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	"Greatest Hits" of Tobacco Control Opponents: (Suggested Responses to Common Queries) [an error occurred while processing this directive] General Secondhand smoke and smoke-free environment Advertising, promotion and sponsorship Economics Tobacco taxation Package messages Tobacco industry “youth smoking prevention” programs FCTC GENERAL Adults have the right to choose to smoke. Very few adults “choose” to smoke. The vast majority of smokers start smoking as children or adolescents, before they know the risks of tobacco use and the addictive qualities of nicotine. They become quickly addicted and, even though most want to quit, few are successful. There are more important health issues to deal with. There are many important health issues, but tobacco use is the leading preventable cause of death in the world, killing 5 million people annually. Fortunately, reducing tobacco use is cheap and feasible. If we can reduce tobacco use, we will have more resources to address those other important problems. People will smoke no matter what. People smoke in large part because tobacco is a socially-supported addiction. We know of many policies ­ such as bans on all tobacco promotion, higher tobacco taxes, and smoke-free environments ­ that effectively change the social environment to discourage tobacco use. These policies have been proven to prevent young people from starting to smoke and help smokers to quit. Governments aren’t serious about tobacco control ­ they are too dependent on tobacco tax revenue. Governments can have it both ways - higher tobacco tax rates are a highly effective tobacco control tool, and they raise more tax revenues. This is true even as taxes and prices reach very high levels. But even if, eventually, tobacco use falls so much that it erodes total tobacco tax revenues, governments will still be in a win-win situation, because tobacco taxes do not come close to paying for the damage caused by tobacco use, estimated at $200 billion every year (World Bank). Tobacco taxes are relatively easy to levy and collect, and tend to have much more popular support than other taxes. But there are many other ways for governments to collect revenues. As economies matures and grow, they become less dependent on excise taxes and more dependent on income taxes, anyway. We need to deal with other drug issues. Globally, tobacco kills far more people than alcohol and illegal drugs, combined. In 2000, tobacco killed nearly 5 million people worldwide, alcohol killed nearly 2 million, and illegal drugs killed about 200,000. Tobacco is a gateway drug that often introduces youth to other drugs. Tobacco control should focus on programs to help smokers quit. Smokers are more likely to quit in a social environment that discourages tobacco use. Higher prices or taxes on tobacco, smoke free environments, and strong warnings on cigarette packages that graphically inform smokers of the risks of smoking all discourage tobacco use. Cessation programs targeted at smokers help, but they do not have a strong impact on their own without broader policy measures that change the social environments. The real solution to reducing tobacco use is to educate our children. Yes, but where do children learn? If children learn in school that smoking is harmful, but leave the classroom to see cigarette ads in their neighbourhoods, tobacco products for sale on every corner, and homes and public places where people are allowed to smoke, the message in the classroom gets lost. This is why school education about tobacco use on its own has been shown to not reduce tobacco use. School education is effective only in a broader environment that reinforces the non-acceptability of tobacco use. SECONDHAND SMOKE AND SMOKE-FREE ENVIRONMENTS There is no proven link between secondhand smoke and disease. Every credible medical and scientific organization in the world ­ including the World Health Organization, the US Surgeon General, national environmental protection agencies, colleges of physicians and surgeons ­ agrees that secondhand smoke exposure causes serious illness and death in nonsmokers. In the US, 53,000 nonsmokers die every year from heart disease and 3,000 die from lung cancer caused by secondhand smoke. Transferring these statistics to a country with 10 million people, we could estimate about 2000 deaths from lung cancer and heart disease among nonsmokers per year due to secondhand smoke. And secondhand smoke makes kids sick: it causes pneumonia, bronchitis, asthma, and ear infections. The only group that still denies this is the tobacco industry and its front groups. There are more important sources of air pollution. Many things pollute our air, and we should work to clean up all health hazards in our environment. But tobacco smoke must be recognized as one of those hazards. Along with solid fuel fires for indoor cooking and heating, tobacco smoke is one of the biggest causes of indoor air pollution, and it is a form of pollution that has an easy solution: eliminating smoking indoors. Shared smoking and nonsmoking areas will solve the problem. This is like having a urinating and non-urinating section in a swimming pool. Would you jump in? If the air is shared, the smoke pollution is shared. Smoke in the smoking section causes disease in the nonsmoking section. Secondhand smoke is just an issue of poor ventilation. Better ventilation may reduce the odour of smoke, but it does not eliminate the harmful chemicals. To eliminate these chemicals in an average smoking office, so many air exchanges would be required that there would be a small hurricane. And why force businesses to invest in expensive ventilation equipment when they can just eliminate the source of the pollution? The cheapest, most effective, and only sensible solution is to eliminate smoking indoors. Smoke-free environments will harm businesses, especially bars, restaurants, and tourist industries. On the contrary. Workplaces that are smoke-free lower their maintenance and insurance costs (health and fire insurance, for example), and their workers are more productive. Smokers and nonsmokers exposed to smoke get sick more often than nonsmokers not exposed, and smoke-free workplaces help smokers to quit smoking. The effect of banning smoking in bars and restaurants has been studied in hundreds of communities. Sales receipts show that sales increase or remain the same in smoke-free bars and restaurants in comparison to those in jurisdictions that still allow smoking. Studies that show otherwise are usually funded by the tobacco industry, and usually look at owner predictions rather than actual sales data. Government doesn’t have the right to tell my business what to do. Businesses do not have the right to endanger the health and lives of their employees and customers. Government is obligated to protect public health and safety, as it does when it regulates drinking and driving, implements seatbelt laws, or sets environmental pollution standards. Smoking restrictions infringe on smokers’ rights. As the old saying goes, my right to swing my arm stops where your nose begins. Smokers do not have the right to harm others with their smoke. Smoke-free environments do not violate the “right” to smoke, they protect the right of nonsmokers’ to breathe clean air. ADVERTISING, PROMOTION AND SPONSORSHIP Tobacco advertising doesn’t affect tobacco consumption. Dozens of studies show that increased tobacco promotion is linked to increased tobacco use in the general population. Promotion is also linked to smoking initiation among specific groups ­ such as women and children ­ as a result of campaigns targeted at them. Studies have also shown that the elimination or near-elimination of tobacco promotion decreases tobacco use. Partial restrictions on promotion have little or no impact on consumption, usually because when only some media or types of advertising are restricted, the tobacco companies simply invest more money in promotions through those avenues still available to them. We should prohibit advertising aimed at kids. It is impossible to draw a clear line defining what advertising is targeted at kids. Cigarette promotion has been successful in reaching youth in large part because it portrays smoking as an “adult” behaviour: something that every adolescent aspires to. And studies have shown that partial restrictions on promotion to not reduce tobacco use. Bans or near-total bans on promotion do reduce tobacco use. Arts and sporting events would disappear without tobacco industry support. Many jurisdictions have banned tobacco sponsorships and, despite dire predictions, most groups have found alternative sponsors. Other jurisdictions have used revenue from tobacco taxes to buy out tobacco sponsorships and fund events. This way, people are exposed to messages about health rather than unhealthy products when they watch sports events or musical concerts. We don’t need to regulate tobacco advertising ­ the tobacco companies have a voluntary code and are behaving responsibly. Tobacco company codes, by the own admission of the companies in internal documents, are designed solely as public relations strategies to forestall meaningful regulation of promotion. The codes are extremely weak, and in most countries the companies routinely violate their own codes. Rather than allowing the fox to guard the chicken coop, the best solution is a legislated ban on all tobacco advertising and promotion. ECONOMICS Tobacco control will cost the economy jobs. Studies in several countries have examined the potential economic impact of the complete elimination of tobacco use and production. The evidence shows that, with the exception of economies almost completely dependent upon tobacco such as Zimbabwe and Malawi, the elimination of tobacco will not affect the economy, or will affect it positively. This is because tobacco use has many externalized costs (costs not paid for by smokers or tobacco manufacturers). When people no longer spend their money on tobacco, they will spend their money on other things ­ usually things that are far less harmful to health and the economy. This alternative spending, in turn, will stimulate other sectors of the economy. Tobacco farmers will go out of business if we reduce tobacco use. Even with global per capita consumption of tobacco declining, current population and tobacco use trends indicate that the total number of smokers will increase from 1.1 billion in 1999 to more than 1.6 billion in 2025. Therefore, even with strong tobacco control measures, it will take generations to reduce tobacco use to the point where farmers go out of business. Tobacco is addictive and has been part of society for decades. It will not go away overnight. In the meantime, governments have an opportunity to assist farmers in transitioning to alternative livelihoods. Tobacco control will cost too much. Reducing tobacco use is one of the most cost-effective health interventions possible ­ tobacco control is comparable to vaccinations in terms of cost-effectiveness per life-year saved. The most effective measures are policy decisions that cost governments very little, and that earn back governments savings in health care costs in a relatively short period of time. The tobacco companies contribute to our national economy. Most tobacco companies are owned by multinational companies based in two or three developed countries, meaning that the profits from cigarette sales are removed from the economy. As tobacco use is reduced, money spent on tobacco products is spent elsewhere on products far less harmful to health and the economy, and this generates economic activity in other sectors. Tobacco taxes more than cover the costs of tobacco use. Tobacco taxes do not come close to paying for the damage caused by tobacco use. And even if they did, taxes do not buy the tobacco industry the right to do damage equivalent to the taxes paid. If I pay $5,000 in taxes, am I entitled to damage $5,000 worth of government property? TOBACCO TAXATION Tobacco taxes hurt the poor and punish smokers. Tobacco taxes are extremely effective in reducing tobacco use. For every 10% increase in the real price of tobacco products, consumption in middle-income countries will drop by about 8%. The decrease will be greatest among youth and the poor, exactly those groups that government policy hopes to benefit the most and that can least afford to bear the burden of tobacco-caused disease. Money from taxes can be used to pay for programs that help smokers quit smoking, and for programs that benefit the poor. Tobacco taxes are just a money grab by governments. It is true that some governments raise tobacco taxes primarily to increase government revenue. But this does not detract from the fact that tobacco taxes are healthy public policy. Government will lose revenue if they increase tobacco taxes. There has not been a single instance where an increase in tobacco tax has resulted in decreased government revenue. On the contrary, data from dozens of countries shows that when tobacco taxes increase, revenue from tobacco taxes increases. Although tobacco consumption falls in response to higher prices, because tobacco is addictive the decline is small in proportion to the tax increase, guaranteeing stable government revenue at least in the medium term. Higher tobacco taxes will increase tobacco smuggling. The level of corruption in a country as measured by the “transparency index” is a far better predictor of tobacco smuggling than the level of tax. In most countries, the benefits of higher tobacco taxes in terms of health and revenue have been significant even in countries where the level of consumption of smuggled tobacco is high. And governments can use increased tax revenue to strengthen anti-smuggling efforts. PACKAGE MESSAGES Package messages are ineffective. The package messages in many countries are ineffective because they are so small and give unclear information. But in Canada and Brazil, where health messages on packages are large and use pictures, messages have motivated many smokers to try to quit smoking. Smokers say that the information is relevant and informs them about the effects of smoking on their own health and on the health of others who breathe their smoke involuntarily. These messages can reinforce other elements of a tobacco control program, such as smoke-free environments. People here buy single cigarettes, they won’t even see packages. If the health messages are large enough and clear enough, people will see them when they are displayed for sale, when they are taken out of smokers’ pockets and purses, and when they are discarded. Package messages are one of the cheapest and widest-reaching forms of public education available. Many people can’t read so package messages won’t work. This is a good reason to have pictures accompanying text messages. Pictures can graphically illustrate the health harms of smoking and secondhand smoke, and can be understood even without text. TOBACCO INDUSTRY “YOUTH SMOKING PREVENTION” PROGRAMS Tobacco companies are concerned about youth smoking ­ they are helping us with youth education programs. Studies have shown that tobacco industry “youth smoking prevention” programs are ineffective. This is not surprising, as they are not intended to be effective. Internal tobacco industry documents show that these programs were designed as a public relations effort meant to build good will with governments and the public, while forestalling meaningful regulation. The programs have three major benefits for the companies. First, by focusing on smoking as not being “appropriate” for children but rather a question of “choosing” to smoke by adults, they reinforce smoking as an “adult behaviour,” thus increasing its appeal to children. The programs typically do not educate about health effects and they reinforce smoking as a “choice” while never mentioning the addictiveness of nicotine and the fact that most smokers want to quit smoking but can’t. Second, governments who receive funding and cooperation from tobacco companies are far less likely to implement meaningful policies to reduce tobacco use. And finally, the programs promote tobacco companies as “good corporate citizens” in the eyes of youth and the general public. Tobacco companies have changed their ways ­ they don’t want youth to smoke. This message is not credible. Almost all of the companies’ new customers are adolescents and children. Without them, companies would go out of business. If the companies were serious about youth not smoking, they would withdraw all of their advertising and promotion, and stop fighting policies that prevent youth from starting to smoke, like higher taxes and smoke-free environments. FRAMEWORK CONVENTION ON TOBACCO CONTROL (FCTC) With the FCTC, the World Health Organization is taking away the sovereign right of countries to decide their own approach to tobacco use. The FCTC has been negotiated by WHO Member States in their capacity as sovereign nations. It is an agreement that countries can choose to sign on to, or not. The vast majority of countries support the FCTC, because they see it as a mechanism to strengthen their national efforts to reduce tobacco use. The FCTC will set up a new, expensive bureaucracy for tobacco control. The FCTC will provide a mechanism for countries to share knowledge and resources to support tobacco control, providing most countries with cost savings and an opportunity to boost the impact of their domestic policies and programs. The FCTC will violate trade agreements. By signing and ratifying the FCTC, countries will acknowledge the importance of measures to protect public health and will be less likely to challenge other countries that implement such measures. Source: Ms. Heather Selin Advisor, Tobacco Control Pan American Health Organization/World Health Organization (PAHO/WHO)

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