World Health Organization WHO REPORT ON THE GLOBAL TOBACCO EPIDEMIC,2011 Warning about the dangers of tobacco fresh and alive mpowEr
20 Avenue Appia CH-1211 Geneva 27 Switzerland www.who.int/tobacco/mpower fresh and alive WHO REPORT on the global TOBACCO epidemic, 2011 Warning about the dangers of tobacco WHO REPORT on the gl obal TOBACCO epid emi c, 2011 ISBN 978 92 4 156391 8
Contents 7 PROGRESS CONTINUES NEARLY 3.8 BILLION PEOPLE ARE NOW COVERED BY AN EFFECTIVE TOBACCO CONTROL MEASURE A letter from WHO Assistant Director-General 8 SUMMARY 12 WHO FRAMEWORK CONVENTION ON TOBACCO CONTROL 14 Article 11-Packaging and labelling of tobacco products 15 Guidelines for implementation of Article 11 16 Article 12-Education,communication,training and public awareness 17 Guidelines for implementation of Article 12 18 WARN ABOUT THE DANGERS OF TOBACCO 18 People have a right to accurate information about the harms of tobacco use 22 Health warning labels on tobacco packaging 28 Anti-tobacco mass media campaigns 38 IMPLEMENTATION OF EFFECTIVE MEASURES CONTINUES TO GAIN MOMENTUM 38 Monitor tobacco use and prevention policies 42 Protect from tobacco smoke 46 Offer help to quit tobacco use 50 Warn about the dangers of tobacco 50 Health warning labels 54 Anti-tobacco mass media campaigns
Contents 7 Progress continues – nearly 3.8 billion people are now covered by an effective tobacco control measure A letter from WHO Assistant Director-General 8 Summary 12 WHO FRAMEWORK CONVENTION ON TOBACCO CONTROL 14 Article 11 – Packaging and labelling of tobacco products 15 Guidelines for implementation of Article 11 16 Article 12 – Education, communication, training and public awareness 17 Guidelines for implementation of Article 12 18 Warn about the dangers of tobacco 18 People have a right to accurate information about the harms of tobacco use 22 Health warning labels on tobacco packaging 28 Anti-tobacco mass media campaigns 38 Implementation of effective measures continues to gain momentum 38 Monitor tobacco use and prevention policies 42 Protect from tobacco smoke 46 Offer help to quit tobacco use 50 Warn about the dangers of tobacco 50 Health warning labels 54 Anti-tobacco mass media campaigns
ABBREVIATIONS AFR WHO African Region 62 Enforce bans on tobacco advertising,promotion and sponsorship AMR WHO Region of the 66 Raise taxes on tobacco Americas 70 National action is critical to achieve the vision of a tobacco-free world CDC Centers for Disease Control and Prevention 74 CONCLUSION COP Conference of the Parties to the WHO FCTC 76 REFERENCES EMR WHO Eastern Mediterranean Region 82 TECHNICAL NOTE I:Evaluation of existing policies and compliance 86 TECHNICAL NOTE Il:Smoking prevalence in WHO Member States EUR WHO European Region 88 TECHNICAL NOTE Ill:Tobacco taxes in WHO Member States NRT nicotine replacement therapy 93 APPENDIX I:Regional summary of MPOWER measures SEAR WHO South-East Asia 107 APPENDIX Il:Regulation of warning labels on cigarette packages and Region national anti-tobacco mass media campaigns STEPS WHO's STEPwise approach 145 APPENDIX IIl:Status of the WHO Framework Convention on Tobacco Control to Surveillance USS United States dollar 150 ACKNOWLEDGEMENTS WHO World Health Organization E1 APPENDIX IV:Global tobacco control policy data WHO FCTC WHO Framework Convention on Tobacco E250 APPENDIX V:Country profiles Control E364 APPENDIX VI:Graphs on tobacco taxes and prices WHO TFI E388 APPENDIX VIl:Age-standardized prevalence estimates for smoking,2009 WHO Tobacco Free Initiative E420 APPENDIX VIll:Country-provided prevalence data E462 APPENDIX IX:Global Youth Tobacco Survey data WPR WHO Western Pacific E504 APPENDIX X:Maps on global tobacco control policy data Region Appendices IV through X are available in electronic format on the CD accompanying this book and online at http://www.who.int/tobacco/
ABBREVIATIONS AFR WHO African Region AMR WHO Region of the Americas CDC Centers for Disease Control and Prevention COP Conference of the Parties to the WHO FCTC EMR WHO Eastern Mediterranean Region EUR WHO European Region NRT nicotine replacement therapy SEAR WHO South-East Asia Region STEPS WHO's STEPwise approach to Surveillance US$ United States dollar WHO World Health Organization WHO FCTC WHO Framework Convention on Tobacco Control WHO TFI WHO Tobacco Free Initiative WPR WHO Western Pacific Region 62 Enforce bans on tobacco advertising, promotion and sponsorship 66 Raise taxes on tobacco 70 National action is critical to achieve the vision of a tobacco-free world 74 CONCLUSION 76 REFERENCES 82 TECHNICAL NOTE I: Evaluation of existing policies and compliance 86 TECHNICAL NOTE II: Smoking prevalence in WHO Member States 88 TECHNICAL NOTE III: Tobacco taxes in WHO Member States 93 APPENDIX I: Regional summary of MPOWER measures 107 APPENDIX II: Regulation of warning labels on cigarette packages and national anti-tobacco mass media campaigns 145 APPENDIX III: Status of the WHO Framework Convention on Tobacco Control 150 ACKNOWLEDGeMENTS E1 APPENDIX IV: Global tobacco control policy data E250 APPENDIX V: Country profiles E364 APPENDIX VI: Graphs on tobacco taxes and prices E388 APPENDIX VII: Age-standardized prevalence estimates for smoking, 2009 E420 APPENDIX VIII: Country-provided prevalence data E462 APPENDIX IX: Global Youth Tobacco Survey data E504 APPENDIX X: Maps on global tobacco control policy data Appendices IV through X are available in electronic format on the CD accompanying this book and online at http://www.who.int/tobacco/
Over the past two years,1.1 billion people have become covered by at least one MPOWER measure newly applied at the highest level. People have an inherent right to receive information about the health dangers of tobacco use,and countries have an obligation to provide it. Dr Ala Alwan,Assistant Director-General,World Health Organization
Over the past two years, 1.1 billion people have become covered by at least one MPOWER measure newly applied at the highest level. People have an inherent right to receive information about the health dangers of tobacco use, and countries have an obligation to provide it. Dr Ala Alwan, Assistant Director-General, World Health Organization
PROGRESS CONTINUES NEARLY 3.8 BILLION PEOPLE ARE NOW COVERED BY AN EFFECTIVE TOBACCO CONTROL MEASURE detailed national-level data collected on a The number of people now protected by This report appears at a crucial moment global basis for anti-tobacco mass media in the fight against the growing epidemic tobacco control measures is growing at a campaigns of noncommunicable diseases (NCDs) remarkable pace.The progress made on applying measures that reduce the demand The data are impressive.More than -primarily cancers,diabetes,and for tobacco is a sign of the increasing impact 1 billion people now live in countries with cardiovascular and chronic lung diseases -which account for 63%of all deaths of the WHO Framework Convention on legislation that requires large graphic health worldwide and for which tobacco use is one Tobacco Control,which continues to be one warnings on every cigarette pack sold in their countries,and 1.9 billion people live of the biggest contributing agents.These of the most rapidly embraced,measurably diseases kill an astounding 36 million people successful treaties in United Nations history. in the 23 countries that have aired high- quality national anti-tobacco mass media each year,with 80%of deaths occurring in This report,the third periodic country-level low-and middle-income countries that can campaigns within the past two years.It examination of the global tobacco epidemic, least afford them.An estimated 9 million is clear that substantial progress is being identifies the countries that have applied deaths occur below the age of 60 years.On made against this deadly product.Low-and effective tobacco control measures that middle-income countries have been in the 19-20 September 2011,the United Nations save lives.These countries can be held up as General Assembly will hold its first-ever forefront of developing anti-tobacco mass models of action for the many countries that high-level meeting to consider the threat media campaigns,showing that countries need to do more to protect their people from and impact of noncommunicable diseases can successfully implement this intervention the harms of tobacco use.Tobacco continues on global health and human development. regardless of income dassification. to kill nearly 6 million people each year, Heads of State will discuss during this induding more than 600 000 non-smokers Nevertheless,the tobacco epidemic meeting in New York how to raise awareness who die from exposure to tobacco smoke.Up continues to expand because of ongoing of and plot strategies against this cluster to half of the world's 1 billion smokers will tobacco industry marketing,population of related diseases that share several risk eventually die of a tobacco-related disease. growth in countries where tobacco use is factors,most notably tobacco use. However,we have the power to change these increasing,and the extreme addictiveness circumstances. of tobacco that makes it difficult for people Because tobacco use and exposure to to stop smoking once they start.Although tobacco smoke cause a large proportion of Over the past two years,1.1 billion people there has been progress,only 19 countries global illness and death,tobacco control have become covered by at least one follow best-practice standards by requiring must be given the high priority it deserves MPOWER measure newly applied at the highest level.This is the result of action large graphic health warnings on tobacco so that we can expand on the successes we product packages-none of which are have already realized.Consequently,tobacco taken by 30 countries-over half of them low-income countries.All countries,in control measures are expected to be scaled classified as low-or middle-income-which partnership with the United Nations,health up as a core component of the outcome for have applied measures that,while requiring development agencies and civil society, the United Nations high-level meeting on relatively little investment,are proven to be NCD's. can and must do more by meeting their highly effective at changing tobacco use commitments under the WHO Framework As Dr Margaret Chan,Director-General of patterns and saving lives. Convention on Tobacco Control and its the World Health Organization has said, The focus of this report is on warning people corresponding guidelines. "What gets measured gets done".This about the harms of tobacco use.People have report is a strong and important step in our an inherent right to receive this information, ongoing measurement of what has been and countries have an obligation to provide achieved in tobacco control and how much it.The two main types of warnings are more countries need to do.We can and must examined:health warning labels on tobacco continue this work-millions of people's packages and national anti-tobacco mass lives are at stake. media campaigns.Large and graphic warning labels and hard-hitting mass media Dr Ala Alwan campaigns have proven effective in reducing Assistant Director-General tobacco use and encouraging people to World Health Organization quit.This report presents for the first time WHO REPORT ON THE GLOBAL TOBACCO EPIDEMIC,2011
WHO REPORT ON THE GLOBAL TOBACCO EPIDEMIC, 2011 7 Progress continues – nearly 3.8 billion people are now covered by an effective tobacco control measure detailed national-level data collected on a global basis for anti-tobacco mass media campaigns. The data are impressive. More than 1 billion people now live in countries with legislation that requires large graphic health warnings on every cigarette pack sold in their countries, and 1.9 billion people live in the 23 countries that have aired highquality national anti-tobacco mass media campaigns within the past two years. It is clear that substantial progress is being made against this deadly product. Low- and middle-income countries have been in the forefront of developing anti-tobacco mass media campaigns, showing that countries can successfully implement this intervention regardless of income classification. Nevertheless, the tobacco epidemic continues to expand because of ongoing tobacco industry marketing, population growth in countries where tobacco use is increasing, and the extreme addictiveness of tobacco that makes it difficult for people to stop smoking once they start. Although there has been progress, only 19 countries follow best-practice standards by requiring large graphic health warnings on tobacco product packages – none of which are low-income countries. All countries, in partnership with the United Nations, health development agencies and civil society, can and must do more by meeting their commitments under the WHO Framework Convention on Tobacco Control and its corresponding guidelines. The number of people now protected by tobacco control measures is growing at a remarkable pace. The progress made on applying measures that reduce the demand for tobacco is a sign of the increasing impact of the WHO Framework Convention on Tobacco Control, which continues to be one of the most rapidly embraced, measurably successful treaties in United Nations history. This report, the third periodic country-level examination of the global tobacco epidemic, identifies the countries that have applied effective tobacco control measures that save lives. These countries can be held up as models of action for the many countries that need to do more to protect their people from the harms of tobacco use. Tobacco continues to kill nearly 6 million people each year, including more than 600 000 non-smokers who die from exposure to tobacco smoke. Up to half of the world’s 1 billion smokers will eventually die of a tobacco-related disease. However, we have the power to change these circumstances. Over the past two years, 1.1 billion people have become covered by at least one MPOWER measure newly applied at the highest level. This is the result of action taken by 30 countries – over half of them classified as low- or middle-income – which have applied measures that, while requiring relatively little investment, are proven to be highly effective at changing tobacco use patterns and saving lives. The focus of this report is on warning people about the harms of tobacco use. People have an inherent right to receive this information, and countries have an obligation to provide it. The two main types of warnings are examined: health warning labels on tobacco packages and national anti-tobacco mass media campaigns. Large and graphic warning labels and hard-hitting mass media campaigns have proven effective in reducing tobacco use and encouraging people to quit. This report presents for the first time This report appears at a crucial moment in the fight against the growing epidemic of noncommunicable diseases (NCDs) – primarily cancers, diabetes, and cardiovascular and chronic lung diseases – which account for 63% of all deaths worldwide and for which tobacco use is one of the biggest contributing agents. These diseases kill an astounding 36 million people each year, with 80% of deaths occurring in low- and middle-income countries that can least afford them. An estimated 9 million deaths occur below the age of 60 years. On 19–20 September 2011, the United Nations General Assembly will hold its first-ever high-level meeting to consider the threat and impact of noncommunicable diseases on global health and human development. Heads of State will discuss during this meeting in New York how to raise awareness of and plot strategies against this cluster of related diseases that share several risk factors, most notably tobacco use. Because tobacco use and exposure to tobacco smoke cause a large proportion of global illness and death, tobacco control must be given the high priority it deserves so that we can expand on the successes we have already realized. Consequently, tobacco control measures are expected to be scaled up as a core component of the outcome for the United Nations high-level meeting on NCD’s. As Dr Margaret Chan, Director-General of the World Health Organization has said, “What gets measured gets done”. This report is a strong and important step in our ongoing measurement of what has been achieved in tobacco control and how much more countries need to do. We can and must continue this work – millions of people’s lives are at stake. Dr Ala Alwan Assistant Director-General World Health Organization