KEY ELEMENTS OF THE FCTC NIGERIAN TOBACCO CONTROL STRATEGY PLANNING MEETING Lagos May 2005

Purpose of Exercise 1.Articulate concise arguments in favor of ratifying the FCTC and the policy measures it contains to policymakers, the media and other potential allies. 2.Enable you to anticipate and counteract common tobacco industry arguments against the FCTC and its policies.

The FCTC... The first international public health treaty negotiated under the auspices of the World Health Organization Objective: “to protect present and future generations from the devastating health, social, environmental and economic consequences of tobacco consumption and exposure to tobacco smoke...” Timeline:

THE FCTC Preamble 38 Articles Full text available at:

FCTC: Key Provisions Comprehensive Ban on Advertising and Promotion Large Health Warning Labels Required Deceptive Labels Prohibited Nonsmokers Must be Protected Content of Tobacco Products to be Regulated Sale to Minors Prohibited

Other Provisions Establish or reinforce and finance national coordinating mechanism or focal point for tobacco control. Endeavor to include tobacco cessation services in national health programs. Prohibit distribution of free tobacco products. Promote participation of NGOs in the development of tobacco control programs. No reservations to the FCTC are allowed.

More In Depth Look at FCTC Provisions on: AdvertisingTaxation Secondhand Smoke Packaging & Labeling Smuggling

Advertising Bans FCTC: Advertising, Promotion and Sponsorship (Article 13) …a comprehensive ban on advertising, promotion and sponsorship would reduce the consumption of tobacco products. Requires a comprehensive ban within five years, including cross-border advertising originating within a Party's territory. Includes indirect as well as direct forms of advertising. Allows for constitutional constraints. The Parties also agree to consider a protocol to elaborate on cross-border advertising.

Advertising Bans and Consumption Scientific and economic rationale for bans: Research shows that comprehensive tobacco advertising and promotion bans can decrease consumption. Partial bans have been found to be ineffective – industry merely shifts spending to non-banned media.

Comprehensive advertising bans reduce cigarette consumption Consumption trends in countries with such bans vs. those with no bans (n=102 countries) Source: Saffer, 2000

Common Arguments Against Ad Bans and Useful Responses

“Tobacco advertising doesn’t affect tobacco consumption” Peer-reviewed studies – including from the World Bank - - show that tobacco advertising causes increased consumption. Advertising is also linked to smoking initiation among specific groups – such as women and children – as a result of campaigns targeted at them.Advertising is also linked to smoking initiation among specific groups – such as women and children – as a result of campaigns targeted at them. If it does not work, why does the industry spend billions a year on it (US$11.2 billion in the United States alone in 2001)?If it does not work, why does the industry spend billions a year on it (US$11.2 billion in the United States alone in 2001)? Studies from countries that have banned tobacco advertising have seen decreases in tobacco use.Studies from countries that have banned tobacco advertising have seen decreases in tobacco use.

“We should only prohibit advertising aimed at kids” It is impossible to draw a clear line defining what advertising is targeted at kids. Cigarette promotion has been successful in reaching youth in large part because it portrays smoking as an “adult” behavior: something that every adolescent aspires to. And studies have shown that partial restrictions on promotion do not reduce tobacco use.

“Arts and sporting events would disappear without tobacco industry support” Many jurisdictions have banned tobacco sponsorships and, despite dire predictions, most groups have found alternative sponsors. Other jurisdictions have used revenue from tobacco taxes to buy out tobacco sponsorships and fund events. This way, people are exposed to messages about health rather than unhealthy products when they watch sports events or musical concerts.

“We don’t need to regulate tobacco advertising – the tobacco companies are proposing a voluntary code.” Tobacco company codes, by their own admission in internal documents, are designed solely as public relations strategies to forestall meaningful regulation of promotion: An industry code will be written [for Pakistan]...so that it can be used as both a lobbying lever and an argument against not introducing formal legislation. Philip Morris, 1994.

TAXATION FCTC: Taxation & Duty Free Sales (Article 6) Tobacco tax increases are encouraged. Recognition that raising tobacco prices "is an effective and important means of reducing tobacco consumption“ Duty-free sales are discouraged. Parties may prohibit or restrict duty-free sales of tobacco products.

Cigarette price and consumption show opposite trends (1) Real price of cigarettes and annual per adult cigarette consumption in South Africa Source: Saloojee 1995

Common Arguments Against Tax Hikes & Useful Responses

“Tobacco taxes hurt the poor and punish smokers” Tobacco taxes are extremely effective in reducing tobacco use. For every 10% increase in the real price of tobacco products, consumption in middle-income countries will drop by about 8%. The decrease will be greatest among youth and the poor, exactly those groups that government policy hopes to benefit the most and that can least afford to bear the burden of tobacco- caused disease. Money from taxes can be used to pay for programs that help smokers quit smoking, and for programs that benefit the poor.

Smoking accounts for much of the mortality gap between rich and poor Risk of death of a 35 year old male before age 70, by education levels in Poland, 1996 Source: Bobak et al., 2000

“Tobacco taxes are just a money grab by governments” It is true that some governments raise tobacco taxes primarily to increase government revenue. But this does not detract from the fact that tobacco taxes are healthy public policy.

“Government will lose revenue if they increase tobacco taxes” There has not been a single instance in which an increase in tobacco taxes has resulted in decreased government revenue. On the contrary, data from dozens of countries shows that when tobacco taxes increase, revenue from tobacco taxes increases. Although tobacco consumption falls in response to higher prices, because tobacco is addictive the decline is small in proportion to the tax increase, guaranteeing stable government revenue at least in the medium term.

“Higher tobacco taxes will increase tobacco smuggling” The level of corruption in a country as measured by the “transparency index” is a far better predictor of tobacco smuggling than the level of tax. In most countries, the benefits of higher tobacco taxes in terms of health and revenue have been significant even in countries where the level of consumption of smuggled tobacco is high. And governments can use increased tax revenue to strengthen anti-smuggling efforts. The level of corruption in a country as measured by the “transparency index” is a far better predictor of tobacco smuggling than the level of tax. In most countries, the benefits of higher tobacco taxes in terms of health and revenue have been significant even in countries where the level of consumption of smuggled tobacco is high. And governments can use increased tax revenue to strengthen anti-smuggling efforts.

Secondhand Smoke FCTC: Secondhand Smoke (Article 8) Parties recognize that scientific evidence has unequivocally established that exposure to tobacco smoke causes death, disease and disability. Obliges parties to adopt “effective” laws to protect citizens from tobacco smoke. Guiding Principle calls on governments to contemplate measures to protect all persons from exposure to tobacco smoke.

Clean Indoor Air Laws, Consumption & Public Health Scientific Rationale Definitive reports by the International Agency for Research on Cancer, the U.K. Scientific Committee on Tobacco and Health, and the U.S. Environmental Protection Agency, among others, have concluded that tobacco smoke is a human carcinogen.

Prohibiting Smoking in Public Places Policy Rationales: Protecting Non-Smokers Influencing Smoking Consumption Changing Social Norms

Common Arguments Against Clean Indoor Air Laws & Useful Responses

“There is no proven link between secondhand smoke and disease” Every credible medical and scientific organization in the world – including the World Health Organization, the US Surgeon General, the International Agency for Research on Cancer – agree that secondhand smoke exposure causes serious illness and death in nonsmokers. Every credible medical and scientific organization in the world – including the World Health Organization, the US Surgeon General, the International Agency for Research on Cancer – agree that secondhand smoke exposure causes serious illness and death in nonsmokers.

“Shared smoking and nonsmoking areas will solve the problem” This is like having a urinating and non- urinating section in a swimming pool. Would you jump in? If the air is shared, the smoke pollution is shared. Smoke in the smoking section causes disease in the nonsmoking section.

“Secondhand smoke is just an issue of poor ventilation” Better ventilation may reduce the odour of smoke, but it does not eliminate the harmful chemicals. To eliminate these chemicals in an average smoking office, so many air exchanges would be required that there would be a small typhoon. Why force businesses to invest in expensive ventilation equipment when they can just eliminate the source of the pollution? The cheapest, most effective, and only sensible solution is to eliminate smoking indoors.

“Smoke-free environments will harm businesses, especially bars, restaurants, and tourist industries” Workplaces that are smoke-free lower their maintenance and insurance costs, and their workers are more productive. Smokers and nonsmokers exposed to smoke get sick more often, and smoke-free workplaces help smokers to quit smoking. The effect of banning smoking in bars and restaurants has been studied in hundreds of communities. Sales receipts show that sales increase or remain the same in smoke-free bars and restaurants in comparison to those in jurisdictions that still allow smoking. Studies that show otherwise are always funded by the tobacco industry allies, and usually look at owner predictions rather than actual sales data.

“Government doesn’t have the right to tell my business what to do” Businesses do not have the right to endanger the health and lives of their employees and customers. Government is obligated to protect public health and safety, as it does when it regulates drinking and driving, implements seatbelt laws, or sets environmental pollution standards.

“Smoking restrictions infringe on smokers’ rights” As the saying goes, “my right to swing my arm stops where your nose begins.” Smokers do not have the right to harm others with their smoke. Smoke-free environments do not violate the “right” to smoke, they protect the right of nonsmokers’ to breathe clean air.

PACKAGING & LABELING Article 11 Every package carries health warnings describing the harmful effects of tobacco use. These warnings and messages: shall be rotating shall be rotating shall be large, clear, visible and legible shall be large, clear, visible and legible should be 50% or more of the principal display areas but shall be no less than 30% of the principal display areas should be 50% or more of the principal display areas but shall be no less than 30% of the principal display areas may be in the form of or include pictures or pictograms. may be in the form of or include pictures or pictograms.

Brazilian Health Warnings

Canadian Health Warnings

Ban Misleading Terms Such as “Light”, “Mild” and “Low-Tar”

PACKAGING & LABELING Scientific and economic rationale Prominent health warnings and messages on tobacco product packages have been found to lead to an increased awareness of risks and an increased desire to quit “Light”, “low-tar” and other misleading descriptors represent one of the biggest consumer frauds of all time. Smokers have a right to know what they are consuming and the risks.

Companies use cigarette packages as a form of advertisement – they are seen every time they are purchased, pulled from someone’s purse or pocket, left on a bar or restaurant table, or held by an actor in a movie. Country-specific warnings help reduce smuggling.

Common Arguments Against Packaging & Labeling and Useful Responses

“Health Warnings are ineffective” The package messages in many countries are ineffective because they are so small and give unclear information. In countries where health messages on packages are large and use pictures, many smokers have tried to quit smoking. These messages can reinforce other elements of a tobacco control program, such as smoke-free environments. A pack a day smoker will see the messages 7,300 to 9,125 times a year.

“People here buy single cigarettes, they won’t even see packages” If the health messages are large and clear enough, people will see them when they are displayed for sale, when they are taken out of smokers’ pockets and purses, and when they are discarded. Package messages are one of the cheapest and widest-reaching forms of public education available.

“Many people can’t read so package messages won’t work” This is a good reason to have pictures accompanying text messages. Pictures can graphically illustrate the health harms of smoking and secondhand smoke, and can be understood even without text.

“It will cost the companies too much to retool their printing presses” The companies change their packaging all the time

SMUGGLING – Article 15 Parties must “monitor and collect data on cross- border trade in tobacco products, including illicit trade, and exchange information among customs, tax and other authorities” Requires parties to implement measures to monitor, document and control the storage and distribution of tobacco products in transit.

Common Arguments Against the FCTC and Useful Responses

“The FCTC is taking away the sovereign right of countries to decide their own approach to tobacco use” The FCTC has been negotiated by WHO Member States in their capacity as sovereign nations. It is an agreement that countries can choose to ratify sign or not. The vast majority of countries support the FCTC, because they see it as a mechanism to strengthen their national efforts to reduce tobacco use.

“The FCTC will violate trade agreements” By signing and ratifying the FCTC, countries will acknowledge the importance of measures to protect public health and will be less likely to challenge other countries that implement such measures. By signing and ratifying the FCTC, countries will acknowledge the importance of measures to protect public health and will be less likely to challenge other countries that implement such measures.

Groups 1. Advertising 2. Taxation 3. Clean indoor air 4. Packaging and labeling (includes warning labels, light & low, etc) 5. The FCTC

Task 1.Develop three key arguments in favor of the policy and be able to present them in a concise and convincing manner 2.Anticipate main industry arguments against the policy and develop responses 3.Develop three main industry arguments for the next group