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Last week, the American Heart Association published a policy statement regarding the actions that must be taken to achieve the end of all tobacco use and nicotine addiction in the United States.

The Union welcomes the statement, published in the scientific journal Circulation, which describes what governments, public health community and health care providers need to do to achieve the “tobacco endgame”. Such a goal first requires minimising the use of all combustible tobacco products and ensuring electronic cigarettes and other recent products do not addict the next generation of youth and adolescents.

According to the American Heart Association, electronic cigarettes have become the most popular tobacco products for youth and adolescents in the United States and are attracting youth to new avenues for nicotine addiction.

The American Heart Association state that this endgame goal is at risk with the tobacco industry’s increasingly aggressive targeting of youth and adolescents, which has driven the rapid rise of electronic cigarettes and other new and emerging tobacco products. They believe these pose an unprecedented threat to human life and the decades of public health efforts to reduce tobacco use.

Dr Gan Quan, Director of Tobacco Control at The Union, said: “We fully support this balanced, comprehensive and timely presidential advisory from the American Heart Association.

“The tobacco endgame is within reach, but we must not let the tobacco industry derail this through the development and promotion of electronic cigarettes.

“Although these products might help people stop smoking, it is still unclear what the long-term health effects of e-cigarettes are.”

For the endgame to be achieved the American Heart Association urgently calls for robust US Food and Drug Administration regulation of all tobacco products to avoid the significant economic and population health consequences of continued tobacco use.

The endgame strategy also needs to be coordinated with the long-standing, evidence-based tobacco control strategies that have significantly reduced tobacco use and initiation in the United States.

Nancy Brown, CEO of the American Heart Association, said: “We are truly at a crossroads in the decades-long war against Big Tobacco over the future of our children.

“We could allow current trends to continue on their disturbing path or we could take action to change the course of tobacco use in this country. If lawmakers, policymakers, health care providers and the public health community seize this moment and do what is necessary to reach the tobacco endgame, we will save millions of lives in the process.”

Please read The Union’s position papers on e-cigarettes and heated tobacco products through the links below:

- e-cigarettes - https://tobaccofreeunion.org/images/The_Union_Summary_Position_Statement_ECs-ENDS_Update_2014_-_2016_update.pdf

- Heated tobacco products - https://tobaccofreeunion.org/images/Heated_Tobacco_Product_Union_Position_Statement_-_Final_25.01.18.pdf


In El Salvador, the Fondo Solidario para la Salud (FOSALUD), with support from The Union, has recently held a press conference to announce the results of two research studies, to help understand the processes by which consumers purchase tobacco and thereby strengthen tobacco control in El Salvador.

The first study explored how advertising and the display of cigarettes at the point-of-sale impacted on the consumer’s impulse to purchase. Findings demonstrated that the display of tobacco products is the principal promotional strategy adopted by retailers. It was found that 91 percent of retailers display cigarettes, and in most cases the display is positioned near to the selling point, or till. This, in turn, had a large impact on consumers’ impulse to purchase, with eight out of 10 smokers saying they had decided to purchase cigarettes at least once at the time of paying their bill because they saw those packages being displayed.

The study went on to demonstrate that, despite point-of-sale promotion, the population is strongly supportive of tobacco control. It was found that 92.3 percent thought that young people should not be exposed to advertisements of products deemed damaging to health, and eight out of 10 approved of the complete removal of point-of-sale display and advertising of tobacco products to discourage consumption amongst young people. Current legislation permits advertising and product display at the point-of-sale.

The second study analysed the impact of health warnings and plain packaging of tobacco products on public perceptions. The World Health Organization Framework Convention on Tobacco Control (FCTC) supports plain packaging and stipulates that packaging carries health warnings describing the harmful effects of tobacco use. Evidence finds that plain packaging reduces the attractiveness of tobacco products; restricts use of the pack as a form of advertising; limits misleading packaging and increases the effectiveness of health warning. Studies have also shown that plain packaging increased an urgency among smokers to quit.

Findings in the FOSALUD study confirmed that health warning labels are effective in stimulating negative emotions and result in an increased number of people who have tried to stop smoking, particularly young people. Young people were also of the opinion that the use of colour had the potential to make the packaging less attractive, induce a sensation of fear, provide an association with a product of inferior quality, and make health-related imagery more visible. The project confirmed that neutral packaging would achieve its objective of reducing demand for tobacco products.

Verónica Villalta, FOSALUD’s Executive Director, stated that the findings from both projects provided the scientific evidence to drive the reform of tobacco control legislation. The case for investment in Tobacco Control in El Salvador, presented by FOSALUD last October, had already proposed specific actions to reduce tobacco consumption: to ban all forms of tobacco advertising, promotion and sponsorship, and to update health warning imagery and introduce neutral packaging.

Mr. Gustavo Soñora, The Union’s Regional Director of Latin America, speaking at the press conference to launch the results of both studies said: “Hopefully, the scientific evidence from the studies by FOSALUD will support new tobacco control legislation, one based on the protection of health as a human right. I also hope to witness the benefits on people’s health of stricter controls in the near future. The sooner these controls are adopted and enforced the better off Salvadorians will be”.

In El Salvador during 2016, 1,624 people died as a consequence of using tobacco, 46 percent of these being classified as premature (when the person concerned was under 70 years). Seventy-eight percent of these deaths can be linked directly to tobacco consumption, with exposure to tobacco smoke making up the remaining 22 percent. It is estimated that in the same year, tobacco consumption cost the nation US$263.6m, which is equivalent to approximately 1 percent of GDP.


The International Union Against Tuberculosis and Lung Disease (The Union) calls for the Turkish Government to revoke the appointment of Mr Riza Tuna Turagay – a Director of British American Tobacco until January 2019 – as Deputy Minister of Commerce by Presidential decree.

Dr Gan Quan, Director of Tobacco Control at The Union, said: “There is a fundamental and irreconcilable conflict between the tobacco industry’s interests and public health policy interests. This recent appointment by Presidential decree comes as a huge disappointment and setback for Turkey.

“We urge the government to take immediate action to revoke this appointment in order to protect public health from the terrible influence of the tobacco industry.”

Turkey is a high-burden tobacco-use country. According to the latest World Health Organization (WHO) report on the global tobacco epidemic in 2017, 16.8 percent of the youth population use tobacco and 30.9 percent of adults use smoking tobacco.

In response to this, the government has worked to strengthen the country’s capacity for tobacco control using a range of tools including taxes, bans on smoking in public places and extensive public education programmes. Turkey has been recognised by the WHO as an international leader in tobacco control and the government has been committed to tobacco control policies for more than a decade.

Turkey has been a Party to the WHO Framework Convention on Tobacco Control (FCTC) since 2005, which stipulates in Article 5.3 that public health policies must be protected from commercial and other vested interests of the tobacco industry.

In 2015, Turkey became the only country in the world to have accomplished all MPOWER measures for tobacco control at the highest level of achievement: M (Monitoring), P (SmokeFree Policies), O (Cessation Programmes), W (Warnings): Health Warnings and Mass Media, E (Advertising Bans), and R (Taxation).

The appointment of a tobacco industry executive to a governmental position is a violation of Article 5.3 of the FCTC and undermines the government’s duty to protect the country’s people from exposure to tobacco and tobacco smoke.


STOP released the following statement on 7 February:

February 7, 2019 (Geneva, Switzerland) Stopping Tobacco Organizations and Products (STOP), a global tobacco industry watchdog, welcomes news that World Health Organization’s Executive Board (WHO EB) reaffirmed its position that it will not work with the Philip Morris International (PMI)-funded Foundation for a Smoke-Free World (FSFW). STOP supports WHO’s call that governments and researchers should also reject overtures from FSFW.

Responding to statements from several countries and civil society organizations at the WHO EB session, Director General Dr. Tedros Adhanom Ghebreyesus further reiterated WHO’s commitment to the WHO Framework Convention on Tobacco Control, the world’s first global health treaty, and the provisions that oblige countries to protect tobacco control policies from tobacco companies and invested third parties.

“We applaud WHO and the countries such as Australia, Netherlands, Panama and Singapore, for standing firm on the evidence-based principle to not collaborate with FSFW, an organization entirely funded by PMI,” said Anna Gilmore, professor of public health at the University of Bath and research lead for STOP. “We urge researchers and governments currently being approached by FSFW to also recognize that FSFW has no place, either in public health science or at the policy table.”

Prior to WHO’s decision, more than 279 organizations and individuals in 50 countries signed an open letter put forward by STOP, urging WHO to reject a publicly advertised approach from the PMI-funded FSFW. In line with this letter, STOP prepared a statement that was delivered by representatives from the World Heart Federation, on behalf of STOP and other public health groups, at the WHO EB meeting in Geneva. The statement reflected broader concern about tobacco industry interference expressed by other member states and others at this session.

About STOP (Stopping Tobacco Organizations and Products)

STOP is a global tobacco industry watchdog whose mission is to expose tobacco industry strategies and tactics to undermine public health. STOP is funded by Bloomberg Philanthropies and comprised of a partnership between The Tobacco Control Research Group at the University of Bath, The Global Center for Good Governance in Tobacco Control, The Union’s Department of Tobacco Control and Vital Strategies.

Please contact our This email address is being protected from spambots. You need JavaScript enabled to view it. for more information or to speak to a STOP spokesperson.



Nominations are now open for the 2019 Union Awards for the following prizes:

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Recently, the National Board of Revenue in Bangladesh has filed law suits against four chewing tobacco companies for tax evasion.


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The Tobacco Control Department is based at The Union Europe Office, Edinburgh, registered charity no. SC039880
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