By Mark Greenwold
Tobacco-related disease is the largest preventable cause of death in the world. In the twentieth century tobacco killed 100 million people worldwide. Currently, more than 6 million people worldwide die of tobacco-related disease every year and the World Health Organization estimates that if current trends continue tobacco will kill one billion people in the twenty-first century. Those who die of tobacco-related disease lose an average of more than ten years of life.
In the past twenty years, substantial progress has been made to reduce smoking in North America, Western Europe and Australia. Smoking rates for both adults and adolescents have been reduced and are continuing to fall. This progress has been the result of hard work and the disciplined implementation of a concerted strategy. The measures that effectively reduce the incidence of smoking are well-established but every one of these measures faces ferocious opposition from the tobacco industry. Faced with declining markets in developed countries, the tobacco industry has targeted developing countries and is working hard to sell its deadly products in those countries. The battle against tobacco-related disease in the twenty-first century will be fought primarily in those countries.
The principal tobacco control measures are identified in the United Nations Framework Convention on Tobacco Control. The FCTC went into effect in 2005 with 58 State parties. The FCTC now has 197 signatories. The Convention requires members States to implement the following major provisions:
- Tax increases that increase the price of tobacco products.
- Requirements for clean indoor air in public buildings, workplaces, and restaurants.
- Restrictions on the advertising of tobacco products to the extent permitted by the State’s constitution.
- Graphic warning labels on cigarette packages.
- Vigorous public information programs, especially those targeted to adolescents
- Expanded availability of cessation programs to help smokers quit.
The FCTC requires State parties to implement these measures but has no enforcement mechanism to ensure that they do. Australia has taken a leadership position with respect to these measures and has achieved results that are among the best in the world.
Australia’s adoption of a plain packaging requirement for cigarettes has been highly successful in accelerating the decline of smoking. The tobacco industry fought this proposal before it was adopted and has done everything it could to invalidate it by litigation. The tobacco companies brought suit in Australian courts and after they lost there they initiated an arbitration proceeding in a tribunal under the World Trade Organization. The panel recently announced that it had decided that it did have not jurisdiction to interfere with the implementation of Australia’s plain packaging regulations. These results are gratifying but they required massive effort and the expenditure of substantial resources. In recent months, the United Kingdom, France, and Ireland have all announced that they will follow Australia’s lead and implement plain packaging.
In recent years determined advocacy by tobacco control champions has achieved remarkable breakthroughs in countries thought to be among the least likely to adopt tobacco control measures. These include adoption in 2015 of comprehensive tobacco control measures in Russia and implementation of clean air requirements in Beijing that prohibit smoking in public buildings, workplaces and restaurants. Adoption of similar measures nationwide in China is a target for 2016.
These breakthroughs have been made possible only through concerted efforts by tobacco control advocates working in each country. Unless such efforts continue, it is altogether possible that the favourable results we have achieved may be reversed. However, the accomplishments of the tobacco control movement in this difficult environment provide reasonable grounds for optimism that progress can be made.
Mark Greenwold is a lawyer practicing in Washington, D.C. who litigates on behalf of State governments against the major tobacco companies. He is also an Adjunct Professor of Law at Georgetown Law Center, where he teaches a course in tobacco regulation. He also serves as a member of the Advisory Council to the Yale School of Public Health and lectures in the Global Public Health Seminar at Yale.
Mark Greenwold will speak about current issues and recent developments in the fight against tobacco on 11 February 2016 at La Trobe University’s City Campus. For more information on this free event and how to register, click here.