27 February 2025
Today, the public health community commemorates the 20th anniversary of the WHO Framework Convention on Tobacco Control (FCTC). When the FCTC came into force on 27 February 2005, it transformed global tobacco control forever by establishing global standards to regulate a harmful industry whose products kill half its customers prematurely.
182 countries and the EU, covering more than 90% of the world’s population, are legally obligated to implement the WHO FCTC’s measures to reduce tobacco use and its burden on society and hold the tobacco industry liable for the harm it causes.
What has been the WHO FCTC’s impact? While smoking prevalence in most countries is gradually declining, WHO reported the world will make a 25% relative reduction in tobacco use by 2025, but will miss the voluntary global target of 30% reduction. There are still 1.25 billion adult tobacco users in the world today due to aggressive industry marketing, promotion, misinformation, and lobbying against effective tobacco control policies.
Singapore is the first ASEAN country to drop to single-digit smoking prevalence (9.2%), while Indonesia is moving in the opposite direction and showing increasing smoking prevalence (29.7%).
Progress has happened across the globe in both large and small countries, as well as in high- and low-income nations, indicating that size and economic status are secondary to political will in reducing tobacco use. In the ASEAN region Brunei, Cambodia, Singapore and Thailand are standout examples of notable achievements in tobacco control.
Table 1: Key events in past 20 years in tobacco control
| Major victories |
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1. More than 130 countries, including 10 ASEAN nations, now apply prominent pictorial health warnings on tobacco packs. Additionally, 26 have adopted standardized tobacco packaging, including 4 in ASEAN (Thailand, Singapore, Myanmar and Lao PDR). 100% smoke-free indoor public places, workplaces and public transport now cover 2.1 billion people living in 74 countries, including most countries in the ASEAN; 66 countries, including Brunei, Lao PDR, Singapore and Thailand, have comprehensive ban on tobacco advertising, promotions and sponsorship; 41 countries have applied taxes more than 70% of retail price. |
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2. In 2016, Uruguay’s victory over Philip Morris International (PMI)’s lawsuit sent a powerful message: a little country cannot be bullied by the world’s largest tobacco company whose revenue is larger than the country’s GDP. |
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3. In 2010, the Philippines adopted the Department of Health-Civil Service Commission Joint Memorandum Circular 2010-001 providing guidance on interaction with the tobacco industry across all sectors – first country in Asia to do so. |
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4. Australia’s victory over legal challenges to its standardized tobacco packaging law at its High Court (2012), under a bilateral investment treaty claim (2015), and at the WTO (2020) was significant in silencing the industry’s tactic to use the trade and intellectual property platforms to oppose stringent tobacco control measures. |
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5. About 40 countries, including six in the ASEAN region (Brunei, Cambodia, Lao PDR, Singapore, Thailand and Vietnam), have banned electronic smoking devices (e-cigarettes and heated tobacco products). |
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6. At COP10, Parties recognized plastic cigarette filters as unnecessary, avoidable and problematic, and recommended an immediate ban consistent with Article 18. |
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7. About 25 countries have adopted a plan or set a target to go tobacco-free and achieve single digit smoking prevalence. |
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8. Ireland and Spain have started charging the tobacco industry for clean-up cost of cigarette butts. |
| Challenges & Missteps |
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9. While smoking prevalence among teens has declined in most countries, youth vaping has increased. Tobacco-related deaths continue to increase across the ASEAN region. |
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10. The tobacco industry has expanded its business in Indonesia and the Philippines, setting up new factories to produce heated tobacco products. Uptake of these products among youth has increased. |
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11. Globally, less than half the countries have implemented Article 5.3 measures to protect themselves and prevent the tobacco industry from influencing public health policymaking. |
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12. In 2017, PMI committed USD 960 million to the US-based Foundation for a Smoke-Free World (now Global Action to End Smoking) to fund research on “harm reduction” to support/encourage governments and public to embrace new products framed as “safer alternatives” to cigarettes. |
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13. More than 70 countries have chosen to regulate ESDs (instead of banning them) while several have reversed the ban and are facing huge problems with youth e-cigarette use. |
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14. Illicit trade of tobacco products remains a huge problem; Only 38% of FCTC Parties (68 countries and EU; none from ASEAN) are Parties to the Protocol to Eliminate Trade in Tobacco Products. |
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15. No country in the ASEAN region has utilized Article 18 to protect the environment from tobacco pollution nor Article 19 of the WHO FCTC to hold the tobacco industry liable for the harm it causes. |
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16. In 2023, New Zealand back-tracked from its “smoke-free by 2025” endgame goal, embraced e-cigarettes, and in 2024 gave 50% excise tax cuts on heated tobacco products. |
Despite two decades of WHO FCTC, the tobacco industry is still big business. Big Tobacco continues to rely on cigarette sales for profits (Table 2) while simultaneously stating smoking is harmful. The revenue of these companies is larger than the tobacco control budgets of most countries, and they continue to exert influence on non-health departments of many countries. The Global Tobacco Industry Interference Indices report how governments have given in to the industry and compromised on regulating it.
Table 2: Top five transnational tobacco companies globally*
| Stick sales** | Revenue (US$) | |
| BAT | 605 billion | 34.06 billion |
| PMI | 621 billion | 31.76 billion |
| Imperial Brands Plc | 21.57 billion | |
| Japan Tobacco Inc | 519.4 billion | 20.23 billion |
| KT&G Corp | 14.8 billion | 4.49 billion |
*Source: https://www.statista.com/statistics/259204/leading-10-tobacco-companies-worldwide-based-on-net-sales/ ; excludes the Chinese tobacco monopoly
**Source: https://www.tobaccoasia.com/features/combustibles-not-burnt-out-yet/
Tobacco is such a lucrative business that the industry refuses to give it up, and competition among the companies is stiff. Korean company, KT&G which is currently world no.5, is planning to become No.4. Its largest growth came from cigarette sales overseas, including in Indonesia. The company’s overseas sales stood at 1.45 trillion won, up 28% from the previous year. Its sales in 2024 reached 5.91 trillion won (US$4 billion). The company’s increasing overseas sales is in line with its expansion outside Korea, mainly in Indonesia, Kazakhstan and Turkiye.
Philip Morris International (PMI) is reaping profits from selling over 620 billion sticks while continuing to speak with forked tongue about how “cigarettes belong in museums” and relaunching its Marlboro cigarettes. Meanwhile the company has been exposed by Reuters for undermining WHO and the FCTC and, more recently, for paying for research to orchestrate acceptance of HTPs in Japan.
To accelerate tobacco control, countries need to shift gear and move from doing “more of the same” to taking more radical, outside-the-FCTC-box, action. For example, Article 2.1 of the FCTC which enables Parties to go beyond what is in the FCTC has not been fully utilized. Countries should be drawing up bold but practical action to end the industry by a target date.
It seems senseless to keep allowing a harmful industry to legally sell an addictive product that kills half of customers prematurely and then struggle to regulate it. Use Article 2.1 to stop the absurdity.
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