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ADDITION OPINION AND DEBATE
Could international human rights obligations motivate
countries to implement tobacco cessation support?
Benjamin Mason Meier
1
| Martin Raw
2,3
| Donna Shelley
2
| Chris Bostic
4
|
Anahita Gupta
1
| Kelsey Romeo-Stuppy
4
| Laurent Huber
4
1
Gillings School of Global Public Health,
University of North Carolina at Chapel Hill,
USA
2
School of Global Public Health, New York
University, New York, NY, USA
3
International Centre for Tobacco Cessation,
UK
4
Action on Smoking and Health (ASH),
Washington, DC, USA
Correspondence
Benjamin Mason Meier, Gillings School of
Global Public Health, University of North
Carolina at Chapel Hill, 103 Abernethy Hall,
Chapel Hill, North Carolina 27599, USA.
Email: bmeier@unc.edu
Abstract
Background and aims: The World Health Organization (WHO) Framework Convention
on Tobacco Control (FCTC) seeks to realize the right to health through national tobacco
control policies. However, few states have met their obligations under Article 14 of the
FCTC to develop evidence-based policies to support tobacco cessation. This article
examines how human rights obligations could provide a legal and moral basis for states
to implement greater support for individuals to overcome their addiction to tobacco.
Analysis: The United Nations (UN) has a well-established legal framework for promoting
human rights, looking to the right to health to realize health autonomy. Where addiction
undermines autonomy, it is widely acknowledged that addiction presents a significant
barrier to cessation for individuals who use tobacco, undermining the right to health.
The UN human rights system could, therefore, provide a complementary basis for moni-
toring state obligations under Article 14 of the FCTC, identifying challenges to FCTC
implementation and motivating states to support tobacco cessation.
Conclusions: The United Nations’human rights system offers a mechanism that could be
used to monitor Framework Convention on Tobacco Control implementation in national
policy, facilitating accountability for the progressive realization of cessation support.
KEYWORDS
Addiction, cessation, Framework Convention on Tobacco Control, human rights, nicotine, right to
health, World Health Organization
INTRODUCTION
The World Health Organization (WHO) has sought to challenge the glob-
alization of tobacco through international law, leading WHO member
states to adopt the Framework Convention on Tobacco Control (FCTC).
The FCTC is an evidence-based treaty that reaffirms the human right of
all people to the highest standard of health and asserts the importance
of policies to influence the supply of and demand for tobacco. Although
the FCTC has achieved some success in limiting the initiation of tobacco
use, this international legal effort has been less successful in promoting
the adoption of cessation measures to ensure that people who use
tobacco receive effective support to free themselves from their harmful
addiction to tobacco. Article 14 of the FCTC obligates states to take
effective measures to promote cessation of tobacco use and adequate
treatment for tobacco dependence, but few states have fully implemen-
ted Article 14 in national policy. Individuals who use tobacco, addicted
to tobacco and limited in their autonomy, have, therefore, been denied
their inherent dignity and fundamental rights. International human rights
law provides a path to recognize tobacco cessation as central to tobacco
control, supporting the 1.3 billion addicted individuals who use
tobacco throughout the world. With the right to health supporting
efforts to free individuals from harmful addictions, health and human
rights accountability mechanisms can support Article 14 implementation,
framing tobacco cessation as a human rights obligation.
In focusing on tobacco cessation policy, this article examines
implementation of FCTC Article 14 and the Guidelines for
Received: 8 February 2022 Accepted: 20 June 2022
DOI: 10.1111/add.15990
Addiction. 2022;1–8. wileyonlinelibrary.com/journal/add © 2022 Society for the Study of Addiction. 1
Implementation of Article 14 (Article 14 Guidelines). Although addres-
sing a wide array of approaches to cessation, this article does not
examine the emergence of alternative nicotine delivery products,
including electronic cigarettes, which are beyond the scope of this
article. Such commercial products did not exist when the FCTC was
negotiated, although the idea that nicotine and tobacco products exist
on a continuum of risk was already established. With the widespread
availability of new non-combustible nicotine products, the product
and policy landscape for cessation has become more complex.
Research to understand nicotine addiction continues to evolve with
the advent of these new nicotine delivery products, yet evidence-
based treatment remains out of reach for most people who use
tobacco, particularly in low- and middle-income countries. Therefore,
implementing Article 14 remains a public health priority for realizing
the right to health, raising an imperative to understand the limited
implementation of Article 14 and to consider how human rights obli-
gations can support national cessation policies.
This article recognizes the need to free individuals from tobacco
addiction and the health harms of tobacco use, realizing human rights
through tobacco cessation. Because addiction limits individual choice,
the article opens by examining international legal obligations under the
human right to health to ensure access to tobacco cessation support.
Drawing from cessation guidelines developed under the FCTC, we ana-
lyze the progress made by states in implementing Article 14, finding this
progress to have been slow in low-, middle- and high-income states. To
strengthen international accountability for the progressive realization of
rights, this article assesses how the WHO FCTC can work alongside the
United Nations (UN) human rights system to support implementation of
effective tobacco cessation measures. We conclude that improving
tobacco cessation support will require a coordinated effort across global
health and human rights governance to realize the highest attainable
standard of health, looking to human rights monitoring mechanisms to
facilitate state accountability for cessation policy.
TOBACCO UNDERMINES THE RIGHT TO
HEALTH
In the 1946 WHO Constitution, states proclaimed for the first time
that ‘the enjoyment of the highest attainable standard of health is one
of the fundamental rights of every human being’[1]. This human right
to health came to be codified by the UN under the 1966 International
Covenant on Economic, Social and Cultural Rights (ICESCR), outlining
state obligations to realize ‘the prevention, treatment and control of
epidemic, endemic, occupational and other diseases’[2]. States bear
obligations to ‘progressively realize’the rights in the ICESCR, and in
accordance with this principle of progressive realization, a state must
take steps to uphold the right to health ‘to the maximum of its avail-
able resources, with a view to achieving progressively the full realiza-
tion of the rights’[2]. Recognizing that the full realization of economic
and social rights depends on financial resources, the principle of pro-
gressive realization provides a degree of flexibility to states while
requiring continuing and progressive steps to implement rights in
accordance with their available resources. To progressively realize the
right to health over time, the UN Committee on Economic, Social and
Cultural Rights (CESCR), the legal body charged with drafting official
interpretations of and monitoring state compliance with the ICESCR,
found in 2000 that states bear obligations ‘to discourage production,
marketing and consumption of tobacco’[3]. The right to health
thereby imposes an obligation on states to safeguard the health of
those addicted to tobacco, supporting individual autonomy, healthy
behaviours and vulnerable populations through the progressive reali-
zation of tobacco cessation policies [4].
Addiction limits individual autonomy
The right to health upholds an ‘entitlement to enjoy conditions that will
maximize the potential for individuals to enjoy health’and the ‘freedom
of individuals to make choices about their own health’[3]. However, the
‘choice’to use tobacco, especially smoking, is largely shaped by tobacco
industry efforts to manipulate chemical, sociocultural and structural fac-
tors that enhance nicotine addiction and undermine individual decision
making [5]. Despite widespread desire to quit smoking, few will achieve
long term abstinence without support [6, 7]. The use of tobacco, initiated
primarily in adolescence, but maintained by addiction, is not an informed
and voluntary choice consistent with the right to health [8]. Even as the
tobacco industry has tried to co-opt human rights rhetoric, cynically
using the language of ‘choice’to advance its corporate objectives [9],
human rights obligations require states to support individuals to free
themselves from addiction to harmful tobacco products [10].
State obligations to support healthy behaviours
through cessation
Under the right to health, states bear an international legal obligation
to facilitate environments in which individuals can make autonomous
decisions about their health. Recognizing the ways in which individual
choice has been impaired by youth targeting, industry marketing and
addiction enhancing (engineering cigarettes to increase addictiveness),
states must progressively realize measures under the right to health to
protect individuals from corporate interference with healthy decision
making —adopting measures that discourage tobacco use and support
cessation [11, 12]. Cessation support helps to overcome the influence
of nicotine addiction and supports the restoration of individual auton-
omy over health. Among tobacco control measures, only adult cessa-
tion provides significant short- to medium-term population health
benefit [13]. Yet, governments often lack the political will to resist
industry influence and promote cessation, with tobacco corporations
lobbying relentlessly to weaken national tobacco control policy, includ-
ing tobacco taxes, which have been among the most effective
approaches for reducing tobacco use and could provide resources for
cessation support [14, 15]. To restore individual autonomy and self-
determination under the right to health, states must implement the ces-
sation measures set out in FCTC Article 14 and its guidelines [16, 17].
2MEIER ET AL.
Population-level prevention to support vulnerable
populations
Yet, despite these cessation obligations, various reports on FCTC imple-
mentation show that states have prioritized population-level prevention
measures—including taxation policy, age restrictions, smoke-free policies,
health warnings, advertising bans and education campaigns—while
neglecting cessation support measures [18]. Because prevention efforts
alone are insufficient to realize the inherent dignity of vulnerable popula-
tions addicted to tobacco, the integration of individual support and
population-level interventions can create an environment that both pro-
motes quitting and offers support to achieve cessation, enabling individ-
uals who use tobacco to make conscious, autonomous decisions about
their health behaviours [19]. Such an integrated approach to cessation
takes account of vulnerable populations—including the effects of pov-
erty, disadvantage and other social determinants of health—to ensure
the progressive realization of the right to health [20].
FCTC ARTICLE 14
FCTC Article 14 obligates states to develop effective measures to
promote tobacco cessation and tobacco dependence treatment,
including in (but not limited to) national health systems, and to collab-
orate internationally to facilitate cessation accessibility and
affordability.
Box: FCTC Article 14
1. Each Party shall develop and disseminate appropriate,
comprehensive and integrated guidelines based on scien-
tific evidence and best practices, taking into account
national circumstances and priorities, and shall take
effective measures to promote cessation of tobacco use
and adequate treatment for tobacco dependence.
2. Toward this end, each Party shall endeavour to:
a. design and implement effective programmes aimed at
promoting the cessation of tobacco use, in such loca-
tions as educational institutions, health care facilities,
workplaces and sporting environments;
b. include diagnosis and treatment of tobacco dependence
and counselling services on cessation of tobacco use in
national health and education programmes, plans and
strategies, with the participation of health workers,
community workers and social workers as appropriate;
c. establish in health care facilities and rehabilitation
centres programmes for diagnosing, counselling, pre-
venting and treating tobacco dependence; and
d. collaborate with other Parties to facilitate accessibil-
ity and affordability for treatment of tobacco depen-
dence including pharmaceutical products pursuant to
Article 22. Such products and their constituents may
include medicines, products used to administer medi-
cines and diagnostics when appropriate [21].
The FCTC’s preamble recognizes ‘that cigarettes and some other
products containing tobacco are highly engineered to create and
maintain dependence;’however, Article 14, the only article of the
FCTC on cessation, presents limited guidance for policy reforms, bud-
getary commitments and monitoring requirements to promote cessa-
tion. Despite the Article 14 obligation in paragraph 1 to ‘take
effective measures to promote cessation of tobacco use and adequate
treatment for tobacco dependence,’the specific recommendations in
paragraph 2 use nonobligatory caveats (e.g. ‘shall endeavour to,’‘as
appropriate,’and ‘when appropriate’), which serve to weaken state
obligations for cessation. Further, Article 14 does not use the words
‘addiction’or ‘choice,’two words that form the public health and
human rights foundation for cessation interventions[15]. This ambigu-
ous language may enable states to shirk their Article 14 obligations.
Therefore, even as the FCTC ‘recalls’the human right to health in its
preamble, Article 14 of the FCTC fails to ground tobacco cessation in
human rights under international law, neglecting the rights of vulnera-
ble individuals and necessitating subsequent guidelines to frame
national obligations to protect individuals from tobacco addiction.
The Article 14 Guidelines interpret this article and detail what
states should do to meet their FCTC obligations. In October 2010, the
fourth FCTC Conference of the Parties (COP 4) adopted these guide-
lines ‘to assist Parties in meeting their obligations under Article 14 of
the FCTC…on the basis of the best available scientific evidence and
taking into account national circumstances and priorities’[22]. Provid-
ing detailed guidance to help states improve cessation support to aid
those addicted to tobacco, the guidelines’‘underlying considerations’
recognize the: addictive nature of tobacco, importance of implement-
ing cessation synergistically with other tobacco control measures,
need for accessible and affordable treatments, importance of active
partnership with civil society, protection from commercial interests of
the tobacco industry and central role of healthcare systems in promot-
ing tobacco cessation [23]. Although the guidelines do not explicitly
look to human rights as a foundation for cessation interventions, they
draw on human rights norms and principles to address tobacco
dependence.
The guidelines are organized in three sections:
1. The development of core infrastructures to support tobacco cessa-
tion, including: analyzing the country’s capacity and resources and
using existing systems and resources as much as possible;
strengthening national coordination; developing national guide-
lines; addressing tobacco use by healthcare workers; and ensuring
HUMAN RIGHTS FOR TOBACCO CESSATION 3
that all people who use tobacco are identified within the health-
care system and offered at least brief advice.
2. The key components of a system to help people who use tobacco
to quit: population level approaches that deliver cessation informa-
tion (e.g. mass communication); brief advice in healthcare interac-
tions; free quitlines; and individual cessation support, including
specialized treatment and accessible, affordable and scientifically
proven medications.
3. A stepwise approach to developing cessation support, wherein
countries with limited resources are urged to initially implement
broad based low-cost measures, through core system infrastruc-
tures, including screening all patients for tobacco use and offering
brief cessation advice, and later progressively implementing more
comprehensive measures and intensive treatments (including
behavioural support and medications) as resources become avail-
able [17, 24].
The guidelines conclude with recommendations for monitoring
cessation implementation, allowing for the evaluation of trends, assess-
ment of state obligations and identification of areas where international
assistance and cooperation may be necessary [21]. Monitoring national
cessation implementation provides a path to facilitate accountability
for state efforts; however, the Article 14 Guidelines have not led to
widespread cessation policy advancements across nations.
STATE IMPLEMENTATION OF ARTICLE 14
Many states have neglected to implement Article 14, failing to estab-
lish policies to progressively realize the right to health through cessa-
tion support. This failure to support those addicted to tobacco
predated the Article 14 Guidelines, with many states prioritizing pre-
vention over cessation [25], and this trend has continued even after
the establishment of the guidelines [17].
Cessation support has been neglected
WHO’sReport on the Global Tobacco Epidemic, 2021 concludes suc-
cinctly that ‘support for quitting remains low’[26]. An in-depth survey
of cessation support across countries has illustrated the relatively low
level of cessation support provision. For example, only a third of coun-
tries had an official national cessation strategy, less than half had
national guidelines and only about a quarter had a cessation budget,
national quitline or specialized treatment services [17]. Despite an
opportunity to address tobacco cessation during the coronavirus dis-
ease (COVID-19) pandemic, with tobacco use leading to higher rates
of severe illness, few states have taken immediate steps to advance
cessation in the pandemic response [27].
The Article 14 Guidelines outline specifically what states should
do to implement cessation support under the FCTC [28], but state
progress has remained limited [29]. An independent survey found
that cessation support was often linked to national income level
[30]. No low-income country had developed a defined budget for
tobacco cessation, a national telephone helpline, an official national
cessation strategy or national cessation guidelines, with some coun-
tries looking entirely to non-governmental organizations (NGOs) to
provide tobacco cessation support. Although not surprising, these
findings possibly reflect a lack of recognition of the cost effective-
ness and affordability of cessation interventions [31]. Governments,
especially in low- and middle-income countries, are deterred by the
perceived cost of cessation support [27], despite the fact that many
cessation interventions are broadly applicable and low cost [30].
Beyond resource constraints, the stigmatization of people who
smoke has reinforced opposition to addressing tobacco addiction,
with this lack of empathy for those who smoke—failing to see those
addicted to tobacco as equal in dignity and rights—posing a challenge
for state expenditures and cessation support. This limited Article 14
implementation has exposed a lack of political will to address tobacco
addiction and left healthcare systems unequipped to deliver tobacco
cessation interventions [32]. Despite such limitations in sustained
funding, there have been initial efforts by NGOs and select states to
advance the right to health through cessation policy.
NGO efforts to promote cessation support
NGOs have played a key role in supporting national cessation mea-
sures, including developing tools to help states meet the Article 14
Guidelines. Through these tools, NGOs have supported governments
(particularly in low- and middle-income countries) in establishing inter-
ventions for tobacco cessation and facilitating accountability for FCTC
implementation [33]. They have drafted model legislation, helped
develop national cessation strategies and guidelines, provided training
for government officials and healthcare workers, supported quitlines
and held workshops to address implementation obstacles [34]. The
Framework Convention Alliance (FCA) (bringing together over 500
tobacco control NGOs from over 90 countries) has shared cessation
knowledge globally and created resources to aid states in implement-
ing Article 14 [32]. These NGO tools have assisted states to imple-
ment Article 14 through the development of a National Situation
Analysis, guidance on drafting national cessation guidelines and a
model national cessation strategy [35]. Such technical support from
NGOs has helped shape national cessation policy, enabling some
states to implement Article 14 more comprehensively.
State implementation to progressively realize
cessation
There has arisen a range of policies across states in implementing
FCTC cessation obligations, as states with divergent capacities have
pursued differential obligations based on their financial resources and
political will.
4MEIER ET AL.
•Low-income states have proven least likely to implement Article
14, as these countries face limited availability of cessation
resources. In Haiti, for example, there are no telephone quitlines
for live assistance with cessation, nicotine replacement therapies
(NRTs) are not legally sold and cessation support is unavailable in
health facilities [36]. Even where there is political will, such low-
income countries may require international assistance to meet
their right to health obligations for individuals facing addiction to
tobacco [37].
•Middle-income states have offered more comprehensive cessa-
tion support. Implementing strong cessation interventions under
financial constraints, Vietnam’s Tobacco Control Fund has been
able to allocate tobacco taxation resources to provide a sustain-
able source of cessation funding [38]. By budgeting additional
cessation resources, middle-income countries have expanded
provider training to aid cessation through: national telephone
quitlines, clinical cessation support (such as health provider
advice) [39–41] or even subsidized pharmacotherapy (or NRT)
purchases [42, 43].
•High-income states, leveraging greater resources toward cessa-
tion support, have been able to implement Article 14 more com-
prehensively in fulfilling their obligations under the right to
health. New Zealand has implemented cessation through: domes-
tic guidelines for healthcare professionals to provide cessation
support (including guidance on provider training), the integration
of behavioural support and subsidized NRT (including telephone
quitlines and text-based support) and international assistance to
respond to tobacco dependence (in other countries) [44, 45].
With tobacco cessation integrated into all levels of healthcare,
high-income countries have pursued expanded education on ces-
sation (providing behavioural support to the public and especially
vulnerable populations), diagnosis and treatment of tobacco
dependence (across all specialties) and financial assistance for
cessation support (subsidizing tobacco dependence treatment
and NRT) [46].
This gradient of cessation support, reflective of the approach taken in
the Article 14 Guidelines, points to the ways in which increasing eco-
nomic resources improve state capacity to progressively meet cessa-
tion obligations; however, it is clear that funding alone does not
determine state commitment to cessation. Where there is political
will, low- and middle-income countries have developed low-cost inter-
ventions and institutional reforms to promote cessation. Such institu-
tional reforms, as recommended in the Article 14 Guidelines, provide
a path to transparently allocate additional funds to tobacco depen-
dence treatment —dedicating tobacco taxation resources to cessation
interventions, designating government representatives responsible for
cessation, incorporating tobacco cessation in health worker training
and developing a national tobacco cessation strategy and national
guidelines [24]. Given these cost-effective avenues for cessation sup-
port, expense need not be the primary obstacle for tobacco cessation,
with political will serving as a crucial determinant of cessation imple-
mentation under Article 14 and with international monitoring neces-
sary to identify challenges and facilitate accountability for the
progressive realization of the right to health [31].
FACILITATING ACCOUNTABILITY FOR
HUMAN RIGHTS IN TOBACCO CESSATION
Where states must take steps over time to progressively implement
cessation support, efforts to facilitate accountability for these changes
will require periodic assessment. These assessments can be provided
through complementary monitoring mechanisms in global health gov-
ernance and human rights governance [47].
Global health governance through FCTC monitoring
In facilitating accountability through WHO governance, the FCTC
Article 14 Guidelines recommend specific process and outcome mea-
sures to monitor cessation, allowing states to develop measurable
objectives, determine the required resources and identify indicators of
progress [21]. These objectives can be based on WHO’s country-spe-
cific guidelines for implementing the FCTC, which provide a founda-
tion for WHO monitoring of FCTC implementation [48]. Assessments
of these cessation policy measures can be undertaken through the
existing FCTC monitoring systems: the Party Report system (through
which states report implementation in a questionnaire) and WHO’s
‘Report on the Global Tobacco Epidemic’(MPOWER).
However, these FCTC monitoring instruments—lacking engage-
ment from civil society, constructive dialogue with government repre-
sentatives and concluding observations to assess implementation—do
not provide validated reporting systems and effective compliance
mechanisms to facilitate accountability for Article 14. (For example,
the Party Report questionnaire is very long, completed by busy gov-
ernment officials pressed for time and lacking civil society input,
review processes and feedback mechanisms. Although MPOWER
seeks to provide more robust monitoring, it has very few, poorly
defined cessation items.) Human rights can support this FCTC moni-
toring. With a human rights decision on the agenda at the upcoming
FCTC Conference of the Parties (COP 10), this human rights focus
provides an opportunity to reaffirm the contribution of the FCTC to
human rights objectives and the United Nations 2030 Agenda for Sus-
tainable Development. The upcoming COP can also help to highlight
the need for cessation support as part of an effective human rights-
based approach to tobacco control, and—in facilitating accountability
for cessation support—to link cessation support to human rights moni-
toring mechanisms. In monitoring the progressive realization of human
rights for those addicted to tobacco, it is imperative that implementa-
tion of Article 14 be reviewed simultaneously through the UN human
rights system.
HUMAN RIGHTS FOR TOBACCO CESSATION 5
Human rights governance to assess progressive
realization
Human rights governance provides complementary monitoring mech-
anisms, applying international pressure on governments and holding
states accountable for the progressive realization of health-related
human rights. In facilitating accountability for human rights obligations
to support tobacco cessation, UN systems of human rights monitoring
are exercised through:
Human rights treaty bodies —With the CESCR respon-
sible for reviewing implementation of the right to
health under the ICESCR, this treaty body has issued
reporting guidelines to frame state periodic reporting,
looking to FCTC standards to frame tobacco control
obligations and providing a basis to monitor the pro-
gressive realization of the right to health under Article
14 [49, 50], with advocates already engaging with the
CESCR to support FCTC implementation [51] and the
Committee on the Elimination of Discrimination
against Women ‘to prevent and reduce nicotine and
tobacco addiction among girls and women’[52].
The Universal Periodic Review (UPR) —Monitoring
and review of national tobacco cessation efforts can
be furthered by the Universal Periodic Review, which
works through the UN Human Rights Council to assess
human rights realization—across all treaties and in all
countries—and has proven effective in approaching
tobacco control through the human right to health,
with the UPR additionally advancing health through its
focus on, inter alia, nutrition security, disease surveil-
lance and sexual and reproductive health and rights
[53, 54].
UN special rapporteurs —In evaluating the realization
of rights, UN special rapporteurs review human rights
implementation by conducting fact-finding missions to
individual countries, thereafter publishing reports
‘about the realization of human rights, conclusions on
human rights implementation, and recommendations
for reform,’[46] with the UN Special Rapporteur on
the right to health having long examined tobacco con-
trol policies in national missions—referencing FCTC
implementation, tobacco marketing and trade restric-
tions [55]—and developed thematic reports on issues
ranging from mental health to neglected tropical dis-
eases [56].
In comparison with FCTC reporting processes, human rights mon-
itoring is more robust, analytic and impactful. Although relying on
state self-reporting, human rights institutions also consider indepen-
dent reports from civil society. This reporting is not the end of the
process, but the beginning. Reports are reviewed publicly, and human
rights institutions question governments and recommend reforms.
These complementary human rights review mechanisms, with atten-
tion to multisectoral government responsibilities and participation
from civil society advocates, provide an institutional basis to address
tobacco cessation through state realization of the right to health.
Given the periodic nature of human rights monitoring, follow-up is
built in, with each review building from previous reviews. This recur-
ring review process can provide an assessment of a state’s progressive
realization of cessation support, with monitoring processes recogniz-
ing best practices in cessation, identifying challenges in national imple-
mentation and facilitating accountability through ‘naming and
shaming’—reviewing implementation publicly, publicizing national
limitations and motivating state action.
CONCLUSION
The FCTC offers a framework to interpret state obligations to pro-
gressively realize the human right to health, with Article 14 and its
guidelines providing a basis to clarify state obligations to ensure
that those addicted to tobacco receive cessation support. However,
Article 14 implementation has been limited. The right to health pro-
vides an alternative basis under international law to recognize the
inherent dignity of those addicted to tobacco, implement FCTC
obligations under Article 14 and facilitate state accountability. To
improve and accelerate cessation support, the tobacco control and
human rights communities must work together to advance comple-
mentary monitoring processes —with civil society participation,
meaningful state dialogue and detailed concluding recommendations
serving as a foundation for accountability in cessation policy. Ensur-
ing that those who use tobacco have the best possible access to
cessation support, with cessation support attainable in all countries
at all levels of development, will require political will and govern-
ment accountability to progressively realize the highest attainable
standard of health.
ACKNOWLEDGEMENT
We are grateful to Robert West for his review of this article.
DECLARATION OF INTERESTS
None.
AUTHOR CONTRIBUTIONS
Benjamin Mason Meier: Conceptualization; formal analysis. Martin
Raw: Conceptualization; formal analysis. Donna Shelley: Conceptuali-
zation; formal analysis. Chris Bostic: Conceptualization. Anahita
Gupta: Investigation. Kelsey Romeo-Stuppy: Conceptualization.
Laurent Huber: Conceptualization.
ORCID
Benjamin Mason Meier https://orcid.org/0000-0002-9870-1387
Martin Raw https://orcid.org/0000-0001-9569-724X
6MEIER ET AL.
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How to cite this article: Meier BM, Raw M, Shelley D,
Bostic C, Gupta A, Romeo-Stuppy K, et al. Could international
human rights obligations motivate countries to implement
tobacco cessation support? Addiction. 2022. https://doi.org/
10.1111/add.15990
8MEIER ET AL.
