Tag: World

World Bank report
Contrary to tobacco industry arguments, taxes and prices have only a limited impact on the illegal cigarette market share at country level, according to a World Bank report, Confronting illicit tobacco trade: A global review of country experiences.
The report, running to about 650 pages, says that evidence indicates that the illegal cigarette market is relatively larger in countries with low taxes and prices while relatively smaller in countries with higher cigarette taxes and prices. Non-price factors such as governance status, weak regulatory framework, social acceptance of illicit trade, and the availability of informal distribution networks are said to ‘appear to be far more important determinants of the size of the illicit tobacco market’.
Part of the Bank’s advice for tackling the illegal trade is for authorities to avoid reliance on the tobacco industry, whose role is said to pose a challenge to countries seeking to address the illegal trade, ‘since the tobacco industry is often linked to illicit trade in tobacco products, either directly or indirectly’.
‘The UK and Ireland case studies emphasize the need to fulfill obligations under Article 5.3 of the FCTC [World Health Organization’s Framework Convention on Tobacco Control] to prevent the tobacco industry from influencing public policy,’ the report says. ‘The case studies, including Colombia, Australia, Georgia, and Malaysia, also confirm prior findings that the tobacco industry regularly overstates levels and changes in tobacco illicit trade to oppose tobacco tax reforms. The Georgia and Uruguay case studies show that when the government responds to industry pressure and reduces taxes due to fears regarding tobacco illicit trade, the result is a decline in revenues and an increase in consumption, while the true drivers of illicit trade in tobacco products remain unaddressed.’
The Bank concludes, in part, that the following actions need to be undertaken to confront the illegal trade in tobacco products.
- ‘Require licensing for the full tobacco supply chain, as required by Article 6 of the [FCTC] Protocol.
- ‘Require use of secure excise tax stamps and other product markings to facilitate enforcement and tax collection, as required by Article 8 of Protocol.
- ‘Establish effective track-and-trace systems to follow tobacco products through the supply chain from production or import to sale to consumers (Article 8 of the Protocol).
- ‘Establish effective enforcement teams equipped with automated reporting devices, to reduce human discretion in tobacco tax administration (Articles 8 and 19 of the Protocol).
- ‘Obtain detection equipment and use it effectively at customs posts (Articles 14 and 19 of the Protocol).
- ‘Develop a risk profile to target inspections (Articles 10, 14 and 19 of the Protocol).
- ‘Set relatively low duty-free allowances (Article 13 of the Protocol and Article 6.2 of the FCTC) for tobacco product purchases, both in terms of amounts and frequency.
- ‘Regulate or ban trade in tobacco products in free trade and other special economic zones (Article 12 of the Protocol).
- ‘Set and enforce significant financial penalties and penal provisions for illicit trade in tobacco products (Articles 15, 16 and 17 of the Protocol).
- ‘Provide for secure and environmentally friendly destruction of seized cigarettes, carried out by the regulatory authorities and not by the tobacco industry (Article 18 of the Protocol).
- ‘Educate the public on the impact of tobacco illicit trade.
February 4, 2019
Focus on lung health
The World Health Organization has said that the focus of World No Tobacco Day 2019 – May 32 – will be on tobacco and lung health.
According to a note on a WHO website, the campaign is charged with increasing awareness of ‘the negative impact that tobacco has on people’s lung health, from cancer to chronic respiratory disease,’ and ‘the fundamental role lungs play for the health and well-being of all people’.
‘The campaign also serves as a call to action, advocating for effective policies to reduce tobacco consumption and engaging stakeholders across multiple sectors in the fight for tobacco control,’ the WHO said.
The World No Tobacco Day 2019 campaign is due to raise awareness on the:
- risks posed by tobacco smoking and second-hand smoke exposure;
- awareness on the particular dangers of tobacco smoking to lung health;
- magnitude of death and illness globally from lung diseases caused by tobacco, including chronic respiratory diseases and lung cancer;
- emerging evidence on the link between tobacco smoking and tuberculosis deaths;
- implications of second-hand exposure for lung health of people across age groups;
- importance of lung health to achieving overall health and well-being;
- feasible actions and measures that key audiences, including the public and governments, can take to reduce the risks to lung health posed by tobacco.
January 31, 2019
WHO urged to block its ears
Public health advocates from around the world today urged the World Health Organization to reject an appeal by the Foundation for a Tobacco Free World to collaborate on tobacco control policies, according to a press note from STOP (Stopping Tobacco Organizations and Products).
The advocates called on the WHO’s executive board to reject the Philip Morris International-funded Foundation’s appeal to WHO.
They said agreeing to such collaboration would depart from WHO’s strict long-standing policy of not working with the tobacco industry, whose business practices have been proven to be contradictory with and detrimental to public health.
‘When public health experts were alerted to the approach, made in advertisements by the PMI Foundation for a Smoke Free world (FSFW), more than 279 organizations and individuals in 50 countries signed an open letter put forward by STOP …,” the note said.
But not Clive Bates, who wrote on his blog that he was sent the draft activists’ letter but decided against signing it. He takes a close look at the letter here.
Meanwhile, Anna Gilmore, professor of public health at the University of Bath and research lead for STOP, was quoted in the STOP note as saying that PMI had “a long and well-documented history of using third parties to infiltrate health policy making”. “No public health gain has ever been achieved by working with the tobacco industry so this latest approach by a PMI-funded entity must be rejected,” she said. “Support to express outrage against the PMI-funded FSFW continues to pour in.”
The text of the activists’ letter to the director general and executive board of the WHO is below
‘We write to you, as members of the global public health community, to express our grave concern at the attempt by the Philip Morris International-funded entity, Foundation for a Smoke Free World (FSFW), to pave the road for partnership with the World Health Organization (WHO).
‘Giving any consideration to an organization that is entirely funded by the tobacco industry would fundamentally undermine the significant health and policy gains made to date on the attainment of the Sustainable Development Goals (SDGs) and prevention of noncommunicable diseases (NCDs) through the implementation of the WHO Framework Convention on Tobacco Control (FCTC). It would specifically undermine WHO FCTC Article 5.3 which seeks to protect public health policies from the vested interests of the tobacco industry and on which much of the success of the treaty rests.
‘We therefore call on you to reject this approach, in the strongest terms, and reinforce WHO’s 2017 notice to governments and the public health community to reject any affiliation with FSFW because of the “number of clear conflicts of interest involved with a tobacco company funding a purported health foundation, particularly if it promotes sale of tobacco and other products found in that company’s brand portfolio”.
‘Analysis of leaked PMI corporate affairs documents suggests that the establishment of the FSFW is consistent with the company’s corporate strategy. The concern is that FSFW effectively operationalizes PMI’s corporate affairs strategy to further PMI’s business interests which include the promotion of its heated tobacco products, a market which PMI seeks to dominate. While PMI and its grantee claim a commitment to reducing harm; reports show that PMIs cigarettes continue to be heavily marketed in ways that attract children and undermine public health policy.
‘We are secure in the knowledge that the WHO does not engage with the tobacco industry or its proxies. We trust that you will respond to the PMI-funded FSFW in a manner consistent with the institution’s long-standing principles to protect its credibility and integrity bearing in mind that legitimizing FSFW through engagement would simply advance PMI’s agenda to the detriment of global health.
‘In the spirit of promoting partnerships to attain the SDGs, we hope that you will take this opportunity to establish WHO’s leadership in implementing the Model policy for agencies of the United Nations system on preventing tobacco industry interference.
‘The health of millions of people requires no less.’
January 29, 2019
Thinking inside the tank
Free-market thinktanks around the world provide a powerful voice of support to cigarette manufacturers in battles against tougher regulations, according to a story in The Guardian that appears under the byline of Jessica Glenza in New York.
The Guardian is said to have examined one of the largest networks of independent free-market thinktanks in the world, organized by Atlas Network, a not-for-profit based near Washington DC in Arlington, Virginia, which it says “connects a global network of more than 475 independent, civil society organizations in over 90 countries to the ideas needed to advance freedom”.
At least 106 thinktanks in two dozen countries were said to have accepted donations from tobacco companies, argued against tobacco control policies called for by the World Health Organization (WHO), or both.
The groups examined by the Guardian are said to have, variously, opposed standardized cigarette packaging, written to regulators in support of new tobacco products, or promoted industry-funded research.
Patricio Marquez, lead specialist on health global practice at the World Bank, said such activity could impact public health efforts. The thinktanks “have created an arsenal of evidence in order to influence policy-making and decision-making”, he said.
In responses to questions from the Guardian, the thinktanks said they were fiercely independent, unswayed by any donations, and they argued pro-business, low regulation and taxation positions as part of a broader free-market philosophy.
Not all the groups in the network that the Guardian analyzed were active in tobacco policy, and some were said to have done so only in isolated instances. Some thinktanks issued policy papers around climate change skepticism, private education, pharmaceutical patent protections, energy deregulation and other conservative causes.
Philip Morris International was said to have told the Guardian ‘ideas are not for sale’, and the story said this was a sentiment echoed by other tobacco companies. ‘We have worked, and will continue to work, with carefully selected organizations around the world who share our desire to promote policies that produce meaningful public health improvements,’ PMI reportedly said. ‘It is absolutely ridiculous to imply that supporting an organization would result in a group taking action they otherwise would fundamentally oppose.’
Meanwhile, Marquez was quoted as saying, in part, that freedom of speech needed to be respected as long as everything was transparent. “In that way, everybody is aware who you are representing,” he said.
The content of the story is based on an investigation by the UK-based Guardian newspaper.
‘This content is funded by support provided, in part, by Vital Strategies with funding by Bloomberg Philanthropies,’ according to a note accompanying the story. ‘Content is editorially independent and its purpose is to shine a light on both the tobacco industry and the world’s most vulnerable populations, who disproportionately bear the brunt of the global health crisis resulting from tobacco consumption,’ the note says, in part.
January 24, 2019
Joint approach to health
With the right discussion and oversight, corporations can be reliable partners in helping governments deal with some of today’s public health issues, according to a note posted on Philip Morris International’s website.
The company says that it has looked at the dynamics between consumers, corporations and authorities across a range of global public health issues through the lens of a new report, Public Health—Much Harder than Rocket Science, which is based on a recent global survey conducted by IPSOS.
‘Consumers all over the world want their governments to do better at solving major public health issues, according to the IPSOS survey of 31,000 respondents across 31 countries commissioned by PMI,’ the note says.
‘In the survey, respondents were asked how important they believed it is for governments to dedicate time and resources to nine global health issues: air pollution, mental health, STDs [sexually-transmitted diseases], healthier food products, opioid abuse, smoking and alcohol abuse, unwanted pregnancies and obesity.
‘When asked about the role of technology and innovation in addressing these issues, 91 per cent of respondents believed technology and innovation had an important role to play. ‘However, respondents did not evaluate government performance highly; … 56 per cent believed the authorities had done a poor job of ensuring access to the latest innovations and advancements that can improve public health.
‘Introduced by PMI in Davos, Public Health—Much Harder than Rocket Science, reviews further the discussions surrounding these important public health issues and the interplays between public vs. private impact and human behavior. It concludes that a collaborative approach is possible: Corporations themselves may well be able to help address some of the public health issues relating to their products. And, authorities would be well advised to tap into corporate resources and use their ingenuity and self-interest to create compelling solutions. With the right discussion and oversight, corporations can be reliable partners in helping governments deal with some of today’s public health issues.’
“Given the scale of these public health challenges, it’s unrealistic to expect advice and exhortations from health authorities alone to make the difference,” argues Marian Salzman, senior vice president, global communications at PMI. “To truly help large numbers of people make the changes they want and need will take a combination of evidence-based public policy initiatives, new technologies and new products.
“The public deserve – and are asking – to hear about better possibilities, regardless of where they have come from.”
More information is at: PMI.com.
All the data can be viewed at: https://www.pmi.com/media-center/news/public-supports-alternatives-to-cigarettes.
January 23, 2019
Health under threat globally
The rise in noncommunicable diseases has been driven by five major risk factors: tobacco use, physical inactivity, the harmful use of alcohol, unhealthy diets and air pollution, according to the World Health Organization.
In publishing its 13th General Programme of Work, the WHO said the world was facing multiple health challenges. ‘These range from outbreaks of vaccine-preventable diseases like measles and diphtheria, increasing reports of drug-resistant pathogens, growing rates of obesity and physical inactivity to the health impacts of environmental pollution and climate change and multiple humanitarian crises,’ it said in a statement.
‘To address these and other threats, 2019 sees the start of the World Health Organization’s new five-year strategic plan – the 13th General Programme of Work. This plan focuses on a triple billion target: ensuring one billion more people benefit from access to universal health coverage, one billion more people are protected from health emergencies and one billion more people enjoy better health and well-being. Reaching this goal will require addressing the threats to health from a variety of angles.’
In its announcement, the WHO listed the following 10 issues as being among those that will demand its attention and that of its partners during 2019: ‘air pollution and climate change; noncommunicable diseases; global influenza pandemic; fragile and vulnerable settings; antimicrobial resistance; Ebola and other high-threat pathogens; weak primary health care; vaccine hesitancy; dengue; and HIV’.
In addressing the question of noncommunicable diseases, the WHO said that diseases such as diabetes, cancer and heart disease, were collectively responsible for more than 70 percent of all deaths worldwide, accounting for 41 million people. This included 15 million people ‘dying prematurely’, aged between 30 and 69.
‘Over 85 percent of these premature deaths are in low- and middle-income countries,’ the WHO said. ‘The rise of these diseases has been driven by five major risk factors: tobacco use, physical inactivity, the harmful use of alcohol, unhealthy diets and air pollution. These risk factors also exacerbate mental health issues, that may originate from an early age: half of all mental illness begins by the age of 14, but most cases go undetected and untreated – suicide is the second leading cause of death among 15-19-year-olds.
‘Among many things, this year WHO will work with governments to help them meet the global target of reducing physical inactivity by 15 percent by 2030 – through such actions as implementing the ACTIVE policy toolkit to help get more people being active every day.’
But it would seem that air pollution is the big threat. The WHO said that nine out of ten people breathed polluted air every day. ‘In 2019, air pollution is considered by WHO as the greatest environmental risk to health,’ it said. ‘Microscopic pollutants in the air can penetrate respiratory and circulatory systems, damaging the lungs, heart and brain, killing seven million people prematurely every year from diseases such as cancer, stroke, heart and lung disease. Around 90 percent of these deaths are in low- and middle-income countries, with high volumes of emissions from industry, transport and agriculture, as well as dirty cookstoves and fuels in homes.
‘The primary cause of air pollution (burning fossil fuels) is also a major contributor to climate change, which impacts people’s health in different ways. Between 2030 and 2050, climate change is expected to cause 250,000 additional deaths per year, from malnutrition, malaria, diarrhoea and heat stress.
‘In October 2018, WHO held its first-ever Global Conference on Air Pollution and Health in Geneva. Countries and organizations made more than 70 commitments to improve air quality. This year, the United Nations Climate Summit in September will aim to strengthen climate action and ambition worldwide. Even if all the commitments made by countries for the Paris Agreement are achieved, the world is still on a course to warm by more than 3°C this century.’
January 18, 2019
Nasvay report flawed
The World Health Organization seems intent on discouraging tobacco smokers from switching from combustible cigarettes to smokeless tobacco products.
In a report published yesterday by its regional office for Europe, the WHO talks of a ‘risk’ in consumers switching from cigarettes to smokeless tobacco products.
The third conclusion of the report says that ‘…[w]ith reducing affordability of conventional cigarettes due to tobacco taxation in some CIS countries, there is a risk that consumers who currently smoke cigarettes will switch to using nasvay and other smokeless tobacco products’. ‘This should be carefully monitored and managed.’
In part, conclusion four says that ‘…[s]mokeless tobacco products should be regulated like all other tobacco products’. ‘In countries where use of smokeless tobacco is low, it might be appropriate to consider a pre-emptive comprehensive ban or other regulatory options to control smokeless tobacco production, turnover, importation and consumption.’
The report, Consumption and approaches to the regulation of nasvay in the Commonwealth of Independent States is said to look at smokeless tobacco use, specifically the use of nasvay in the CIS, but it casts its net wide in respect of products and countries.
In the first of its conclusions, the report says that several parties to the WHO’s Framework Convention on Tobacco Control had agreed that smokeless products should be regulated with the same rigor as traditional tobacco products are regulated.
And it says that other parties called for a comprehensive ban on existing and new smokeless tobacco products.
Although the report has in its sights all types of smokeless tobacco products; it seems, at the same time, to concede that the use of some such products is less risky than that of others; or even that the use of some is not risky at all. In the nasvay-specific section of the report’s section of The health effects of smokeless tobacco use; it says: ‘Nasvay can be considered a dangerous form of smokeless tobacco…’
January 16, 2019
ILO pressed on tobacco link
Government members of the International Labour Organisation’s (ILO) governing body have been told that the expiration in December of the ILO’s contract with Japan Tobacco International – the organization’s only remaining contract with the tobacco industry – creates an opportunity for the ILO to start afresh in 2019.
The advice comes in an open letter posted on the website of the Framework Convention Alliance and signed by about 100 ‘public health, development, human rights, and corporate accountability organizations’.
The letter states, in part: ‘While the world waits for the ILO to align itself with the 181 countries party to the WHO [World Health Organization] Framework Convention on Tobacco Control (FCTC), at this 334th Governing Body meeting [scheduled for today], we, the undersigned organizations, respectfully request the following decisions be adopted:
1. No longer accept any funding from the tobacco industry including corporations profiting from tobacco and ancillary groups that receive tobacco industry funds, in accordance with the UN model policy;
2. Implement the integrated strategy using Regular Budget Supplementary Account funds in the short term;
3. Work closely with relevant UN agencies, e.g. FAO, UNDP, to assist tobacco farmers and workers to find alternate livelihood; and
4. Allow current contracts with the tobacco industry to expire, do not negotiate for the renewal of expired contracts, and do not establish any new contracts with the tobacco industry or its proxies.’
The full version of the letter is here.
October 31, 2018
Mutual assured destruction
Air pollution is a public health emergency that is killing seven million people every year and seriously damaging the health of many more, according to Dr. Tedros Adhanom Ghebreyesus, the director general of the World Health Organization writing in The Guardian on Saturday.
Tedros ended his piece by saying that the world had turned the corner on tobacco. Now it had to do the same for the ‘new tobacco’: the toxic air that billions breathed every day.
‘Despite this epidemic of needless, preventable deaths and disability, a smog of complacency pervades the planet,’ Tedros said. ‘This is a defining moment and we must scale up action to urgently respond to this challenge.
‘The bald truth is that bad air quality puts the health of billions at risk from the simple act of breathing. The World Health Organization estimates nine in 10 people globally breathe polluted, toxic air.
‘Filthy air is a health risk at every stage of life. Exposure to air pollution during pregnancy can damage a developing baby’s vital organs including the brain, heart and lungs and lead to a range of conditions including asthma, heart disease and cancers.
‘Air pollution also negatively affects brain development during childhood, lowering children’s chances of success in school and employment possibilities later in life.’
Tedros said that the WHO was due shortly [October 30-November 1] to host in Geneva, Switzerland, the first global conference on air pollution and health, where leaders would chart next steps for future action to cut air pollution in their countries.
October 29, 2018
Trying to work with the WHO
A grouping of members of the international vaping industry and campaigners has vowed to continue to try to engage with the World Health Organization’s tobacco control group.
This is despite the group’s calls for reform having been ignored by the WHO during its biennial Conference of the Parties (COP8) to the Framework Convention on Tobacco Control that was held in Geneva earlier this month.
Organisations from 16 countries across North America, Europe, Asia and Australasia, led by the UK Vaping Industry Association (UKVIA), had signed a joint call to action addressed to the WHO asking it to treat tobacco and vaping regulation separately.
‘Since gathering in 2016, the WHO tobacco control group has encouraged member states to ban vaping products outright as part of a tobacco control plan, despite acknowledging the contribution which vaping could make to reducing global smoking rates,’ the grouping said in a press note co-ordinated by the UKVIA.
‘This position is not only at odds with countries who advocate smokers switching to vaping as part of their harm-reduction strategies – such as the UK and New Zealand – but could also open the door to potential vaping bans worldwide. Some have argued that it is also undermining progress in countries where e-cigarettes are used as an effective harm-reduction tool.
‘In spite of attempts to open a dialogue with the tobacco control group, journalists and industry were shut out of the COP8 proceedings.
‘The tobacco control group has also refused to differentiate between vaping products and tobacco products according to a report of the COP8 session. Its spokesmen have since declared that many new products marketed as smoke-free and heat-no-burn were creating confusion among consumers, “leading them to believe that they are safer to use [ than cigarettes], even though there is no independent research confirming it”.
‘Persisting in this position contradicts an ever-increasing number of independent scientific studies showing that vaping products are an effective smoking cessation tool which is less harmful than traditional tobacco products. These include reports from Public Health England, Action on Smoking & Health, the Royal College of Physicians, Cancer Research UK and the Adam Smith Institute in the UK alone.
‘The WHO’s reticence to reform its policy also stands in stark contradiction to the UK Government’s positioning on vaping products since earlier this year. In a review of the evidence to have emerged since 2015, the Department of Health concluded that regulations needed to balance the risks of vaping products with their potential benefits and that restrictions on communicating these potential benefits when compared with tobacco products should be reconsidered.
“We and our international co-signatories are extremely disappointed that the WHO tobacco control group is refusing to support harm reduction as part of its global smoking cessation strategy,” said Lizi Jenkins, a member of the UKVIA’s COP working group and head of regulatory affairs at BSMW, the e-liquid manufacturer Blend & Bottle. “By refusing to acknowledge the wealth of scientific evidence demonstrating that vaping is less harmful than smoking and is helping smokers to quit tobacco, it is doing an active disservice to public health.”
October 23, 2018