Tobacco and Human Rights

Written Laurent Huber, Executive Director of Action on Smoking & Health and co-authored by Kelsey Romeo-Stuppy, Managing Attorney at Action on Smoking & Health.

Tobacco remains the leading cause of global preventable death, illness and impoverishment, killing more than 8 million people annually [1].  Left unchecked, tobacco will kill 1 billion people this century. During the worldwide COVID-19 pandemic, addressing tobacco use is even more important, as tobacco negatively impacts the outcomes for COVID-19 patients that smoke or are exposed to tobacco smoke. Furthermore, the tobacco pandemic, even at the best of times, costing the global economy up to two percent of its GDP [2] imposes a tremendous burden on national health systems.  

Tobacco has been recognized as a barrier to development and a call to fully implement the World Health Organization Framework Convention on Tobacco Control (the global tobacco treaty or FCTC) is included as a target in the UN Sustainable Development Goals that were adopted in 2015, and as the United Nations Development Program notes, the FCTC is an accelerator for Sustainable Development and reducing tobacco use is critical to achieving every goal in the SDGs [3].

But in addition to being a Development challenge, the tobacco epidemic is also increasingly being identified as an obstacle to achieving human rights objectives that have been recognized at the highest level through international human rights treaties.

Tobacco negatively impacts many rights, including:

Right to health: The negative impact of tobacco on the right to health has been best articulated  by the Danish Institute for Human Rights (DIHR) when they concluded after conducting an evaluation of Philip Morris International in 2017 that “there can be no doubt that the production and marketing of tobacco is irreconcilable with the human right to health” and in the same year the UN Global Compact, the world’s largest corporate sustainability imitative under the UN,  excluded the tobacco industry because “tobacco products are in direct conflict with UN goals, particularly with the right to public health, and deters progress towards the achievement of SDG 3 [4]”.

Right to development: Tobacco is not only expensive to the global economy, but to individuals as well. As an example, the poorest households in Bangladesh spend almost 10 times as much on tobacco as on education. And at country level, over 10.5 million currently malnourished people could have an adequate diet if money spent on tobacco were spent on food instead. Unfortunately, it’s the poorest who tend to smoke the most. Globally, 84% of smokers live in developing and transitional economy countries.

Women’s rights: Tobacco companies also target consumers based on gender, and specifically target women in countries where gender equality is becoming the norm leading to a feminization of smoking.   For example, in 2010, in its concluding observations, the Committee on the Elimination of all forms of Discrimination Against Women (CEDAW) expressed concern about the negative impacts of tobacco on the women of Argentina, particularly about tobacco advertising directed at women. The committee went on to urge Argentina to ratify and implement the FCTC in order to protect the right to health of women and girls [5].

Rights of racial minorities: Tobacco companies also target consumers based on race. For example, in the United States, due to menthol cigarette advertising that has been targeted at the Black community for decades, nearly 9 out of 10 black people that smoke, smoke menthol cigarettes [6].  However, the tobacco industry, time and again has opposed legislation to phase out mentholated tobacco products.

Children’s rights: Tobacco products violate children’s rights [7], including the protection of children from child labour in tobacco production [8] and from misleading information (e.g., advertising). Children are also at risk for exposure to second hand smoke; over 165,000 children die per year due to the harms of second-hand smoke [9].

Right to a healthy environment: “From tobacco cultivation [10] [11] and curing, to cigarette manufacturing, distribution, consumption and discarding, every stage in the global tobacco supply chain involves considerable resource inputs, and results in the production of wastes and emissions [12].” Additionally, about 4.5 trillion cigarettes [13] are discarded each year worldwide, amounting to 80 million kilograms of tobacco waste and making cigarette butts the most littered item on Earth [14]. The environmental damage that tobacco causes, on top of its negative health, social and economic impacts, makes it incompatible with the global development agenda and with human rights.

During this unprecedented pandemic, tobacco, cigarettes, and the actions of the tobacco industry are even more of a blight on society and an added obstacle to protecting human rights. As the WHO states,

“Tobacco smoking is a known risk factor for many respiratory infections and increases the severity of respiratory diseases. A review of studies by public health experts convened by WHO on 29 April 2020 found that smokers are more likely to develop severe disease with COVID-19, compared to non-smokers. COVID-19 is an infectious disease that primarily attacks the lungs. Smoking impairs lung function making it harder for the body to fight off coronaviruses and other diseases. Tobacco is also a major risk factor for noncommunicable diseases like cardiovascular disease, cancer, respiratory disease and diabetes which put people with these conditions at higher risk for developing severe illness when affected by COVID-19. Available research suggests that smokers are at higher risk of developing severe disease and death [15].”

Tobacco, COVID-19, the right to health, and development are inextricably linked, and it is essential now, more than ever, that governments not only implement the FCTC in its entirety but also provide cessation support to those citizens that want to quit and also consider novel measures to protect the right to health as encouraged by Art 2.1 of the FCTC which states that “In order to better protect human health, Parties are encouraged to implement measures beyond those required by this Convention and its protocols”.

The tobacco control community has increasingly begun to advocate for a human rights-based approach to advance health and decrease the burden of the tobacco pandemic and the 2018 World Conference on Tobacco or Health (WCTOH) adopted an exemplary Cape Town Declaration on human rights and a tobacco free world supported by 165 signatories and formally submitted to the Office of the High Commissioner for Human Rights.  An approach that utilizes human rights rhetoric, tools and platforms can further expedite tobacco control goals. The global health community should take every opportunity, including the upcoming sessions of the UN Human Right Council to elevate the profile of the FCTC as a best practice tool to make progress towards SDGs and denounce any tobacco industry interference at national level. 

Furthermore, country reports can be submitted to the oversight committees for treaties such as the International Convention on Economic, Social and Cultural Rights, or the Convention on the Rights of the Child, that can then assess and adjudicate actions required by the State party. These reports are one demonstrably effective example of how, by addressing tobacco control, nations of the world make progress not only towards health targets, but also development and human rights goals and objectives.   Furthermore, the public health community can use human rights platforms such as the UN Human Rights Council to encourage whole of government engagement in FCTC implementation to achieve the SDGs and also to denounce tobacco industry interference to countries’ efforts to protect the right to health of its citizens.

Tobacco exacerbates inequalities, perpetuates poverty, and is a barrier to achieving development as well as a barrier to achieving the right to health. It is essential that we consider tobacco policy through these human rights lenses.

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References

[1] Available from Tobacco (who.int)

[2] Available from Tobacco kills more than 7 million people per year and is costing the world economy USD 1.4 trillion annually | UNDP Office in Geneva

[3] Available from https://www.who.int/fctc/implementation/publications/who-fctc-undp-wntd-2017.pdf

[4] Available from Frequently Asked Questions | UN Global Compact

[5] Committee on the Elimination of Discrimination against Women (2010), ‘Concluding Observations for Argentina, Section 39’, available from: http://www2.ohchr.org/english/bodies/cedaw/cedaws46.htm

[6] Available from Tobacco use in the African American community (truthinitiative.org)

[7] Children’s Rights and Tobacco Control, The right to a tobacco-free world, Unfairtobacco, January 2020. Brochure Children’s Rights and Tobacco Control | unfairtobacco

[8] Child labour in tobacco growing has been defined as one of the worst forms of child labor (according to ILO Convention 182) due to its detrimental effect on the physical and mental health of the children, especially from nicotine poisoning. ILO Convention 182: https://www.ilo.org/dyn/normlex/en/f?p=NORMLEXPUB:12100:0::NO::P12100_ILO_CODE:C182 and Child labour rampant in tobacco industry | Tobacco industry | The Guardian

[9] Available from https://www.who.int/quantifying_ehimpacts/publications/shsarticle2010/en/

[10] Available from Mangora_Unfairtobacco_Tanzania_deforestation.pdf

[11] Available from https://unfairtobacco.org/wp-content/uploads/2018/12/Akhter_Unfairtobacco_Bangladesh_pesticide-pollution.pdf

[12] Tobacco’s total environmental footprint is comparable to that of entire countries and its production is often more environmentally damaging than that of essential commodities such as food crops. For the six trillion cigarettes manufactured annually, 32.4 Mt of green tobacco are cultivated on 4 million ha of arable land and are then processed into 6.48 Mt of dry tobacco worldwide. Globally, the tobacco supply chain contributes almost 84 Mt CO2 eq emissions to climate change, 490,000 tons 1,4-DB eq to ecosystem ecotoxicity levels, over 22 billion m3 to water and 21 Mt oil eq to fossil fuel depletion annually. As a result of the shift of tobacco production from richer to poorer regions, these environmental impacts are not felt equally around the world. Developing countries and the most vulnerable communities bear most of the burden, WHO-FCTC-Enviroment-Cigarette-smoking.pdf, Maria Zafeiridou, Nicholas S Hopkinson, Nikolaos Voulvoulis, 2018

[13] Available from Cigarette butts are toxic plastic pollution. Should they be banned? (nationalgeographic.com)

[14] Available from 9789241512497-eng.pdf;jsessionid=299567FD41B1E3B90D0ECFA6BADB7FC5 (who.int)

[15] Available from WHO statement: Tobacco use and COVID-19