Report on the WHO Framework Convention on Tobacco Control (FCTC) 8thConference the of Parties (COP 8)

General incorporated association Japan Society for Tobacco Control
Sakuta Manabu, Chairperson

COP 8 (8th Conference of the Parties) was held in Geneva, Switzerland from 1-6
October 2018.

There are currently 181 member nations of the COP, and during therecent convention, 1200 people from 148 nations met to form one the largest COP yet.
The venue was the International Conference Hall (CICG), which about 10 minutes
from the banks of Lac Léman (Lake Geneva) and about 5 minutes from its famous
fountain by walking.

In the other direction, Professor Miyazaki Kyoichi and I

climbed a mountain slope for 7 to 8 minutes to stay at an inexpensive hotel that
helped to host the Framework Convention Alliance (FCA), a FCTC alliance with 500
organizations worldwide.
On September 30, there was a pre-COP policy briefing of the FCA.

From 8 am to

6 pm, we discussed global anti-tobacco strategies, heated tobacco, human rights for
one’s body, anti-smuggling protocols and other topics. At this meeting, I explained
passive smoking prevention laws and ordinances in Tokyo and the rest of Japan.
Despite some shortcomings, these laws and ordinances are better than what existed
previously, and are better than nothing even if other countries have morecomprehensive and strict anti-tobacco regulations.
According to FCTC authorities, the achievement rate of each COP article in 2018(2016) was as follows:
Article 8 88% (86%), Article 7 77% (64%), Article 12 71% (59%), Article 16 70% (59%),
Article 5 66% (57%), Article 6 64% (56%), Article 13 61% (57%) Article 15 61% (50%),
Article 10 57% (48%), Article 14 51% (42%), Article 20 51% (41%), Article 9 48%(40%), Article 18 35% (35%), Article 19 28% (24%), 17 Article 13% (15%).
Among these articles, Japan has thoroughly achieved only article 14 (thetreatment of dependence).

Nations that are not able to enforce Article 8 (preventionof passive smoking), which has a limited time to implement, include 116 nations forpassive smoking in private automobiles, 50 nations for passive smoking in nights
clubs, 41 nations for passive smoking in pubs and bars, as well as other examples.
With respect to Article 11 (tobacco packaging and labeling), which also has a limited
time to implement, there were 75 nations with health warnings covering at least 50%

of the tobacco package and 65 nations with health warnings using figures or photos.
However, Japan is not yet included in these categories.
On the first day of the COP (1 October), Secretary General Bella remarked that aperson from the media who seemed favorable to tobacco industry interests waspresent at meeting.

So a motion was proposed and approved to not let information

leak until after the meeting.

For this reason, it became impossible to communicate

in general about tobacco control measures.

I had been unaware that people might

adopt interests of the tobacco industry, but thereafter media badges granting
permission to attend were removed.

Although many from the media pointed outthat the tobacco convention was closed unlike the Treaty on Global Warming, we feltthat we had no choice due to possibility that the principles of the convention could beundermined.

Similar to situations at meetings of the Inter Governmental

Organization (IGO), the International Criminal Police Organization (Inter Pol),World Trade Organization (WTO), giving observer status to organizations connectedwith the tobacco industry creates a conflict of interest according to Article 5.3 of theFCTC.
However, at COP 7, the tobacco industry sometimes maintained a status of public
citizens during the deliberation of Article 8 (regulations to prevent passive smoking),and JTI argued that the conference was not transparent, but I think that such astance was inevitable.

After COP 7, parties agreed that each country should

publicize information to citizens in accordance with its rules of procedure orphilosophy, but some countries including Japan do not follow this procedure and thuscreate a lack of transparency.
Discussions on the first agenda of Global Strategy (a strategic framework) began at
12:50, but it appeared that Japan had no clear purpose in this regard, and that it
opposed the merits of the framework and did not follow reporting procedures.

In theafternoon session, the secretariat reported that "there are no obligations for eachcountry, and guidelines will be published anyway" regardless of individualcontributions, among other information.

Regarding obligations to follow or tocontribute to a strategic framework, I have repeatedly confirmed that Japan is notbound and can act voluntarily.
The strategic framework will determine which measures should be taken torevitalize the FCTC from 2019, and the details are described in ANNEX 1 of COP
8/11 from COP 8 main document published by the FCTC.
Regarding the Global Strategy for the medium term and whether each country
should be bound by its regulations, I wrote in the Smoking Cessation Journal(volume 13, issue 2) that signatory nations already have about 80 ordinances whichthey are required implement according to the existing FCTC.

But although theFCTC has had a significant impact during its first decade due to these ordinances,
cases of lax enforcement remain in each country.
(1) Each nation and citizen organizations can harmonize enforcement efforts with
the FCTC Secretariat and the COP.
(2) To broaden the impact of FCTC, the convention should cooperate with outsideorganizations like the United Nations.
(3) Funding for operations can be made through normal budget processes in eachnation.
(4) Through these activities, FCTC can be made more effective.

So it is necessaryfor a country like Japan to be able to completely enforce the convention treaty.

At the conclusion, with the exception of two or three countries like Japan that werein opposition, other countries decided to implement the agreements of theconvention.
In the night session, each country made reports about the domestic use of tobacco.
I was surprised to find that Brazil had achieved a smoking rate of only 10.5%, andthe reality is that it is increasingly difficult to cut the rate below 10%.

Australia

started to use plain packaging, and China raised the tobacco tax from approximately
US$0.5 per box to approximately US$2 per box and started a system of smoking
cessation clinics. Tobacco regulations in Hong Kong and Macao were also discussed.
For the next agenda of heated tobacco and nicotine vapor, the discussion heated up,
and it was decided to extend the discussion until Thursday evening at 11:00 pm.
The Russian delegation led the discussion and strengthened the wording of theconclusion by deleting references to the theory of harm reduction.

Even if nicotine

is not used, heating and steaming produces still produces some toxicity, although theexact levels have yet to be determined.

In particular, the risk to vascularendothelial cells due to hydrocyanic acid needs to be made clear.

As a conclusion ofthis agenda, Committee A did not object to a resolution was made at the general
meeting.
Regarding heated tobacco, it has become a source of concern for people involved innational health departments and health care programs, but the COP 8 resolution
provided more definition.

Accordingly, each country decided to prioritized thefollowing matters:a)

To prevent this new kind of tobacco from re-establishing common tobacco use.

b)

In accordance with Article 8 of the WHO FCTC, existing passive smoking

prevention laws shall be applied so that people will not be exposed to passive
smoking from this new kind of tobacco.
c)

To prevent harms to health from this new kind of tobacco.

d)Concurrent with Article 13 of the WHO FCTC, not to advertise, not to promotesales of and not to sponsor this new kind of tobacco.

e)

In accordance with Article 9 and 10 of the WHO FCTC, to clarify and to regulate
the contents of this new kind of tobacco.

f)

In accordance to Article 5.3 of the WHO FCTC, to protect tobacco regulation
policies and activities from the interests of the tobacco industry.

g)

To restrict or to prohibit the manufacture, import, promotion, presentation or
use of this new kind of tobacco, thereby protecting people's health.

yielding seven clauses.
In accordance with these provisions, the Japanese government can regulate heated
tobacco and nicotine vapor like traditional tobacco, especially according to the lawsthat prevent passive smoking, and must be vigilant about their production and uses.
As I learned later, companies in tobacco industry (PMI, BAT, JTI) rented a finerestaurant, La Potiniell, with views the fountain on Lac Léman and the Alps andheld an invitation convention from the first day. Fortunately, it seems that thedelegation from Japan did not attend.
Following the conclusion of COP 8, Hong Kong, which had previously banned ecigarettes (using nicotine liquid), also banned heated (or heat-not-burn) tobacco. Thisban could spread to Thailand, Malaysia, India and other countries that have alreadyprohibited e-cigarettes and/or nicotine liquid.

In any case, since authorization fromthe FCTC and WHO was obtained, the risk of criticism from these policies has been
reduced.
Translation of resolution on heated (heat-not-burn) tobacco
http://www.jstc.or.jp/uploads/uploads/files/essay/COP8WA.pdf

New York Times newspaper report
http://www.jstc.or.jp/uploads/uploads/files/information/NYTHTP.pdf