Medical Professionals and Low- and Middle-Income Countries Must be Engaged to End Smoking Worldwide
The World Health Organization Framework Convention on Tobacco Control (WHO FCTC) was negotiated and adopted to decrease the burden caused by smoking both on the health and economies of the countries most affected. The smokers, users of tobacco, and tobacco growers remained at the heart of discussions and, therefore, the FCTC encompassed both demand and supply-side measures. However, as a recent research report published in the British Medical Journal (BMJ) has uncovered, actions of the FCTC have not led to the broad impact on smoking that many in the global health community anticipated when the treaty was first introduced.
As we noted in our response letter to the authors of that report, for the FCTC to be truly effective, implementation of all its articles is crucial along with other critical factors not mentioned in their report. In our opinion, the lack of progress and impact on smoking rates after FCTC’s adoption comes from a failure to develop targeted methodology for low- and middle-income countries (LMICs). Targeting LMICs requires translation of evidence from high-income countries used during the FCTC negotiating process, provision of resources to undertake research, ability to enforce FCTC-compliant laws, and supportive environments needed for the smokers to quit.
All medical professionals need to be at the forefront of efforts to curb smoking. This is a role we have played since the 1960s: The 1962 report by the Royal College of Physicians and the 1964 report by the US Surgeon General on smoking and health to this day remain examples of groundbreaking work led by medical professionals. In fact, a study conducted by British doctors in the 1950s found statistical proof of links between smoking and many diseases.
All aspects of health care are embracing technological advances, cancers are now detected earlier in their onset, and the private sector is working hand-in-hand with medical professions in both clinical and preventive care. The medical profession is best positioned to harness the opportunities offered by the emergence of disruptive technologies. We need to lead this work with innovators to spearhead research that will uncover the needs of the smoker and support smokers’ efforts to quit smoking combustibles.
Adoption of the FCTC remains a watershed moment for tobacco control and for elevating the importance of putting an end to the smoking of combustible tobacco around the world. But in order to achieve our goal, we must put the smokers in the heart of the discussion. Including smokers and their perspectives will be the only way we will truly accelerate the end to combustible tobacco.