Several countries of the Americas have made progress in the implementation of tobacco control policies in order to reduce the suffering and casualties as a result of its use. However, there is still much to be done to prevent the spread of the product, which kills about a million people a year in the region. This is the conclusion of the Report on Tobacco Control to the Region of the Americas 2016 (available in English and Spanish), released by the Pan American Health Organization/World Health Organization (Paho/WHO).
The document reveals the most up-to-date picture of the tobacco epidemic in 35 Member States 10 years after the Framework Convention on Tobacco Control of WHO has entered into force.
According to the report, only half of the population of the Americas (inhabitants of 17 of 35 countries) is fully protected against the harmful effects of smoke by laws that require tobacco-free environments in all enclosed public places and work, as well as in the public transport system.
The report also notes that graphic warnings on the harmful effects of tobacco are required in 16 countries (representing 58% of the population of the Americas), while only five countries (with 27% of the region’s population) prohibit the advertising, promotion and sponsorship of tobacco, acts that increase their use, especially among young people and women.
The higher taxes on tobacco are the most effective strategy to reduce the demand, as high prices encourage users to give up smoking and discourages other people to start smoking. This, however, is a measure of the Framework Convention on Tobacco Control which showed the least progress. Chile is the only country in the region where taxes on cigarettes account for more than 75% of the retail selling price. Other countries such as Argentina, Jamaica and Peru have taken measures recently to increase taxation, although not as much as 75% recommended by Paho/WHO.
“It is imperative and urgent to protect all populations against the epidemic of tobacco-related diseases the full implementation of the measures provided for in the Framework Convention”, said the Director of Paho/WHO, Carissa Etienne F. “Only if we act now we will have a generation of tobacco-free and save millions of lives.”
Smoke-free spaces; large health warnings in graphical format; ban on advertising, promotion and sponsorship; and tax increases are the four measures of the Convention, designated by who as appropriate options to reduce tobacco consumption, but also the burden of non-communicable diseases.
Tobacco use is responsible for the cost of 33 billion dollars to Latin America’s health systems, which is equivalent to 0.5 percent of its gross domestic product. Taxes on sales of cigarettes currently cover less than half of those costs.
Tobacco is responsible for about 14% of deaths among adults over 30 years in the Americas. In addition, he is the only risk factor common to four main groups of non-communicable diseases: cardiovascular, chronic respiratory, cancer and diabetes, which are responsible for 80% of deaths in the Americas, 35% of which are considered premature, i.e. before the 70 years.
There are 127 million smokers in the Americas. On average, 17% of the adult population consumes tobacco, although the report show that the prevalence varies between countries – Chile 39% and 7% in Barbados and Panama (data of 2013).
The full implementation of the Framework Convention on Tobacco Control will help countries to achieve the global target of 30% reduction in the prevalence of tobacco consumption among people aged over 15 years until 2025 and will contribute substantially to 25% reduction in the number of premature deaths by non-communicable diseases to this year.
“In these 10 years since the Treaty entered into force, the region of the Americas has advanced considerably, but we should not let our guard down”, said Anselm Hennis, Director of the Department of Non-communicable Diseases and Mental Health of PahoO/WHO. “The States parties have an obligation to continue to comply with the terms of the Convention, addressing simultaneously other challenges, including the increasing use of new products and fight against obstacles persisted, as the strong interference of the tobacco industry.”
In the Americas, 30 of the 35 Member States of Paho/WHO ratified the Convention, but the implementation of the agreement has been uneven. According to the report, only six countries in the region fully implemented four of the six demand reduction measures known as MPOWER. Eleven signatories still have not implemented any of the measures.
The MPOWER measures include monitoring tobacco use policies and prevention; protecting people from exposure to tobacco smoke; offering help for smoking cessation; warning people about the evils that smoking brings; enforce bans on advertising, promotion and sponsorship; and raise the price of the product.
The Framework Convention on Tobacco Control has 180 signatories worldwide. It is the first international public health treaty legally binding developed under the auspices of the WHO. The signatories are obliged to execute it fully, enacting national legislation to reduce both the supply as the demand. In 2012, the Conference of the Parties of the Agreement, a higher level of the treaty decision, approved a protocol to eliminate the illicit trade of tobacco products, which is a new international treaty, itself. Three countries of the Americas-Ecuador, Nicaragua and Uruguay – are parties to the protocol, while some others are in the process of ratification.
Implementation of the Framework Convention on Tobacco Control in the Americas
• 30 of 35 countries in the Americas have ratified the Convention;
• 17 countries are totally smoke-free enclosed public places, workplaces and public transport system;
• 16 countries use graphic health warnings covering at least 50% of cigarette packaging, along with all the characteristics specified by the Convention and its guidelines;
• 13 countries in the Americas have tobacco tax since 2012;
• 5 countries have completely banned all forms of advertising, promotion and sponsorship;
• 8 countries offer smoking cessation assistance and provide a free telephone line, with counseling and nicotine replacement free of charge;
• 3 countries have ratified the new Protocol to eliminate illicit trade in tobacco products.