Analysis and Comment

Public health

Mexico and the tobacco industry: doing the wrong thing for the right reason?

BMJ 2006; 332 doi: 10.1136/bmj.332.7537.353 (Published 9 February 2006)
Cite this as: BMJ 2006;332:353

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  1. Jonathan Samet, professor1,
  2. Heather Wipfli, research associate (hwipfli@jhsph.edu)1,
  3. Rogelio Perez-Padilla, investigator2,
  4. Derek Yach, director, global health3
  1. Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD 21205, USA
  2. Instituto Nacional de Enfermedades Respiratorias, CP 14080, Mexico
  3. Rockefeller Foundation, New York, NY 10018, USA
  1. Correspondence to: H Wipfli
  • Accepted 6 January 2006

By linking payments to a health fund with sales of cigarettes, the tobacco industry is undermining international agreements to control smoking

In May 2004 the Mexican government announced an agreement with the tobacco industry that related to tobacco control measures and industry contributions to the Seguro Popular de Salud, a programme for people without health insurance.1 Although the agreement has received little international discussion, it has implications not only in Mexico but in other countries that may be tempted to follow Mexico's example. The timing of the agreement raises concern that it may be an industry model for counteracting the effect of the World Health Organization's Framework Convention on Tobacco Control.

What is the agreement?

The agreement was signed by two agencies within Mexico's ministry of health and by British American Tobacco, Phillip Morris of Mexico, and Cigatam (Cigarros La Tabacalera Mexicana). Notable elements include:

  • Minor limitation on the size of billboards

  • Restriction on the surface area of the pack for health warnings

  • Specific exclusion of graphic health warnings

  • Disclosure of ingredients “respecting industrial secrets and confidential information.”

These elements conflict with key articles in the Framework Convention on Tobacco Control, which Mexico ratified only days before the agreement was announced (see bmj.com).2 Article 11 of the convention calls for health warnings covering a minimum of 30% of the principal display areas of packaging, …

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