Opportunities and risks of the proposed FCTC protocol on illicit trade

Illicit trade in tobacco products presents a threat to public health because it undermines the use of tax and price policies, which are among the most effective mechanisms for reducing tobacco consumption. Parties to the WHO Framework Convention on Tobacco Control (FCTC) are in the final stages of negotiating a protocol aimed at strengthening international cooperation in the fight against illicit tobacco trade. While an effective multilateral response to illicit tobacco trade would make a significant contribution to global tobacco control, achieving this through the FCTC forum is challenging. First, while illicit tobacco trade is a health problem, the expertise, experience and capacity needed to combat illicit trade are not traditionally found in health agencies. The development of links with other agencies, both domestic and international, is critical to ensure both an effective response and an efficient use of limited governmental and non-governmental resources. Second, in many parts of the world, the tobacco industry cooperates closely with governments in the combating of illicit trade. This cooperation poses risks for tobacco control, particularly if relationships and norms of cooperation spill over into other areas of FCTC implementation. An examination of the industry's positioning suggests that it sees an opportunity to portray itself as 'legitimate' and 'responsible', a friend of governments, and a way to integrate itself into FCTC processes. This paper makes suggestions for moving forward in this challenging area towards ensuring that the approach taken actually reduces illicit tobacco trade, strengthens tobacco tax policies and does not operate to undermine the FCTC.     

Building the evidence base for effective tobacco control policies: the International Tobacco Control Policy Evaluation Project (the ITC Project)

The Framework Convention on Tobacco Control (FCTC) is a seminal event in tobacco control and in global health. Scientific evidence guided the creation of the FCTC, and as the treaty moves into its implementation phase, scientific evidence can be used to guide the formulation of evidence-based tobacco control policies. The International Tobacco Control Policy Evaluation Project (ITC Project) is a transdisciplinary international collaboration of tobacco control researchers who have created research studies to evaluate and understand the psychosocial and behavioural impact of FCTC policies as they are implemented in participating ITC countries, which together are inhabited by over 45% of the world's smokers. This introduction to the ITC Project supplement of Tobacco Control presents a brief outline of the ITC Project, including a summary of key findings to date. The overall conceptual model and methodology of the ITC Project--involving representative national cohort surveys created from a common conceptual model, with common methods and measures across countries--may hold promise as a useful paradigm in efforts to evaluate and understand the impact of population-based interventions in other important domains of health, such as obesity.     

International trade agreements: a threat to tobacco control policy

International covenants establish a role for governments in ensuring the conditions for human health and wellbeing, which has been recognised as a central human right. International trade agreements, conversely, prioritize the rights of corporations over health and human rights. International trade agreements are threatening existing tobacco control policies and restrict the possibility of implementing new controls. This situation is unrecognised by many tobacco control advocates in signatory nations, especially those in developing countries. Recent agreements on eliminating various trade restrictions, including those on tobacco, have expanded far beyond simply international movement of goods to include internal tobacco distribution regulations and intellectual property rules regulating advertising and labelling. Our analysis shows that to the extent trade agreements protect the tobacco industry, in itself a deadly enterprise, they erode human rights principles and contribute to ill health. The tobacco industry has used trade policy to undermine effective barriers to tobacco importation. Trade negotiations provide an unwarranted opportunity for the tobacco industry to assert its interests without public scrutiny. Trade agreements provide the industry with additional tools to obstruct control policies in both developed and developing countries and at every level. The health community should become involved in reversing these trends, and help promote additional measures to protect public health.     

The conceptual framework of the International Tobacco Control (ITC) Policy Evaluation Project

This paper describes the conceptual model that underlies the International Tobacco Control Policy Evaluation Project (ITC Project), whose mission is to measure the psychosocial and behavioural impact of key policies of the Framework Convention on Tobacco Control (FCTC) among adult smokers, and in some countries, among adult non-smokers and among youth. The evaluation framework utilises multiple country controls, a longitudinal design, and a pre-specified, theory-driven conceptual model to test hypotheses about the anticipated effects of specific policies. The ITC Project consists of parallel prospective cohort surveys of representative samples of adult smokers currently in nine countries (inhabited by over 45% of the world's smokers), with other countries being added in the future. Collectively, the ITC Surveys constitute the first-ever international cohort study of tobacco use. The conceptual model of the ITC Project draws on the psychosocial and health communication literature and assumes that tobacco control policies influence tobacco related behaviours through a causal chain of psychological events, with some variables more closely related to the policy itself (policy-specific variables) and other variables that are more downstream from the policy, which have been identified by health behaviour and social psychological theories as being important causal precursors of behaviour (psychosocial mediators). We discuss the objectives of the ITC Project and its potential for building the evidence base for the FCTC.     

Human rights-based approach to tobacco control

The Framework Convention for Tobacco Control (FCTC) is currently the most potent tool for implementation of tobacco control laws across the globe. The FCTC is derivative from previously constructed international human rights conventions. These previous conventions have enforcement mechanisms, unlike the FCTC. However, the FCTC relies on state parties to report periodically on its implementation rather than on a continuous monitoring system. The Human Rights and Tobacco Control Network proposes that abiding by the principles of human rights delineated by international treaties, citizens across the globe can demand effective action for tobacco control. This paper explains the link between fundamental human rights and the right to tobacco control. Mechanisms are described to link the FCTC and its principles with human rights-based monitoring reports, which are provided to oversight committees for the other human rights conventions. The initial work of the Human Rights and Tobacco Control Network is summarised and considers the future directions for the human rights-based approach to tobacco control.     

Building capacity for tobacco control research and policy

The Fogarty International Center (FIC) initiative, "International Tobacco and Health Research Capacity Building Program" represents an important step in US government funding for global tobacco control. Low- and middle-income countries of the world face a rising threat to public health from the rapidly escalating epidemic of tobacco use. Many are now parties to the Framework Convention on Tobacco Control (FCTC) and capacity development to meet FCTC provisions. One initial grant provided through the FIC was to the Institute for Global Tobacco Control (IGTC) at the Johns Hopkins Bloomberg School of Public Health (JHSPH) to support capacity building and research programmes in China, Brazil, and Mexico. The initiative's capacity building effort focused on: (1) building the evidence base for tobacco control, (2) expanding the infrastructure of each country to deliver tobacco control, and (3) developing the next generation of leaders as well as encouraging networking throughout the country and with neighbouring countries. This paper describes the approach taken and the research foci, as well some of the main outcomes and some identified challenges posed by the effort. Individual research papers are in progress to provide more in-depth reporting of study results.     

全球经济政策不确定性对中国粮食价格波动影响的实证分析（网络首发、推荐阅读）

不断调整的国内外经济政策,不仅对我国利用国际市场资源带来挑战,还可能通过价格传导的形式影响国内粮食价格,甚至粮食生产。在广泛搜集影响粮食价格波动相关因素的基础上,采用主成分分析和时变参数因子增强向量自回归模型（TVP-FAVAR）相结合的方法,分析了供求因素、金融及能源因素以及全球经济政策不稳定性对我国粮食价格的影响。主要研究发现如下：全球经济政策不确定性对国内粮食价格有显著的负向冲击;不同种类粮食价格对不确定性冲击的响应是有差异的。针对模型结果,提出如下政策建议：在中美贸易战愈演愈烈的今天,面对来自国际市场的不确定性冲击,政策制定者应该采取组合策略平抑国际市场的冲击;政策制定者应针对不同粮食品种实施有差别的价格政策和调节手段;加强粮食市场信息监测系统建设,提高根据价格监测信息准确解读市场行情的能力,制定多样化价格调整政策来抵消外部市场的不确定性冲击;我国可以通过与更多具有粮食出口潜力的国家实施更多的贸易自由协定,为国民寻求更加稳定的外部供给渠道,减缓主要国家贸易政策不稳定性带来的不利影响。     

Globalisation of tobacco industry influence and new global responses

The globalisation of tobacco marketing, trade, research, and industry influence represents a major threat to public health worldwide. Drawing upon tobacco industry strategy documents prepared over several decades, this paper will demonstrate how the tobacco industry operates as a global force, regarding the world as its operating market by planning, developing, and marketing its products on a global scale. The industry has used a wide range of methods to buy influence and power, and penetrate markets across the world. It has an annual turnover of almost US$400 billion. In contrast, until recently tobacco control lacked global leadership and strategic direction and had been severely underfunded. As part of moving towards a more sustainable form of globalisation, a global enabling environment linked to local actions should focus on the following strategies: global information management; development of nationally and locally grounded action; global regulation, legal instruments, and foreign policy; and establishment of strong partnerships with purpose. As the vector of the tobacco epidemic, the tobacco industry's actions fall far outside of the boundaries of global corporate responsibility. Therefore, global and local actions should not provide the tobacco industry with the two things that it needs to ensure its long term profitability: respectability and predictability.     

Achieving the Framework Convention on Tobacco Control's potential by investing in national capacity

May 2003 marked a critical achievement in efforts to stem the global tobacco epidemic, as the member states of the World Health Organization unanimously endorsed the Framework Convention on Tobacco Control (FCTC). However, the adoption of the FCTC signifies only the end of the beginning of effective global action to control tobacco. Over the next several years the utility of the FCTC process and the treaty itself will be tested as individual countries seek to ratify and implement the treaty's obligations. Significant barriers to the treaty's long term success exist in many countries. It is crucial that the international tobacco control community now refocuses its efforts on national capacity building and ensures that individual countries have the knowledge, tools, data, people, and organisations needed to implement the convention and develop sustained tobacco control programmes. This paper provides a model of national tobacco control capacity and offers a prioritised agenda for action.     

Trade liberalisation and tobacco control: moving from a policy of exclusion towards a more comprehensive policy

Notwithstanding the fact that it has been 10 years since empirical confirmation that trade liberalisation may increase tobacco consumption, tobacco control policy with respect to trade liberalisation and related processes remains largely underdeveloped. The most commonly articulated policy, that tobacco be excluded from the scope of trade agreements, is problematic for a number of reasons and has not been widely implemented. In light of this fact and the potential role of the Framework Convention on Tobacco Control, further research and policy development are needed in the area.     

Food and agriculture policy: issues related to prevention of noncommunicable diseases

Good nutrition depends on access to a healthful food supply. Although a great deal of attention has been paid to food intake as a determinant of nutrition and overall health, little attention has been paid to the food supply system, health risks embedded in it, and its effect on people's choices. Most national governments intervene in their agricultural sectors in order to provide benefits to producers and consumers; however, these interventions are not designed with public health in mind. Governments should consider population nutrition and chronic disease risk when devising and implementing agricultural and food policies. They should seek opportunities to adjust agricultural and trade policies to be consistent with national health and nutritional priorities and guidelines. Although the paper gives several examples, country-specific policy changes can be determined only through analysis of individual country policies and nutrition conditions.     

基于实证分析的中国烟草产品国际竞争力研究

近年来，中国烟草产业既面临着国外烟草产品进入的冲击以及控烟履约的双重压力，又担当着为国家财政增税的重任，其发展已不能单纯依靠国内需求拉动，更应该积极面向全球需求，开发国际市场。为了精确地测度我国烟草产品的国际竞争力，构建了国际市场占有率（IMS）、贸易竞争力指数（TC）和显性比较优势指数（RCA）三个指标，以计量经济学手段分析了我国烟草产品在全球市场中的主要特征及问题。研究发现，我国烟草及烟草产品的整体竞争力较弱，但烟叶产品在国际市场上有一定的竞争力。      

Consensus for tobacco policy among former state legislators using the policy Delphi method

OBJECTIVE: To test a novel approach for building consensus about tobacco control policies among legislators. DESIGN: A pilot study was conducted using a two-round, face-to-face policy Delphi method. PARTICIPANTS: Randomly selected sample of 30 former Kentucky legislators (60% participation rate). MAIN OUTCOME MEASURE: Consensus on tobacco control and tobacco farming policies. RESULTS: Former state legislators were more supportive of tobacco control policies than expected, and highly supportive of lessening the state's dependence on tobacco. Former state legislators were in agreement with 43% of the second-round items for which there was no agreement at the first round, demonstrating a striking increase in consensus. With new information from their colleagues, former lawmakers became more supportive of workplace smoking restrictions, limitations on tobacco promotional items, and modest excise tax increases. CONCLUSIONS: The policy Delphi method has the potential for building consensus for tobacco control and tobacco farming policies among state legislators. Tobacco control advocates in other states might consider using the policy Delphi method with policymakers in public and private sectors.     

The political economy of food price policy during the global food price crisis of 2006-2008

This paper finds support for seven political economy hypotheses that influenced governments’ policy choices during the 2006–2008 global food price crisis. Governments focused most heavily on consumer and trade policies rather than on policies designed to increase production. They also preferred policy changes with lower implementation costs, implying that responses to past crises were the best predictor of future actions. To explain the variety of responses and policy failures, a framework is proposed that locates policies along the twin dimensions of unitary vs. fragmented decision-making processes and social welfare maximizing vs. self-interested policy goals. Many of the common policy responses can be explained by a benchmark model of unitary decision makers seeking to increase social welfare. In contrast, fragmented government decision-making, uncertainty, and self-interest generate policy and implementation failures, significant departures from the benchmark model, and reductions in social welfare. Mistrust between government and the private sector causes a lack of transparency, which fuels mistrust and uncertainty, leading to additional policy and implementation failures.     

《烟草控制框架公约》研究Ⅱ.主要內容、对烟草业的影响和需采取的措施

文章在对"吸烟与健康"的早期研究、世界卫生组织烟草控制的历史,以及《烟草控制框架公约》的制定过程进行了简要回顾的基础上(见本文第1部分),全面概括了其主要内容,并就其对烟草业的影响进行分析,探讨了在未来履行公约具体义务的过程中,烟草业可采取的有关应对措施。      

The vital role of science in global policy decision-making: An analysis of past, current, and forecasted trends and issues in global red meat trade and policy

As global populations and economies change, the dynamics of global trade and policy change as well. In analyzing the past trends and projections for global populations, economic developments, animal product production and consumption, global trade policy, and current issues being faced, one can begin to make some predictions or projections as to how the global red meat and poultry infrastructure will change and, more importantly, point to areas where a proactive approach is necessary to shape these changes to meet the most globally beneficial end. Many issues face the global red meat industry, from food safety to animal disease, and are becoming more and more complicated as consumer knowledge increases and as politics intervene. Internationalized science is key and vital in the future of global trade policy as science can address the more informed consumer in a manner, which reduces anxiety over unknowns. The role of the industry is to provide the information and knowledge to the consumer necessary to convey the validity of globally accepted standards, which relate to ensuring consumer safety, animal welfare, and provide assurances that these standards are being met within the production sector.     

Ethical and legal aspects of global tobacco control

On 28 February 2005, the Framework Convention on Tobacco Control came into force as a result of at least 40 countries becoming State Parties through ratification of this first ever health treaty sponsored by the World Health Organization. This article discusses the bioethical, trade, and legal aspects of global tobacco control. Special emphasis is given to globalisation of tobacco use and the challenges it poses to sovereign nations. It also advocates a bioethical basis in the pursuit of global solutions to expanding tobacco use.     

Implementation of the WHO Framework Convention on Tobacco Control in mainland China

As per China's ratification of the WHO Framework Convention on Tobacco Control (FCTC), it should have implemented effective packaging and labelling measures prior to 9 January 2009 and enacted a comprehensive ban on all tobacco advertising, promotion and sponsorship prior to 9 January 2011. In addition, universal protection against secondhand tobacco smoke should have been implemented before 9 January 2011 by ensuring that all indoor workplaces, all indoor public places, all public transportation and possibly other (outdoor or quasi-outdoor) public places are free of secondhand smoke. The authors conducted a review of various sources of information to determine the current status of FCTC implementation in mainland China. Even though China has made considerable efforts to implement the FCTC, there is still a significant gap between the current state of affairs in China and the requirements of the FCTC. The Chinese tobacco monopoly under which commercial and other vested interests of the tobacco industry are jeopardizing tobacco control efforts is thought to be the most crucial obstacle to the effective implementation of the FCTC across the country.