In the Journal this month, Editor, Ruth Malone, highlights how “Indonesia not only permits but abets and encourages some of the most aggressive tobacco advertising in the world, including tobacco advertisements featured on police traffic kiosks.”

Watch the revealing video below to see just how the industry is exporting its most aggressive strategies, those no longer permitted in most wealthy countries, to Indonesia.

Ruth Malone, Editor

Something was new and exciting in the air at the World Conference on Tobacco or Health in Singapore last week: a ramped-up visibility of the problem of the tobacco industry vector. One must wonder whether the industry may have misjudged in so aggressively challenging in the courts Australia’s decision to implement plain packaging of cigarettes. This and its other actions to directly and indirectly undermine effective implementation of the WHO Framework Convention on Tobacco Control (FCTC) through trade disputes and other tactics–coming on top of the enormous literature based on industry documents that shows the industry’s continuing interest in thwarting public health–have prompted an unusually and encouragingly  aggressive response from the World Health Organisation. Director General Margaret Chan’s blazing speeches, urging governments to stand together against the tobacco industry, made repeated references to fighting the “despicable” industry. In her multiple high-profile sessions at the conference, Dr. Chan bypassed the often frustratingly cautious approach of many high-level bureaucrats, using her stature to demonstrate true leadership and stepping into a role as the movement’s chief cheerleader.

For someone who has spent a career studying the industry’s often-covert activities aimed at disrupting any effective public health response to the tobacco disease epidemic, this emphatic focus on the industry was heartening. So often the industry is still treated as a normal business like any other, an entity that will always be with us in something like its current form. At this meeting, it became clear that this is no longer accepted as a given. How this takes form in the global tobacco control movement and among policymakers is yet to be seen, but there can no longer be doubt that the world’s highest authority on health recognizes the need to address directly the industry vector.

Yesterday’s opening plenary at the WCTOH 2012 was simply dynamite – one of the best sessions I have attended. (The only downer being that that the ballroom isn’t big enough to accommodate all conference attendees.) Health ministers from Turkey, Uruguay, Australia and Norway took part in an exciting and inspiring panel discussion on how they are countering tobacco industry litigation and defending essential public health legislation. I got the real sense that tobacco industry legal threats are no longer as intimidating to governments – this will surely have a knock on effect to other countries once these court challenges are successfully resolved.

The plenary chair, WHO head Margaret Chan was passionate and frank (and surprisingly funny too). Delegates were pleasantly surprised at her “all guns blazing” approach. She also pledged that regional WHO staff would be empowered to act and speak as freely on vital tobacco control policy reform.

An interesting challenge was issued at the plenary by Greg Connolly - he believes there is no need for WCTOH after 2030 as this must be our target date of ending the global tobacco epidemic. When countries like Indonesia have yet to join the game, can we really be talking about endgame scenarios in tobacco control? What do you think?

Margaret Chan (centre) with world leaders in tobacco control (photo courtesy of Elif Sezginer Dagli)

The Luther Terry Awards were also presented last night and an extra special shout out of warm congratulations goes to the recipients, all of whom have helped shape this journal over the past 20 years:

Stan Shatenstein (Canada), Mike Daube (Australia), Martin Raw (UK), Yussuf Saloojee (South Africa), Prabhat Jha (Canada) Melanie Wakefield (Australia), Mira Aghi (India)

And now for a few Twitter highlights from yesterday’s sessions:

During her keynote address to the 15th World Conference on Tobacco Or Health, WHO head Margaret Chan put her own spin on the classic Virginia slims campaign, “you’ve come a long way, baby” – reminding the tobacco industry that “we’ve come a long way, bullies” since the iconic ad campaign to hook women on cigarettes. Chan also rallied the large crowd of 2600 delegates, urging them to not take bullying from the industry lying down. The scene has been set for a conference with a strong theme of pulling together to battle tobacco industry interference in implementing effective tobacco control.

This is the first world conference where delegates will be Tweeting their impressions and thoughts on the proceedings #wctoh12. I will be highlighting a selection of these tweets on the blog daily. Social media has been getting a lot of attention so far at the conference, this is a hugely positive change from India three years ago, where my presentation on new media had to be included as part of a session on sport sponsorship as it didn’t fit elsewhere.

Tell us about your goal for the conference -what do you hope to achieve? Some initial thoughts from other delegates:

Marc Linder, University of Iowa College of Law writes:

I’m a law professor at the University of Iowa teaching a course on the History of the Regulation of Smoking and Tobacco in the United States who would like to bring to Tobacco Control readers’ attention my just published very lengthy web-only free-access book on this subject.

“Inherently Bad, and Bad Only”: A History of State-Level Regulation of Cigarettes and Smoking in the United States Since the 1880s. Volume 1: An In-Depth National Study Embedding Ultra-Thick Description of a Representative State (Iowa)

This book lays out empirical and methodological underpinnings for studying the early period of anti-cigarette legislation in the United States by overcoming the lack of primary source-based historical scholarship. Constantly repeating wildly erroneous claims at second, third, and more remote hand, anti-smoking academics and pro-tobacco apologists have fundamentally distorted history, on the one hand by dismissing the early anti-cigarette movement as merely religiously and morally motivated and the legislation it secured as unenforced exercises bereft of historical relevance, and, on the other by absurdly magnifying its achievements. Reconstruction of the national scope of the real course of the passage and repeal of statewide legislative bans on cigarette sales to adults from the late 1880s until 1927 pays special attention to the non-governmental driving forces of the Woman’s Christian Temperance Union’s health-based support of and the monopolistic American Tobacco Company’s opposition to such interference with consumer freedom. In this panoramic analysis is embedded ultra-thick description of the enactment, enforcement, and repeal processes in Iowa as a representative state. In order to present the full sweep of tobacco control regulation, the narrative continues into the present, under the new circumstances of a mass movement and monolithic scientific warnings of secondhand smoke exposure’s lethality, by capturing the shift in focus to anti-public smoking legislation-which had, ironically, originated just as sales ban repeals were spreading in the wake of World War I-again using developments in Iowa, interpretatively enriched by interviews with numerous legislative, executive, administrative, and nongovermental actors, as a sequence of microcosms.
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Ruth Malone, Editor

Congratulations to our colleagues in Australia who have just passed world class, groundbreaking legislation mandating plain packaging for cigarettes! More details will follow later in the journal’s News Analysis section, but this really is taking aim at one of the industry’s major marketing venues, the one smokers hold in their hand and regard many times a day. Plain packs will help break that bond, which is undoubtedly why the industry fought tooth and nail against the bill, pleading for higher taxes instead, begging for some other kind of regulatory reining-in. Kudos to Australian policymakers who stood with public health and made protecting the public a higher priority than protecting the tobacco companies. Of course, the industry has threatened lawsuits, but the Australian government is ready for them. The journal salutes all those who have worked so hard to make this possible, and we are proud to have published some of the research that helped make the case.

by Stan Shatenstein

At the end of June, the Foundation for Future Studies (Stiftung für Zukunftsfragen) launched the online project, ’United Dreams of Europe’ (www.uniteddreamsofeurope.eu), the goal of which was allegedly to offer “an insight into the European study of the same name to be published in autumn 2011. For this project more than 15,000 Europeans were questioned in addition to 27 in-depth interviews with Members of the European Parliament, scientists and students.”   It would all be so, well, dreamy, except that the Foundation for Future Studies is a creation of British American Tobacco (BAT) Germany, founded in 1979 and based in Hamburg, just another part of the usual scheme of CSR (Corporate Social Responsibility) whitewashing that’s now the hallmark of the tobacco industry. In the firm’s own inarticulate words, justifying the existence of the project, “British American Tobacco (Germany) believes in adding values to the community in which they operate.” (sic)   What must be taken seriously, however, is that BAT Germany has forged powerful alliances. The home page of the book project (http://www.uniteddreamsofeurope.eu/the-book) features José Manuel Barroso, President of the European Commission, sharing top-equal billing with BAT’s Prof Dr Ulrich Reinhardt, Scientific Head of the Foundation for Future Studies. And before anyone from the general public was able to post a dream, eight MEPs (Members of the European Parliament) from seven countries –  Germany, Hungary, Spain, Slovenia, Bulgaria, Austria and the Czech Republic – got the ball rolling by sharing their harmonious ‘future visions’.   Over the past couple of days, tobacco control advocates have begun to dominate the dream entries, sharply changing the substance and tone of the postings in ways sure not to please BAT Germany. It remains to be seen if the Stiftung für Zukunftsfragen will take down any postings or encourage pushback from BAT Germany employees, MEPs or other supporters.   Below is a slightly edited version of my posting to the ‘United Dreams of Europe’ site. I represent myself as from Riga, Latvia, birthplace of one of my grandparents, rather than my native Canada, so that my dream would appear on the main list, but entries may be posted from anywhere in the world.

Dream 351

Stan Shatenstein

from Riga / Latvia

So many people have posted thoughtful, even profound visions for a united Europe but my dream is that all who have written will post again and withdraw their names from “the chance to win a trip to Brussels”.

If it has not been made clear to you already, the ‘United Dreams of Europe’ is a campaign cynically crafted by the Stiftung für Zukunftsfragen (Foundation for Future Studies), an Initiative of British American Tobacco.

The tobacco industry does not sponsor dreams, it crushes them.

Professor Dr Ulrich Reinhardt, the Scientific Head of the Stiftung für Zukunftsfragen, and Chair of the Board of Trustees, has been, since 1999, Research Associate at the BAT Freizeit-Forschungsinstitut (Leisure Research Institute). Other members of the Executive Board include Peter Halacz, General Manager British American Tobacco Baltic and Ulf Bauer, Head of Corporate Communication and Policy, British American Tobacco (Industrie) GmbH, with these Members of the Board of Trustees as well, Ad Schenk, CEO of British American Tobacco (Vice-Chair of the Board of Trustees) and Michael Kraushaar, former Director of Policy and Corporate Communication Europe, British American Tobacco.

It is important to name and shame these people. It is important to be reminded that smokers and their families and friends cannot enjoy their ‘leisure’ years because smoking has ruined their ability to breathe if it hasn’t actually killed them off before they retire.

These soulless sellers of poison have asked you to pour out your hearts and share your visions of what Europe can be, but they kill Europeans – and Asians, and Africans, and Americans and Oceanians – for a living. The better they and their shareholders do, the more Europeans, our fellow men, women and children, will die prematurely and unnecessarily.

Even if you smoke, don’t allow yourself to be bought by these cynical death merchants who want to treat you to a trip to Brussels paid for by the misery and suffering of others.

British American Tobacco’s dream is everyone else’s nightmare.

http://www.uniteddreamsofeurope.eu/the-event

http://www.uniteddreamsofeurope.eu/united-dreams

http://www.uniteddreamsofeurope.eu/about

Policymakers to prevent Europe from suffocating

Estimated by the World Health Organisation to rise to the third leading cause of death by 2020, chronic obstructive pulmonary disease (COPD) is virtually unknown amongst not only the general public but also amongst many healthcare professionals in primary care.

COPD cannot be cured,  which makes prevention, a timely diagnosis and a therapy tailored to the patients’ needs all the more important, to ensure that people with COPD can contribute to society and enjoy a good quality of life for as long as possible.

In order to reduce the cost and personal burden of this debilitating disease, the European Federation of Allergy and Airways Diseases Patients’ Associations (EFA) recommends that governments:

• Cite COPD explicitly as a warning on tobacco products
• Make access to spirometry testing available to all those at risk
• Improve  cooperation between patients, those working in primary care and specialists to ensure a patient-centered management of the disease that supports staying active
• Induce employers to adopt flexible approaches to allow their staff with COPD to remain in the work force
• Support the mobility of people with COPD on oxygen therapy
• Fund research on how to prevent exacerbations
• Address COPD co-morbidities, such as depression

Several countries, including this example from Canada, do include a COPD warning on cigarette packs which could easily be adopted around the globe.

By Ruth Malone, Editor Tobacco Control

Cancer nurse and University of California, San Francisco graduate student Elisabeth Tove Gundersen, a member of the advocacy group Nightingales Nurses attended the Philip Morris International shareholder meeting today in New York City and spoke about how difficult it was for her patients to stop smoking. CEO Louis Camilleri, himself a smoker, said that tobacco “was not that hard to quit.” Gundersen told him that if he developed disease from smoking, she would provide him good care at UCSF.

Twenty years after the CEOs of all the US tobacco companies got up in front of Congress and swore nicotine was not addictive, tobacco company executives are still lying through their teeth!

I hesitated to share this commentary on the TC blog as I know anyone who questions the efficacy and safety of e-cigarettes is tarred and feathered as a “quit-or-die” prohibitionist before the “ink” even settles on the page. But, as many online commentators have discussed the perceived positive effects of recent e-cig promotion by celebrities, I think it is important to provide some balance to this discussion.

I implore all readers to remember that I speak strictly  from the Australian context and perhaps the political and social context are different in your neck of the woods. Myself,  Tobacco Control and the BMJ wholeheartedly welcome all civil debate.

This commentary was originally published on 11 April 2011 by the not-for-profit news and information service, The Conversation. I am the sole author and these opinions are strictly my own and not that of Tobacco Control.

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