Patients and the public in tobacco control and health

advocacyWhy and what is needed?

Mervi Hara, Executive DirectorASH Finland

7th ECToH, Conference on Tobacco or Health,

Porto, Portugal, 22-25 March, 2017

Why to talk about tobacco?

Cigarettes and some other products

containing tobacco are highly engineered

to create and maintain dependence,

and many of the compounds they contain

and the smoke they produce are

pharmacologically active, toxic, mutagenic

and carcinogenic.

Source: Framework Convention on Tobacco Control, 2003

Tobacco’s toll

• A common and highly dangerous risk factor

• 1 person dies from a tobacco-related disease every 6 seconds

• Kills around 6 million people a year,

600 000 are the result of second-hand smoke

Source: WHO

Tuberculosis and tobacco

• Smoking is a risk factor for TB, independent of alcohol use and other socioeconomic risk factors

• Increases the risk of TB disease by more than 2,5 times

• More than 20% of global TB incidence may be attributable to smoking

Source: WHO 2009

Tobacco industry

In 2015:

• cigarette retail values were worthUS$ 698,541.7 billion

• over 5.5 trillion cigarettes were sold

• More than billion smokers worldwide

• Industry analysts predict: retail value will increase by 37.3% over 5 yrs

Source: Campaign for Tobacco-Free Kids, 2016

Maximize profits

“Our strategy is focused on maximising sales, cost and cash opportunities to deliver sustainable shareholder returns.”

Imperial Tobacco, 2017, http://www.imperialbrandsplc.co

The Industry Says

”Portray the debate as one betweenthe anti-smoking lobby and the smoker, instead of pro-health publiccitizens versus the tobacco industry.”

Philip Morris USA, 1992

The industry wants

• Increase consumption

• Minimise regulation

• Avoid public criticism and liability

• Re-design products

Addiction is the key

Tobacco industry needs youth to replace those who quit or die.

People who do not start smoking before the age of 18, are unlikely ever to begin.

Avoid public criticism & liability

Legitimize themselves where they operate

• using corporate philanthropy

• funding “socially responsible” activities

• conducting media “trainings”

• funding supportive “research”, distorting science

Economic importance

In their own words:

”Tobacco industry is legal industry, it is a part of democratic culture: law-abiding corporate citizen, paying taxes and offering jobs.”

Re-design the products

“We’ve long promoted snus, … which is a proven reduced risk -product – but it lacks wide consumer appeal and availability globally.”

…. “with the rise in popularity of products such as Vapour Products (e-cigarettes) –that harm reduction has moved from a concept to a global reality.“

Source: www.bat.com, access March 7th, 2017

Designing Smokefree Future

“Now we’ve made a dramatic decision. We will be far more than the leading cigarette company. We’re building PMI’s future on smoke-free products that are a much better choice than cigarette smoking.Indeed, our vision – for all of us at PMI – is that these products will one day replace cigarettes.”

Philip Morris 2016

Source: www.pmi.com, access March 9th 2017

What to do?

Take all necessary measures to discourage production, marketing and consumption of tobacco.

• Forerunners and pressuregroups

• Make social ills public• Opinion leaders• Create networks and forums• Campaign

The role of civil society

Be strategic and focused

Develop a Plan• Clarify your goal• Work with partners• Develop key messages• Identify the messengers• Identify and develop multiple

strategies

Implement the plan!

”We hold in our hands the solution to the global tobacco epidemic…

The cure for this devastating epidemic is dependent not on medicine or vaccines, buton the concentrated actions of governmentand civil society.”

Dr. Margaret Chan, Director-General, WHO, 2008