Impact assessment of the WHO Framework Convention on Tobacco Control: introduction, general findings and discussion

The emergence of non-communicable diseases (NCDs) as the leading cause of global death and disease became evident towards the end of the 1990s. Awareness of this development led in 2000 to the adoption of the World Health Organization’s (WHO) Global Strategy on Prevention and Control of Non-communicable Diseases and subsequent publicity.1 2 Well before this, governments, health authorities and non-governmental organisations (NGOs) had developed a range of actions in many countries and internationally to combat smoking. There was overwhelming evidence on the devastating and growing impacts of tobacco use on public health. The WHO has long had a commitment to tobacco control: in 1970, the World Health Assembly called on governments to take action to reduce smoking,3 and in 1979, a report of the WHO Expert Committee on Smoking Control described a blueprint of various policy interventions to reduce the prevalence of smoking.4 With growing international pressure, negotiations were started in the late 1990s to prepare and adopt an international framework convention to curb the global tobacco epidemic. The WHO Framework Convention on Tobacco Control (FCTC) was adopted in 2003 and entered into force in 2005.5 Tobacco control became one of the key pillars of the WHO Global NCD Strategy that emphasised prevention through influencing the four main behavioural risk factors: tobacco use, unhealthy diet, physical inactivity and harmful use of alcohol. Indeed, the FCTC was the first specific instrument for this work. It was followed by the WHO Global Strategy on Diet and Physical Activity in 2004 and the Global Strategy on Harmful Use of Alcohol in 2010,6 7 but what was and remains unique for tobacco is that the FCTC is an international legal instrument, binding in countries that have ratified it (currently 181 Parties, including the European Union). In the 12 years in …