FDI WORLD DENTAL FEDERATION

Transcription

1 FDI WORLD DENTAL FEDERATION STATEMENT TO THE WORLD HEALTH ORGANIZATION FOR THE OCTOBER 2000 PUBLIC HEARINGS ON THE The FDI World Dental Federation is a 100 year-old non-profit Federation of 140 National Dental Associations, representing 700,000 dentists worldwide, and 30 International Dental Associations. Its missions are (1) to be the authoritative, professional, independent, worldwide voice of dentistry, (2) to support the principle that all people should have access to the best possible care to achieve optimal oral health, (3) to support and promote the interests of the member associations and their members, and (4) to contribute internationally to the development and dissemination of policies, standards and information related to all aspects of oral health care. Funding: The FDI is supported entirely by annual subscriptions by its members and revenues from its wholly owned subsidiaries for publications and congresses. Interest in the FCTC Process: The FDI World Dental Federation is privileged to be in long-standing official relations with the World Health Organization. It recognises the adverse general health effects of tobacco use and the conclusive evidence that tobacco use damages oral health, increases risks of developing life-threatening oral diseases, and adversely affects many oral health services. Several FDI position statements addressing tobacco prevention and control serve as guides to the Federation, its Member Associations and to all dentists and dental staff worldwide. The FDI encourages its National Member Associations to petition country governments to negotiate and ratify FCTC treaties and to pursue policies that truly avert and reduce tobacco-related health, well-being, social, environmental and economic problems. Through the close relationships with its National Member Associations and its co-operation with dental as well as non-dental health and scientific organisations, the FDI is uniquely positioned to support the FCTC and other initiatives. FDI Recommendations: The FDI commends the WHO for its Tobacco Free Initiative and fully supports the goal and objectives of a Framework Convention on Tobacco Control. The FDI fervently desires that, in due course, treaties will be ratified by an overwhelming majority of WHO member States, and that terms reached will be those that result in significantly reduced use of tobacco.

2 1. Tobacco industry involvement: The FDI urges WHO that statements made and actions taken by the tobacco industry must not be allowed to retard, obstruct or divert the FCTC negotiation process. 2. Cessation: The FDI recognizes that evidence is now strong that specific clinical interventions can increase patient quit rates, and that methods, such as those recently recommended by the U.S. Public Health Service, are as effective when applied in a dental environment. The FDI recognizes that cessation services are an essential component of tobacco control since, even if comprehensive preventive measures were adopted globally, more than a billion smokers and users of unburned forms of tobacco would still be addicted and at risk. International measures are needed (1) to ensure that effective pharmaceuticals and professional education programmes are available worldwide, (2) so that intergovernmental incentives can be devised to promote universal competence and commitment to integrating cessation services into practice, (3) to promote global assessment standards and intercountry research partnerships for assessing tobacco-related use, behavioral factors, health effects, and intervention measures across cultures and between social systems, and (4) to facilitate global science transfer and support for cessation methods that emerge from research. The FDI recommends that cessation services be a priority protocol of the FCTC. 3. Service gap: The FDI recognizes that most initiation of tobacco use and onset of addiction occur among children and youths. Youth prevention programmes and adult cessation programmes overlook youths who are using and are dependent on tobacco. Thus, their dependence only becomes more established with time and related risks to health greater. Conversely, interventions that focus only on youths are exploited by conveying adult only label as an attractive forbidden fruit. The FDI recommends that both cessation and preventive services include individuals of all ages. 4. Control all forms of tobacco: Although there are 1.2 billion smokers, the FDI recognizes that tobacco is commonly used without being burned and that numerous constituents in tobacco itself are harmful. In addition, there are synergistic effects between many tobacco constituents and other substances such as alcohol, arecoline, nutritional, viral and other environmental exposures and genetic predisposition. All forms of tobacco are addictive. Smokers may use unburned forms when smoking is not possible. Initial use of unburned forms may lead to smoking. The FDI recommends that prevention and control measures encompass all forms of tobacco use. 5. Harm reduction without tobacco: Harm reduction measures should not include use of alternative tobacco products. Harm reduction strategies may include the use of various nicotine replacement, nicotine action blocking, or other drugs. Those that are recommended have withstood the rigor of scientific investigation so that specific actions, benefits, indications and contraindications are known and objective guidance developed. Clearly, tobacco free is a meaningful concept, free of confusing qualifications and nuances. The FDI recommends that the FCTC express a strong position 2

3 against the use of any tobacco product as a substitute for another, including use of tobacco during the quitting process. 6. Fairness: Duty free sales, special trade status, and other favours to the tobacco industry should be ended. In addition, tobacco should not be exempted from consumer protection laws, nor illegal trade tolerated. The FDI recommends that justice be sought by ending special favours to tobacco trade, removing tobacco industry exemptions to fair laws, and by enforcing laws that are abridged by tobacco companies and their distribution systems. 7. No immunity: The FDI recommends that tobacco companies not be given immunity or other shields against litigation charges brought in international or country justice systems, and that no central system of justice preempt action by a lesser court. 8. Stop advertising and promotion: Intense advertising and promotion methods are aimed at creating a desire to initiate or an excuse to continue use of tobacco, and to encourage ex-users to relapse. The FDI recommends that advertising and promotion of tobacco products be banned. Where this is not possible, tobacco companies should be required to provide independently developed and tested in-kind, equal space for space, time for time, and type of public health information and warnings about products as is used to promote the products. False and misleading tobacco product advertising should be strictly prohibited. 9. Protect non-users: Environmental tobacco smoke (ETS) and other constituents in tobacco can harm the developing fetus. After birth, ETS continues to adversely affect all individuals exposed. The FDI recommends that strong environmental tobacco smoke measures be negotiated that protect all individuals who do not use tobacco. 10. Research and surveillance: The FDI recommends that research and surveillance components be integrated into all global, intergovernmental and country tobacco prevention and control activities, with special attention given developing countries. 11. Marketing strategies: The FDI recognizes that the numerous protocols proposed must be presented in terms that are close to the hearts of the public, and especially to policy makers. Examples of high interest themes across cultures are justice, health and well-being, security and freedom. These themes resonate. The FDI is concerned that many sound proposals, as currently described, will not be quickly comprehended, nor likely to gain wide public support. Policy makers need to be presented with issues that the public quickly comprehends as in the interest of both people and the country. The greatest challenge is to present the FCTC and its protocols in terms of a few simple, positive, relevant, credible images. 3

4 First, yearning for justice has been a deep-seated emotion throughout the ages. The industry must be held to the standards required for the vast majority of products that are in international commerce. The FDI recommends that issues such as smuggling, duty free sales, trade agreements, and prohibition of immunity from litigation be presented as examples within a central theme of seeking justice and fairness. Second, all people seek well-being; the pleasures of vitality, dignity and purpose, and seek to avoid harm, illness and threats to their sense of selfworth. The traditional public health focus on death and adverse health effects of tobacco use should be subservient to appeals to individual, community and country health and well-being. The FDI recommends that that issues such as testing and reporting ingredients in tobacco and tobacco smoke, product regulation, protecting women, protecting children, protecting the public from environmental tobacco smoke, and cessation services be cited as means of promoting health and well-being. Third, security is a basic desire, and economic security the most recognizable means for attaining it. The subject of money holds everyone s attention sometimes to distraction. How personal, community and country policies that favor the tobacco industry dissipates wealth and produces economic instability must be exposed. The FDI recommends that issues such as agricultural policy, taxes, investment strategies, and the economics of trade should be presented as examples of individual, community and country fiscal responsibility and economic development. Fourth, individuals, communities and countries yearn to be independent, selfmade, and freely seeking their own destiny. The true nature of public health practice is not so much to perform services for the public as to provide the knowledge and skills that nurture the public s dignity and sense of selfdetermination. Tao Te Ching, 200 B.C. is often quoted; A leader is best when people barely know he exists. Of a good leader, who talks little, when his work is done, his aim fulfilled, they will say, We did this ourselves. The reduction of demand for tobacco products should follow strategies that ensure enlightened self interest as much, if not more, than measures that control access. Issues such as controlling advertising and promotion, and tobacco company sponsorship of public entertainment, should be balanced with culture-specific public education about addiction, media manipulation of public attitudes, and the public s need for responsibility for self, family and community. The FDI recommends that public education emphasize personal responsibility for avoiding and discontinuing the use of tobacco and that being tobacco-free is a symbol of independence and freedom. Finally, since they are consistent with the intent and particulars of FDI recommendations above, the FDI supports resolutions approved during the final plenary session of the 11th World Conference on Tobacco OR Health, namely, (1) that all governments, as part of a comprehensive tobacco control program, include effective cessation methods, and that these be made available and affordable in all countries, (2) the FCTC be strong, driven by 4

5 public health considerations, not precluding nations from adopting stronger measures and fully integrating NGOs working for tobacco control in the process, (3) that the international tobacco control community work vigorously to exclude and remove tobacco and tobacco products from bilateral and multilateral trade agreements that would have negative public health consequences, and (4) that all national health ministries should have full-time staff charged with overall responsibility for ensuring sustained country tobacco control programs. FDI World Dental Federation 7 Carlisle Street London W1V 5RG United Kingdom Tel: +44 (0) Fax: +44 (0) worldental@fdi.org.uk \\FDI2\VOL1\DATA\EXEC\SUZY\Special Committees\TOBACCO\Framework Convention Statement for WHO August 2000.doc Version dated: 29th August