The world's first international tobacco control treaty

The third world is approaching a “Tobacco Holocaust”. The Tobacco
industries, with declining tobacco consumption in parts of the west, are
now targeting Asian and eastern European markets intensively. We need an
international coalition that could address tobacco issues that cross
borders. World Health Organization's (WHO) tobacco control treaty(1) is
only the first step forward. The real test would be in implementing the
measures effectively. The following staggering statistics call for an
urgent action on the part of international community and urge
international agencies to review their existing policies and programs, to
ensure that tobacco control is given prominence.

* Tobacco kills more people than AIDS, alcohol, cocaine,
homicide, suicide, motor vehicle crashes and fires combined. It has
already killed 70 million people since 1950. Annual global tobacco related
deaths are about 3 million (one third in developing nations) and is
expected to rise to more than ten million by the 2020s(2). By 2030, 70% of
all deaths due to tobacco will occur in developing nations (presently it
is 50%). Tobacco-related diseases are responsible for 1 in 10 adult deaths
worldwide(3).

* With current patterns, about 500 million people alive in
the world today will eventually be killed by tobacco use (nearly a half
will be today's children and teenagers)(4). If tobacco control is
extremely successful and adult tobacco consumption is cut to half by 2020,
there will still be over 250 million people dying of tobacco consumption.

* Seventy percent of Chinese men smoke and, if they do not
change their habits, a third of them, now under 30 years (more than 50
million), will eventually die of smoking. Tobacco is predicted to account
for 13 percent of all deaths in India by 2025. In Thailand, 250 million
children alive today will eventually die from tobacco if they take up
smoking at the present rate(5).

In a developing country with a per capita GDP of $2000,
effective tobacco prevention costs approximately $20 to $40 per year of
life gained. Lung cancer treatment costs $18,000 per year of life
gained(6). For the USA, direct health care costs related to tobacco were
estimated in 1980 to be US $16 billion (7% of national health care costs)
and indirect mortality & morbidity costs were US $26 billion.

Approximately five trillion cigarettes (1,000 / human
on earth) are produced annually. In 1999 tobacco industry spent $8.24
billion a year as marketing expenditures. This amounts to $22.5 million a
day – nearly $1 million an hour!

Philip Morris, Japan Tobacco and British American
Tobacco, the world’s 3 largest cigarette companies, now own or lease
plants in at least 40 countries each. In 1998, they had combined tobacco
revenues of more than $88 billion, a sum greater than the total gross
national product of Albania, Armenia, Bahrain, Bolivia, Botswana,
Bulgaria, Cambodia, Cameroon, Estonia, Guyana, Honduras, Jamaica, Jordan,
Laos, Latvia, Madagascar, Moldova, Mongolia, Nepal, Nicaragua and Togo
combined(7).

We need to create an international coordinating agency to reduce and
monitor tobacco consumption. Key areas for action include facilitating
international agreements on smuggling control, discussions on tax
harmonization to reduce the incentives for smuggling, and ban on
advertising and promotion involving the global communications media.

References:

1. Gilmore AB, Collin J. The world's first international tobacco
control treaty. BMJ. 2001;325:846-847.

2. World Health Organization, World Health Report 1999 (Geneva: WHO,
1999) http://www.who.int/whr/1999/en/report.htm and World Bank, World
Development
Indicators 1998, http://www.worldbank.org/data/wdi/pdfs/tab2_1.pdf
3. World Bank, Curbing the Epidemic: Governments and the Economics of
Tobacco Control, 1999; http://www1.worldbank.org/tobacco/reports.htm

4. World Health Organization, World Health Report 1999 (Geneva: WHO,
1999); http://www.who.int/whr/1999/en/report.htm

5. World Health Organization, “Tobacco Epidemic: Much More than a
Health Issue,” Fact Sheet No. 155, 1998; http://www.who.int/inf-
fs/en/fact155.html

6. World Bank, Curbing the Epidemic: Governments and the Economics of
Tobacco Control (Washington: World Bank, 1999);
http://www1.worldbank.org/tobacco/reports.htm

7. As of January 2000, Philip Morris and Japan Tobacco had
subsidiaries, affiliates and licensing agreements in 63 and 44 countries
respectively, while BAT had subsidiaries and affiliates in 74 countries.
Source: “International Cigarette Manufacturers,” Tobacco Reporter, March
2000.