Uneven implementation of FCTC articles impeding tobacco control

Islamabad : Two years have slipped by since the World Health Organization (WHO) adopted the Global Strategy to Accelerate Tobacco Control 2019-2025 (GS2025). However, when it relaunched GS2025 last month, there were no signs of progress vis-a-vis implementation of the Framework Convention for Tobacco Control (FCTC). What resonated, on the contrary, were ongoing failures in policy implementation.

Dr. Ehsan Latif, Vice President of Grant Management and Development at the Foundation for a Smoke-Free World has expressed these views while drawing attention to priority areas for smoking cessation in a recently published blog. He sees “uneven implementation of several FCTC articles” as being responsible for the WHO’s trajectory of failure in the domain of tobacco control.

Dr. Ehsan, who has previously served as senior adviser for Non-Communicable Diseases and Director of Tobacco Control at the International Union Against Tuberculosis and Lung Disease, refers to the ‘WHO Report on the Global Tobacco Epidemic 2019: offer to help quit tobacco use,’ which highlights that only 23 nations have introduced comprehensive cessation programmes, even though in many countries, many tobacco users report wanting to quit.”

In Dr. Ehsan’s opinion, while this could be the result of government inaction and scarcity of funds, there still exists a window of opportunity. “Though FCTC implementation has been slow, there is now an opportunity to disrupt this stagnation. Given the delay in the Conference of Parties to the FCTC (COP9), we have an extra year in which to discuss high priority action areas in tobacco control. We needn’t accept bureaucratic inaction; and, in fact, we have a moral imperative to demand change,” he writes, urging countries to dedicate available time to the development of evidence-based recommendations. Dr Ehsan, who has more than 20 years of experience in managing the development and implementation of cohesive strategies to achieve public health gains, believes millions of lives could be saved by focusing on new approaches to cessation, including Tobacco Harm Reduction (THR). THR refers to strategies designed to reduce the health risks associated with tobacco smoking, but which may involve the continued use of nicotine. Dr. Ehsan believes countries can achieve a tangible difference in cessation rates through inclusion of Nicotine Replacement Therapy on the National Essential Medicines List. Many countries have resisted doing so.

Dr. Ehsan also believes that important progress made in the area of THR by some countries like the UK and USA must not be ignored. He points out that “the WHO narrative on tobacco control excludes important progress in the area of THR.”

In this context, he makes a mention of the United States FDA authorization to market heated tobacco products and snus as “modified tobacco risk products;” and success stories from countries like Japan and South Korea, both of which have used THR to decrease the smoking-related health burden. In conclusion, Dr. Ehsan has proposed more aggressive implementation of cessation assistance and a focused approach towards filling critical gaps in knowledge and funding—measures that need to be taken ahead of COP9.