2012 GLOBAL PROGRESS REPORT on implementation of the WHO Framework Convention on Tobacco Control Contents Scopes of global progress report Overall progress in implementation of the Convention Implementation of the Convention by provisions Prevalence of tobacco use and tobacco-related mortality Priorities and challenges in implementing the Convention Conclusions GLOBAL PROGRESS REPORT 2012 2 Scopes of global progress report Provides a global overview of the status of implementation of the Convention, on the basis of the 126 reports provided by the Parties in the 2012 reporting cycle; Tracks progress made in implementation of the Convention between different reporting periods; Draws conclusions on overall progress, opportunities and challenges, and provides key observations by article. GLOBAL PROGRESS REPORT 2012 3 Overall progress in implementation of the Convention Current status of implementation Progress in implementation between reporting periods Examples of recent strong achievements GLOBAL PROGRESS REPORT 2012 4 Current status of implementation Articles with the highest reported implementation rates (with more than 65% average implementation rates across the 126 Parties analysed): Article 8 (Protection from exposure to tobacco smoke) Article 12 (Education, communication, training and public awareness) Article 16 (Sales to and by minors) Article 11 (Packaging and labeling of tobacco products) GLOBAL PROGRESS REPORT 2012 5 Current status of implementation (cont’d) Articles with reported implementation in the range 40% to 60%: Article 15 (Illicit trade in tobacco products) Article 6 (Price and tax measures to reduce the demand for tobacco) Article 5 (General obligations) Article 10 (Regulation of tobacco product disclosures) Article 20 (Research, surveillance and exchange of information) Article 14 (Demand reduction measures concerning tobacco dependence and cessation) Article 9 (Regulation of the contents of tobacco products) Article 13 (Tobacco advertising, promotion and sponsorship) GLOBAL PROGRESS REPORT 2012 6 Current status of implementation (cont’d) Articles with the lowest reported implementation rates (of less than 25%): Article 18 (Protection of the environment and the health of persons) Article 19 (Liability) Article 22 (Cooperation in the scientific, technical and legal fields and provision of related expertise) Article 17 (Provision of support for economically viable alternative activities) GLOBAL PROGRESS REPORT 2012 7 Average implementation rates (%) of substantive articles GLOBAL PROGRESS REPORT 2012 8 Progress in implementation between reporting periods Changes in percentages of average rates of implementation by article GLOBAL PROGRESS REPORT 2012 9 Progress in implementation between reporting periods Articles that attracted relatively high positive changes over the reporting periods: Article 8: +15 percentage points Article 13: +12 percentage points (for the comprehensive advertising ban) Article 12: +11 percentage points Article 16: +7 percentage points Article 20: +5 percentage points GLOBAL PROGRESS REPORT 2012 10 Progress in implementation between reporting periods (cont’d) Article 22: +4 percentage points; and Article 14: +3 percentage points Overall (all substantive articles): +4 percentage points (from 52% (by 2010) to 56% (in 2012)) GLOBAL PROGRESS REPORT 2012 11 Examples of recent strong achievements Article 8 Australia, Canada – smoking bans including partly covered or outdoor areas Article 9 Brazil – ban on the use of additives Article 11 Australia – plain packaging; Uruguay, Mauritius – increase in the size of pictorial warnings GLOBAL PROGRESS REPORT 2012 12 Examples of recent strong achievements (cont’d) Article 13 ban on displays of tobacco products at the point of sale: Australia (at subnational level), Canada, Finland, Ireland, Nepal, New Zealand, Norway, Palau and Panama; and ban on advertising of tobacco products at points of sale: Australia (at subnational level), Finland, Ireland, Nepal and Ukraine GLOBAL PROGRESS REPORT 2012 13 Article 5 (General obligations) 74 Parties reported having comprehensive tobacco-control strategies, plans and programmes (Article 5.1) 102 Parties reported having designated a national focal point for tobacco control; 76 Parties have a tobacco-control unit (Article 5.2(a)) 91 Parties reported having established national coordinating mechanisms for tobacco control (Article 5.2(a)) GLOBAL PROGRESS REPORT 2012 14 Article 5 (cont’d) Adoption of legislative, executive, administrative and other measures (as per Article 5.2(b)) in relation of ratification of the WHO FCTC GLOBAL PROGRESS REPORT 2012 15 Article 5.3 (Protection of public health policies from the tobacco industry) 68 Parties reported taking steps to prevent tobacco industry interference 34 Parties took measures to make information on tobacco industry activities available to the public Specific references on Article 5.3 included in national legislations: Burkina Faso, Djibouti and Namibia GLOBAL PROGRESS REPORT 2012 16 Article 5 (cont’d) – Key observations Achievements Challenges More Parties report having developed and implemented comprehensive tobacco control strategies and programmes Reduced capacity for tobacco control at administrative and technical levels in about one fifth of Parties 79% of Parties strengthened their existing or adopted new tobacco control legislation after ratifying the Convention National coordinating mechanisms should be strengthened In 15 Parties tobacco control legislation is still missing Lawsuits initiated by the tobacco industry Increasing number of Parties cover Article 5.3 in their national legislation GLOBAL PROGRESS REPORT 2012 17 Article 6 (Price and tax measures to reduce the demand for tobacco) Total tax rates levied by Parties on cigarettes by WHO region (% of average retail prices) GLOBAL PROGRESS REPORT 2012 18 Article 6 (cont’d) Percentages of Parties reporting on types of tobacco excise taxation across reporting periods, by WHO region GLOBAL PROGRESS REPORT 2012 19 Article 6 (cont’d) Mean average prices per pack of 20 cigarettes (US$) for different reporting periods, by WHO region GLOBAL PROGRESS REPORT 2012 20 Article 6 (cont’d) 38 Parties reported that they prohibit or restrict duty-free sales to international travelers 57 Parties prohibit or restrict imports by international travelers of tax- and duty-free tobacco products 14 Parties provided information on earmarking tobacco taxes for health 35 Parties provided data on economic burden of tobacco use GLOBAL PROGRESS REPORT 2012 21 Article 6 (cont’d) – Key observations Achievements Increased proportion of Parties levying excise taxes or apply specific or mixed excise systems GLOBAL PROGRESS REPORT 2012 Challenges Collection and provision of taxation/pricing data, especially in the case of tobacco products other than cigarettes Lack of data on economic burden of tobacco use in around ¾ of Parties 22 Article 8 (Protection from exposure to tobacco smoke) Number of Parties (of 120 Parties that provided information on this area) applying various degrees of bans on tobacco smoking, by setting GLOBAL PROGRESS REPORT 2012 23 Article 8 – Extent of smoke-free regulations Number of Parties (of 109 Parties that reached their individual five-year time frame for implementation) reporting complete bans on tobacco smoking, by the number of types of public places in which such bans apply GLOBAL PROGRESS REPORT 2012 24 Article 8 – Enforcement of measures 88 Parties reported having mechanisms/infrastructures for the enforcement of smoke-free measures (monitoring/prosecution arms) Compliance monitoring • • • • Health, sanitary, labour and educational inspectorates (national/subnational) NGOs Police force Mechanisms to receive and address citizens’ complaints Penalties/prosecution • • Embedded in national legislations Types and level of administrative penalties laid down in codes of administrative offences/violation GLOBAL PROGRESS REPORT 2012 25 Article 8 – Time frame for implementation (5 years, in the guidelines) Number of Parties (of 109 Parties that reached their individual five-year time frame for implementation) reporting complete bans on tobacco smoking, by types of public places GLOBAL PROGRESS REPORT 2012 26 Article 8 (cont’d) – Key observations Achievements Increased rate of complete bans Extending the bans to partly covered and outdoor areas GLOBAL PROGRESS REPORT 2012 Challenges Only about half of Parties provide “complete” protection (in all analyzed settings) Missed timelines for implementation Complete bans only applying to subnational jurisdictions Enforcement-related difficulties Need to improve knowledge on existing legislation (e.g., educational campaigns) 27 Article 9 (Regulation of the contents) and Article 10 (Regulation of tobacco product disclosures) Number of Parties implementing provisions under Article 9 GLOBAL PROGRESS REPORT 2012 Number of Parties implementing provisions under Article 10 28 Articles 9 and 10 – Key observations Achievements Increase in the number of Parties requiring disclosure to government authorities Some Parties banning additives (e.g. flavours) – Australia, Brazil, Canada, Chile, Panama, South Africa Requiring reduced ignition propensity standards – EU, Norway, South Africa GLOBAL PROGRESS REPORT 2012 Challenges Relative lack of legislation requiring the testing and measuring the content and emissions Lower rates of disclosure to the public – mostly tar, nicotine and CO required on the packs Shortage of independent testing facilities 29 Article 11 (Packaging and labeling of tobacco products) Number of Parties implementing provisions under Article 11 GLOBAL PROGRESS REPORT 2012 30 Article 11 – Time frame for implementation (3 years) Number of Parties that have implemented the eight time-bound provisions under Article 11 (of 119 that reached their individual three-year deadlines) GLOBAL PROGRESS REPORT 2012 31 Article 11 – Key observations Achievements Parties increasing the size of warnings and including pictures and pictograms Coordination at subregional levels (CARICOM, EU, GCC) New strong measures and breakthroughs (plain packaging) WHO FCTC Health Warnings Database and sharing licenses for the use of pictorial warnings GLOBAL PROGRESS REPORT 2012 Challenges 19 Parties reported not requiring health warnings at all Comprehensiveness of packaging policies is still low Less than half of Parties require over 50% and pictorial warnings Interference of the tobacco industry is intense (filing legal actions or delaying effective legislation) 32 Article 12 (Education, communication, training and public awareness) Areas covered in Parties’ educational and public awareness programmes GLOBAL PROGRESS REPORT 2012 33 Article 12 (cont’d) Number of Parties that reported targeting specific groups in educational and public awareness programmes GLOBAL PROGRESS REPORT 2012 34 Article 12 – Key observations Achievements 115 Parties implemented some educational and public awareness programmes Children, young people and the general public are the most frequently targeted groups Communication programmes on newly adopted tobacco control legislation More Parties share details of their educational programmes in their reports GLOBAL PROGRESS REPORT 2012 Challenges Gender specific messages are still not widespread Fewer messages on economic and environmental consequences of tobacco use Broad and sustained media campaigns are resource intensive 35 Article 13 (Tobacco advertising, promotion and sponsorship) Over 2/3 of Parties (86) reported introducing a comprehensive ban on all forms of tobacco advertising promotion and sponsorship 53 of the Parties with a ban in place include cross-border advertising, promotion and sponsorship originating from their territory in the ban Five Parties (Canada, Cook Islands, Ghana, Japan and Mexico) explained that they are precluded from doing so by their constitutions or constitutional principles GLOBAL PROGRESS REPORT 2012 36 Article 13 (cont’d) Number of Parties reporting inclusion of selected provisions in their ban on tobacco advertising, promotion and sponsorship (of 86 Parties that reported a comprehensive ban) GLOBAL PROGRESS REPORT 2012 37 Article 13 – Time frame for implementation (5 years) Number of Parties implementing timeline-bound provisions under Article 13 (of 109 Parties that reached their individual deadlines for implementation) GLOBAL PROGRESS REPORT 2012 38 Article 13 – Key observations Achievements Challenges 9 Parties reported introducing a ban of displays of tobacco products at POS Banning cross-border advertising originating and entering the territory 4 Parties reported of having implemented a ban on advertising at POS Tobacco advertising on the Internet Timely implementation of the advertising ban (less than half of Parties) GLOBAL PROGRESS REPORT 2012 39 Article 14 (Measures concerning tobacco dependence and cessation) Half of the Parties reported having developed integrated national cessation guidelines based on scientific evidence and best practices Over half of the Parties (76) reported including tobacco-dependence diagnosis and treatment and counselling services in their national tobacco-control strategies, plans and programmes Almost 2/3 of Parties (81) integrate tobacco dependence services in their health-care systems; in 1/4 of Parties such services are fully reimbursed, in another 1/4 they are partially reimbursed 1/3 of Parties (46) included tobacco dependence treatment in the curricula of medical professionals GLOBAL PROGRESS REPORT 2012 40 Article 14 (cont’d) Number of Parties reporting a specific programme to promote cessation of tobacco use GLOBAL PROGRESS REPORT 2012 41 Article 14 – Key observations Achievements Use of novel approaches and new technology to promote cessation (smartphone applications, interactive media devices (touchscreen technology), text messaging, and web-based messaging, use of social networking site Facebook) Gender specific programmes (UK: cessation guidelines for pregnant women; Canada, France: special programmes on cessation to women) Increase in the number of Parties which include NRT in their essential drug lists GLOBAL PROGRESS REPORT 2012 Challenges Low rates of inclusion of tobacco dependence treatment in the curricula of health professionals High market prices for pharmaceutical products that may help users to quit 42 Article 15 (Illicit trade in tobacco products) 2/3 of Parties (84) reported enacting or strengthening legislation to control illicit trade; and 7 more have begun to develop such legislation More than half of Parties (69) provided data on seizures of illicit tobacco products 17 Parties provided data on the share of smuggled tobacco products on the national tobacco market (ranging from 0.20% (Sweden) to 40% (Botswana)) Over 1/4 of Parties (36) reported that they developed a tracking and tracing regime GLOBAL PROGRESS REPORT 2012 43 Article 15 (cont’d) Number of Parties reporting implementation of Article 15 provisions GLOBAL PROGRESS REPORT 2012 44 Article 15 – Key observations Achievements Number of Parties reporting implementation of Article 15 provisions. GLOBAL PROGRESS REPORT 2012 Challenges Relatively low implementation of tracking and tracing regimes Need for a reinforcement of tools and capacities for the effective implementation of this article 45 Article 16 (Sales to and by minors) 90% of Parties (112) reported prohibiting sales of tobacco products to minors and 2/3 of Parties (84) reported prohibiting sales by minors The legal age of majority was specified as ranging from 16 to 21 years Examples of activities undertaken to raise awareness among tobacco sellers of the rules concerning sales to minors and to monitor compliance with such rules is available from several Parties Good practices on reducing the accessibility of tobacco vending machines to prevent minors from using them are available from Australia, Austria, Belgium, Canada and San Marino GLOBAL PROGRESS REPORT 2012 46 Article 16 (cont’d) Number of Parties reporting implementation of Article 16 provisions GLOBAL PROGRESS REPORT 2012 47 Article 16 – Key observations Achievements Challenges One of the highest overall implementation rates for this Article Monitoring compliance and enforcement of measures on sales to minors 24 Parties reported recently amending their national legislation in this area Parties which still allow the use of tobacco vending machines take measures to make them less accessible to minors Various sales practices still allowed and/or difficult to enforce (street sales, sales of individual sticks and small packs) GLOBAL PROGRESS REPORT 2012 48 Article 17 (Provision of support for economically viable alternative activities) 62 Parties reported (of 129 reporting) growing tobacco in their jurisdictions the reported share of the value of tobacco leaf production in GDP is around or below 1% good examples of approaches to providing alternative livelihoods are available from a few Parties (Bangladesh, Brazil, Canada, Malaysia, Mexico) GLOBAL PROGRESS REPORT 2012 49 Article 18 (Protection of the environment and the health of persons) Recent progress reported by Parties in areas such as: • • • • • • introducing policies to regulate tobacco manufacturing implementing measures to improve energy savings and reduce emissions in the course of tobacco production inspecting tobacco manufacturing facilities regularly to verify compliance with production standards establishing sanctions for environmental pollution caused by tobacco manufacturing developing guidelines for good agricultural practices in the use of fertilizers, plant protection products and water consumption ensuring that agricultural pesticides are only sold by dealers on prescription from agricultural engineers GLOBAL PROGRESS REPORT 2012 50 Articles 17 and 18 – Key observations Achievements good practice examples available from a few Parties on the provision of alternative livelihoods and protection of the environment in relation to tobacco growing and manufacturing GLOBAL PROGRESS REPORT 2012 Challenges implementation of these articles are still to be strengthened need for improved data collection on specific programmes and relevant research need for strengthened platforms for information exchange 51 Article 19 (Liability) 35 Parties reported having implemented measures that tackle criminal and civil liability, including compensation, for the purposes of tobacco control Examples on progress provided by a few Parties in areas such as • • implementation of measures in respect of civil or criminal liability with a view to enforcing tobacco-control policies developing legislative measures for civil or criminal liability Brazil indicated that legislation was being developed to establish the compensation to be paid by the tobacco industry to the Government for the treatment costs of tobacco-related diseases GLOBAL PROGRESS REPORT 2012 52 Article 19 – Key observations Achievements around one quarter of Parties reported having implemented liability measures a few Parties reported on their legislative framework and/or specific examples GLOBAL PROGRESS REPORT 2012 Challenges few Parties reported operationalizing their existing frameworks for criminal and civil liability in relation to tobacco control scarcity of successful and welldocumented court cases to serve as examples of good practice 53 Article 20 (Research, surveillance and exchange of information) Number of Parties reporting implementation of research activities, by topic GLOBAL PROGRESS REPORT 2012 54 Article 20 – Reported research areas surveys within the Global Tobacco Surveillance System (Global Youth Tobacco Survey; Global Adult Tobacco Survey; Global School Professionals Survey; Global Health Professions Students Survey) tobacco use among young people (Netherlands) impact of tobacco-control policies on smoking rates and patterns of quitting (Republic of Korea) exposure to tobacco smoke in hospitality venues (Spain) tobacco policy monitoring, with special regard to supply and labelling of tobacco products and exposure to tobacco smoke (Panama) comorbidity of tobacco use with alcohol consumption (Togo) tobacco industry interference with tobacco policy development (Ecuador) GLOBAL PROGRESS REPORT 2012 55 Article 20 – Surveillance systems around or less than half of Parties cover, in their surveillance systems, • • • • • patterns of tobacco consumption exposure to tobacco smoke determinants of tobacco consumption consequences of tobacco consumption social, economic and health indicators related to tobacco consumption. examples of practices concerning regular collection of tobaccorelated national data provided by Lithuania, Malta, Republic of Korea, South Africa GLOBAL PROGRESS REPORT 2012 56 Article 20 – Key observations Achievements Challenges strengthening of research and surveillance capacity reported by a number of Parties lack of research programmes, including basic research (e.g, collection of prevalence data) training and support to those engaged in tobacco control and facilitation of exchange of information reported by around half of Parties insufficient national capacity and funding for research, monitoring and evaluation lack of established and functioning national system for epidemiological surveillance in around half of Parties relative lack of gender-specific research and research in the treatment of tobacco dependence GLOBAL PROGRESS REPORT 2012 57 Article 21 (Reporting and exchange of information) Status of reporting by the Parties combined submission rate of first (two-year) and second (five-year) reports: 73% since the start of reporting under the Convention (February 2007), the Secretariat had received at least one implementation report from 159 (91%) out of 174 Parties in 2012, in the first reporting cycle linked to the regular COP session, 126 (72%) of 174 Parties that were due to report actually submitted an implementation report notable improvement in the completeness of reports strengthened efforts to assist Parties in reporting, including Internetbased training sessions and individual assistance and clarifications to Parties provided by the Secretariat GLOBAL PROGRESS REPORT 2012 58 Article 22 (International cooperation) Percentage of Parties reporting on assistance they provided or received, by areas of assistance GLOBAL PROGRESS REPORT 2012 59 Article 22 – Key observations Achievements 1/3 of Parties reported on assistance provided or received 16 Parties also reported encouraging implementation assistance through membership in international organizations most of the assistance received or provided was in the area of establishing and strengthening national tobacco-control strategies, plans and programmes GLOBAL PROGRESS REPORT 2012 Challenges Parties report more on assistance received than on assistance provided Need for further strengthening international cooperation to facilitate compliance with various requirements of the Convention and further promoting cooperation through existing global, regional and subregional mechanisms and through the United Nations system 60 Prevalence of tobacco use Estimated regional averages for prevalence of smoking and smokeless tobacco use among adults (%) GLOBAL PROGRESS REPORT 2012 61 Prevalence of tobacco use (cont’d) Estimated averages for prevalence of smoking tobacco among adults by country income group (%) GLOBAL PROGRESS REPORT 2012 62 Tobacco related mortality More than one third of the Parties (50) reported on tobacco-related mortality data, up from only 15 Parties in 2010 Source of mortality data in the 50 Parties that reported such data: • • • 31 Parties collected data from local studies 14 cases Parties referred to academic journal articles in five cases Parties provided mortality estimates supplied to them by WHO Need for strengthening research involving patterns of tobacco related morbidity and mortality in many Parties; in addition, the methodologies of various studies should be aligned to ensure that monitoring of morbidity and mortality data provides a sound basis for strengthened implementation of the Convention. GLOBAL PROGRESS REPORT 2012 63 Smokeless tobacco products – summary of reported data In the reporting instrument, Parties are required to report data on the prevalence of SLT use, licit supply, seizures, taxation and prices of SLT products. 2/3 of the Parties that submitted a report in the 2012 reporting cycle included data on SLT in their reports, but the completeness of the information provided varies greatly. In general, SLT products are taxed at lower rates than smoking tobacco products, but several Parties (Norway, Serbia, Singapore, Sweden and the United Kingdom) reported recent increases in taxes applied to SLT products. Some Parties provided details of their legislation, regulations or policies concerning SLT products (Australia, Brunei Darussalam, European Union, Malta, New Zealand). Three Parties (Australia, Iceland, Nepal) reported on recently completed or ongoing research concerning SLT. GLOBAL PROGRESS REPORT 2012 64 Priorities in implementing the Convention The most frequently reported priority areas are: • • • • • • • adoption, implementation and enforcement of tobacco control legislation, strategies and action plans and strengthening capacities for tobacco control (Article 5) protection from exposure to tobacco smoke (Article 8) education, communication, training and public awareness (Article 12) taxation of tobacco products (Article 6) packaging and labelling of tobacco products (Article 11) treatment with regard to tobacco dependence and cessation (Article 14) tobacco advertising, promotion and sponsorship (Article 13). GLOBAL PROGRESS REPORT 2012 65 Constraints and barriers interference by the tobacco industry in tobacco-control policy development lack of or insufficient political will insufficient level of financial resources for tobacco control lack or weakness of intersectoral coordination within the country, including the lack of understanding, interest or commitment of sectors other than health regarding the need for intersectoral action for tobacco control GLOBAL PROGRESS REPORT 2012 66 Conclusions 1. The transition to the new reporting cycle linked to regular sessions of the COP has been relatively smooth, with 72% of the Parties submitting reports in the 2012 reporting cycle. 2. Implementation rates continue to show disparities between different policy measures; highest implementation rates on Articles 8, 12, 16 and 11. Lowest implementation rates on Articles 18, 22, 19 and 17. 3. With regard to implementation of time-bound requirements of the treaty, the picture is also mixed; full and timely compliance seems to be hard to achieve in most Parties. 4. When comparison is made of progress between the initial (2007–2010) and 2012 reporting periods, the measures related to education, communication and training (Article 12), advertising, promotion and sponsorship (Article 13), and protection from exposure to tobacco smoke (Article 8), emerge as those with the highest positive changes in implementation rates. GLOBAL PROGRESS REPORT 2012 67 Conclusions (cont’d) 5. Several Parties reported on recent measures that mark strong achievements that could inspire accelerated implementation internationally. 6. The measures related to international cooperation and mutual assistance between the Parties continue to be in general underutilized, and thus have great potential for improvement. 7. Comparable data show a continued or emerging decrease of smoking prevalence in several Parties, particularly those with robust tobacco-control policies. 8. Novel products, often effectively marketed, are increasingly appearing on the market (e.g, new smokeless tobacco products). 9. More than half of the Parties that reported in the latest reporting cycle noted a substantial number of constraints and barriers that prevent them from fully implementing the Convention. GLOBAL PROGRESS REPORT 2012 68 The 2012 Global Progress Report available at: http://www.who.int/fctc/reporting/summary_analysis/ GLOBAL PROGRESS REPORT 2012 69