Scaling up of MPOWER tobacco control needed

New Zealand and other countries in the world need to scale up the cost-effective, proven and WHO recommended strategies to reduce the number of deaths attributed to tobacco use. The World Health Statistics Report (2008) of WHO released 10 days before this year's World No Tobacco Day (31 May) ups the urgency to scale up quality interventions to control tobacco use.

About half of all countries in the world implement none of the recommended tobacco control policies, despite the fact that tobacco control measures are cost-effective and proven. Moreover, not more than 5% of the world's population is fully covered by any one of these measures.

World Health Statistics Report (2008) had further confirmed that heart disease, obesity, and tobacco use were among the leading causes of deaths worldwide. The number of deaths from non-communicable chronic conditions, the risk to which is exacerbated by tobacco use, is alarmingly rising far more than the number of deaths from communicable diseases like HIV, TB or Malaria.

The single most preventable cause of death world wide, the report stated, is tobacco use. Tobacco use has been found to kill one-third to one-half of its users, according to this report.

Earlier in February 2008, WHO had released the World Tobacco Epidemic Report which underlines not only the evidence-based fact that tobacco epidemic is worsening but also recommends a comprehensive package of six-effective tobacco control policies – clubbed as 'MPOWER' that have demonstrated results in helping countries stop the diseases, deaths and economic damages caused by tobacco use.

The MPOWER package includes:

M: stands for 'monitor' tobacco use and prevention policies. Assessment of tobacco use and its impact must be strengthened.

P: stands for 'protect' people from tobacco smoke. All people have a fundamental right to breathe clean air. Smoke-free places are essential to protect non-smokers and also to encourage smokers to quit.

O: stands for 'offer' help to quit tobacco use. Services to treat tobacco dependence are fully available in only nine countries with 5% of the world's population. Countries must establish programmes providing low-cost, effective interventions for tobacco users who want to quit.

W: stands for 'warn' about the dangers of tobacco use. Despite conclusive evidence, relatively few tobacco users understand the full extent of their health risk. Graphic warnings on tobacco packaging deter tobacco use, yet only 15 countries, representing 6% of the world's population, mandate pictorial warnings (covering at least 30% of the principal surface area) and just five countries with a little over 4% of the world's people, meet the highest standards for pack warnings. More than 40% of the world's population lives in countries that do not prevent use of misleading and deceptive terms such as 'light' and 'low tar'.

E: stands for 'enforce' bans on tobacco advertising, promotion and sponsorship. Partial bans on tobacco advertising, promotion and sponsorship, do not work because the industry merely redirects its resources to other non-regulated marketing channels. Only a total ban can reduce tobacco consumption and protect people, particularly youth, from industry marketing tactics. Only 5% of the world's population currently lives in countries with comprehensive bans on tobacco advertising, promotion and sponsorship.

R: stands for 'raised' taxes on tobacco. Raising taxes and therefore prices, is the most effective way to reduce tobacco use, and especially to discourage young people from using tobacco. Only 4 countries, representing 2% of the world's population, have tax rates greater than 75% of retail price.

"Reversing this entirely preventable epidemic must now rank as a top priority for public health and for political leaders in every country of the world" said Dr Margaret Chan, Director-General of the WHO in the summary.

However the global tobacco epidemic stands starkly apart from other conventional disease control programmes because of an aggressive tobacco industry that is hell-bent on protecting and expanding its markets globally, particularly in the developing countries of Asia and Africa. Tobacco corporations across the world have not only been aggressively protecting and promoting their tobacco markets, particularly in the developing countries, but also trying their best to either abort or weaken the public health policies that begin to take shape in countries around the world.

"Big Tobacco's interference in health policy is one of the greatest threats to the treaty's implementation and enforcement. Philip Morris/Altria, British American Tobacco (BAT) and Japan Tobacco (JT) use their political influence to weaken, delay and defeat tobacco control legislation around the world. While the industry claims to have changed its ways, it continues to use sophisticated methods to undermine meaningful legislation" had said Kathy Mulvey of Corporate Accountability International at the recent meeting last year on the global tobacco treaty – the Framework Convention on Tobacco Control (FCTC).

The alert monitoring of tobacco corporations in New Zealand and holding them accountable for violating existing health policies will further boost the impact of the WHO's recommended MPOWER package in reducing tobacco use globally.

Bobby Ramakant

(The author is a regional Correspondent and a member of Network for Accountability of Tobacco Transnationals (NATT). He can be contacted at: bobbyramakant@yahoo.com)

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