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The Government of Chad has adopted a draft decree to prevent tobacco industry interference in policy-making, in line with Article 5.3 of the World Health Organization’s Framework Convention on Tobacco Control.

The Union provided technical assistance to the Chadian government to draft this important piece of legislation, which will help to protect the people of Chad and its economy from the damage caused by tobacco.

Each year, more than 3,400 Chadian citizens are killed by tobacco-related diseases, and more than 5,000 children and 489,000 adults continue to use tobacco, according to 2016 data from the Tobacco Atlas . In Chad, tobacco use costs the government millions of US dollars in healthcare and lost productivity from tobacco-related diseases. An individual smoker in Chad who smokes 10 cigarettes per day from the leading brands will spend an average of 27% of their total income on tobacco products each year.

“Chad has made good progress in recent years on tobacco control laws, with the introduction of smokefree legislation, graphic health warnings and a ban on all tobacco advertising,” said Daouda Adam, Union Technical Adviser in the region. “However the introduction of Article 5.3 was vitally needed, because the tobacco industry is actively targeting African countries like Chad that offer untapped and youthful markets, relatively weak tobacco control laws and prime land for growing tobacco.”

The Union has supported tobacco control projects and activities in Chad since 2008, including providing capacity building support to key policy-makers and government staff, under the Bloomberg Initiative Grants Programme.

“I'm very pleased with this achievement because it will secure the progress already made by Chad on tobacco control,” said Dr Nenodji Mbairo, Union grantee and Coordinator of the national tobacco control programme at the Ministry of Public Health. “Article 5.3 was not included in the national tobacco control law adopted in 2010 – but now we have a tool, a weapon of protection for the law.”

 

The Union is supporting efforts to declare Hyderabad a smokefree city in the lead up to the 50th Union World Conference on Lung Health, taking place in Hyderabad from 30 October – 2 November 2019.

“Smokefree Hyderabad” will ensure that smokefree laws are implemented in all public places in the city to protect people from secondhand smoke exposure, which causes life-threatening diseases and is responsible for over a million deaths each year globally. The initiative will emphasise the mandatory display of “no smoking” signs, enforcement of smokefree laws in all public and work places and the prohibition of tobacco sales in and around educational premises.

In the week leading up to World No Tobacco Day (31 May 2019), The Union delivered two capacity building workshops for the Hyderabad City Police Department, training more than 350 senior- and mid-level police officers and enforcement officials on smokefree laws. The City Police Commissioner, Mr Anjani Kumar, inaugurated the workshops and said: “the general health of the public should be improved. For any family to prosper, being healthy is necessary.”

Union Technical Advisor, Mr Govind Kumar Tripathi, facilitated the training which focused on the ‘Cigarette and Other Tobacco Products Act 2003’, with an emphasis on Section 4, which relates to reducing the public’s exposure to secondhand smoke by making public places smokefree.

“This training is important to strengthen the capacity of police officers to enforce smokefree laws”, said Dr Rana J Singh, Deputy Regional Director for South East Asia at The Union. “However, multi-stakeholder engagement in this initiative with a focus on all government departments, media and civil society will also be crucial for achieving the goal of a smokefree Hyderabad.”

To garner public support and raise awareness of this initiative, The Union organised a sports event called “Run for smokefree Hyderabad” on the eve of World No Tobacco Day, in partnership with the Department of Health, Medical and Family Welfare, Government of Telangana, and the Greater Hyderabad Municipal Corporation. Around 500 people showed their support for Smokefree Hyderabad by taking part in the two kilometre run, including health professionals, members of medical and dental associations, media personnel, civil society representatives, social activists, students and members of the general public.

In his speech at the event, Mr E Rajendra, Minister of Health, Medical and Family Welfare, Government of Telangana, acknowledged the relevance and importance of this year’s World No Tobacco Day theme: Tobacco and Lung health. He said that, on behalf of Hyderabad and the state of Telangana, he would be proud to welcome Union World Conference delegates from around the world to a smokefree Hyderabad in October.

 

Today, The Union is supporting World No Tobacco Day, which this year highlights tobacco’s deadly toll on lung health. The Union calls for renewed efforts to strengthen tobacco control in all countries and integrate tobacco control into health promotion and disease control programmes – measures that are critically needed to prevent the millions of deaths caused by tobacco-related lung diseases each year.

In addition to being a leading cause of debilitating non-communicable diseases such as lung cancer and chronic obstructive pulmonary disease (COPD), smoking is also a major risk factor for tuberculosis (TB): the deadliest infectious disease in the world. In 2017, 1.6 million people lost their lives because of TB, and 10 million people fell ill with the disease. It is estimated that more than 20% of global TB incidence can be attributed to tobacco. A robust study conducted in 2014 demonstrated that regular smoking doubles the risk that people who have been successfully treated for TB will develop TB again. Smokers with TB are also more likely to die from the disease. Offering smoking cessation advice and support to TB patients is one strategy The Union is using which is simple to adopt and proven to save lives.

The most effective way to protect people’s lung health from the harms of tobacco is through full implementation of the WHO’s Framework Convention on Tobacco Control (FCTC), and by adopting the six evidence-based MPOWER measures. The Union has helped more than 50 countries to implement MPOWER-based policies – such as smoke-free laws, graphic health warnings on packaging and tobacco advertising bans – impacting billions of people globally. Together with our partners around the world, The Union has been making huge progress – but with over eight million people still dying every year from tobacco-related diseases, it is not enough.

“We cannot ignore the overwhelming evidence of tobacco’s impact on lung health,” said Dr Gan Quan, Director of The Union’s Department of Tobacco Control. “We should also remain vigilant of efforts from the tobacco industry to undermine tobacco control policies, notably through its recent tactics in hijacking the narrative of ‘harm reduction’ through new products such as IQOS.”

Tobacco industry interference in policy-making remains a lethal threat to lung health. The rise of e-cigarettes and heated tobacco products like IQOS, are being promoted by big tobacco as safer alternatives to smoking – but we do not know what the long-term impact of these products may be on lung health. The liquid used in e-cigarettes, for example, contains many toxins which can cause lung diseases such as COPD, lung cancer and asthma, not to mention cardiovascular diseases.

The evidence available indicates that these new tobacco products are not risk-free, yet they are being aggressively marketed as such in low- and middle-income countries, where tobacco control policies are not yet strong enough or well enough implemented to protect non-smokers and young people.

Dr Gan Quan said: “the recent campaign launched by Phillip Morris International (PMI) to rebrand WNTD as World No Smoking Day not only reveals its indifference to the millions of people suffering from diseases caused by smokeless tobacco products, but also serves as a reminder for us that this is simply another tactic by PMI to promote its deadly products.”

Presently, the world is not on track to achieve the Sustainable Development Goal (SDG) of a one-third reduction by 2030 in premature deaths caused by non-communicable diseases – and we are still a long way from ending the TB epidemic. To achieve these milestones, we must be ever more vigilant against the devious tactics of the tobacco industry, and tobacco control must be a priority for governments and communities worldwide.

 

The Union staff and partners took part in the fourth National Conference on Tobacco or Health (NCTOH) in Mumbai, India, in February.

The NCTOH is held annually in India and focuses on strengthening the implementation of the World Health Organization’s (WHO’s) MPOWER policies and the National Tobacco Control Program (NTCP).

Dr Rana J Singh, The Union’s Tobacco Control Lead in India, chaired the Scientific Committee of this year’s conference. Dr Singh said: "It was an honour to chair the Scientific Committee. A large number of high quality scientific papers were presented during three days and I hope that those who attended the conference learned a lot and are equipped with the tobacco control tools to help end tobacco use in India."

Dr Gan Quan, the Director of The Union’s Tobacco Control Department, participated in the Tobacco-Free Generation panel session and chaired two sessions on promoting tobacco control research in India and combatting tobacco industry interference.

The Union also organised a plenary session entitled 10 Years of NTCP, a workshop to strengthen monitoring, evaluation and research, and a symposium on tobacco industry interference and the WHO Framework Convention on Tobacco Control (FCTC) Article 5.3.

The Union staff and partners presented more than 10 abstracts at the conference, supported the State Tobacco Control Cell of Maharashtra in their NTCP training, and distributed hundreds of technical resource materials.

 

The Union is concerned with the US Food and Drug Administration’s (FDA) decision this week to authorise Philip Morris International’s (PMI) IQOS – which heat rather than burn tobacco using a battery-powered system – for sale in the United States.

The FDA decision comes despite growing concerns from public health organisations about the health impacts of heated tobacco products (HTPs). The potential benefits and risks from HTPs to the public health remain undetermined but early independent research indicates that tobacco companies are understating the risks.

The Union is concerned that decisions like the FDA’s authorization of the sale of IQOS should not be made until more independent evidence on the health impact is available.

One of the biggest risks of allowing IQOS to be sold is the uptake of use among non-smokers and young people. We need much more evidence in this area before products should be allowed to be marketed in order to protect non-smokers and young people from the scourge of tobacco.

Furthermore, this decision sets a dangerous precedent to governments around the world who are similarly under pressure to allow IQOS to market. This is of particular concern in low- and middle-income countries where the tobacco industry is already aggressively targeting consumers and the tobacco control policies are not yet strong enough or well implemented to protect non-smokers and young people.

It is a small consolation that a decision on the separate modified risk tobacco product (MRTP) application that PMI also submitted for these products to market them with claims of reduced exposure or reduced risk has not yet been made. This means that PMI cannot make any explicit or implicit claim that IQOS are less harmful than cigarettes.

The FDA decision comes with marketing restrictions on the products in an effort to prevent youth access and exposure. This means that the products have been banned from advertising on TV and radio, and online marketing. The Union is concerned that the enforcement of IQOS marketing restrictions will be difficult, especially on social media, where children and young people are particularly vulnerable.

The Union urges the FDA to carefully monitor and analyse the marketing and sale of this product to protect children and young people. To assess the impact of the FDA’s decision, it will be crucial to establish post-market assessment of the uptake of IQOS among non-smokers and youth.

 

The Union welcomes new analysis published by the Tax Justice Network highlighting how British American Tobacco (BAT) is taking advantage of accounting loopholes to systematically shift profits out of low- and middle-income countries to avoid paying the full corporate income tax in the countries that most need these revenues.

According to the report, for every dollar British American Tobacco (BAT) paid in tax in the developing countries it operates in, it shifted more than half a dollar that would have been taxed locally to a subsidiary located in the UK where BAT paid almost no tax.

Tax Justice Network estimates Bangladesh, Indonesia, Kenya, Guyana, Brazil and Trinidad and Tobago together stand to lose a total of nearly $700 million in tax revenue by 2030 from the financial manoeuvring of just one tobacco company if business continues as usual.

Tobacco use imposes massive social and economic costs, especially in low- and middle- income countries where 80 percent of the world’s smokers live, yet British American Tobacco is exploiting the rules to pay far less than countries’ tax codes call for.

Ashes to Ashes: How British American Tobacco avoids taxes in low and middle income countries was published on the heels of BAT’s annual shareholder meeting in London. It reveals a range of mechanisms used by the tobacco company in 2016 to shift income equivalent to over 12 per cent ($941 million) of its pre-tax profits to BAT Holdings Ltd, a UK-based subsidiary where BAT paid almost no corporate income tax.

Dr Gan Quan, Director of Tobacco Control, says: “The Union welcomes this evidence reinforcing that BAT cannot be trusted, particularly by low- and middle-income countries and investigations should be launched immediately in these countries into the company’s corporate tax payments. These countries are being left with a huge burden of death and disease caused by tobacco products.”

Dr Gan Quan, Director of Tobacco Control, says: “The Union welcomes this evidence reinforcing that BAT cannot be trusted, particularly by low- and middle-income countries and investigations should be launched immediately in these countries into the company’s corporate tax payments. These countries are being left with a huge burden of death and disease caused by tobacco products.”

 

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