Academic journal article Environmental Health Perspectives

Framework Convention on Tobacco Control: Progress and Implications for Health and the Environment. (Guest Editorial)

Academic journal article Environmental Health Perspectives

Framework Convention on Tobacco Control: Progress and Implications for Health and the Environment. (Guest Editorial)

Article excerpt

The Framework Convention on Tobacco Control (FCTC) is the first international treaty ever negotiated by the member states of the World Health Organization (WHO). The final draft of the FCTC (WHO 2003) addresses a wide range of issues including price and tax measures, protection from exposure to secondhand smoke, regulation and disclosure of the contents of tobacco products, packaging and labelling, education, communication, training and public awareness, advertising, promotion and sponsorship, tobacco dependence and cessation measures, illicit trade, and sales to and by minors and liability.

Why focus on tobacco? Dramatic changes in global patterns of tobacco use and tobacco-attributable deaths and disease, and a relentless rise in the number of deaths from tobacco use provided the impetus for the WHO to take the unprecedented step of a global treaty. Although tobacco use has declined in many high-income countries, there have been sharp rises in tobacco use, especially among men, in low- and middle-incomes countries in recent decades. These increases have been fueled by falling real prices and rising incomes that have made cigarettes increasingly affordable, and by aggressive and sophisticated tobacco advertising. Close to 60% of the 5,700 billion cigarettes smoked each year and 75% of tobacco users are in developing countries (World Bank 1999; WHO 2002). This shift in the global pattern of tobacco use is reflected in the changing burden of tobacco deaths: At present, about half of the nearly 5 million deaths each year are in developing countries, but by the time the annual death toll doubles to 10 million (in two decades), 70% of the deaths will be in developing countries (Murray and Lopez 1996; WHO 2002).

Countries and development agencies are increasingly recognizing that tobacco use has negative implications for development that go beyond damage done to health outcomes and life expectancy of tobacco users and people exposed to second-hand smoke. The money that poor households spend on tobacco products (often 4 or 5% of all their disposable income) has very high opportunity costs, diverting scarce resources away from food and other basic needs. If two-thirds of the money spent on cigarettes in Bangladesh were spent on food instead, it could save more than 10 million people from malnutrition (Efroymson et al. 2001). New research in India found that tobacco use is associated with worse nutrition outcomes (Shukla 2003) and with worse child health outcomes (Shukla et al. 2002; Bonu and Rani. Personal communication 2003).

There are also negative consequences of tobacco growing: environmental degradation caused by the tobacco plant leaching nutrients from the soil, pollution from pesticides and fertilizers, deforestation as a result of the fire-curing of some common varieties of tobacco, and over a million tires accidentally caused each year by lit cigarettes and matches that cause over $27 billion dollars of damage each year (Leistikow et al. 2000). Finally, tobacco cultivation and manufacturing involve significant occupational hazards for many workers exposed to "green sickness" from handling raw tobacco, unsafe handling of pesticides, and inhalation of tobacco dust.

The final draft of the FCTC (WHO 2003) specifically touches upon issues related to the environment and to tobacco farming. The Preamble stresses the significance of the impact of tobacco use on environmental health and on the environment:

   Reflecting the concern of the international community about the
   devastating worldwide health, social, economic and environmental
   consequences of tobacco consumption and exposure to tobacco smoke.

   Recognizing that scientific evidence has unequivocally established
   that tobacco consumption and exposure to tobacco smoke cause death,
   disease and disability ....

In its main body, the final draft of the FCTC (WHO 2003) specifically addresses concerns related to the protection of the environment. …

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