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Tobacco use is the cause of the most preventable cancer deaths, and in many countries, the leading cause of cancer death. Furthermore, it is a risk factor that is the most globalized, and as such it has elicited a global response through the World Health Organization (WHO).

The cornerstone of tobacco control policies is the WHO Framework Convention on Tobacco Control (FCTC), its Guidelines, and the Illicit Trade Protocol. The WHO FCTC is the only treaty negotiated under the auspices of the WHO, and includes 179 Parties.

The treaty entered into force in February 2005 and provides an internationally coordinated response to combating the tobacco epidemic with specific steps for governments addressing tobacco use. These include demand reduction measures such as adopting tax and price measures to reduce tobacco consumption; banning tobacco advertising, promotion, and sponsorship; creating smoke-free work and public spaces; placing health warnings on tobacco packages; and supply reduction measures such as combating the illicit trade in tobacco products.

Text alternative: Cumulative change in affordability of cigarettes, 1990–2006 Chart showing that from 1990-2006 cigarettes became relatively more affordable in low and middle-income countries but became relatively less affordable in high-income countries

In low- and middle-income countries, cigarettes have become more affordable because taxes and prices have been rising more slowly than increases in incomes.

Cumulative change in affordability of cigarettes (percent of income required to purchase cigarettes), 1990–2006

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The cornerstone of tobacco control policies is the WHO Framework Convention on Tobacco Control (FCTC), its Guidelines, and the Illicit Trade Protocol.

The most widely implemented tobacco control policies are focused on reducing the demand for tobacco products, thereby decreasing consumption and prevalence by reducing initiation (prevention) or increasing cessation (intervention). Tax and price policies are often cited as the most effective demand-sided policy, because taxes are able to be increased on a regular and consistent basis. Evidence in Brazil, Thailand, and South Africa suggests that increases in taxes and price were the largest contributors to the decline in tobacco use.

Tobacco control policies must ensure that tax increases result in tobacco product price increases of such magnitude that the affordability of tobacco products declines. Over the last 20 years, tobacco products have become less affordable in high-income countries because of tax and price increases, and because incomes have not been growing rapidly. However, the opposite has been seen in low- and middle-income countries where cigarettes have become more affordable because taxes and prices have been rising more slowly than increases in incomes.

In South Africa, as cigarettes became less affordable, cigarette consumption began to decrease.

Cigarette prices, affordability and consumption in South Africa, 1961-2012

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“Tobacco is the only industry that produces products to make huge profits and at the same time damage the health and kill their consumers."

Dr. Margaret Chan Director-General of the World Health Organization