Tobacco Control Policies: - PowerPoint Presentation

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Tobacco Control Policies:WHO Framework for Tobacco Control(FCTC) and MPOWER

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FCTC / MPOWER These are the Global tobacco control policies and legal instruments. Need to be adapted

at country level

to develop country legislations and tobacco control programmes.

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WHO Framework Convention on Tobacco Control (WHO FCTC) WHO Framework Convention on Tobacco Control is the first international treaty negotiated under the

auspices

of WHO. Developed in response to the globalization of the tobacco epidemic

Evidence-based

treaty reaffirms the right of all people to the highest standard of health.

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World Health Assembly adopted FCTC on 21 May 2003 and the convention entered into force on 27 February 2005.Currently

180

countries are parties to the treaty, including the European Community.This Conference of Parties

(COP) is the governing body of the WHO FCTC and is comprised of all Parties to the Convention Member States that have signed the Convention

.

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India in FCTC: Signed:10th September 2003

Ratified: 5

th February 2004India among first few countries to ratify the treaty.

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Detailed Introduction to FCTC ArticlePart I:

(Article 1 & 2)

Introduction

Part II:

(Article 3 to 5)Objective, Guiding principles and General obligations engendered by the treaty Part III:

Demand-side reduction measures

Article 6

Price and tax measures to reduce the demand for tobacco

Article 7

Non-price measures to reduce the demand for tobacco

Article 8Protection from exposure to tobacco smoke Article 9Regulation of the contents of tobacco products Article 10Regulation of tobacco product disclosures Article 11Packaging and labelling of tobacco products Article 12Education, communication, training and public awareness Article 13Tobacco advertising, promotion and sponsorship Article 14 Demand reduction measures concerning tobacco dependence and cessation

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Detailed Introduction to FCTC Article

Part IV:

Supply-side reduction measures

Article 15

Illicit trade in tobacco products Article 16

Sales to and by minors

Article 17

Provision of support for economically viable alternative activities

Part V:

Other provisions under FCTC to name are

Article 18Protection of the environment and the health of persons Article 19Liability Article 20 to 22Cooperation and communicationArticles 23-26Institutional arrangements and financial resourcesArticle 27Settlement of disputes Articles 30-38"Final provisions”, covering statutory matters such as means of acceding to the Convention, entry into force, and so on.

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Main Provisions of TreatyThere are two broad provisions suggested in the FCTC viz. Demand reduction and Supply reduction measures contained in many Articles to the convention :Article 5.3 : Protecting public health policies

Articles 6-14: Demand reduction

provisions Articles15-17: Supply reduction provisions

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Art. 5(3) – General Obligations:To “protect these [public health] policies from commercial and other vested interests of the tobacco industry”

Article

5(3)

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Article 6: Price and Tax measuresIncreasing tobacco taxes is best way to reduce consumption

Especially

among the young and the poorTaxes must keep pace with inflation

and

with increasing consumer spending power

Tobacco taxes are generally well accepted

Higher taxes increase revenues, help pay for tobacco control and other health/social programs

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Article 8: Protect citizens from exposure to tobacco smoke in workplaces, public transport and indoor public places

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Article 11: Place

rotating health warnings on packs that cover 30% or more of the package and can include pictures or pictograms

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Pakistan

Japan

INDIA

PAKISTAN

Article 13: Enact comprehensive bans on tobacco advertising, promotion & sponsorship

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Training package developed by The Union and WHO-TFI to help parties to the FCTC to fulfil their obligations www.tobaccofreeunion.org/content/en/411

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FCTC Resources

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Global Progress on FCTCSigned by 187 countries, Zimbabwe is the last country

Ratified by 180

countries, USA still not ratified

120+ parties have adopted

and strengthened their tobacco control legislation.

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High implementation of protection from exposure to tobacco smoke (Article 8), packaging and labeling (Article 11)Low implementation of bans on tobacco advertising, promotion and sponsorship (Article 13)Significant

improvements in implementation of price and tax measures (Article 6).

Significant protection from exposure to tobacco smoke (Article 8), Limited progress on Article 14- tobacco

dependence and cessation.

Global Progress on FCTCContd…

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India and FCTCNational Tobacco Control Cell (NTCC) established in

February 2001

Indian Tobacco Control legislation, COTPA was enacted in May 2003,

just

before FCTC came into force(Articles 8,11,13 &16)India ratified FCTC in February 2004 India launched a comprehensive National Tobacco Control

Programme

(NTCP) with dedicated budget in 2006-07

Established tobacco product testing labs(Article 9)

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National Level Mass Media campaigns launched since 2008(Article 12) Establishing tobacco cessation centres and

launced

National Quit Line(Article 14)Actions initiated for Supply side measures like alternative crops and livelihood(Article 17)High level inter-ministerial committee constituted to ensure coordinated approach for tobacco control

India and FCTC

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WHO MPOWER StrategyThe WHO FCTC provide the foundation for countries to implement and manage tobacco control

To

help make this a reality, WHO introduced the MPOWER measures These measures are intended to assist in the

country level

implementation of effective interventions to reduce the demand for tobacco, contained in the WHO FCTC.

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MPOWER Goal : World where no child or adult is exposed to tobacco smoke. MPOWER Vision

It encourages policy-makers, civil societies,

health-care providers and others, to envision a world free of tobacco use. The package provides the tools to create a world where tobacco use declines by promoting a legal and socio-economic context that favours tobacco-free living.

MPOWER Goal & Vision

http://www.who.int/tobacco/mpower/mpower_english.pdf

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Monitor tobacco use and prevention policies

P

rotect people from tobacco smokeOffer help to quit tobacco useWarn about the dangers of tobacco

E

nforce bans on tobacco advertising, promotion and sponsorshipRaise taxes on tobacco

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Policies & Intervention MPOWER Package

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Monitor Tobacco Use and Prevention PoliciesAccurate monitoring is essential:-Tobacco use prevalence-Impact of policy interventions-Tobacco industry marketing, promotion and lobbying

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”What gets measured gets done.”

Dr. Margaret Chan

WHO Director-General

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Protect People from Tobacco SmokeNo safe level of second-hand smokeSmoke-free environments protect health of non-smokers and help smokers quitOnly completely smoke-free indoor areas with no exceptions work

Active liquor licenses and bar/restaurant employment both increased in NYC after going smoke-free

Smoke-free laws are popular and do not harm business

Worker safety measure

SFAA effective

March 2003

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Offer Help to Quit Tobacco Use

Nicotine replacement therapy

can double quit rates

Nicotine is addictive

Health care system has primary responsibility to treat tobacco dependence

Quit lines also effective

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Warn About the Dangers of TobaccoMost people are unaware of full range of health risks of tobacco use, SHS exposureAnti-tobacco ads help change image of smoking

2/3 want to quit

3/4 approve of warnings

More than half changed opinions

Pack warnings are effective, especially if they have pictures covering half of pack

Impact of pack warnings in Brazil

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Enforce Bans on Tobacco Advertising, Promotion and SponsorshipTens of billions of dollars spent each year to promote tobacco Advertising increases sales, illness and death

Bans are effective, but only if comprehensive

9 times faster reduction in consumption with ban than without after 10 years

Comprehensive advertising bans amplify effects of other interventions

Advertising in all media must be banned

All marketing and promotion must be prohibited

Enforcement is essential

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Raise Taxes on TobaccoIncreasing tobacco taxes is best way to reduce consumption especially among the young and the poorTaxes must keep pace with inflation

and

with increasing consumer spending power

Tax rates vs. consumption, South Africa

Higher tobacco taxes

reduce consumption

Tobacco taxes are generally well accepted

Higher taxes increase revenues, help pay for tobacco control and other health/social

programs

World Bank

recommends 65 to 85% tax of retail price of tobacco products

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Global Progress of MPOWER

MONITOR :

More than 2.3 billion people (a third of the world’s

population)

are now protected by at least one of the MPOWER measures at the highest level of achievement. Nearly 1 billion people are protected by two or more measures at the highest level.

Nearly 1.3 billion people are newly protected by at least one measure applied nationally in the past five

years (since

WHO released the first

report).

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PROTECT : Smoke-free public and work places created ,continues to be the most commonly established measure at the highest level of achievement.

There are 32 countries that passed complete smoking bans covering all work places, public places and public transportation (between 2007 and 2012) and protecting nearly 900 million additional people.

Since 2010, 12 countries and one territory, with 350 million people, passed strong smoke-free laws at a national level.

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OFFER :More than half a billion people in nine countries have gained access to appropriate cessation services in the past five years. However

, there has been little progress since 2010, as only four additional countries with a combined population of 85 million were newly provided access to cost-covered services including a toll-free national quit line

.

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WARNEffective health warning labels on tobacco packaging continue to be established by more countries. In

the past five years, a total of 20 countries with 657 million people put strong warning label requirements in place, with 11 countries (with 265 million people) doing so since 2010.

Mass Media

National mass media campaigns, first assessed in 2010, have been conducted in the past two years by about one fifth of countries, which have more than half the world’s population

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ENFORCE :Ban on Tobacco Advertising, Promotionand

Sponsorship (TAPS)

Complete bans on all tobacco advertising, promotion and sponsorship have been put in place to protect more than half a billion people in 16 countries in the past five years.

Since

2010, six countries with nearly 400 million people newly established this measure at the highest level.

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RAISE TAXRaising taxes to increase the price of tobacco products remains the measure least likely to be established. Only

14 countries and one territory with 166 million people have increased their

tax rates to sufficiently high levels in the past five years, and only six countries with 29 million people have done so in the past two years.

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Institutional MechanismAdequately staffed national tobacco control government structures have been established by six countries with 413 million people in the past five years.

In

the past two years, three countries with 150 million people newly established a structure to manage National Tobacco Control Programmes

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MPOWER & INDIAIndia has taken many steps to effectively implement WHO MPOWER, the technical assistance package of six evidence-based policiesMonitor:

The Global Adult Tobacco Survey, (GATS) conducted in 2009-10 India has been conducting and supporting regularly Global Youth Tobacco Survey (GYTS 2003, 2006, 2009)

,

Global School Personal Survey (GSPS 2006, 2009) and Global Health Professions Student Survey(GHPSS 2005-09). Many state governments and CSOs has been monitoring tobacco control legislation enforcement at state, district and city level.

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Protect: Section 4 of COTPA ensure all public, workplaces and many open places are smokefree. However, the legislation exempts hotel having thirty or more rooms or restaurant having seating capacity of thirty persons or more and the airports which may provide for a smoking area or

space.

Offer:To support tobacco users quit tobacco is an important component of India’s National Tobacco Control Programme (NTCP). A district level tobacco cessation

centre

(TCC) is being established in each district hospital and is provided with staff, equipments, training and outreach activities

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Warn: Section 6,7,8 and 9 of COTPA provides that youth are protected and everyone is warned about harms of tobacco use through specified health warning labels on all tobacco products. Additionally, National level Mass Media Campaigns have been launched since 2008 to educate public about harms of tobacco and highlight enforcement of policy provisions of COTPA.

Enforce:

Section 5 of COTPA discourages the use or consumption of tobacco products by

eliminating all forms of direct & indirect advertising, promotion & sponsorship of tobacco products

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Raise: The tax base of tobacco in India is heavily dependent on about 14% of consumption by cigarette

smokers; Non-cigarette tobacco products accounting for 85% of the tobacco consumption contributes only 15% of the total tobacco

taxes.Specific excise is imposed on cigarettes (per 1000 sticks) based on the length of the cigarette and the tax rates are higher for filter than non filter.

Tobacco

taxes on cigarettes are very low: 38-52%Tobacco Taxes on Bidi varies from Rs.14-26 per 1000 sticks.Tobacco Taxes on SLT: Based on Further, Tobacco taxes in India are not regularly adjusted for inflation, and over time tobacco products are becoming increasingly affordable

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Raising bidi taxes to Rs 98 per 1000 sticks ...would raise over Rs 36.9 billion in tax revenues ...and prevent 15.5 million deaths in current and future

bidi smokers

. Raising cigarette taxes to Rs 3691 per 1000 sticks ...would increase tax revenues by

over

Rs 146 billion ...and prevent 3.4 million deaths in current and future cigarette smokers.http://global.tobaccofreekids.org/files/pdfs/en/India_tobacco_taxes_report_en.pdf

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Thanks