The Report on Tobacco Control in the Region of the Americas 2013, launched today, summarizes progress in the implementation of the WHO Framework Convention on Tobacco Control (FCTC), the first international public health treaty, which entered into force in 2005.

In the Americas, 29 of 35 countries are Parties to the treaty, which obliges its States Parties to apply a series of polices and measures to reduce tobacco consumption and protect their populations from secondhand smoke.

“The results are encouraging, since in the nine years that the agreement has been in effect, many lives have been saved,” said Adriana Blanco, PAHO/WHO regional advisor on tobacco.

Blanco also warned that “a large proportion of the Region’s population, especially young people, [still] continue to be exposed to tobacco smoke in public places as well as to promotional activities aimed at encouraging the use of a highly addictive product.”

There are 145 million smokers in the Region (accounting for 12% of the world’s total) and it is estimated that around 1 million people lose their lives as a consequence of tobacco every year. “The addiction, disease, and death associated with tobacco are absolutely preventable,” Blanco said.

According to the report, less than half the population is protected from exposure to second hand smoke through 100% smoke-free environments and barely a quarter of the population is protected from tobacco advertising.

Furthermore, tobacco packaging only contains graphic health warnings on tobacco’s harmful effects to health in fewer than half the countries.

For tobacco control programs to have a greater impact, they should include interventions that not only prevent young people from starting to smoke, but also encourage smokers to quit.

“The great burden of mortality due to tobacco in the first half of this century can only be avoided if the people who are smoking today give up tobacco use,” according to the report.

It also explains that the tobacco industry “continues to market and promote its products to low-income populations, women, and young people, while implementing increasingly aggressive strategies against tobacco control policies.”

The age-standardized prevalence of tobacco use among adults in the Americas is 22% and varies widely among countries, from 41% in Chile to 7% in Barbados and Saint Kitts and Nevis, the report points out. Among the youngest group (aged 13 to 15 years), the prevalence of tobacco use varies from 35.1% in Chile to 2.8% in Canada.

The gap between young women and men who smoke is narrowing in several of the Region’s countries, such as Argentina, Canada, Chile, Colombia, and Uruguay.

Require large, graphic health warnings on tobacco packaging that effectively inform consumers; protect young people from aggressive tobacco industry marketing, banning all forms of tobacco advertising, promotion, and sponsorship; monitor use of tobacco products; protect people from exposure to second-hand smoke; offer help to quit smoking; and raise taxes on tobacco products.

These are the six practical, affordable, and achievable measures recommended by WHO to help countries implement specific measures in the Convention.

In the Americas, implementation of the Convention has progressed, but it still faces challenges:

• They are now 17 countries that have 100% smoke-free laws, which means they ban smoking in indoor public spaces, indoor workplaces, and public transportation. From 2011 to 2013, Brazil, Chile, Costa Rica, and Jamaica joined this group.

• Even so, these 17 countries account for only 46% of the Region’s population.

• Just five countries, accounting for 25% of the population of the Americas, are protected from the influence of tobacco advertising, promotion, and sponsorship.

• Most of the Region’s countries levy excise taxes on tobacco products, but few are using them yet as a public health measure designed to reduce tobacco consumption. However, countries including Panama, Ecuador, and Costa Rica have made progress in this area; Panama and Costa Rica are even using a percentage of the tobacco tax revenue they collect for health purposes.

• Only 16 countries require graphic health warnings that cover at least 50% of the principal display areas on the packaging, with countries such as Canada and Uruguay requiring warnings covering 75% and 80% respectively.

For the first time, this report provides information not only on cigarette use but also on other tobacco products, both smoked and smokeless. For example, among adults, smokeless tobacco consumption is low (ranging from 3.5% in Venezuela to 0.1% in Saint Kitts and Nevis).

However, in the group of consumers aged 13 to 15 years, the percentages are higher, for example reaching 12.6% in the Dominican Republic. Smokeless tobacco use by young people is most pronounced in the Caribbean.

“It is erroneously believed that smokeless tobacco is a less harmful alternative to smoking. It is also less expensive and it is seen as an option where smoking is banned,” the report notes. It adds that, “for this reason, it is important to continue monitoring its use.”