Abstract
Tobacco use is responsible for one in three cancer‐related deaths. Thanks to 50 years of aggressive public education efforts, tobacco use is declining in most industrialized countries. However, worldwide, tobacco consumption is actually increasing, driven in part by population growth and economic development in China, India, Indonesia, and parts of Africa and the Middle East. There are now approximately 1.3 billion smokers in the world, and 84% of them reside in the developing world. Tobacco use is the world's leading cause of preventable death, directly causing 30% of the 11.5 million annual cancer predicted by 2030 deaths. In recognition of this enormous threat, the member countries of the WHO adopted the Framework Convention on Tobacco Control [FCTC], the first international treaty devoted to health. The FCTC has been ratified by over 160 countries, but some large countries such as the United States and Russia have yet to ratify the treaty. Ratification obligates countries to implement a comprehensive set of common sense policies intended to reduce the demand for tobacco use. These policies include measures to: keep the price of tobacco high; protect nonsmokers from exposure to tobacco smoke; regulate products; control packaging and labeling of tobacco products; ban tobacco product marketing; educate the public; promote and assist tobacco cessation and prevention; prevent sales to minors; and promote alternative uses for tobacco croplands. Estimates indicate that aggressive implementation of FCTC policies could prevent 10 million excess cancer deaths anticipated over the next 20 years. The policies included in the FCTC were selected on the basis of scientific evidence. However, as the FCTC continues with its critical implementation phase in the next 5 years, and as nations that have ratified the treaty decide what specific policies will be implemented to meet their treaty obligations, it will become increasingly important that scientific evidence continue to guide the adoption of policies that will work effectively. There is already evidence that the tobacco industry is working to undermine the FCTC by encouraging countries to adopt policies that, although compliant with the FCTC, are suboptimal. As in clinical medicine, good public health practice demands that rigorously evaluated evidence guide the adoption of new tobacco control interventions. Thus, in the next few years, amassing a strong body of evidence from a methodologically sound evaluation of FCTC policies will be critical. This can then be used to guide governmental policymakers in the future.
Citation Information: Cancer Prev Res 2010;3(1 Suppl):ED05-03.
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