HEALTH-LATAM: Smoking Finds Fertile Ground among the Poor

By Mario Osava Reprint | | Print |

Mario Osava

RIO DE JANEIRO, Nov 12 2001 (IPS) - The number of smoking-related deaths in the world will climb from the current four million to 10 million within the next 20 years, hitting lower-income segments and the populations of poor countries especially hard.

Half of those early deaths affect developing nations today – a proportion that will rise to 70 percent by 2020, warned Vera da Costa e Silva, project manager with the World Health Organisation’s (WHO) “Tobacco Free Initiative”.

Costa e Silva told IPS that that was due to the growing number of people smoking in the developing world, a trend that has levelled off in rich countries.

For that reason, transnational tobacco giants are focusing their efforts on markets in Latin America, Africa and Asia, she explained.

The Brazilian expert coordinated the first Latin American Seminar on the Framework Accord on Tobacco Control, which drew representatives from 19 countries to Rio de Janeiro last Monday through Thursday to debate proposals to be taken to a global conference scheduled for the end of the month in Geneva.

The meetings form part of the process of drafting the framework accord on tobacco control, designed to combat smoking by clamping restrictions on advertising, fighting smuggling and regulating other mechanisms used by the tobacco industry to promote smoking.

Tobacco will be responsible for one billion deaths this century, 150 million in the first two decades alone, stated WHO Director-General Gro Harlem Brundtland in a Nov 1 call to action against this grave public health threat.

In China, she observed, 100 million of the country’s 300 million people currently under the age of 29 will die early due to smoking.

Among the measures approved at the first Latin American seminar were to “gradually prohibit all direct and indirect forms” of publicity and advertising of tobacco.

Efforts in that direction will begin with rules and restrictions on advertising, as well as requirements of transparency from tobacco companies, which would be forced to divulge their spending on publicity.

Another proposal discussed was to increase the price of cigarettes – an effective way to reduce consumption, according to experts – by raising taxes.

It is also essential to crack down on contraband, falsification of brands and other illicit forms of trade that lead to an expansion in offer, the participants in last week’s meeting underlined.

We must make taxes and prices in the region more uniform, because the disparities fuel smuggling, said Costa e Silva, who pointed out that smokers pay a 75 percent tax on cigarettes in Brazil, compared to a mere 12 percent in Paraguay.

Such gaps in tax levels between two neighbouring countries is an “invitation” to contraband and brand-name piracy, she declared.

Prices also vary widely from country to country. Despite the high taxes, Brazil’s cigarettes are “too cheap,” because basic elements like labour and raw materials are inexpensive, said the WHO official, who noted that a pack of cigarettes that costs three dollars in Switzerland sells for just 50 cents in Brazil.

Costa e Silva added that high prices are a highly effective mechanism, because they lead to lower consumption among minors – the age at which smoking addictions tend to take hold.

In addition, high cost dissuades consumption among the lowest- income sectors, where smoking is expanding faster.

With the exception of Brazil and Venezuela, anti-smoking programmes in Latin America are weak, said Costa e Silva, who headed prevention programmes in Brazil’s National Cancer Institute prior to assuming her current post in the WHO.

There is still limited understanding that tobacco is a drug and a public health problem that claims more lives than AIDS, tuberculosis, maternal and child mortality, and malaria together, she stressed.

The WHO official added that governments lack the data needed to lay to rest mistaken views, such as the fear that higher taxes will reduce revenues. Misguided economic arguments often stand in the way of necessary action, she added.

The aim of the new international treaty, which is to be debated and negotiated until 2003, will be to apply strict controls to the tobacco industry, which currently enjoys a relative lack of regulation, and uses subterfuges to get around the few rules that do exist, said Costa e Silva.

In Brazil, for example, advertising is already banned, but companies find their way around that by sponsoring events and concealing publicity in TV programmes like soap operas.