To analyse the extent to which parties to the WHO Framework Convention on Tobacco Control (FCTC) have implemented Article 6 since the convention's entry into force.Methods
Compliance was measured using nine indicators, derived from the 2016 version of the FCTC's reporting instrument's core questionnaire, and the WHO's MPOWER cigarette affordability measure. Data were collected from WHO country profiles, and the 12 country mission reports by the Impact Assessment Expert Group.Results
The number of parties reporting any type of excise tax increased from 87% (134/154) in 2008 to 92% (160/174) in 2016. Specific excise tax systems were implemented by 36% (63/174) of FCTC ratifying countries in 2016, up from 32% (49/154) in 2008. The proportion of parties with mixed tax structures has increased from 25% (39/154) in 2008 to 32% (56/174) in 2016. The proportion of parties that levy the tax as a fully ad valorem tax has decreased from 29% (45/154) in 2008 to 24% (42/174) in 2016. Cigarettes have become less affordable in 46% (78/168), more affordable in 13% (21/168) and unchanged in terms of affordability in 41% (69/168) of parties between 2008 and 2016. The number of parties that earmark tobacco tax revenues for public health increased from 13 in 2008 to 30 in 2016. Many finance ministries are hesitant to increase the excise tax, mainly due to illicit trade concerns.Conclusion
While there has been some improvement in tobacco tax policy over time, parties should adopt stronger tax measures, despite industry opposition and threats about illicit trade. Parties should implement FCTC Article 5.3 and ratify the Protocol to Eliminate Illicit Trade in Tobacco Products.