The United States on Wednesday joined more than 190 other nations in approving a World Health Organization treaty that aims to reduce tobacco use worldwide. Public health officials and organizations praised the measure as a step toward reducing the harmful impact of cigarettes and other tobacco products.

“Today we are acting to save billions of lives and protect people’s health for generations to come,” said Dr. Gro Harlem Brundtland, WHO director-general in a statement.

The treaty, called the Framework Convention on Tobacco Control, is the first binding agreement ever negotiated by the international health body, though it must first be ratified by at least 40 WHO member nations to take effect.

The American Cancer Society, the Campaign for Tobacco-Free Kids, and three other American health organizations issued a statement praising the WHO nations for adopting the treaty, and calling on members to ratify and implement it quickly.

According to WHO statistics, tobacco use accounts for nearly five million deaths each year, and that figure could double by the year 2020. About 70% of those projected deaths will be in developing nations, the WHO said; tobacco use in many developing nations is rising, while it is declining in some industrialized countries.

“The growing death toll from tobacco use is horrible and unacceptable,” the ACS statement said. “With the adoption of the tobacco treaty, nations have finally taken coordinated action to turn the tide of this epidemic.”

RESOURCES: Harmful Effects of Tobacco Tobacco and Cancer WHO Tobacco-Free Initiative

The new treaty lays out specific steps countries must take to curb tobacco use, particularly among young people.

“Ninety percent of smokers start by age 18 or earlier,” said Vince Willmore, communications director for the Campaign for Tobacco-Free Kids, “so if we can significantly reduce youth tobacco use, we can significantly reduce the number of people who become addicted and die (from tobacco).” He emphasized that helping current smokers quit is also essential.

The document calls for a comprehensive ban on all tobacco advertising, promotion, and sponsorships, with less stringent requirements for countries that have constitutional constraints on such bans.

“Considering the extraordinary number of studies that have been conducted on the effects of advertising on behavior, and particularly on smoking rates, this provision is considered by many to have the greatest potential (to curb tobacco use),” said Emily Bleimund, international tobacco analyst for the American Cancer Society.

The treaty also encourages high taxes on tobacco products as a means of discouraging people – especially young people -- from continuing or starting a tobacco habit.

Tobacco packaging is also targeted. The convention requires large health warning labels that cover at least 30% of each tobacco package, and it prohibits the use of terms like “light” or “mild” that the WHO says “create a false impression” that some tobacco products are less harmful than others.

This provision is important, Willmore said, because it helps counter the tobacco industry’s “slick advertising.”

Moreover, while the health dangers of tobacco are widely known in the United States, the same isn’t always true for other nations. A 1999 survey found that 40% of people in China did not know smoking could cause lung cancer.

“Tobacco kills more than AIDS, legal drugs, illegal drugs, road accidents, murder, and suicide combined,” WHO documents report. Yet more than one billion people worldwide – 46.5 million of them Americans – use tobacco.

It is not clear whether the United States will ratify the treaty. US Health and Human Services Secretary Tommy Thompson, who attended Wednesday’s proceedings in Geneva, Switzerland, said the US is reviewing the document.

Earlier this year, the United States expressed reservations about some of the provisions in the treaty, and tried to add a clause that would allow nations to opt out of provisions with which they disagreed.

But Thompson said the US is committed to controlling tobacco, citing efforts to educate Americans about the dangers of smoking and US-led research on smoking control programs.

US support of the treaty is important, Bleimund said, because “tobacco use is an international problem.”

“It is vital that the countries that consume tobacco and those that produce tobacco are bound by certain restrictions that will help halt the smoking epidemic,” she said.

The United States has made considerable progress, mainly on the state level, in curbing smoking, advocates said. Many states and cities have taken steps to ban smoking in workplaces and restaurants, and 29 states and the District of Columbia have increased tobacco taxes over the past year.

However, there are some areas where more needs to be done. Budget shortfalls have led some states to cut anti-tobacco programs, said Willmore, of the Campaign for Tobacco-Free Kids. And the federal government still has not given the Food and Drug Administration authority to regulate tobacco products.

Willmore said the US can take steps to implement some of the measures in the treaty regardless of whether it’s ratified or not.

“We should be restricting ads to the extent allowed by our constitution, we should be increasing the size of warning labels, we should be increasing taxes and using the money to fund tobacco cessation programs,” he said. “There’s no reason to wait for this treaty for the federal and state governments to do the right thing.”