© WHO, World No Tobacco Day 2016 campaign

Determined activists drive tobacco control

30th May 2016

Increasingly, though at varying paces, governments are adopting stronger policies to reduce the devastating impact of tobacco on societies. Recently, the public health community has celebrated the successful adoption of plain cigarette packaging rules in several gountries, highlighted by World No Tobacco Day this year with the theme: Get ready for plain packaging

It's the campaigning efforts of persisent individuals that has bouyed much of the momentum for tobacco control throughout the world, and in this blog Marty Logan of the Frameworke Convention Alliance shares the stories of 3 of them, based in South Korea, Kenya and India.

Dr Hong Gwan Seo’s conversion to tobacco control activist began as he puffed on a cigarette reading medical literature on the harms caused by smoking. 
“As a doctor I thought I knew the dangers, but as I read I realized smoking was crazy; it was like committing suicide slowly. So I quit.” - 

Dr Hong Gwan Seo, South Korea

That was 1988, the year that the Korean Association on Smoking or Health (KASH) was founded. Since then, there have been two high points for advocates in South Korea, says Dr Seo. In 1995, the Health Promotion Act created smoke-free spaces and banned tobacco advertising. In 2014-15, the government adopted a range of tobacco control (TC) measures: cigarette prices rose 80 percent thanks to a tax hike and it was announced that packages would have to carry graphic health warnings by December 2016. 
Dr Hong Gwan Seo
In 2012 the fifth session of the Parties to the global tobacco control treaty, the WHO Framework Convention on Tobacco Control (FCTC) was held in Seoul. Remarkably successful since it came into force in 2005, the FCTC now counts 180 Parties with nearly 90 percent of the world’s population. Implementing the FCTC’s measures has been called the ‘best of best buys’ in tackling NCDs. “Full implementation of the WHO Framework Convention on Tobacco Control would bring the single biggest blow to heart disease, cancer, diabetes, and respiratory disease,” said WHO Director-General Margaret Chan in 2011. 
Unfortunately, implementation of the FCTC has been slow overall, due to many factors: lack of political will – at times the result of interference from the tobacco industry – insufficient resources and poor coordination among the various government departments in positions to implement TC measures. The agenda of COP7, to be held in New Delhi in November 2016, includes items designed to address lagging implementation. 
Framework Convention Alliance (FCA) is working to ensure that Parties to COP7 make the right decisions to accelerate implementation. This includes following up on a report expected from a working group on sustainable measures for the FCTC and another on ideas to improve how Parties report on progress in putting in place their treaty obligations.
Till now, the determination of activists like Dr Seo has played a major role in pushing TC forward in many countries. In Kenya, for example, the government adopted the Tobacco Control Act in 2007 but it has yet to be put into force. “A huge part of this problem is due to tobacco industry interference,” says Emma Wanyonyi, CEO of the International Institute for Legislative Affairs. “Kenya has a strong tobacco industry which … has strong political connections that have many times become a challenge for TC. However, political will to ensure sufficient financial resources are available for effective implementation has also been a challenge.”
Emma Wanyonyi, CEO International Institute for Legislative Affairs
Since 2007, Emma has worked to get TC measures implemented. She admits it can be draining. 
“Sometimes TC work can be daunting and feel too much. But upon reflection on where we have come from, what we have achieved so far and the impact we have had on lives of present and future generations, I am encouraged to stay on and give a little more.” - Emma Wanyonyi, Kenya
She notes that the industry has appealed a court ruling earlier this year that ordered the measures in the TC Act to be implemented. “The battle is still on, and is unlikely to end even when the matter is settled: the industry will not go down without a fight. As TC advocates we just have to find our footing and negotiate this rough terrain, expecting the worst from the Industry, while striving to determine the TC agenda for the county.”

In India, Dr Rakesh Gupta established the Rajasthan Cancer Foundation (RCF) in 2002 because his employer would not allow him to work on TC and other cancer control activities. His achievements are many, including advocacy that led to Jhunjhunu being named Rajasthan’s first smoke-free city in 2007, and the State Police Academy declared tobacco free in 2008. The latter development led to all six Police Training Centres in the state being declared tobacco-free, in 2010, while Jhunjhunu became the first smoke-free district in the state in 2012. In 2013 Dr Gupta received a World No Tobacco Day Award for his work as an individual.

“Progress has been significant,” he notes. “Also a whole new generation of tobacco control activists have emerged in every state of India along with tobacco control committees. But (these achievements) appear insignificant and insurmountable due to the large tobacco-using population in the rural and poorer urban India, lack of sustained awareness especially to the benefits of quitting, poor outreach for tobacco cessation, paucity of tobacco-free environments and low tobacco taxes.”

“I think it (being tobacco control advocate) has made me live for a very important public health and societal cause. It is much more satisfying than to have lived solely as a surgical oncologist.” - Dr Rakesh Gupta, India

Today Dr Gupta self-finances his TC work from the income of his government pension but he is happy he chose to become an advocate: “I think it has made me live for a very important public health and societal cause. It is much more satisfying than to have lived solely as a surgical oncologist.”
Dr Rakesh Gupta (right), in an interview for the Rajasthan Cancer Foundation
Back in Seoul, Dr Seo says he never thought of giving up the TC fight, “because I think that I am doing the right thing.” Noting that GHWs should be in place by year-end, KASH – where Dr Seo is now president – is turning to banning tobacco advertising in retailers. “The Ministry of Finance announced on Sept. 11, 2014 that it would prohibit such advertising. But there has been no progress since then.”

About the Author

Marty Logan has been Communications Manager at Framework Convention Alliance (FCA)@FCAforTC since 2010. He was formerly a journalist in Canada and Asia.