Global Efforts for Reducing the Burden of Smoking

Cigarette smoking and other tobacco use impose a huge and growing public health burden globally. Currently, approximately 4 million persons are killed annually by tobacco use; by 2030, estimates based on current trends indicate that this number will increase to 10 million, with 70% of deaths occurring in low- and middle-income countries. Numerous studies from high-income countries, and a growing number from low- and middle-income countries, provide strong evidence that increases in tobacco tax, dissemination of information about health risks from smoking, restrictions on smoking in public places and in workplaces, comprehensive bans on advertising and promotion, and increased access to cessation therapies are all effective in reducing tobacco use and its consequences. Despite this evidence, tobacco control policies have been unevenly applied, partly because of political constraints. When the tobacco control policies that have been adopted by individual governments were reviewed, upper-middle-income countries had significantly higher total legislative scores than low- and middle-income countries. This suggests a relationship between the comprehensiveness of tobacco control policies and income level. However, there are other factors that may contribute. A key political tool for addressing political opposition to tobacco control policies is an earmarked tobacco tax. In addition, a key pillar to help overcome some of the constraints against implementing effective tobacco control policies is the Framework Convention on Tobacco Control (FCTC). The FCTC aims to be an international treaty that would commit countries to adopting strong, effective tobacco control policies. The treaty was recently unanimously adopted by the 192 member states of the WHO.