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WNTD 2000 QUIT
World No Tobacco Day, May 31, 2000
Backgrounder 5/5

Tobacco Control and Government Options

As guardians of the health of their citizens, governments have many options in taking action to reduce tobacco use. The interventions described below can help societies quit their dependency on tobacco. The extent to which countries are able to intervene and how they intervene depend greatly on the economic and social circumstances of each country. But experience from around the world suggests that as countries invest more in tobacco control, the impact on tobacco use will be higher, and the improvements to health will be greater. Investment in tobacco control will not only yield the returns of a healthier population, but also help reduce health care costs, and improve sustainable development.

Leading by Example

  • Federal, state/provincial, and local governments should provide smoke free workplaces for all government employees. If smoking areas are allowed, they should be separately ventilated from the rest of the work place.
  • Governments should provide support for employees who want to quit smoking, such as smoking cessation counseling in the workplace and subsidies for pharmaceutical cessation aids where available.

Healthy Public Policies

The conclusions of a new World Bank Report on tobacco clearly outline the need for healthy public policies that will cut tobacco use. These include:

  • Tobacco taxes. Although there is no single "optimal" tax level, countries with comprehensive and effective tobacco control policies generally have tax levels between 2/3 and 4/5 of the retail price of tobacco. Regular tax increases may be necessary to ensure that tobacco does not become more affordable as a result of inflation and rising incomes.
  • Health information on tobacco packages. Small health warnings on packages, usually found on the side in small print, tend to be ignored. More effective is information that is specific, relevant, novel, and takes up a significant portion of the package. Large warnings, photos, and other information can help smokers by motivating them to quit, and decrease the allure of the package to youth.
  • Comprehensive restrictions on tobacco promotion. Countries that restrict promotion to the maximum extent possible, in a comprehensive manner, have found such bans to be effective. A comprehensive ban should prohibit direct advertising, indirect promotion through sponsorships of sports and cultural events, and promotion through non-tobacco items and services such as t-shirts, matchbooks and travel agencies. It should also include all media: radio, television, internet, print, outdoor and point-of-sale advertising. Several countries have implemented or soon will implement advertising bans, including the European Union, where all tobacco advertising and sponsorships will be banned in 2006.
  • Restrictions on smoking in work places, including public places. Employees have a right to be protected from work place health hazards, including second-hand tobacco smoke. Prohibitions on smoking in work places or separately ventilated smoking areas can provide adequate protection from these hazards. Governments at the national, regional and local level can help ensure smoke-free environments in work places, including public places such as restaurants. Studies show that this can be done without reducing business, and that in some cases smoke-free policies increase business and cut down on employer costs.
  • Smuggling controls. In many countries, the availability of cheap smuggled tobacco undermines efforts to reduce tobacco use and reduces country revenue from tobacco taxes. Countries can benefit from smuggling control strategies that include resources for law enforcement, adequate penalties, tax markings on packages, and tracking systems to monitor exports.

Investment in Health and Community Infrastructures

Healthy public policies work best when they are reinforced by other interventions at various levels. By implementing policies and complementary programs, governments can increase the effectiveness of both.

  • Support for smoking cessation. Quitting smoking is very difficult, but success is greatly increased by behavioral counseling and pharmaceutical treatment. National health systems should include support for these interventions, including reimbursing health professionals for providing advice to smokers who want to quit. Governments can also implement toll-free telephone "hotlines" and other measures to help smokers quit.
  • Public information campaigns. Mass media campaigns have been used successfully in many jurisdictions to inform the public and build support for other tobacco control interventions. These campaigns can tie together diverse activities and messages and increase their impact. For maximum effectiveness, campaigns need to be professionally designed and use paid advertisements in print, television and radio to ensure adequate visibility.
  • Support for non-governmental organizations. In countries with effective tobacco control interventions, non-governmental organizations have been an integral part of achieving success. Medical and other health professional societies, health charities such as cancer

societies and heart associations, and tobacco control coalitions can provide expertise on issues, raise public awareness, and make available educational, prevention and cessation programs.

  • Support for community action. Local action reinforces national messages and builds support for stronger policies on tobacco. Support to local governments or community groups can help involve citizens, implement and enforce smoke-free and other policies, and tailor national interventions to the diverse needs of specific communities.

Monitoring and Evaluation

Accurate and current information about tobacco use, tobacco-caused death and disease, and public knowledge and attitudes is necessary to measure progress and the impact of interventions. Countries should implement monitoring systems such as the Global Youth Tobacco Survey, the Global Survey of Health Professionals, or other surveys to obtain comparable data, and should collect data on tobacco-caused death and disease.

Assisting Tobacco Growing Communities

Reducing tobacco use will benefit most economies. Some tobacco growing communities will gradually experience economic transition, but governments and other groups can work with these communities in developing strategies to ensure their long-term well being, such as transitional subsidies and policies to encourage alternative crops and livelihoods.

Financing for Interventions
  • Many interventions, such as tobacco control policies, cost little to implement except for enforcement costs, and end up providing great financial benefits to countries by reducing health care costs. Other interventions can be financed through tobacco taxes, as is the case in many states in the United States, Australia and elsewhere. By investing tobacco tax revenue in tobacco prevention and control programs, governments can save lives and prevent illness, rather than having to pay for health care for those suffering tobacco-related illnesses.
  • An international treaty, the Framework Convention on Tobacco Control, soon to be negotiated by countries, may include a financial mechanism to help developing countries implement tobacco control interventions. Developing countries that participate in the negotiation process can help ensure their needs are considered.

For more information contact:

Heather Selin (202) 974-3383; selinhea@paho.org

Bryna Brennan (202) 974-3457; brennanb@paho.org