Deborah Sy
Just days after the close of the 78th World Health Assembly (WHA78) in Geneva which highlighted the adoption of the pandemic treaty and lung health (Promoting and Prioritizing an integrated lung health approach), the global community marked World No Tobacco Day (WNTD) 2025. WNTD is an opportunity to reflect on how global health governance can either reinforce or weaken our collective preparedness for diseases impacting lung health, as well as broader health and environmental justice.
Strengthening lung health through tobacco and nicotine control
Protecting lung health is essential for pandemic preparedness and resilience. Airborne pathogens have driven most major pandemics in the past century, including the 1918 flu, SARS, H1N1, and COVID-19. Scientific and recent historical analysis suggests that the most likely source of the next pandemic will again be a respiratory virus. Tobacco remains the most preventable cause of lung damage, accounting for 3.3 million lung-related deaths annually (Global Burden of Disease Study, 2021). Second-hand smoke exposure also causes cancer, while vaping aerosols pose documented harms to lung health. Additionally, mounting research links tobacco and nicotine addiction to increased anxiety, depression, and mental health struggles among youth. The WHA resolution calls for integrating tobacco and vaping control into all primary care and public health responses.
Pandemic agreement financing and the under-used potential of tobacco taxes
While the pandemic agreement does not have a clear funding strategy, the Fourth International Conference on Financing for Development (FfD4) that will be held in Seville, Spain in June/July 2025 could provide a pathway. One proven – but often underutilized – sustainable finance model approach for development is raising tobacco taxes. A 10% price increase cuts consumption by 4–5% while generating substantial domestic revenue. Countries like the Philippines and Turkey have successfully used tobacco taxes to expand health coverage and fiscal space. Although the First Draft text for the FfD4 fails to specifically mention tobacco taxes, they are mentioned in the zero draft for the Political Declaration for UN High-Level Meeting on Noncommunicable Diseases and Mental Health set for discussion at the 79th UN General Assembly in September.
Intergenerational and environmental justice
Civil society groups like the Non-Communicable Disease Alliance recommend accelerating FCTC implementation and including conflict of interest safeguards. But this is not enough. The Political Declaration for the 79th UN General Assembly should include explicit commitments to hold the tobacco industry liable for harms to health, including youth mental health, environmental degradation, and pandemic-related vulnerabilities. This is both a matter of intergenerational justice and policy coherence called for by Global Youth Voices (GYV) since 2022. The youth movement has been calling for the tobacco industry to pay for the harm already caused—from addiction and lung damage to mental health struggles—as well as future costs. In response to WHO’s World No Tobacco Day campaign and report Unmasking the appeal Bright Products, Dark Intentions, GYV turned its demands into action, committing to knock on doors of government agencies.
The United Kingdom parliament’s proposed “polluter pays” levy on tobacco companies to fund healthcare recovery from smoking-related diseases can be viewed as a precedent. Such examples should be elevated at the Seville meeting: tobacco taxation and liability mechanisms are not just fiscal tools but instruments of justice and sustainability. To counter tobacco industry’s greenwashing tactics, including in healthcare and the environment, tobacco tax proceeds could also be dedicated to displacing tobacco industry CSR (Corporate Social Responsibility) efforts including in pandemic efforts. When Australia replaced tobacco sponsorship funding with dedicated tobacco taxes, it destabilized long-standing ties between tobacco companies and sports and arts bodies.
Cigarette filters, made of non-biodegradable cellulose acetate, offer no proven health benefits. In fact, their use is associated with increased risk of adenocarcinoma, a more aggressive form of lung cancer. Over 4.5 trillion cigarette butts are discarded each year, making them the most littered plastic item on earth. Conservative estimates put the cost of tobacco plastics at $26 billion annually. Single-use vapes have also emerged as a major contributor to the plastic waste crisis.— annual vape waste is said to stretch for over 7,000 miles, harming ecosystems already under pressure and our oceans. WHO, along with Netherlands and Belgium have called for bans or phase-outs of cigarette filters. Belgium, France, and the United Kingdom have moved decisively to ban disposable vapes, in addition to over 40 countries banning vaping devices, citing their appeal to youth and environmental damage. In August 2025, negotiators will reconvene in Geneva for the Resumed Fifth Session of the Intergovernmental Negotiating Committee on Plastic Pollution (INC-5.2). Here, the challenge is to ensure alignment between the plastics treaty and the tobacco control treaty.
Opportunities to act must be taken
The 11th WHO Framework Convention on Tobacco Control Conference of the Parties (COP11) in Geneva this November offers a chance to consolidate these momentum shifts. Parties should align their decisions with outcomes from WHA78, FfD4, and INC-5.2 and send a strong message: there can be no lung health resilience, no serious pandemic prevention, and no plastic pollution solution without holding the tobacco industry to account.
The message for 2025 across these platforms must be unequivocal: strong lungs need strong health systems. Tobacco control is central to supporting lung health, ensuring pandemic resilience, and securing intergenerational and environmental justice.
Governments have four opportunities this year: June, August, September, and November—to act together and act decisively. They must align on these important issues of financing and governance. If they get it right, we don’t just protect lungs—we protect life itself.
Deborah Sy is a lawyer and global health advocate, serving as Head of Strategy and Global Public Policy at the Global Center for Good Governance in Tobacco Control (GGTC), the convener of Global Youth Voices. She is also the Senior Advisor and Founder of Health Justice Philippines, an observer to the UN Environment Programme and the UN Plastics Treaty negotiations, and lead author of “Tobacco Industry Accountability for Marine Pollution: Country and Global Estimates.”