Governance for tobacco control, in accordance with WHO FCTC Article 5, includes enacting and implementing tobacco legislation and regulations; promoting compliance and enforcing legislation; developing national tobacco control strategies; and reinvigorating or establishing mechanisms for multisectoral coordination.

Tobacco control requires health and non-health sectors to work together as well as policy coherence across whole of government. It is critical that there is alignment of both policies and will among them all. Stakeholders include policymakers across areas of health, finance, trade, education and more, academics, and civil society organisations.

FCTC 2030 partners have played an important role in engaging with these various stakeholders to support coordinated and focused action for tobacco control. 

“The tobacco industry has operated for years with the express intention of subverting the role of governments and of WHO in implementing public health policies to combat the tobacco epidemic.” – as stated in the World Health Assembly resolution WHA54.18. 

The tobacco industry employs a range of tactics to undermine or subvert tobacco control efforts and influence policy, and is a barrier to the successful implementation of the WHO FCTC. Tactics include political lobbying, financing research, and undertaking social responsibility initiatives. Addressing tobacco industry interference is key and WHO FCTC Article 5.3 and its implementation guidelines provide recommendations on how to protect public health policies with respect to tobacco control from commercial and other vested interests of the tobacco industry. In countries with less stringent tobacco control regulations, the tobacco industry has a greater sway in policymaking and promotion of tobacco products. In low- and middle-income countries (LMICs) in particular, population demographics often differ from high-income countries (HICs) such that a greater proportion of the population is younger and therefore an attractive population for the tobacco industry to encourage uptake of tobacco products.

 The FCTC 2030 project has assisted several countries in countering tobacco industry interference through the provision of technical support and expertise and facilitating multi-sectoral collaboration. 

Tax and price policies are widely recognized to be one of the most effective means of influencing demand for and thus consumption of tobacco products. A large body of evidence shows that, despite tobacco being highly addictive, consumption of tobacco products does decrease in response to price increases. Studies show that for every 10% increase in price, consumption decreases by between 4% and 8%. When uniform specific taxes are applied, it reduces incentives for people to switch to cheaper options. In addition to decreasing consumption, extra revenue from taxation can also be reinvested in tobacco control and public health measures.

Increasing taxation on tobacco products can be a challenging process – the FCTC 2030 project has therefore offered technical expertise in economic modelling as an evidence base for taxation and tax increases, as well as supported engagement of multi-sectoral stakeholders involved in taxation policy. 

Tobacco packaging is an important element of advertising and promotion. Article 11 of the WHO FCTC and its implementation guidelines recommend actions to increase effectiveness of packaging and labelling measures, and Article 13 addresses tobacco advertising, promotion and sponsorship. Changing the way that tobacco products are packaged, marketed and sold is key to reducing their attractiveness, presence and prominence and thereby decrease consumer demand. Instead of branded packages, plain packaging and the incorporation of health warnings have been shown to reduce the attractiveness of tobacco products and effectively address misleading and deceptive packaging. The recent World Trade Organization (WTO) Appellate Body ruling in favour of Australia’s plain packaging laws paves the way for other Parties to pursue plain packaging. Plain packaging, in combination with graphic health warnings, and other evidence-based tobacco control measures, has been a key area of work delivered through the FCTC 2030 project. 

Preventing initiation and uptake of tobacco is important to reduce the number of new users, but cessation support is also important for current smokers and to reduce the number of current users. Quitting tobacco use has immediate and long-term health benefits, which translates into greater population health and economic benefits (1).

Article 14 of the WHO FCTC and its implementation guidelines recommend actions to promote cessation and provide adequate treatment for tobacco dependence. The guidelines (1) encourage Parties to strengthen or create a sustainable infrastructure which motivates quit attempts, ensures wide access to support, and provides sustainable resources to ensure that such support is available; (2) identify key effective measures needed to promote tobacco cessation and incorporate tobacco dependence treatment into national tobacco control programmes and health-care systems; and (3) urge Parties to share experiences and collaborate. Evidence also shows that tobacco cessation initiatives are most successful when implemented as part of a comprehensive tobacco control strategy.

FCTC 2030 project partners have supported the integration of tobacco cessation programmes into primary healthcare systems.