Action on Smoking and Health, an organization founded in 1967 that seeks to ensure that the public health community addresses the tobacco epidemic in a unified and coherent manner, has released a report The WHO FCTC Implementation Guide for U.S. State and Local Officials. The introduction is below. The full report is here.
Tobacco use is still the number one preventable cause of death in the U.S., killing about 480,000 people each year; it is responsible for over 20% of all American deaths. Tobacco kills about half of its long-term users. With approximately 44 million adult smokers, we can expect the death toll to continue for decades to come. And every day, about 3,200 children smoke their first cigarette. Over 1,000 of those children will eventually be killed by tobacco.1
The United States has made serious strides in combating the death and disease caused by tobacco. The federal government, states, and localities have enacted many effective laws and programs, severely limiting cigarette advertising, banning smoking in public places, and raising taxes on cigarettes. These actions have led to a decrease in cigarette consumption and averted many premature deaths. We’ve come a long way, but there is still a lot left to do.
To combat this epidemic, countries around the world negotiated and then, in 2003, adopted the first international treaty on health, the Framework Convention on Tobacco Control (FCTC). Since that time, 178 countries and the European Union have become party to the FCTC,2 and countries all over the globe have begun implementing its life-saving measures. The FCTC sets out specific steps for governments on how to address tobacco use, including how to adopt tax and price measures to reduce tobacco consumption; ban or restrict tobacco advertising, promotion and sponsorship; create smoke-free work and public spaces; put prominent health warnings on tobacco packages; and limit tobacco industry interference when setting public health policies. In addition to the FCTC, the parties have drafted guidelines for implementation for many of the relevant articles, including Articles 5.3, 8, 12, 13, and 14. These guidelines were designed to give countries assistance when implementing the FCTC, to make sure the measures contained in the treaty are implemented as effectively as possible. The FCTC measures have had an immensely positive effect in countries that have ratified and implemented the treaty.
The United States negotiated and signed the FCTC on May 10th, 2004 but unfortunately, the U.S. has not yet ratified the treaty and is not a party to the FCTC.3 Action on Smoking and Health strongly encourages the United States to become a party. However, regardless of whether the United States ever ratifies the treaty, the FCTC still provides excellent lessons and examples that federal, state, and local governments can adopt in order to further protect the health of the U.S. population.
Now that most nations of the world have become parties to the FCTC, the focus on implementation is at the national level. In federal systems such as the United States, significant sovereign powers reside with state governments, which to varying degrees empower local governments to regulate in the public interest. While tribes and territories are not the target audience for this guide due to the wide variance in laws and sovereign status, many of the lessons would be applicable to those jurisdictions as well. This guide and the associated database are intended to help state and local officials adopt effective strategies, based on the FCTC, in their home jurisdictions.
Many of the most crucial advancements in tobacco control in the U.S. began at the local level. National ratification of the FCTC is not a prerequisite for greater action.
1 U.S. Department of Health and Human Services, The Health Consequences of Smoking- 50 Years of Progress: A Report of the Surgeon General (2014), available at http://ash.org/wp-content/uploads/2014/01/full-report.pdf .
2 Action on Smoking & Health, A half Century of Avoidable Death: A Global Perspective on Tobacco in America 5 (2014), available at http://ash.org/wp-content/uploads/2014/06/US-TOBACCO-REPORT_FNL-WEB1.pdf.