[6] The FCTC represents a watershed moment for international public health; not only was the treaty the first to be adopted under WHO's Article 19, but it also marks one of the first multilateral, binding agreements regarding a chronic, non-communicable disease.

According to Mamudu and Studlar, since the adoption of the FCTC in 2003, "shared sovereignty through multilevel governance has become the norm in the tobacco control policy area for EU members, including having one international organization negotiate within the context of another.

[12] In compliance with Resolution 48.11, the WHO employed Roemer and Taylor to draft a background paper on the various mechanisms available to the WHO in effectively controlling tobacco use worldwide.

[12] This background paper provided a concrete recommendation for a framework convention, as opposed to alternative international legal action.

Allan M. Brandt, the esteemed Harvard University historian of the tobacco industry, reports, "some considered it unrealistic, impractical, and overly ambitious, and preferred a nonbinding 'code of conduct'".

Brundtland, a Norwegian medical doctor with a Master of Public Health degree from Harvard University, threw her full support behind the idea for a binding multilateral treaty on tobacco control.

[14] According to Elinor Wilson, the past vice-president of World Heart Federation, "the FCTC is an excellent example of government/non-governmental collaboration through the Framework Convention Alliance resulting in global public health gains".

[15] Such collaboration between NGOs and the WHO forever changed the way that the WHO treats nongovernmental organizations, and in 2002 the WHO constitution was amended to reflect this shift in relations.

[13] Once negotiations for the FCTC were underway, the tobacco industry again made attempts to lessen the blow of international legislation on their business by lobbying delegates at the convention in Geneva.

Article 17 of the Framework Convention states: "Parties shall, in cooperation with each other and with competent international and regional intergovernmental organizations, promote, as appropriate, economically viable alternatives for tobacco workers, growers and, as the case may be, individual sellers".

Significant provisions of the treaty require that parties implement the following measures: World Map Status The United States is a non-party to the Framework Convention on Tobacco Control.

[4] When the signed treaty was put up for ratification, President George W. Bush failed to send the FCTC to the United States Senate for consideration, thereby preventing the full participation of the U.S. in the implementation of the Framework Convention.

Among the provisions unsuccessfully opposed by the U.S. were the requirement for warning labels to be written in the language of the country where the tobacco products are being sold, and the ban on deceptive and misleading descriptions such as "low tar" or "ultra-light", which might infringe on trademark protections.

[20] Additionally, Corporate Europe Observatory recommends to "proactively list all meetings [...] between Commission officials and the tobacco industry and/or their representatives".

Investigations by Reuters have shown that one particular company, Philip Morris International (PMI), secretly infiltrated tobacco control negotiations and an executive[24] then lied about it: "Asked in an earlier interview whether Philip Morris conducts a formal campaign targeting the treaty’s biennial conferences, [Andrew] Cave gave a flat “no.”"[25] In 2017, the Convention Secretariat started a new project, FCTC 2030, to help parties to strengthen treaty implementation[26] by aligning it with the United Nations 2030 Agenda for Sustainable Development and its Sustainable Development Goals (SDGs).

This will include workshops, toolkits, online training on tobacco control, south-south and triangular cooperation, and other forms of assistance to national governments to accelerate treaty implementation.

[29] The Convention Secretariat will also be able to provide intensive support up to 15 selected countries that are Parties to the WHO FCTC, are eligible to receive ODA and have demonstrated the motivation and commitment to advance treaty implementation.

This will include the provision of direct, demand-driven expert advice, technical assistance and peer support to build domestic capacity to improve tobacco control in line with available resources.