Pre-Sessional Working Group, 49th Session, 21-25 May 2012
Tobacco Control and the Right to Health
Tobacco will kill an estimated one billion people in the 21st century in the absence of aggressive action by governments to advance tobacco control and smoking cessation. Eighty percent these deaths will be in developing countries – those least able to manage this epidemic. One in two smokers will die from a tobacco related disease and 50% of these deaths will be in middle age. The human stories behind these statistics are so often heartbreaking. Not only illness and death, but also the impact on families due to loss of primary breadwinners, the toxic exposures and lost educational opportunities for children who work in tobacco farming, environmental degradation through deforestation and runoff of pesticides into rivers, and the contribution of tobacco purchases to increased poverty and malnutrition. The World Health Organization projects increasing numbers of smokers over the next 20 years, with women in low- and middle-income countries being a particular target of tobacco marketing.
A broad evidence base supports a combination of legal, policy, medical, environmental and behavioral interventions that governments can take to control tobacco and improve health. Tobacco taxes, clean indoor air laws, comprehensive bans on advertising and promotion, public information campaigns, graphic warning labels on tobacco products and smoking cessation have all been shown to reduce tobacco consumption and dependence. As such, States Parties to the Convention on Economic, Social and Cultural Rights are obligated to pursue tobacco control under their duties to respect, protect and fulfill Article 12: the Right to the Highest Attainable Standard of Health.
The following submissions to the 49th Pre-Sessional Working Group of the Committee on Economic, Social and Cultural Rights summarizes the tobacco control content within each State Party report. Each submission concludes with three to four key recommendations for improvement and a list of questions that the Committee can raise to country representatives to encourage stronger tobacco control policies. For each report, we consulted with local tobacco control advocates in the country under review. HRTCN believes that these tobacco control strategies and recommendations sit at the heart of government obligations to respect, protect and fulfill the right to the highest attainable standard of health.
Tobacco Control and the Right to Health in Japan
The Human Rights and Tobacco Control Network (HRTCN) has reviewed Japan’s report to the Committee on Economic, Social and Cultural Rights with respect to tobacco control and the right to health. We are concerned that Japan’s report to the Committee only mentions tobacco twice, yet tobacco remains a major cause of premature morbidity and mortality in Japan. Tobacco is discussed as a risk factor under “Health Japan 21,” a national plan to address non-communicable (lifestyle) diseases, but the report does not acknowledge the seriousness of Japan’s tobacco epidemic or discuss specific tobacco control measures or remaining areas of need.
HRTCN calls the Committee’s attention to the high prevalence of tobacco use in Japan. According to 2010 data from the Japanese Ministry of Health, Labor and Welfare, 32.2% of men and 8.4% of women in Japan smoke. Japan also lacks basic resources to help smokers quit. There is no national quit line, and nicotine replacement therapies, although available, are only covered for people who have smoked more than ten pack years and can visit doctors about tobacco 5 times or less in a year.
Although Japan has ratified the Framework Convention on Tobacco Control, domestic tobacco control laws and policies remain weak and are often voluntarily enforced. As of January 1, 2010, Japan did not have smoke-free laws prohibiting smoking in public places, healthcare facilities such as hospitals or bars/restaurants. The Japanese government maintains close financial ties to the tobacco industry. As of 2008, the Ministry of Finance controlled 50% of Japan Tobacco, and many Members of Parliament have personal investments in the tobacco industry. More troubling, the Ministry of Finance sets the tobacco control budget under the Ministry of Health. The Ministry of Health has a budget of 50 million yen for tobacco control, well below the 250 million yen devoted to the prevention of mad cow disease.
HRTCN is particularly concerned about the Japanese tobacco industry’s use of bilateral trade and investment treaties to undermine tobacco control in other countries. Earlier this year, Japan Tobacco joined British American Tobacco and Philip Morris in using provisions under the Australia-Hong Kong investment treaty to sue the government of Australia over a new law requiring plain packaging for cigarettes. Litigation through trade agreements is a growing industry tactic intended to both undermine existing legislation and discourage tobacco control law-making in other nations.
Consequently, HRTCN asks the Committee to raise the following issues to Japan’s country representative:
Combat Tobacco Industry Influence: 1. End litigation through bilateral investment treaties against plain packaging laws in Australia and other countries. 2. Divest government ownership of Japan tobacco in order to limit tobacco industry influence over domestic tobacco control legislation and increase the Ministry of Health’s budget for tobacco control public health initiatives.
Strengthen health warnings: 1. Pass and enforce plain packaging restrictions for cigarettes and tobacco products, including domestically manufactured and duty-free items. 2. Pass legislation prohibiting the use of ambiguous terms such as “light” or “low tar” on tobacco products.
Clean Indoor Air Laws: Pass and enforce national clean indoor air legislation to reduce exposure to environmental smoke at healthcare settings, schools, restaurants/bars and other public spaces. Japan currently has among the weakest clean indoor air standards in the Western Pacific region.
Smoking Cessation: 1. Expand smoking cessation services including quit lines and access to nicotine replacement therapies. 2. Strengthen education on tobacco control and smoking cessation among health professionals to create smoke-free role models.
HRTCN works to advance a human rights based approach to tobacco control – utilizing the legal remedies and reporting requirements of current treaties and conventions, including the recent Framework Convention on Tobacco Control, the Convention on the Rights of the Child (CRC), the Convention on the Elimination of Discrimination Against Women (CEDAW) and the Covenant on Economic, Social and Cultural Rights. HRTCN will educate on and utilize measures that are currently accessible and will encourage adoption of new measures in order to decrease the morbidity and mortality of the people with the least agency to claim their rights.