19.0.1 The globalisation of the tobacco epidemic
The ‘devastating health, social, environmental and economic consequences of tobacco consumption and exposure to tobacco smoke’ are a truly global problem (WHO Framework Convention on Tobacco Control, Article 3).1
Over the past few decades, the tobacco epidemic has spread across the world, facilitated ‘through a variety of complex factors with cross-border effects’, including trade liberalisation, direct foreign investment, global marketing, transnational tobacco advertising, promotion and sponsorship, and the international movement of contraband and counterfeit cigarettes (WHO Framework Convention on Tobacco Control, Foreword). The globalisation of the tobacco epidemic has had profound effects. According to the World Health Organization (WHO), tobacco kills more than eight million people per year, and causes annual economic losses of US$1.4 trillion worldwide.2,3
Most of these deaths occur in developing countries, where the economic impacts of the tobacco epidemic—increased social, welfare and healthcare spending by governments, and significant loss of income to families—are felt particularly acutely.2-5 At the same time, tobacco use remains a leading cause of preventable death in high-income countries6 While the prevalence of tobacco use, its associated morbidity and mortality, and tobacco producers and products vary globally, the effects of tobacco within countries share a number of commonalities. These include the severity of its health impacts and the role of the highly globalised tobacco industry in driving the problem.7
19.0.2 The development of the WHO Framework Convention on Tobacco Control
The international community negotiated the WHO Framework Convention on Tobacco Control (WHO FCTC) to address this ‘globalization of the tobacco epidemic’ (WHO FCTC, foreword), a trend that became increasingly apparent from the 1970s.7 As recognised in the preamble to the treaty, ‘the spread of the tobacco epidemic is a global problem with serious consequences for public health that calls for the widest possible international cooperation and the participation of all countries in an effective, appropriate and comprehensive international response’.
The WHO FCTC—which was adopted in 2003 and came into force in 2005 , provides a global framework for tobacco control. It has been one of the most rapidly and widely supported treaties in the history of the United Nations and is the first treaty ever to be negotiated under the auspices of the WHO. Its objective is to:
‘protect present and future generations from the devastating health, social, environmental and economic consequences of tobacco consumption and exposure to tobacco smoke by providing a framework for tobacco control measures to be implemented by the Parties at the national, regional and international levels in order to reduce continually and substantially the prevalence of tobacco use and exposure to tobacco smoke’ (WHO FCTC, Article 3).
As of October 2024, the WHO FCTC had 183 Parties.8 Under international law, each of the Parties—having ratified, accepted, approved or acceded to the WHO FCTC—must perform, in good faith, all obligations contained in the Convention (Vienna Convention on the Law of Treaties, Article 26).9 Parties are also encouraged, under Article 2.1, to implement measures beyond those required by the Convention in order to better protect public health.
In addition, six countries have signed the WHO FCTC, but have not ratified, accepted or approved it.8 In signing the Convention, these countries have undertaken, as a matter of international law, not to defeat the object and purpose of the Convention (Vienna Convention on the Law of Treaties, Article 18). As stated in the foreword to the WHO FCTC, signatories also ‘indicate that they will strive in good faith to ratify, accept, or approve it, and show political commitment not to undermine the objectives set out in it’.
Australia became a signatory to the WHO FCTC on 5 December 2003, soon after the Convention opened for signature. Australia was one of the first 40 countries to ratify the WHO FCTC, and so became a Party on 27 February 2005, the date on which the WHO FCTC came into force. Australia is thus legally bound to perform, in good faith, the full range of obligations outlined in the Convention.
As noted in 2003 at the adoption of the WHO FCTC, the new treaty was ‘a groundbreaking step in advancing national, regional and international action and global cooperation to protect human health against the devastating impact of tobacco consumption and exposure to tobacco smoke.’10 However, while a cornerstone of global tobacco control governance, the WHO FCTC is not the only international instrument in this area. As will be discussed in the next section, the WHO FCTC has become increasingly integrated into the broader global health and development agendas.
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References
1. World Health Organization. WHO Framework Convention on Tobacco Control. Geneva: World Health Organization, 2003. Available from: https://apps.who.int/iris/bitstream/handle/10665/42811/9241591013.pdf?sequence=1.
2. World Health Organization. Fact sheet: Tobacco. Geneva: World Health Organization, Available from: https://www.who.int/en/news-room/fact-sheets/detail/tobacco.
3. National Cancer Institute (United States) and World Health Organization, The Economics of Tobacco and Tobacco Control. NCI Tobacco Control Monograph Series Vol. 21.Bethesda, MD, United States, and Geneva 2017. Available from: https://cancercontrol.cancer.gov/sites/default/files/2020-08/m21_complete.pdf.
4. Vital Strategies and Tobacconomics. The Tobacco Atlas. Illinois: Vital Strategies and Tobacconomics 2022. Available from: https://tobaccoatlas.org/about/.
5. World Health Organization. Tobacco Threatens Us All: Protect Health, Reduce Poverty and Promote Development. Geneva: World Health Organization, 2017. Available from: https://www.paho.org/en/file/46196/download?token=2YY-s04I.
6. World Health Organization. Global Health Risks: Mortality and Burden of Disease Attributable to Selected Major Risks. 1 January 2009. Available from: https://iris.who.int/bitstream/handle/10665/44203/9789241563871_eng.pdf?sequence=1.
7. Zhou S and Liberman J. The Global Tobacco Epidemic and the WHO Framework Convention on Tobacco Control—The Contributions of the WHO's First Convention to Global Health Law and Governance, in Research Handbook on Global Health Law. Burci G and Toebes B, Editors. Edward Elgar Publishing; 2018.
8. United Nations Treaty Collection. WHO Framework Convention on Tobacco Control. New York: United Nations, Available from: https://treaties.un.org/pages/ViewDetails.aspx?src=TREATY&mtdsg_no=IX-4&chapter=9&clang=_en.
9. Vienna Convention on the Law of Treaties 1969. New York: United Nations, 2005. Available from: https://legal.un.org/ilc/texts/instruments/english/conventions/1_1_1969.pdf.
10. World Health Assembly. WHO Framework Convention on Tobacco Control. 21 May 2003. Available from: https://apps.who.int/gb/ebwha/pdf_files/WHA56/ea56r1.pdf.