frequently implemented measure by 2014 was smoke-free public places (28% of the countries implemented this), while the least frequently implemented measure was advertising bans (13% of countries).

By 2014, support for stop smoking services had been adopted by 16% of countries and a quarter (25.4%) had implemented health warnings on cigarette packaging.

Only a fifth of countries (22.2%) had implemented high taxation on tobacco, which is considered to be the most effective measure for reducing smoking, especially in low- and middle-income countries where smokers are more price-sensitive.

Despite progress made, the authors said that not all reduction measures had been fully implemented at the same pace.

One of the authors, Dr Geoffrey Fong, from University of Waterloo, said: “The WHO-FCTC has been a success in reducing tobacco use in countries that engaged in strong implementation and saw their smoking rates decline.

“While the progress has been remarkable, there are still far too many countries where domestication of the treaty and its implementation has fallen short.”

Alex Engel, international tobacco control manager at Cancer Research UK, said that despite significant progress in some countries, too many have not fully adhered to the treaty.

“It’s alarming that only one in five countries have implemented adequate tobacco tax and price increases, which are the most effective measure for reducing smoking, especially in low-and middle-income countries,” she said.

“Smoking is the single most preventable cause of death in the world, killing almost 6 million people and causing more than £800 billion in health care costs and lost productivity annually worldwide.”

* Gravely S, Giovino GA, Craig L, et al. Implementation of key demand-reduction measures of the WHO Framework Convention on Tobacco Control and change in smoking prevalence in 126 countries: an association study. The Lancet, published online first 21 march 2017. DOI: 10.1016/S2468-2667(17)30045-2

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