2/27/24, 12:41 AM
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`Tobacco
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`31 July 2023
`
`ﺔﯾﺑرﻌﻟا
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`Tobacco kills up to half of its users who don’t quit (1-3).
`Tobacco kills more than 8 million people each year, including an estimated 1.3 million non-smokers
`who are exposed to second-hand smoke (4).
`Around 80% of the world's 1.3 billion tobacco users live in low- and middle-income countries.
`In 2020, 22.3% of the world’s population used tobacco: 36.7% of men and 7.8% of women.
`To address the tobacco epidemic, WHO Member States adopted the WHO Framework Convention on
`Tobacco Control (WHO FCTC) in 2003. Currently 182 countries are Parties to this treaty.
`The WHO MPOWER measures are in line with the WHO FCTC and have been shown to save lives
`and reduce costs from averted healthcare expenditure.
`
`(4)
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`https://www.who.int/news-room/fact-sheets/detail/tobacco
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`1/7
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`JLI Ex. 2010, Page 1 of 7
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`Tobacco
`Key facts
`Leading cause of death, illness and
`impoverishment
`The tobacco epidemic is one of the biggest public health threats the world has ever faced,
`killing over 8 million people a year around the world. More than 7 million of those deaths are
`the result of direct tobacco use while around 1.3 million are the result of non-smokers being
`exposed to second-hand smoke
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`All forms of tobacco use are harmful, and there is no safe level of exposure to tobacco.
`Cigarette smoking is the most common form of tobacco use worldwide. Other tobacco
`products include waterpipe tobacco, cigars, cigarillos, heated tobacco, roll-your-own tobacco,
`pipe tobacco, bidis and kreteks, and smokeless tobacco products.
`Around 80% of the 1.3 billion tobacco users worldwide live in low- and middle-income
`countries
`, where the burden of tobacco-related illness and death is heaviest. Tobacco use
`contributes to poverty by diverting household spending from basic needs such as food and
`shelter to tobacco. This spending behaviour is dicult to curb because tobacco is so addictive.
`The economic costs of tobacco use are substantial and include signicant health care costs for
`treating the diseases caused by tobacco use as well as the lost human capital that results from
`tobacco-attributable morbidity and mortality.
`Key measures to reduce the demand for
`tobacco
`Surveillance is key
`Good monitoring tracks the extent and character of the tobacco epidemic and indicates how
`best to tailor policies. Almost half of the world's population are regularly asked about their
`tobacco use in nationally representative surveys among adults and adolescents.
`More on monitoring tobacco use
`Second-hand smoke kills
`Second-hand smoke is the smoke that lls restaurants, oces, homes, or other enclosed
`spaces when people smoke tobacco products. There is no safe level of exposure to second-
`hand tobacco smoke. Second-hand smoke causes serious cardiovascular and respiratory
`diseases, including coronary heart disease and lung cancer, and kills around 1.3 million people
`prematurely every year.
`Over a quarter of the world's population living in 74 countries are protected by comprehensive
`national smoke-free laws.
`More on second-hand smoke
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`Tobacco users need help to quit
`Among smokers who are aware of the dangers of tobacco, most want to quit. Counselling and
`medication can more than double a tobacco user ’s chance of successful quitting.
`National comprehensive cessation services with full or partial cost-coverage are available to
`assist tobacco users to quit in only 32 countries, representing around a third of the world's
`population.
`More on quitting tobacco
`Pictorial health warnings work
`Hard-hitting anti-tobacco mass media campaigns and pictorial health warnings prevent
`children and other vulnerable groups from taking up tobacco use, and increase the number of
`tobacco users who quit.
`Over half the world’s population live in the 103 countries that meet best practice for graphic
`health warnings, which includes among other criteria, large (50% or more of the main areas of
`the package) pictorial health warnings displayed in the local language.
`1.5 billion people live in the 36 countries that have aired at least one strong anti-tobacco mass
`media campaign within the last 2 years.
`More on tobacco health warnings
`Bans on tobacco advertising lower consumption
`Tobacco advertising promotion and sponsorship (TAPS) increases and sustains tobacco use by
`eectively recruiting new tobacco users and discouraging tobacco users from quitting.
`One third of countries (66), representing a quarter of the world’s population, have completely
`banned all forms of TAPS.
`More on tobacco advertising bans
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`Taxes are eective in reducing tobacco use
`Tobacco taxes are the most cost-eective way to reduce tobacco use, especially among youth
`and low-income groups. A tax increase that increases tobacco prices by 10% decreases tobacco
`consumption by about 4% in high-income countries and about 5% in low- and middle-income
`countries.
`Even so, high tobacco taxes are rarely implemented. Only 41 countries, with 12% of the world's
`population, have introduced taxes on tobacco products so that at least 75% of the retail price
`is tax.
`More on tobacco taxes
`Illicit trade of tobacco products must be stopped
`The illicit trade in tobacco products poses major health, economic and security concerns
`around the world. It is estimated that 1 in every 10 cigarettes and tobacco products consumed
`globally is illicit.
`Experience from many countries demonstrates that illicit trade can be successfully addressed
`even when tobacco taxes and prices are raised, resulting in increased tax revenues and
`reduced tobacco use. 
`The WHO FCTC Protocol to Eliminate the Illicit Trade of Tobacco Products (ITP) is the key supply
`side policy to reduce tobacco use and its health and economic consequences.
`More on eliminating the illicit trade of tobacco products
`Newer nicotine and tobacco products
`Heated tobacco products (HTPs) are tobacco products that produce aerosols containing
`nicotine and toxic chemicals upon heating of the tobacco, or activation of a device containing
`the tobacco. They contain the highly addictive substance nicotine, non-tobacco additives and
`are often avoured.
`Despite claims of “risk reduction”, there is no evidence to demonstrate that HTPs are less
`harmful than conventional tobacco products. Many toxicants found in tobacco smoke are at
`signicantly lower levels in HTP aerosol but HTP aerosol contains other toxicants found
`sometimes at higher levels than in tobacco smoke, such as glycidol, pyridine, dimethyl
`trisulde, acetoin and methylglyoxal. 
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`Further, some toxicants found in HTP aerosols are not found in conventional cigarette smoke
`and may have associated health eects. Additionally, these products are highly variable and
`some of the toxicants found in the emissions of these products are carcinogens.  
`More on heated tobacco products
`Electronic cigarettes (or e-cigarettes) are the most common form of electronic nicotine delivery
`systems (ENDS) and electronic non-nicotine delivery systems (ENNDS) but there are others,
`such as e-cigars and e-pipes. ENDS contain varying amounts of nicotine and harmful
`emissions. Use of ENDS/ENNDS products is colloquially referred to as ‘vaping’. However this
`does not mean that they are harmless or emit water vapour.
`E-cigarette emissions typically contain nicotine and other toxic substances that are harmful to
`users and non-users who are exposed to the aerosols second-hand. Some products claiming
`to be nicotine-free have been found to contain nicotine.
`Evidence reveals that these products are harmful to health and are not safe. However, it is too
`early to provide a clear answer on the long-term impacts of using them or being exposed to
`them. Some recent studies suggest that ENDS use can increase the risk of heart disease and
`lung disorders. Nicotine exposure in pregnant women can have negative health consequences
`on the fetus, and nicotine, which is a highly addictive substance is damaging for brain
`development. 
`More on e-cigarettes
`Nicotine pouches are pre-portioned pouches that contain nicotine and are similar to traditional
`smokeless tobacco products such as snus in some respects including appearance, inclusion of
`nicotine and manner of use (placing them between the gum and lip). They are often promoted,
`as “tobacco-free”, which can be used anywhere and in some jurisdictions, such as the US, they
`are referred to as “white pouches”.
`WHO response
`There is a fundamental and irreconcilable conict between the tobacco industry ’s interests and
`public health policy interests. The tobacco industry produces and promotes a product that has
`been proven scientically to be addictive, to cause disease and death and to give rise to a
`variety of social ills, including increased poverty.
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`2/27/24, 12:41 AM
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`Tobacco
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`Monitor tobacco use and prevention policies.
`Protect people from tobacco use.
`Offer help to quit tobacco use.
`Warn about the dangers of tobacco.
`Enforce bans on tobacco advertising, promotion and sponsorship.
`Raise taxes on tobacco.
`
`(1)
`
`et al.
`
`BMC Med
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`https://www.who.int/news-room/fact-sheets/detail/tobacco
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`6/7
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`JLI Ex. 2010, Page 6 of 7
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`The scale of the human and economic tragedy that tobacco imposes is shocking, and also
`preventable. The tobacco industry is ghting to ensure the dangers of their products are
`concealed, but we are ghting back.
`The WHO FCTC is a milestone in the promotion of public health. It is an evidence-based treaty
`that rearms the right of people to the highest standard of health, provides legal dimensions
`for international health cooperation and sets high standards for compliance. Since its entry
`into force in 2005, the WHO FCTC has 182 Parties covering more than 90% of the world’s
`population.
`In 2007, WHO introduced a practical, cost-eective initiative to scale up implementation of the
`demand reduction provisions of the WHO FCTC, called MPOWER. 
`The 6 MPOWER measures are:
`WHO has been monitoring MPOWER measures since 2007. For more details on progress made
`for tobacco control at global, regional and country level, please refer to the series of WHO
`reports on the global tobacco epidemic.
`More on MPOWER
`References
` Doll R, Peto R, Boreham J, Sutherland I. Mortality in relation to smoking: 50 years'
`observations on male British doctors. BMJ. 2004 Jun 26;328(7455):1519.
`(2) Banks, E., Joshy, G., Weber, M.F.
` Tobacco smoking and all-cause mortality in a large
`Australian cohort study: ndings from a mature epidemic with current low smoking
`prevalence.
`13, 38 (2015).
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`2/27/24, 12:41 AM
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`Tobacco
`
`et al.
`
`BMC Med
`
`(4)
`
`(5)
`
`Plain packaging of tobacco products: evidence, design and implementation
`
`WHO global report on trends in prevalence of tobacco use 2000-2025, fourth edition
`WHO report on the global tobacco epidemic 2021
`
`Tobacco Free Initiative
`WHO Framework Convention on Tobacco Control
`More about tobacco: topical overview
`
`https://www.who.int/news-room/fact-sheets/detail/tobacco
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`7/7
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`JLI Ex. 2010, Page 7 of 7
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`(3) Siddiqi, K., Husain, S., Vidyasagaran, A.
` Global burden of disease due to smokeless
`tobacco consumption in adults: an updated analysis of data from 127 countries.
`18,
`222 (2020).
` Global Burden of Disease [database.Washington, DC: Institute of Health Metrics;
`2019. IHME,accessed 17 July 2023
`WHO global report on trends in prevalence of tobacco use 2000-2025, fourth edition. WHO,
`Geneva, 2021
`Guide
`Publications
`More about tobacco
`