0.52 WHO REPORT on the global TOBA CCO ep idemic 2011

70 WHO REPORT ON THE GLOBAL TOBACCO EPIDEMIC, 2011 The WHO Framework Convention on Tobacco Control states 1: Article 5: Each Party shall develop, implement, periodically update and review comprehensive multisectoral national tobacco control strategies, plans and programmes … [and] establish or reinforce and finance a national coordinating mechanism or focal points for tobacco control. In addition, WHO FCTC Article 26.2 indicates that each Party shall provide financial support in respect of its national activities intended to achieve the objective of the Convention 1. National programmes are needed to lead tobacco control efforts Building national capacity to carry out an effective and sustainable national tobacco control programme NTCP is critical to reversing the tobacco epidemic 143. Strategic planning and leadership for the NTCP should occur centrally within the ministry of health 143. A national coordinating mechanism at a high level of government should be convened with an official mandate to develop tobacco control infrastructure and coordinate policy implementation 14. In larger countries, the NTCP should be designed for flexible implementation by decentralizing authority to subnational levels so that interventions can more effectively reach the entire country 14. Since most tobacco control interventions are carried out at the local level, success depends on adequate resources and capacity building for local public health professionals and government leaders 14. Tobacco use prevalence often differs across income, age, ethnic groups and by gender, indicating social inequity. As national tobacco control programmes are designed to reduce tobacco use, efforts to ensure that population subgroups with disproportionately high rates of tobacco use are reached by policies and programmes are essential 161. Funding for tobacco control is inadequate Each country’s government must provide its NTCP with a steady source of funding at national and, where appropriate, subnational levels 143. Governments collect nearly US 133 billion in tobacco excise tax revenues each year, but spend less than US 1 billion combined on National action is critical to achieve the vision of a tobacco-free world 71 WHO REPORT ON THE GLOBAL TOBACCO EPIDEMIC, 2011 High-income 167.57

1.36 Middle-income

17.60 0.013

Low-income 5.43 0.001 Per capita total tax revenue from tobacco products Per capita public spending on tobacco control 180 160 140 120 100 80 60 40 20 US per capita TOBACCO CONTROL IS UNDERFUNDED Note: Based on 51 countries with available tobacco excise revenue data for 2009; expenditure on tobacco control for several of these countries was estimated from figures reported between 2007 and 2010, adjusting for inflation. Tax revenues are tobacco product or cigarette excise revenues in 2009 for included countries. In a departure from the WHO Report on the Global Tobacco Epidemic, 2009, revenues here pertain to excises rather than all taxes on tobacco products. Due to this more stringent criterion, fewer countries are represented than in the 2009 report. Governments collect nearly US 133 billion in tobacco excise tax revenues each year, but spend less than US 1 billion combined on tobacco control – 97 of this amount are spent by high-income countries. RECENT ACHIEVEMENTS AND DEVELOPMENTS Within the past year, the Russian Federation has adopted its Concept for State Policy on Actions Against Tobacco Use for 2010–2015 in accordance with Article 5 of the WHO FCTC. A formal tobacco control programme mechanism has been established within the Ministry of Health and Social Development with responsibility for implementing a comprehensive national strategy that addresses all WHO FCTC requirements, including provisions on tax increases, advertising bans, smoke-free places, warning labels, cessation services, and public education activities that will include anti-tobacco mass media advertising. Specific programme goals have been set for 2015, including reducing tobacco use prevalence by 10–15 and reducing the number of people exposed to second-hand tobacco smoke by half 162.