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To mark World No Tobacco Day 2014, the BMJ has published a special online issue of Tobacco Control with the theme taxes, prices and illicit trade. We’d also like to take this opportunity to congratulate our Editorial Board chair, Professor Ken Warner, and Economics editor, Professor Frank Chaloupka on being awarded a WHO World No Tobacco Day Award. On World No Tobacco Day (31 May), WHO calls on countries to raise taxes on tobacco to encourage users to stop and prevent other people from becoming addicted to tobacco. High prices are particularly effective in discouraging young people (who often have more limited incomes than older adults) from taking up smoking.
WHO calculates that if all countries increased tobacco taxes by 50% per pack, governments would earn an extra US$ 101 billion in global revenue.
Countries such as France and the Philippines have already seen the benefits of imposing high taxes on tobacco. Raising taxes on tobacco in support of the reduction of tobacco consumption is a core element of the WHO Framework Convention on Tobacco Control (FCTC), an international treaty that entered into force in 2005 and has been endorsed by 178 Parties. A comprehensive ban of all tobacco advertising, promotion and sponsorship is required under the WHO Framework Convention for Tobacco Control (WHO FCTC) for all Parties.
Attempts by the tobacco industry to undermine the WHO Framework Convention on Tobacco Control (WHO FCTC) are becoming ever more aggressive. Every year, WHO recognizes individuals or organisations for their accomplishments in the area of tobacco control. Bolivia: the Health and Sport Ministry, in coordination with the Pan American Health Organization (PAHO), WHO, the  Municipal Government of La Paz, the Bolivian Police and Armed Forces organised a  festival to inform people of the negative effects that nicotine produces on the  body. Congo: The tobacco control group ROCAT in partnership with the Ministry of Health and Population and WHO Country celebrated World No Tobacco Day 2013 with a series of events including a press Conference by the Minister of Health briefing, outreach campaigns, and TV and radio coverage. Gabon: WNTD in Gabon focused on a number of high level meetings held with key authorities including the President of the National Assembly and the Minister Delegate to Health.
Jamaica: An outside broadcast addressing tobacco advertising, promotion and sponsorship (TAPS) was held, as well as a national forum. Pacific Islands: The Cook Islands received a WHO WNTD award for its progress in tobacco control since ratifying the FCTC in 2004. Romania: World No Tobacco Day in Romania highlighted the European Commission’s ‘Ex-smokers are unstoppable’ campaign. Switzerland: NGO CIPRET ran an advertisement campaign in the canton of Geneva for WNTD with posters displayed in over 350 locations throughout the city and canton, and large ads in newspaper.
A national level multi-stakeholder consultation was held in New Delhi, at which the government and NGOs resolved in favour of a complete ban on advertising, promotion and sponsorship (TAPS) of tobacco products. The consultation was organized by HRIDAY (Health Related Information Dissemination Amongst Youth) and Voluntary Health Association of India (VHAI) in collaboration with The Ministry of Health and Family Welfare (MoHFW), GoI and World Health Organization Country Office for India.
Mary Anne Charity Trust (MACT) is an NGO in Tamil Nadu state which works actively in the advocacy of change in policies related to tobacco. The Mayor of Chennai Corporation, Honourable Saidai Samiyappan Duraisamy inaugurated the event and gave the key note address. The illustrations that were created will serve as knowledge building tool in exhibitions conducted in schools across the state in an effort to educate the kids on the ill effects of tobacco.
The Indian Cancer Society, Delhi, organised a poster and skit competition, held in the lead up to WNTD. Every year, WHO recognizes individuals or organisations in each of the six WHO Regions for their accomplishments in the area of tobacco control. Cook Islands – The ministry of health sponsored a poem and story competition as well as quizzes at Titi-kaveka College and Avarua school, with prizes for winning students. Federated States of Micronesia Kosrae – a policy makers’ advocacy meeting was held to discuss Article 13 of the FCTC, and a plan was developed to push for passage of a comprehensive ban on tobacco advertising, promotion and sponsorship. Papua New Guinea – primary school students developed a banner and posters, which were then used in a walk.
Marshall Islands – national and local police teamed up with tobacco control coalition team members to remove all tobacco advertising and promotion signs and illegal point of sales displays and replace them with WNTD posters provided by WHO in Fiji.
Samoa – a bike ride around the island was the culmination of a week of campaigning and advocating for smoke free buildings. Tuvalu – a week of community awareness was undertaken in schools, workplaces, community halls and businesses. Solomon Islands – following a range of public awareness raisings activities in the lead up to WNTD, a public parade was held, with speeches by government officials, the WHO representative, and a youth representative.
Kiribati – as the first tobacco act was passed in April 2013, this formed the theme for Kiribati, ‘Support Tobacco Act’ (Kaota am boutoka nakon te Tua ibukin Kauarerekean Kabonganaan te Baake iaon Kiribati.) To raise awareness, activities included radio shows, press releases, awareness programs, a smoke free basketball tournament and public program with a drama show, health check and quiz. Fiji – promotion of new cessation assistance services was held at a health centre, along with news about new pictorial health warnings and tobacco free sites. The event drew on the findings of a study conducted through the ‘ex-smokers are unstoppable’ campaign.
The majority of smokers who took part in the survey say that they smoke between 70 and 140 cigarettes per week (10-20 cigarettes per day), a figure which applies to 32.4% of Romanian smokers. About 28% of Romanian smokers find it difficult to resist the urge to smoke when they are enjoying tea or coffee. Doctor Ioana Munteanu, President of the Tobacco Section of the Romanian Lung Society, who also spoke at the roundtable, said “Where the process of quitting smoking is concerned, it is very important for us to be aware of both the internal and the external factors which facilitate it.
The European Commission’s “Ex-Smokers are Unstoppable” campaign inspires smokers to kick the habit by celebrating the achievements of ex-smokers from all over Europe. Dr Sarah England from Bloomberg Philanthropies expressed congratulations for the approval of Vietnam’s new tobacco control law and conveyed an official letter of Michael Bloomberg, Mayor of New York city to the Vietnam Prime Minister for the great achievements of Vietnam in curbing the tobacco epidemic. VINACOSH, together with a coalition of Vietnamese health groups and international NGOs including the World Lung Foundation, collaborated in an innovative effort to use online media to engage the public around implementation of a new smoke-free law.
Mobile and social media efforts were particularly energised by a partnership with the Youth Union of Vietnam , a steadfast supporter of tobacco control policies in Vietnam, who sent out the word and provided ‘on the ground support’ in the form of hundreds of youth demonstrating at press conferences, attending campaign events, using social media and SMS to build supporters for the online campaign, and going business-to-business to provide smokefree signs and alert owners of their new obligations under the law. The Hue Municipal People’s Committee in collaboration with the Vietnam Public Health Association hosted WNTD and national No Tobacco Week.

A workshop on ‘Evaluating the implementation of smoke-free program in Hue city’ was also held on May 27th. A bike parade was held on June 9th 2013 with the theme ‘Environment protection and smoke-free Nha Trang city’.
The Bolivian news website laRazon reported that for World No Tobacco Day, the Health and Sport Ministry, in coordination with the Pan American Health Organization (PAHO), WHO, the  Municipal Government of La Paz, the Bolivian Police and Armed Forces organised a  festival to inform people of the negative effects that nicotine produces on the  body. The slogan chosen for this year’s WNTD was “Ban all forms of tobacco advertising, promotion and sponsorship” and this was adopted by 19 countries, including Panama and Colombia, to reduce tobacco use.
The WNTD slogan will also be used in the country to stop tobacco companies from recruiting younger smokers. The data were gathered in some twenty cities across the country and looked at 12,254 students between the ages of 12 and 21. The Vice-Minister of Health Promotion, Martin Maturano, noted that the government was taking action to put a stop to tobacco use: “We first want to inform people of the health effects of smoking. He explained that an ongoing communication policy is being implemented through college health services and also noted that eight graphic warnings had recently been added to cigarette packs showing the different risks associated with the product. Willy Alanoca, in charge of Drug Use Prevention at the Ministry of Health pointed out the tobacco companies specifically try to hook the youngest kids.  “The Bolivian tobacco industry reaches the youngest kids by giving them CDs, iPods, backpacks and flash drives. According to Mr Alanoca, the Ministry’s study of ‘Tobacco industry negligence and strategy in Bolivia’ gathered images of minors selling this unhealthy product.
Another analysis showed high levels of air contamination in discotheques in six cities, Alanoca confirmed. The other aspect of the law being violated is the prohibition on selling cigarettes at locations near colleges and universities. The Anti-tobacco Law of 2005 ratified the WHO FCTC and created the Inter-institutional Commission on Tobacco Control and Prevention.
Martin Maturano, the Vice-Minister of Health Promotion noted that other rules also fall short. World No Tobacco Day in Gabon focused on a number of high level meetings held with key authorities including the President of the National Assembly and the Minister Delegate to Health. On 30 May, a press luncheon hosted by NGOs and WHO was held to brief the media on Article 13 of the Framework Convention on Tobacco Control and its implementation in Gabon. Finally on May 31, 2013, events culminated with an address by Mr Nzue Obame, the Resident Representative WHO and Ministry of Health. This is the question asked in a short video produced by ASH USA to mark World No Tobacco Day.
On World No Tobacco Day in the Philippines capital Manila, commuters were stunned to find grisly crime scenes in various locations in the metro. The tobacco ‘crime scenes’ are actually art installations vividly illustrating what tobacco companies don’t want people to see: smoking kills.
Analysis and debate of the latest tobacco control research findings and policy developments. Based on 2012 data, WHO estimates that by increasing tobacco taxes by 50%, all countries would reduce the number of smokers by 49 million within the next 3 years and ultimately save 11 million lives. They also encourage existing young smokers to either reduce their use of tobacco or quit altogether. Tobacco kills nearly 6 million people each year, of which more than 600 000 are non-smokers dying from breathing second-hand smoke.
Article 6 of the WHO FCTC, Price and Tax Measures to Reduce the Demand for Tobacco, recognizes that “price and tax measures are an effective and important means of reducing tobacco consumption by various segments of the population, in particular young persons”.
The World Health Organisation (WHO) and partners everywhere highlight the health risks associated with tobacco use and advocate for effective policies to reduce tobacco consumption.
For example, where jurisdictions have banned advertising of tobacco products through point-of-sale displays – known as tobacco “powerwalls” – or banned the advertising and promotional features of tobacco packaging through standardised packaging, the tobacco industry has sued governments in national courts and through international trade mechanisms.
This year, Mr Paul Kasereka Lughembe of the Democratic Republic of Congo and the Honourable Dr Pradit Sintavanarong, Minister of Public Health, the Kingdom of Thailand were recognised for the WHO Director-General Special awards. WNTD was also an opportunity highlight the findings from a study which showed increased smoking among young women, and a lower age of initiation. Held from 28-30 May, the meetings were a chance to discuss government policy making in relation to tobacco control. Participants included local government officials, law enforcement authorities, parliamentarians, health & education government departments, media, lawyers, civil society organizations, youth and community members. A media roundtable was held, where two doctors discussed the benefits of smoking cessation. As Switzerland has very weak legislation concerning tobacco advertising, promotion and sponsorship the campaign was somewhat provocative – and provoked a strong reaction from the advertising industry. In the capital Manila, commuters were stunned to find grisly crime scenes in various locations in the metro. The national week of Tobacco Control in Vietnam kicked off with a ceremony held on 25 May, which attracted 450 participants from the National Assembly, Government Offices, related Ministries, WHO Vietnam, Tobacco Control Working Groups, mass media and students. The health secretary of the ministry of health and family welfare, Shri Keshav Desiraju while inaugurating the wall of shame said: “We will issue guidelines to the departments concerned to ensure that appropriate action is taken to prevent violation of TAPS”. State Focal Points (Tobacco Control), State Consultants (NTCP), State WHO Consultants and civil society organizations working on tobacco control, from nearly 15 sates of the country attended the consultation. MACT along with Tamil Nadu State Tobacco Control Cell, Cancer Society India and other NGOS organised “Tamil Nadu- Illustrators for Tobacco Control,” on May 31 to commemorate World No Tobacco Day.
The mayor appreciated the goal of the event to take the art works to the government schools and educate the children about the danger of consuming tobacco. They used their creative skills to create awareness on the negative effects of tobacco products. They gathered around the illustrators with curiosity and were much thrilled about the work that was carried out. Activities included a rally, a cancer screening camp, and a ‘wall of shame’ of violations of India’s TAPS ban. There were 6 awardees in the Western Pacific region this year including the Cook Islands Ministry of Health. The Director of Health and Minister of Health joined in with an impromptu comedy piece, and the Minister committed to championing the passage of a Tobacco Control Bill.

There was also a walkathon, followed by a ‘battle of the bands’ for the best song about health. On WNTD itself, two government officials were part of a radio broadcast as Quit Smoking Champions. There was also an official event with speakers from the ministry of health and WHO, which was broadcast on national radio. This was covered by both television and radio, and was complemented by billboard displays at the hospital and near the airport.
A skit about the physical and social impacts of tobacco use was performed by a local youth group in collaboration with nursing school students. Professor Doctor Florin Mihaltan, President of the Romanian Lung Society and one of the doctors who spoke at the roundtable, said: “The European Commission’s Ex-Smokers are Unstoppable campaign, through which this study was conducted, shifts the main focus from the dangers of smoking to the benefits of smoking cessation. Over half of Romanian smokers (56.3%) say that they want to quit their habit within a year. 27% have a hard time socialising with other smokers when trying to quit, while 22% are most tempted by the “morning cigarette”. It is very interesting to see that a very large proportion of the respondents believe that the secret of quitting resides within themselves. It offers people free help to stop smoking through iCoach, a free online stop-smoking tool based on extensive scientific research and clinical experience of psychologists and communication experts. Organized by the Vietnam Committee on Smoking or Health (VINACOSH), it attracted 450 participants from the National Assembly, Government Offices, related Ministries, WHO Vietnam, Tobacco Control Working Groups, mass media and students.
The Vice Minister of Health, Vietnam conveyed his appreciation and acknowledged the considerable support of all ministries, sectors and mass organizations, international donors (Bloomberg Philanthropies, SEATCA) for the cause of tobacco control in Vietnam. The effort also included a mobile short code that allowed supporters to SMS in their support.
The launch event was held with about 300 participants from the health sector, youth union, women’s union, labour union and delegates from provincial people’s committee, city leaders, representatives from government departments and other organisations. This was followed by outreach to public facilities to raise public awareness about the availability and implementation of smoke free policies in Vietnam.
Supported by Nha Trang Municipal People’s Committee in collaboration with Vietnam Public Health Association and Khanh Hoa Provincial Public Health Association, the event attracted 2000 participants including many young people, as well as Mr Takeshi Kasai, Representative of WHO in Vietnam. Medical school graduates of the Universidad Mayor de San Andres and Escuela Nacional de Salud also participated in the event that took place in the Plaza Camacho in La Paz, where music was provided by the group Bajo  Fianza.
He also objected to the fact that club owners do not enforce the rules mandating smoke-free public places, especially those where young people are present. This was followed by the establishment of tobacco focal points and a briefing room of the dangers of tobacco in the building housing the school health services. The installations are part of a campaign called Cause of Death: Tobacco, spearheaded by HealthJustice Philippines in partnership with the Department of Health (DOH), the Metro Manila Development Authority (MMDA), Southeast Asia Tobacco Control Alliance (SEATCA), and the New Vois Association of the Philippines (NVAP), among others.
If no action is taken, tobacco will kill more than 8 million people every year by 2030, more than 80% of them among people living in low- and middle-income countries.
The tobacco industry also uses sponsorship and especially corporate social responsibility tactics to trick public opinion into believing in their respectability and good intentions while they manoeuver to hijack the political and legislative process. His Excellency the Prime Minister Recep Tayyip Erdogan, Republic of Turkey received the WHO Director-General’s Special Recognition certificate. In Islamabad,  a 150 feet long banner carrying signatures from tobacco control activists from all over the country demanding strict tobacco control laws and their effective implementation was displayed. They addressed key issues like negative effects of smoking, health problems caused due to tobacco products, and economic loss of the smokers’ family. The event met with its objective when the public enthusiastically discussed about tobacco and its ill effects. The Cook Islands ratified the FCTC in 2004, and was the first Pacific Island country to produce and work toward a national Tobacco Control Action Plan. Champion awards were presented to advocates of the SI tobacco free initiative, including government agencies, a church, taxi service and global youth leadership group. 80% of Romanians believe that willpower is the key to quitting while 43% identify motivation as the most important factor. When asked how they would feel if they never smoked again, 42% of Romanians said that they would feel proud. Since the launch of the programme in June 2011, a total of 380,819 Europeans have registered to iCoach 22,325 of whom are Romanians. Vietnam has 143 mobile subscribers for every 100 inhabitants, so learning how to best use mobiles to support tobacco control advocacy is very important for the success of future campaigns. A few years later the number of young men dying from lung cancer in France started to go down. The tobacco ‘crime scenes’ were actually art installations vividly illustrating what tobacco companies don’t want people to see: smoking kills.
Similar activities, also organised by the Cancer Aid Society, were held in Mumbai and Kanpur.
Among other successes, areas where the country has made great strides in the past year include a tobacco tax increase and successful launch of a unique Blue Ribbon campaign. The event was attended by numerous media representatives, and obtained massive print, online, radio and TV coverage in Romania. Another 42% believe they would feel healthier and more in control of their health.  Over half of the 1,000 people questioned in Romania believe that smoking gets in the way of certain activities and 20% of respondents believe that smoking affects sporting performance. And as tobacco-related disease and death often strikes people in the prime of their working lives, productivity and incomes fall. In the Philippines, one year after increasing taxes, the Government has collected more than the expected revenue and plans to spend 85% of this on health services. This is the proportion of people who classed themselves as a non-smoker after 3 months on the programme.

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