The treaty envisages an international tracking system which aims to halt the smuggling and counterfeiting of tobacco products — a trade which accounts for 11 percent of the total tobacco market and costs governments an estimated $40 billion in lost tax revenue.

“This is a game-changing treaty,” Chan said in an address to a meeting in Seoul of the WHO’s Framework Convention on Tobacco Control (FCTC), which has been ratified by 176 countries since coming into force in 2005.

“This is how we hem in the enemy,” she added, calling the pact a major step towards “eliminating a very sophisticated criminal activity”.

The protocol gives signatory states five years to establish a tracking and tracing mechanism on cigarettes and every other tobacco product. The system will use non-removable markings and will be coordinated globally to detect illegal tobacco trading.

Agents, suppliers and tobacco manufacturers will all have to be licensed. Manufacturers will have to carry out checks on customers to ensure they are genuine or if they have associations with criminal organisations.

In her address Monday, Chan lambasted the tobacco industry for seeking to “maintain its profits and kill at the same time” and accused it of complicity in the illicit tobacco trade.

“It is a ruthless industry that quite literally cannot afford to lose.

“It behaves like a corrosive substance that can eat and slip through any cracks or fissures in the armour of our defences,” she said.

Monday’s pact marks a departure for the FCTC, whose main focus so far has been on curbing demand for tobacco products rather than controlling the supply chain.

The Framework Convention Alliance (FCA), which groups around 300 non-government organisations working for tobacco control, said it was “excited” by the adoption of the pact, which required four years of intense negotiations.

“The illicit trade in tobacco feeds the worldwide tobacco epidemic by flooding markets with cheap producers and keeping tobacco taxes low,” said FCA director Laurence Huber.

The six-day FCTC meeting in the South Korean capital will also review guidelines on tax measures to reduce tobacco demand, recommendations on promoting alternatives to tobacco growing, and regulation of smokeless tobacco products like e-cigarettes.

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Excellencies, distinguished delegates, ladies and gentlemen,

I am delighted to address this fifth session of the Conference of the Parties to the WHO Framework Convention on Tobacco Control. Our shared goal is to see this treaty fully implemented, to see its powers fully used to reduce tobacco consumption and exposure to tobacco smoke, everywhere in the world.

As this session opens, support for the Convention has grown to 176 Parties, representing nearly 90% of the world’s population. This shows the scale of the impact you can have.

Since the treaty came into force seven years ago, the work of this conference has given more than ten articles of the Convention teeth and traction by creating supplementary instruments.

You have done so in a spirit of solidarity, fully mindful of the transnational nature of the tobacco threat, and fully aware of the need to build implementation capacity among Parties with meager resources. Success depends on a capacity to implement, everywhere.

In crafting guidelines and recommendations, this body reaches well beyond the domains of medicine and public health. You gather evidence and support from multiple sectors, like trade, finance, agriculture, education, labour, the environment, law enforcement, and the judicial system.

The work of this conference is a model of multisectoral collaboration but also of an interagency response, as you will be discussing during this session.

The Convention is a powerful instrument for prevention, but also for international cooperation. This importance has been recognized in recent political declarations on noncommunicable diseases and on the social determinants of health.

You are inspired by the preventive power of what you are doing. I can think of no other undertaking that can make such a huge contribution to better health in every corner of the world. And that includes the health of young children and unborn babies.

This has always been one of the anti-tobacco campaign’s most compelling arguments. Tobacco use is the epidemiological equivalent of a drive-by shooting. It hurts the innocent bystanders as well as those held captive by an addiction that damages their health.

You are united by a shared spirit of determination but also out of necessity, given the nature of the opposition, of the forces that are equally determined to undermine, circumvent, and interfere.

The tobacco industry behaves like a corrosive substance that can eat through, or seep through, any crack or fissure in the armour of our defences. Our response must be to seal all these cracks and fissures, one by one, with science and evidence, supported by instruments for applying this knowledge and backed by the rule of law.

This is what you are doing. This is what makes the work of this conference so monumentally important. With the guidelines and recommendations you put forward, and now with the first protocol before you for approval, you are hemming in the enemy, cutting off its options, giving it less space to manoeuvre.

As we know from experience, the tobacco industry will challenge the best science, promote arguments that have nothing to do with the facts, and fund front groups to give these arguments a cloak of legitimacy. This industry will lobby lawmakers, woo the press and, now, fund plaintiffs to challenge legislation.

In a recent and most disturbing trend, the showdown between governments, seeking to safeguard the health of their citizens, and industry, seeking to maintain its profits, has moved to the courtroom.

I know you will want to join me in congratulating Australia and Norway for recent rulings that upheld the legality of their tough control measures. We are united in our support for other countries facing similar interference.

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The treaty entered into force in February 2005. It was signed by 168 of the 192 WHO member states and today there are  more than 170 WHO member states have become Parties to the convention. The United States has not yet become a Party to the treaty.

The FCTC is a legally binding treaty that requires countries bound by the treaty or Parties  to implement evidence-based measures to reduce tobacco use and exposure to tobacco smoke. When effectively implemented, the FCTC is a powerful tool to reduce the devastating global consequences of tobacco products on health, lives and economies.

The FCTC sets out specific steps for governments addressing tobacco use, including to:

• Enact and undertake comprehensive bans on tobacco advertising, promotion and sponsorship;

•  Ban misleading and deceptive terms on cigarette packaging such as “light”, “low-tar” and “mild”;

• Implement rotating health warnings on tobacco packaging that covers at least 30 percent (ideally 50 percent or more) of the display areas – this may include pictures or pictograms;

• Protect people from tobacco smoke exposure on public transport, and indoor work and public places;

• Adopt or maintain taxation policies aimed at reducing tobacco consumption; and

• Combat illicit trade in tobacco products. This requires monitoring, documenting and controlling product movement as well as including origin and destination information on packaging plus enacting legislation with appropriate penalties and remedies.

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John Seffrin, chief executive of the American Cancer Society, issued this warning while speaking at a high-level forum of the world’s 100 leading cancer experts gathered in the Swiss resort of Lugano.

They said governments must do far more than they have done to control the global tobacco industry, either by raising cigarette prices dramatically, outlawing tobacco marketing or by taxing the multinational profits of the big cigarette firms.

According to scientists, smoking kills more than half of all smokers, mostly from cancer, and yet despite it being the single biggest avoidable risk of premature death, there are about 30 million new smokers a year.

They said that if the current trends continue – with cigarette companies targeting the non-smoking populations of the developing world – then hundreds of millions of people will be dying of cancer in the second half of this century.

Some of the experts attending the World Oncology Forum went further by calling for an outright ban on cigarettes and for the tobacco industry to be treated as a terrorist movement for the way it targets new markets with a product that it knows to be deadly when used as intended.

“We have a major global industry producing a product that is lethal to at least half the people who use it. It will kill, if current trends continue, a billion people this century,” the Independentquoted Dr Seffrin as saying.

“It killed 100 million in the last century and we thought that was outrageous, but this will be the biggest public health disaster in the history of the world, bar none. It all could be avoided if we could prevent the terroristic tactics of the tobacco industry in marketing its products to children.

“There is a purposeful intent to market a product that they know full well will harm their customers and over time will kill more than half of them. The industry needs to be reined in and regulated,” he said.

Worldwide, tobacco causes about 22 percent of cancer deaths each year, killing some 1.7 million people, with almost 1 million of them dying from lung cancer. Yet the numbers of new smokers among the young is rising faster than the numbers giving up.

The latest study into the health effects of smoking, which was published in The Lancet and involved 1.3 million women, showed that tobacco is even more dangerous than previously supposed but the benefits of giving up smoking are greater than expected.

Sir Richard Peto of Oxford University, a co-author of the Million Women study who worked closely with Sir Richard Doll, is also the scientist who first calculated how many people this century will die from tobacco-induced cancers.

“We have about 30 million new smokers a year in the world. On present patterns, most of them are not going to stop, and if they don’t stop, and if half of them die from it, then that means more than 10 million a year will die – that’s 100 million a decade in the second half of the century,” Professor Peto said.

“So this century we’re going to see something like a billion deaths from smoking if we carry on as we are. In Europe we have about 1.3 million premature deaths per year now, of which about 0.3 million are deaths by tobacco. There’s nothing else as big as that.

“If you put all causes together, you wouldn’t get a total that’s half of that caused by tobacco, and tobacco kills more people by cancer than other diseases. Smoking is still the most important cause of cancer… If you smoke a few cigarettes a day, it will be the most dangerous thing you do,” he added

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We have also seen increased demand in cessation support, in the form of a short intervention by a health care provider, counselling, or other treatment modality.

However, medical practitioners and tobacco cessation specialists express the concern:  “It is so difficult for a smoker in my country to have access to quitting support once they make the move to quit.” This is typically followed by “so they often give up and keep on smoking because it is cheaper for them in the short term.”

A number of global health governance tools and global advocacy opportunities can help secure resources for tobacco treatment at the local level.

The medical community can help advocate at the national and global levels.

This advocacy can create a global mechanism that will help secure resources for treatment and reach the objectives set by the UN Summit on Non Communicable Diseases.

Following the UN Summit in Sept 2011, the World Health Assembly adopted a global target calling for a 25% reduction in preventable deaths from NCDs by 2025.

Given tobacco is a leading risk factor for NCDs, this target can be achieved only if we address the tobacco epidemic through a number of interventions such as a ban on tobacco product advertising, tax and price measures to reduce smoking prevalence, smoke free policies and ensuring that smokers have access to treatment.

We expect that in September, a target will be approved demanding a 30% reduction in global smoking prevalence by 2015.

We need to use these targets in all of our advocacy efforts as we hold our governments accountable to these commitments.

The upcoming 5th Conference of the Parties (COP5) of the FCTC (November 2012) in Seoul, Korea, provides a unique opportunity to address the lack of resources for tobacco control, including resources for the treatment of tobacco dependence.

The meeting will provide more than 170 governments a platform to discuss and explore solutions to address the lack of resources for implementation of tobacco control measures.

It is crucial that governments agree at COP5 to set up a process that reviews the barriers countries face and develop solutions to address them.

The FCA proposes that governments move forward with the development of a working group that will review the implementation of the treaty, review mechanisms of assistance for implementation of the treaty, and identify implementation challenges as well as provide assistance to overcome them.

Another problem we face is that Non Communicable Diseases  (NCDs ) — which include Cardiovascular, Cancer and Chronic Lung Diseases, for which tobacco is the leading risk factor — are absent from the development agenda and global development goals such as the Millennium Development Goals (MDGs).

This has led to a lack of resources for treatment of tobacco addiction from the major development agencies such as USAID, CIDA, DFID and other major development donors.

The MDGs are up for review as they expire in 2015, and this process, along with the outcomes of the UN Summit on NCDs, provides a unique opportunity to address the lack of treatment resources.

Our strategy should be to move from a current over- dependence on philanthropic funding to development aid in countries that need it, followed by fiscal independence at the national level for tobacco control programs through taxation of tobacco products.

There are examples from other fields that could be applied to tobacco in the area of development and prevention of NCDs.

There is an interesting example from Sweden, where they are attempting to move from only addressing pathogenesis to addressing salutogenesis.

Sweden found it to be cost effective to implement interventions through the medical community that encourages sedentary individuals to change their behaviour and exercise.

When a patient visits a doctor, they are asked if they exercise, frequency, intensity etc…

If the patient says they do not exercise, then a referral is made to a motivational therapist, a personal trainer, etc…

Based on the success of these interventions, they developed a pilot program through the Swedish Development Agency, and funds were made available to start a similar project in Vietnam.

These types of programs could be developed for tobacco control by integrating cessation measures along with other tobacco control measures in the development agenda of donor agencies.

For this to happen, the medical community will need to advocate in both donor countries as well as low and middle countries.

The medical community can engage in these processes by staying attuned to the development of the FCTC COP campaigns.

You can do this by visiting the Framework Convention Alliance web site and by following the FCTC Action Now! campaign.

From this date forward, all cigarettes will be sold in drab, olive-green packaging with enormous health warnings, with the brand only visible in a small, standard font. The government hopes to make smoking less appealing to children and reduce smoking levels population-wide. “This is good news for every Australian parent who worries about their child picking up an addictive and deadly habit”, said Roxon, who, as Australia’s former Minister for Health and Ageing, introduced this pioneering legislation. Big tobacco has not yet given up, with two other cases ongoing. Philip Morris Asia is suing Australia for breach of an investment treaty with Hong Kong, while Ukraine, Honduras, and the Dominican Republic have fi led a complaint with the World Trade Organization, claiming the legislation breaches Australia’s commitment under global trade rules. Both cases are likely to take years and will not prevent Australia actually introducing plain packaging. However, should the tobacco companies succeed, the government would likely have to fi nancially compensate them for their loss of brand (but not withdraw the plain packaging).

WHO Director-General Margaret Chan said she hoped that this decision would start a domino-eff ect of similar legislation in other countries, helping prevent some of the 6 million deaths estimated to be caused by smoking every year. The UK has just fi nished a consultation on plain packaging and another is ongoing in New Zealand.

The European Union has announced it will probably revise its tobacco products directive during 2012, which could include plain packaging measures. “This decision will embolden governments, especially in low- and middle-income countries, that have been hesitant to implement the
measures in the WHO Framework Convention on Tobacco Control [FCTC], fearing some sort of ‘backlash’ from the tobacco industry, such as a lawsuit”, said Laurent Huber, Director of the
Framework Convention Alliance, a group of more than 350 organisations in more than 100 countries that support the FCTC. “India, South Africa, Indonesia, and China are said to be
considering plain packaging”, he added.

By Tony Kirby of the Lancet

The World Health Organization (WHO) strongly welcomes the landmark decision from Australia’s High Court to dismiss a legal challenge from the tobacco industry, and calls on the rest of the world to follow Australia’s tough stance on tobacco marketing.

Several major tobacco companies challenged Australia’s legislation to require cigarettes and other tobacco products to be sold in plain packaging without any branding. But the industry’s attempt to derail this effective tobacco control measure failed. As of December 2012, Australia will be the first country to sell cigarettes in drab, olive-green packaging without branding.

With Australia’s victory, public health enters a brave new world of tobacco control. Plain packaging is a highly effective way to counter industry’s ruthless marketing tactics. It is also fully in line with the WHO Framework Convention on Tobacco Control. The lawsuits filed by Big Tobacco look like the death throes of a desperate industry. With so many countries lined up to ride on Australia’s coattails, what we hope to see is a domino effect for the good of public health.

The case is being watched closely by several other countries who are considering similar measures to help fight tobacco.

The evidence on the positive health impact of plain packaging compiled by Australia’s High Court will benefit other countries in their efforts to develop and implement strong tobacco control measures to protect the health of their people and to stand resolute against the advances of the tobacco industry.

Tobacco use is one of the most preventable public health threats. Tobacco products will eventually kill up to half of the people who use them – that means nearly six million people die each year. If governments do not take strong action to limit exposures to tobacco, by 2030 it could kill more than eight million people each year.

The WHO Framework Convention for Tobacco Control entered into force in 2005. Parties are obliged over time to take a number of steps to reduce demand and supply for tobacco products including: protecting people from exposure to tobacco smoke, counteracting illicit trade, banning advertising, promotion and sponsorship, banning sales to minors, putting large health warnings on packages of tobacco, increasing tobacco taxes and creating a national coordinating mechanism for tobacco control. More than 170 countries are Parties to the Convention.

For further information, please contact:

Glenn Thomas
Communications Officer
WHO
Telephone: +41 22 791 3983
Mobile: +41 79 509 0677
E-mail: thomasg@who.int

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