With tobacco-related deaths surpassing 8 million each year, the battle against tobacco’s detrimental effects remains a pressing global health concern. On July 31, 2023, the ninth WHO report on the global tobacco epidemic was unveiled, underscoring the urgency to address tobacco consumption, revealing both notable achievements and areas that warrant increased attention.
The report highlights a significant trend: an increasing number of countries are steadily advancing in safeguarding their citizens from tobacco-related risks. This advancement is particularly highlighted by the statistic that now, 5.6 billion individuals worldwide are covered by at least one effective tobacco control policy, a five-fold surge from 2007.
The report tracks the progress made by countries in tobacco control since 2008 and, marks 15 years since the introduction of the MPOWER technical package which is designed to help countries implement the demand-reduction measures of the WHO Framework Convention on Tobacco Control. The report shows that many countries continue to make progress in the fight against tobacco, but efforts must be accelerated to protect people from the harms of tobacco and second-hand smoke.
Despite the progress, only four countries, namely Brazil, Mauritius, the Netherlands and Turkey have adopted all the anti-tobacco measures recommended by the MPOWER package. The WHO has urged countries to scale up their use of recognised measures to reduce tobacco use, including enforcing advertising bans, plastering health warnings on cigarette packages, raising tobacco taxes and providing assistance to those who want to quit.
A prominent focus of the report is directed towards the establishment of smoke-free zones. In 2022, a substantial leap was achieved, providing protection to 2.1 billion people in smoke-free indoor public spaces, workplaces, and public transportation—a remarkable seven-fold increase since 2007. While the progress highlighted in the report is praiseworthy, there remains a scope for improvement. The well-being of a nation’s population should consistently take precedence, and countries can continuously enhance their efforts in this vital domain.
The journey of progress is vividly reflected in the numbers: the number of countries embracing one or more MPOWER measures has surged from 44 in 2007 to an impressive 151 in 2022. Additionally, the ranks of countries enacting two or more MPOWER measures have swelled nearly ten-fold, escalating from 11 to 101 nations. Moreover, 48 countries stand firm with three or more policies, extending protection to 1.5 billion individuals.
Despite the steady progress witnessed since 2007, it’s crucial to acknowledge that the pace has decelerated since 2018. Over the past two years, five countries—Cabo Verde, Myanmar, Nicaragua, Sudan, and Zambia—previously bereft of best-practice measures, have elevated their efforts to attain the highest level of achievement in one or more measures. Significantly, all five nations fall under the low- or middle-income category, highlighting the universal nature of the struggle.
Drilling down into specific measures, the report spotlights the paramount importance of shielding individuals from tobacco smoke—a pivotal focus of this year’s report. The comprehensive coverage of smoke-free environments in public indoor areas emerges as a compelling narrative. The global report reveals that in 2022, a staggering 2.1 billion people across 74 countries were now protected by smoke-free laws spanning indoor public places, workplaces, and public transportation. This marks an awe-inspiring seven-fold surge since 2007, underscoring the burgeoning success of smoke-free initiatives.
The effectiveness of these smoke-free environments is twofold: they safeguard non-smokers from second-hand smoke’s perils and contribute to “denormalizing” smoking, incentivizing smokers to contemplate quitting. Importantly, the number of people newly shielded by these smoke-free laws exceeds 2 billion, a testament to the profound impact of policy changes.
However, challenges persist, particularly in the realm of designated smoking areas or rooms (DSRs). The report underscores that 71 countries still permit DSRs, particularly prevalent in hospitality venues like restaurants, bars, and cafés. A noteworthy revelation is that the eradication of these provisions in 39 countries could instantly elevate their status to best-practice level, a stark reminder of the room for improvement.
Moving forward, it’s encouraging to note that eight countries stand merely one measure away from achieving all MPOWER measures at the highest level of accomplishment. Within this group, Ethiopia, the Islamic Republic of Iran, Ireland, Jordan, Madagascar, Mexico, New Zealand, and Spain are primed to lead by example.
While the progress of tobacco control is heartening, the report doesn’t shy away from revealing stark disparities. Over 2 billion people remain devoid of any protective measures offered by MPOWER. Among the areas that demand attention, banning tobacco advertising, promotion, and sponsorship (TAPS) stands out as a pivotal battleground. In 2022, seven countries ascended to the highest level of TAPS bans, signifying a positive trajectory. Yet, it’s evident that high-income countries lag in this aspect, underlining the necessity for global cooperation.
Graphic health warning policies assume a central role in the report, covering over 4.5 billion people or 57% of the global population. This measure secures the highest population coverage among MPOWER’s components and spans a diverse array of countries. The surge in adoption of such policies reflects the growing acknowledgment of their efficacy in deterring tobacco use.
A poignant challenge remains in the realm of electronic nicotine delivery systems (ENDS). While 121 countries have enacted regulations in some form, 74 countries continue to lack any ENDS ban or regulations, leaving over 2 billion people at risk. The complex landscape of ENDS regulation underscores the need for a cohesive approach to safeguarding populations, especially the youth who are often targeted by enticing flavors.
In conclusion, the report underscores the undeniable progress made in tobacco control, fueled by MPOWER measures and global collaboration. However, it serves as a clarion call for continuous efforts to accelerate progress, protect populations, and ensure a healthier future free from the shackles of tobacco’s harm.
India’s Tobacco Control Progress Evaluated Through MPOWER Indicators
The MPOWER package, a comprehensive framework outlined by the World Health Organization (WHO), lays out strategic areas of action to combat the global tobacco epidemic. These encompass a range of key objectives:
- 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
Assessing India’s performance against these MPOWER indicators provides insight into the nation’s strides and areas that warrant further focus.
As of 2021, India’s adult daily smoking prevalence stands at 6 percent, reflecting a significant step towards reducing tobacco consumption. In key aspects of tobacco control, India excels in offering assistance to individuals aiming to quit tobacco use. The country’s endeavors to raise awareness about the hazards of tobacco consumption also stand out, emphasizing the importance of educating consumers.
A closer look at compliance with bans on tobacco advertising, promotion, and sponsorship, as well as adherence to smoke-free laws, reveals a moderate level of success. While there’s room for improvement, India’s commitment to limiting tobacco industry influence is evident.
In terms of smoke-free environments and smoking bans, India’s progress places it in the moderate category. With six to seven public places entirely smoke-free, the nation showcases a significant effort to protect citizens from the dangers of second-hand smoke.
India’s performance in mass media anti-tobacco campaigns is commendable, marked by the execution of a national campaign featuring five to six appropriate characteristics. This approach underscores India’s commitment to disseminating essential information about the perils of tobacco use, effectively targeting a wide audience.
On the taxation front, where raising prices is a potent tool to deter tobacco consumption, India’s share of total taxes in the retail price of the most widely sold brand of cigarettes stands at 57.6 percent. This signifies an effort to discourage tobacco use through increased costs.
India’s journey in tackling the tobacco epidemic is characterized by both achievements and opportunities for growth. While offering aid to quit tobacco use and warning the public about its dangers have yielded commendable results, measures related to advertising bans, smoke-free environments, and taxation still hold potential for further advancement. As India continues to navigate the challenges of tobacco control, its commitment to the MPOWER indicators and WHO’s strategic framework underscores the nation’s dedication to creating a healthier, smoke-free future for its citizens.
References:
https://www.who.int/publications/i/item/9789240077164
https://www.downtoearth.org.in/news/world/only-four-countries-making-full-efforts-to-end-smoking-who-89881 https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(22)00341-2/fulltext
Picture Credits: – NDTV