Late last month, leaders from the World Health Organization (WHO) celebrated the 10th anniversary of its Tobacco Control Treaty. As the first intergovernmental treaty established to increase tobacco control globally, the treaty sought to significantly decrease the global health burden of tobacco.
The treaty has been widely embraced by UN-member countries, and covers 90% of the world’s population. A decade later, 80% of the countries that ratified the Treaty have strengthened or adopted new tobacco control laws, according to Dr. Vera Luiza da Costa e Silva, Head of the Convention Secretariat, Framework Convention on Tobacco Control. Additionally, smoking bans in public places (i.e., restaurants, workplaces, and public transportation) have been implemented in 48 of the 180 ratifying countries.
In her address marking the 10th anniversary of the Tobacco Control Treaty, WHO Director Dr. Margaret Chan recognized the efforts of governments, health providers, and non-government organizations (NGOs). However, Chan also recognizes that although much progress has been made, obstacles to a smoke-free world remain.
Tobacco use stands out as the single greatest cause of preventable morbidity and mortality worldwide,
Dr. Vera Luiza da Costa e Silva, Head of the Convention Secretariat, Framework Convention on Tobacco Control, warns:
Every year, 8.2 million people die from cancer; at least 1.6 million or 20% of these are tobacco-related. In total, more than 6 million people will die this year from tobacco-related diseases including cardiovascular diseases, chronic lung diseases and cancer.
Obstacles to a Tobacco Smoke-Free World
The WHO sees several challenges to address in the fight against tobacco:
- Tobacco control fatigue. As smoking rates have declined, so has the urgency to enhance controls. According to Chan, “[the tobacco] industry is eager to recruit the next generation of smokers, [and is] especially targeting women.”
- Failure to implement the most effective measures. Taxing the sale of tobacco products is one of the most effective measures in reducing tobacco demand; however, it is one of the least implemented.
- Tobacco industry interference. Chan cites the use of trade and investment agreements to challenge anti-tobacco actions by governments: “The tobacco industry fights hardest against those measures that work best, like price increases, bans on advertising and sponsorship, large pictorial warnings on packages, and plain packaging.”
- Illicit tobacco trade. Though tobacco control has increased significantly, illicit trade accounts for 1 in every 10 tobacco products consumed globally.
- Alternative nicotine delivery systems. The use of alternative tobacco products (i.e., water pipes, smokeless tobacco, and eCigarettes) is gaining popularity and, for the most part, such use remains unregulated.
Quitting Is Difficult, but Support Is Mobile
Data suggests that most smokers want to quit, but fail because tobacco is so addictive. New ways to reach people, and support them through the behavior change process are needed. As Her Royal Highness Dina Mired of Jordan, Director General of the King Hussein Cancer Foundation, elegantly states:
If we don’t take action now, we will continue to suffocate under an enormous cloud of smoke, a cloud that impairs our vision and makes us unable to see the deadly consequences of tomorrow.
mHealth is a promising new player on the field of behavior change and addiction recovery. Through text messaging, smartphone applications, and social media, mHealth helps public health messages reach smokers with warnings of the health consequences of tobacco use, and give them new tools to help them quit. According to Erik Augustson, Ph.D., MPH, program director of the Tobacco Control Research Branch of the National Cancer Institute:
mHealth allows us to significantly increase the reach of our interventions in a cost-effective way.
In the UK, National Health Service-funded programs, such as MiQuit, offer personalized smoking cessation support through SMS messaging. Other campaigns, (i.e., SmokefreeTXT in the US and Quit Now Canada) offer mobile tools, resources, and community support for people striving to stop using tobacco products.