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.