A Framework of Multi-method Modelling Using System Dynamics and Enhanced Analytic Hierarchy Process Towards the Solution for Tobacco Endgame

Article 5.3 of the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) requires that: "In setting and implementing their public health policies with respect to tobacco control, Parties shall act to protect these policies from commercial and other vested interests of the tobacco industry in accordance with national law." While this sets clear standards for governments, there is no equivalent for health and related organisations and those who work with them. The tobacco industry, now more than ever, seeks the credibility of association with reputable scientists and organisations, as part of a strategy to present itself as part of the solution to a problem it has created and continues to promote. At the same time, it opposes evidence-based action to reduce smoking and its harms. This paper proposes that it is time to establish a civil society equivalent of Article 5.3 to protect reputable organisations from associating with or lending support and credibility to the tobacco industry.

What Difference Would a Binding International Legal Instrument on Alcohol Control Make? Lessons from the World Health Organization Framework Convention on Tobacco Control’s Impact on Domestic Litigation

In successfully negotiating the Framework Convention on Tobacco Control (FCTC), the World Health Organization (WHO) has led a significant innovation in global health governance, helping to transform international tobacco control. This article provides the first comprehensive review of the diverse campaign initiated by transnational tobacco corporations (TTCs) to try to undermine the proposed convention. The article is primarily based on an analysis of internal tobacco industry documents made public through litigation, triangulated with data from official documentation relating to the FCTC process and websites of relevant organisations. It is also informed by a comprehensive review of previous studies concerning tobacco industry efforts to influence the FCTC. The findings demonstrate that the industry's strategic response to the proposed WHO convention was two-fold. First, arguments and frames were developed to challenge the FCTC, including: claiming there would be damaging economic consequences; depicting tobacco control as an agenda promoted by high-income countries; alleging the treaty conflicted with trade agreements, "good governance," and national sovereignty; questioning WHO's mandate; claiming the FCTC would set a precedent for issues beyond tobacco; and presenting corporate social responsibility (CSR) as an alternative. Second, multiple tactics were employed to promote and increase the impact of these arguments, including: directly targeting FCTC delegations and relevant political actors, enlisting diverse allies (e.g., mass media outlets and scientists), and using stakeholder consultation to delay decisions and secure industry participation. TTCs' efforts to undermine the FCTC were comprehensive, demonstrating the global application of tactics that TTCs have previously been found to have employed nationally and further included arguments against the FCTC as a key initiative in global health governance. Awareness of these strategies can help guard against industry efforts to disrupt the implementation of the FCTC and support the development of future, comparable initiatives in global health.

The World Health Organization (WHO) Framework Convention on Tobacco Control originated in 1993 with a decision by Ruth Roemer and Allyn Taylor to apply to tobacco control Taylor's idea that the WHO should utilize its constitutional authority to develop international conventions to advance global health. In 1995, Taylor and Ruth Roemer proposed various options to WHO, recommending the framework convention-protocol approach conceptualized by Taylor. Despite initial resistance by some WHO officials, this approach gained wide acceptance. In 1996, the World Health Assembly voted to proceed with its development. Negotiations by WHO member states led the World Health Assembly in May 2003 to adopt by consensus the WHO Framework Convention on Tobacco Control-the first international treaty adopted under WHO auspices. The treaty formally entered into force for state parties on February 27, 2005.

This is a content analysis of 489 written documents and 142 hearing testimonies, submitted to the World Health Organisation (WHO), regarding the Framework Convention on Tobacco Control (FCTC) during the comment period of 2000. Our aim was to consider the benefits and limitations of inviting public participation. We found that, overall, those who offered commentary were in support of the FCTC and any ensuing treaty, especially if it protected children. The minority who opposed the treaty argued that restrictions on tobacco trade would further damage the economies of poor nations that are financially dependent upon tobacco. The FCTC that was adopted at the World Health Assembly in May 2003 addressed many of the concerns raised by the public in written commentary and hearing testimony: children and youth; advertising and sponsorship; tobacco product labelling; second-hand smoke; taxes; smuggling; liability; tobacco product regulation; and the involvement of non-government organisations (NGOs). We conclude that the benefits of public participation in public health policy formation are numerous, including levelling the playing field for public health activists and NGOs, building the expertise of advocates that can be generalised to other public health efforts, giving the political process legitimacy and credibility, as well as coalition building and grassroots momentum.

Recourse to litigation and positive judicial interventions is one of the most effective tools to meet public health objectives. The present review envisions compiling litigation and judicial measures in Southeast Asia Region (SEAR) while assessing their role in advancing smokeless tobacco (SLT) control, and equally highlighting, how tobacco industry has used litigation to undermine tobacco control efforts in the Region. The litigation, especially from the SEAR, up to 2017, that have facilitated SLT control or have been used by the tobacco industry to challenge an SLT control policy decision were reviewed. Most of the litigation related to SLT control from the Region are on pictorial health warnings. Bhutan has imposed a complete prohibition on sale, manufacture and import of all kinds of tobacco products and the litigation there relates to the prosecution of offenders for violating the ban. Judiciary in the Region is well informed about the ill-effects of tobacco use and remains positive to tobacco control initiatives in the interest of public health. In India, several SLT-specific litigation helped in better regulation of SLT products in the country. Litigation has compelled governments for effective enforcement of the domestic tobacco control laws and the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC). Parties to the WHO FCTC must now use Treaty Article 19 to strengthen their legal procedures and make the tobacco industry liable, for both criminal and civil wrongs.

The 2003 India Tobacco Control Act (ITCA) includes provisions designed to reduce tobacco consumption and protect citizens from exposure to secondhand smoke. India ratified the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) on February 27, 2005. The WHO FCTC is the world's first public health treaty that aims to promote and protect public health and reduce the devastating health and economic impact of tobacco. The Global Health Professions Student Survey (GHPSS) was developed to track tobacco use among third-year dental, medical, nursing, and pharmacy students across countries. Data from the dental (2005), medical (2006), nursing(2007), and pharmacy (2008) GHPSS conducted in India showed high prevalence of tobacco use and a general lack of training by health professionals in patient cessation counseling techniques. The Ministry of Health and Family Welfare could use this information to monitor and evaluate the existing tobacco control program effort in India as well as to develop and implement new tobacco control program initiatives.

Background:The present work concerns the adoption of domestic tobacco control legislation in Ecuador after ratification of the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC).Methods:Analysis of legislation, and...

INTRODUCTIONTobacco control efforts have been advancing globally, including the adoption and entry into force of the World Health Organization (WHO) Framework Convention of Tobacco Control (FCTC), as well as the adoption of the European Union EU Tobacco Products Directive. With the present review, the European Network for Smoking and Tobacco Prevention (ENSP) and European Respiratory Society (ERS) aim to provide a comprehensive overview on the status of WHO FCTC implementation, policy achievements and priority areas across countries in the WHO Europe Region.METHODSThe review was conducted through a triangulation of data extracted from a survey administered to ENSP members, the WHO FCTC Implementation Database, Tobacco Control Laws and the Tobacco Control Scale 2016.RESULTSUsing the WHO MPOWER measures as a framework, we report on the implementation status of nine FCTC articles across 47 countries in the WHO Europe Region. The average number of articles fully implemented was 3.58. FCTC articles least fully implemented were: Article 5.3 on Tobacco Industry Interference (25.5%, n=12), Article 20 on Research (34.0%, n=16), and Article 15 on Illicit trade (40.4%, n=19). The most commonly fully implemented articles were: Article 8 on Smoke-free legislation (63.8%, n=30), Article 16 on Underage sales (57.4%, n=27), and Article 6 on Price and tax measures (51.2%, n=24). Policy achievements and recommended priority areas for future national tobacco control activities varied greatly among countries.CONCLUSIONSFindings highlight the multitude of successes in tobacco control efforts across the region in recent years, but point out the need to address gaps in FCTC implementation.

The World Health Organization (WHO) MPOWER measures are a set of highly effective tobacco control measures drawn from the WHO Framework Convention on Tobacco Control (FCTC), designed to help countries reduce the prevalence of tobacco use. The WHO Report on the Global Tobacco Epidemic is published biennially to monitor global implementation of these measures. This review aimed to critically assess the status of MPOWER implementation in the Eastern Mediterranean Region. Data were collected for WHO Reports on the Global Tobacco Epidemic, focusing on the most recent 2019 edition. Regional population coverage figures were calculated using this data and population figures for the countries of the Region. Between 2007 and 2018, for any MPOWER measure, there were 29 cases of countries progressing to the highest level of achievement; 23 cases of countries progressing to the intermediate levels from the lowest level; 12 cases of countries falling from the highest level; and 18 cases of countries falling to the lowest level. 57.7% of people are covered at the highest level for the monitoring measure; 63.7% for the smoke-free policies measure; 6.7% for the cessation measure; 60.7% for the health warnings measure; 37.4% for the mass media measure; 29.4% for the advertising bans measure; and 16.1% for the taxation measure. Countries must work comprehensively to improve tobacco control. Regional priorities should include lifting more people out of lowest level coverage for the health warnings and mass media measures, increasing taxation on tobacco products and improving access to cessation services.

Tobacco control civil society organisations mobilised to influence countries during the negotiation of the World Health Organisation (WHO) Framework Convention on Tobacco Control (FCTC) between 1999 and 2003. Tobacco control civil society organisations and coalitions around the world embraced the idea of an international tobacco control treaty and came together as the Framework Convention Alliance (FCA), becoming an important non-state actor within the international system of tobacco control. Archival documents and interviews demonstrate that the FCA successfully used strategies, including publication of a newsletter, shaming symbolism and media advocacy to influence policy positions of countries during the FCTC negotiation. The FCA became influential in the negotiation process, by mobilising tobacco control civil society organisations and resources with the help of the Internet, and framing the tobacco control discussion around global public health.

The Conference of the Parties to the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) adopted by consensus, at its fifth session held in Seoul from November 12 to 17, 2012, the Protocol to Eliminate Illicit Trade in Tobacco Products. This instrument is the first protocol to be adopted within the framework of the FCTC and is open to participation by parties to the FCTC.

President Clinton is known to be strongly against tobacco, but it remains unclear whether his government will actively support the World Health Organization Framework Convention on Tobacco Control (FCTC). At...

Background: Tobacco use is a major public health concern worldwide. Zambia has been controlling tobacco use in terms of legislative interventions, and acceding to the World Health organization (WHO) Framework Convention on Tobacco Control (FCTC). The study was aimed to determine the baseline prevalence of current smoking to be used in the evaluation of the implementation of the WHO FCTC. Methods: Survey data from the 2002 and 2007 Global Youth Tobacco Surveys (GYTS) were used to estimate the prevalence of tobacco use. The standard protocol for GYTS was used in the surveys, and only data for students aged 13 to 15 years was used in the analysis. Data were analyzed using SUDAAN (Research Triangle institute), and SPSS (version 11.5) software packages. Weighted analysis was used to produce estimates together with their 95% confidence intervals (CI). Results: The current cigarette smokers were 9.2% in 2002 and 6.8% in 2007 (p>0.05), with an overall rate of 7.4% (95%CI [7.1, 7.7]). No significant difference in current cigarette smoking rates was observed between sexes. However, compared to students of age 15 years, those of ages 13 and 14 years were less likely to be current smokers (AOR=0.82, 95%CI [0.77, 0.88]) for 13 years, and AOR=0.90, 95%CI [0.85, 0.96] for 14 years). Conclusion: The results of this study show that Lusaka district is in the first stage of the tobacco epidemic. There is urgent need, guided by the WHO FCTC, for effective interventions to be put in place before the epidemic becomes unmanageable.

AimsTo report progress among Parties to the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) in developing national tobacco treatment guidelines in accordance with FCTC Article 14 guideline recommendations.DesignCross-sectional study.SettingElectronic survey from December 2011 to August 2012; participants were asked to complete either an online or attached Microsoft Word questionnaire.ParticipantsOne hundred and sixty-three of the 173 Parties to the FCTC at the time of our survey.MeasurementsThe 51-item questionnaire contained 30 items specifically on guidelines. Questions covered the areas of guidelines writing process, content, key recommendations and other characteristics.FindingsOne hundred and twenty-one countries (73%) responded. Fifty-three countries (44%) had guidelines, ranging from 75% among high-income countries to 11% among low-income countries. Nearly all guidelines recommended brief advice (93%), intensive specialist support (93%) and medications (96%), while 66% recommended quitlines. Fifty-seven percent had a dissemination strategy, 76% stated funding source and 68% had professional endorsement.ConclusionFewer than half of the Parties to the WHO FCTC have developed national tobacco treatment guidelines, but, where guidelines exist, they broadly follow FCTC Article 14 guideline recommendations.