| United Nations | E/1997/62 |
Economic and Social Council
Distr. GENERAL
15 May 1997
ORIGINAL: ENGLISH
Substantive session of 1997
Geneva, 30 June-25 July 1997
Item 6 (b)
COORDINATION QUESTIONS: MULTISECTORAL
COLLABORATION ON TOBACCO OR HEALTH
Progress made in the implementation of multisectoral
collaboration on tobacco or health
Report of the Secretary-General
CONTENTS
Paragraphs Page
BACKGROUND ................................................. 1 - 4 2
I. FOLLOW-UP TO THE IMPLEMENTATION OF COUNCIL RESOLUTIONS
ON TOBACCO OR HEALTH ................................. 5 - 49 2
A. Organizations and bodies of the United Nations
system ........................................... 7 - 23 3
B. Member States .................................... 24 - 29 7
C. Intergovernmental organizations .................. 30 - 35 8
D. Non-governmental organizations ................... 36 - 49 9
II. CONCLUSIONS AND RECOMMENDATIONS ...................... 50 - 56 12
Annexes
I. World Health Assembly resolution WHA 48.11, "An international
strategy for tobacco control" ....................................14
II. World Health Assembly resolution WHA 49.17, "International
framework convention for tobacco control" ........................16
BACKGROUND
1. The first substantive consideration of the problem of tobacco or
health was undertaken by the Economic and Social Council in 1993. By
its resolution 1993/79 on multisectoral collaboration on tobacco or
health, the Council requested the Secretary-General to seek the full
multisectoral collaboration of the organizations and bodies of the
United Nations system and other international organizations, as
appropriate, in contributing to the successful implementation of
effective and comprehensive strategies for tobacco control.
2. Given the mandate of the United Nations Conference on Trade and
Development (UNCTAD) in the area of commodities and the need to
examine the economic adjustments that countries might need to
undertake in the follow-up to Council resolution 1993/79, a focal
point for the issue was designated by the Secretary-General of the
United Nations within UNCTAD at the end of 1993, with responsibility
for the implementation of the resolution.
3. At its substantive session of 1994, having considered the report
of the Secretary-General (E/1994/83), the Council adopted resolution
1994/47, in which it called on the Secretary-General to report to it,
at its substantive session of 1995, on progress made by the United
Nations system focal point on tobacco or health, as defined in Council
resolution 1993/79.
4. At its substantive session of 1995, having considered the report
of the Secretary-General (E/1995/67), the Council adopted resolution
1995/62, in which it took note of World Health Assembly resolution
48.11 (annex I), in which the Director-General of the World Health
Organization (WHO) had been requested to study the feasibility of
developing an international instrument on tobacco control to be
adopted by the United Nations, taking into account existing trade and
other conventions and treaties. The Council also recognized that
several organizations and bodies of the United Nations system had
implemented World Health Assembly resolution 46.8, in which the
Assembly had called for a ban on the use of tobacco within the
buildings of the United Nations system; requested the United Nations
system focal point on tobacco or health to intensify the dialogue with
organizations of the system and Member States in order to strengthen
tobacco control policies; invited Member States, bilateral and
non-governmental organizations and organizations of the United Nations
system to provide the necessary support to enable the focal point to
carry out his mandate in an effective manner; and requested the
Secretary-General to report to the Council at its substantive session
of 1997 on progress made by the focal point in the implementation of
multisectoral collaboration on tobacco or health.
I. FOLLOW-UP TO THE IMPLEMENTATION OF COUNCIL
RESOLUTIONS ON TOBACCO OR HEALTH
5. Pursuant to the mandates of the above-mentioned resolutions, the
United Nations focal point on tobacco or health established and
maintained close relations with Governments, intergovernmental and
non-governmental organizations, particularly in the area of
information and exchange of communications among concerned
organizations.
6. Given the issues raised by the resolutions on matters of health,
education and welfare, the focal point also established contacts with
the WHO regional offices, ministries of health, national committees of
the United Nations Children's Fund (UNICEF) and ministries of
education. In order to secure maximum outreach to concerned
organizations the focal point contacted the regional representatives
of the International Union Against Cancer, and through them their
national member organizations. In mid-1996, the focal point became an
active participant of GLOBALINK, an intranet service available to
tobacco control experts from around the world that has become a very
important source of information through its interactive electronic
conferences.
A. Organizations and bodies of the United Nations system
7. In seeking to intensify the dialogue with the organizations and
bodies of the United Nations system, the United Nations focal point on
tobacco or health contacted over 30 United Nations entities; replies
were received from most of them.
8. Many entities have participated in the efforts of the United
Nations system to strengthen tobacco-control policies as they affect
the working environment. Those entities most committed to the cause of
creating an effective smoke-free environment on their premises have
included the International Labour Organization (ILO), the
International Civil Aviation Organization (ICAO), UNICEF, the Office
of the United Nations High Commissioner for Refugees (UNHCR), the
United Nations Educational, Scientific and Cultural Organization
(UNESCO) and WHO. Other entities, such as the United Nations
Secretariat in New York, the United Nations Offices in Geneva and
Vienna, and the United Nations Institute for Training and Research
(UNITAR) have instituted policies to limit smoking to restricted areas
and are still in the process of re-evaluating those policies with a
view to more effective implementation. Other entities have implied by
their responses that the question has yet to be fully addressed. In
some cases, existing tobacco-control measures are being reviewed with
a view to obtaining a smoke-free environment. Many entities have also
indicated that they support the World No Smoking Day. In addition,
the United Nations Secretariat, the International Fund for
Agricultural Development, IMO, UNIDO, the United Nations Institute for
Training and Research and UNHCR offer medical assistance to staff
through training sessions and/or counselling, and keep staff informed
of the health hazards of smoking. The United Nations Secretariat, the
World Intellectual Property Organization and WHO have established
focal points on the subject in order to coordinate their response to
the problem.
9. A number of United Nations entities are also undertaking or
proposing to undertake substantive studies and activities in order to
address tobacco-related questions.
10. The activities of the Statistical Division of the United Nations
have continued to focus on the compilation and dissemination of
statistics on tobacco production, consumption and trade, as well as
the incidence of smoking, publishing data on those issues in its
Statistical Yearbook, Compendium of Social Statistics and Indicators
and Industrial Statistics Yearbook.
11. Since the publication of its study entitled "The economic role of
tobacco production and exports in countries depending on tobacco as a
major source of income", UNCTAD has received requests for studies on
agricultural alternatives to tobacco production in developing
countries that are highly dependent on tobacco production and exports.
Since the economic role of tobacco production has raised interest in
the Council and elsewhere, UNCTAD has submitted to the International
Development Research Centre a research proposal, still under
consideration, entitled "Economic aspects of development of
agricultural alternatives to tobacco production and export marketing
in Malawi and Zimbabwe" - the economies of those two developing
countries are most dependent on tobacco exports. It is believed that
that type of research could serve as a pilot study for the application
of economic evaluation tools useful to many other tobacco-producing
developing countries as they consider agricultural crop alternatives
to tobacco production.
12. Now that nicotine has been recognized as an addictive substance,
UNCTAD, in cooperation with the International Council on Alcohol and
Addictions and the European Medical Association Smoking or Health, is
organizing a round table that will focus on the economic and social
aspects of alternative nicotine-delivery devices, such as skin
patches, chewing gum and nasal inhalers.
13. The UNCTAD Division on Investment, Technology and Enterprise
Development is considering undertaking a study on the role of
multinational tobacco companies in the global expansion of tobacco
consumption, particularly in the developing countries and countries in
economic transition.
14. The United Nations Environment Programme (UNEP) has indicated that
under its Environmental Law Programme Activity Centre, with its long
and successful record of brokering several international conventions,
protocols and other legal instruments, it can work with the United
Nations system focal point, WHO and other relevant organizations in
developing a framework convention on tobacco control.
15. UNICEF is increasing its support to programmes that contribute to
the health and development of young people, one component of which is
the prevention of tobacco consumption. It is in the process of
finalizing its Notebook on Programming for Young People's Health and
Development, which includes a focus on tobacco. UNICEF regional and
country offices have been encouraged to strengthen their collaboration
with the United Nations system and with other partners in relation to
programmes that focus on preventing the use of drugs such as tobacco
and alcohol. Concerned that the marketing of tobacco products is
undermining its efforts to save the lives of millions of children
annually from preventable diseases, UNICEF is urging a global ban on
the promotion and sale of tobacco products to protect children in
third world countries. Recognizing that the international community
urgently needs a comprehensive, long-term strategy to combat tobacco,
particularly in the developing world, UNICEF has welcomed a recent
pledge by the seven major industrialized countries (Canada, France,
Germany, Italy, Japan, United Kingdom of Great Britain and Northern
Ireland, United States of America), Russia and European Union to work
together to promote education and public awareness of the
environmental hazards of tobacco smoke to children.
16. Given its involvement in the control of illicit drugs, the United
Nations International Drug Control Programme (UNDCP) recognizes the
health implications of tobacco use, and thus collaborates with the WHO
Programme on Substance Abuse in activities that address tobacco and/or
alcohol.
17. World Bank activities in the health sector (including sector work,
policy dialogue and lending) discourage the use of tobacco products.
The Bank does not lend directly for, invest in or guarantee
investments or loans for tobacco production, processing or marketing.
However, in the few countries that are heavily dependent on tobacco as
a source of income and of foreign-exchange earnings (i.e., countries
where tobacco accounts for more than 10 per cent of exports),
especially as a source of income for poor farmers and farm workers,
the Bank seeks to help those countries diversify away from tobacco
production. It does not lend indirectly for tobacco production
activities, although some indirect support of the tobacco economy may
occur as an inseparable part of a project that has a broader set of
objectives and outcomes. Also, unmanufactured and manufactured
tobacco, tobacco-processing machinery and equipment, and related
services are included on the negative list of imports in loan
agreements, and cannot be included among imports financed under loans.
Finally, tobacco and tobacco-related producer or consumer imports may
be exempt from borrowers' agreement with the Bank in order to
liberalize trade and reduce tariff levels.
18. The Food and Agriculture Organization of the United Nations (FAO)
has reaffirmed its commitment to respond, subject to the availability
of resources, to requests of member Governments wishing to investigate
options for diversification away from tobacco production. FAO has not
extended support or assistance for a number of years to any projects
intended to expand tobacco production. At the same time, FAO has
monitored developments in the production, consumption and trade of
tobacco. Periodically, FAO analyses the longer-term prospects to
provide a framework for evaluating the changing structure of the
market for tobacco, and - through the quantification of consumption trends -
the possible health implications of smoking. FAO considers that the
multisectoral collaboration coordinated through the United Nations
focal point on tobacco or health is an appropriate means for
developing comprehensive and effective strategies, which take account
of the full economic and health implications associated with tobacco
production and consumption.
19. In addressing the subject of drug abuse, UNESCO includes in its
educational activities - intended particularly for children and young
adults - information about the dangers of tobacco. On 31 May 1996,
UNESCO joined WHO and the International Olympic Committee to
commemorate World No Tobacco Day under the theme of Sports and the
Arts without Tobacco. The documentation on that event was distributed
to the UNESCO national commissions, regional offices and the worldwide
UNESCO network of associated schools (about 2,000). In addition,
UNESCO, in collaboration with two French non-governmental
organizations, CIPADED and Vie et sante', published a book in English,
French and Arabic, entitled Farnatchi and the Mysterious Red Bag, on
preventive education against tobacco use. Aimed mainly at children
aged eight to 13 years in Arab-speaking countries, it was disseminated
to the UNESCO national commissions and field offices in the Arab
Member States. UNESCO will shortly make available on its Internet Web
site information concerning the use and dangers of tobacco, and its
possible solutions.
20. WHO has played a leading role in tobacco control for many years
since the establishment of the tobacco or health programme in 1990.
Its plans of action 1988-1995 and 1995-2000 have provided the
framework for the development of national tobacco control legislation
in many countries.
21. Recognizing this critical need, the Ninth World Conference on
Tobacco and Health, held in Paris in 1994, adopted a resolution urging
national Governments' ministries of health and the World Health
Organization to initiate action immediately to prepare and achieve an
international convention on tobacco control to be adopted by the
United Nations as an aid to implementation of the International
Strategy for Tobacco Control adopted by the same Conference (see annex
II). In May 1995, the World Health Assembly, in its resolution WHA
48.11, requested the Director-General to report to the Assembly at its
forty-ninth conference on the feasibility of initiating action to
prepare and finalize an international convention on tobacco control to
be adopted by the United Nations, taking into account existing
international trade and other conventions and treaties. The
Director-General submitted his report on the feasibility of developing
an international instrument for tobacco control to the WHO Executive
Board at its ninety-seventh session. The report, inter alia, calls
for the promulgation of an international framework convention for
tobacco control and implementing protocols. The World Health Assembly
adopted, by majority vote, resolution WHA 49.17 (see annex II to the
present report) on the development of a WHO international framework
convention for tobacco control, and a project proposal for its
preparation is being implemented.
22. ICAO, at its nineteenth assembly, in 1992, adopted resolution
Abbe-15 on smoking restrictions on international passenger flights.
As of 1 July 1996, several States and many airlines had introduced
smoking restrictions, varying from partial smoking bans on certain
flights (depending on destination or maximum flight time) to a
complete ban on all flights. ICAO has issued further correspondence
that provides guidance and advice on the implementation of the global
ban on smoking (State letter AN 5/13-96-79 of September 1996),
including a questionnaire seeking information on the degree of
implementation of resolution A29-15 (State letter AN 5/13-97/8 of
January 1997). Some States have been hesitant to implement resolution
A29-15 because they believe that legislation against smoking is
difficult within the context of air law and aviation regulations.
ICAO believes that a framework convention on tobacco control would
assist such States in enacting the required legislation.
23. UNIDO has indicated that it is ready to assist interested
countries in preparing and implementing programmes for alternative
high value-added processed crops. Further to the UNCTAD proposal (see
para. 11 above) on the impact of the tobacco economy in Zimbabwe and
Malawi, UNIDO has indicated that a much larger study covering
non-exporting, tobacco-producing developing countries, such as China
and Pakistan, would be useful.
B. Member States
24. The United Nations system focal point contacted all Member
Governments with permanent missions to the United Nations Office at
Geneva. The information received mainly concerned national tobacco
control policies and matters of particular concern to ministries of
health, education and welfare, and to some extent covered information
already appearing in earlier reports. The new information provided is
set out below.
1. Developed countries
25. Many of the developed countries reported enactment of anti-smoking
regulations and legislation (Belgium, Canada, Italy, New Zealand,
Norway, Sweden and the United Kingdom of Great Britain and Northern
Ireland), including such measures as health warnings on packaging;
taxation on tobacco products; reporting requirements for
manufacturers, distributors and advertisers; bans on smoking in public
places; and discouraging tobacco access to youth. Support for the
development of a framework convention on tobacco control, as called
for in World Health Assembly resolution 49.17, was indicated by
several countries (Belgium, Canada, Germany, Sweden). Some preferred
to support measures for individual countries, using the existing
regulations established by the European Community (Italy and the
United Kingdom). Many countries (Belgium, Canada, Denmark, Norway and
Sweden) had instituted public information campaigns to sensitize the
public to the health risks linked to smoking. Such activities
included education and health information and anti-smoking campaigns,
with some Governments targeting their campaigns to youth or women.
One Government has initiated international standards to measure the
contents of nicotine and tar in the smoke from roll-your-own tobacco
(Norway), and another has contributed financially to programmes
supporting WHO programmes that assist other countries (Canada).
2. Newly industrialized countries and countries in
economic transition
26. The replies received from newly industrialized countries and
economies in transition indicate that those countries share with the
developed countries a high concern about the health risks associated
with tobacco consumption. They have adopted legislation and
administrative ordinances to protect the population at large,
especially high-risk groups, such as the young; fiscal measures to
discourage tobacco consumption; advertising bans in newspapers, radio
and television; and measures to disseminate information materials for
increasing public awareness of the dangers of smoking. Some of those
countries (China, Russian Federation, Pakistan and Singapore) have
reported that they generally disseminate information materials to
increase public awareness of the dangers of smoking through
hosting/organizing conferences and round tables, organizing
anti-smoking public education campaigns, and in general establishing a
supportive environment that is conducive to making non-smoking the
norm. One Government sought multisectoral collaboration in its
campaign against smoking, securing the assistance of public and
private sectors. One Government (China), strongly supporting the
development of a framework convention on tobacco control, indicated
that a number of issues, such as women and tobacco, approaches to
tobacco cessation, financing tobacco control and tobacco control
programmes, were areas best suited to multisectoral collaboration and
international cooperation. As a step towards more effective smoke
control activities, some countries (Mexico and Turkey) have made
improvements in data collection and research on tobacco prevention,
health care and rehabilitation. Another (Czech Republic) supported
the creation and proliferation of smoking- cessation clinics.
3. Other developing countries
27. In a large number of developing countries in Africa and in
most of Asia and Latin America tobacco use is increasing among the
population. According to WHO and World Bank estimates, it is
precisely in this group that the risks associated with tobacco
consumption is likely to be the highest in the future. According to
estimates, while in 1995 tobacco consumption was responsible for
3 million deaths - 2 million in the developed countries and 1 million
in the developing countries - by the year 2025, world mortality will
reach 10 million - 3 million in the developed countries and 7 million
in the developing countries. As the multinational tobacco companies
confront increasing restrictions on their operations in the North, it
is expected that they will try to compensate for the loss of markets
by opening up and expanding their markets in the South.
28. Some countries have adopted a comprehensive anti-smoking policy
(Cameroon, Mauritius, Oman), in some cases complemented with the
training of schoolchildren and teachers on the risks of tobacco
consumption on health, and the introduction of national targets for
the reduction of tobacco consumption (Trinidad and Tobago). Other
countries discourage smoking in public and at official gatherings,
except at specified times and in specific places (Ghana, Nigeria).
29. Some countries have introduced legislation on tobacco control
that places a ban on audio-visual advertisements on tobacco products
via electronic media (Jamaica and Nigeria), prohibits cinema
advertisement of tobacco products and advertisement of tobacco
products in literature of any kind intended for persons under 18 years
of age, and enforces mandatory use of health warnings of tobacco
products (Jamaica).
C. Intergovernmental organizations
30. A number of intergovernmental organizations have undertaken
activities supportive of United Nations and WHO resolutions in the
field of tobacco or health.
31. The Arab Bank for the Development of Africa has reported that,
consistent with its lending policy of encouraging food security
projects in the agricultural sector, it has not participated in the
financing of any tobacco-related projects.
32. The Asian Development Bank has stated that although the Bank
does not have a formal policy restriction on the financing of projects
that are indirectly associated with tobacco, its projects do not
promote nor encourage the cultivation of tobacco. The Bank realizes
that because of the great difficulty in making a significant impact on
the supply side given the existing favourable market conditions for
tobacco, efforts should focus on reducing demand for tobacco,
especially by young people. The Bank, therefore, supports efforts to
limit the use of tobacco through the promotion of healthier lifestyles
in the context of health projects.
33. In 1995, the Ministers of Health of the Gulf Cooperation Council
adopted a resolution containing provisions concerning the restriction
of nicotine and tar levels in cigarettes. The resolution also
established an increase of customs duties to reach 100 per cent, and
assigned a committee to work with health authorities to provide
information materials for health awareness, such as media campaigns,
and to introduce programmes to combat smoking. In addition, a
recommendation has been made by Ministers of Industry to the concerned
authorities not to issue licences for tobacco-manufacturing factories
of all types.
34. The European Commission adopted on 18 December 1996 a
communication to the European Council and the European Parliament on
the current and proposed community role in combating tobacco
consumption, in which specific reference was made to international
efforts and the proposed WHO convention on tobacco control. The
Commission has expressed, through its focal point on tobacco and
health, an interest in meeting with WHO to discuss the policy aspects
of the preparation of the framework convention for tobacco control and
to explore the possibilities for further cooperation.
35. The Organisation for Economic Cooperation and Development (OECD)
reported that its member countries pursue policies designed to enhance
the health status of populations. At the organizational level, OECD,
as part of the work of its committees, monitors the taxation of
tobacco. Its annual publication, Consumption Tax Trends, lists the
specific excise and ad valorem excise taxes on cigarettes, cigars and
rolling tobacco, information that facilitates the use of fiscal
instruments in the determination of national health policies. OECD
has also reduced smoking in its meeting rooms and facilities.
D. Non-governmental organizations
36. A large number of non-governmental organizations have also been
very active in the struggle to creating a smoke-free environment.
37. The International Federation of Red Cross and Red Crescent
Societies, at the Twenty-fifth International Conference of the Red
Cross and Red Crescent Movement and at the Fifth General Assembly of
the International Federation (then the League) urged its national
societies to (a) establish programmes of education and public
information on the effects of the use of tobacco; (b) support WHO
measures for the implementation of strategies on smoking control; and
(c) encourage either a total ban or restrictions or limitations on
tobacco advertising. As a result, many national societies, as well as
the secretariat of the Federation, including all regional and country
delegations, as well as all vehicles of the Federation - both in
Geneva and in the field - became smoke-free as of 1 May 1997.
38. The International Council on Alcohol and Addictions (ICAA), a part
of the International Non-Governmental Coalition Against Tobacco,
reported that it will co-sponsor with UNCTAD and the European Medical
Association on Smoking and Health the organization of a technical
round table on alternative nicotine delivery systems. ICAA is also
co-sponsoring a workshop at Cairo in May 1997 on methods to reduce
smoking: the need for innovative approaches. ICAA is also
co-sponsoring the Tenth World Conference on Tobacco or Health at
Beijing.
39. The Non-Smokers' Rights Association is very supportive of the
development of an international instrument on tobacco control, and has
already cooperated with WHO in the preparatory work leading up to the
adoption of the WHO resolution on a framework convention.
40. The International Air Transport Association has been monitoring
the initiatives taken by its member airlines to implement partial or
total bans of smoking on board aircraft, and in 1995 considered the
issue of a voluntary worldwide ban on smoking. There was majority
support for some form of joint industry action on that matter, but
agreement could not be reached on a non-binding establishment of
"recommended practice". It was felt that the issue had significant
commercial implications, so that it would be ineffective in the
marketplace, and that action was better left to the discretion of
individual airlines.
41. The International Council of Nurses, consistent with its strategic
mission to promote healthy public policy and social well-being
worldwide, has been working closely with its constituent national
nurses associations in over 112 countries to collaborate in a
concerted fight against tobacco use in all its forms. It has sent a
letter of protest to the Director-General of the European Commission
opposing support for a round table on the theme "Europe of the
regions" organized by the tobacco company Phillip Morris; has
condemned the use of threats or trade sanctions to compel nations to
increase importation of tobacco products; has adopted a smoke-free
policy and banned smoking in its offices; has developed for the 1997
International Nurses Day a resource kit on the theme "Healthy young
people: a brighter tomorrow", which dealt with the prevention of
tobacco use by young people; and disseminates information to its
member national nurses associations on the health hazards of tobacco
use and its prevention through its official journal, the International
Nursing Review.
42. World Vision International has reported that it continues to
carry on extensive health education against tobacco and its ill
effects on health. As a matter of policy, it does not support any
income-generation projects linked to tobacco, nor does it accept any
donations from such sources. Its offices are totally smoke free, both
for staff and visitors. It supports the development of a
comprehensive framework convention on tobacco control; however, it
favours a total ban on the production, sale, purchase, import, export,
storage and use of tobacco in all countries.
43. The Asian Consultancy on Tobacco Control, through its Director,
has been a member of the WHO Expert Advisory Panel on Tobacco or
Health since 1984, and has provided consultancy assistance to WHO
regional offices on policy development. ACTC has participated in
specific missions to support the development of national policy,
programmes, legislation and health education projects on tobacco or
health in many countries of the Asian region. ACTC also supports the
idea of the international framework convention on tobacco control.
44. The International Olympic Committee has cooperated for many years
with WHO on several projects to promote healthy lifestyles. The
Summer and Winter Olympic Games have been proclaimed smoke free since
1988. The Committee co-sponsored the 1996 World No-Tobacco Day, which
was dedicated to the theme "Sport and the arts without tobacco: play
it tobacco free".
45. Many of the Scout associations of the World Organization of the
Scout Movement have developed educational programmes for tobacco-free
societies. Learning how to avoid taking drugs, including tobacco and
alcohol, is the subject of youth programmes promoted by the
organization in several countries and supplemented through
publications and educational materials.
46. A number of non-governmental organizations in Brazil (the National
Cancer Institute of Brazil, along with the Brazilian Tobacco Control
Coordinating Committee, the National Heart Foundation, the Latin
American Women's Association) sponsored and organized the First Latin
American Congress on Tobacco Dependency and the Second Brazilian
Congress on Tobacco Dependency at Fortaleza, Brazil, in June 1996.
The Congress, which was well attended and included delegates from
Latin America's Tobacco Control Coordination Committee, focused on
various tobacco-related subjects, such as environmental impact,
alternative crops, active and passive smoking, nicotine as an
addictive drug, analysis of cigarette chemicals, tobacco advertising
and marketing, the impact of tobacco consumption on women and
agricultural alternatives to tobacco production. Discussions led to
the adoption of a number of recommendations concerning strategies for
tobacco control in Brazil through the official global plan for
1996-2000, and similar strategies for other Latin American countries
were considered.
47. On the same occasion and inspired by the WHO World No-Tobacco Day
theme "Sports and the arts without tobacco", the United Nations system
focal point launched the initiative for an international mountain-
climbing expedition against smoking. An expedition of 28 climbers
against smoking successfully reached the summit to Aconcagua, the
highest mountain in the world outside Asia, on 14 January 1997. The
expedition was totally self-financed and co-sponsored by the
government of Mendoza, the Argentine Union Against Smoking and the
Secretariat of Sports of the Government of Argentina.
48. The International Union Against Cancer established GLOBALINK, an
intranet service, which operates through a system of electronic
conferences at which tobacco-related subjects are discussed and
information exchanged. These have included such topics as tobacco
control legislation, litigation, tobacco advertising, tobacco and
children and youth, tobacco and women, and health-related aspects of
tobacco consumption. GLOBALINK has proposed that a special fund be
allocated to network communications, by providing appropriate
communications equipment (Internet) to all countries, which could
greatly improve tobacco control and could significantly assist
countries in the implementation of tobacco-control legislation based
on the experience of other countries.
49. The Tenth World Tobacco Conference on Tobacco or Health (24-
28 August 1997) is being hosted by the Chinese Association on Smoking
and Health and the Chinese Medical Association. The Theme of the
Conference, "Tobacco: the growing epidemic", has been chosen to
reflect the increasingly global nature of the problem. The location
of Beijing for the Conference is particularly important, since China
is the largest cigarette producer and consumer in the world, with
three hundred million smokers consuming 30 per cent of the world's
cigarettes.
II. CONCLUSIONS AND RECOMMENDATIONS
50. Over the two-year period under review, a number of important
events have contributed to a significant change in the international
tobacco control situation, the most important of which is growing
public awareness of the public health risks associated with tobacco
consumption, which has led Governments, especially in the advanced
countries, to adopt stronger legislation on tobacco production,
processing, marketing and use, especially in public places.
51. A turning point was reached recently in the international struggle
to control the operations of the biggest tobacco multinationals, when
a number of major tobacco transnationals - some of which have recently
admitted that tobacco is addictive and causes cancer and heart disease -
met with anti-smoking groups and officials of the Government of the
United States of America to discuss the terms of a settlement on a
very large number of liabilities. According to reliable press
sources, those multinationals are willing to accept government
regulation, and would be prepared to pay as much as $300 billion over
the next 25 years in the form of a fund under which smokers could seek
compensation.
52. So too, newly industrialized countries and countries with
economies in transition have become more sensitized to the dangers of
tobacco, and in many of them the media are actively promoting the
adoption of stricter legislation. Moreover, the statistical evidence
points to a growing pandemic of health risks related to tobacco
consumption, as multinational tobacco companies seek to expand their
markets in countries of the developing world to compensate for the
loss of traditional markets in the developed countries.
53. On the intergovernmental level, more and more organizations have
begun to address tobacco-related questions, either by banning tobacco
in the workplace or or adopting policies relevant to their work
programmes. Particularly noteworthy, especially as they concern
advocacy, have been the efforts of several elements of civil society;
their activities have been effective in promoting action at the
international and national levels, in supporting legislation and in
informing users of the global nature of the problem.
54. Another major change during the last two years in the field of
tobacco control has been the impact of the development of the
Internet, a technological revolution which, at a very low cost, has
provided access to the latest, generally reliable global information
on tobacco on a 24-hour basis. As proposed by GLOBALINK, that is an
area that presents the greatest potential for action in the immediate
future.
55. In compliance with Council resolutions on tobacco or health, the
United Nations system focal point has consolidated contacts with
Governments, intergovernmental and non-governmental organizations.
That process has expanded notably, thanks to the Internet, which has
facilitated access to information (although it presents a challenge in
controlling and usefully managing the mass of data collected). Much
remains to be done, however, in terms of implementation of World
Health Assembly resolution 46.8.
56. Concerning the future of the Tobacco or Health Programme, a
commitment to providing a minimal level of resources for such
activities will be essential if the United Nations system is to
respond effectively to all the new requests for action on the issues
discussed in the present report. One option would be to establish a
voluntary trust fund to finance the main activities of the United
Nations system focal point. A small amount of resources allocated to
the United Nations system to mobilize a coordinated international
response to the challenge of developing effective tobacco control
policies could make a significant impact due to the networking
arrangements and links established with governmental,
intergovernmental, non-governmental and civil society organizations.
There is a need to create a minimal capacity for undertaking related
activities in order to fully tap the complementarity resources and
potential of those institutions.
Annex I
FORTY-EIGHTH WORLD HEALTH ASSEMBLY
Resolution WHA48.11
An international strategy for tobacco control
The Forty-eighth World Health Assembly,
Recalling and reaffirming resolutions WHA33.35, WHA39.14, WHA43.16
and WHA45.20, all calling for comprehensive multisectoral, long-term
tobacco strategies and outlining the most important aspects of
national, regional and international policies and strategies in this
field,
Recognizing the work carried out by the Organization in the field
of tobacco or health, and noting that the plan of action of the
"tobacco or health" programme for 1988-1995 comes to an end this year,
Noting that the Director-General and the Secretariat contributed
to the success of the Ninth World Conference on Tobacco and Health
(Paris, October 1994) at which an international strategy for tobacco
control was adopted covering the essential aspects of WHO policy in
this field: curbing of the promotion of tobacco products, demand
reduction particularly among women and young people, smoking cessation
programmes, economic policies, health warnings, regulation of tar and
nicotine content of tobacco products, smoke-free environments, and
marketing and monitoring,
1. COMMENDS the International Civil Aviation Organization response to
ban smoking on all international flights as of 1 July 1996;
2. URGES those Member States that have already successfully
implemented all or most of a comprehensive strategy for tobacco
control to provide assistance to WHO, working with the United Nations
system focal point on Tobacco or Health (located in United Nations
Conference on Trade and Development), so that these bodies can
effectively coordinate the provision of timely and effective advice
and support to Member States seeking to improve their tobacco control
strategies, including health warnings on exported tobacco products;
3. REQUESTS the Director-General:
(1) to report to the Forty-ninth World Health Assembly on the
feasibility of developing an international instrument such as
guidelines, a declaration, or an International Convention on
Tobacco Control to be adopted by the United Nations, taking into
account existing trade and other conventions and treaties;
(2) to inform the Economic and Social Council of the United
Nations of this resolution;
(3) to strengthen WHO's advocacy role and capacity in the field
of "tobacco or health" and submit to the Forty-ninth World Health
Assembly a plan of action for the tobacco or health programme for
the period 1996-2000.
Twelfth plenary meeting, 12 May 1995
A48/VR/12
Annex II
FORTY-NINTH WORLD HEALTH ASSEMBLY
Resolution WHA49.17
International framework convention for tobacco control
The Forty-ninth World Health Assembly,
Recalling resolutions WHA29.55, WHA31.56, WHA33.35, WHA39.14,
WHA43.16 and WHA45.20, all calling for comprehensive, multisectoral,
long-term tobacco control strategies,
Noting with satisfaction that the Director-General has prepared a
report on the feasibility of developing international instruments for
tobacco control, as requested by resolution WHA48.11, and that this
report concludes that the development of such instruments is feasible,
1. URGES all Member States, and, where applicable, organizations of
the United Nations system and other international organizations
progressively to implement comprehensive tobacco control strategies
that include the measures referred to in resolutions WHA39.14 and
WHA43.16 as well as other appropriate measures;
2. URGES Member States to contribute the necessary extrabudgetary
resources to permit the implementation of this resolution;
3. REQUESTS the Director-General:
(1) to initiate the development of a framework convention in
accordance with Article 19 of the WHO Constitution;
(2) to include as part of this framework convention a strategy to
encourage Member States to move progressively towards the adoption
of comprehensive tobacco control policies and also to deal with
aspects of tobacco control that transcend national boundaries;
(3) to inform the Secretary-General of the United Nations of this
initiative, and to request the collaboration of the United Nations
system, coordinated through the United Nations system focal point
on "tobacco or health";
(4) to keep the Health Assembly informed of the development of
the framework convention in his biennial reports to the Health
Assembly on the progress and effectiveness of Member States'
comprehensive tobacco control programmes, as called for in
resolution WHA43.16.
Sixth plenary meeting, 25 May 1996
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