Updated

Experts attending a global anti-smoking conference Monday called on the United States, Russia and other countries with large numbers of smokers to join an international tobacco control treaty.

Public health officials are meeting in Bangkok this week to help implement the 2003 treaty, called the Framework Convention on Tobacco Control, or FCTC.

Ratified by 148 countries, the treaty became international law in February 2005 and commits co-operating countries to implement measures proven to reduce tobacco use.

These include banning — within constitutional limits — all tobacco advertising, mandating graphic warnings on tobacco packaging, expanding measures to protect nonsmokers from secondhand smoke, increasing tobacco product prices, and battling cigarette smuggling.

Forty-six countries have either not signed, or failed to ratify, the treaty, including the United States, Russia and Indonesia.

"It's a substantial issue," said Dr. Haik Nikogosian, head of the U.N. World Health Organization FCTC Secretariat.

"Joining the convention — by the U.S. and Russia — will have a global effect," he said, referring not only to the two countries' high consumption but also to their large exporting capacity.

The Chinese are the world's biggest smokers, with their country accounting for 30 percent of the international market for cigarettes. The United States, Russia, Japan and Indonesia are the next-biggest markets.

According to WHO, tobacco consumption caused 5.4 million deaths in 2006 — one death every 6.5 seconds. Tobacco will kill 10 million people each year by 2020, with 70 percent of the deaths in developing countries, it says.

The World Health Assembly — the WHO's supreme decision-making body that meets annually — adopted the treaty in May 2003 and U.S. President George W. Bush signed it a year later but did not submit it to the Senate for ratification.

"It is inexplicable and unacceptable that the United States is not a party to the treaty," said Damon Moglen, vice president of the Campaign for Tobacco-Free Kids, a Washington, D.C.-based advocacy group.

"This current government's unwillingness to send it to the Senate, to move along and ratify it, is part of the general trend that the government has of not being an international partner," he said, drawing a parallel to the Bush administration's 2001 decision not to join the Kyoto Protocol, the international treaty on climate change.