On 28 May, 2004, Mexico became the first country in the Americas to ratify the WHO Framework Convention on Tobacco Control (FCTC). Shortly after ratification, the government entered into an agreement between the then Secretary of State for Health and the leading tobacco companies operating in the country – including the two largest, Cigarros La Tabacalera Mexicana (Cigatam, a subsidiary of Philip Morris International (PMI)) and British American Tobacco (BAT).
The agreement established restrictions on tobacco advertising, marketing, and labeling, largely consistent with those in BAT’s and PMI’s voluntary codes. In addition, the tobacco industry agreed to contribute MXN 1 per pack sold to the Fund for Protection against Catastrophic Costs of the System for Social Protection in Health, which benefits families not eligible for social security. The document also specified that there would be no tax increases on tobacco products while the agreement was in force. These conditions ran counter to the framework guidelines, as national and international public health advocates claimed that tobacco industry donations to the fund could cultivate a favorable public image. They also argued that the agreement demonstrated the tobacco industry’s influence in Mexico in preventing significant advances in tobacco control. The appointment of a new Secretary of State for Health led to the non-renewal of the agreement in 2006.
The legislative power to implement many recommended tobacco control policies rests with the federal government. The federal General Health Law establishes, inter alia, regulations for taxation of tobacco products, restrictions on advertising of tobacco products, requirements for health warnings on tobacco packages, restrictions on sales of tobacco products, educational and communication programs, and improvements to smoking cessation services. The creation of a National Office on Tobacco Control (NOTC) in 2008, within the Health Secretariat, has the 7 potential to support these tobacco control priorities. However, it is important to note that the NOTC resides within the Council for the Treatment and Control of Addictions (CONADIC), while the legislative authority of the Health Secretariat lies within the Federal Commission for the Protection against Sanitary Risk (COFEPRIS). Therefore, the NOTC can advise on legislation but does not have the authority to put forward legislative initiatives directly.
Tobacco Control Policy: Mexico DF
The Ministry of Health for Mexico City has set state-level tobacco control priorities including:
- preventive campaigns and actions to reduce smoking prevalence;
- monitoring and promoting compliance with the regulations on tobacco sales;
- preventive programmes within educational establishments;
- enhancing the quality of smoking cessation services.
The General Health Law of 1990 restricted smoking in some public indoor places. However, the law was effectively discretional, did not require smoking areas to be physically separate and was open to differing interpretations. Combined with a very weak enforcement process, it had little effect in reducing exposure to second-hand smoke.
In 2000, a regulation issued under the General Health Law restricted smoking in federal government buildings and offices. This included buildings in which public services are provided (such as airports and schools), and hospitals and clinics within the National Health System. The new regulation, however, reiterated the pre-existing mandatory requirement to have smoking areas in all facilities covered by the regulations – although for the first time, specified that they should be physically separate and have ventilation installed. Effectively, however, the regulations still did not permit facilities to be 100% smoke-free.
In January 2004, the Ley de Protección a la Salud de los No Fumadores en el Distrito Federal [Law for the Protection of the Health of Non- Smokers in the Federal District] came into force but the Executive did not support the law, regulations were not published and it was effectively ignored. Moreover, this law only required establishments to set aside at least 30% of their premises for non-smokers. While the law was exceedingly weak, the advantage of its existence was that it could subsequently be amended to require smoke-free spaces, therefore avoiding the need to introduce completely new legislation.
On 26 February 2008, the Legislative Assembly for Mexico DF approved amendments to the 2004 Law for the Protection of the Health of Non-Smokers and simultaneously approved the accompanying Law for the Functioning of Commercial Establishments [Ley para el Funcionamiento de Establecimientos Mercantiles]. Changes to the former meant that changes to the latter were needed to ensure that the two laws were consistent. The law requires all enclosed public places and workplaces, including public transport, restaurants and bars to be 100% smoke-free. Designated smoking rooms (DSRs) are not allowed under the law – making DF the largest jurisdiction in Mexico to introduce a comprehensive smoke-free law. The law came into effect on 3 April 2008.
On the same day, the Senate approved a new national tobacco control law. The Ley General para el Control del Tabaco [General Law on Tobacco Control] restricts smoking in indoor workplaces and enclosed public places but requires these places to have separate DSRs or outdoor smoking areas, with businesses having 180 days to set them up. The federal law was published on 30 May 2008 and came into force on 28 August. Regulations under the law were finally issued on 31 May 2009. The federal law requires smoking areas in all establishments, although these areas can be outdoors. The DF law is therefore more protective than the national legislation.