Pubdate: Sat, 23 Oct 1999 Source: International Herald-Tribune Copyright: International Herald Tribune 1999 Contact: http://www.iht.com/ Author: Gro Harlem Brundtland, director-general of the World Health Organization ACT GLOBALLY TO CONTROL TOBACCO USE GENEVA - Amid globalization's benefits to health lie certain real threats. Tobacco looms as one of these. In 1999, 4 million people will die from tobacco-related illness, a figure that will increase to 10 million per year by 2030. That is more than the total number of deaths from malaria, maternal and major childhood conditions and tuberculosis combined. Seventy percent of these projected deaths will occur in developing countries. Increased smoking rates among teenagers and women have been reported in recent months by studies in Brazil, China, Egypt, India, Norway, Russia and Switzerland. These findings suggest that unless tough measures are taken, the global toll of tobacco related deaths, misery and economic hardship will increase dramatically throughout the first half of the 21 st century. Tobacco is unique as a mass consumer product. It kills almost half of its regular users. Its use starts among the young, often well under 18, who underestimate the long-term health effects and overestimate their ability to quit when they want. Tobacco is designed to be addictive. Unprecedented levels of advertising, marketing and sponsorship encourage tobacco use. Brand extension into clothing, adventure, music and arts events aims to circumvent advertising bans. Tobacco brands are now among the most pervasive images in many cities around the world. The role of the tobacco industry in preventing governments and international agencies from introducing sound public health policies is being increasingly documented. Tobacco industry documents that were made public following recent settlements in the United States are now available on the Internet and in two depositories that are open to the public. The documents provide solid evidence of how all the major policy measures that are required to reduce tobacco use have been systematically opposed by front groups and nongovernmental organizations established or supported by the tobacco industry. These groups have been commissioned for decades to conduct research and publish articles in major media aimed at casting doubt on the need for tobacco control or on the effectiveness of intervention. The World Health Organization, along with its UN partners, a growing cadre of nongovernmental organizations and private sector representatives, is leading an invigorated global tobacco control effort. It aims to ensure that all young people are protected from tobacco and that adults are made aware of its dangers and given the support needed to quit for life. This partnership knows what works: price increases using excise tax; total bans on all forms of tobacco advertising, promotion and marketing; bans on smoking in public places; strong counteradvertising; cessation programs that use pharmaceutical intervention; better control of smuggling, and welldesigned school and community-based media campaigns. We do not need new vaccines or new knowledge. We need political commitment and action. Aware that there are limits to the abilities of individual governments to control tobacco, the WHO has called for accelerated development of a Framework Convention on Tobacco Control. This is the first time that the WHO has used its constitutional right to develop a legally binding treaty. When WHO member states convene in Geneva this week, the first working group will start defining the public health basis for the convention. The aim is to craft a global tool to cope with a global epidemic. To succeed, we need to be alert to the likely efforts by those who continue to oppose public health measures. We also need to move rapidly toward global and national action that reaches tomorrow's potential tobacco users. - --- MAP posted-by: Richard Lake