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Report on Tobacco Control in the Region of the Americas, 2018 ISBN: 978-92-75-12015-6 Report on Tobacco Control in the Region of the Americas 2018 REPORT ON TOBACCO CONTROL IN THE REGION OF THE AMERICAS I Report on Tobacco Control in the Region of the Americas 2018 Washington, DC 2018 Also published in Spanish Informe sobre el control de Tabaco en la Región de las Américas, 2018 ISBN: 978-92-75-32015-0 Report on Tobacco Control in the Region of the Americas, 2018 ISBN: 978-92-75-12015-6 © Pan American Health Organization 2018 All rights reserved. Publications of the Pan American Health Organization are available on the PAHO website (www.paho.org). Requests for permission to reproduce or translate PAHO Publications should be addressed to the Communications Department through the PAHO website (www.paho.org/permissions). Suggested citation. Pan American Health Organization. Report on Tobacco Control in the Region of the Americas, 2018. Washington, D.C.: PAHO; 2018. Cataloguing-in-Publication (CIP) data. CIP data are available at http://iris.paho.org. Publications of the Pan American Health Organization enjoy copyright protection in accordance with the provisions of Protocol 2 of the Universal Copyright Convention. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the Secretariat of the Pan American Health Organization concerning the status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the Pan American Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the Pan American Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the Pan American Health Organization be liable for damages arising from its use. CONTENTS Foreword ....................................................................................................................................................................................................vii Acknowledgments ..................................................................................................................................................................................viii Introduction ................................................................................................................................................................................................. 1 1. The Tobacco Epidemic and the Status of Tobacco Control ............................................................................................3 1.1 The tobacco epidemic: current status and trends ..................................................................................................................... 3 1.2 Progress in implementation of the MPOWER tobacco control measures worldwide and regionally .................................... 16 1.3 Financial impact of tobacco use on health systems in Latin America (Andrés Pichon-Riviere) ��������������������������������������������� 20 2. Mandates and Frame of Reference for Tobacco Control ���������������������������������������������������������������������������������������������������������� 22 2.1 Tobacco control within the framework of noncommunicable disease prevention and control ���������������������������������������������� 22 2.1.1 Worldwide frame of reference .................................................................................................................................... 22 2.1.2 Tobacco control in the 2030 Agenda for Sustainable Development (Roy Small) ������������������������������������������������������� 23 2.1.3 Regional commitments ................................................................................................................................................ 24 2.2 The WHO Framework Convention for Tobacco Control ........................................................................................................... 25 2.2.1 The FCTC 2030 Project: strengthen implementation of the FCTC to achieve the Sustainable Development Goals (Vera Luiza da Costa e Silva, Andrew Black and Rodrigo Santos Feijó) ��������������������������������������������������������������������� 28 2.3 Guidelines and policy alternatives and recommendations for implementation of the WHO Framework Convention on Tobacco Control .................................................................................................................. 28 2.4 The Protocol to Eliminate Illicit Trade in Tobacco Products .................................................................................................... 29 2.4.1 The international process of accession to the Protocol to Eliminate Illicit Trade in Tobacco Products and its entry into force (Patrick Musavuli and Nicolás Guerrero Peniche) ���������������������������������������������������������������� 31 2.5 Principal decisions of the seventh Conference of the Parties and regional perspective (Reina Roa) ����������������������������������� 31 3. The MPOWER Package: Progress in Its Implementation in the Region of the Americas .................................................. 36 M Monitor tobacco use and prevention policies ................................................................................................................ 36 P Protect people from tobacco smoke ............................................................................................................................... 41 O Offer help to quit tobacco use ........................................................................................................................................ 44 W Warn about the dangers of tobacco ............................................................................................................................... 48 E Enforce bans on tobacco advertising, promotion, and sponsorship .............................................................................. 52 R Raise taxes on tobacco ................................................................................................................................................... 57 3.1 Tobacco taxation as a policy that benefits everyone in Latin America and the Caribbean (Mark Goodchild) ....................... 62 4. Challenges and Lessons Learned.................................................................................................................................................. 67 4.1 Tobacco industry: a continuous challenge (Eduardo Bianco) .................................................................................................. 67 4.2 Regulation of electronic nicotine delivery systems (ENDS), electronic non-nicotine delivery systems (ENNDS), and new tobacco products (Armando Peruga) ............................................................................ 68 4.3 “Killer Flavors”: a campaign sounding the alarm on flavored cigarettes (Patricia Sosa) ....................................................... 71 4.4 Consistency between trade policies and tobacco control policies: lessons learned (Benn McGrady) .................................. 72 4.5 Reflections on the ICSID award in the case ofPhilip Morris International v. Uruguay: impact of this decision on tobacco control policies and other public health measures (Ministry of Public Health, Uruguay) ����������������������������������������� 73 5. Technical Note ���������������������������������������������������������������������������������������������������������������������������������������������������������������������������������� 75 6. References ......................................................................................................................................................................................... 79 7. Country Profiles �������������������������������������������������������������������������������������������������������������������������������������������������������������������������������� 83 REPORT ON TOBACCO CONTROL IN THE REGION OF THE AMERICAS III 8. Annexes ........................................................................................................................................................................................... 154 8.1 Prevalence of current adult cigarette and tobacco smoking, most recent surveys (data provided by countries) ............... 154 8.2 Prevalence of current youth (aged 13–15 years) cigarette and tobacco smoking, most recent survey, or survey with data available for these indicators (data provided by countries) .................................................................. 156 8.3 Prevalence of current adult smokeless tobacco use in the Region of the Americas, most recent survey, or survey with data available for these indicators (data provided by countries) ..................................................... 158 8.4 Prevalence of current youth (aged 13–15 years) smokeless tobacco use, most recent survey, or survey with data available for these indicators (data provided by countries) ................................................................
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