Global Tobacco Control Progress Report 2023: Key Developments and Trends

Editor's note: Previously, 2FIRSTS had reprinted and published "Oriental Tobacco News: 2023 World Tobacco Control Compliance Progress Report (Part I)". The following content continues from the previous article.

Regulation and disclosure of ingredients

The Framework Convention on Tobacco Control (hereinafter referred to as the Convention) requires Parties to take effective measures for regulating and disclosing the components of tobacco products, but progress has been slow due to the high level of specialization and numerous legal barriers. According to the latest available data, the compliance rates for testing components and emissions among Parties are 52% and 48% respectively, while reporting to the government has rates of 70% and 62%, and disclosing to the public has rates of 58% and 47%. In 2023, South Korea passed the Tobacco Harmful Impact Control Act, mandating cigarette manufacturers, importers, and distributors to conduct biennial testing of harmful substances such as naphthylamine, nickel, benzene, vinyl chloride, arsenic, and cadmium in cigarettes and e-cigarettes, and report the types and levels to regulatory authorities, who will decide which components should be disclosed to the public. Morocco has strengthened component regulation by setting maximum limits for tar, nicotine, and carbon monoxide in domestically sold individual cigarettes at 10mg, 1mg, and 10mg respectively.

In recent years, flavor regulation has become a focus of control in various countries in order to reduce the attractiveness of tobacco and prevent underage smoking. The ban on mint flavor in Europe and the United States is progressing slowly. The European Union banned mint flavor in cigarettes in 2020 and in heated tobacco products in 2022, but the effectiveness of the ban has been limited. The U.S. Food and Drug Administration (FDA) had originally planned to introduce a ban on mint flavor in cigarettes and cigars in August 2023, but due to controversy over discriminatory practices against people of color and exacerbating illegal trade, the U.S. House of Representatives decided to prevent the FDA from using Congressional funding to enforce the mint flavor ban. This ban is currently still under consideration.

Packaging and labeling

Article 11 of the Convention requires parties to implement effective measures on packaging and labeling of tobacco products according to their national laws. Some parties have implemented stricter packaging measures, including graphic health warnings and plain packaging. According to the latest available data, out of 224 countries and territories worldwide, 138 countries and territories have implemented graphic health warnings on cigarette packaging, with 25 countries passing plain packaging laws.

In 2023, a few countries and regions continued to promote graphic health warnings and plain packaging for tobacco products. Some countries even went as far as implementing health warnings on individual cigarettes, with Canada leading the way by enacting the Tobacco Products Appearance, Packaging and Labeling Regulations. This regulation requires health warnings to be printed on individual cigarettes and small cigars, making Canada the first country in the world to take this measure. The new rules came into effect on August 1, 2023, and will be phased in gradually. Australia had previously announced plans to implement health warnings on individual cigarettes as well. Oman also introduced plain packaging legislation, becoming the second country in the Middle East, after Saudi Arabia, to implement this policy. In the United States, the legal controversy surrounding graphic health warnings on cigarette packaging continues (see "Legal Responsibility" section below for more details).

Advertising promotions, public awareness, and promoting smoking cessation

Article 12 of the convention requires contracting parties to strengthen public awareness of tobacco control through various media tools, education, and training programs. Article 13 requires contracting parties to widely prohibit tobacco advertising, promotion, and sponsorship based on their constitution or constitutional principles. Article 14 requires contracting parties to take effective measures to promote smoking cessation.

In terms of advertising, promotion, and sponsorship regulations, the consensus among the parties to the convention is to have a "broad ban" rather than a "complete ban." By 2023, 80% of the parties to the convention have adopted "broad ban" measures, while only 17 parties have implemented a "complete ban." In terms of strict measures, the following aspects are more stringent: first, banning display sales. The parties prohibiting display sales in retail stores increased from 49% in 2020 to 54% in 2023. Second, banning brand extension. Brand extension is considered an indirect form of advertising, using tobacco brands or trademarks for non-tobacco products to achieve long-term, legal tobacco advertising effects through the marketing of those products. The parties banning brand extension increased from 49% in 2020 to 54% in 2023. Third, banning tobacco descriptions or use in entertainment media, which was a key topic at the 10th Conference of the Parties to the Convention (COP10). The parties implementing this measure increased from 57% in 2020 to 60% in 2023. This measure poses legal risks and significant controversy due to restricting the freedom of entertainment products and the audience's choice. For example, South Korea agreed through mainstream television station agreements, rather than legislation, not to include scenes of tobacco products in television dramas on their platforms, which resulted in a large number of viewer complaints, while the depiction of tobacco consumption on other platforms significantly increased.

Children and adolescents remain a key focus in the areas of education, communication, training, and public awareness, with increasing participation from health and education workers, social public institutions, and non-governmental organizations. The main content covers areas such as tobacco consumption, the health hazards of tobacco smoke exposure, and the benefits of quitting smoking, with a significant increase in the promotion of the harmful effects of tobacco on the environment.

In promoting smoking cessation, more than half of the contracting parties will integrate tobacco dependence diagnosis and treatment as well as smoking cessation counseling services into the national healthcare system. However, funding remains tight, affordability of smoking cessation medications is low, and nicotine replacement therapy remains the mainstream method of smoking cessation, with an increase in the use of drugs such as bupropion and varenicline. In 2023, the UK government announced an annual allocation of £70 million (approximately 9.4 Chinese yuan to 1 British pound) to promote smoking cessation services, with a focus on reducing the attractiveness of e-cigarettes to minors. Ireland has developed the "National Smoking Cessation Clinical Guidelines," which outline the best practices for smoking cessation among adults and provide smoking cessation counseling and assistance, particularly focusing on pregnant women and patients with special diseases.

Reduce the supply of tobacco.

Crackdown on illegal trade

In the post-pandemic era, global illegal tobacco trade continues to grow, accounting for 12.5% of the total global tobacco trade, with a value exceeding the total of illegal trade in goods such as oil, wildlife, timber, art and cultural products, and diamonds. Article 15 of the Convention requires parties to take effective measures to eliminate illegal tobacco trade. Due to high taxes, technological barriers, monitoring difficulties, and control challenges, illegal tobacco trade is a global problem. Widely regarded effective measures include licensing systems, printing origin labels, establishing tracking and tracing systems, and destroying illegal products, with implementation rates of 69%, 66%, 46%, and 74% respectively, according to the latest available data. Because of high and varying tax burdens, convenient transportation links, and numerous duty-free zones, the tobacco counterfeiting and smuggling industry has been persistently strong and is intensifying in the post-pandemic era in the European Union. According to the latest available data, in 2022, illegal cigarette consumption in the EU reached 716,000 boxes, resulting in member state governments losing approximately €11.3 billion in tax revenue, an increase of 8.5% from 2021. To address this, the EU has been strengthening the development of tracking and tracing systems, enhancing cooperation among member states, and collaborating with multinational tobacco companies. Croatia has discovered an increase in "ant-like" smuggling through its tracking and tracing system, where travelers strategically carry small quantities of cigarettes across borders multiple times. These cigarettes are mostly stored in secret warehouses for redistribution to other parts of Europe, with only a small percentage being sold in the Croatian local market.

Protecting minors

Minors are the central focus group of tobacco control laws and policies. Article 16 of the Convention requires parties to take effective measures to prohibit the sale of tobacco products to minors, including banning vending machines, single or small packet sales, and free distribution of cigarettes, with enforcement rates of 63%, 69%, and 82% respectively. Countries such as Australia, Japan, and South Korea have not banned vending machines due to considerations such as protecting consumer interests, but have instead implemented various methods to enhance age verification.

In recent years, many measures have been taken to protect minors, such as strengthening the regulation of new tobacco products, widely banning tobacco advertisements, increasing the legal age to purchase tobacco, and implementing flavor regulations. The momentum to raise the legal age to purchase tobacco to 21 in 2023 has weakened. Currently, a total of nine countries and regions including Turkmenistan and Uzbekistan have raised the legal age to purchase tobacco to 21. The lowest legal age to purchase tobacco is 15 (Comoros), while the highest is 24 (Sri Lanka). 18 remains the most common legal age to purchase tobacco.

Other key topics

Environmental protection and human rights issues

Article 17 of the Convention states that Contracting Parties shall support economically viable alternative activities, while Article 18 emphasizes the protection of the environment and the health of individuals involved in tobacco cultivation and production. Although these articles are not at the core of the Convention's focus, in recent years, with the continued efforts of the World Health Organization and some non-governmental organizations in tobacco control, issues such as tobacco control, environmental protection, and human rights have gained increasing attention. This has led to tobacco control moving up the global governance agenda and discourse system. The World Health Organization will focus on environmental protection and alternative livelihoods for World No Tobacco Day in 2022 and 2023, and COP10 will also prioritize environmental protection and human rights. Some Contracting Parties have proposed radical tobacco control measures such as banning cigarette filters during meetings.

Despite the increasing attention from anti-smoking advocates in the public sphere, the implementation rates of Articles 17 and 18 of the Convention on Tobacco Control have been on the decline. According to the latest available data, out of 85 contracting parties involved in tobacco cultivation, only 31% have taken measures to promote alternative livelihoods for tobacco farmers, and 33% have implemented measures to protect the health of individuals. In the tobacco production process, only 39% of contracting parties have taken measures to protect the health of individuals.

From a specific country perspective, Andorra is promoting industrial diversification and integration by combining tobacco cultivation with organic food production and livestock farming. Colombia has introduced policies to support the integration of tobacco cultivation with the cultivation of crops such as corn and soybeans in the Santander and Boyacá provinces. The Slovak capital, Bratislava, has launched a project to turn discarded cigarette butts into asphalt, led by Slovak government agencies with participation from tobacco companies and waste management enterprises. Czech Republic requires tobacco products with filters to clearly label their packaging with information about the presence of plastics, negative environmental impacts, and appropriate waste disposal methods. Finland has implemented a law requiring all cigarettes sold in the country to be self-extinguishing in order to reduce smoking-related accidental fires, following similar regulations in Australia and Canada.

Legal responsibility

Article 19 of the treaty requires contracting parties to take legislative action or promote existing laws to address criminal and civil liability. Recently, there have been new developments in two significant tobacco control-related legal cases in the United States.

One is the case of graphic warning labels on cigarette packaging in the United States. In March 2020, the FDA issued regulations requiring the use of graphic warnings on cigarette packaging and tobacco advertisements, sparking another round of legal battles surrounding the graphic warnings. In April 2020, Reynolds American, ITG Brands, Liggett Group, and other U.S. tobacco companies filed a lawsuit in the Eastern District Court of Texas seeking to overturn this regulation and revoke the FDA's authorization to issue graphic warnings. In December 2022, the court ruled that the information conveyed by the graphic warnings was "not entirely factual and exceeded the necessary scope." The court also stated that the government could have sought other, more optimal solutions, such as increasing funding for anti-smoking ads or intensifying education on the harmful effects of smoking. Therefore, the court concluded that the graphic warnings infringed upon the tobacco companies' freedom of speech, violating the First Amendment of the U.S. Constitution, and ordered the regulation to be revoked. The FDA appealed to the U.S. Fifth Circuit Court of Appeals on February 1, 2023. In March 2024, the Appeals Court ruled that the graphic warnings do not violate the First Amendment, granting the FDA a partial victory. It is expected that future legal disputes surrounding the graphic warnings will continue.

One case is the flavor ban in California, USA. In 2020, California implemented a flavor ban, prohibiting all non-tobacco flavors in tobacco products, including mint. Following this, Reynolds American, tobacco retailers group, and e-cigarette shops filed a lawsuit, arguing that California's flavor ban conflicted with federal law and should be overturned. In March 2023, the court rejected the plaintiffs' lawsuit, and they appealed to the Supreme Court, which denied the appeal in January 2024. California, with the highest population in the US, could set a legal precedent that may impact federal and state legislation and judiciary.

Regulation of new tobacco products

With the rapid development of new tobacco products, it has become a common consensus among countries to strengthen comprehensive regulation. In 2023, the new developments and trends in the regulation of new tobacco products are worth paying attention to.

First, the regulation of tobacco products in the entire series continues to deepen. The development of new types of tobacco products has led to the continuous expansion of the scope of tobacco products, prompting the introduction of new regulatory measures. Following the comprehensive strengthening of regulation on heated cigarettes and e-cigarettes, more regulatory agencies will include nicotine products from tobacco sources, nicotine products from non-tobacco sources, and even nicotine-free tobacco imitation/derivative/alternative products in the regulatory scope. This will regulate the entire chain of production, distribution, and consumption.

Secondly, disposable e-cigarettes have become a focus of regulation. With low costs and high accessibility, the soaring sales of disposable e-cigarettes are facing increasing regulatory pressure, with more and more countries strictly controlling them. The U.S. FDA has currently approved 23 varieties of e-cigarettes from 3 companies for pre-market tobacco product applications (PMTA), including only one disposable e-cigarette from NJOY (acquired by Altria Group) in June 2022. In 2023, as sales of disposable e-cigarettes that did not pass PMTA surged, especially among young people, the FDA intensified its regulation, rejecting the PMTA of many disposable e-cigarettes and collaborating with customs and other agencies to speed up the seizure and clearance of unauthorized products. In December 2023, the U.S. International Trade Commission (ITC) initiated a 337 investigation into disposable e-cigarettes exported to the U.S. based on applications from domestic e-cigarette companies citing unfair competition. In December 2023, France issued a ban on disposable e-cigarettes. In January 2024, the UK government announced plans to ban disposable e-cigarettes. In March 2024, Belgium issued a ban on disposable e-cigarettes.

The third issue is that regulatory authorities have not reached a consensus on whether new tobacco products are "harm-reducing". Currently, new tobacco products are still diverse and mixed, attracting young people and generating continuous controversy, such as the "gateway effect". Most regulatory agencies in many countries and regions generally do not agree that they have "harm-reducing" characteristics. The US FDA has established a regulatory framework for "modified risk products", which is essentially a certification channel for certain products to reduce harm. In 2023, only one oral tobacco product from the US Smokeless Tobacco Company was approved. So far, the FDA has approved three categories of products from five companies as "modified risk products", including heated cigarettes, very low nicotine cigarettes, and oral tobacco, excluding e-cigarettes. The UK is one of the few countries that believes e-cigarettes have "harm-reducing" characteristics and has consistently supported e-cigarettes, recently strengthening regulations on disposable e-cigarettes and flavored e-cigarettes. The World Health Organization continues to uphold its position of not recognizing the "harm-reducing" characteristics of new tobacco products, and COP10 has not yet reached a resolution on the classification and regulation of new tobacco products. It is expected that in the future, as new tobacco products become more refined, production technology matures, regulatory measures become more precise, and operational entities become more compliant, the controversy over whether various products are "harm-reducing" will intensify.

4. Key trends in tobacco control initiatives.

In 2023, the World Health Organization and the secretariat of the Framework Convention on Tobacco Control continue to play important roles in global tobacco control efforts, while non-governmental organizations such as the Bloomberg Philanthropies continue to launch tobacco control actions through financial support and advocacy campaigns.

The World Health Organization.

Organize international conferences and events to guide countries in strengthening tobacco control. Host COP10 and the third Conference of the Parties to the Protocol to Eliminate Illicit Trade in Tobacco Products, focusing on strengthening tobacco control arrangements on the meeting agenda. Conduct expert group discussions during the closed session on daily work within the framework of the Convention. The theme of the 36th World No Tobacco Day is "Grow food, not tobacco", urging Parties to conduct promotional activities globally on this theme.

When he heard the announcement from the FDA on Thursday, he said he needed to do some research on the company because it is a small business.