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All articles written by Karen Evans-Reeves and Ruth Canty unless otherwise attributed. Ideas and items for News Analysis should be sent to k.a.evans reeves@bath.ac.uk
GLOBAL
The 10th session of the Conference of the Parties (COP10) of the WHO Framework Convention on Tobacco Control (WHO FCTC) took place in Panama City in February 2024 to review global progress in tobacco control to date and to deliberate on future measures (figure 1). Delegates from 142 member Parties attended alongside public health organisations from across the globe. The following stories feature key decisions and outcomes from COP10.
The 10th session of the WHO Framework Convention on Tobacco Control (WHO FCTC) occurred in Panama City in February 2024. Source: Secretariat of the WHO FCTC.
Advancing environmental protection at COP10: Implications for tobacco’s toxic plastics and extended producer responsibility
In the ongoing battle against plastic pollution to protect the marine environment, a decision at COP10 on the implementation of Article 18 (Protection of the Environment) serves as a beacon of hope. Every year, some 4.5 trillion littered plastic cigarette butts contribute to the consistent ranking for the top plastic items in debris collected (eg, 33% in beach clean-ups and 29% in harbours). Significant by count but relatively small in volume, cigarette butts, aside from being a persistent plastic pollutant, are also highly toxic contaminants that have been proven to kill a variety of aquatic organisms. Cigarette butt leachates are phytotoxic, cytogenic, neurotoxic, genotoxic, mutagenic and teratogenic.
The decision, which expressly considered the work of the Intergovernmental Negotiating Committee on Plastic Pollution (INC) and the ‘ongoing global efforts in relation to hazardous waste management policies/standards,’ both reaffirms the resolve to protect present and future generations from the devastating consequences of tobacco consumption and paves the way for a more comprehensive approach to dealing with tobacco’s toxic plastics. It acknowledges that the proliferating plastic filters of cigarettes are unnecessary and avoidable and that problematic single-use plastics pose a serious risk to the environment, including marine life and ecosystems. It also notes that the ‘WHO has recommended an immediate ban on cigarette filters and vaporisers in its submission to the INC.’ It calls on nations to explore comprehensive regulatory options, which include an immediate ban concerning filters and related electronic devices and urges them to protect tobacco-related environmental policies from the commercial interests of the tobacco industry. Nations are also urged, in relation to national and international policies on plastics and hazardous waste, to align with treaty objectives and efforts to address tobacco plastics including electronic devices.
Another notable point in the COP decision is its stance on extended producer responsibility (EPR). EPR requires producers, including importers, to extend their responsibility for the environmental impact of their products throughout their lifecycle. While EPR has been recognised as a valuable approach to addressing plastic pollution, its implementation in the context of tobacco-related plastic waste presents unique challenges. The COP decision emphasises the need to prevent tobacco industry interference in the implementation of EPR measures. It calls on Parties to counter the so-called corporate social responsibility activities of the tobacco industry and ensure that the tobacco industry’s implementation of EPR systems does not inadvertently contribute to undermining the objectives of the WHO FCTC. The Global Tobacco Index presented at the side event of the COP highlights so-called CSR in the environment sector, by which the tobacco industry undermines advertising bans and allows it to access policy-makers.
COP10 also instigated processes to seek justice for tobacco industry behaviour. The decision on implementing Article 19 (liability) recognises ‘the potential use of liability in protecting the environment from tobacco harms’ and urges nations to ensure that the work undertaken in relevant international fora on the environment (under which plastic pollution treaty negotiations fall) supports tobacco control and does not undermine it. Finally, the Convention Secretariat was requested ‘to participate in global fora to promote policy coherence between tobacco industry liability and the development of international law in relation to the environment,’ since there are stronger liability regimes under international environment laws, and aligning with global trends in implementing the polluter pays principle could be a means to make the tobacco industry pay for its plastic pollution. Given this context, strengthened liability regimes in relation to tobacco-related environment laws should be within the scope of the COP-established expert group’s mandate, which was to, among others, ‘support Parties, on request, to strengthen their liability regimens, including administrative measures, to ensure accountability and deterrence, improve access to justice and allow for effective remedies for those affected by tobacco harms.’ At COP11 in 2025, we expect to see further guidance through a report on ‘regulatory options regarding the prevention and management of waste generated by the tobacco industry and its products, including a ban on plastic cigarette filters and the management of hazardous waste from cigarettes, based on scientific evidence.’
As countries prepare for the upcoming fourth session of the INC in April 2024, the COP decision provides crucial guidance on how to address tobacco-related plastic pollution effectively through multisectoral collaboration and policy coherence. This represents a significant step forward in the global effort to combat plastic pollution, particularly in the context of tobacco-related plastic waste. By calling for measures to prevent tobacco industry interference and warning against tobacco industry-run EPR schemes, the COP decision sets the stage for more comprehensive and effective environmental protection measures. As countries move forward, it is imperative to heed the provisions of the COP decision and work towards a healthier, more sustainable future for all.
Deborah Sy,
Head of Global Public Policy & Strategy at the Global Center for Good Governance in Tobacco Control, Thailand.
debby@ggtc.world
COP10: youth groups call out tobacco industry for manipulating them
As part of proceedings at COP10, Global Youth Voices (GYV), a coalition of 39 youth public health organisations campaigning for a greener, healthier world, made a statement condemning the action of the tobacco industry and urging COP10 to take unequivocal action to protect future generations from the tobacco epidemic. The action of the youth movement has been cited as a particular highlight of COP10 (figure 2).
Global Youth Voices reads its pledge statement to during COP10 proceedings. Photo credit Geoffrey. T. Fong, University of Waterloo, Ontario, Canada. COP10.
The GYV statement at COP10 asked the delegation to ‘adopt decisions that shield us from the manipulative practices of tobacco and related industries.’
The statement highlights that the coalition of young people know that they are the target market of industries such as tobacco and that these industries have ‘no qualms in selling and marketing addictive recreational products that have the potential to ensnare an entire generation in a web of addiction.’
The statement cites the health of young people and the destruction of the environment as key reasons why the delegation should act to end tobacco and other novel product innovation and to hold the tobacco industry financially accountable for previous, current and future harms. The statement argues that the industry should not be allowed to align itself with deceptive terms such as ‘harm reduction’, ‘wellness’, ‘social responsibility’, ‘environmental steward’ or ‘producer responsibility’.
The statement continues:
‘Instead it must be held accountable for the lasting pain and suffering it has inflicted and will continue to inflict on countless lives. It must bear the financial consequences of the devastation it has wrought on the planet. Front groups and persons that voice industry positions should also be held accountable as they put us in danger.’
COP10 made a number of decisions which will protect children and young people from tobacco and protect the environment. Namely, the development of new guidelines on the depiction of tobacco products in entertainment media (including digital media), the establishment of two expert groups, one to explore forward-looking measures to eliminate tobacco use and another to explore the financial liability of the industry, and for Parties to take account of the environmental impacts across the whole lifespan of tobacco and strengthen the implementation of Article 18 (which states that Parties must have due regard to the protection of the environment). However, decisions pertaining to novel products differed to the next COP. Given that youth uptake of novel tobacco and nicotine products is ever-increasing, this delay is problematic.
GYVs’ statement urged the COP10 delegation to ‘change the course of our future’, the promised actions go some way to achieving this change.
MOP3 promises progress on illicit tobacco trade
Since 2018, Parties to the Protocol to Eliminate Illicit Trade in Tobacco Products (the Protocol) have met immediately following the WHO FCTC COP, with these meetings being known as MOP (Meeting of the Parties to the Protocol). This year saw the third MOP meeting (MOP3).
The MOP proceedings got off to a rocky start given the challenges Parties faced in MOP1 in 2018 as they worked to come to terms with highly technical topics such as tobacco tracking and tracing (T&T), followed by the COVID-19 pandemic leading to a virtual MOP2 and then the delay of MOP3 into 2024 due to civil unrest in Panama in November of last year. However, MOP3 ultimately proved to be productive with all agenda items being approved.
A key focus in MOP discussions to date has been tobacco T&T—a requirement under Article 8 of the Protocol where Parties must introduce measures to track tobacco products through the legal supply chain in such a way that allows the authorities to trace them and identify if a legal product has ended up in the illegal market. The MOP agenda featured a report from a working group established at previous MOP proceedings on T&T.
Recommendations from the report were adopted, which include the introduction of an interim global information sharing point, developed by the United Nations International Computing Centre, which enables data sharing across Parties’ individual T&T systems. MOP also saw the adoption of a roadmap for potential future research on topics relevant to the Protocol that have been under-researched, namely key inputs in the tobacco supply chain and duty-free sales. However, this research would need to be funded by extrabudgetary contributions from Parties, meaning that despite the decision it is far from guaranteed.
Discussion of Budgetary matters saw the adoption of an Investment Fund for Implementation of the Protocol, similar to the one also approved at COP10. Parties’ assessed contributions also featured on the agenda. Twenty-three Parties to the Protocol have been in arrears as of April 2023, with committee B agreeing on restrictions for MoP engagement for Parties that do not catch up on their arrears.
Lastly, similarly to CoP10, MoP3 also saw the adoption of a Panama Declaration, reiterating the key focus points of the treaty and outlining the obligations of Parties to the Protocol. These range from enhancing cooperation between Parties and relevant regional and international intergovernmental organisations (MoP3 saw the approval of the United Nations Office on Drugs and Crime as an observer, for instance), to being alert to tobacco industry efforts to undermine efforts to eliminate the illicit tobacco trade.
Dr Allen Gallagher,
Research Fellow, Tobacco Control Research Group, University of Bath
STOP, a tobacco industry watchdog
a.gallagher@exposetobacco.org
Panama: country achieves endgame and hosts COP10 but insists there is still work to be done
Panama is a small country which has achieved its tobacco control endgame, with a national smoking prevalence of less than 5%. In addition to this achievement, the country hosted the WHO FCTC COP10 this year.
The country has a long tobacco control history commencing in the 1970s with the implementation of Law Cabinet Decree No. 56, which mandated the placement of the health warning ‘Beware Smoking is Harmful to Health’ on cigarettes, and health warnings on all tobacco advertising. Citizens were encouraged to report non-compliance with these measures and violations were punished with fines between US$100–US$500.
On 26 September 2003, Panama became a signatory to the WHO FCTC and became a Party through ratification on 16 August 2004.
In 2007, the National Health and Quality of Life Survey (ENSCAVI) was carried out, reporting an adult tobacco consumption prevalence of 9.4%. In January 2008, the Tobacco Control Law No. 13 was adopted in line with the guidelines of the FCTC. The law implemented smoke-free legislation, graphical pictorial health warnings on tobacco products as well as a ban on misleading descriptors, a comprehensive advertising and sponsorship ban and a ban on vending machines and tobacco sales in sports, health and educational establishments. Its implementation led to a decrease in acute myocardial infarction and a decrease in youth tobacco smoking prevalence from 18.6% of 13–15 year olds in 2002 to 8.3% in 2008.
On 10 January 2013, Panama became a signatory of the Protocol for the Elimination of Illicit Trade in Tobacco Products, which was ratified on 23 September 2016. In that same year, Panama took on the challenge of carrying out the first Global Adult Tobacco Survey, which revealed a national smoking prevalence of 6.4% among adults, one of the lowest national smoking rates in the world.
The National Health Survey of Panama carried out in 2019 revealed that 5.0% of the adult population aged 15 years and older in the country consumed tobacco products. This marks a key moment since the endgame target has now been achieved in Panama, although with some variations in prevalence between different regions within the country.
As part of the efforts made in tobacco control, Panama hosted COP10 and MOP3, which took place between 5 February 2024 and 15 February 2024 at the Panama Convention Center; receiving around 1200 delegates in the case of COP10 and 500 delegates during MOP3. It has been an honour and at the same time a great responsibility to assume the challenge of planning, organising and executing the meetings of the governing bodies of these two international treaties.
During this event, significant advances (as mentioned in the other news stories here) were achieved:
Adopting measures to expedite the implementation of the FCTC.
Strengthening policies to prevent tobacco industry interference in governments.
Protecting the environment from the negative consequences of tobacco products, adopting decision FCTC/COP10(14) regarding WHO FCTC Article 18 implementation, which urges Parties, among other things, to take into account the environmental impacts of the cultivation, manufacturing, consumption and waste disposal of tobacco products and related electronic devices, with a sustainable and holistic approach.
Exploring new prospective tobacco control measures to protect citizens’ right to health.
Promoting greater awareness among the population about the adverse health consequences of new and emerging tobacco and nicotine product use.
Staying alert to advertising, promotion and sponsorship of novel and emerging tobacco and nicotine products.
Strengthening strategies to combat illicit trade in tobacco products, particularly with regard to T&T, as well as guidelines for the study of illicit trade in tobacco products.
Adopting administrative-financial decisions for the sustainability of the implementation of the WHO FCTC and the Protocol, aimed at supporting the application of the action plan and the Global Strategy to Accelerate Tobacco Control.
Despite these achievements, Panama continues to wage a titanic battle against the commercial interests of the tobacco industry in favour of the health of the population. This involves providing tobacco cessation services, raising awareness and providing health education. To capitalise on our position, we now need to regulate the contents of tobacco products, novel tobacco products that are being illegally placed on the national market to entice new consumers and we need to increase taxes. It is imperative to increase taxes and continue to expose the strategies and interference of the tobacco industry whose purpose is to undermine the measures that the country has been applying for nearly 20 years with the purpose of protecting the health of present and future generations through tobacco control.
Dr Reina Roa, Director
National Commission for Tobacco Control of the Ministry of Health (MINSA), Panama.
Laurent Huber, Executive Director
Action on Smoking and Health USA
huberl@ash.org
World No Tobacco Day 2024: protecting children from tobacco industry interference
World No Tobacco Day, established in 1987, is an annual event which highlights the preventable death and disease caused by the tobacco epidemic. Each year there is a theme to highlight a specific aspect of tobacco control. WNTD themes from the past few years have included health impacts of tobacco use on the heart (2018), the lungs (2019), tobacco industry interference in health policy decisions (2020), commit to quit (2021), tobacco threats to the environment (2022) and the hazardous nature of tobacco growing (2023). This year, 2024, the focus is on protecting children from tobacco industry interference ‘to protect future generations and ensure that tobacco use continues to decline.’
The WHO recognises that 13–15 years across the globe continue to use tobacco and nicotine products and are the targets of tobacco industry marketing, not only through conventional means but also through new digital media, including the most streamed shows on popular entertainment streaming platforms. Drawing on a recent Truth Initiative report, the editorial in this edition of Tobacco Control describes the methods tobacco companies use to target youth and explains that 60% of the 15 most popular shows on streaming platforms contained depictions of tobacco use (figure 3).
Truth Initiative report, 2022.
In their statement to COP10, GYV (mentioned in the previous story) described how youth are exposed to tobacco imagery and marketing:
We urge you to end the tobacco industry’s insidious strategy of introducing innovative and alluring features (eg, biodegradable filters) or products (eg, vaping devices) and using digital media, including entertainment media to influence our impressionable minds. Such tactics only serve to perpetuate addiction and endanger our well-being.
Given the continuing threat to young people from this insidious marketing and the will of the youth themselves, WHO’s WNTD 2024 focus could not be more timely.
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Footnotes
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Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests No, there are no competing interests.
Provenance and peer review Not commissioned; internally peer reviewed.