Tobacco control in Nepal and FCTC Convention

1. Academic Seminar Presentation
On,
Tobacco Control initiatives: FCTC
Convention and Nepal .
Keshav Raj Ojha
MPH 1st Sem.
PUCMAS, 3rd Batch
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2. Outline of the presentation
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 Background, Introduction and Historical contest.
 Global and National Phenomena.
 FCTC convention .
 Tobacco control initiatives in Nepal.
 Critical analysis of tobacco control initiatives.
 Summery.
 Total no of Slide - 52
Tentative presentation time – 30 Minute

3. Objectives
 To give an Overview of Tobacco control
initiatives in Nepal.
To Compare the tobacco control activities of
Nepal with other Countries.
To give an Overview of FCTC Convention on
tobacco control.
Critical analysis on tobacco control initiatives
of Nepal.
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4. Historical context
 1993 – campaign to raise support for an
international legal approach.
 9th
World conference on Tobacco and Health
(Paris, 1994)
“... Immediately initiate action to prepare and achieve an
International Convention on Tobacco Control...”
 Official mandate introduced into WHO policies;
WHA (1995-96)
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5. Historical context
 Tobacco Free Initiative (TFI) in 1998, Media advocacy
and social marketing campaign, highlighting tobacco
epidemic.
 52nd
WHA, 1999
 Technical working group (TWA).
 Intergovernmental negotiating body.
 TWG produced provisional text of proposed framework
convention.
 Text accepted by 53rd
WHA (May 2000).
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6. Historical context
 21 May 2003, 56th
WHA unanimously adopted WHO
FCTC
- 1st
global PH treaty.
 The Convention was opened for signature (16 June 2003
-29 June 2004)
-168 signatories.
 27 Feb 2005 WHO FCTC entered into force.
 178 countries have ratified (88% of world population)
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7. Global and National Phenomena
Tobacco epidemic
 Public health problem
 Leading cause of premature death
3.5 million deaths in 1998.
10 million expected deaths a year by
2030
 70% in developing countries
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8. Global and National Phenomena
 Tobacco kills nearly 6 million people , hundreds
of billions of dollars of economic loss; & kills
over 8 million people each year by 2030 (WHO
report, 2011)
 If reduce smoking by 20% by 2020, it could
save 150 million lives (Frieden T et al 2007)
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9. Global and National Phenomena
Cigarette smoking causes about one of every
five deaths in the United States each year.
– 278,544 deaths annually among men (including
deaths from secondhand smoke)
– 201,773 deaths annually among women (including
deaths from secondhand smoke)
– More than 480,000 deaths annually (including deaths
from secondhand smoke)
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10. Global and National Phenomena
Cigarette smoking causes premature
death:
• Life expectancy for smokers is at least 10 years
shorter than for nonsmokers.
• Quitting smoking before the age of 40 reduces the
risk of dying from smoking-related disease by
about 90%.
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11. National Phenomena
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12. National Phenomena
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13. WHO FCTC
 The WHO Framework Convention on
Tobacco Control: first global public health
treaty.
 To protect current and future generations
from the effects of tobacco consumption and
to reduce tobacco use and exposure to
tobacco smoke.
 Membership: 178 Parties (incl. EU) to the
FCTC
 Out of 175 WCO Member States, only 15 are
not Parties to the WHO FCTC
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14. 11 Sections and 38 Articles
 Measures to Prevent Interference by
tobacco industry.
 Measures to Reduce Demand for Tobacco.
 Measures to Reduce Supply of Tobacco.
 Other Measures.
FCTC: Elements
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15.  “in setting and implementing their public health
policies with respect to tobacco control, Parties shall
act to protect these policies from commercial and
other vested interests of the tobacco industry in
accordance with national law.”
 “Payments, gifts and services, monetary or in-kind,
and research funding offered by the tobacco industry
to government institutions, officials or employees can
create conflicts of interest.”
Industry interference
(Article 5.3)
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16.  Price and tax measures
 Non-price measures
Demand Reduction
Provisions
(Articles 6-14)
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17. Tobacco tax increase reduces smoking
(Article 6)
“Increasing the price of
cigarettes by increasing
cigarette taxes is the BEST
and FASTEST way to
reduce tobacco use.”
World Bank, 1999 Evidence from UK
Real Price and Consumption of Cigarettes
in the UK, 1971-96
Real price and consumption of cigarettes in the UK
1971-1996
9000
10000
11000
12000
13000
14000
15000
16000
17000
1971 1974 1977 1980 1983 1986 1989 1992 1995
Year
CigaretteConsumption
1994prices(£m)
£ 1.25
£ 1.45
£ 1.65
£ 1.85
£ 2.05
£ 2.25
£ 2.45
£ 2.65
Price(£)1994value
PRICE
CONSUMPTION
Source: Townsend J 1998, Central Statistical Office (UK) (1965-93)
 tax and price policies
 prohibition of tax and duty-
free tobacco products
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18. Demand Reduction:
Non-price Measures
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19. Second hand smokeSecond hand smoke
(Article 8)(Article 8)
Parties are required to adopt and
implement effective measures to
protect against exposure to tobacco
smoke in:
• indoor workplaces,
• indoor public places,
• on public transport,
• and other public places
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20. Packaging and labelingPackaging and labeling
((Article 11)Article 11)
 No promotion through false,
misleading or deceptive terms
such as "light", “mild" or “low
tar".
 Occupying 50% of main
displays, no less than 30%
 Rotating messages
 Pictures and text on the
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21. Education and trainingEducation and training
(Article 12)(Article 12)
 Public awareness on health and
socio-economic risks of tobacco
and benefits of tobacco. cessation
and tobacco-free lifestyle
 Public access to information on the
tobacco industry.
 Training or sensitization and
awareness programmes.
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22.  Comprehensive ban of all
tobacco advertising,
promotion and
sponsorship
 Includes cross-border
advertising, promotion
and sponsorship
originating from a territory
Advertising, promotion andAdvertising, promotion and
sponsorshipsponsorship
(Article 13)(Article 13)
Ban tobacco advertising, promotion and sponsorship
Theme for World No Tobacco Day 2013
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23. Tobacco use cessation
(Article 14)
Smoking cessation is an
essential measure to
reduce tobacco morality in
the coming years.
- WHO 2001
effective measures to
promote cessation of
tobacco use and adequate
treatment for tobacco
dependence
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24. Supply Reduction
Measures
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25.  Mark the origin & indicate
destination of the product, whether it
is legally for sale on the domestic
market
- Tobacco package print “to be sold in …
(country name)
 Monitor cross border trade of
tobacco and exchange customs
information
 Destroy illicit tobacco seized.
Illicit trade of tobacco
(Article 15)
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26.  Prohibit distribution of free
tobacco products to the public
 Ban small packs of less than 20
cigarettes.
 Ban vending machines.
Sales to and by minors
(Article 16)
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27.  Tobacco grown in over 120 countries on
more than 4 million hectares of land
- If food production, could feed 10-20 million
people
 Economically viable alternatives
- tobacco workers, growers and, as the case may
be, individual sellers.
Alternative livelihoods and
environment (Article 17)
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28.  Protection of the environment and the health
of persons
 Liability
 Scientific and technical cooperation
- Research, surveillance and exchange of
information
- Reporting
- Cooperation in the scientific, technical, and legal
fields and provision of related expertise
Others measures
(Articles 18-38)
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29.  Institutional arrangements and financial
resources
- COPs
- Secretariat
- Relation between COPs and intergovernmental
organization
- Financial resources
 Settlement of disputes
 Development of the convention
- Amendments to convention
- Adoption and amendment of annexes
Others measures contd…
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30. • From the 1st
to 5th
five year plan(1956-
1990)
Objectives of GoN was to increase tobacco
production
Janakpur cigarette factory -1959
Tobacco Development Board
Tobacco Control in Nepal
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31. Ban on smoking in public places (transport,
hospitals, schools, workplaces) through
cabinet decision of June 1992
2049/2/19
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32. Ban on advertisement,
promotion and sponsorship of
tobacco and its products
through electronic media
since Feb. 1998 by executive
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33. Supreme Court Verdict
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37. Tobacco Product (Control and
Regulatory) Act, 2011
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38.  6 Chapters and 27 Sections
1. Preliminary(Section 1-2)
2. Control of tobacco Products (S 3-6)
3. Production, Sales and distribution of Tobacco (S
7-11)
4. Inspection, Investigation and Prosecution (S 12-
16)
5. Punishment and Appeal (S 17-18)
6. Miscellaneous (S 19-27)
Tobacco Product (Control and
Regulatory) Act, 2011
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39. Short Title and Commencement:
(1) This Act shall be called "Tobacco Product (Control and Regulation)
Act, 2010.
• Definitions: Unless the subject or context requires
otherwise, in this Act:-
(a)"Tobacco products”
(b) "Smoking
(c) "Consumption of tobacco”
(d) "Manager" means the person who has the ultimate authority to
make decisions on matter of affairs in the public place and in case
of public transportation and the word also includes the driver of such
transportation.
(f) "Manufacturer" means the manufacturer of tobacco.
Chapter 1
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40. (a) The bodies, institutions and offices of the State and
of the Government,
(b) Educational institutions, libraries, training and health
related institutions,
(c) Airport, airlines and public transportations,
(d) Child Welfare Homes, Child Care Centers,
Hermitage for old (Bridasaram), Orphanage, Children
Park and club,
(e) Public toilets,
(f) Work place of industries and factories;
Explanation: For the purpose of this Section, workplace
means an indoor or outdoor area in which employees
perform the job at industries and factories, enterprises
and plant machineries.
Chapter-2
To be deemed Public Places
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41. (g) Cinema hall, cultural centers and theatres.
(h) Hotel, motel, resort, restaurant, bar, dining hall, canteen,
lodge, hostel and guest houses,
(i) Stadium, covered halls, gymnasium, swimming pool houses,
(j) Departmental store and Mini market,
(k) Pilgrimage and religious places,
(l) Public bus stand and ticketing center.
In addition to the public places referred as above, other
places prescribed by Government of Nepal shall also be
deemed as public places having analyzed the
importance and sensitivity of such places and by
publishing a notification in the Nepal Gazette.
Public Places contd.....
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42.  Label, Trademarks, Wrappers and Packaging
 Details to be submitted: nicotine and other contents
 Warning messages and pictures to be mentioned:
 Prohibition on Advertisement and sponsorship:
No person including the manufacturer shall be allowed to
advertise and promote or release or sponsor any program,
news or information about tobacco products through
newspaper and electronic media like radio, television,
FM, internet, email, interaction program, hoarding board,
wall painting, logo, signage, writing, visual, audio, mark,
through a person or any other media.
Chapter 3
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43. Tobacco Product Pictorial Health
Warning Directive 2068- (1)
Cigarette Cartoon,
Parcel
Cigarette Packet
Rectangle Bidi
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44. Tobacco Product Pictorial Health
Warning Directive 2068 contd......
Khainee, Gutha and
others
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45. Examples…..
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46.  < 18 yrs and pregnant women
100 meter distance from educational and health
institutions, child welfare homes, child care
centers, elders’ care home.
To gift or distribute tobacco products free of costs.
Prohibition in sale, distribution and
display:
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47. Inspector ( any government officer designated by GoN )
and Manager may conduct inspection.
Investigation and Inquiry: The Inspector shall carryout
necessary investigation and inquiry
Filling of cases: the Inspector shall, within 25 days from
the date of completion of the investigation and inquiry,
case file before the authority soliciting legal opinion of
the concerned Government Attorney.
Chapter 4: Inspection, Investigation and
Prosecution
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48.  The manager shall punish if a person smokes in
contravention of this act : expell from that place or liable to
pay a fine of one hundred rupees or the both
 The authority hearing the case shall impose the following
punishment :-
(a) not putting the notice : a fine not exceeding five thousand rupees.
(b) Section 7, 8, and 9 : a punishment with a fine not exceeding 50,000
rupees and such tobacco products shall also be confiscated.
(c) Prohibition on Advertisement and sponsorship: a fine not exceeding
one hundred thousand rupees.
(d) Prohibition in sale, distribution and display: a fine not exceeding ten
thousand rupees.
(e) except clauses (a), (b), (c) and (d) : a fine not exceeding five
thousand rupees.
 Appeal: to case hearing authority: an appeal to the
concerned appellate court within thirty five days of such
decision.
Chapter -5 Punishment and Appeal
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49. Formation of Committee :
Health Tax Fund:
Government of Nepal to be plaintiff:
Authority to Hear Cases: The Chief District Officer shall
be the authority to hear and decide the cases filed under
this Act.
To provide assistance: the local administration shall
provide necessary assistance upon the request made by a
Manager and the Inspector.
Power to frame rules: Government of Nepal may frame
necessary rules in order to implement the objectives of this
Act.
Chapter 6 : Miscellaneous
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50. MPOWER provides for six most effective
and important tobacco control policies:
 Monitoring tobacco use and prevention
policies;
 Protecting people from tobacco smoke;
 Offering help to quit tobacco use
 Warning about the dangers of tobacco
 Enforcing bans on tobacco advertising,
promotion and sponsorship
 Raising taxes on tobacco for effective tobacco
control
Strategy for Tobacco Control: MPOWER
(WHO report on global tobacco epidemic 2008)
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51.  The WHO has publicly stated: “The tobacco
industry, its trade associations and key allies
should be kept from the negotiating process.”
 WHO’s ‘one-size-fits-all’ approach.
 Proposals impacting the movement of tobacco
products across borders pose a real risk of
restricting international trade.
 Effective implementation Mechanism of policy
in Nepal.
 Industrial influence over government.
CRITICISMS on Tobacco Control Initiatives
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