The United States has a special responsibility to help end the tobacco epidemic, as it is a leading exporter. "Exporting tobacco addiction from the USA," 351 Lancet 597 (1998); 352 Lancet 152 (1998); and John Britton, "Tobacco: The Epidemic We Could All Avoid," 52 Thorax 1021-1022 (1997).
|The "Framework Convention on Tobacco Control" website is http://www.who.int/toh/fctc/fctcintro.htm.
The announcement by the U.S. government on this issue, in the Federal Register, on (a) a public hearing and (b) opportunity for email and mail comments (which this site covers) is at: http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=2000_register&docid=00-4388-filed.
An international advocacy group, Action on Smoking & Health (UK), is at this website, http://www.ash.org.uk/international.html
The World Health Organization (WHO) has initiated negotiations on a Framework Convention on Tobacco Control in an effort to promote a coordinated international response to tobacco, the most deadly epidemic of all time. A Framework Convention is a type of multilateral treaty, which allows governments to proceed incrementally by establishing first a general framework followed by specific protocols.
Tobacco is truly a global problem. WHO estimates that each year about 4 million people die from tobacco-related illness. If current trends continue, this figure will rise to about 10 million per year by the year 2030, with 70% of those deaths occurring in developing countries.
WHO understates the problem. WHO ignores many tobacco-related aspects. It says merely that more people are expected to die from tobacco-related illness over the next 30 years than from AIDS, tuberculosis, automobile accidents, maternal mortality, homicide and suicide combined. As you can tell from its material, WHO ignores the tobacco role in AIDS, homicide, and suicide. That is why our input is important, to cite these matters.
Just as infectious diseases know no political boundaries, leaving individual countries incapable of effectively containing them, the tobacco epidemic also requires international cooperation if it is to be controlled. The challenges that transcend the borders of nations include:
* Cigarette smuggling across national borders.
* The increased liberalization of trade and investment, which has provided tobacco, companies the opportunity to expand their operations.
In May 1999, the 191 member states of WHO unanimously endorsed the start of negotiations for the Framework Convention on Tobacco Control (FCTC) to deal with these and other issues. A record 50 nations took the floor to pledge financial and political support for the Convention, including the five permanent members of the United Nations’ Security Council, as well as major tobacco growing and exporting countries. The FCTC will be the world’s first tobacco control treaty and has the potential to have an historic impact on global public health.
Under the convention/protocol approach, governments negotiate a framework convention that calls for cooperation in achieving broadly stated goals and contain agreements regarding issues on which there is consensus. At the same time, states may negotiate separate protocol agreements on more technical or contentious issues. This approach has been used to address other global problems, such as climate change.
The Tobacco Free Initiative (TFI), a cabinet-level project of WHO created by Director-General Gro Harlem Brundtland, will act as Secretariat for the FCTC during the negotiations. Meanwhile, a Working Group, open to all WHO Member States, has been created to prepare proposed draft elements of the FCTC. The Working Group will have its second meeting from 27-29 March 2000 in Geneva. A draft report, which will be considered by the Working Group, will be posted on the FCTC web page one month prior to this meeting. The Group will then prepare a final report that will serve as the starting point for formal negotiations, which are scheduled to commence in October 2000. Though the negotiation of each treaty is unique and depends upon the political will of states, WHO foresees adoption of the Convention and related protocols no later than May 2003, after which it will open for ratification.
The actual content of the Convention and related protocols will depend upon the priorities of the member nations. Possible issues that could be addressed include: tobacco price and tax policies; passive smoking; protecting women, children and adolescents; smuggling of tobacco products; sale of duty-free tobacco products; advertising, promotion and sponsorship of tobacco products; tobacco product regulation, including testing and reporting of tobacco product ingredients and constituents, and the ability to require tobacco product modification; tobacco industry regulation; information exchange; health education and research; agricultural policies; and tobacco use prevention and cessation. Discussions with government delegations and Secretariat staff indicate that, aside from the text of the Framework Convention itself, the first three protocols to be negotiated may be on smuggling, advertising and cessation/treatment.
This narrow focus means that we need to emphasize banning cigarettes' manufacture and sale, not these ultra-limited aspects that are not a real solution.
As the home to the world’s largest multinational tobacco company, and as an exporter of tobacco addiction, the United States has a particular responsibility to display constructive leadership and support for the Framework Convention process. This will involve, among other things, ensuring high-level representation from the United States at the negotiations and committing political and financial support to the Framework process.
The negotiation and implementation of the FCTC could make an enormous contribution to stemming the growth of the tobacco epidemic by raising national and international awareness, implementing effective national tobacco control measures and providing technical and financial resources. The Convention will also serve as a platform for multilateral cooperation on aspects of tobacco control that transcends national boundaries, including global marketing/promotion of tobacco products and smuggling.
In addition to the specific benefits of the Convention and related protocols, the process leading to the passage of the FCTC is likely to:
* Help mobilize national and global technical and financial support for tobacco control.
* Bring new ministries, including those dealing with foreign affairs and finance, more deeply into the tobacco control effort.
* Mobilize NGOs and other members of civil society in support of stronger tobacco control.
* Raise public awareness of marketing tactics used by transnational tobacco companies abroad.
There is also a "Campaign for Tobacco Free Kids" effort, at http://tobaccofreekids.org/campaign/global/.
In Canada, there is also a "Physicians for a Smoke-Free Canada" effort, at http://www.smoke-free.ca/eng_issues/govt_fctc.htm.
Feel free to tailor your comments to any interests of concern to you or your organization. Examples (or you may categorize these issues in different ways, or identify others):
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