Implementation Of Framework Convention On Tobacco Control Research Articles

Advancing progress on tobacco control in low-income and middle-income countries through economic analysis

BackgroundMore than 80% of the world’s 1.3 billion tobacco users live in low-income and middle-income countries (LMICs), where progress to address tobacco and its harms has been slow. The perception...

Framework Convention on Tobacco Control 2030-A Program to Accelerate the Implementation of World Health Organization Framework Convention for Tobacco Control in Low- and Middle-Income Countries: A Mixed-Methods Evaluation.

Framework Convention on Tobacco Control (FCTC) 2030 Program (2017-2021) was launched to accelerate World Health Organization (WHO) FCTC implementation in 15 low- and middle-income countries (LMICs). We evaluated the Program in six domains: Governance; Smoke-Free Policies; Taxation; Packaging and Health Warnings; Tobacco Advertising, Promotion, and Sponsorship (TAPS) bans; and International and Regional Cooperation. Following a mixed-methods design, we surveyed (June-September 2020) FCTC focal persons in 14 of the 15 countries, to understand the Program's financial and technical inputs and progress made in each of the six domains. The data were coded in terms of inputs (financial = 1, technical = 1, or both = 2) and progress (none = 1, some = 2, partial = 3, or strong = 4) and a correlation was computed between the inputs and progress scores for each domain. We conducted semi-structured interviews with key stakeholders in five countries. We triangulated between the survey and interview findings. FCTC 2030 offered substantial financial and technical inputs, responsive to country needs, across all six domains. There was a high positive correlation between technical inputs and progress in five of the six domains, ranging from r = 0.61 for taxation (p < .05) to r = 0.91 and for smoke-free policies (p < .001). The interviews indicated that the Program provided timely and relevant evidence and created opportunities for influencing tobacco control debates. The FCTC 2030 Program might have led to variable, but significant progress in advancing FCTC implementation in the 15 countries. As expected, much of the progress was in augmenting existing structures and resources for FCTC implementation. The resulting advances are likely to lead to further progress in FCTC policy implementation. What this study adds: In many LMICs, WHO FCTC policies are not in place; and even when enshrined in law, they are poorly enforced. It is not clear how financial and technical assistance to high tobacco-burden LMICs can most effectively accelerate the implementation of WHO FCTC policies and offer value for money. Bespoke and responsive assistance, both financial and technical, to LMICs aimed at accelerating the implementation of WHO FCTC policies are likely to lead to progress in tobacco control.

Could international human rights obligations motivate countries to implement tobacco cessation support?

The World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) seeks to realize the right to health through national tobacco control policies. However, few states have met their obligations under Article 14 of the FCTC to develop evidence-based policies to support tobacco cessation. This article examines how human rights obligations could provide a legal and moral basis for states to implement greater support for individualsto overcome their addiction to tobacco. The United Nations (UN) has a well-established legal framework for promoting human rights, looking to the right to health to realize health autonomy. Where addiction undermines autonomy, it is widely acknowledged that addiction presents a significant barrier to cessation for individuals who use tobacco, undermining the right to health. The UN human rights system could, therefore, provide a complementary basis for monitoring state obligations under Article 14 of the FCTC, identifying challenges to FCTC implementation and motivating states to support tobacco cessation. The United Nations' human rights system offers a mechanism that could be used to monitor Framework Convention on Tobacco Control implementation in national policy, facilitating accountability for the progressive realization of cessation support.

Evaluation of the implementation of the Framework Convention on Tobacco Control (FCTC) in Colombia.

Evidence-based interventions recommended in the Framework Convention on Tobacco Control of the World Health Organization (WHO FCTC) are subject to implementation factors that might affect their actual effectiveness. The Colombian law enacting key commitments from WHO's FCTC was signed in 2009. This study aims at evaluating the potential impact of the enactment and implementation of these WHO FCTC on four outcomes for tobacco consumption (last-year cigarette smoking prevalence, prevalence of heavy smokers, prevalence of lower-intensity smokers and monthly smoking incidence). We used data from the National Psychoactive Substances Consumption Survey (NPSCS) in 2008 (n = 29 164) and 2013 (n = 32 605), and assessed changes in these four outcomes WHO FCTC using propensity score matching (PSM). Propensity scores were obtained using key socio-demographic variables and by matching through a 'Kernel' estimation. Matching quality tests were performed. The common support for both survey samples was 60 793. Sub-analyses were conducted using a governance index to assess the effect of heterogeneous governance levels, proxying implementation, over the country. We found that cigarette year-prevalence and cigarette month-incidence decreased after matching around 8 and 1.2 percentage points between 2008 and 2013, respectively. Consumption might have shifted, at least partially, from heavy smoking towards lower-intensity smoking. Departments with a higher governance index showed larger reductions of tobacco use, possibly associated to a stronger WHO FCTC implementation. This study highlights the impact that the WHO FCTC had on tobacco consumption in a middle-income country and shows the importance of governance strength as a mediating mechanism for WHO FCTC impact. These results advance current knowledge on the effectiveness of WHO FCTC and shed light on the relevance of governance as a key factor in the WHO FCTC implementation.

Smokeless tobacco policy in Bangladesh: A stakeholder study of compatibility with the World Health Organization's Framework Convention on Tobacco Control.

Smokeless tobacco (ST) is the predominant form of tobacco used in Bangladesh and is associated with adverse health outcomes. Bangladesh ratified the World Health Organization's Framework Convention on Tobacco Control (FCTC) in 2004. There are concerns that FCTC legislation and implementation of ST control policy is insufficient in Bangladesh. The aim of this study was to investigate the achievements and challenges of ST policy in Bangladesh and its alignment with the FCTC. We conducted semi-structured key informant interviews with 20 stakeholders from government and non-government offices and international funding agencies, including tobacco control advocates, policy makers and non-governmental organisation workers. We used NVivo software to create key themes and the framework method for thematic analysis. Our findings revealed a lack of national policy in terms of disclosure of harmful contents, illicit trade and standardised packaging of ST. Legislation remains ineffective in relation to graphical health warnings and tax measures. Challenges to ST control identified included inadequate law enforcement; paucity of research, surveillance, and evidence generation; and supply chain control. We identified lack of congruence of ST policies with FCTC due to slow progress in implementation of FCTC measures, lack of a country-specific policy and industry interference. To comply with FCTC, participants recommended strong leadership and political commitment, co-ordination between public and private sectors and proper use of tobacco control resources. Bangladesh has adopted several important FCTC measures, but further strengthening of ST policy is needed to enable full implementation of FCTC.

Overcoming barriers to disseminate effective smoking cessation treatments globally

Purpose The purpose of this paper is to review the barriers in the dissemination of effective smoking cessation treatments and services globally. Offering tobacco users help to stop using tobacco is a key demand reduction measure outlined under Article 14 of the World Health Organisation (WHO) Framework Convention on Tobacco Control (FCTC). Implementing Article 14 can reap great dividends for the billion plus tobacco users around the world and their families, friends and societies. Design/methodology/approach A review of the status of the global implementation of Article 14 using available literature on smoking cessation products, services and national guidelines. Discussing innovative approaches being currently explored in South Asia that can lead to faster adoption and implementation of Article 14 globally. Findings Major gaps remain in cessation products’ availability and resource allocation for cessation services globally. Current licensed products are falling short on delivering and sustaining smoking cessation. Innovation in cessation products and services needs to build on learnings in nicotine pharmacokinetics, behavioural insights from consumer research and tap into 21st century tools such as mobile based apps. National implementation of FCTC’s Article 14 needs to follow guidelines that encourage integration into existing health programmes and health-care practitioners’ (HCPs) upskilling. Originality/value Smoking cessation is a desirable health outcome and nicotine replacement products are a means of achieving cessation through tobacco harm reduction. E-cigarettes are sophisticated nicotine replacement products. Innovation is urgently needed to fill the gaps in smoking cessation products and services, and for converting global policy into local practice. In low- and middle-income countries (LMICs), HCPs’ knowledge, attitudes and practice regarding tobacco use and cessation may hold the key to rapidly scaling up cessation support and delivery to achieve FCTC objectives sooner. Additionally, HCPs can play an important role in offering smoking cessation support in existing national health programmes for TB, cancer screening and maternal and child health. Also, widely prevalent smartphone devices may deliver smoking cessation through telemedicine in LMICs sooner, leapfrogging the hurdles of the existing health-care infrastructure.

POLITICAL ECONOMY ANALYSIS IN NON-COMPLIANCE INDONESIA TOWARDS FRAMEWORK CONVENTION ON TOBACCO CONTROL

&lt;p&gt;This research attempts to analyze the reason or consideration of Indonesian government to not ratify Framework Convention on Tobacco Control (FCTC) yet, in political economy analysis comprises interest of many actors, limitations of capacity of state, the influence of ratification towards Indonesian tobacco trade, FCTC implementation among the Parties, and projection of Indonesia’s possibility to comply with this regulation. FCTC has a number of instruments in tobacco control which was arranged by World Health Organization since 1999. This research become necessary due to Indonesia as only one a country in Asia which have not ratified yet, whereas Indonesia has been the fifth biggest of tobacco consumer in the world. It is a qualitative research, where data were collected through interview technique to the certain sources, and other supporting data from books and publication document. It has been analyzed using Chayes concept about compliance and non-compliance with international regulatory agreement consist of ambiguity and lack of capacity, interests, norms, and efficiency. In observing this issue, we can clarify that different interests of actors have become major consideration of Indonesian government to not comply with this convention regarding on the differences priority within ministry, the existence of business actors to influence the decision maker, employment, tobacco farmers, and social cultural aspects. In the forthcoming, there is a possibility that Indonesia will ratify FCTC due to Tobacco Roadmap which is arranged by Ministry of Industry of Indonesia in long-term planning assert that health aspect will be the main priority more than state revenues and employment. In addition, there are a lot of regencies and cities in Indonesia which have been implementing tobacco control regulation. This research, eventually, is expected to provide input analysis to the government in accordance with FCTC.&lt;/p&gt;

FCTC implementation: the role of state or non-government organizations? An example of the Czech Republic.

Smoking is the leading cause of premature mortality and morbidity. The aim of this study was to provide the first national description of organizational capacity and involvement in tobacco control (TC) measures outlined by the WHO Framework Convention on Tobacco Control (FCTC) within the Czech Republic. Data were collected in a national cross-sectional survey of all 14 organizations engaged in TC activities within the Czech Republic. Organizational capacity (defined as skills, supports, partnerships, resources, and leadership) to implement TC activities, and level of involvement in key FCTC measures were assessed and compared across organizations. Despite the high economic costs of tobacco use, few organizations were involved in TC activities. 50% of all organizations involved in TC activities were non-government or non-profit organizations. Less than one third of organizations reported having a sufficient number of staff or adequate funding to work effectively. Skills for chronic disease prevention (CDP) practice including assessment, identifying relevant practices, developing and implementing initiatives were rated more favourably than skills to evaluate these activities. Level of involvement was ranked highest for activities that focused on creation of smoke-free environments and lowest for activities that focused on raising taxes and sales to minors. Organizations tended to be more involved in individual, rather than population-level prevention strategies. Inadequate funding, insufficient number of staff dedicated to working on TC, and lack of political will were major barriers. This paper provides the first national description of organizational capacity and level of involvement in FCTC measures within the Czech Republic.

An Intertemporal Analysis of Post-FCTC Era Household Tobacco Consumption in Pakistan.

Since the ratification of the WHO Framework Convention on Tobacco Control (FCTC) in 2004, Pakistan has taken various measures of tobacco control. This study examines how these tobacco control measures are associated with change in household-level tobacco consumption patterns in Pakistan over the decade (2005 to 2016) after FCTC ratification. We used multiple waves of the household survey data of Pakistan from 2004–2005 to 2015–2016 for analyzing household-level tobacco use. We find that tobacco consumption remains at a significantly high level (45.5%) in Pakistan despite the recent declining trend in the post-FCTC era. During the preparatory phase of FCTC implementation between 2005 and 2008, the smoking rate was on the rise, and smokeless tobacco use was declining. Over the implementation phase of FCTC policies between 2008 and 2016, the pattern of change in tobacco use reversed—the smoking rate started to decrease while smokeless tobacco use started to rise. However, the decrease in the smoking rate was slower and the increase in smokeless tobacco use at the national level was driven by an increase among the poor and middle-income households. These trends resulted in the growing burden of tobacco expenditure among the poor and middle-income households relative to the wealthier households.

Exploration of Policy Makers' Views on the Implementation of the Framework Convention on Tobacco Control in the Gambia: A Qualitative Study.

BackgroundThe World Health Organization’s Framework Convention on Tobacco Control (FCTC) is the first international health treaty and has now been ratified by 181 countries. However, there are concerns that in many countries, particularly in sub-Saharan African countries, FCTC legislations and implementation are weak. In this study, we report a qualitative study undertaken to assess policy makers’ awareness of the FCTC and national tobacco control policies, and assessed the achievements and challenges to the implementation of the FCTC in the Gambia.MethodsThe study involved semi-structured one-to-one interviews with 28 members of the National Tobacco Control Committee in the Gambia, which is responsible for formulating tobacco control policies and making recommendations for tobacco control. We used the Framework method and NVivo11 software for data analysis.ResultsOur findings demonstrate that the Gambia has made modest progress in tobacco control before and since ratification of the FCTC, particularly in the areas of policy formulation, bans on tobacco advertising and promotion, smoke-free laws, and tobacco taxation. Although several pieces of tobacco control legislation exist, enforcement and implementation remain a major challenge. We found that policy makers’ awareness of polices covered in the FCTC was limited.ConclusionOur findings highlight several challenges to the FCTC implementation and the need to step up efforts that will help to accomplish the obligations of the FCTC. To achieve the obligations of the FCTC, the Gambia should develop specific public awareness interventions, establish cessation services, mobilize adequate resources for tobacco control and strengthen tobacco surveillance and research.

Towards ‘a balanced delegation’ or enhancing global health governance? Analysis of parties’ participation in the Conference of the Parties to WHO Framework Convention on Tobacco Control

IntroductionThe success of the WHO Framework Convention on Tobacco Control (FCTC) depends on parties’ active participation in its governance and implementation, particularly via biennial Conference of the Parties (COP) meetings....

Limited implementation of the framework convention on tobacco control’s tobacco tax provision: global comparison

ObjectiveTo quantify changes in tobacco tax rates and cigarette affordability after countries ratified the WHO Framework Convention on Tobacco Control (FCTC) using with the WHO MPOWER standards.MethodsWe used logistic regression...

How Can Progress on Global Tobacco Control Inform Progress on NCD?

Dr. Gro Harlem Brundtland's appointment as Director General of the World Health Organization (WHO) in 1998 led to a stronger global focus on tobacco control, and eventually, all noncommunicable diseases (NCD) and mental health. Since the adoption of the Framework Convention on Tobacco Control (FCTC) in 2003, global health has turned toward addressing all NCD. I pose 2questions. 1) What lessons can we apply from the WHO FCTC development and implementation processes to broader aspects of NCD prevention and control? 2) In retrospect, what could we have done better? I also propose 3 lessons: 1) it takes a broad-based alliance to make progress; 2) visible and courageous leadership matters, andis aided by financial support; and 3) in developing the FCTC, WHO focused on a few messages: demonize industry, tax, and regulate tobacco. We now need to broaden public and private players required for progress, use insights on levering market forces for NCD control, and build approaches that demonstrate empathy for millions struggling with NCD risks.

From global agenda-setting to domestic implementation: successes and challenges of the global health network on tobacco control.

Global policy attention to tobacco control has increased significantly since the 1990 s and culminated in the first international treaty negotiated under the auspices of the World Health Organization--the Framework Convention on Tobacco Control (FCTC). Although the political process that led to the creation of the FCTC has been extensively researched, the FCTC's progression from an aspirational treaty towards a global health governance framework with tangible policy effects within FCTC member countries has not been well-understood to date. This article analyses the role of the global health network of tobacco control advocates and scientists, which formed during the FCTC negotiations during the late 1990 s, in translating countries' commitment to the FCTC into domestic policy change. By comparing the network's influence around two central tobacco control interventions (smoke-free environments and taxation), the study identifies several scope conditions, which have shaped the network's effectiveness around the FCTC's implementation: the complexity of the policy issue and the relative importance of non-health expertise, the required scope of domestic political buy-in, the role of the general public as network allies, and the strength of policy opposition. These political factors had a greater influence on the network's success than the evidence base for the effectiveness of tobacco control interventions. The network's variable success points to a trade-off faced by global health networks between their need to maintain internal cohesion and their ability to form alliances with actors in their social environment.

Investment incentives and the implementation of the Framework Convention on Tobacco Control: evidence from Zambia

PurposePolicy misalignment across different sectors of government serves as one of the pivotal barriers to WHO Framework Convention on Tobacco Control (FCTC) implementation. This paper examines the logic used by...

World Health Organization: Do we have to intensify global tobacco control efforts?

Sir, Globally, consumption of tobacco account for 6 million deaths every year, and has been acknowledged as one of the leading public health concerns threatening the mankind.[1] Furthermore, close to 80% of the word's smokers are from low- and middle-income countries, and it is anticipated that the number of deaths can increase up to 8 million by the year 2030, in the absence of effective public health interventions.[1,2] Recognizing the magnitude of the problem and its impact on different aspects of an individual/family/society, the World Health Organization has developed a Framework Convention on Tobacco Control (FCTC), which was thoroughly supported by the member states.[2,3] The FCTC target was to reduce the global consumption of tobacco by 30% by the year 2025 and to achieve the same, MPOWER (viz. Monitor tobacco use and prevention policies; Protect people from tobacco use; Offer help to quit tobacco use; Warn about the dangers of tobacco; Enforce bans on tobacco advertising, promotion, and sponsorship; and Raise taxes on tobacco), was introduced in the year 2008.[3] In fact, in Iran, multiple indicators targeting policy makers, stakeholders, and the community, have been developed to evaluate the implementation of FCTC.[4] A wide range of studies have been performed to assess the utility of telephone interactive voice-response tobacco cessation support service; and opinion of general population regarding smoking scenes in movies; hence that awareness among stakeholders regarding tobacco control can be enhanced.[5,6] Although, recent estimates reflect a gradual decline in the rate of tobacco usage, only 37 nations are expected to achieve 30% tobacco reduction as initially set for the prevention and control of noncommunicable diseases.[2] This has been attributed to the wider challenges and obstacles identified in different settings such as poor awareness among the general population about the adverse effects associated with tobacco consumption, especially in low-resource settings; legal hurdles; poor surveillance activities; absence of effective measures to facilitate reduction in tobacco demand; lack of measures to protect people from tobacco smoke or to extend adequate help to quit tobacco use; and no strict enforcement of bans on tobacco advertising, promotion and sponsorship.[2,3,7] In order to intensify the global efforts to counter the tobacco epidemic, it is important to realize that adequate monitoring and thorough surveillance is the key to modify the existing policies in the local settings, and that second-hand smoke can kill both adults and children.[1,2] In addition, implementation of other measures like extending help to quit consumption of tobacco by offering them counseling and medications; organizing periodic awareness campaigns preferably in the local language of the residents; consistent display of pictorial warnings on tobacco products; enforcing ban on tobacco advertising, promotion and sponsorship related activities; and raising taxes on tobacco products to discourage its usage.[2,3,7,8] In conclusion, it is the need of the hour that policy makers should intensify the tobacco control efforts and work in a concerted manner along with other stakeholders to constantly improve the tobacco control. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

Do Iranian tobacco growers support the World Health Organization framework convention on tobacco control?

Context:Studies on the World Health Organization Frame-work Convention on Tobacco Control (FCTC) are scarce in Iran and the Eastern Mediterranean region (EMR).Aim:This study was conducted in 2007-2008 in Iran to design a practical evaluation model of the implementation of FCTC with the potential to be adopted in the EMR. Given that, the findings of this evaluation can be useful in increasing political and public support for enforcing the implementation of legislations, testing their feasibility, and maintaining sustainability. The viewpoints of tobacco growers as part of stakeholders in this regardwould have an influential role.Settings and Design:This study was a qualitative one to investigate the tobacco growers viewpoints about thestrengths/weaknesses of FCTC implementation in Iran.Materials and Methods:In this study, we conducted semi-structured in-depth individual interviews with 5 tobacco growers. All interviews were carried out with their permissionwere recorded and were assured that their interviews will be kept confidential. All questions were related to different FCTC articles, then written transcripts were prepared and the basic concepts were extrapolated.Statistical Analysis:After transcribing the recorded interviews, we extracted first level codes and main concepts from them.Results:The findings suggested that although tobacco growers agreed with FCTC implementation, however, subjects like the necessity to support tobacco growers and obtaining insurance from the government, the necessity of the enforcement of national tobacco control law and planning to decrease access to tobacco by policy makers were the most key points that tobacco growers pointed to them.Conclusion:Our results showed that tobacco growers agreed with the implementation of FCTC but they worried about their job and the expenses of their daily life. Therefore, it seems that policy makers have to design a plan to support tobacco growers for changing tobacco with a safe cultivate.

The potential effects of tobacco control in China: projections from the China SimSmoke simulation model

Objective To use a computer simulation model to project the potential impact in China of tobacco control measures on smoking, as recommended by the World Health Organization Framework Convention on...

Exploring the implementation of the framework convention on tobacco control in four small island developing states of the Pacific: a qualitative study

ObjectivesTo determine what variables influence the implementation of the Framework Convention on Tobacco Control (FCTC) in small island developing states of the Pacific and how they affect its success or...

WHO Framework Convention on Tobacco Control in China: barriers, challenges and recommendations

The aim of this study was to analyze the barriers in the implementation of the Framework Convention on Tobacco Control (FCTC) in China and present recommendations on ways to address these challenges in tobacco control in China. We review the available literature on progress and explore the barriers and challenges that impede a speedier pace in the adoption of the effective tobacco control measures, and present recommendations based on in-depth knowledge of decision-making process on the implementation of FCTC in China. The pace of progress in China is too slow. China faces intractable political, structural, economic and social barriers in tobacco control, which make the whole-hearted implementation of FCTC measures a painstaking process. The authors recommend a comprehensive approach to speed up the implementation of tobacco control measures. This includes strong political leadership from the top, structural changes to the tobacco industry and government oversight of the tobacco industry, as well as advocacy and support for tobacco control from civil society at the grassroots level.