Challenging public health acceptability of current international standards on tobacco products: paving the way for strengthened cooperation.

As tobacco control eVorts gain worldwide momentum, policy makers, scientists, and public health advocates are focusing on the development of an appropriate set of international standards to regulate tobacco products. Often forming the technical basis of national regulations, international standards for tobacco have a widespread impact on growers, manufacturers, and consumers. Established in 1947, the International Organization for Standardization (ISO) is a global federation of national standards bodies from 130 countries with a mission “to facilitate trade, exchange and technology transfer through . . .improved health, safety and environmental protection, and reduction of waste . . .” 2 Over the past two decades, ISO has developed 36 standards under technical committee 126 related to tobacco and tobacco products. The published standards range in scope from “Sampling of batches of raw material” to “Routine analytical cigarette-smoking machine—definitions and standard conditions.” 4 In recent years, one of ISO’s most widely used tobacco standards has come under fire. It is now recognised that ISO’s routine analytical smoking machine used to measure, regulate, and label tobacco products does not accurately determine a smoker’s intake. In fact, Bates and colleagues argue that current ISO tests act to legitimise “the false claims of low tar cigarettes.” Development of novel tobacco products, such as RJ Reynolds’ Eclipse cigarette, also point to the urgent need to evaluate the true eVect of emerging technologies. As a critical step in the development of the Framework Convention on Tobacco Control (FCTC) of the World Health Organization (WHO), a key conference on “Advancing knowledge on regulating tobacco products” concludes that ISO and the US Federal Trade Commission (FTC) tests are not intended to assess the biological or epidemiological impact of tobacco products. It challenges ISO to “ensure that its members recognize and adhere to the principle that ISO/ FTC measurements and methods are used to monitor performance and not health impacts of tobacco product.” Clearly, ISO is not fulfilling its pledge to improve health in the area of tobacco and tobacco products, as stated in its mission “to facilitate trade . . .through . . .improved health.” This commentary explains why ISO has been unable to create international standards on tobacco which address public health concerns, and explores alternative structures for tobacco standards development.