Global Tobacco Control Progress and Challenges with New and Emerging Products
The 2021 World Health Organization (WHO) Report on the Global Tobacco Epidemic describes the progress made in tobacco control despite the unprecedented challenges presented by the COVID-19 pandemic. As of 2020, more than 5.3 billion people, or 69 percent of the world’s population, were protected by at least one comprehensive tobacco control policy—an increase from 5.1 million protected in 2018. There are now 146 countries with at least one best-practice tobacco control policy in place and seven countries adopting best-practice measures for the first time (Cook Islands, Cote d’Ivoire, Ethiopia, Iraq, Morocco, Paraguay and Tonga).
Despite the promising advancements in tobacco control, many countries remain vulnerable to emerging nicotine and tobacco products. The report calls attention to the proliferation of emerging nicotine and tobacco products, such as electronic nicotine delivery systems (ENDS).
Such products’ increasing availability is coupled with misinformation campaigns that market ENDS as clean, smoke-free or a safer option to traditional tobacco and nicotine products. The rapid evolution of ENDS has presented regulatory challenges across the globe. As of 2020, 32 countries have banned the sale of ENDS and 79 countries have implemented one or more legislative measures to regulate ENDS, covering 2.4 and 3.2 billion people, respectively. However, 84 countries have no bans or regulations on the sale or use of ENDS.
Flavors, product design, and marketing strategies attract new users, especially children and adolescents, to try and use ENDS. A recent review cited in the report found nearly 20 percent of children and adolescents reported ever using ENDS, across 50 of the 67 countries reporting ENDS use. Another study in the United States found 70 percent of adolescents (ages 12 to 17) reported using e-cigarettes “because they come in flavors I like.” Some markets have approximately 16,000 unique flavors, including dessert, candy, and fruit profiles that appeal to children and adolescents.
To address the rapidly evolving nature of tobacco epidemic, the CDC Foundation is working to increase public health professionals’ knowledge and recognition of emerging tobacco products like ENDS. In collaboration with the Centers for Disease Control and Prevention (CDC), the CDC Foundation is developing an eLearning course titled Global Tobacco Control in a Changing Landscape, designed to increase public health professionals’ awareness of global tobacco use and control in a changing landscape. The course will provide tools to enhance global tobacco control strategies. The course will be available in 2022 and it when available, along with other resources for countries and partners, can be found on GTSS Academy.
While the strides made in tobacco control around the world are encouraging, there is still much work to be done. Tobacco use or exposure kills 8 million people annually, including one million non-smokers from second-hand smoke.
New and emerging tobacco products allow the tobacco industry to attract younger users, and subsequently grow the industry’s customer base. The CDC Foundation is pleased to partner with CDC and WHO, with support from Bloomberg Philanthropies and the Bill & Melinda Gates Foundation, to improve and save lives by supporting global tobacco surveillance around the world and empowering countries to enhance their own tobacco control policies.
