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Researchers call for ban on tobacco sales by 2040
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International experts are calling for the sale of tobacco to be phased out by 2040 and for governments to be proactive and institute strict policy to guide this process.
“The time has come for the world to acknowledge the unacceptability of the damage being done by the tobacco industry and work towards a world essentially free from the legal and illegal sale of tobacco products,” Robert Beaglehole, DSc, of the University of Auckland, said in a press release.
Beaglehole and colleagues presented a series paper in The Lancet that emphasizes the importance of phasing out tobacco products within the next 3 decades and highlights ways the goal can be met.
The researchers presented three scenarios: continuing with the status quo, full implementation of WHO’s Framework Convention on Tobacco Control (FCTC), and a “turbo-charged” initiative by both the private and public sector.
The problem with the status quo, the researchers wrote, is the scenario is based on restricted ambition, low political will, and weak financing.
Complete implementation of the FCTC has its benefits; however, the FCTC emphasizes reducing demand for tobacco rather than reducing factors such as the supply of tobacco products and trade issues, the researchers wrote.
Less than 10% of the world’s population is covered by excise tax levels at the recommended level, and only 15% have access to cessation programs.
The third scenario of a “turbo-charged” push builds on the second scenario of implementing the FCTC. The researchers wrote that a stronger push is required for tackling opposition from the tobacco industry, and there must be an engaged private sector.
The United Nations and WHO, according to the researchers, need to provide greater leadership and support than they currently do. The researchers propose that the UN hold a high-level meeting to promote a tobacco-free world and ensure international agreement on the exemption of tobacco products from World Trade Organization rules. They also said public health measures to tackle tobacco should not be viewed as a restraint to trade.
“A world where tobacco is out of sight, out of mind, and out of fashion — yet not prohibited — is achievable in less than 3 decades from now, but only with full commitments from governments, international agencies, such as UN and WHO, and civil society,” Beaglehole said in the release. –by Ryan McDonald
Disclosure: Beaglehole reports being a member of The Lancet NCD Action Group and reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
Perspective
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Joseph R. DiFranza, MD
A paper authored by professors Robert Beaglehole and Ruth Bonita in The Lancet calls upon the United Nations to lead a “turbo-charged” effort against the sale and consumption of tobacco. It has been 10 years since WHO introduced the Framework Convention on Tobacco Control (FCTC). This, the first international treaty negotiated under WHO’s auspices, has 180 signatory nations, covering 90% of the world’s population. Parties to this health treaty pledge to protect their citizens from tobacco by enacting laws to protect nonsmokers from secondhand smoke, curtail the promotion of tobacco, prevent its sale to minors, increase prices through taxation, and require bold and effective health warnings on packages. While 80% of the signatory countries have strengthened their tobacco control laws in some way, progress has been too slow in the eyes of the public health community.
WHO projections that tobacco will cause 1 billion deaths in this century warrant swifter action. As world tobacco control leaders gather in Abu Dhabi for the 2015 World Conference on Tobacco or Health, they are prodding WHO to rally countries to live up to their pledges and set a goal of eliminating tobacco by 2040. With the recent explosion in the development of electronic cigarettes, it is feasible that the smoked tobacco cigarette may follow the spittoon into oblivion as informed consumers choose to satisfy their nicotine addiction with less hazardous products.
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Michael B. Steinberg, MD, MPH
The goal of a tobacco-free world by 2040 would represent one of the greatest public health accomplishments in history. Beaglehole and colleagues present a plan for achieving a worldwide tobacco prevalence of less than 5% over the next 25 years. Their plan capitalizes on established agreements among 180 countries, the WHO Framework Convention on Tobacco Control (FCTC) and calls for even more global cooperation. Unfortunately, a number of nations — including the United States — do not participate in the FCTC. Additionally, the influence of tobacco industries on governments is a major issue. In China, the state owns the tobacco industry, and in the United States, tobacco companies and their billions of dollars are some of the most influential contributors to politicians throughout the country. In the United States, there has been a lack of political will to stand up against the powerful tobacco lobby and to implement any true and meaningful policies on a national level. The good news is that some states and municipalities have taken steps. Hawaii increased its tobacco age of sale to 21, and some local governments have done the same. Clean indoor air laws are spreading at the local and state levels throughout the country, but we still have a long way to go. It is inexcusable that as a world leader, the United States does not join other nations in ratifying the FCTC. Despite more than 50 years since the first Surgeon General’s report on tobacco, our health care system pays for expensive interventions for tobacco-caused disease, but not for tobacco treatments that would eliminate the need for those expensive interventions. Until we as a society have the political and social will to say no to tobacco industry influence and properly fund evidence-based tobacco treatments, the hope of a tobacco-free world will not be realized.
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