Framework Convention On Tobacco Control Research Articles

Association between Tobacco Industry Interference Index (TIII) and MPOWER measures and adult daily smoking prevalence rate in 30 countries

BackgroundThis study aimed to investigate the impact of tobacco industry interference on the implementation and management of tobacco control and the tobacco epidemic using the Tobacco Industry Interference Index (TIII) and MPOWER—a package of measures for tobacco control—and adult daily smoking prevalence in 30 countries.MethodsThe TIII was extracted from the Global Tobacco Industry Interference Index 2019 and Global Center for Good Governance in Tobacco Control (GGTC). MPOWER measures and adult daily smoking prevalence rate were extracted from the World Health Organization (WHO) report on the global tobacco epidemic in 2021. We assessed the ecological cross-lagged association between TIII and MPOWER scores and between TIII and age-standardized prevalence rates for adult daily tobacco users.ResultsTobacco industry interference was inversely correlated with a country’s package of tobacco control measures (β = -0.088, P = 0.035). The TIII was correlated with weaker warnings about the dangers of tobacco (β = -0.016, P = 0.078) and lack of enforcement of bans on tobacco advertising promotion and sponsorship (β = -0.023, P = 0.026). In turn, the higher the TIII, the higher the age-standardized prevalence of adult daily tobacco smokers for both sexes (β = 0.170, P = 0.036). Adult daily smoking prevalence in males (β = 0.417, P = 0.004) was higher in countries where the tobacco industry received incentives that benefited its business.ConclusionWhere the interference of the tobacco industries was high, national compliance with the Framework Convention on Tobacco Control (FCTC) was lower, and the prevalence of adult daily smokers higher. National governments and global society must work together to minimize the tobacco industry’s efforts to interfere with tobacco control policies.

Bridging the gap in the implementation of the World Health Organization’s Framework Convention on Tobacco Control Article 5.3 in India: Insights from an opinion poll and stakeholder consultation

ABSTRACT Background: Article 5.3 of the World Health Organization Framework Convention on Tobacco Control (FCTC) outlines a roadmap for the parties to safeguard public health policies in compliance with the national law from the influence of commercial and other vested interests of the tobacco industry. Aim: The study was conducted with the aim to identify gaps and bring existing Indian policies in compliance with Article 5.3 of FCTC. Materials and Methods: A nationwide cross-sectional opinion poll involving respondents aged >18 years (n = 164) and a panel discussion (n = 31) were conducted. Results: The majority of stakeholders expressed (strongly agree = 65% and agree = 22.6%) the need for a nationwide policy to regulate interactions between public officials and the tobacco industry. About 56.7% felt the need to expand existing protocols and codes of conduct for public officials across India. Over 84% of the participants supported incorporating specific sections to implement Article 5.3 into the Cigarettes and Other Tobacco Products Act Amendment Bill 2020. The majority of participants supported the need for guidelines for medical bodies and prohibiting tobacco companies from participating in corporate social responsibility activities. Conclusion: The Government of India should comprehensively adopt Article 5.3, in all states and union territories, adopting a whole-of-government approach in partnership with the community and civil society under the “whole-of-society” approach for effective tobacco control measures.

CLUSTERING NEGARA BERDASARKAN SKOR PENGENDALIAN KONSUMSI TEMBAKAU MENGGUNAKAN ALGORITMA DBSCAN

Smoking is an activity that has a detrimental impact on the health of individuals, families, communities and the environment, both directly and indirectly. Therefore, it is necessary to control global tobacco consumption. The World Health Organization (WHO) in the Framework Convention on Tobacco Control (FTCT) developed the MPOWER strategy: a which countries can use to control tobacco consumption. In this study a clustering analysis of tobacco use control will be carried out based on the MPOWER score: a from WHO for each country using the Density Based Spatial Clustering of Applications with Noise (DBScan) algorithm. DBSCAN is a cluster formation algorithm based on the level of distance density between objects in a dataset. Using a density radius of 1.72 with a minimum point of 4 objects obtained from the kNNdisplot function on Rstudio produces 4 clusters, 75 data as noise, and the Davies Bouldin-Index value as the best cluster validity is 1.08118.

Addressing tobacco industry influence in tobacco-growing countries.

Protecting policy-making from tobacco industry influence is central to effective tobacco control governance. The inclusion of industry actors as stakeholders in policy processes remains a crucial avenue to corporate influence. This influence is reinforced by the idea that the tobacco industry is a legitimate partner to government in regulatory governance. Addressing the influence of the tobacco industry demands a focus on the government institutions that formalize relationships between industry and policy-makers. Industry involvement in government institutions is particularly relevant in tobacco-growing countries, where sectors of government actively support tobacco as an economic commodity. In this paper, we discuss how controlling tobacco industry influence requires unique consideration in tobacco-growing countries. In these countries, there is a diverse array of companies that support tobacco production, including suppliers of seeds, equipment and chemicals, as well as transportation, leaf buying and processing, and manufacturing companies. The range of companies that operate in these contexts is particular and so is their engagement within political institutions. For governments wanting to support alternatives to tobacco growing (Article 17 of the Framework Convention for Tobacco Control), we illustrate how implementing Article 5.3, aimed at protecting tobacco control policies from tobacco industry interference, is fundamental in these countries. Integrating Article 5.3 with Article 17 will (i)strengthen policy coherence, ensuring that alternative livelihood policies are not undermined by tobacco industry interference; (ii)foster cross-sector collaboration addressing both tobacco industry interference and livelihood development; and (iii)enhance accountability and transparency in tobacco control efforts.

Implementation Questions of the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) in Georgia

The World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) is an international treaty established by WHO to address the global health issue of tobacco consumption, necessitating implementation at the national legislative level.
 The article explores the global problem of tobacco use and how it led to the creation of an international treaty to regulate it. It discusses how the FCTC was planned and Georgia's role in it. The analysis covers the legal side of the FCTC, including international and local rules for putting it into action. The article also talks about the challenges that have made it difficult to meet the FCTC's obligations from both legal and political viewpoints. This is the first attempt to explain the FCTC and the issues it faces in being adopted and carried out in Georgia.

Tobacco Cultivation Regimentation: An Ethnographic Treatise from Pagergunung Village, Bulu, Temanggung

Indonesia, as the sixth largest tobacco-producing country in the world, has participated in the Framework Convention on Tobacco Control (FCTC) by issuing compromise regulations through Government Regulation (PP) No. 109 of 2012. This regulation regulates restrictions on tobacco production and distribution of products made from tobacco raw materials. Furthermore, PP No. 109 of 2012 determines the increases in tobacco excise rates and the determination of limits on nicotine levels also sparked unrest among tobacco farmers in the Temanggung area. This article attempts to explain the insistence of farmers, especially in the eastern slope of Mount Sumbing, Pagergunung Village, Bulu District, Temanggung, in maintaining tobacco cultivation even though they are faced with an anti-tobacco campaign from the FCTC. The continued cultivation of tobacco can be understood as a form of regimen of cultivated plants. This article is an anthropological study with a regimentation theoretical perspective and ethnographic approach as a research method which presents the research results. From this research, it is known that the cultivation regimen is controlled by mythology, tobacco trade tricks, and the pretext of tradition as a socio-cultural surplus.

Implementation of the Article 13 WHO FCTC measures and changes in cigarette smoking among youth in 42 countries

IntroductionDespite a decline in global smoking prevalence among adolescents, around 21 million youth report current cigarette smoking. Exposure to tobacco advertising, promotion and sponsorship (TAPS) is a risk factor for...

Trends in age of tobacco use initiation over time in Bangladesh, India and Pakistan: analysis of cross-sectional nationally representative surveys

ObjectiveTobacco use begins at an early age and typically leads to a long-term addiction. The age of initiation for tobacco use is not well studied in South Asia, where 22%...

Critical analysis of tobacco taxation policies in Pakistan after two decades of FCTC: Policy gaps and lessons for low- and middle-income countries.

Tobacco taxation remains a poorly used intervention to control tobacco use in many low- and middle-income countries (LMICs) including Pakistan even after two decades of FCTC adoption. This study identifies gaps and implementation challenges in the current Tobacco Taxation and Pricing Policies (TTPP) in Pakistan, and highlights key policy implications and lessons for LMICs to strengthen tobacco control measures. We used qualitative document analysis to examine the policy documents to assess the TTPP against the WHO Framework Convention on Tobacco Control (FCTC) guidelines for the implementation of Article 6 of the FCTC. In addition, we used secondary data on tobacco tax and prices to assess the impact of TTPP on tobacco affordability in the country. Although Pakistan taxes raw tobacco, cigarettes and other tobacco products (cigarillos, cigars, cheroots), the existing TTPP falls below the WHO FCTC requirements of: uniform tax level, simple tax structure and 70% share of excise tax in the price of a product's pack; among others. There are also multiple issues in tobacco tax administration such as lack of monitoring. This is leading to the availability of highly affordable tobacco products in the country. Pakistan does not have a clear strategy on using tobacco taxation and prices as a public health tool in the country. Existing TTPP face dual issues of flawed structure and poor administration translating into highly affordable tobacco products and low revenues in the country. There is a need to introduce multisectoral tobacco control policies in countries like Pakistan in the context of the tobacco sector political economy.

Air Pollution inside Vehicles: Making a Bad Situation Worse.

Thailand has successfully forwarded Article 8, Protection from Exposure to Tobacco Smoke, of the World Health Organization's Framework Convention on Tobacco Control (WHO FCTC). It achieved its 100% smoke-free goals in public places in 2010, next pursuing other bans in outdoor places to lower particulate matter air pollution (PM2.5). Our aim was to expose the secondhand smoke levels in vehicles since SHS is a danger to everyone, but especially to children and youth. This is the first experimental study of its kind in Thailand. We measured PM2.5 for 20 min under four conditions in 10 typical Thai vehicles, including commonly used sedans and small pickup trucks. We used an established protocol with two real-time air monitoring instruments to record PM2.5 increases with different vehicle air exchange and air conditioning conditions. Monitoring was recorded in the vehicle's front and back seats. The most common Thai ventilation condition is all windows closed with fan/air conditioning (AC) in operation because of Thai tropical conditions. Mean exposure levels were three and nearly five times (49 and 72 μg/m3) the 24 h WHO standard of 15 μg/m3 in the back and front seats, respectively. These high PM2.5 exposure levels warrant action to limit vehicle smoking for public health protection.

The Challenges of Tobacco Fiscal Policy Implementation in Mexico From the Perspective of Key Actors.

Raising tobacco taxes is considered the most effective strategy to avoid smoking initiation and discourage its use, especially among vulnerable groups. However, few low- and middle-income countries have adopted high tobacco taxes. Raising taxes is, therefore, an opportunity to strengthen and accelerate tobacco control. The objective of this study is to analyze the barriers and facilitators to the tobacco tax increase in Mexico. Based on the Governance Analytical Framework, data were generated through 17 in-depth interviews with key intersectoral actors for fiscal policy. The interviews were transcribed and coded according to Hufty's theory of governance. Robust scientific evidence, intersectoral coordination, and the presence of "champions" boosted progress in tobacco control (facilitators). The main barriers were the incomplete implementation of the World Health Organization-Framework Convention on Tobacco Control (WHO-FCTC) and MPOWER package and lack of commitment ("political will") by government decision makers and legislators, misinformation about the effects of tobacco taxes, and strong tobacco industry interference. Robust evidence is necessary but not sufficient to advance the implementation of the MPOWER (WHO-FCTC) actions. To achieve tobacco tax increases and public policies that protect people from unhealthy products in general, the implementation of policies or legal frameworks against industry interference in the development of public policies is imperative. By analyzing the barriers and facilitators to increasing the tobacco tax in Mexico, this study identifies two key messages: (1) The need to sensitize legislators and the general population to the problem of smoking not only through epidemiological data but also through testimonies that highlight the life experiences and adversities faced by people who smoke. (2) The need for a regulatory framework to prevent industry interference in public affairs and conflicts of interest. The same framework could be very useful for public health policies to control the consumption of ultra-processed food products or alcohol.

Commentary] The WHO strategies to reduce tobacco-related deaths are insufficient

The World Health Organization’s Framework Convention on Tobacco Control (FCTC) aims to combat global tobacco-related deaths. While it has reduced smoking in some regions, its overall effectiveness is debated, especially regarding alternative nicotine products like e-cigarettes and Swedish snus. Although the WHO views these as threats, evidence suggests they could aid harm reduction. With differing smoking trends in various countries and emerging evidence supporting alternatives, the upcoming 10th Conference of the Parties (COP10) in Panama represents a crucial juncture to reassess and potentially redefine global tobacco control strategies.

Capacity of enforcers and level of enforcement of the Tobacco Control Act 2015 in Kampala, Uganda.

Tobacco use is a leading cause of preventable deaths worldwide. Uganda enacted the Tobacco Control Act (TCA) 2015 to domesticate implementation of the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) regulations. This study assessed the capacity to enforce the TCA and associated factors, as well as the level and barriers to its enforcement in Kampala, Uganda. A cross-sectional study using both quantitative and qualitative methods was employed. A structured questionnaire was used for quantitative data collection, and a WHO adapted capacity assessment open-ended guide was used for key informant interviews. Multivariable logistic regression was used to obtain odds ratios and 95% confidence intervals for the independent predictors for capacity to enforce the TCA. A total of 162 respondents from 5 institutions and six key informants were involved in the study. Findings established that only 23% (37/162) of the enforcers had the capacity to enforce the TCA. Male enforcers [OR = 0.16, 95% CI (0.05-0.55)], those who did not know when the law was enacted [OR = 0.19, 95% CI (0.07-0.52)], those with no plans to enforce the law [OR = 0.22, 95% CI (0.05-0.93)], and older enforcers (aged 31-40 years) [OR = 0.27, 95% CI (0.09-0.81)] were less likely to have the capacity to enforce the TCA. The level of enforcement of the TCA was mainly low to moderate for most of the institutions mandated to enforce it. Lack of knowledge about the law amongst the enforcers and general public, and inadequate funds were reported as major barriers to enforcement of the TCA. The capacity to enforce the TCA in Kampala was low. There is potential to enhance the capacity of enforcers through further dissemination of the Act, as well as sensitization of enforcers, institutional managers, and the general public about the legislation.

Building On Success in Tobacco Control: A Roadmap Towards Tobacco-Free Oman (Perspective Review)

Tobacco use remains a leading cause of harm to public health. Despite nearly two decades of ratifying the WHO Framework Convention on Tobacco Control (FCTC), Oman is still striving to achieve the best practice approach in different FCTC measures. Current epidemiological data shows that the prevalence of tobacco use among adults in Oman is steadily increasing with time. This review highlights the progress that has been made in the various FCTC measures, as well as how Oman has the possibility to attain the best practice approach in the various FCTC measures, and even go beyond that by implementing policies that have the potential to achieve a tobacco-free Oman by 2040.

Menthol and Other Flavor Chemicals in Cigarettes from Vietnam and the Philippines.

Tobacco product flavors can increase product appeal, adolescent initiation and experimentation, and difficulty quitting. Flavored tobacco products are not restricted in Vietnam or the Philippines despite the high smoking prevalence among those 15 years of age and older (24% and 23%, respectively). There are no published reports to our knowledge on the levels of flavor chemicals in the cigarettes sold in these two countries. Cigarettes were purchased in Vietnam (32 brand variants) and the Philippines (19 brand variants) during 2020. Chemical analyses gave the mg/filter, mg/rod, and mg/stick (= mg/(filter + rod)) values for 180 individual flavor chemicals. Values were calculated for menthol, clove-related compounds, and "other flavor chemicals" (OFCs). Five flavor groupings were found among the brand variants purchased in Vietnam: menthol + OFCs (n = 15), OFCs only (n = 8), nonflavored (n = 7), menthol + OFCs with a clove flavorant (n = 1) and menthol only (n = 1). Three flavor groupings were found among the brand variants purchased in the Philippines: menthol + OFCs (n = 10), nonflavored (n = 5), and menthol only (n = 4). A range of flavored cigarette products are being offered by tobacco companies in Vietnam and the Philippines, presumably to maximize cigarette sales. Regulation of flavor chemicals should be considered in these two countries. Article 9 of the WHO Framework Convention on Tobacco Control (FCTC), ratified by both Vietnam and the Philippines, states that "there is no justification for permitting the use of ingredients, such as flavoring agents, which help make tobacco products attractive." Flavors increase product appeal, adolescent initiation and experimentation, and difficulty quitting. These analyses found that cigarettes purchased in Vietnam and the Philippines contained menthol and other flavor chemicals. Tobacco companies are offering multiple flavor chemical profiles and nominally nonflavored versions in these countries; regulation of flavor chemicals should be considered in these two countries.

Advocacy counterstrategies to tobacco industry interference in policymaking: a scoping review of peer-reviewed literature

BackgroundThere has been remarkable tobacco control progress in many places around the globe. Tobacco industry interference (TII) has been identified as the most significant barrier to further implementation of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC). Civil society has been recognised as a key actor in countering TII. While TII has been extensively studied for several decades now, there is little research that focuses on counteractions to limit it and their effectiveness to do so. This scoping review seeks to map the peer-reviewed literature on civil society’s activities of countering TII in policymaking to identify common counterstrategies and assess their effectiveness.MethodsData sources: We searched Embase, IBSS, JSTOR, PubMed, Science Direct, Scopus and Web of Science using the following terms: (“Tobacco industry” OR “Tobacco compan*”) AND. (“corporate political activity” OR “CPA” OR “lobbying” OR “interference”) AND (“advoca*” OR “counter*” OR “activi*”), without time or language restrictions. Study selection: Our selection criteria included peer-reviewed studies that were written in English, German, or Spanish that drew on primary data and/or legal and policy documents and reported at least one specific example of civil society members or organisations countering tobacco industry action-based strategies. Data extraction: Advocates’ counterstrategies were analysed inductively and countered industry strategies were analysed using the Policy Dystopia Model (PDM). Perceptions of effectiveness of countering attempts were analysed descriptively.ResultsWe found five common counterstrategies among 30 included papers covering five WHO regions; 1. Exposing industry conduct and false claims; 2. Accessing decision-makers; 3. Generating and using evidence; 4. Filing a complaint or taking legal action; 5. Mobilising coalition and potential supporters. These counterstrategies were used to work against a wide range of industry strategies, which are captured by five action-based strategies described in the PDM (Coalition Management, Information Management, Direct Access and Influence, Litigation, Reputation Management). While some studies reported the outcome of the countering activities, their impact remained largely underexplored.ConclusionThe review shows that peer-reviewed literature documenting how civil society actors counter TII is scarce. It suggests that advocates employ a range of strategies to counter TII in its different forms and use them flexibly. More work is needed to better understand the effects of their actions. This could stimulate discussions about, and facilitate learning from, past experiences and help to further enhance advocates’ capacity.

Diverse e-cigarette regulations in the Asia Pacific: A health economic perspective.

Diverse e-cigarette regulations in the Asia Pacific: A health economic perspective.

Plain Packaging in Tobacco Control: A Bibliometric Analysis.

The tobacco epidemic is affecting 8 million people with 1.2 million deaths worldwide. The Framework Convention on Tobacco Control (FCTC) was adopted by the World Health Organization (WHO) Member States in 2003 to counter the growing tobacco menace. Articles 11 and 13 of WHO FCTC suggest plain packaging of tobacco products to reduce the visibility and make tobacco products look less attractive. The current bibliometric analysis was conducted to analyze the visibility and impact of the scientific productions contributing to plain packaging globally. The bibliometric analysis allowed a quantitative analysis of all scientific publications indexed in Scopus. The sample was defined using the keywords "plain packaging OR standardized packaging" AND "tobacco." Five broad bibliometric domains were assessed for analysis: namely, scientific production, authors, sources or journals, countries, and thematic areas using R programming v4.2.2 and VOSviewer. The total number of documents published regarding plain packaging in tobacco control from 1992 till mid-2022 was determined. Australia tops the list with 99 publications, followed by the United Kingdom, United States, New Zealand, Canada, France, India, Netherlands, Spain, and Egypt. The author citation network showcases the link between the 21 top documents, with a minimum of 50 citations per document. The two main indicators assessed were the total number of articles published in the journal and the h index. Bibliometric indicators in this study illustrated that scientific publications/efforts to implement the WHO FCTC guideline concerning plain packing laws were neglected in most countries.

The 20th anniversary of the WHO Framework Convention on Tobacco Control: hard won progress amid evolving challenges

World No Tobacco Day on May 31, 2023, marks the 20th anniversary of the WHO Framework Convention on Tobacco Control (FCTC). Adopted in May, 2003, member states committed to stem an alarming rise in tobacco-related deaths worldwide, predicted to rise from 5 million to 10 million deaths by 2020 if no action was taken. 1 WHOWorld Health Assembly adopts historic tobacco control pact. https://www.who.int/news/item/21-05-2003-world-health-assembly-adopts-historic-tobacco-control-pactDate: May 21, 2003 Date accessed: May 22, 2023 Google Scholar In 2021, about 8 million deaths were attributable to tobacco use. 2 Vital StrategiesTobacco atlas, 7th edition. https://tobaccoatlas.org/Date: 2021 Date accessed: May 22, 2023 Google Scholar Although still unacceptably high, despite a 1·7 billion rise in global population, this burden of tobacco deaths was a 40% lower increase than projected before the introduction of the FCTC. Proposed to WHO in 1995 by scholars Ruth Roemer, Allyn Taylor, 3 Roemer R Taylor A Lariviere J Origins of the WHO Framework Convention on Tobacco Control. Am J Public Health. 2005; 95: 936-938 Crossref PubMed Scopus (130) Google Scholar and their colleagues, supported by civil society, underpinned by World Bank analysis, 4 Jha P Chaloupka F Curbing the epidemic, governments and the economics of tobacco control. World Bank, Washington, DC1999 Google Scholar legitimised by revelations from internal tobacco industry documents, 5 National Association of Attorneys GeneralThe Master Settlement Agreement. https://www.naag.org/our-work/naag-center-for-tobacco-and-public-health/the-master-settlement-agreement/#:~:text=Under%20the%20MSA%2C%20tobacco%20manufacturers,certain%20such%20payments%20are%20madeDate accessed: May 22, 2023 Google Scholar and championed by the WHO Director-General at the time Gro Harlem Brundtland, the FCTC is the first and only treaty to be negotiated to date under the auspices of WHO. It became one of the most widely embraced treaties in UN history: 182 states parties have acceded to the treaty, covering more than 90% of the world's population.

The role of principled engagement in public health policymaking: the case of Zambia’s prolonged efforts to develop a comprehensive tobacco control policy

ABSTRACT Background The Framework Convention on Tobacco Control (FCTC) requires countries to develop and implement multi-sectoral tobacco control strategies, including policies and legislation. Zambia, potentially faced by a rising problem of tobacco smoking, signed the FCTC in 2008 but has been unable to enact a tobacco policy for over a decade. Objective This study explores the role of ‘principled engagement’, a key element of the theoretical framework for collaborative governance, in Zambia’s delayed success to develop a comprehensive tobacco control policy. Methods This was a qualitative case study of key stakeholders in the collaborative process of trying to develop a tobacco policy in Zambia. Participan-ts were sampled from across various sectors, including government departments and civil society, comprising anti-tobacco activists and researchers. A total of 27 key informant interviews were undertaken. We supplemented the interview data with a document review of relevant policies and legislation. Data were analysed using thematic analysis. Results Several factors hindered efforts to attain principled engagement, including the adverse legal and socioeconomic environment in which the collaborative regime evolves; poor planning of meetings and frequent changes in tobacco focal point persons; lack of active and meaningful participation; and communication challenges among the key stakeholders. These collaborative dynamics, coupled with the opposition to tobacco control efforts from within some government departments, revealed the inadequacy of the current collaborative governance regime to facilitate enactment of a comprehensive tobacco control policy in Zambia. Conclusion Efforts to develop a comprehensive tobacco control policy in Zambia will require addressing challenges such as disagreements, communication, and leadership at engagement level across interested sectors. We further argue that principled engagement has a greater role to play in unlocking these efforts and should therefore be embraced by those entrusted to lead the process to develop tobacco policy in Zambia.