Global tobacco control treaty is leaving some countries vulnerable to increase in tobacco consumption
Studies provide evidence for urgent need to tackle smoking globally, especially in low- to middle-income countries
TORONTO, June 20,听2019听鈥撎齌here is no statistical evidence that global cigarette consumption has fallen as a result of the World Health Organization鈥檚 Framework Convention on Tobacco Control, and in low- and middle-income countries it has actually increased, according to two studies led by global health researchers at 91亚色.
The studies, published in听 (BMJ), put into question the widely held belief that the FCTC has been the most successful health treaty ever created. An international treaty adopted in 2003 to reduce harmful tobacco consumption, the FCTC鈥檚 听had never been scientifically studied on a global level. The research also puts the spotlight on the urgent need not only for investment in tobacco control practices but also听an evaluation of the effectiveness of this international law and reporting practices.
鈥淭he policies promoted by this treaty听鈥撎齪lain packaging, smoke-free areas, tobacco taxes听鈥撎齢ave been monolithically proven to be effective,鈥 says Steven Hoffman,听professor in the Dahdaleh Institute for Global Health Research, Faculty of Health, and Osgoode Hall Law School, who is听lead author of the studies.
鈥淲hat this study shows is that it鈥檚 probably not enough at the global level to recognize these policies as important or to formally adopt them. We need countries to implement them to make sure they鈥檙e affecting people鈥檚 lives around the world. If not, what鈥檚 at stake, according to the WHO, is one billion people around the world might die from tobacco consumption in the 21st century.鈥
In the first study, Hoffman and co-author听Mathieu Poirier, assistant professor, 91亚色鈥檚 Faculty of Health,听analyzed data collected from 71 countries, representing 95 percent of the world鈥檚 tobacco consumption and over 80 percent of the world鈥檚 population between the years of 1970 and 2015. The data collection is the largest appraisal and selection of comparable national estimates of tobacco consumption done to date, in an effort to better understand international cigarette consumption trends since 1970. Researchers found that cigarette consumption fell in most countries, however consumption trends varied from country to country, especially in lower-income countries.
The听听dataset looked at sales, production, imports, and exports, with up to six different sources compiled for each country per year. Researchers found a general decline in per capita cigarette consumption beginning around 1985 in five of the top ten cigarette-consuming countries: United States, Japan, Poland, Brazil, and Germany. The United States, Canada, and Australia all demonstrated similar continuous declines in consumption since the early 1980s, while Latin American and Caribbean countries experienced more modest declines. In contrast, per capita consumption rose steadily in China and Indonesia. China was found to be the world鈥檚 leading consumer of cigarettes, with over 2.5 million metric tonnes consumed in 2013 鈥 more than the next 40 highest consuming countries combined.
In the second study, Hoffman and his team used the data from the first study and looked at it in the context of the听Framework Convention on Tobacco Control which has been ratified by 181 countries since its adoption in 2003. This gave researchers a clear intervention point on tobacco consumption for the study. The study听used two听quasi-experimental methods, the first using interrupted time-series analysis (ITS) and the second using in-sample forecast event modelling. The data showed听no significant change in the rate at which global cigarette consumption had been decreasing after adoption of the treaty.
鈥淭his study sets a new gold standard for how to evaluate international laws,鈥 said co-author Poirier. 鈥淭he FCTC was widely celebrated at the time it was launched and no one has actually evaluated that treaty on a global level until now.鈥
The research showed that after 2003, high income and European countries experienced a decrease in annual consumption by more than 1,000 cigarettes per adult, while low- and middle-income and Asian countries showed an increase of more than 500 cigarettes annually per adult.
Researchers suggest that varied implementation of tobacco control policies and shifting trends in cigarette affordability across countries may have generated market equilibrium effects that incentivized the tobacco industry to move its lobbying, marketing and promotion activities away from countries with strict guidelines and toward countries with less stringent measures.
鈥淲e found quantitative evidence that could support that idea: that tobacco companies, after the Framework Convention on Tobacco Control, specifically went to jurisdictions that were not implementing proven tobacco control policies as rapidly as we saw in high income countries,鈥 said Hoffman. 鈥淚f this is true, this means the FCTC could even have unintentionally caused harm by encouraging tobacco companies to target the many more people who live in these areas and Asian countries who would have fewer governmental protections against the companies鈥 efforts.鈥
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Media Contact:听听Anjum Nayyar, 91亚色 Media Relations, 416 736 2100 ext. 44543听anayyar@yorku.ca






