1. Tobacco Control Policies:
WHO Framework for Tobacco Control(FCTC) and MPOWER

2. FCTC / MPOWER
These are the Global tobacco control policies and legal instruments.
Need to be adapted at country level to develop country legislations and tobacco control programmes.

3. WHO Framework Convention on Tobacco Control (WHO FCTC)
WHO Framework Convention on Tobacco Control is the first international treaty negotiated under the auspices of WHO.
Developed in response to the globalization of the tobacco epidemic
Evidence-based treaty reaffirms the right of all people to the highest standard of health.

4. World Health Assembly adopted FCTC on 21 May 2003 and the convention entered into force on 27 February 2005.
Currently 180 countries are parties to the treaty, including the European Community.
This Conference of Parties (COP) is the governing body of the WHO FCTC and is comprised of all Parties to the Convention Member States that have signed the Convention.

5. India in FCTC: Signed:10th September 2003 Ratified: 5th February 2004
India among first few countries to ratify the treaty.

6. Detailed Introduction to FCTC Article
Part I: (Article 1 & 2)
Introduction
Part II: (Article 3 to 5)
Objective, Guiding principles and General obligations engendered by the treaty
Part III:
Demand-side reduction measures
Article 6
Price and tax measures to reduce the demand for tobacco
Article 7
Non-price measures to reduce the demand for tobacco
Article 8
Protection from exposure to tobacco smoke
Article 9
Regulation of the contents of tobacco products
Article 10
Regulation of tobacco product disclosures
Article 11
Packaging and labelling of tobacco products
Article 12
Education, communication, training and public awareness
Article 13
Tobacco advertising, promotion and sponsorship
Article 14
Demand reduction measures concerning tobacco dependence and cessation

7. Detailed Introduction to FCTC Article
Part IV:
Supply-side reduction measures
Article 15
Illicit trade in tobacco products
Article 16
Sales to and by minors
Article 17
Provision of support for economically viable alternative activities
Part V:
Other provisions under FCTC to name are
Article 18
Protection of the environment and the health of persons
Article 19
Liability
Article 20 to 22
Cooperation and communication
Articles 23-26
Institutional arrangements and financial resources
Article 27
Settlement of disputes
Articles 30-38
"Final provisions”, covering statutory matters such as means of acceding to the Convention, entry into force, and so on.

8. Main Provisions of Treaty
There are two broad provisions suggested in the FCTC viz. Demand reduction and Supply reduction measures contained in many Articles to the convention :
Article : Protecting public health policies
Articles 6-14: Demand reduction provisions
Articles15-17: Supply reduction provisions

9. Article 5(3) Art. 5(3) – General Obligations:
To “protect these [public health] policies from commercial and other vested interests of the tobacco industry”

10. Article 6: Price and Tax measures
Increasing tobacco taxes is best way to reduce consumption
Especially among the young and the poor
Taxes must keep pace with inflation and with increasing consumer spending power
Tobacco taxes are generally well accepted
Higher taxes increase revenues, help pay for tobacco control and other health/social programs

11. Article 8: Protect citizens from exposure to tobacco smoke in workplaces, public transport and indoor public places

12. Article 11: Place rotating health warnings on packs that cover 30% or more of the package and can include pictures or pictograms

13. Article 13: Enact comprehensive bans on tobacco advertising, promotion & sponsorship
Pakistan
Japan
INDIA
PAKISTAN

14. Training package developed by The Union and WHO-TFI to help parties to the FCTC to fulfil their obligations

15. FCTC Resources

16. Global Progress on FCTC
Signed by 187 countries, Zimbabwe is the last country
Ratified by 180 countries, USA still not ratified
120+ parties have adopted and strengthened their tobacco control legislation.

17. Global Progress on FCTC Contd…
High implementation of protection from exposure to tobacco smoke (Article 8), packaging and labeling (Article 11)
Low implementation of bans on tobacco advertising, promotion and sponsorship (Article 13)
Significant improvements in implementation of price and tax measures (Article 6).
Significant protection from exposure to tobacco smoke (Article 8),
Limited progress on Article 14- tobacco dependence and cessation.

18. India and FCTC
National Tobacco Control Cell (NTCC) established in February 2001
Indian Tobacco Control legislation, COTPA was enacted in May 2003, just before FCTC came into force(Articles 8,11,13 &16)
India ratified FCTC in February 2004
India launched a comprehensive National Tobacco Control Programme (NTCP) with dedicated budget in
Established tobacco product testing labs(Article 9)

19. India and FCTC
National Level Mass Media campaigns launched since 2008(Article 12)
Establishing tobacco cessation centres and launced National Quit Line(Article 14)
Actions initiated for Supply side measures like alternative crops and livelihood(Article 17)
High level inter-ministerial committee constituted to ensure coordinated approach for tobacco control

20. WHO MPOWER Strategy
The WHO FCTC provide the foundation for countries to implement and manage tobacco control
To help make this a reality, WHO introduced the MPOWER measures
These measures are intended to assist in the country level implementation of effective interventions to reduce the demand for tobacco, contained in the WHO FCTC.

21. MPOWER Goal & Vision
MPOWER Goal : World where no child or adult is exposed to tobacco smoke.
MPOWER Vision
It encourages policy-makers, civil societies, health-care providers and others, to envision a world free of tobacco use.
The package provides the tools to create a world where tobacco use declines by promoting a legal and socio-economic context that favours tobacco-free living.

22. Monitor tobacco use and prevention policies
Protect people from tobacco smoke
Offer help to quit tobacco use
Warn about the dangers of tobacco
Enforce bans on tobacco advertising, promotion and sponsorship
Raise taxes on tobacco

23. Policies & Intervention MPOWER Package

24. Monitor Tobacco Use and Prevention Policies
Accurate monitoring is essential:
-Tobacco use prevalence
-Impact of policy interventions
-Tobacco industry marketing, promotion and
lobbying

25. ”What gets measured gets done.”
Dr. Margaret Chan
WHO Director-General

26. Protect People from Tobacco Smoke
No safe level of second-hand smoke
Smoke-free environments protect health of non-smokers and help smokers quit
Only completely smoke-free indoor areas with no exceptions work
Active liquor licenses and bar/restaurant employment both increased in NYC after going smoke-free
Smoke-free laws are popular and do not harm business
Worker safety measure
SFAA effective
March 2003

27. Offer Help to Quit Tobacco Use
Nicotine is addictive
Health care system has primary responsibility to treat tobacco dependence
Quit lines also effective
Nicotine replacement therapy
can double quit rates

28. Warn About the Dangers of Tobacco
Pack warnings are effective, especially if they have pictures covering half of pack
Most people are unaware of full range of health risks of tobacco use, SHS exposure
Anti-tobacco ads help change image of smoking
3/4 approve of warnings
More than half changed opinions
2/3 want to quit
Impact of pack warnings in Brazil

29. Enforce Bans on Tobacco Advertising, Promotion and Sponsorship
Tens of billions of dollars spent each year to promote tobacco Advertising increases sales, illness and death
Bans are effective, but only if comprehensive
Comprehensive advertising bans amplify effects of other interventions
9 times faster reduction in consumption with ban than without after 10 years
Advertising in all media must be banned
All marketing and promotion must be prohibited
Enforcement is essential

30. Raise Taxes on Tobacco
Increasing tobacco taxes is best way to reduce consumption especially among the young and the poor
Taxes must keep pace with inflation and with increasing consumer spending power
Tobacco taxes are generally well accepted
Higher taxes increase revenues, help pay for tobacco control and other health/social programs
World Bank recommends 65 to 85% tax of retail price of tobacco products
Higher tobacco taxes
reduce consumption
Tax rates vs. consumption, South Africa

32. Global Progress of MPOWER
MONITOR :
More than 2.3 billion people (a third of the world’s population) are now protected by at least one of the MPOWER measures at the highest level of achievement.
Nearly 1 billion people are protected by two or more measures at the highest level.
Nearly 1.3 billion people are newly protected by at least one measure applied nationally in the past five years (since WHO released the first report).

33. PROTECT :
Smoke-free public and work places created ,continues to be the most commonly established measure at the highest level of achievement.
There are 32 countries that passed complete smoking bans covering all work places, public places and public transportation (between 2007 and 2012) and protecting nearly 900 million additional people.
Since 2010, 12 countries and one territory, with 350 million people, passed strong smoke-free laws at a national level.

34. OFFER :
More than half a billion people in nine countries have gained access to appropriate cessation services in the past five years.
However, there has been little progress since 2010, as only four additional countries with a combined population of 85 million were newly provided access to cost-covered services including a toll-free national quit line.

35. WARN
Effective health warning labels on tobacco packaging continue to be established by more countries.
In the past five years, a total of 20 countries with 657 million people put strong warning label requirements in place, with 11 countries (with 265 million people) doing so since 2010.
Mass Media
National mass media campaigns, first assessed in 2010, have been conducted in the past two years by about one fifth of countries, which have more than half the world’s population

36. ENFORCE :Ban on Tobacco Advertising, Promotionand Sponsorship (TAPS)
Complete bans on all tobacco advertising, promotion and sponsorship have been put in place to protect more than half a billion people in 16 countries in the past five years.
Since 2010, six countries with nearly 400 million people newly established this measure at the highest level.

37. RAISE TAX
Raising taxes to increase the price of tobacco products remains the measure least likely to be established.
Only 14 countries and one territory with 166 million people have increased their tax rates to sufficiently high levels in the past five years, and only six countries with 29 million people have done so in the past two years.

38. Institutional Mechanism
Adequately staffed national tobacco control government structures have been established by six countries with 413 million people in the past five years.
In the past two years, three countries with 150 million people newly established a structure to manage National Tobacco Control Programmes

39. MPOWER & INDIA
India has taken many steps to effectively implement WHO MPOWER, the technical assistance package of six evidence-based policies
Monitor:
The Global Adult Tobacco Survey, (GATS) conducted in
India has been conducting and supporting regularly Global Youth Tobacco Survey (GYTS 2003, 2006, 2009), Global School Personal Survey (GSPS 2006, 2009) and Global Health Professions Student Survey(GHPSS ).
Many state governments and CSOs has been monitoring tobacco control legislation enforcement at state, district and city level.

40. Protect:
Section 4 of COTPA ensure all public, workplaces and many open places are smokefree. However, the legislation exempts hotel having thirty or more rooms or restaurant having seating capacity of thirty persons or more and the airports which may provide for a smoking area or space.
Offer:
To support tobacco users quit tobacco is an important component of India’s National Tobacco Control Programme (NTCP). A district level tobacco cessation centre (TCC) is being established in each district hospital and is provided with staff, equipments, training and outreach activities

41. Warn:
Section 6,7,8 and 9 of COTPA provides that youth are protected and everyone is warned about harms of tobacco use through specified health warning labels on all tobacco products. Additionally, National level Mass Media Campaigns have been launched since 2008 to educate public about harms of tobacco and highlight enforcement of policy provisions of COTPA.
Enforce:
Section 5 of COTPA discourages the use or consumption of tobacco products by eliminating all forms of direct & indirect advertising, promotion & sponsorship of tobacco products

42. Raise:
The tax base of tobacco in India is heavily dependent on about 14% of consumption by cigarette smokers; Non-cigarette tobacco products accounting for 85% of the tobacco consumption contributes only 15% of the total tobacco taxes.
Specific excise is imposed on cigarettes (per 1000 sticks) based on the length of the cigarette and the tax rates are higher for filter than non filter.
Tobacco taxes on cigarettes are very low: 38-52%
Tobacco Taxes on Bidi varies from Rs per 1000 sticks.
Tobacco Taxes on SLT: Based on
Further, Tobacco taxes in India are not regularly adjusted for inflation, and over time tobacco products are becoming increasingly affordable

43. Raising bidi taxes to Rs 98 per 1000 sticks. would raise over Rs 36
Raising bidi taxes to Rs 98 per 1000 sticks ...would raise over Rs 36.9 billion in tax revenues ...and prevent 15.5 million deaths in current and future bidi smokers.
Raising cigarette taxes to Rs 3691 per 1000 sticks ...would increase tax revenues by over Rs 146 billion ...and prevent 3.4 million deaths in current and future cigarette smokers.

44. Thanks