Gates, Bloomberg Target Cigarettes

Billionaires pledge $500 million, but will it do any good?

If money were all it took, tobacco smoking would be on the run after Bill Gates and Michael Bloomberg jointly pledged last month to fight tobacco use worldwide, especially in low- and middle-income countries, through the Bill and Melinda Gates Foundation and Johns Hopkins University.

Mayor Bloomberg, who has been involved in anti-smoking campaigns for years, admitted at a joint news conference that "all the money in the world will never eradicate tobacco. But this partnership underscores how much the tide is turning against this deadly epidemic."

The program, put together by Bloomberg and Dr. Margaret Chan of the World Health Organization (WHO), is an ambitious, multi-faceted effort to be coordinated by the Bloomberg Initiative to Reduce Tobacco Use, the WHO, the World Lung Foundation, the Johns Hopkins Bloomberg School of Public Health, and the Centers for Disease Control and Prevention (CDC).

As Donald G. McNeil described the $500 million program, dubbed Mpower, in the July 24 New York Times: "It will urge governments to sharply raise tobacco taxes, prohibit smoking in publics places, outlaw advertising to children and cigarette giveaways, start antismoking advertising campaigns and offer people nicotine patches or other help quitting." The program also intends to bring "health officials, consumer advocates, journalists, tax officers and others from third world countries" to the U.S. for workshops and training.

It will not be the first such effort--far from it. Troubled by the rising tide of nicotine dependence among the common folk, Bavaria, Saxony, Zurich, and other European states outlawed tobacco at various times during the 17th Century. The Sultan Murad IV decreed the death penalty for smoking tobacco in Constantinople, and the first of the Romanoff czars decreed that the punishment for smoking was the slitting of the offender’s nostrils.

In America, the Prohibition years from 1920 to 1933 coincided with a short-lived effort to prohibit cigarettes. Leaving no stone unturned in the battle to eliminate drugs and alcohol from American life, Henry Ford and Thomas Edison joined forces to wage a public campaign against the “little white slavers.” Edison and Ford wanted to stamp out cigarette smoking in the office and the factory. Although that effort would have to wait another 75 years or so, New York City did manage to pass an ordinance prohibiting women from smoking in public. (See Siegel, Ronald K. Intoxication: Life in Pursuit of Artificial Paradise). Fourteen states eventually enacted various laws prohibiting or restricting cigarettes. By 1927, all such laws had been repealed.

Finally, Adolf Hitler himself took on the battle against cigarettes--and lost. In 1942, after letting loose a torrent of misbegotten screed about "the wrath of the Red Man against the White Man," Hitler, in one of the most aggressive anti-smoking campaigns in history, banned smoking in public places and slapped heavy taxes on tobacco. But by the mid-1950s, smoking in Germany exceeded prewar levels.

There is no evidence to suggest that any culture that has ever taken up the smoking of tobacco has ever wholly relinquished the practice voluntarily.

Photo Credit: National Health Service

100 Million Killed By Tobacco

WHO estimates 1 billion more deaths in 21st century.

The World Health Organization (WHO) estimates that 100 million smokers died of tobacco-related causes in the 20th century, making cigarettes the leading preventable cause of death worldwide.

The agency estimates that as many as a billion people will die from tobacco in the 21st century, if present trends continue.

According to the WHO report, “Global Tobacco Epidemic 2008,” almost two-thirds of all smokers live in only ten countries, with China accounting for as much as 30 per cent of the total. Nearly 60 per cent of Chinese men smoke cigarettes, the report claims. The other leading countries, in order of consumption, are India, Indonesia, Russia, the U.S., Japan, Brazil, Bangladesh, Germany, and Turkey.

“The shift of the tobacco epidemic to the developing world will lead to unprecedented levels of disease and early death in countries where population growth and the potential for increased tobacco use are highest and where health care services are least available,” the report concluded. Or, as the Economist puts it, “the tobacco industry is getting the world’s poor hooked before governments can respond.”

The Economist reports that the most powerful prescription for fighting the trend is higher taxes: “Studies show that raising tobacco taxes by a tenth may cause a 4 per cent drop in consumption in rich countries, and an 8 per cent drop in poor ones, with tax revenue rising despite lower sales. The agency wants a 70 per cent increase in the retail price of tobacco, which is says could prevent up to a quarter of all tobacco-related deaths worldwide.”

The eradication of tobacco use will be as difficult as fighting insect-born diseases, WHO officials say. The WHO analysis strongly asserts that “partial bans on tobacco advertising, promotion and sponsorship do not work.”

In a soon-to-be-published paper by researchers at MIT and the University of California, cited by the Economist, the authors claim that “the monetary value of the health damage from a pack of cigarettes is over $35 for the average smoker, implying both that optimal taxes should be very large and that cigarette taxes are likely progressive.”

In a forward to the report, noting that 5.4 million people a year die from lung cancer and tobacco-related heart diseases, WHO Director-General Margaret Chan wrote that the world has reached “a unique point in public health history as the forces of political will, policies and funding are aligned to create the momentum needed to dramatically reduce tobacco use and save millions of lives by the middle of the century.”

What are cigarette makers doing to combat these grim revelations? According to the Economist, “The tobacco industry is regrouping in order to focus on ‘promising’ markets and escape the pesky lawsuits it is likely to face in rich, litigious countries.”

photo credit: UCR/California Museum of Photography