Published: 11/21/2002
In recent years, many low and moderate-income nations have experienced sharp increases in tobacco use, prompting the World Health Organization (WHO) to issue urgent calls for action. Dr. Hiroshi Nakajima, former director of WHO, called the growing tobacco epidemic "a fire in the global village."

Today research shows that entire countries and regions are on the brink of widespread tobacco addiction -- and the epidemic of cancer, lung disease, and heart disease that will begin a generation later.

Can it be stopped or slowed? The Framework Convention Alliance, a group representing 60 nations and comprised of more than 200 non-governmental organizations -- including the ACS and the International Union Against Cancer (UICC) -- thinks so. The Alliance is working now to develop global regulations. An historic international treaty may be finalized this spring.

The American Cancer Society, led by CEO Dr. John Seffrin, is actively working to help develop strong, culturally appropriate tobacco control programs.

At risk are Sub-Saharan Africa, China, Japan, Southeast Asia, Latin America, and North Africa, according to research by WHO. If trends continue, 500 million people alive today will be killed prematurely by tobacco-related diseases. And half of those are children now, who could be protected from ever starting to smoke by strong regulations.

(At left: Tobacco billboard towers over school yard in Pakistan. Photo: Courtesy of Ehsan Latif.)

Only 5% of the world's smokers live in the US, where tobacco use is discouraged and smoking rates are dropping. The other 95% live in countries where free trade agreements bring more products to local markets than ever before--including cigarettes. Treaties protect "free trade" of tobacco, and public health issues are frequently ignored.

In these countries tobacco smuggling is common. This illegal practice prevents governments from collecting billions of dollars in tobacco taxes – and creates a black market of smuggled cigarettes that often fall into the hands of children.

An outrageous story of tobacco smuggling in Iraq was reported by the Wall Street Journal on October 10, 2002. US trade sanctions bar companies from selling cigarettes in Iraq that were made in the USA. Yet since the Persian Gulf War ended in 1991, the newspaper reports that American-brand cigarettes became more plentiful in Iraq than ever before. So plentiful that smugglers began "exporting" them to Iran by backpackers crossing mountain trails.

As for tobacco taxes…sources quoted in the Wall Street Journal story said that Saddam Hussein's oldest son, Uday, has allegedly collected "taxes" of about $10 million a year on both legal and smuggled cigarette imports since 1995. One source doubted that much of the money ended up in legitimate government bank accounts.

In some nations where tobacco use is growing, even basic health warnings don't seem to reach all citizens. A 1999 survey found 40% of Chinese people didn't know that smoking could cause lung cancer. In China's cities people must also endure heavy smog, which boosts the toxic effects of cigarette smoke, yet many smokers in places like Beijing don't have a clue of their unusually high risk for lung cancer.

Very few of China's women smoke compared to men (4% and 67% respectively)—and tobacco companies are reaching out to this untapped market with promotions. One company has sponsored a popular dance club in Beijing three times a week and paid attractive young women to spread free 555 brand cigarettes through the crowd. Club-goers dance in the smoke-filled disco, under huge banners displaying the snappy 555 logo.

The tobacco industry has stepped up the marketing of cigarettes in poorer nations, which have few resources to resist or even to regulate tobacco advertising. International health experts want to see global actions to fight tobacco marketing.

Critical controls on tobacco are under consideration right now by members of WHO's Framework Convention on Tobacco Control (FCTC). The final session--coming in February 2003--will produce a treaty to reduce tobacco-related deaths around the world. It's considered the best hope to roll back the tide of tobacco use and illness

The ACS Fellows Training Program trains promising tobacco control leaders from key regions of the world and offers follow-up help when needed. Trainings have taken place in Warsaw, Poland, and Mumbai, India. Upcoming sessions are planned in Goa, India, Romania, Finland, and Bolivia.

When decisions are close on important tobacco-related policies, ACS issues position statements to explain which choice will protect the greatest number of people from tobacco use and illness. Cross-border tobacco smuggling and tobacco advertising during soccer's World Cup are two of the complex issues ACS addressed in the last year.

Two ACS manuals are now available for tobacco control leaders around the world and more titles are planned. Secondhand Smoke and Engaging Physicians explain well-tested strategies to mobilize a community against tobacco. Media Advocacy and Coalition Development should be available in early 2003.

The Society supports the WHO Framework Convention on Tobacco Control, which is expected to produce an international tobacco control treaty this spring. ACS has worked with the UICC to work out key issues during and between work sessions held in Geneva, Switzerland. Along with other key non-profit groups, ACS has supported the ideals of the FCTC in Central and South America.

More on the Global Tobacco Pandemic from Dr. John Seffrin, CEO, American Cancer Society; President, International Union Against Cancer

The Battle Over China's Smokers

Show your support for a strong FCTC treaty. Click here to see a letter you can send to President Bush today..