Tobacco control in low-income and middle-income countries: findings from WHO FCTC investment cases
John A. Tauras
Abstract
The health consequences of tobacco consumption have been the subject of rigorous scientific research for over 70 years. Despite the overwhelming evidence that has accumulated on the deleterious health effects of tobacco smoking, over 1.1 billion people worldwide smoked tobacco regularly in 2020.1 Current tobacco consumption is concentrated in low-income and middle-income countries (LMICs), with approximately 80% of people who use tobacco now living in LMICs.2 Indeed, tobacco use is one of the leading causes of preventable death and disease worldwide. Each year, tobacco claims the lives of over 8 million people, including an estimated 1.3 million people who do not smoke but are exposed to secondhand smoke.3 Efforts to decrease tobacco consumption in some countries date back to the 1960s following the first research published on the adverse health effects of cigarette smoking. However, the adoption of the WHO Framework Convention on Tobacco Control (FCTC) served as a catalyst for significant progress in global tobacco control. The FCTC was developed in response to the worldwide expansion of the tobacco epidemic. It was adopted by the World Health Assembly in 2003 and entered into force in February 2005. The FCTC is one of the United Nations treaties with the broadest adoption worldwide. Currently, there are 183 Parties to the FCTC, covering more than 90% of the world population.4 The FCTC presents a comprehensive plan for member nations to tackle the tobacco epidemic and provides a diverse range of evidence-based measures aimed at reducing both the demand for tobacco (Articles 6–14) and the supply of tobacco (Articles 15–17).5 The core demand reduction strategies5 consist of price and tax measures to reduce the demand for tobacco, as well as non-price measures, including the following: