[Intl-tobacco] Tobacco Pandemic - Brandt and Richmond; ratify FCTC, exclude tobacco from trade deals

[Robert Weissman]

[snip]

First, the Framework Convention on Tobacco Control recently adopted by
the World
Health Organization offers a multilateral network for tobacco control and
regulation. This unprecedented WHO treaty requires the ratification of
40 countries
to go into effect. Despite promises from the Bush administration, the
United States
has yet to sign.

Second, it is crucial that tobacco be excluded from all multilateral trade
agreements. Treating tobacco as a conventional product offers the
industry the
opportunity to use the liberalization of trade to secure new smokers.

[snip]


Tobacco Pandemic
By Allan M. Brandt and Julius B. Richmond
Washington Post
Thursday, January 15, 2004; Page A21


Forty years ago this week U.S. Surgeon General Luther Terry mounted the
stage at
the State Department Auditorium to announce the conclusions of his blue-ribbon
advisory committee on smoking and health. In the first nationally
televised news
conference ever held by a surgeon general, Terry told the nation that cigarettes
had been scientifically demonstrated to be a
primary cause of lung cancer and a severe risk to health.

For those who had followed the research findings of the 1950s, the
report offered
little that was new, but it was nonetheless a momentous event in the
history of
modern public health. Ultimately, the report was to mark the beginning
of a
revolutionary shift in the cultural meanings of cigarette use and a dramatic
decline in smoking in the United States.  At the time Terry spoke to the nation,
more than 45 percent of all adults in this country smoked cigarettes regularly.
Today fewer than one-quarter are smokers.

Throughout the 1950s, as impressive epidemiological and clinical data
came to
implicate cigarettes as a cause not only of lung cancer but of
cardiovascular and
respiratory disease, the tobacco industry launched a massive campaign to disparage
these scientific studies and foment a
"controversy" about the risks of smoking. In January 1954, the industry, already
facing rising public concern about the dangers of smoking, issued a "Frank
Statement to Cigarette Smokers," published in 448 newspapers across the
country. In
this full-page ad, the industry assured the American public:

"We accept an interest in people's health as a basic responsibility,
paramount to
every other consideration in our business. We believe the products we
make are not
injurious to health.

"We always have and always will cooperate with those whose task it is to safeguard
the public health."

Although the industry promised to fund scientific research, in reality
it created a
sophisticated public relations operation to deny the harm of smoking. At
the same
time, as we now know from internal corporate documents uncovered in litigation,
tobacco industry scientists consistently confirmed the presence of multiple
carcinogens in tobacco.

When Terry appointed his advisory committee, he offered the industry an opportunity
to eliminate any of the 150 physicians and scientists under
consideration. By so
doing he shrewdly ensured that the industry could not disparage the
report as
biased. And, tellingly, a number of the 10 committee members began their
investigation in 1962 as committed smokers. Photos of the committee
meeting at the
National Library of Medicine show a smoke-filled room with a conference table
littered with ashtrays. Terry himself gave up cigarettes in the weeks
before the
report was released, convinced that he should serve as a role model for
the nation.

Confronted with the surgeon general's report, the tobacco industry
decided to stay
the course, insisting that the case against cigarettes had yet to be scientifically
proven, that more research was required and that the scientific "controversy"
continued. Although such proclamations tested the credulity of the
public, even
into the 1990s the industry persisted in
contesting the overwhelming scientific findings demonstrating the harm
of smoking.
In 1994 seven tobacco company chief executive officers told a congressional
committee -- under oath -- that they did not know whether smoking caused disease
and that they did not believe cigarettes were
addictive. The companies not only violated common ethics, they may well have
violated the law, as judges and juries have found.

Although public health officials and physicians have sometimes voiced skepticism
about campaigns to alter behavior for health reasons, the decline of
smoking over
the past four decades marks a truly impressive example of the capacity
of an
informed public to curtail harmful behaviors. Today we are beginning to
reap the
important benefits in human health of this decline in smoking,
especially in the
pronounced reductions of cardiovascular diseases and deaths.

But it would be premature to celebrate the fall of the cigarette, even
as Americans
come to live in an increasingly smoke-free world. In the United States
some 400,000
people continue to die each year from tobacco-related diseases, and
every day 3,000
children join the ranks of regular smokers. The industry continues to promote
smoking to the tune of $11 billion a year in marketing and advertisements.

The industry now claims to have turned over a new tobacco leaf,
admitting the risks
of its product and working to prevent youth smoking. But such
pronouncements are
only one more smokescreen, a thinly veiled attempt to reduce legal
liabilities and
relegitimize a stigmatized product and a rogue industry.

In recent years the multinational tobacco companies have turned their
attention to
new markets abroad. Taking advantage of the growing trends of trade liberalization
and globalization, they have successfully gained access to previously restricted
markets in Eastern Europe, Asia and Africa. As smoking rates have
declined in the
West, they have skyrocketed in the developing world.

At no moment in human history has tobacco presented such a dire and
imminent risk
to human health as it does today. Indeed, we stand at the outset of a global
pandemic of diseases caused by tobacco that is nothing short of
colossal. In the
year 2000, 8.8 percent of all deaths across the
planet were associated with cigarette smoking; this figure marks a 45 percent
increase in tobacco deaths since 1990. According to current projections,
the number
of deaths attributable to tobacco will double to 10 million by 2030,
with 70
percent of those deaths occurring in the developing
nations.

There are, of course, ways to mitigate this coming epidemic.

First, the Framework Convention on Tobacco Control recently adopted by
the World
Health Organization offers a multilateral network for tobacco control and
regulation. This unprecedented WHO treaty requires the ratification of
40 countries
to go into effect. Despite promises from the Bush administration, the
United States
has yet to sign.

Second, it is crucial that tobacco be excluded from all multilateral trade
agreements. Treating tobacco as a conventional product offers the
industry the
opportunity to use the liberalization of trade to secure new smokers.

Rarely in human history has a product turned out to be so popular, so profitable,
so addictive and so deadly. In the course of the last century -- as
Terry's report
made clear -- we came to know, rationally and scientifically, the
character of the
harm it inflicts. The disease and death
generated by tobacco force us to confront a well-known but often-avoided reality:
that public health must engage economy and politics at the same time it deploys
science and medicine. May this be the legacy of Surgeon General Luther Terry's
report.