Tobacco control in Latin America: past, present and future

04 Feb 2013

After Uruguay in 2006, eight out of ten South American countries passed smoke-free laws. For some time there was even a ninth country – Paraguay – but the tobacco industry (TI) used legal trickery to undermine that move. Only Bolivia has not drafted legislation to become smoke-free.

The past
In the early 2000s, only Brazil had adopted effective TC measures: a quite comprehensive advertising ban, graphic health warnings (the world’s second) and others, making it an international TC leader.

During the negotiation phase of the WHO Framework Convention on Tobacco Control (FCTC) there was a significant shift in the positions of LA countries concerning the FCTC: from being the weakest supporters worldwide to backers of a strong Convention. This change was lead by Brazil, English-speaking Caribbean countries, Panama and Paraguay.

In the ratification phase, 4 countries from LA and the Caribbean were among the 40 required for the FCTC to come into force: Mexico, Panama, Trinidad and Tobago and Uruguay. Canada was the first in AMRO region.

The Present
The FCTC came into force in 2005. Brazil, the region’s historic TC leader, had problems ratifying the Convention due to TI interference via the country’s tobacco growers, which also slowed the country’s overall TC progress. Uruguay and Panama took the lead, ratifying the FCTC and starting to implement most of its measures.

Colombia overcame problems with ratification and soon passed a comprehensive law. Then came the outcomes, first in Uruguay. Results from that country showed a significant decrease in adult smoking, and even greater reduction among youth, as well as lower hospital admissions for cardiac arrest. The snowball began gathering speed.

In the last few years, most LA countries have passed national TC legislation that complies with their FCTC commitments, making the region a leader in implementation of the Convention.

But all that glitters is not gold. LA is now facing fierce TI opposition, which is undermining progress. The most visible case is the challenge by Philip Morris International (PMI), via the World Bank, to Uruguay’s TC measures. But all of LA is in the industry’s sights.

Another example: Brazil. In 2011, its Congress passed a national smoke-free law, but President Rousseff has not yet endorsed it. Why? Because of its potential impact on Brazilian tobacco growers? No, due to TI interference.

A recent example occurred at the fifth session of the FCTC Conference of the Parties, in November 2012, in Seoul. Honduras and Nicaragua sent official delegations with just one objective: to fight plain packaging as exemplified by Australia’s law! Who do you think funded them?

The future
It is time for LA to act on TC, but also to consider the future. What should be our next step? Which country will adopt an ‘end game’ strategy?

I personally believe that we must continue implementing the FCTC as strongly as possible, including the positive decisions of COP5. The next steps should be to define and implement:

  • A tobacco taxation and pricing policy aimed at achieving public health objectives;
  • A strategy for enforcing FCTC Article 5.3, to prevent TI interference;
  • Plain packaging;
  • A ban on the exhibition of tobacco products (including at point of sale);
  • A national monitoring and evaluation system.

While we take the time to celebrate the TC achievements of this region, let’s not diminish our efforts – the TI would love to take advantage of that opportunity!

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