2007 johns hopkins bloomberg school of public health section b tobacco control experiences in...

2007 Johns Hopkins Bloomberg School of Public Health

Section BSection B

Tobacco Control Experiences in Developing Countries


Tobacco Control Experiences in Developing Countries

Several developing countries had started putting in place tobacco control policies before the FCTC negotiations began

The FCTC negotiations process gave momentum to the tobacco control efforts in such countries and encouraged those without any measures to initiate policies and activities for tobacco control

Whereas developing-country parties can learn from “best-practice models” in the developed world, there are some success stories from the developing-country parties

Efforts should be made to encourage south-south cooperation in scientific, technical, and legal fields


Tobacco Control Experiences: Brazil

A party to the FCTC, Brazil has had a national tobacco control program since 1989

This program has achieved important positive results Smoking prevalence among adults (age 18+) decreased

from 34.8% in 1989 to 22.4% in 2003: a 35% decrease

In 2003, motivated by the FCTC negotiation process, the president of Brazil created the National Commission for the Implementation of the FCTC and its Protocols A formal governmental forum that convenes the

representation of 13 different ministries Its main goal is to build a state agenda for the FCTC

implementation


Tobacco Control Experiences: South Africa

A party to the FCTC since 2005, South Africa has one of the most comprehensive tobacco control policies in the world

The 1993 Tobacco Products Control Act included strong measures on smoke-free public places, taxation, health warnings, and advertising bans

The Tobacco Products Amendment Act came into force in South Africa in October, 2000

Political commitment and strong tobacco control networks enabled adoption and implementation of strong tobacco control policies


Source: van Walbeek. (2003).

Cigarette Price and Consumption: South Africa


Tobacco Control Experiences: Thailand

Incorporated tobacco control as a key component of its overall health promotion strategy

Serves as a best-practice example in tobacco control policies Strong pictorial health warnings on tobacco products Progressive taxation policy on tobacco products

There are dedicated funds available for health promotion and tobacco control programs through earmarked tobacco and alcohol taxes (Health Promotion Foundation Act, 2001)


Image source: The University of Sydney Tobacco Control Supersite. (2006).

Tobacco Control Experiences: Thailand

Health warnings in Thailand


Tobacco Control Experiences: India

In 2003, adopted a comprehensive legislation on tobacco control: The Cigarettes and Other Tobacco Products Act

Elaboration of rules for implementation of various measures of the Act is ongoing; several challenges related to implementation remain

A growing network of NGOs working on tobacco control and strong partnerships are being established between governmental and NGOs at various levels of governance for FCTC implementation


Recommendations for FCTC Implementation

Establish a national coordination mechanism, involving multiple stakeholders, for implementation of policies towards full compliance with FCTC provisions—ensure its freedom from tobacco industry influence

Develop a comprehensive national tobacco control legislation in line with the provisions and obligations under the FCTC

Conduct a situation analysis of tobacco control in the country to analyze existing policies and develop new policies along with strengthening of existing measures, in accordance with the FCTC provisions



Integrate tobacco control into existing health systems, at all levels of governance (federal, state, provincial, local) to ensure sustainability of tobacco control interventions

Strengthen human and institutional infrastructure for implementation of tobacco control measures (this may be done by establishing a national tobacco control program)

Ensure coordination between different governmental agencies involved with tobacco control at national, provincial, and municipal levels

Strengthen NGOs, especially those working on health and development issues, so that tobacco control can be integrated within a broad civil society agenda in the country



Train personnel engaged in tobacco control in monitoring and evaluation of tobacco control measures

Conduct appropriate communication and public awareness campaigns to build a critical mass of public opinion in support of FCTC implementation and compliance with tobacco control legislation

Develop locally appropriate cessation programs to support tobacco users in quitting tobacco use



Develop a national tobacco control research agenda that addresses not only health effects of tobacco use but also the socioeconomic aspects

Establish and integrate a tobacco control surveillance program within the health systems


*Source: da Costa e Silva, V.L. (2004).


Build national and regional capacity for tobacco product testing and disclosure of constituents and emissions Essential for compliance with the provisions related to

regulation of contents of tobacco products and disclosures

Establish a national regulatory authority to regulate tobacco products Revenue-generating models for such regulatory bodies

exist For example, Brazil: ANVISA (the National Agency

for Sanitary Surveillance) is mandated to collect $35,000 USD* as annual registration fee for each brand from the tobacco companies



Mobilize resources for FCTC implementation Conduct needs assessment, in light of total obligations

to the FCTC, to identify program priorities as well as technical and financial needs for FCTC implementation

Seek support from bilateral and multilateral funding mechanisms and international agencies such as the WHO

Explore funding opportunities through mechanisms such as the Bloomberg Initiative to reduce tobacco use

Actively participate in sessions of the Conference of the Parties to the FCTC for relevant matters, including the negotiation and adoption of protocols and guidelines for implementation of selected provisions



Be vigilant of tobacco industry strategies to counter efforts at FCTC implementation As countries attempt to implement comprehensive

advertising bans, the tobacco industry might use surrogate advertising and promotion strategies such as product placement in electronic media and movies

As taxation policies are put in place, governments need to monitor and curb possible increase in illicit trade (in which the tobacco industry might be complicit)

Identify and promote economically viable alternatives for tobacco workers, growers, and sellers


Summary

The success of the FCTC will be determined by the political commitment and resources applied for its implementation

Several developing countries are parties to the FCTC and are now faced with the challenges of implementation

There are existing best-practice models, from both developed and developing countries, on effective tobacco control implementation

This lecture identifies challenges faced by developing countries in tobacco control and recommends strategies for effective implementation of the FCTC in a developing-country context

2007 johns hopkins bloomberg school of public health section b tobacco control experiences in...

Documents

tobacco control efforts

tobacco control programs

tobacco products control

earmarked tobacco

place tobacco control

tobacco products amendment

thailand health warnings

fctc implementation