Public Health Perspectives on Tobacco Control: The Framework Convention

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In 2003, the World Health Organization (WHO) member states successfully negotiated the organization’s first ever framework convention on tobacco control. The aim of negotiating this particular framework was with a view to ensuring global accountability in public health. This means that the Public Health Perspective on Tobacco Control is recognized and certified by the World Health Assembly (WHA). At the moment, it is made up of nearly 190 member states.

Prior to drafting of the FCTC, a number of products and services provided by individuals and corporations both locally and internationally had resulted in a lot of damage. Therefore, the FCTC was meant to address some of these issues regarding tobacco products as well as their processes. Look at from another perspective, the FCTC could be regarded as an attempt to protect and save millions of lives who have are daily exposed to the dangers of tobacco use (Hawkes & Yach, 2007, p. 1).

Even as the FCTC agreement is more of a health mitigation guideline, it also has the potential to gradually do away with many tobacco-related problems. The main role of the FCTC is to handle the menace of illicit trading of tobacco products, and the associated liability in sponsorships, promotions, information disclosure and regulation of tobacco products to minority groups. In addition, it also deals with the issues of advertising and product labeling, public awareness, education and training on the dangers of such products.

Moreover, the FCTC is also involved in cessation procedures, tobacco dependencies, and efforts to protect passive smokers. Upon its inception, the treaty was meant to completely eradicate tobacco-related problems (Headen & Robinson, 2001). The treaty could not have been formulated at a better time because in the 1990s, majority of the states were actively involved in the establishment of trade unions.

Before the FCTC came into existence, citizens of poor nations were being blatantly exposed to the dangers of tobacco, among other dangerous materials. On the other hand, citizens of rich nations were not exposed to the similar dangers of tobacco use. As such, the establishment of the FCTC treaty was intended to assist in curbing such malicious exposure in order to lower tobacco exposure in the developing as well as the developed nations.

By eradicating or reducing most of the tobacco related problems, it was hoped that this would curb the deterioration of the global economy and also reverse the declining population by maintaining and restoring good human health to enable individuals to get more involved in developmental and economic activities and still reduce the cost incurred by tobacco-related problems.

Simply put, the FCTC is mainly concerned with economic and health issues. The establishment of the FCTC in 2003 led to the production of a lot of literature material on tobacco use. This was intended to curb the problems associated with tobacco use. You can find some of this content online in softcopy. Other hard copy material can be found at different institutions and organizations.

While searching for relevant material on the subject manner, two articles that that appeared to address the issues of the tobacco menace at great length were found.

One of the articles was titled, ‘implementing smoke-free environment’ while the other one was titled, “smoking cessation and the right to health”. The two articles mainly seemed to address tow fundamental techniques/strategies useful in helping to curb the tobacco menace both local and internationally and for this reason, they were found to be of great significance (U.S. Office of the Surgeon General, 2006, p. 6).

The contents of the two articles helped to shed more light on the tobacco use menace. This is important, because it offers the victims of tobacco products hope of redemptions form the imminent danger of tobacco use.

Upon undertaking further research to gain more insight into the implementation of the policy in various sections of the world, the writer was motivated enough to read the entire articles. In this case, the experiences acquired upon the implementation of the aforementioned two strategies in Uganda, Sudan, and Kenya was important, based on the most of the published work.

In choosing the three aforementioned countries, use was made of rational and logical reasoning, as opposed to random arbitrary technique. The statistical data choices implemented while making the choices were affirmed on rational and logical grounds. Statistics from the World Health Organization show that nearly 5 million individuals die every year from tobacco-related illnesses. Of these, almost 50% are from the developing countries.

The report further indicated that over 500,000 individuals die every year due to second-hand smoking. These figures are projected to rise worldwide and in the next three decades, they shall have increased three-folds (Mclean, 2002, p. 361).

On the other hand, this increase would not be proportional to the figures estimated from the developing nations, such as the three aforementioned countries. By taking part in this study, the intention was to exploring the level of preparedness of the developing nations in dealing with the tobacco menace by way of implementing some of the strategies advocated for by the FCTC (Hawkes & Yach, 2007, p. 5).

Two of the main strategies advocated for by the FCTC in order to do away with the tobacco menace include a smoke-free environment and cessation. Even as these issues are well addressed in the FCTC literature, on the other hand, there are variations with regard to their implementation from one country to another (American Academy of Pediatrics, 2004, p. 8).

The two articles confirmed that citizens of the three countries were highly predisposed to tobacco-related risks. The articles have described majority of the residents in Uganda, Kenya and Sudan as ardent consumers of tobacco products, while some of them are already addicted to these products. These findings reveal that implementing both the cessation and smoke-free environment in the three countries would play a key role in the fight against tobacco use.

The use of tobacco products among Kenyan males was lower in comparison with their counterparts in the two other countries. Nonetheless, the overall rate of consumption of tobacco products in the three countries is almost similar. The ruling authorities in the three countries appeared to have made little progress in the areas of cessation.

Despite there being an awareness of the term cessation among individuals in various state authorities, very few of them were actually trying to implement this strategy (Boonn, 2010). In addition, evidence from various reports demonstrated total or little devotion on the part of the government regarding the cessation processes (Campaign for Tobacco-Free Kids, 2005). In both Uganda and Kenya, cessation efforts were mainly being undertaken through the health sector, along with the associated divisions (Hahn, 2009, p. 35).

In addition, only few policies that have been formulated by the government to assist in cessation processes. Weak funding and little concern about law enforcement mechanisms are indicative of the high level of passiveness on the part of the government in the implementation and support of cessation policies.

By directing the cessation programs to the health sector, this is a sign that the government is not willing to incur the cost of implementing such policies and in helping those who are in need of them (Bailey et al, 2003, p. 47). In this case, the same healthcare providers are used to accompish two different kinds of jobs (Rehm , 2006, p. 34). Such an approach comes at a disadvantage to physicians, nurses and other health care providers as they are normally required to undertake additional responsibilities.

Consequently, the healthcare providers tend to be dissatisfied as evidenced by their mild responses, not to mention that some of them do not even provide cessation services to those in need. Others offer the services reluctantly even as their provision of quality health care services declines.

These practices are a sign that the countries have failed to accomplish the anticipated health improvements via the cessation process owing to a poor overall approach (Campaign for Tobacco-Free Kids, 2006). Consequently, this has a negative impact on other healthcare services intended to treat various tobacco-related malignancies (American Lung Association, 2006, p. 9).

With regard to the issue of establishing smoke-free environment, nothing much has been done by the three countries, and the approach resembles the one of cessation procedures. Nonetheless, there is ample evidence to suggest that the three government are committed the creation of a smoking free-environment, albeit in an indirect way.

For example the Kenyan government has enacted a number of policies to assist in the creation of a smoke-free environment. Also, the government has funded various non-governmental initiatives aimed at assisting the citizens to stop smoking within certain designated areas. In this case, the municipal council is charged with the responsibility of enforcing these policies (Anderson, 2004, p. 452).

With regard to the issue of policy formulation in creating a smoke-free environment, the Kenyan government has already enacted policies that prohibits smoking is social and public places, and this is a big step towards curbing the menace (Zwar, 2007, p.126). The Kenyan government has also established designated smoking zones.

The Sudanese and Ugandan governments are yet to implement similar policies. Whereas this could be seen as a big step towards the attainment of the FCTC goals, it could also be seen as a form of negative progression. To start with, discouraging smoking in public places while creating smoking zones does little to discourage the behavior. There is also a failure on the part of the government in terms of defining social and public places in relation to the environment.

It is important to note that the two policies are not in any way useful in the creation of smoke-free zones (Anderson, 2004, p. 452). One way to combat tobacco use is by imposing heavy taxes on tobacco-related products. Heavy taxation is among the key elements of the FCTC that have been crucial in trying to achieve a tobacco-free environment. Because heavy taxation on tobacco products would eat into the profits of investors, the idea is to create diversion in investing in the industry.

At the same time, highly priced tobacco products would also discourage users to consume these products. Consequently, some consumers stop using the products of tobacco firms. By sidetracking consumers, tobacco firms are likely to operate at a loss and may eventually close down (CDCP, 2008).

Another implication is that these clients could be obliged to consume other forms of products with additional nutritional value, other that the tobacco products. Besides, discouraging smoking by overtaxing tobacco products forces investors in the industry to consider other options (Mclean, 2002, p. 67).

A good example of a government that has adopted the idea of taxation to derail the tobacco industry is Indonesia. Although Indonesia is not a developed nation, the government has created the right environment to facilitate the implementation of this policy. In addition, the Indonesian government has embraced peace and democracy in the establishment of corruption-free territories. Against this backdrop, the Indonesian government decided to increase the price of tobacco products by more than 13 %.

This translates into a consumption deficit of 3 billion cartons. At the same time, approximately 3.5 million people have stopped smoking, and the government realised nearly 17 million dollars in revenue collection. In contrast, the three African countries are marred by corrupt habits and chaotic environments that have seen citizens continue to use tobacco products in spite of the high cost (CityMatCH, 2005, p. 5).

Most poor and developing countries seem not to have made much progress in trying to implement the FCTC components. Nonetheless, there is a lot of optimist that they shall establish the ideal standards to enable them progress with the war on tobacco use.

However, this shall be solely determined by the ability of the World Health organization (WHO) to establish a strong channel that will collect the necessary information to facilitate the implementation of policies and decisions that affect individuals, local, regional and international communities. In an effort to contain the tobacco menace, the WHO has adopted a three strategy model, that is, structural, developmental process as well as information outcomes and data assessment (World Health Organization, 2004).

Already, there is a clear indication that the WHO is committed to facilitating in the achievement of the FCTC activities by collaborating with other like-minded organizations. For example, the Center for Disease and Prevention, the WHO and the Canadian Public Health Association have put in place a survey kit to monitor the consumption of tobacco products across various demographics of the human race.

By creating a global tobacco surveillance system, the aforementioned organizations have in effect created a structural path that will allows accessibility to even the smallest of institutions like schools where smoking could be deep-rooted largely due to peer-pressure. In addition, it will also be possible to access large multinational organizations charged with the responsibility of designing and developing critical policies and rules.

Also, it will become easier to establish community training and educational systems to fight the tobacco menace. Data collected via these key tools or instruments are crucial in providing clear information to enable leaders from different countries to fully appreciate the severity of the effects of using tobacco products. It shall also serve the purpose of creating the best opportunity to address the arising problems (World Health Organization, 2004).

Many individuals have generally criticized the FCTC/WHO surveillance and control programs, and that the organization is passively and indirectly involved in implementing the necessary remedial measures; nonetheless, the WHO has play an active and direct role in organizing various events aimed at reducing the effects of tobacco use across the globe. Such efforts involve organizing world conferences at various countries.

Other efforts of the WHO include organizing international conventions where participants can use data and records from the grassroots level to assess the tobacco situation and also propose remedial measures to take in future in order to curb the menace (World Health Organization, 2004).

Reference List

American Academy of Pediatrics. (2004). Dangers of secondhand smoke. Chicago: American Academy of Pediatrics.

American Lung Association. (2006). Freedom from smoking: Clinic facilitator training workshop manual. New York: American Lung Association.

Anderson, L. (2004). A Guide to patient recruitment and retention. Boston, Mass: Thomson Healthcare Inc.

Bailey, L., Furmanski , W., & Edsall, E. (2003). From challenge to opportunity: Organizing, financing and delivering statewide tobacco cessation services and activities Washington, D. C.: Center for Tobacco Cessation.

Boonn, A. (2010). Tobacco cessation works: An overview of best practices and state experiences. Washington, D.C.: Campaign for Tobacco-free.

Campaign for Tobacco-Free Kids. (2005). Research and facts, Factsheets, Tobacco and kids. Web.

Campaign for Tobacco-Free Kids. (2006). A broken promise to our children: The 1998 State Tobacco Settlement eight years later. Washington, D.C.: Campaign for Tobacco-Free Kids.

CDCP. (2008). Smoking-Attributable Mortality, Years of Potential Life Lost, and Productivity Losses. Atlanta, GA: Center Of Disease Control and Prevention.

CityMatCH. (2005). Youth smoking prevention. New York: City Match.

Hahn, R. (2009). Anthropology and Public Health: Bridging Differences in Culture and Society. Michigan: Oxford Scholarship.

Hawkes, C. & Yach, C. (2007). The world’s framework convention on tobacco control: implications for global epidemics of food related deaths and disease. J Public Health Policy,24(2/4), 274-90.

Headen, W., & Robinson, G. (2001). Tobacco: from slavery to addiction in Braithwaite and Taylor. New York: Health Issues in the Black Community.

Mclean, S. (2002). Management of tobacco and alcohol drug problem. Oxford, Mass: Oxford University Press.

Rehm, J., Taylor, B., & Room, R. (2006). Global burden of disease from alcohol, illicit drugs and tobacco. Drug and alcohol Review, 25, 502- 512.

U.S. Office of the Surgeon General. (2006). The health consequences of involuntary exposure to tobacco smoke. Rockville: Office of the Surgeon General.

World Health Organization. (2004). . Web.

Zwar, N. (2007).Tobacco and cardiovascular diseases incomprehensive management of high risk cardiovascular patients. New York: US information healthcare.

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