CANCER CONTROL 2014 47
Importance of tobacco control and future challenges
The World Health Organization Framework Convention on
Tobacco Control (WHO FCTC) is a global public health treaty
adopted by the World Health Assembly in 2003. At the time
of the first printing of The Tobacco Atlas, the FCTC was a year
away from adoption. As of September 2013, 177 parties have
, making the FCTC one of the most quickly ratified
treaties in history. Towards the goal of assisting countries
with implementing tobacco control policies, a set of broad
measures was introduced under the name MPOWER
(Monitor tobacco use and prevention policies, Protect people
from tobacco smoke, Offer help to quit tobacco use, Warn
about the dangers of tobacco, Enforce bans on tobacco
advertising, promotion and sponsorship, and Raise taxes on
With these goals in mind, The Tobacco Atlas suggests
fourteen specific policy actions and strategies that contribute
to the goal of reducing global tobacco use and will in turn
significantly impact on global cancer rates:
‰ All countries that have not done so should sign and ratify
the WHO FCTC ensuring a structured support system for
local and national tobacco control efforts.
‰ The next round of Millennium Development Goals to be
established by the UN in 2015 should include tobacco
‰ Tobacco issues should be incorporated into national
policies regarding non-communicable diseases.
‰ Increased government funding for research and
surveillance is needed, ideally derived from a tax on
tobacco products. This is most crucial in developing
countries where tobacco use is high and/or increasing.
‰ Tobacco industry regulations should be more stringent,
particularly in the case of licensing nicotine as an
‰ Excise taxes on tobacco should be at least 70% of the
retail price, as high taxes have been proven a deterrent to
tobacco use. "Duty-free" tobacco should be prohibited.
‰ Health care professionals have a responsibility to model
tobacco-free behaviour. Such behaviour, along with the
smoke-free policies and curricula of health-education
institutions, can work to reduce societal tobacco use.
‰ Strengthened support for the difficult act of quitting
smoking is required and the inclusion of monetary
incentives and lower health-insurance rates is
‰ Anti-tobacco messages and campaigns that have proven
effective in some areas should be replicated in other
parts of the world.
‰ Continued research and monitoring on novel tobacco and
nicotine products is needed in order to ensure the public
is well-informed about the relative health risks, both
those inherent to these products as well as in comparison
to established products.
‰ Where tobacco farming is widespread, assistance should
*Relative Income Price (RIP) = Percentage of annual per capita income, measured by per capita GDP, needed to purchase 100 packs of cheapest cigarettes.
-21.7%Low- and Middle-
By Country Income
In China, cigarettes have become
much more af ordable over the
last 10 years. In 2000 nearly 14%
of the average annual per capita
income was needed to buy 100
packs of the cheapest cigarettes.
In 2010 this number dropped to
less than 3%.
< < DECREASE in RIP | INCREASE in RIP > >By WHO Region
Figure 8: Changes in affordability of cigarettes