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The Union congratulates the state of Chhattisgarh in India for banning the sale of loose cigarettes, in an effort to combat tobacco use in the region. Loose cigarettes are sold without any specific health warnings, contravening India’s Cigarettes and Other Tobacco Products Act (COTPA) 2003, which requires all tobacco products to have graphic health warnings.

Around one million people die from tobacco-related diseases in India each year. Chhattisgarh has made good progress on tobacco control in recent years. According to the India Global Adult Tobacco Survey (GATS) 2016, prevalence of tobacco use in the state reduced by 14.1 percentage points, from 53.2 percent in 2010 to 39.1 percent in 2016. However, 7.5 million people continue to use tobacco in Chhattisgarh.

“The Union welcomes this significant action by the Chhattisgarh state government to ban the sale of loose cigarettes,” said Dr Rana J Singh, Deputy Regional Director for South East Asia at The Union. “Achievements like these make a valuable contribution to reducing tobacco-related deaths in Chhattisgarh.”

The Union has supported the Chhattisgarh state government to advance tobacco control for many years. Since October 2018, The Union has supported the state health department to build capacity of stakeholders to enforce legislation, including prohibiting the sale of loose tobacco products and graphic health warnings on tobacco packaging.

The Union also welcomes the recent announcement from the Chhattisgarh Health Minister that the state will take action against smokeless tobacco, which is highly addictive and damaging to health. Smokeless tobacco – especially Gudakhu, a paste made with tobacco, molasses, lime, red soil and water and rubbed over the teeth and gums – is widely used in Chhattisgarh.

 

Dr Adriana Blanco has been appointed as the new Head of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) Secretariat, effective from 1 March 2020.

Dr Blanco will take over from Dr Vera Luiza da Costa e Silva, who has led the FCTC Secretariat since June 2014. Dr da Costa e Silva actively participated in the negotiations for the WHO FCTC and has worked tirelessly to promote and progress the evidence-based tobacco control measures in the FCTC.

The WHO FCTC is an international, evidence-based treaty that reaffirms the right of all people to the highest standard of health. It provides a set of practical measures that are proven to reduce tobacco use, such as increasing tobacco taxation and banning tobacco advertising, promotion and sponsorship.

Tobacco use causes eight million deaths around the world, 80 percent of which occur in lower- and middle-income countries (LMICs) where tobacco control policies tend to be weaker.

“One of the challenges facing the implementation of the FCTC is the tobacco industry’s attempts to undermine tobacco control measures which threaten the industry’s existence and profits,” said Dr Gan Quan, Director of Tobacco Control at The Union.

With the emergence of new nicotine and tobacco products such as e-cigarettes, the tobacco industry is re-branding itself as part of the solution to the tobacco epidemic, while continuing to aggressively market its traditional tobacco products around the world.

Dr Gan Quan said: “It is important that the tobacco industry is not able to distract from or derail the implementation of the evidence-based measures of the FCTC, which is the most effective way to reduce tobacco use and prevent the unnecessary death and suffering it causes.”

Since 2006, The Union has co-managed the Bloomberg Initiative to Reduce Tobacco Use Grants Program in partnership with the Campaign for Tobacco-Free Kids. The programme awards funds to projects delivering high-impact tobacco control interventions, based on the WHO FCTC, in LMICs. To date, 1060 grants worth over US$175 million have been awarded.

The Union looks forward to continuing our work with the FCTC Secretariat under the new leadership of Dr Blanco, to support LMICs to implement the measures in the WHO FCTC and protect the right to health of billions of people.

 

The Union welcomes the announcement that tobacco vendor licensing has been made mandatory in the state of Uttarakhand, India, to regulate the trade of tobacco products in the state.

The Union and its partner, Balajee Seva Sansthan (BSS), worked closely with the government to develop this state level order issued by the Department of Urban Development under the Uttarakhand Municipal Corporation Act 1959.

The order will prohibit the marketing, manufacturing, storage, packaging and processing of any tobacco products in the state without a license. Licensed vendors will also be required to comply with the provisions set out in the Cigarettes and Other Tobacco Products Act (COTPA) 2003 and the and Juvenile Justice Act, 2015. Under these provisions, the sale of any product that is primarily targeted to children, such as biscuits and sweets, will also be prohibited in shops licensed to sell tobacco products. This is to reduce children’s exposure to tobacco.

“This order will help protect more than 10 million people of the state from the harms of tobacco and crucially will restrict opportunities for children to see and buy tobacco products,” said Dr Rana J Singh, Deputy Regional Director for South East Asia at The Union. “We hope that other states will follow the strong example set by states like Uttarakhand in protecting people, and especially children, from tobacco.”

The Union will work with local partners to support the Uttarakhand State Government and city administrations to effectively implement this order by developing implementation guidelines and building capacity of law enforcers in the state.

The Union has supported many other states to limit the accessibility and availability of tobacco products, including Bihar, Jharkhand, West Bengal, Punjab, Himachal Pradesh and Madhya Pradesh.

Currently, The Union’s Global Implementation Program, funded by Bloomberg Philanthropies, is supporting cities in West Bengal and Jharkhand to improve compliance with COTPA through the implementation and enforcement of vendor licensing.

 

At a special World Health Organization (WHO) session titled Novel and emerging nicotine and tobacco products held at the 50th Union World Conference on Lung Health, a panel of experts discussed the threat posed by e-cigarettes and heated tobacco products on global public health.

In the session, Dr Gan Quan, Director of the Tobacco Control Department at The Union, presented on the particular challenges of regulating e-cigarettes in low- and middle-income countries. Of increasing concern is the uptake by youth, which is rising dramatically, and the substantial evidence that vaping leads young people to go on to smoke conventional cigarettes (National Academies of Science, Engineering and Medicine, 2018).

Most of the available evidence on the extent to which e-cigarettes lead to smoking conventional cigarettes comes from the United States. In many low- and middle-income countries smoking rates are higher, cigarettes are more easily available, and smoking is still an accepted social behaviour – causing the public health community to fear an even worse risk of young people who vape to go on to smoking in these countries.

Dr Gan Quan’s presentation also examined the lack of evidence for the effectiveness of e-cigarettes as a cessation tool, emphasising the need for stronger implementation of the evidence-based MPOWER policies recommended by the WHO Framework Convention on Tobacco Control – such as increased tobacco taxation and advertisement bans – as the best way to reduce smoking.

“If developing countries can implement MPOWER effectively, we will see millions of smokers quit on their own” said Dr Gan Quan, pointing to the falling smoking rates in the US over the past 60 years. “MPOWER is the solution.”

The panel recommended that countries adopt a precautionary approach with e-cigarettes, and commended the example shown by India in banning e-cigarettes outright.

Dr Doug Bettcher, Senior Adviser, Director-General’s Office at WHO, and co-chair of the session, described the tobacco industry as having misleadingly co-opted the term “harm-reduction”, a valid public health approach in other contexts, to market new tobacco products for profit.

The global public health community has responded with derision to the tobacco industry’s strategy to market itself as part of the solution to the tobacco epidemic, viewing this as a cynical attempt to involve itself in conversations with decision-makers and interfere in policy-making. In response, Bloomberg Philanthropies has set-up the global tobacco industry watchdog STOP, of which The Union is a partner, to support stakeholders with evidence and tools to counter the industry.

Dr Bettcher encouraged attendees at the session to sign The Union’s Tobacco Control Pledge and commit to taking a stand against the tobacco industry. Delegates can sign the Tobacco Control Pledge at The Union booth in the Spoorthi Vedika: Community Connect space – or sign online – to become a tobacco control advocate and help end the tobacco epidemic.

 

The Union welcomes the approval of a Bill by Brazil’s Federal Senate on Tuesday 12 November extending measures to fight the tobacco epidemic in the country. The Bill will now go before the Chair of Deputies for final approval, which is expected in 2020. Once approved, the Bill will take effect in 90 days.

The Bill includes major tobacco control advances including a ban of tobacco product displays at point of sale, a ban on importing and marketing of flavoured tobacco products, strengthened graphic health warnings on tobacco packaging, and a ban on smoking in cars with children present, with tough fines for drivers who are caught breaking this law.

The Bill was approved by the Federal Senate despite opposition by tobacco industry allies and front groups such as ABRASEL (Associação Brasileira de Bares e Restaurantes).

“Tobacco causes eight million deaths per year worldwide, and more than 400 deaths per day in Brazil,” said Dr Gustavo Sóñora, Regional Director of The Union Latin America. “The Union celebrates this achievement as a major step forwards in the fight against tobacco use, and an example for other countries to follow.

“We also urge Brazil – as one of the world leaders in implementing evidence-based tobacco control policies – to continue its leadership by reconsidering the introduction of plain packaging, which was originally proposed but left out of the final Bill.”

The Union has been supporting Brazil's tobacco control efforts for more than a decade. Our joint work with the National Cancer Institute (INCA) and the Oswaldo Cruz Foundation (Fiocruz) contributed to a sweeping 2011 tobacco tax policy reform, the creation of the first government-run online observatory to monitor tobacco industry interference, and online training of 700 health inspectors to implement and enforce tobacco control legislation across the country.

The Union will continue to work closely with our partners to support Brazil in implementing this Bill, and to encourage the adoption of other evidence-based tobacco control policies such as plain packaging, to further reduce tobacco use and the unnecessary death and suffering it causes.

 

The Union congratulates Mexico for the decision to increase tobacco excise tax in line with the national inflation rate. This measure was approved by the Mexican Parliament in October and was included in the Economic Package proposal for the year 2020. Tobacco tax will be reviewed each year and adjusted according to the inflation rate.

Increasing tobacco tax to ensure that tobacco products become increasingly unaffordable is one of the most effective policies for reducing tobacco use set out in the World Health Organization’s Framework Convention on Tobacco Control (WHO FCTC).

The Union collaborated with Union grantee, the National Council Against Addictions (CONADIC), to provide technical assistance to the government of Mexico and support the decision to update tobacco excise tax each year based on the inflation rate.

“The Union welcomes this decision as a positive sign that the Mexican government is committed to strengthening tobacco control in the country,” said Dr Gustavo Sóñora, Regional Director of The Union Latin America.

“However, tax on tobacco products in Mexico is still too low. The Union urges Mexico to consider further increasing tobacco tax, one of the most effective policies of the WHO FCTC, to encourage smokers to quit and to make smoking unaffordable for young people.”

The Union has provided technical assistance to further tobacco control policies in Mexico since 2006, and helped establish the first ever smokefree beach in the country; beach San Martin in Cozumel. The Union has supported partners to strengthen the enforcement and evaluation of tobacco policy, and to present scientific evidence for tobacco control subnationally in each of Mexico’s 32 provinces.

Tobacco control efforts in Mexico have shown positive results, with the national smoking rate declining from 28 percent in 1990 to 16 percent in 2017. However, with over 16 million Mexican people still using tobacco in 2017, The Union will continue to provide support to partners and the government of Mexico to further implement the policies set out in the WHO FCTC, to reduce the preventable diseases and early death caused by tobacco.

 

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