The fight against tobacco is not over

The role of the FCTC in stymieing tobacco use in low-income countries: recommendations from the WHO Framework on Tobacco Control

Policies that encourage quitting and discourage new smokers will continue to be crucial to ridding the world of smoking. The US Food and Drug Administration is considering limiting nicotine levels in cigarettes, to make quitting easier, because high-income countries are ahead of their lower-income neighbours in this regard. In low-income countries in Africa, raising taxes on cigarettes has proved to be difficult due to the interference of tobacco companies.

The researchers at the University of Sierra Leone found that breathing second-hand smoke was strongly associated with adolescent tobacco use. But there were several other factors that increased risk, including exposure to tobacco industry promotions and a lack of education about tobacco’s health effects.

Recommendations from the WHO Framework Convention on Tobacco Control could be used to address some of these factors. The FCTC was adopted by the World Health Assembly in 2003 to stymie tobacco use globally through regulatory strategies. The main components include monitoring tobacco use, banning tobacco use in public spaces, providing cessation services to people who want to quit, placing graphic warning labels on tobacco products, banning tobacco companies from advertising and sponsorships and raising taxes on tobacco products.

The Effects of Taxes on Human Health, Education and Health in Low- and Middle-Income Countries, As Revealed by Gilmore and Drope

“I think of it in terms of power imbalances,” Gilmore says. In countries with small gross domestic products (GDPs), she says, wealthy industries can interfere and influence in ways that they might not be able to in richer nations. She says that the companies will do outrageous things in low- and middle-income countries.

Jeff Drope is a health-policy researcher at University of Illinois Chicago’s School of Public Health. He thinks that fears that revenue will fall if taxes increase are not true. Revenue increases because people are paying more taxes. The South African government raised cigarette taxes to 50% in the mid 1990s. By 2004, this tax had increased by 256% per pack, and smoking prevalence dropped from 32% to 24%. The government revenue rose by 140%9.

Tobacconomics, a tobacco-control think tank at the University of Illinois Chicago that counts Drope among its researchers, studied the potential results of tax increases in several low- and middle-income countries, including North Macedonia, Pakistan, Mexico, Argentina and Indonesia. The group found that if tobacco sales went down, it would lead to job growth in areas like food, education and health.

In 2014, Senegal also introduced comprehensive legislation and began requiring graphic health warnings on cigarette packages in 2017. The tobacco taxes were raised to 65%.

Smoking kills. Maybe that was not the most original thought you read today, but it is worth repeating. In 2019, around 14% of all deaths were caused by tobacco smoking — and were therefore entirely preventable. What a colossal waste.

Smoking-related diseases, as well as indirect costs of smoking, such as lost labour due to disability and death, cost the world more than US$1.4 trillion in 2012 Costs outweigh the value of cigarettes.

The vast majority of people who will die will be those who continue to smoke; quitting at any age reduces the risk of a smoking-related death considerably6. Smokers who stop before 40 have less risk of death than smokers who don’t.

Policies that promote smoking cessation are common in countries with high economic and social development, and have led to roughly equal numbers of current and former smokers. In nations with lower development, where an increase in smoking might have occurred more recently, cessation efforts are yet to have as significant an effect8.

Haleon’s Perspective on Anxiety and Addiction: The Case for a Stimulated Effective Treatment of Nicotine In Cigarettes

We are pleased to acknowledge the financial support of Haleon in producing this Outlook. Nature is the sole holder of all editorial content.

The health effects of tobacco use are clear, but nicotine’s role in perpetrating these harms is not fully understood. The rising popularity of alternative nicotine delivery methods, such as e-cigarettes or vapes, is giving researchers more desire to find out.

Nicotine in cigarettes makes it hard to quit smoking. The brain regions involved in addiction are stimulated by this new approach to help people kick the habit. The technique has already been approved for use in the United States, and it could improve considerably as researchers get a better handle on what goes on in a nicotine-addicted brain.