The first global treaty on tobacco control goes into effect Sunday, Feb. 27. The Framework Convention on Tobacco Control (FCTC) requires member countries to take specific steps to stop people from using tobacco, and to put stronger tobacco control policies in place.

So far, 168 nations have signed the treaty and 57 have ratified it.

"[The treaty's] entry into force is a demonstration of governments' commitment to reduce death and illness from tobacco use," said Lee Jong-wook, MD, director-general of the World Health Organization (WHO), which negotiated the treaty.

According to the WHO, tobacco kills nearly five million people in the world every year. In the United States alone, tobacco kills about 440,000 people each year; nearly one-third of all cancer deaths are caused by tobacco use.

"Sunday marks the dawn of a new era in tobacco control," said John R. Seffrin, PhD, chief executive officer of the American Cancer Society. "The FCTC stands as testimony to the commitment of the World Health Organization, governments, and civil society to reverse the course of this global pandemic."

Countries that ratify the treaty are promising to take strict measures to control tobacco.

The FCTC bans all tobacco advertising, sponsorships, and promotions, except in countries like the US whose constitutions do not allow a complete ban. It also requires countries to put large warning labels on the front and back of cigarette packages, and encourages higher tobacco taxes.

Countries that ratify the treaty must pass laws to limit smoking in indoor workplaces and take steps to fight tobacco smuggling. They are also urged to promote tobacco prevention and cessation programs.

Many countries already have measures like these in place, said Vera Luiza da Costa e Silva, director of the WHO's Tobacco Free Initiative. But the treaty will allow countries to coordinate their anti-tobacco efforts more effectively.

"This will leave fewer loopholes for the tobacco industry, which currently finds ways to circumvent national laws," she said.

The United States has signed the treaty, but has not yet ratified it. ACS and other groups sent a letter to President George W. Bush urging him to send the treaty to the Senate for approval.

"It would be a tragedy for the United States not to join the FCTC," said Stephen F. Sener, MD, national volunteer president of ACS. "Our nation should be leading on this issue, not watching from the sidelines. We should ratify the convention, implement it, and help low-income nations do the same."

There is no deadline for countries to ratify the treaty. However, only countries that ratify it before November 2005 will be able to vote on decisions about how to implement the treaty when the member countries hold their first governing conference in 2006.