Les Hagen, Garima Bhatt, Rakesh Gupta, Sonu Goel, Opinder Preet Kaur Gill & Tara Singh Bam
Twenty years after the World Health Organization’s Framework Convention on Tobacco Control (FCTC) came into force, the landmark treaty has reduced global tobacco use by an estimated 118 million people. However, according to a new civil society report produced by ASH Canada using data obtained from the Global Tobacco Control Progress Hub (a global open-access surveillance platform for the FCTC and tobacco control), progress has slowed in the past few years. A key indicator, the age-standardized prevalence of current tobacco use among persons aged 15 years and older, will not be met on schedule. Further delays are possible unless governments accelerate treaty implementation.
The FCTC has been ratified by 182 countries and the European Union, and is credited with saving millions of lives. It is the world’s first public health treaty, designed to curb tobacco use through various evidence-based measures, including advertising bans, smoke-free laws, tax increases, and graphic warning labels. The treaty is also directly tied to Sustainable Development Goal (SDG) Target 3.a, which calls for strengthened implementation of the FCTC in all countries.
The broader SDG agenda, approved by the United Nations in 2015, includes 17 goals aimed at ending poverty, protecting the planet, and improving health and well-being by 2030. Goal 3 focuses on promoting health for all, and tobacco control is a key part of that vision.The original objective of Target 3.a and its related FCTC strategy, was to achieve a 30% global reduction in tobacco use between 2010 and 2025. This required reducing tobacco use prevalence from 27.3% to 19.1%, or roughly 240 million fewer people worldwide. But the recent independent progress report — endorsed by 57 civil society organizations — contains discouraging news. Based on current trends, the world is projected to fall short of this 2025 target by an alarming 95 million people.
The report, released in May, warns that the delayed implementation of the FCTC Global Strategy means the tobacco control treaty no longer serves as an “SDG accelerator” — a term used to describe its broad impact across the SDGs.
The FCTC Global Strategy 2025, approved in 2018, represents a seven-year roadmap to accelerate treaty progress. Its three strategic goals included accelerating implementation, building cross-sector partnerships, and protecting the treaty’s achievements. But according to a WHO report published in January 2024, the 2025 target is unlikely to be met for several more years.The UN’s 2023 midpoint review of SDG progress echoed the concerns raised in the civil society report. Target 3.a was classified as showing “fair progress, but acceleration needed.” The review cited several global setbacks, including the COVID-19 pandemic, armed conflicts, and climate change.
Despite these challenges, there are signs of progress as described in the 2024 WHO report. Since 2010, 150 countries have reported declines in tobacco use, and 56 are on track to meet the original 2025 target, according to the WHO. The reduction in tobacco use among women is also encouraging, helping to close gender gaps in health outcomes.
Still, the divide between high-income and low-income countries is growing. Wealthier nations have made significant strides in implementing FCTC measures, while many poorer countries often lack the necessary funding, infrastructure, and political support to follow suit. This disparity is contributing to widening health inequities — a major concern for global development.To help get treaty implementation back on track, the civil society report offers eight key recommendations for governments and FCTC stakeholders. Implementation of the FCTC Global Strategy must be accelerated, especially in low- and middle-income countries. High-impact policies like tax increases, smoke-free laws, advertising bans, graphic package warnings, and free or subsidized cessation programs should be prioritised. Protections against tobacco industry interference across all levels of government must be strengthened. Engagement with civil society organizations in advocating for strong tobacco control policies should be prioritised. Funding for tobacco control in all countries must be increased and sustained. The FCTC and Target 3.a should be integrated into national health plans and SDG reviews. Tobacco control efforts must be linked to pandemic recovery, climate action, and human rights initiatives. The tobacco control funding gap must be closed and national coordination mechanisms for tobacco control established.
These recommendations align with the “Dublin Declaration,” which was delivered at the World Conference on Tobacco Control (WCTC) in Ireland, in June 2025. The declaration urges governments to hold the tobacco industry accountable and embed tobacco control in broader health and development agendas.
Civil society engagement is a cornerstone of the FCTC, as outlined in Article 4 of the treaty. This recent report marks the first independent analysis of overall treaty implementation since the FCTC came into force. As the 2030 SDG deadline approaches, governments must recommit to the treaty’s goals and restore tobacco control as a top priority. “Millions of lives are at stake,” the report warns. “Efforts to enhance and accelerate FCTC implementation are well justified and can make a substantial contribution to health outcomes and sustainable development.”
The stakes are high. Tobacco use remains one of the leading causes of preventable death worldwide, killing more than eight million people each year. Without stronger action, the gains made over the past two decades could stall — or even reverse.
For now, the message from civil society is clear: the treaty works, but only if governments adhere to their commitments. Given the enormous global impact of tobacco use on public health and sustainable development, we cannot afford to lose momentum. Governments need to accelerate FCTC implementation to ensure the treaty achieves its full potential.
Authors
Les Hagen, Garima Bhatt, Rakesh Gupta, Sonu Goel, Opinder Preet Kaur Gill & Tara Singh Bam
The authors are members of the Tobacco Control Section of the International Union Against Tuberculosis and Lung Disease (“The Union”).
Editors Note: