Tobacco Policy

Comprehensive tobacco control policies can have a major impact on tobacco use prevalence, consumption and public health. The most effective tobacco control programmes are comprehensive and cover a wide range of interventions, including cessation, public awareness campaigns on danger of tobacco use, surveillance and evaluation measures, networking and partnership building and policy and regulations. In a broad policy framework, each country’s mix of interventions depends on political, social, cultural and economic factors. Public support is a crucial determinant for success of any tobacco control programme.

The elements for the WHO comprehensive policy supported by Member States are summarized below. The WHO Western Pacific Region, Tobacco Free Initiative Programme, provided this information.

Elements of Comprehensive National Policy

	Fiscal Policy: Increase price of all tobacco products beyond inflation; Use part of the revenue to fund tobacco control efforts.
	Information Policy: Ban tobacco advertising and promotion; Ensure effective health warnings are placed on all tobacco products; Invest in counter-advertising and health education.
	Protect people from exposure to environmental tobacco smoke by establishing smoke-free public places.
	Regulate tobacco products.
	Provide tobacco dependence treatment.
	Ensure adequate institutional support for tobacco control capacity building, applied research, and regular surveillance activities and programme evaluation.
	Support media debates on need for tobacco control, the availability of policies that work and the role of the tobacco industry in thwarting implementation of “healthy” policies.
	Assist farmers to diversify for tobacco growing.

Source: Adapted from World Health Assembly Resolutions

Tobacco control laws and regulations play a critical role in tobacco control. They provide the regulatory framework to express the government’s policies on tobacco. According to the World Bank, the most effective interventions are those that reduce demand. These interventions include:

	Higher cigarette taxes
	Banning all cigarette advertising and promotion
	Restrict smoking in public places
	Requiring strong warning labels and messages on all tobacco product packaging, advertisements and event sponsorship and
	Increased access to cessation services for those who want to quit using tobacco products.

Higher tobacco taxes have been shown to be one of the most effective measures to reduce tobacco use. Low income and the young populations are most harmed by smoking itself, which imposes massive costs in terms of morbidity, mortality, health care expenses, and other social and psychological burdens. Low-income earners and the young are also the beneficiaries of higher tobacco prices because they are more likely to quit, cut back or avoid tobacco addiction.

Higher taxes leading to a 10 percent rise in cigarette prices would motivate about 42 million people to quit smoking, estimates WHO and World Bank researchers. Raising cigarette taxes could prevent about 10 million tobacco-related deaths (9million of these in low and middle-income countries). Not only will tobacco consumption and tobacco deaths drop, but also government revenues will actually rise by 7 percent on average for a 10 percent increase in cigarette taxes.

Figure 3:	Retail Price of 20 Domestic Brand Cigarettes with Tax in Selected African Countries.
Source:	Tobacco Control Country Profiles, American Cancer Society, 2000.

To date, only a few African countries have developed and adopted comprehensive tobacco control policies. Both South Africa and Mali have passed strong tobacco control legislation to protect the health of their people from tobacco and progress is being made in several other African countries to introduce comprehensive tobacco control policies, legislation and regulations. Below is a brief summary of the components of Mali’s and South Africa’s tobacco control legislation.

Mali’s tobacco control legislation includes:

	prohibits tobacco product advertising in the cinema and on radio and television;
	prohibits tobacco promotions;
	requires warning labels on tobacco packaging;
	requires ingredient disclosure on tobacco packaging; and
	prohibits smoking in aircraft, educational facilities, government buildings, health care facilities, public transportation, workplaces and other public places.

In July 1999, SOS TABAGISME, a Malian NGO very active in tobacco control advocacy, organized a successful court order to stop the distribution of free cigarettes. In July, two multinational tobacco companies staged a grandiose promotional parade in Bamako where cigarette brands “Craven A” and “Gauloise” were being distributed free to the public, including minors. SOS TABAGISME obtained a court order forcing the companies to stop their promotional campaign, which was in violation of the new Malian law prohibiting the promotion of tobacco products.

South Africa has passed and implemented a strong tobacco products control act that came into operation in October 2000. The new act includes:

	reduces of the maximum levels of tar and nicotine to 12mg and 1.2 mg respectively
	restricts smoking in public places, including restaurants, passenger ships, passenger trains, workplaces, airports, places of accommodation; places where the primary business is the sale of alcohol beverages and places where the primary business is the provision of entertainment
	bans tobacco product point of sale in retail outlets; and ? prohibits tobacco sponsorship of events and
	prohibits tobacco product marketing and advertising.

Additionally, tobacco taxes were increased by 29% in South Africa’s 1998-finance budget. This represents a 50 percent increase in the average retail price of a packet of cigarettes.