To reduce health disparities in a single act, the United States should join the global community in ratifying the first international public health treaty, the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC). Tobacco addiction, the leading cause of preventable premature deaths in the world, will claim as many as a billion lives in this century. To counter this human catastrophe, 153 countries have ratified the FCTC since 2003. The United States has yet to do so.
Your new administration can restore our country’s global leadership role by ratifying this treaty, which legally obliges all signing governments to implement a common set of articles to protect the public’s health. These articles include requiring large, rotating health warnings, which may include graphic photographs, covering at least 30 percent of tobacco packaging; enacting comprehensive bans on tobacco advertising, promotion, and sponsorship (to the full extent allowed by the U.S. Constitution); banning misleading and deceptive descriptive terms such as “light” and “mild”; promoting clean indoor air by prohibiting smoking in public places; increasing tobacco taxes; and other key measures.
Tobacco addiction drives health inequities locally and globally. People on the lower rungs of the socioeconomic ladder are burdened disproportionately. For example, while smoking prevalence among adults in the U.S. is, on average, about 21 percent, rates approach 31 percent for those who live below the federal poverty level. Smoking prevalence is even higher among adults with 9 to 11 years of education (35.4 percent) or a General Educational Development diploma (46.0 percent). By 2030, 80 percent of more than eight million tobacco-related deaths projected annually will occur in low- and middle-income countries. The enormity of this toll reflects not just steady population growth, but also the tobacco industry’s aggressive efforts to target and market to vulnerable populations.
While the U.S. Secretary of Health and Human Services signed the FCTC in 2004, President Bush has not yet brought it before the Senate for possible ratification. As our new President, you can transform promise into progress, bringing us closer to public health’s noblest goal: enjoyment of the highest attainable standard of health for every human being.