TAKE A DEEP BREATH...

Stark economics mean hard choices about cigarettes

WHAT do cigarettes of the 1960s have in common with cars of the same era?
Both polluted the air, killed people and were marketed as highly glamorous.
And both had the potential to be made safer.

The car was lucky enough to meet the young American lawyer and activist
Ralph Nader. Forty years ago next month, he published his first article
savaging manufacturers for building cars designed for "style, cost,
performance and calculated obsolescence, but not---despite the 5 million
reported accidents, nearly 40 000 fatalities, 110 000 permanent
disabilities and 15 million injuries yearly---for safety".

In 1965, he followed it up with his now classic book Unsafe at Any Speed:
The Designed-in Dangers of the American Automobile. Although one industry
leader dismissed the campaign as a fad ("of the same order of the hula
hoop") the book became a bestseller. Seat belts, collapsible steering
columns, airbags and myriad other safety features became commonplace. The
bottom line was that the death rates from accidents fell throughout the
industrialised world.

The tobacco industry never found its Nader. But thanks to a new report from
the UK anti-smoking lobby group Action on Smoking and Health (ASH) and the
Imperial Cancer Research Fund, we now know that the tobacco industry has
been developing methods for making tobacco safer since the same year that
Nader began his campaign. The tobacco industry has amassed some 58 patents
for techniques to cut the level of toxic chemicals in tobacco smoke. Not
one has been implemented.

Obviously these revelations will have their first impact on legal action
currently being taken against tobacco companies (see p 4). But they raise a
deeper question---should governments demand safer tobacco just as they have
demanded safer cars? Of course, we should not be under any illusion that
"safe" tobacco will be easy to make. But "safer" cigarettes are a different
matter.

Most of us can see some virtue in cars and in the need to make them safer.
But when it comes to cigarettes, shouldn't we try to get rid of them
altogether?

In an ideal world that might be true, but all the signs at the moment are
that the worldwide war against smoking is being lost. Smoking may be
declining in the wealthier nations, but tobacco consumption is booming in
poor countries. Take China alone. There, the WHO estimates that for every
cigarette not smoked in the developed world over the past twenty years,
three more have been smoked in China. It now has 300 million smokers, more
than in the developed world combined, and male smokers get through 15
cigarettes a day on average. And the story of booming cigarette sales is
the same throughout Asia and the former Soviet bloc.

Why is this epidemic happening unchecked? Tobacco is everywhere in league
with government. In China, the national tobacco monopoly produces almost a
third of the world's cigarettes, employs 10 million farmers, and provides
the Chinese government with $10 billion a year in tobacco taxes. Western
nations haven't helped. The US government's main response was to threaten
trade sanctions until China agreed to let foreign companies get a slice of
the action.

Nor, tragically, is there a compelling economic argument for governments to
take firm action against tobacco. The tax revenues are huge and smokers
tend to die at an age when the best of their working lives is past.
Although treating lung cancer may be expensive, economic analyses show that
it is not as expensive as looking after retired workers facing the
drawn-out diseases of old age.

As the director-general of the WHO put it a few years ago, the tobacco
epideruic is not like any other---there is no pathological agent, virus or
bacteria. The epidemic, he said, "is sustained only by the profit
motive---simply by money". And given the power of money, safer cigarettes
may be a good bet until the poor nations' consumers start to hit back as
they have in the West.

Economic forces might even be used to speed matters. If we are not going to
get rid of tobacco altogether, then why not base cigarette taxes on the
chemicals they create and their relative health risk? A small American
company, Star Scientific which develops ways to make safer tobacco plans to
introduce a cigarette next year which is free from one of the worst
carcinogens. With an incentive, the big companies.which have far larger
resources could be made to dust off their patents too.