Beyond the regulation by the FDA: Is the tobacco use effectively controlled in the United States?

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Framework Convention on Tobacco Control (FCTC) is the first international treaty adopted by the World Health Assembly in Public Health field in 2003 with the aim of decreasing in the global tobacco consumption and exposure. This treaty provides some frameworks to help countries in regulating the tobacco use by policies including a prohibition of tobacco advertising, compulsory indication of the harmful effect of tobacco on its packaging, and heavy taxation on cigarettes.

Although the effectiveness of policies was proven in many countries where the FCTC was adopted earlier, the U.S. has not ratified the FCTC yet. There might be several factors that have delayed ratification, but the Family Smoking Prevention and Tobacco Control Act (FSPTCA) could be the main reason, which actually complies with the FCTC. The FSPTCA authorized the FDA to regulate the manufacture, distribution, and marketing of tobacco products. However, this act was criticized because “the law offers the tobacco industry an opportunity to rehabilitate its image and products as they are now FDA regulated.

FCTC-Ratification-Seven-Years-Later

Stephen F. Sener, MD, national volunteer president at the American Cancer Society said that the U.S has a critical role in ratifying the FCTC, especially for low-income countries. Rationale of his critiques is mainly based on the fact that the U.S., as the fourth biggest tobacco producer in the world, has an huge international impact since it is the home country of multinational tobacco companies, such as Philip Morris.

Although President Obama promised his strong commitment for FCTC before he was elected, he has not shown his presence in this field. In order to promote more effective domestic tobacco control as well as international norms in the U.S., understanding the discrepancies between the FSPTCA and the FCTC is essential. Therefore, we strongly urge senators to set the agenda again so that Obama addresses this gap as the first step to ratify FCTC.

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7 Responses to “Beyond the regulation by the FDA: Is the tobacco use effectively controlled in the United States?”

  1. spak13 Says:

    Thanks for the post and bringing attention to this important issue. International treaties are incredibly powerful instruments, yet their effectiveness depends on ratification and implementation which are not enforceable. That can be an opportunity for soft power, which is an increasingly utilized form of diplomacy, especially by countries like Brazil and Uruguay, who are have used their participation in the FCTC negotiations as strategic platforms to build their image in teh global arena. Brazil in particular is seen as one of the emerging leaders in global health, with their policies and efforts on access to medicines, universal health coverage and tobacco control. This post rightly mentions that the U.S. has yet to ratify it yet many national policies are already in line with those of the FCTC; this is an opportunity for the U.S. to exercise global health diplomacy and further its reputation as a health leader; however, the huge economic interests at stake present a tension that may be difficult to reconcile.

  2. annachung1 Says:

    Given the amount of studies that show how detrimental tobacco is to our health, this treaty should be ratified to further the control over tobacco worldwide. And hopefully this will contribute to the elimination of tobacco use.

  3. Raj Singaraju Says:

    Implementing the FCTC will take a deliberate effort from a broad spectrum of stake holders who have an interest in tobacco cessation. The US is the fourth largest producer of tobacco in the world and companies that produce tobacco, like Philip Morris and British American Tobacco, have taken deliberate steps to undermine the FCTC’s implementation. Both of these companies have “developed internal theoretical models of globalisation to understand why and how the tobacco industry was the target of global-level regulation, using these models to develop responses.” They have used these models to stop the efforts of NGOs world wide in addition to the US. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3188334/

  4. broland3 Says:

    As an asthmatic who is very sensitive to tobacco smoke I found this blog very interesting and informative. To provide a little bit of background on where I’m coming, I was diagnosed with Asthma when I was a young child. Growing up in the United States (where smoking was already on a decline) wasn’t too bad, although occasionally smoke from the smoking-section in restaurants would find it’s way to my seat and my family would need to be reseated. It wasn’t until I traveled to Europe when it became more of a problem. In Europe smoking is much more prominent and it greatly bothered my Asthma several times. Therefore I support an international treaty putting more restrictions on smoking world-wide. Especially since the U.S. is a big manufacturer of cigarettes, I feel that the treaty would send a very clear message about the negative impact of tobacco products. However, as the article points out, I think the treaty should be reexamined so that the tobacco manufacturers can’t use it’s language to their advantage. A newly drafted treaty could be the solution to this problem.

  5. sludmer1 Says:

    Thanks for this post, I learned a lot! I think the FCTC implementation would make a huge difference, especially in developing countries where many people smoke. The benefits of decreasing cigarette smoking are so far reaching and well understood that it’s amazing this has not yet been passed. This will be a huge step in improving global health, thanks for writing about it!

  6. kmansukh Says:

    Thank you for the informative post. While you are absolutely correct in making a pleas to the Senators of the United States,, there is a more fundamental issue of Tobacco lobbyists that have the resources and have used them to support many campaigns across the country. So, it would not be easy for Senators that have won with the support of “tobacco funds” to now turn their back on their business partners.
    In addition, what really alarms me about smoking cessation is that there is a general lack of healthcare services that focus on the real problem – which is the addiction. Smoking, is harmful. However, it is the repetitive chronic physiological need to smoke that has deleterious effects on the human body. So, I would like to see the government focus on the tobacco cessation programs that are helping people quit the addiction. One of the best ways in Nicotine Replacement Therapy (NRT) which is alarmingly MORE expensive than a pack of cigarettes – which entirely defeats the purpose of incentivizing smokers to quit.

  7. cmeghea Says:

    I agree that it is important for US to ratify the FCTC, for various reasons outlined by others who already commented (soft power, international status, etc). However, compared to even countries who did ratify the FCTC, the US is more advanced in its tobacco control measures.

    To make my point, I am using the six components of MPOWER, a set of measures derived from the FCTC intended to assist in the country-level implementation of effective interventions to reduce the demand for tobacco.

    Monitor tobacco use and prevention policies: data on tobacco use and prevention policies is collected consistently at the federal level (www.cdc.gov) and at the state level.
    Protect people from tobacco smoke: many US states passed smoke-free legislation banning smoking in public places, unlike for example some European Union countries that did ratify the FCTC
    Offer help to quit tobacco use: free quit lines are available in many states.
    Warn about the dangers of tobacco: mandated by federal legislation, cigarette health warnings are present on cigarette packs.
    Enforce bans on tobacco advertising, promotion and sponsorship: federal legislation bans tobacco advertising on radio and TV and restricts advertising in other forms of media (print, online)
    Raise taxes on tobacco: most US states significantly raised taxes on tobacco in the past decades

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