the tobacco atlas
DESCRIPTION
tobacoTRANSCRIPT
DR JUDITH MACKAY Et DR MICHAEL ERIKSEN
WORIO IlEALTH ORGANIZATION
9-
'70~
o
o
3 Male Smoking
S'noking has been portrayed hy itssellers as a 013nl),. masculinehabit, llnkcd to health, happiness. Gi\IDAM-D fiU1CSS. wealth, po\\'cr and sexual " success. In reality, it leads tosickness, prcm.lturc. death andsexual problems .
Almost one hill ion men in the: world smoke - ..bout 35 I)t!rcent of men in developed countriesand 50 percent of men in
dcveloping countries. Trends in both developed and devcloping countries show that male smoking rates h.1\'C now peaked and.slowlj- hut surely f arc declining.However, this i5 au extremely510\\' trend over decades. and in
the meantime men arc dying in their millions from tobacco. In general, the educated man is gh'ing up the habh first. so th:n srnoklng is hcco,nlng a habit of poorer, less educated males.
(nina deserves special mcnucn because of the enormity of the problem. Comprising over 300
millicn male smokers. this huge market is. accorcHng to Philip Morris, "'the most important
feature.on the landscape."
UtJITEO SlAIES Of A"'E~ICA
BRAZIL
----.
Smoking trendspe:rtcnlage: of male: smoktfS1960-2000 wecled ceumrtes
81" C~1900 78% ~
19}'O
e6t .. O1960 S~ 0
1970 4~
.,..01965 .... 0
1910l8llt 0
millionmen in China- equal to tho
ontlre population of tho USA-are smokers
Japan
1980 61qtO1990 $4CIb
_ 2000
UK
1980 ll~.. 90
USA
197928<MJ
24 15 and ever 16and over 18 ind ovct- h p
------------ _ _.
10 Costs to the Economy
The .ohacco indY"r}, uses
economic argument.s 10 pcr(uiule go\-crnmenu. the nu:di.a .Ind the genc:r.tl populauon lh"'t -,",oking benefits the cconorny. It cuimJ
th.>t if tobacco control m.uurcsMe introd1JCt"d. t.a.x rMTnUCJ willfall, Jobs "ill be Iosl .and there "ill be g"'.IIu"I<hlp 10 tbe econom}.
But the indwlry greo"l}' cxolggeralC51hc "CUflOfnic lu~, if .my. which loWcco control measures \\;11 QUSC and theynever nlt.IHI(ln the eeonomle ro~LS
which robaoco Inflict:.. ul)un e'er) country.
Tobacco's cost to go\'crnlnen~.to employe r s and to the environment includes soci aI.
welfare and health care JlI>eluJing.loss of foreign cxch.lnge In
Smoking accountedfor over
of total he.hh ""r. expen". In the USA
In 1999
Average days off sick6.16 per year in the USA
1001
HeHa20cN
in11)4)rting cigdrCth:.s; lu~suftuut that could gru\\1 food: <:':):-l$ of Ilres and dJJo.lgc to hUihliugs caused by careless .'Illtuking;environmental costs """ging froln deforestation 10 collection of smokers' litter • absenteeism,
decreased 1"'o"u<l1> il)'. highernumbers or 3ccidcnll and higher
insurance premiums,
Trash collectedin the USA43 st31'" 1996
oga~l1t b~tts);,_ , 20'l10
;Co< ~t!:if:r:•.,:l:_"r·
40
4.53
! I
~I19 16
-
I
1 t Costs to the Smoker
The economic costs of snloking to smokers and their Iamillcs include rnoncy spent on buying 10000::0,\\'hidt could otherwise be used on food, clothing and shelter, I'mil), holidays Or a car.
A. smoking kills. quarter of .11 smokers In the.ir \\'orklng ye ..rs, Jimoking deprives the ltmokcr's (amity of ,nan), yean of income. Smokers also suffer loss of income through illness. FoUo\\ing a smoker's prenlluurc death, a partner. children or elderlypJ.rcnt5 can be Jcli destitute.
Folmlly members of smokers Jose toccme througl1 (line taken looking afeer smokers when they are sick, and time lost lOlkingthem to hospital. In somede\tcloping countries a hospital\fi~it can 1:3k(: days,
Smokers also have to shoulder flightr health Insurance premiums. and nlany other mlscellaneous costs, sudi a5Ina'CAscd wear and tear on .heirhome, IS \\·('11as increased fire risk.
Minutes or labour wortcdto purchase 20 cigarettes2000 stlectt:d c:itits
tID internalional brand
EEB 10<01b",nd
62 62 -20 23 23 20 20
IIIrm UlJII IIIlIII ImllAbu Dhlbl Copenhagen Jak.rta Johannesburg Montrial Mumbal Nairobi Santiago ShlngMI W ......United Arab Denmark Indonesll South Africa Canada Indl. Kenya Chile ~il'\l Poland
Emirates
42
2 Types of Tobacco Use
Manufactured cigarettesconsist of shredded orrcconstitut c'<1 tobacco processedwuh hoodrcds of chemicals. Ofcenwith ,\ Iiltcr , they are
manufactured by a machine, and are Ute predominant form of tobacco used worldwide.
Bidis consist of .I small amount of
tobacco, hand-wrapped in dried tcmbuml leaf and lied with string.
Despite their sn1311 size. their Car and carbon mnnoxlde deliveriescan be higher than manufacturedcigarcuC$ because or the need to
!,ulT harder 10 keep bidi. lit. Cigars arc made of air-cored and fermented lob.1OCOS whh :. tobacco\\"-"ppcr, and come In 11lany$Ilap~..: and sbcs. from dgart!lh:-.IIi1..cclcigarillWi. double COrOllA!,
cheroots. stumpcn, chuuas and
dhumns. In reverse chuu.) and dhumtt sllloldng, the ignited end
of the cigar is placed inside the mouth. There \\'~Sa revival orcig..u-sllloking at the end of the20th century .... nong both rncn anti women.KrClck8 arc clove-flavoured cig~rCltcs. They contain a wide rJ.nge of exotic na"ourings and cUSl:nol, \vlti"" ha." an AnaeSlhctising effect • .;tllo\\'ing fordeeper smoke inh.13lion.Pipes are made oflu;.1f, slate, Cl.l)' or other substance - tobacco Is plnccdln the bowl and inh ..lcd through the stem, sorncumcs
tJ1fough ,"at cr.Sticks ere 11l,.ulc frOIH sun-cured tobacco 1:nO'\'11 a~ hrus ;a11(1
wrapped in <:igolfCUC paper.
Cigartttts arc: aViilablelhrOlJ9hout the world.
Filter-tipped d9afcu~ art usually more populir than unfil'tled cigirettc:s. Hind
(olled cigarc:ttc:s ate also widctv smoktd in many
countries.
Cigars arc smolted throughout the world,
Regional varialions indudc: cheroots ~nd stumpc_n
twol'(rn ind central Europe) ind dhumtis
(conlc~1 cheroots) used in India.
.''legion and
parbof Asi a,
T~t'CO is ust'd orally Ihroughoul Ih. wo~d. but
princ1pitly In Southeast Asia, In Mumbai.lndia, SGqt, of
women chc.w tob~ctO.
22
9 Deaths
Cigarette, kill half of all lffeume users. Half die in middle age -
between J5 311(169 yC.lrs old.No other OOI1!IUnICr product is
as dangerous, or kills as many people. Tobacco kills more than AIOS, leg.11 drugs. illegal (frugs. road accidents, murder, ':UH)
suicide ccmblncd.
T obacco already kills more men
mendt'Ytloping cecrnrles
1.B million
womenindustrialixd countrio
0.5 million
me"in (Ic\'cloping countries than inlndusrrlaltsed countries. and it h: IikeJ)' that deaths 31'I1ong women will won he the same.
While 0.1 billion people died from tobacco usc in UIC 20th centur),. ten rimes as Illan), will die in the 21s1 centur),. ~1atcrnal J",oklng during pregnancy is
responsible for rnan)' foetal deaths and hi a 150 a major cause ofSudden Inf,nt Death Synclromc.
Passive ,uloking in the heme. workplace, or in public places also kill!!. although in lower
numbers. However, those killed,10 nol die Ircm their own hahlt ,
but feorn someone else's.
wom~dcvt:loping co'Jntrits ---
0.3 million
Total deaths Prcmaturc dc:.ths
from tobar:t'Oworldwide:
2(}(J()
,otold .. ths4.2 million
men3.4 million
w"""'"0.8 million
-indu!llnaliSfd c:ounlri~1.6 million
Cbtklrcn lire Jl particular risk Ircm cdclts !lIuoking. and even
slnC)king IJYother adults aroundit pregnant woman has a harmfuleffect on a foetus.
of everyone alive today
Past and futureAnnllil deaths due to tobacco cltitNted wOf'ktwide'950-2030 pro)«,td
will eventually be killed by tobacco
3 million
7 million proj<Cttd
1.32.1
million
pro)«,.d
2025'0
20300.2
millionnegligible 1975
1950
2.1 million
2000
to2030
••
36 Industrialised countries dtvcloplng counlries
j
13 Manufacturing Tobacco
&.ch )"c')r, ever fht: trillioncig~r('tlCJ.a~ m.anUr~ClUraJ.
China is b), r.. the brgeSt dg~reltc rnanUf.lClUrc·r. folln\\'etJhy the: USA. Chinc,\c agarel"'! production tncrcascd from 225 billion dgm:llCJ annuall), in 1960 to 1.7 trillion II. ycar in 1995 • .1
seven-fold iucreasc. TheCCOI1QIT1ic value of toh.1cc:o products I~vast , tOllllinghundred. orhillion. or us doll ....,) YC.Jr. Very Ihtle' o(,hi .. Illon«'1 b: spt:nt on \ol\KCU ibClr. ~'ore is spent on fNpa. nher,. ~ntl~ng 1Iw. on tol"""",.
NCMly 2 million people .lUemployed In d~ tnJnufoKture oftohacco prndllM~. t\\·o·ddrdJ ofwhom are "'orklng In China, Indl~ and hlllol1f'!oloa.Joh In~!i('$ whlch would rc~uh flVnn 3 reduction In loilolrol ("lnSutnllllnn are estimated to be fairly small.'·cchnoIQgic.l1 ,uJv.lnOCJ ill hoth filnlling ,uul Ill.anuf.lcturing have ;) ",uch IArgtr Iml~r.'t nn JOMthanlob.lcco control ('ITort"
l-IUI1Jr-cd~or d,elnk;al.) .aft'
",lcJaIto tob.acc:o in themlnufocture or dg.arell es,Addlti\·~s make ,",,,kr e.ldcr lD
Inhale into the lung •• nd .lIow for
........."" -
le~~ tohOlCQlIn be ueed in ciU:h
dg.1rcttc. 'roda)" ~ ciwarc·u.·J Art
highly englnecl'(·.I. c.qul.ltcly deli:lgncll"lIicotlnc dclh·(·ry devtees".
[ksldCJ mlng h~J' tcbaecc per dg;arctlc, the l"'tJlnpo~ltlon of , he
Wh~~ the tobacro dollar goesFor ~ry dollar spent on tobattO In Ihe USA.,.
~
.!".l
s.c..,. of the.,. of lddlll..s
ItId of.tl.tr
dgOlr<'ttc b 011\0 ch..1nging.~l;,nur.lcturl'nlllr(' udng mon'
~ tcdtnologlcs. sud!• IS "'nllmng- .,.~
rccoll,thutC'.1 tub..1t'CtJ. "hieh :•;;
lhc UiC or
nlakC':s it (',"Ier 10 ..dd cllClnic.lIJ.&n(110 inclu.k-Ic .. ralrln ....uu.l dust
"hic
h h.d »1'(.'\iol»ly been dlJC.n1ed.
-...
48..~........ .e.N
~ -_.llIl-C<l
II> Imondlm
dptllt.
14 Tobacco Companies
Philip Morris is the world's larg(!
$t transnational tobacco colllpaJ\y. whose Marlboro brandis the world leader. In 1999 theconlpany had sales of over llSS47 billion. However, excluding the US domestic market, BAT sells the mostcigareut>.5 worldwide and has the largest network in the most countrlcs.
The. tobacco industry is amixture of some or the mostpowerful tr.lnsnationalcomrnc ..cial companies in the world. T OblCCO cornpanlcs, whlch frequently merge, ownother huge industries and nan an intricate vartery or john Ventures.
State tobacco monopolies havebeen in decline slnce the 19805. About 7 .000 medium '0 lilrge
state-owned enterprises were privauscd in the 1980 s and 3
further 60,000 in the 1990 .. Ircr the collapse of the former Soviet Union. From the late 1990s. the lr.-iF has pressurised countriessuch "-'I the Republic of Korea, tileRepublic ofMoltlol", Thailandend Turkey to prlvettse their state tobacco industry lL'la condition of I03N.
The remaining monopoliesrepre!W!nt i\ cemhlnedcousumptlon of 2 hili Ion dgJrctttS or -40 percent of the world's total cigarette consumption.
Since the carly 1990s, Ute cigarette companies lta\'c
m;ul,h'cly incrc;)~ccl ,heir1l1"lluf3cnlring capaol)' intlC\'c1ol'ing countries and eastern Europe. where once the rich c:ountrie:t c-xpurh .-.d ..death I1ntldisease", inlTcasingly these arc manufactured loeaJI)'.
50
"We see the new :t' ..,."..,L markets openinq up --,., in Central Asia andthe Commonwealth ofIndepondent Stato. A8 really belnq the future ot BAT vell
into tho noxtcentury."
BAT. 1994
leading manufacturer by country
headquerters location of major uansntlllontll tobacco companies
• Philip Monil
• British Amcnc.n reeaeee (BAO
Japan teeaeee Inu:rnation.1 UTIJ
• R« ... ta
• Altadls
\-
Au•
n
CONTENTS
Eor:eword 9
Dr Gro Harlem Brundtland,Director-General. wo-ld Health Organization
Preface II
Ackno'''')cdgmcnts 13
Photo Credits 15
About the Authors 17
I The History of Tobacco 18The global.pread oftob.cco from the Americas to the rcst or the ,,'orld. Hi~lorjcal h.ighlighu: of kc~' c\'cnlS aud action taken to curb the epidctnic.
Part One: PREVALENCE AND HEALTH
2 Types of Tobacco UscDifferent forms of srnoking and other forms of tobacco, Inc]uding cigarelle5, pipes, bid Is, kretcks.
22
3 Male Smoking 24Smoking prevalence among men. Trends in$cle<.1CdCQuntric:r,Srnoking among physidans,-'01' 10 countries. Tobacco industry quote.
4 Female Smoking 26Snloking prevalence anlong women. Trends in selected countries. Where women smoke ;\1
mllrb ,)S W,'I) Wh"rc Olcn smoke IPO rimes
as much as women. 'Iobaceo industry quote.
5 Youth 28Tob ..ceo use prevalence lIlnQng male and female)'0\1111. 1'.."lvo smoking. Youth perception of,moking. 'Iobacco indw;try quotes.
6 Cigarette Consumption 30Annual ciga.rette consumption per person.Top 5 countries. GlobaIlncreues from 1880 to2000. Increases in the .a\·cruge number of cig.rettes smoked ill China between 1952 and 1996.
7 Health Risks 12
How smolting har"" )'ou. Smoking in pn:gnancy.Deadly chemicals. Proportion of lung cancer, COPO and ischaemic heart disease. Tobacco
Industry quo,es.
8 Passive SmokingH .. m caused by pass;"e smoking. Chi.ldren exposed to paw"f! 'molting. Numbers ~fT~ed by push'e smoking. Tobacco industry quotes.
If Deaths 16Deaths from tobacco use In men and women.Dying In your prime: 35· to 69-year-old., \vho die from tobacco, PaSI and future deaths from tONeco:1950 to 2030. Deaths in developed and developingcountries. Number of people alive t.O<iay ,,-ho will c\'Cnlwlly die from tobacco, Tobacco industry quote.
Part Two' THE COSTS OFTORACCO
10 Costs to the EconomyHeehh care com attributable to tob.tcco_\Vorking cb)'f lost due to tONCCO. Co$1& of rires and liner collection. Tobacco industry quo, es.
I J Costs to the Smoker 42
Cost Or I, pack of Marlboro dga.n.-nes or equlvalent
international brand. ~"inu(cs or labour worked to buy. p.ckel of dgM'Ctlcs. The CO>l of. peek of,P\1arlboro dg;u-eucs or equivalent intern.ltiorul b rand compared with food or clothing.
B
19 Politics
The tobacco industry spends
million. of doli ars trying '0Influence public policy. It makes major contributions to elected
officillis and political parties, p.l)ments (,0 go"cmmcnlS to support infrastructure such ismass tT.lnsit and large investmentsin sophisticated public relations campaigns. Tbe industry also gives money to civic, educationaland charitable organJ~tlons and ahost of other s.
Since 1995 US tobacco companies
have donated more than S32 million in political contributions to state and federOlIcandidate, and political parties in the USA, with over 80 percent of
this paid to influence federal elections ~ntl ofllceholders. From1995 to 2000 current members of
the us Congressluve received over SS million in contributions from tobacco companies, and
nearly six out of ten haveaccepted tobacco nloney.
The tobacco industry snug!lt to delay. and eventually defeat, the EC directive on tONCCO
advertising and sponsorship by seeking the aid of figure5 at the
highest levels of European politics while ill times attempting toconceal the Industry's role.
Parliamentarians in Europe have accepted money and even senior
positions in tobacco companies.T obJCCO companies .1150 .lttcrnpt
to influence the political process, by sub,ldising the air travel of candidates and their .talT. funding political convemions andinaugurations, and bosting
fundnisers. As well .. ampaigo contributions. tobacco companies
conduct direct lobb)ing and sophisticated public relauons campaigns. induding paid medl •• to influence the opinions of political decision-makers,
Comprehensive tobacco
legid.tioD was dcf .. ted in the US Senate in 1998. Those who voted against thelegl,!ation Iudreceived on average, nearly (our
times as much mooey from the tobacco industry in the two yeal'S before their last election, as these\\'ho voted in favour of the bill.
Bu}ing Influence and f~\'oun
through polttical conttibudons lscommon practice; however, most countries do not require
mandatory reporting.
-r-rll'.~
'III"
Smok,l", Iebaeee COlIn';l S,l;BI.... -_~
teeeeee In.Stitutf $2~ 1 m
$3.7mBrown Eo WIII1.mson (BAn
$4.1mUS Iobaeco Company
S5.4m
Buying influenceExp.nditurt on lobbving by
US lobaeea comP~l'IjtS USA 1997
~.JJI1
RJ RcyooldS
loll': $35.5 million
62
.
legacy w~bsit~ _
N_mba of docu01C1ln <d.ting 10 tach to_nlIY foundon thr Legacy wtb~tr of tobacco industry docvmcnts 2002
"'. high., 111<figun:.lh. morr:impc$nllht .... nlry isto tht induslly.
• 5.000 ond ._
• 1.000 • ',999
• 500-999IUSS'" 100.'99
ffOIIATIO"
"nett 100
no dit'il Of othtr countries
_.-"-
'_-.
- --
...•.....
--- ._.
.J.'•
-A.i. 1a nov tbe priority tarqat tor the
world anti-tobacco movement.
W. Ihould re=-mb,r that .1U.S. cigArette oxport. toAI:itl account for 010 •• to
70' of our volume and97\ of our profit
The 1,nplicatlonl for our bUlino,._'hould this lOBqua
be succe •• ful,ftre
aignificant.*
-Naturally, .o~ pooplovill suspect tbat we at
the Tobacco Institute have.pent .0 long fi9hting thecl;.rette controveray thatw. hAve become 4 little
paranoid. But let me •• aureyou that paranoia i.justified. They are
out there: they are out toc;et U••-
Tobacco Inatitute,USA, 1979
-document retention
policy, •
BAT'. description ot the policy und.r
which tbou ••nd. ofincrinJnatin, docu=ent.
wer'e destroyed.
.... P.hi1 .... iioir.ri.·ii·.1.9.89•• I11 ••••••••••••• 1.••••••••••• 67
16
"_pritt Is only OM of m,,,v radon that influmcc: ""u9gling rates. Other mort importlnt f.ctOl'l include: 1M tobllXJl)
Incflolrtr(s own role il'l '1c:l1itatingsmuggling; th~ I,el. of ,ppf09riatt
controls Oft tobattO ptocfucts inl"kmltJonal tn6e; ,rld the txi1.tcfttt of
ttmenctltd s.muggfil'lg MtWorits, unUttnstd dlstritwtion. 1&lCanti~
P''''99lin9 l.awl,wtil" cn(on:~tnt andotrtd.1 corruption.· WHO. 2000
S(
Between 300 and 400 billion ciglrettc.J were smuggled in1995. equal to about one third of.11 the leg.lI), imported cig.re" es,
ClgareLtes are: the world's most"'idel), srnuggled legal consumerproduct. They are smuggled J.CTOj$ almost c\'cry national border b), constantly changing routes.
Cigarette snluggling ColUSCSImmeasurable harm. lntcrnatlonal brands become affordable to low- Income consumers and to inlage. conscious young people in developing countries, Illegal dgarettes evade lcg.u restrictions end health rcguJation3, end while the tobacco companies reap their profits. govemnlents lose tax revenue.
Some govc,mlncnLot arc now!lulng tobacco coulpanics for revenue lost due to sinuggling,cti"itic. allegedly condoned bythe companies. ]\ie:.tS'UfCll needed to control ,muggllng should include "lonitoring dgilrctte routes, using u:.chnolc)giClllysophlsttcared tax-paid m ar king' un tobacco predccu. printing unique serial numbers on allp.ckagt. of tobaceo products, and
UNITEO S1ATl'S Of AMERICA
Projtct1:4 ,h.reif no .ttion taIc~n
ProjmrdWftjf new rMuym; .-t taltm.nd dllty InCft.st4 by ~
..
Tax few:nue lost for am kIny 50ad smugglC'd Into the EuroptJn Un.ion US$ 1997
incre:ASlng pcnaltles,
54 ...Tackling tobacco smuggling
Ciga/cues smuggled Into the UK~s perccntage: of markc:t $hIre
1996 - 2004 proj«ttd
lIvt. ,nlm.1s$24.000
Mllk powd.,$36.000
shI,. ,I\
t 8 I Internet Sales
"'The ..... ..- to 5<11cWiM wwW k easy to ,.ck ...be: IIIIUth dtt.., thM .IuY, cN,rfed
at dte. rttall co..ettf. and be cn'ttt!d by tent .f ",UItOflS .f ptOf* C'Vtrf • ..,.
o••rrttn. the inttmet w •• "" .. fot you."OrAd 5t:ttltfrt;, lVog,jngfOtl fort. 2000
WHERE ARE THE 600DS?
Ciga.reue vendors ;'Irr "cry e.uy tolocale: onUnc;: by tht' jhnplcst5CarciJ medt.1ni~l1ui.
1"hi. mode or perch •• etnnslatcs tnte global penetratfonof tobacco produets, unprecedented ..ccev or dg~retteJ '0 minon, chc~peignett es through I.... oklonce.u>d smuggling .... 1 unfettered ad venWng. mukcting.u>d promotion.
It is often In'f'Ouiblc t.o identify the country of origin of sneh vendors, The m'jorit)' '1'1"''' tobe In Europe .n,1 the USA, btltcounrrtcs as \'.rletl .loS C)'llnl~anel P4.nanlll JI50 offer Internet Ales, Str.1ngely, some vendor •• eke credit card dct.II, fromprospecttve purchlJer'lC hut then neither chugc ItOr ,U'p'tch .nydglrctte.t:.
Iert orduing (rom 12 websiltswhich claim 10 orrer low prite ciguetles10 the UK mutet 1001
12] situ sut ciglreltu
lite chuged but did Dot srld cigutttes
situ toot 10 .. oary and srot 10 cigurttu
Pritu quoled for 200 ciglreltu I'ClO - £271
Rcllil pricc in UK 1£38.60
Prier In UK If Inluceplcd by Customs I (38. IS
The Internet 1"1,,, used by tob.acco intc.rc.u to undc.rulc.c sophisti .. ted public rclatioru. to denigrll,c pro.ht,hh o~»lit..ationJ and Individual., to undermtne t~
science of'tobscec, and 10 "U;'Ick
tobacco ronlro11cglsliatlnn (see m,l' 20). Legislation has not yelQught up ,,'htl this new threat to
"Most sites off~ring cheap cigardtes are a rip off. All cigarettes bought via the lnternet must bear UK taxes. There arc no allowances or loopholes. Cigarettes bought from sites that do not arrange
·Philip Morris admits being behind Wav~sn~t website. an internet company set up to run fashion parades and rave parties where cigar~tt~s are sold at a discount."
health.Sale. of dgolrclICIIllnd other
forms or tol~(!oo over theinternet started in (,.lme~t In the
mid.I990s, and ". prrtllct«1 to rise In (uture.
60
payment of UK taxes arcliable to forfeiture. In the last year Customs have destroyed over 10 million such cigarettes:
HM Customs and Excist. UK2000
AustralianPress. 2000
Associated
'
"""
. • Tobacco
-
20 Smokers' RightsOrganisations
..• ..F.O".M.'.-:l-S "t
-.-·~"Ift·VJ,,'''Roum
• Stidldf'lg Rolen kLlngm
$_
kt(f_rtJoOn
dttta
lISt• rcw;es ta~ ..
• Amf'ric:a.l'l StnoUft-AD~t
• tu\)Of\ll Smolrl1AlIl»!«
.. ",'-"-"
'd_Cl-ub
• A\WIC'!IlJOfW
Itallal'll hollla1Oti• rdcftlllOnC
J'NcoI
The 10h"(,NI Indu\:lry h ..~ long "ppl"CdIUt.~) rhe In1)"'H'UnCC 4nd difficulty "f rnohilbing smokers to """,k QU' on !>d,.lf of .".ok ... • rigll ... Con sequ.n,ly the toln= comj)o'nif'1 hj\(' 1nv~tig..ted ~Y. th.u th.), c;oulrl",tlmulote" the development "f grouP" ofsmoker •• ro .-" 10 I"" e the~\lPIKII1,or at I....).. the"ppe.lr ..nee or J"I'l'ort frOIl'14moker. :Hul other "11111t1r,,u1rthtrel p.\rty allie.".
'rh('rC': are fewer than two .Ic,zen,S,tlokc'''''' rlgll1~ ol'g .. nl!loilll(I1)~ 111 the wcrkl, anti 1'11.1arc ill 11M'
developed world, 11", luh.atu)
inltwlry c)tK'\U\l('nl.l
IlIu'lr~lcth"tw hile Itl.1.ll)'or IhclloC
org.lnlj,ltioru
purpon '0 he incl<p<n<len. of theloNeco lncfu,"u'Y'''' 'e.1~totOmt'.1t'f' cft'~"d('nt on tob.K"ro
64
ctJ1npany funding. In 1 1988docemeo t, the 1...4d of Philip~'orri;: Aid. "Should "'C .trhc toset up fOREST .~"., orgmis;1tioftJ throughout our reg;orul".
A. the request of PlUhp MutT" the public ",11I1ons flnn ofErunon-~'arltell,)r formt'tl,hc N at ion.U Smokers Alliance •• smokers rights group, in 1993. Philip MorrlJ Initi,lIy pro, hl.<I the N,tio",,1 Smok .... Alii,,,,,,,,\rlth $+ milllen In s("("(1Funcllng.l)oc\lInent5,ho\\' thiU I'hUlp l\lorris ronntt'Il\i!nilar grtHII." throughout Europe. 11•• ..- "gnwoo"" groups.
.In.
"ith ~l('irf.ad •• o(-independen",," fromthe indwtry •• llowed ,r..,m.o do.nd .. ,. thinG' pilltlid~tobacxo ronlfW1lt"' could ",.t .
-TO .u= up, thon, on using our natural allies_ We have ~d. a start; we hava provod that it con be dono, we have found that
the),con be 4 very efrective
torce; and we intend to
do more in the future .-.
PhiUp "orrlo, 1985
7
Tobsceo is ""eked ,,,th lurmful
I Health Risks
.md addlctive JUMl,Jr\CCj.
SciendOc evtdence has Jho\\'nconcluslvely ih ... 11rom .. oftobacco cause health probteus'hrougholllilfc, frequen'lyresulting In death or disability.
~adly dlemials
reeeeee smo~ C'Of"ta tIS over 4J)1JO~".
'0"'" of wlUcll ......." narted om,."_,csJl'!d ~ 9) 3tt \nown 01 ~t:d ca-rO~
Smoke rs hIV. markedlyincreased risks or muluplecancers, particularly lung cancer,.md arc at f.Jf gr(!"l~r rlJk orhc.t.rt disease straltct, emphy sem. andm.lny other fat"l.Jnll non·f.ll.ll dlse ases. I( ther chew tolwcoo.,hey rl!k """",r of ,he lip. 'ongueand mouth.
Women JulTer .tddhioml hc::~hh Ti,;". Smoking In pregn.ney b d.lngcroulC 10 the mother ~4 wellas 10 the f<.ctu" espedAlly In I)oorcountries where health f.cllitie,arc lnadcquate.
Malenl,.1 sll'Ioking II not only hamlful during pregnancy. hut Ius long.'erm dTcCtJ 011the bobrafier birth. Thl' b ofton coml"'undrd by .. posure '0p»!i"e .moking rrom d~ mother. f.,hor or other .dul .... "aking.
While tobseeo kllls ",1111".,.mere than I, help'. re>cw itunder'''",y c.xamining Mly poJJiblchealth bcnCnlS or nicotine anti also tf)1ng '0 Ilnd ••• fe use fortobacco, por,lcul,,,I), In 'he Iletd of gene1ic n'o~lIn(·;uICin. 11,c aim Is 10 prOdUL'C \'~{."Cincl or
hUln311 protciru fc)r Il'I(!t,II,: ...1 use, or even'0 clean up loll lbo, h.u "<CI1contaminated \,'Ilh C'.JCploJi\'el.
32
Babes in the wombSmoking in pregnancy
tncrt.~~ riJb:Sponta.""" ._ I ml>Clm.tg<
tttopcp<t<lN ..... AbnopbO plae<ftox Pbctntl prHV'~
Pttmatu1't n,;pUltt of d\c ".cmbtanaPr .... "'« bo""
FoetuJ.:Small« Infan' (for~,"""".I.i')
Stillborn InrantBirth d.rO<1S. '9 congenital limb redu<tlon
Incrc:aStd nicotine r«t:pl011ln babY's brlin Incr.. std IIltlihood of
Infanl smollng as. ,ren.g<lPossible pliySl<a1.nd 1IIt",.1
10ng.'tmI.Heeu
Tobatco smok. includes as feurld ,n
Atttonc paint Jtri pptt
AlTimonil:floor
dafter Al>cnle ant polson
Butane lighttt turl cadmium
Clr ~tttriacarbonmono»de: Clr c,xhaust
(umelDOT
In..ctitld. Hydrogtn <yanid. 9" "".mbtn
Methanol rodttt (uti
N.pthal... mou' bill.Toluene ,
""Vinyl_.
pI•• tics
Emy cigar"'. ta),67 tninliits off)'OoJ'
life:
5"'If"..""" .. ttl twft ._., '"'-
1InOkw.,. rht id"'tty will ItdiM. jvrt a• popubrioft whic:h 6of:I ..of 9fw bil'tt'l
w,1I ",,",Nally chriadlt."JU RcyrIold1rne.rtMr. " ..
The o\'Cr\\·lltllrning n1.jol'l\), of smokers begin tobacco U~ before the), re ..eh Jidull_hood, Arl'lung
those young ),)(:01'1(' \\·ho S"lOL::c:. nearly Qnco<lu.1ncr Jlnoked their fir.!!l dgart"!ttt before: they reached the age of len.
Several f"ClOrJ "'<TeASe the risk
or youth .. nuking. These include tob.o<co induslTy.d •..,niIing.mel promotion, ~y .aCU'U to tob.ac:co producu • .and 10", prices. Peer prenurc pl"y. Animpon~t role
through rocnd' and .<lbling.· smoking. Other risk faCiors aiSociatco ,,·lth )'uulh inloldng include having a hJ'''cr lk:lf.hni)gc lhan peers, and pcrOliving that tohilt.'CU u ..e h, norfH~1 (lr "CU(,'" •
~'13.nystudies show tllli p",rcnl:.1.moking Is .<..oeh,,~1 with higheryoutt, )IHoklng.
While the most eeriou. eiT...... ort~ we oo"nally occur.rtcr decades or smokIng. there.a.rc alJO imnlnli ..te n~;a'h'c beahh tiTccts ror young .mok ..... Most """'go moke ... ar e a Ir•• <ly adc.liC1('d \\ htle In le)olt'Sa".nCt".The younger. I,,·.. on ""gln, to smoke, the gr('.lIrr lht,· rbk orC\IC'HUoIlly COlllr.1C1ll1g !lIloklng.
CJUlICJ ,IIJCIM!8 aueh 1&) cancer or Ilc_,,,rt d!.(!:&set
The higllC't yo,lIh IIHoklng r.l1escan be rounelln ern,rJI andEa.ntm Europe, M:ctl()nt ur India ••lIltl some o( the \VC'.,crn p.lC,nCbb.ncIJ.
28
o
Ukn",)
gl,l. Youth
ft_ "'an SIlo of youngpcop1.
in 1Io1la ..... 110'-' Cosu Riel. Indonnia, Malawl, Mon
'.serrat.fot.nd. Ru"lo, Singeporr.
and Vtnrzurla thinkstnOkt look mOft auracllvt.
of young peoplo who continue to smoke WIll dIefrom smoking
Euly smokers0... 30'lIl of child ...
5moktd thd, first whokOg.rrtlt before age 10
in Ghinl, Grcn.cta. Guyana. India. Jam.jca. PaI.u.l\)f.nd.
N M.rianailland<.nd 5t lucie.
oof chlldr.n worldwldo
ar. oxpos.d 10 p.. slve smoking al
home
I
ACKNOWLEDGEMENTS\Ve would like to tlpnk the Centers for DiseaseControl and Pre\'erltion (CDC). USA. for providing financial upport for this atl ss.
Many people be e helped in the preparation of this atlas. Firstly QUT Ih.mks to all those at the World Health Org ieation:
Headquarters, ~encva:Joycc Blecker, l'ionconlmu,niC3blc Disease
Prevention and Hchth Promotion (NI)H), Noncommunicable IJisc.1SCS and Atcnul Health Cluster (NMH);
Douglas Bertch r; Tobacco Fr(..'CInitiati\'e (10FT),Noncommunicable Diseases and Menr ..J HealthCluster (NMH);
David Bramley; Health Information
M.lnagclncnt and ~issemination (lMD). Evidenceand Information fOf Polic)' Cluster (EIP);
Glan Luca Bur . Office:: of the Legal Counsel(LEG);
Vera Luil:! cia COsta e SiI,'., Tobacco Free Initiative (TFI), Ndnoommunieable Di •eases and Mental Health Clutter (NMH);
Emmanuel Guindon, Tobacco Free Initiative(Tf'1) Noncommunicable Diseases and Alent")Health Cluster (N'r'H);
Ewa Carlsson Hoppergcr, omce of the LogolCounsel (LEC); j
J>r.lbholt Jha. COmmission on ~1~crocconomics and Health (CMH), Evidence and Inform .. ion for Polic), Cluster (Eli');
Ala.n Lopez, E~dencc and Informatinn forPolicy Cluster (EI~);
Garrett Mchl, 7onoommunrc.ble Dlsease Prevention and Heahh Promotion (NPH), Noncommunicable Diseases and Mental HealthCluster (NMH);
Dianra ~1uno,.tI.I Noocommunlceble Diacoue Prevention and H Ith Promotion (NPH), Ncnccmruuotcabl Dlseases and Mental Health Cluster (NMH);
EI AtiO Musu~ I', Tobacco Free lnittatlve (TFI),Noncommuulcabl Dbc.SC4I and Mental Health
Cluster (NMH);Pekka Pwka, ~oncommuniahlC Disease
Prevention and H alth Prcmcrlon (NPH), Noncommunicabl Diseases and Alent ..1 Health Cluster (NMH);
Leanne Ililey. Noncolluflunh.:ahle Db.('<L~
II
Prevention and Health Promotion (NPH).
Noncommunicable Diseases and Mental HealthCluster (NMH);
Paula Soper, Tobacco Free Initiative (fFI), Noncommunicable Di scases and Menul Health Cluster (NMH);
Derek Yach, Noncommunicable Disuses andMent.1 Health Cluster (NMH).
Regional offices:Karen Kltmowski, Charles [\1"""ngo, AFRO,;
Fuimah M S EI AWa, EMRO;Pats), Harrington, Haile: Nikogoiim. lone)J. Petrea,
EURO;Heather Selin, Armando Perug., P.~HO; Martha 0",,;, SEARO;Hu·ley Stanton. WPRO.
For their advice on particular nllps and subjects,"'C would like to thank the: follO'oving:
2.. Types of Tobacco UscSami .. Asma, CDC, USA; Prakash Gupu, Ta..Institute or Fundamental Research, Indla;
1. Male Smoking and •. Female Smoking MarlC) Corrao, Alnericiln Cancer Society. USA; Amanda Sandford, ASH UK:
S. YouthCYTS Coordinators; Wick Warren, CDC, USA;
6. Cig..reue ConsumptionTom Capehart, Economic Research Service, USDA; Prakash Cup ta, Tal' Institute of Fundamental Research. India;
7. Health Ri.k.Gary Giovmo, Roswell Park Cancer Institute, USA; CorInne Pearlman, Ccmlc COlnpilny. UK;Jonathan Samet, Johns Hopkins Institute for Glob.1Tobacco Control, USA; Sun Shatensteln,Collllnunic::ation. ccnsuhant, C"natia:
8. P... b-e SmokingChve Bnes, ASH UK; Corinne Pea.rlm.:Ln, Comic Company, UK; Jonathan Samet, John. Hopl:ln. Institute for Cloh.1 'robscce Conrrel, USA; Wick W ... -en, CDC, USA:
13[' J
rnarkcting:• controls on smoking in public places and
,,'orkpI3CCS;• expanded aOCl'S:It:o effective means of
quitting;• tough oounterad\'(!rtislng;• tigln controls on smuggling.
10
Tbese nlust all be Implemented if the predicted expansion of the epidemic as outlined in this aLlol$is to be prevented.
The picture is f3.r from bleak. Glob"Uy. we haveseen a sea ch.Ulge over the past few years. Agr()unds\\~11nr local, national and glohal actions ismO\'ing the puhlic beahh 19O'ul41 a heat!'
DR GRO H.\RLE\l BRUNOn.,,,O
Genc' ...June 2002
B
Publications of the world Health Organi7..atiouC3n he obtained front:
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Requests fOT permission to reproduce or translate \VHO publications - whether for sale or for noncommercial disrrfhution - shouldbe addressed to:
PubhcaucnsacldfW as abo,.cfax: +41 22 791 4806email: pcrmissions®,-,'ho. int
The designations employed and the presentation of the matcrtal in 1,hispubltcation do not imply the expression of any opinion whatsoever on the partof the world Health Organi'l..3tionconcerning thelegal IHatus of any OOW'ltry, territory. city or arei) or of iu authorities, or con(."Crning the delimit.a.tion or its Ieonncrs or boundaetes. Dotted lines on maps represent appmxlmate border Jines for which there may not yet be full agreement.
The mention of specific compsntcs or of certainmanufacturers' products does not imply that they are endorsed Or' recommended by the \\'or-iel Health Or1,ranjzationin preference to others of It similar nature that llrl! not mentioned. Errors and omissions excepted, the names of proprieta.ry product' arc distinguished by initi.ll C'Jpit<l1lcucrs.
The world Health Organi'l"ltion docs notwarrant that the inforll1alion contained in thispobhcarcn i5 complete and correct and ,hall nothe liable for .loy dllinolgcs Incurred ;1.\ it ~SU)l of itslL"C.
The authors alone arc responsible for the \~C\\'S
expressed in this puhlication.
'9 11
f.ng Yilhi poi"tJOgt loll, 'fD1l at
woli,. .$CCIfdlC'l1100
Oftt's b1It ..
,tama,.
... ..... ......
. pimtfIIWI..
""0:.,.
_
r
J
1 The History of Tobacco
..." MClC'ftt t~ wtIc:ft tH bfti ",-.as blrrtn and the ~ wttt Ihr Ore'l $pili iC'ftt f."Jt # .... WI to j;I¥t
".",.ftlty. ~ )IIc uMI('d Om' ,tic world~hnt h« ritht hMId toud'lnf tf'Ic
loOlJ. thert gI'CW ,oblOb. Alief~""fth~ 'eft hJl'ldto~d theIOiLthm 9'c.
there ,rtW tob.ttO." Hllron 1t,4,," '"yUI
·l*'" S,..nl.nh ~pot'I Itlcit Journey met
w,U, IJrfll mwflltudtJ of ptOplt. Mell and WOl'lle" with n,tbrlnch In ilm, haneh a!'lel
h«bt to smoke .tlc, ttltlr <vstom."
e NO'IC.mbtf 1-4'2
Asia
,_tqIOrt on dilng-trs of
Iffi~ml)
t9~CthIU 50:1:"~Q\($ ('OfluDi of ttr: tobatto ClhllOS
'''1(1 foft'9"tompilr;.t:s
1900 China .a1"l'lOS1t:fltltdy pelltvattci oy fortig~ tob.ct"O
USA~~I"Il<romoh """" 'GI~...,l.f.'I.a
, t
"'"' ea-ee It! Nil
USA_"" Dot«. 0'K:!
USA MJtO( '(pot! 011~50Oft s"'oliftt (W~1ldn
.,011 Q,.""f'I'I)
USAFim ,,\_ 011.)9
~'"g It.antom IoItluomc 10 u'c~ ".ttf~1to the noM. hIt",r.,. tD the
bJ .... 4..,. .....I. tilt kM9I. .... 1ft III<WICk. ftlflld.., 'lilac: thtfuf fltWUt
the hetTfIIolc Stn11J11 ."..,.III< 1M' G ~ ...........
.10-. Iof Eoi ....A Cbw'krtwftt to 1000«0 1504
Chi •• Phol ..... "'" G'~1100<,L"se 0I1.... 1ttltyo(
r"")lft tig"lttUtl1.. beIf''Iponedi<'!toChJtlI~frf'l:
~SlftCt ".Nt .._. C2fftf'
t_
' ..... ifywc;an·twfWI money. MMI~"
r"" US "dlck", (ko'gc W.lhtngtOft"rCllfJt:Uto he'" liNnet
the Am"fean Civil W.,. 171&
wnhln 150 )N'" ol l.:olu,"l>u" nudlng ",ilr.lngt· 1"lI\t'44-'n ,ht, Nt'\\ \Vnrlcl. luh.w:(1) \\,l~being used around the glub,·. Ib rapidspreed eud w1dCJoI)rc.kI." ('l'IAIl(_f!
chirilcterisc the .uJdlction cu tbe plant .\t'(ot"'KI lob.Kvm. Onh: t.he
mode of d<li •• ')' h .. du.ng<d. In lhe 18th ernlury. ,"uO hrlct ~'\""1.};
.he 19th, M"II1') " ... Iw .!!~ofthe dg>r: .Ilt '0.h ,,·rtlury "'"
1100
1600
'5l<>-o.l"'1&00 TobKu
Il\trochrc.':('d~b I.PI" Of tilt Ptuhppinf$
~
2000
the rise of the 'n ..nllr.Kt\lrc~ddl..reue •• ntl "lilt II. gr •• II)Increased number or ."lokers.AI the beginning of'the liltcenttlry a.hClUlone third of atiuhJ In th" '\'nrlll, Inchulfng InCTCJilngnumhers (If \\ Olnen, uM'4I,uhaco).
Aunt.lt. ~ (2)1987ftru pbct 10 ...
1001«(0 I... to f.tl.<>" ~.ttll
(.,,,d.Uo,, to*'Utt tON(.'(Q
j
1100
-- 17 A.IIT.llaTobktO .m'tU
OeSf1ltr. thuuurul" of "Iliclic~ sho\\,ing that loblcco In ~II its (onn. kills it. UJet'S, anti Jilioking
c:ig ..rc:ues kill, nO"'UK'n, pc:of)Jc
from tof»c:co W(' conbnu~ Co
wltll ttlt n".Act1
Cp'oe o...OU_JM:\
"..".',*h""_I"
""""
"" Nf'W lc.1M4
condnue 10 .moke • .lOd dC.ltht
lnac_.
18
..llehl_
26 Legislation: Health Warnings 78 "'here health \\>arnings are required by Ja\\'. fmpact on snlokcrs of Canadiin \\·arnine,s. Publicsupport for I'isible health warnings. Tobaccoindustry quote.
27 Health Education 8Q
\~'orld No Tobacco Day: partidpaling countries, and themes from 1988 to 2002. Quit & \\'in c.lItll,rugns. Tobacco industry quotes.
28 Quitting 82Percentages of cx-snlokers. Quitting calendar: till:': benefits of l:itopping Sllloking. Ell'ccu on d~ths if smoker. quit. E.ffect of 5nlOkint rcstrictiol\S III home .lnd ,11 ,,·ork. Imp~ct of inter\'cntlons onquitting.
29 Price Policy 84Tobacco tax as 3. proportion of dgarcile price. Cigarette price increases compared with
consumption in the UK. Government Income from
tobacco, Cigarene tax .1:1 a proportion of price in the USA. Tobacco industry quolc.
]0 Litigation 86Lt.·galaction again!.t tile tobacco industry:perwnal injury, puhlic intcrc.<rt. non-smokers'and go"c;rlunent (",,'suils. Cases brought by the tobacco induslry. Smug,e..(in~ IitiJ!.J.tion. Toll.1COO inclustrr quote.
31 Projections by Industry 88Projected ralts of groll1h and dedine of .obacco consumption by country 1998·2008. Regional proj~ctJOl\',
32 The· Future 20
Epidemiology. he.lth. economics.the tobaocoIndustry, action taken projected to 2050.
Part Six: WORLD TABLES 92
Table A: The Demographics of Tobacco 94Popu1ation. Adult prc\<altnce. Youth SJllOking.
Youth exposed to pusi\'c smokint. Cie:M'Cnc: oonsunlption. Quitting.
T"bl,. R· The Business of Tobacco 102
Land area devoted to gro"'ing cobacco; quanti I)' produced. Number of tobacco \\'O'r1..ers; number ordg~l"t:tles manufactured. C,jgarene Imports andexports: tOblCCO leaf import! and exports. Cost
"f.pack of Malboro cigar<:ucs or cquil .. lentincemationJ.1 brand; minute! of labour needed to buy a pack of cigarettes. Tu as a proportion of cigarette price: tobacco tax revenues as a percenug-t of tou.1 tu: I"C\-c:nue.Tobacco industrydOOlmcntc;
Glossary Wl
Source' wII,cCu) Contact" us
12
T cbeccc u grown In ever 125countries, on O\"Cf " millionhectaru of land •• 'hin! or whichi. in Chi .... lone. The glo ... 1 tobacco crop b worth approxlmatcly USS 12 billion. a Inl,1I rrJt.-tiul1 or the lotal amount
generated from the llJlc of nllnufacturcd tobaceo products.
Tcbacce iJ gro\vn on leQ thanone ~tcent of.he wceld's'gricuhur.ll and. and on • wid. nriely or .toll, ;and ell mila,. Since the 1960s, the hulk ofproduotion hu reeved (ro"' the Amt'-ric..u to Africa and As ... : I..,d dc, eted '0
tobacco growing h.u I,..", halved
G
-
Tobacco
-but h .... Iono," deubled In Chin a,
.In the USA, C."od •• nd Me.loo,
Mal.wi and Unl, .. lllcpubUc ofTanl.anfa.
111(:1production of tuhaccu ICI"t' hill more tI"arl doubled alnce the 196():j, tou,Ulng nc;trly7 "lillion "lelrlr ton. In 2000.
The gn.:.lIcr use or ((rlilbe .... andpe>,ldd ..... well .. the tncreasedmcdunlwlion. th.u hot .. eproduced the", higher yield • .or.en,iroMlenully ,.. maglng. Thoproblem docs no' cnd with gro"'ng tol""",: ,he P"""''- used In curing '01>"""" I"....aUJC 1111,,!lvc defof'CSlation.
There arc rullllons of tobacco fanncr. worhlwtde. 11,c: 101,11Ct."()
induslry cxplolu them by cQnlrihuting to the-Ir debt burden. whlle u$lng Ihelr economle plightto argue ag.ahul effort. 10 control tobacco. In the USA, ,he IKH1<I between the: 'o~cco Induj'try ind the toNeco ('rln~rflrully 1:1beginning '0 bro.k down, andp."ncrshlp' .,c de .. loplng between the rafmf'N.uw1 ,he pubUc health cOlo,nuniIY.
46
countriesproduc:e
of the world's tobac:c:o
[)c,fol'Htati 0"1'n>portJon of ,otal a... al ckfo,tsudon.ttribl.ltabtt to tobil«o'999 Kltflrd count,iH
.
_
17 Tobacco Industry Promotion
Cigarettes.", pos>ibly u.. most eurketed prodUCt in u.. world.While there I. no rc!bblc estim'le of glol>.l cigu.uem .. keling expendnu .... , It I,cleoarJy In the tenJ of billions orus doll .... year,
In the USA ..l.one Over$10 billion" spent a ycar on rnilrkcling clg;1.rcltcJ, and this at a time wben ad\'c.nulng iJprohibited on lde,;.lon .nd radio, when wre;1.1'C Umiutiont on eertaln l)l"" of oUldoor ",h'eni';ng and sponJOMlp, and w~ dguc"c .. Ies are filling, AnnUAJ markedng C::J(pcndhurc I) over 5200 per '"loker. and ever46 cenu for evert p.ck sold.Promotion",1 ,allo\v.ln«J. th.at b paymutl made to rcrallers 10 facllit:ue 811es. QI(l('()\lnl for 4- 1percent of lh. 101,,1expenditureon cigarette rnarkclfng.
CIgore ue marketing" bolderiU\(1 more aggn:1Jh'c. In dc.,·c_lopingcoWllrie. tl1.J.nh I. in thedeveloped world, Clg.r<"c.d,·cnlslng on ltl.,'don Ind radio (I common, and 0 nrlct)' of oth.r venues are esploued. These IncllKle sporu, Ins, pop, f.,hlon and ,tn:cl evenu ....dventure
toun. contt'Ju. gi,·c.a\\·"y' :.and the. internet.
There ere alto ehe hidden ad"ettJsemtnlS such .u the plaoemcut ur (.".I.g.r\!lh~.lnoking and tob.lO(.·o prOdUCt8 In nl,ns. In.uldltton there I" .,)()nlOf&.hlp of universities, good.",iII don.uonJ for c:onlmunhy eve:nll • .md id,·ertI';ng of ou... goods andproducu bo.rlng the dg"."c name, Such m.lrkcdng b seen throughoul both lho developed and the dC"doping world.
58
.".
'SM1Ga1nBo
-
PHOTO CREDITSfront cover:Boy smoking, SeychellesCredit: Harry An('·tHlcn ~ \\fHO
back cover:£loy in the road selling packs to drivers and p.uscogcrs, PhilippinesCredit: D..,id T""
\Voln,!" tobacco worker, Vietnam
Credit: Judith Mackay
[\1(':0 smoking water pipes, S;audi ArabiaPhoto: Garrell Mehl (!;I WHO
Pari I Prevalence and HealthMan and dlild smoking, Chinareprinted from .1/;oS Tho I1C\\'spapcr. liong KongCrccHt: Carol Bctson
Part 2 The Cost of Tobacco Tobacco lea\'(:), TItailand Credit: [udith Mackay
Part 3 The Tobacco TradeWoman tagging tobacco, tobacco ranor)" Virginia, USACredit: Ken Hammond CI USI).~
Part" Prcmctlon)Jo)' In ,he road st~lIing Paeks 1,0 ,1rhoa> a,nd p.lSsengcrs. PhlllpplnesCredit: Daniel Tan
P.1r( S Taking Action'Smoking Is Ugly" l""'Itr,erencd hy Olrlsty Turlington ..nd reprinted courtesy or the Cemer.s ror Disease Control and P",,'Colion (CDC)
I',rl 6 World Tobl esOld 1\1;ln, Sri Lank,.. Credit: Garreu Mehl
15I
.,t.
-
6 Cigarette Consumption
"SIIort. ... "" ...ay .tttflptod......,.....,..."' .. jodt .. uslIy .......... bdGtt
COMpiIt't*t .. u.c dtaft"tt't k tht5yWIboI of tht Nc:hiM
N(,,,,Yort ;im~'115
Global con.,;ullllltlon of dgll'e-tlt"!I ha~ been rblng steAdily since nlanuracturc:d dgafcucs were introduced at the::beginning of the20th century. Whil. consumptionill levc:lllng olT lln(1 evendecre~ing in some countries,\\'orld\\-;de more people are smoking, .".1 smoke rs aresmoking more dgarctt es.
'The: numbers of .."oken will inacuc m~i"l)' due to cx-puuion of !h. world', popubtion. By
U.ltlD STAffS Of _U(I.C"
---~o--
2030 there ",,11 be ~t 1C:.Iit another-2 billion people In the world. Even ifpf'C\'O\IC"nC'(' nte. rOlli, the absolute number or snlokcr1 \\,111increase. TIle expectedCOllliJ1ujng decrease In "lllJc:
5moking prevalence will be offset by the InO"t:.lJC:in fcmOlle .moking rates. e<pccially in de"e1oplng countries.
The """umpllon of Iobo= hasradl<d !h. proportioru or •
China1,643 billioo
Top 5 countries s;u""" 01 -'998
--I'
-
glob.! epidemic. Tobo=computiu arc cr.anJdngOUI
dgarcttcs at I"" rate ort"", and ah.lf trillion a year - n.orly 1,000dgarcttes {or C\'uy man, "'Ormlt,
and .nlld Of' .h'I,lallc"
- 15 billion cigarettes are
Ciguettu account for the largcat share of nl,lnur.actured tcbaceo producu, 96 percent of total "a lee u)C!'. A,I.t, AUJlrOlli"
and the Far East are by far the Iargesl consumers (2,715 billion clg.rclt.cs), followed by !heAmericas (7~S billion), Easl,,",
Europe aod Former Soviet Ecxmomks (631 bllUon) and Wes lom Europe (606 billion).
30
Japan328 billioo
Russia258 billion
Indonesia215 biaioo
smoked worldwideeveryday
Global cigarette consumption Bilions 01 Itkb
1.000
300
_!!_~~..!!!.-'88G 1890 t900 .9.0 .920 .930 .940
4 Female Smoking
•_the Ootmftllowtr k'IItI of tobaecD Ide
aIIIOft9 wontm in the wodLdon .. trt.flrtd: Iw.llth .w•.f"t.M.U. IMIt rat11ft' sodJl
tnditioM ..,. WOftItfI'. to. ~ rnourttt.. Dr. Gro H.rtmt Irv~.
O;'trtor Ckner.I, WHO. ""
About 250 11111110n \,'0111en In then'ClrJd arc daJly smokers. Abbut22 percent or women Indeveloped couturics :and 9 percent or women In de\'eloping countries smoke tobscco. In addition. "'.10Y women In south A~I.achen'I~.
Cig~rcllr 'fuokl"g .among women is d.clining In m."y developed oo"",rI es, no .. bl), Australi •• CONdo. the UK .00 the USA. )Jut
lhi) Il"C'nd ,. nOI foundin .11 developed countrie •. In several MJulh~nl. cell, ....1;anti eastern Europt'An countrlcf dgi1rcttc .!ulloklng Is either .!itHI
increasing UlllUlIgwomen or haJ not 1110\\'11 .an)' deellnc.
TIle tebaecc In4'hutry pro.nOlte.
dgarcttc. to women u~(ng seduetlve but false h".ages or,iu.)ity. slimnt'\J. modtmlty.tmmdp.l~on. IOphlnlc.,lon ... d"""uI ellure. In ,..,.II,y. II towe.dbecc and de,th ..Tob.ccocomp.nja h.a,·~now produced ~
range ofbrlnd. aimed ~t wumen.~tOJl notable are thc "women- only-" hr,ln{I~: theM' ·(c",lnl'W!C'" dgarC\lCI are long. extra-sllm,10\\··I.1r. light -culoured ormenthol.
O' AUU'CA
-,
-Snokln9 behavlour ot wo.tndUf • .r. frOll that of men...more hiqhly motlvated to amoto_ thoy find it harder to atop Imokin9_ vomen aro more neurotic than ~n- there ~.Y bo a ca.o for
launching a romal. orIented cigarette with rolatively
high deliver i•• of nicotine_"
1916 ra •• arch report,8ritl.h Aaerlc.n Tobacco
26
The Tobacco AtlasDr Judith Mackay
and Dr Michael Eriksen
B " nh
N
-
15 Tobacco Trade
Top 10Leaf exporters
thousand metric Ions1999
No>... '" 0
..;:Top 10
leaf importe rs thousand mttric tons
1999
52...
Tobacco trade is big business, forboth the raw material (tobacco Iea ves) and the finished product (manufactured dgaretles).
Brazil is the large.~t exporter of tobecoo leaf. and the Russian Federation an d the USA are the Jargest importers. Some countriesth.t grow tobacco, such .. theUSA, also import (oreign tobacco as well as exporting their 0\\'0
tobacco leaves. Interestingly, the USA exports approxfmatcly the same amount of tobacco that ii' imports. Because US tobacco ispopul ar globally. and tends to bemore expensive than tobaccofrom other countries, the value."of US tobacco leaf experts are about double that of the same quantityof imports.
Manufactured dgarett es are ilia traded glob.lly. Agoin, the USA is
the luges, ex poner of manufactured dgueues,accounting for nearly 20 percent of the world total. ).1"" Is tbe l.rgC5t lmporter of cigarettes.
According to gO\'cmment reports. 846 billion cig>rettes were exported, but only619 billion were reponed to beimported. Sutistics ouch as these provide ~ sense of the size of the dgorette smuggling problem.
Chin. is quietly emerging ...s:lgnJncant dgaretle exporter 1
increasing from virtually no exporu in 1980 to O\'C':T
20 billion cigarettes exported in2001. worth abcur USS320 million. In 2005 the value of Chin<t'$ export trade in cigarettes is predicted to be USS6(l()million.
AU55IA~f!D£1I4JIOH
TobattO leavestMtric: tons 2000
tol3l imported: 196. 597 tol3loport<d: 182, 519
US imports
--4.. US exports
us imports and exports
PART 5TAKING ACTION
"One never notices what has been done; one can only sec what remains lO be done,"M.,ie Curie (1867 19J.l)
69
4 5 6Costs Tax
C''tuh r...s.r.nl J"
il'l\ffna,ioNI
icc- IJ")pOI'tionor tAX.&J l.IX Uglierbnlod ~'f'oI'lUt ..~ht
71;l 1.897.000 0.80
0 1.776.4SO 114,300 6.24
27.3ool 716.500 3.71
~l
'~!
~I
as: I
"".00
1Man~"tUri"ti
I.iu... (oumriol,t.lboru or
"' .... 1 ~ru«4('(1hl tUb. '·u~ mdUlU'y... ~u;, ..IC'r" br .......t ..."',.& (»de 0)/ I~rt.on ~~ t.u
lOIt'l'n.atfurYl j\briboro or OI'c:ll£ilteu(' I"C'O'nUCl-"iI~umbe:r Og.u-rUt; 1:w"N)
.r ~nur~u,"l~'o,k~
d_ _."..."~dM"
t'luILm..US pcr """ dl} """"'" I"""""'P P'''''''''P
14 Sal" t lGtts and Nevis10 Solnl LuC.
20 362 Saint Vincent ~ndGrtnadines1 7 Samoa~l
4~t
3.J5'1b 5 San Mirina21 Sao Tam e a rId I'IIIICIp<
'.30 0.93 1.81>6 Sa.di Arabiao.n 0.28 89 s.n.g.1
44!.lb 3.7100 14 Sqdodlts21 Si.... Leon.
3.92 3.52 Singapore 42.6 1.969 Slngapole11 Slovakia0 34'1b
-I 63 .. 36 s_ ..
1 Solomon lsI.nds52~t3,110
65 Somalia37.795 1.34 1.34 Johlnn_1lI 19.5 331l!> 1.1 SOb 62' s..thAfna
) 15 Barctlona 21.19.277 1 79.000 2.16v 1 t-till!nd 21.4
721l!> 2.37'1b 3.183 SpaIn
23.11' 1.78 1.56 - 241l!> 66 Sn unka4971 87 S.dan
17 Suriname21 SW11iland
S60 1.75 3.64 =,:"m 27.6 69'¥1 1.63'1b 3.512 Swtdcn12.5
-I 39.515 2.80 1
11.1 52'!'.! 1.69'lb 4,134 SWltzeti.and
2BO ZlIficht.12 71 Syrian Arab Republic
-I4.551 - - laJitistan
53 Tanzania. UnitC'd Rt"pvbl< of24.033 t
~l47.000 1.08 O.59I8i"9~ot 35 621liD 1,240 Thailand
13 Togo4 Tonga
166 157 Trmiltad and Tob>9"3.554 1.96 65 Tunisia
21.504 1.23 089 I,"'nbul 30 +21liD 0.21'1b 1.033 Twt<y0 Jurtmt.ntStan0 TlMru
33 U9inda29 Ut:tarM
~5 ILondon 39.77~ I J.23'1b 9.181 Unit.d Klngdoo1> 0{ Gr. B< a N ~.
0.2; 1 Abu D~abi 19.7 l-H Uni!«I Arab Emiralts
39:[
2's~I
3.60 0\''''90 18 241l!> 0.44'11> 78.615 Unittd Sialts of Amt.n(2LoIAn~d" 20
3.14 1.42 - 6OlI> 2.1Wlb ~.ay29 UzoWmn
0 Varll,liltv1.42 1.28 Car.lCO> ,28.5 501!> 2.30'1b 1.145 Vt-nuueb0.72 0.57 361liD 329 Vict Nim
96. 28 Yemen
Q2~14,9001 0 0.94 522 y~
S03 2.03 Ja.. Cl.04 .. 73 Zambia4.290 1.15 0.65 8(I'Ib 1.17'" 864 Zimbiab""t.
109Ba:a. c
of an indivi(lual (''Olil-ract-
S\\'eclclllngs and nil\'ouring a1~t5. V.lriClic." or p.ut
indude kaddlpudl, Ilogesoppu, gundi. kadaparn. zard a, paniwala, klwam, tnishri, ani pills. It is coJnmonty
chewed in parts of Southeast Si3. especially in ruralIndi a,
Passive smoking - lnh.lin& cigarettc, cigar. or pipe smoke produced by another- individual. It is composed of second-hand smoke (exhaled by the smoker), and sidcstream smoke (\\'hich drif''' ofT the tip of the
cigarette or cig.r or pipe howl).
Pipes - Made of briar, slate, day or other rubs ta nee. lotMCCO is placed in a bowl and smoke is inhaled through the stem, scmeum through water.
Prevalence - Srnoking pn!\illcncc is the perccntage of smokers in the total populati~n. Adult 5nloking is u.su.lly defined lIS aged I S years and above.
Promotion - A representation about a product or service by :Uly means, \\'hcthfr directly or indirectly, including any C()(nmUniCltiOtOf information 'lbout aproduct or service and ns P" (."C and dlsrrfbutlcn. that islikely to lofluence and shape unudes, beliefs and behaviours about d,C produc or service.
Retailer - A person who is cng~ged in .1 business thatincludes the sale uf a tobacco product to consumers.
Risk - 11," likelihood of in~rring a par.icul.r event or circurnsrauce (e.g. risk of dikil!e measures the chances
disease].
Smoke-free areas - Arc;asi"'hcrc :nnoking or holding a lighted cigarette, Cigar or pil)C is banned.
Smoker - Someone who, a tJ,C lime of the survey.smoke •• ny '01,,= product either d.ily Or occaSionally.
Snuff - Moist ,"ulT Is taken orally. A small .moun. of ground tobacco is held ill th mouth between the cheek
and gunl. Incrc;u:ingly, man flC1urcn ;U'Cpre·packaging nlo~.st &nun' into srOlin fl"lper or cloth I~keuto make UIIC of the product ,asier and neater. Other products include khalnf , $h~lrnlaah, na1S/It:lS\\~. Dry,nulT I. powdered tobacco ~ .. is Inhaled .hrough the
n... 1 p''''.ges or taken orall
Tar - 11l( raw anhydrQu.a:nleoune-Free oondcn.ulc of smoke.
Tar and nicotine yield - The amount of tar and nicotine ill milligram$ in one cigarette, i1$ determined by. machine designed to measure smoke. ~lacbineyields of tar and nicotine levels arc not necessmly wlutsmokers actually inhale.
Tobacco ater+butable he~lth carr: cow - He.1hh COSt.calculated on the .verage proportion of p>rricubr diseases attributable 10 loNCCO usc.Dirm cosu include: com related to the <ll"cr.1ge proportion of the occurrence of dtsease attributable to tobacco: health services costs such as ho!pi~1 services,physiciill and outpatient services, prescfpticn drugs, nursing homc services, borne hcalthal't, allied heahhcare: ct.anged expenditures from Increased utilisation of services.InJirm cons include: COsts imposed on a bousebold fromtobacco-related illness or prcnuturc death; loss of
production and cuning.; household he.llh;
rsychol<>gk.1 <'O>~', such as the effec ts of grief.
Tobacco attributable mortality - 10e number of deaths attributable to tobacco use \\ithin a specific population.
Tobacco control organisation - A non-profit organisation whose purpose is to reduce tobacco ccnsumprlon and pro1CC'l nonsmokers (min the e.ffectSof irn'oluntlry smoking,
Tobacco industry documents - Previously secret. internal intlustry P.lJ>Cf'S tNt have new been placed in the public dctnalu M a reruh of court rulings,
'tobacco t;a,Xc;5 - Tol.XOI tevted on tobacco flroducu.Tbcre are 1\\"0 baslc meehcds of tobacco taxation:• nominal or specific 1oli,xCJ - taxes based on 011Jet
.,.mount of tAX per dgareut' or gram of tobACCO.• Ad loal",.tm taxes - taxes assessed as a IKrcentagc nlarJc.-
ul' on 1I,e re ra il«lIing price of'tobsceo products.1bul tebeeee tJX reft':rJ to a oonlbjnation of boUl methods pI", '"y ,..Iue added uX (VAl) wbereappllcablc.
I C J111
.......
1'
-~
,.
O""-"~~"~MXr
c-.I.....,,'.....,..'.,.,-1001.
I The History of Tobacco
£.~ .. .,1•.-..0.. 1m. \'01:\"),_1V:411_411
IIlJIIloriWlloo+kJ"_dl" ~~UM_'.) n.. u....- fw.;fn," NuwOllllt" lOOO
Jell,", II. t~ ..HtlJhl-.(tt,. Hflhh ldwmlon A\ltho"11. UK. July 199&
SOURCES_-As_-""": ....... --'""_ht..c-
..........._~_.. 1OIOC~ ,.....w ...~",ia c:.-t..we tl70~ P'I" ~."at)cfc:..-- 41,.,.4IIt fIA"""_').Iv-n. 1*.._.... (I'''~ ~ ....a....w. ...... WwWttnM!"--, '. ~ \-fIoliNc.-I~ .."'...... .,;..~""""M< ...........,.......,.,.
(Kr)).'_' 1'I)''''I~~~.lwn~Jdu'''''' .I.omwl]KJuctt R.Au\" '.IIIM.t.; "_Koff If, ltN, IC.. ,lwlWJot tW,,. _ 1M'-'I. ...'.I""1""W """"*' <4dJ ~ ..,. Ik.a. ......."lK)~~fw r......,.,cl'OlO) Ho:oo1IIo,-_.s......."" ~
IlfwIMhIJ liN_" tJ"'II,jr~n'll.AU"" A Koopf. N~ 'r01'.I"' ._,._ ........ "",~, ..-.....IiIu..'do ,..,.,._. _'MC)
)"'1,",I)B.. n.. u..,.,. ,u..-. ..~ .....4.Ifon-fi,.-. """._--
(._I.m.
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,~ ... ..,..,.~"""'_PIC'_
.,......I
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..
..
.'
.,
.,
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,.
..
,.
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..
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........ Oc:wbc:, 1995(d~ ._"...~.....,c,.-....._..-"-'III'" ... KR.. r.w.lL. LC. ,.,.. ... I..... w.n.. Utt
........... CIooiro" "'"""""'-' , "oCl~I"'~ ._.,_'lm ..................~Af1""'-.a..c.l~""""_.~ ..... a,lJ....,...XXXI\'~t\.. ~ ...... --... .............. -.-..
u.s.. nrr.,-'-'" J I~..d 11..-..srn s-a.,..,J " .... -...,A.m.. It. "fJ'O"'.,Ill.- Satrr- c-nI ...~ .....1Ibt
~ ",., II~ w..m. ....... JI-W - 'CfO"'o c:-...1.h,J.p_'U,.........._~~.1,.1I,."Wl~"I_.J''~'''~'_...I.I.'.'.f.'7..)...
......s...ttI
I~ A_rir_I~.b~." ..I.nriooII •• ttl\\'.IIon J (cod), n,,....J...Ii .js.Huy. t.Lc-:, ..... ..w" ........ ]000
Co_ ....... , ... AI:.A TO" ~c_..., P"rof.te" l'OOO
, I.--""'_ ~l. .. ~ • ..,WI'IIO
1iINn:fI.,k .. _. .. "'l{h."" -J1"*"'t'l""_od r,,-1M•• 11I'OI1OIoc.., thtN...I.GNIca..~,it!~ _ ToI~.1I 1I".!\It, OU_', c.n...... 1m
Y.:h 0. s.IooIN Y.~l,ltlt'ft 0. s-linl s..d .y,w. UNJ,it ""J C",l.".,n. MttC.c.pr1i:Jw,-n, South A~In. '''1
c...~c.n.-.-.lJnc: ~ ~ "...._.{~ JM.\'_'_'_'r.... "a......llT(l, f('U ~, 1101 s.r.tr.Ca_uC_'~--' .. I_:."".c .,.,"d~~ • ....,.....,....~-..lJa(.I.tlt.t.c.... I. ~t:lIl.nUl ... ~"_'U. ""_""'s."", "'_ I, r.a. ..... ._ ,,"o...d c np"'t" -Lot ..w.. (.... ~ "'!. o.tlt. v-t,l (,.....~_... ...~..._-*-c .. ~.(W. ... ".." '10 ...
Part One:PREVALENCE AND HEALTH
"c'u_.'"~ ......_......
priof ••
cw..1..,.~,..,..."tI ~
.....
'. 0.,..--
l'toOc-.
......_~..ioI~ I',..~ a..c...
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~~
c.oa.: ~ , ... .-_".
~,. .. )~~ .. c;...6.
2lYl"" "rTobaccu Usc w.... u., (1W4) ~ • ..._,. ..... ~...,........,~_" ' _ _'''''''_'_'''''''''_'''_Jo..,.......
)'AIN MAl'*1,,).1., 4,11c.oI,.IIt,'uc-.~~M «<. ~(lI',>CI''_'~, ....
GuJ!U ,'Co. Sltrw, or~dl'm~.c.urd·t~""..'
III L4ttoI "-tQ. ~ tntW. - _....I''''t r...,_,_
W.5" Il'IIlnil" ...I, In lIomb,),,-lnt""
'""'" 'tHo 1(1): 114-110
O"-"' lf _~,.."..."Do141. ,.....,. "" Jnc-.~~c- .•~ ........ I"V_.-....t ....~.~ ........ I-NJ
"'HI)
-'H.\\tlfl.tlk.ll\h o.P"A_. ~ l1li1 A ~, w.~, Gnwu.
o19.".,a,,,.cJ"-""-""."."."..._.......,....w .......~~~C)IIoo..'_
......S-~ WIK). ,,,, ,XIOI .. n.' "_ Wwnor--.l"""_ ttl J"""~"IIoIdt~.c-JJi-h~.J_ ...."""""_
........ (i.rwo,- •• s.JI.wr'-l ~,tO. ,,,. c,."a..-.,......o.-..-. -.,"."-"- ''''' ,.••..1......_,. .-',''.'''-, lOOI. ~
.... _J .. ,,._ ,..,
j Male SnlOking
..... f,M\, ~~."" ..... ....._ '*-' ...._..t~ ....... ' ',\......., .. u...a. .. ~ a... C.,).-.,w.- s,.,._..,,.,-.,._.,c_ :. ('"._ '--' ...
~ .. .._ ('uO~o-."'_ • ....u..c.. ..wIr...,.CXlOI) n...,Inf"- J ." ..n..t~""",'_
1 , ""po .rl."f'~An""~""" r_,..ft ........
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a...~":("W"Iom.lt.....,._..,_"I'.p..l.t.t.l,),)-O.&".._ Jl ........_._....t..i.p....... :0""'I',~M-"'_" N ....
~.(.....-.~ ,_f......,.. .~ .....~. w.- ..I ~"T-'~-
(:o'),) n.t_,_",. c-w ,....J - .".,.~..... w~"- ...._......-.....-....l_l ...4.~. ''''''--».0.1..('~
• ........... _ ............ , ....... , lOO1;
o..wc:-~o.r.-...--~w..tt" .. 'I..,.". ......... '"not.'-- ~ ~~_ ... O'-- .........
-........-..."..".". "'"""_"'.-"..'"..,.,...,.~ ~... J"_.....",._'\ .0..-lM".)I)
0.., ..... Ol'-.'"'''' t''''''' ~.t..-... ,.......a-..~ ...~""",(..t .... ~_,
.
'.',I" IK•• 'MIi...,. ..... tl ..',_ 1tf'i.....,....(Pl\HOt
tc:,,,"" ..... _..-'.' ......... O'I."" .............. ._ ......._-1"_ C_'" "" _.., lOOJIU ~tv......, O'!"r c.a.,~ ""I"lft_. -n"1I1d<_"lI_ IItC _I$uIO~ ~ ..... A.-Io._c-.-
..._. '- l._ _. ....\\arW ..... Orr-
........................,lDDl.n.t....,.-I C-.a~-'" ." .. ~~ ......'- • .......",.I I....,..'~ Mm.~~.",.. """-. ~C...II"~ ....._. fII .................'- .•'Il.'..' ...t .
113
I\talba,() Qr l"",. I.Alxlur n(fllt'd tu TubA Tob,.(l('O'''Juh"h'l\l bnnd bu1;1l~of IJf"Oport1on vtdR ~;nt«"n.lion41 ..t..rlb(lrno .. ufogllO'CUC' r'r>-C'r'I"C'''.''
NumlWOr CI};.lR'ClO IK"'tld ~uh~Jml p.... 1'"'1)(1of"dOIli
207 60S,1Z2 46.500 1.55 1.24 M(xiCO Citv 49.4 60101 1."~ 2,121
2
767
3,142 ~ 73'IIJ 6.37qt, 39 fltp.141139 90.000 2.80 2.56 Amstetdam 18.5 72'10 1.4.Qb 1.9SG Netherlands
'50 3.71 J.69 Audcl,nd 3S,3 2,353n
HewaalandNicarogua
29 Nigtt0 0.86 0.86 529 Nigtria
11.76qt, 2.755
87
101
-
J
-
J 4 ~"LlnUr'~1Uring C0511i Tax
,lu.....~ C-O'"w"
itKhutttdOC\lJllftiLto
ondM'
.r "lol"\lr"dutc't1 IntcrnJ1.ion.a1 ortOtll t..u: "".C).n~11i(:m Jutt lla pod "'Y .....~ pt~
1'I'(.I,kt' .... btMlt n:~..:n\lC' "u..silt'I"""""'!"
3.800' 610 l<b>non6 It:!Dtho
91 105 L>b<1ia1.251 •. 55 1.82 24 lJby>n Arob Jamahiriya
418 0.1t;qb 44 uthuan~"20.750 2.24 1.90 ltJj(ttllboo~ 12 495 lux<mboo~
S,60' 2' Mat'f'dl)n~.Formef Yuges. Rep. of81. Madagascar74 J .2"1 Malawi
9,873 1.13 1.08 Kuala Lumpur 20.7 3J<Ib 1,429 ". .. I;rysro3 Maid.....
31 Mili158 140 .... Ito
M.rsh.lllsland.Mauntal\fa
MauntlusMeXICO
W,iuontSi •• ~ted Statd ofJ -I 2 Mold"",. Republic of
Mona('()0 -I
2,301 2.63 1.36
2,059
4 =1
~
8 Mongolia179 Mototto32 Moumbiqut
440 Myanmar0 Namib1;
~ I Nauru
6.'8 6.48 Oslo 38.5 7!A11
0 1
'~IUf:
1I0owayOman
5,701 J6.6<l4 0.83 0.53 73... 0.1Iqt, 630 ~nman~ 5 Polo.
177 1.20 1.20 P:lnama 1,220 Panama617
260 11
1.85 1.85 60 Polpva New GUlnu1.10 0.93 168 "''19'''1
47°1 1.42 1.34 ::1 .40 1'<",
14.6821 '0.400 0-67 0.511 Manit, G3Il1o '.907 Ph'''Wincs12,4.0 110,000 1.51 1.13 Warsaw 5S,~ 39"'" 3.2G<a> 2.161l Polond
1.'9~1 1.86 1.77 L"bon 26'j 81_ 095 Po""9·1
7.5001 21,000 1.01 0.88 o.2~ 90 Rom~nja17,GOO "293,000 0.98 0.59 MoS(O'N 71.3 503 Russia" FtdrratioM
0' Rwanda
•• d ... , fIJI 1.. ,,-",," $o\'iet U",100 107
• s •Yuuth c-"po.!lcd tu Cigarette Quitting Cou.ntries
"ass;' -e smoking.1 home 1 consumption percen~d of people who quit smoking
ptrrtnuges u>.Iuul per ptnon by 2002
Saint Kitts .nd Nevis26.9'!'o Saint lucia
32.5'!'o Saint Vincent and GJtnOdincs1,509 Sa..,.
San Mo rinoSao Tome- and Principe
81030W
9'11> SaudiAnbia-Xn<g.J
S<v<:h.U es-465 Siwal<on.
35.1'11> 1,230 Sing.por<:2,282 SIovaua2.917 Slovenii
618 Solomon IslandsSomalia
43.6'!'o 1,516 35'!'o South Africa2.779 Spain
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HM Custom, & Excise, UK 60health education BlldIIhealth risks 32:l3
from chemicals 32 in pregnllle)' 12
health warning. 78-79 uo:Hirayama.Takeshi 1.8 history of tobacco I..8d.2Holld.y, cigorette brand 52Honghe, cig3.rette brand -5.2Hongtashan, cigarette brand 52Hope, cig.trette brand 59hubbl), bubbly 22
IDRC-RITC 2Jimports
of eigorettes 51of tobacco leaf ill
indoor air pollution h infertility 13INFOTA863tnrernational tobacco comr 1
organisations 72-73internet sales 6.Cb61
james I of England l!. 18 japan Tobacco International
dgarcttc manufacturer 5£}
john Player, cigarette brand 52
kreteks U. WKrong Tbip, Cigarette brand 5.2Kyle, Ken 18
Legacy website, documents 66-67Lewin, Louis 2Qlitiglltion ~longbeach, cigarette brand 52 longlife, cigarette brand Lcrtllard.
Minnesota depository 66lung dtseases
in passi\'e smokers 15in smokers 13
Madison, cigorette brand 5.2male smoking 24-25
trends in 2A.
manufacturing tobacco !8:::i2additives i2tobacco per cigarette i2
marketing 5.8:5.2Marlboro
packet cost by couno:ry 42-43 popularity and promotion5S::S2
~"cmphi5. ciga.n:uc brand 5.9.Middle East, hislOry 1.2~1i1dSeven, cigarette brand 5.2Minnesota Depository
documents 66Moene, cigarene brand 5.2
nicotine J 11addiction 31rcplccerneru theropy U. W
Naoonal, dgarette b ran d 5.8 ""'c.,,, Yor! Times lD
Ochsner, Alton 1SOsdcnc, Tom 11Oxford AfrJ,caJ Ccmponion 2 ]
Panama 60pan 01... 1., Ll.. IIIpassive smoking 34-35! III
and children ?!. 1:land dcatlu 16Doll, Sir Richard 1:lHirayarna.Takcshi L8In LISA 15
Peter Stuy vcsanr, cig<1.rcHe brand5.2
Pcto, Richard ~Petra. dgarctt,e brand 52Philip Morels,
cigartttc manufacturer SO cost benefits of smoking ~
documents 22. 62health education SOliligation &2pohtics g, Ii]
smokers' rights organisations (d.65sll)oking ill work 11tactics 21tax ..tion &5t.eenage mloking 18
\Va\'csnet 6Dphysicians who smoke 25 pipes 22, W
politics~pregnancy, health risks 32prevalence of smoking
male 2!::l5 fem.le 2.6::22. youth 2.2
price policy Si:8!iPrima, cigarette brand 59Prince, cigarette brand 59 product placement 1J J
projections 88-89, 9Q..9J
promotion 5.&:.52coupons 5.8entertainment sponsorship 5.8free samples 5.8on public transport s.sspeciality item distribution iB.peci.1 olTen and gifts 5.8sports ss~ als.o ad"ertising
Quit & Win Campaign &lk8Jquitting Sf!. 8.L S2:SlQur'an !!3
Reader's Digest 1.8Red & White, ciguctte brand 52Red Chi .. , cigarette brand 52 regional tobacco control
orgmisaoons 2lReemsta
dgareue manufacturer 5.0research 70-21
comparative expenditure in USA2llGlobal Youth Tobacec Surve)'"2!b2Ipublished tobacco ar tieles 2J
retai Ies-s 5.SRich, Adrienne ssR.j.RC)llolds
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Part Two:
THE COSTS OF TOBACCO
10 Costs to the economy
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fRC. Il.r IthrUCff.iHntM.'w" lilt SIItWf. I He C"lmupI)MG \'A ...... ,\t",I~ (UK) I.ltI. ,~.....,_ <4'" I ,Id .... '000. (0..,...,.
U~
aJI1IOAkOn" T.... 1.aIWIon..14 ~ '''., I" II_.._. •• .-...... ec..1:t'1 forec..~,I~"tIw~.
ITXl'J"t ' ...... ~AR.N..JIU.b_I._ .... w..-J--M
"""....,.."J. t"'" lOOO
~ ~ .... II""'U'O' Ia-.. ~r.:.. w.wn.~, .... o- ~ • .._
..... ,r~1OO1
16 Smuggling
MAIN MAl)JiI:& .. _.(.. ...... +IJ • ....,.,.,.-.I"'~_' ...'.....,I\ t
t.or.""'n" prit'''' ~"" Mdb• .,.UW,. 0J.r4 ~"1 '"-.:<MXl Jll
"..".u..r,.n.;._,.u......-+a "' ... .,_ ................ _ .... s-"Iov. c.np..p '" """'" r_ .....
tJtw ..... f!r'J/~~n--tIItn/~'I'-~ ". ~_I.mon In dx - .... tr)'- I.be""~'''',~ ""plll .....
(_NI 1191.1j.'''...'... Ic.'s'rc. , ", MorIY !lI". AJt'«lI'w.r tll"",til un C.:...,.-, ...Noi. SrMA
l.u(ll' k'" Cn.lH. ~ 0."""1" r..",,_) )00)
GilfM'I;.l. •• " HlllW A. lt~ 1hd1PuoIII')'.,.1 ftc.., ..", !ll'nollrla1ft ,'tl••
N"'I~ II (/l.rnfIon1k- R~ J...... IN, w. ••, JMrf"1 runI..,..
S.SoIl11",,1,.1.,-. 0, MfGrIllpt D. ~". "I","" u.._,_, ..,.... {d.fo- LM .. \\btU ..... \\"/"/'. ,,~~ nc."WId .... N4if •• :.~
M•.. ..._W I. r"'_'" 1001t\:r .........1.romfllii"""'-ioII< "fIJIl.tI~ ~ MIl [ftC' 1-IGn-.,.. XlOI
lAC.a INn lOti \("(,"() S,MUr.CIJN:Cw"-' u.m.~, 11MCu.lDIN m WW.IIM T,........,. Ux. M.wd.:<m
lOST'U\"'UIC_JI....,_., ........ ,_.,_ ...... t.....,_
.".__....I."I~'j'._..,.....",.~"u"..c"..l."...'I'' '.'..~....1.. 11......
119
ltlRN1NC NO\V .••Phitip ~\orril:' 1"hc f'n1p0c6~~or PM Inltn!.\OOrI'I (JD s"lOkmf _
Iiaid.
'''' ....... ]7,"'",,,,", "'S, , ('''''"'..."''''1 ............ /202 )26' )SI
IU6"
THI< 11\,.,'FR..~ATI()NAI_ TOkACCO CflO\,'f.RS .••
S.MOKERS ARE NOT ...RJ ~noldt docall)ertt 21 Dcttmbtt l!m. B.to.No. 50)3; 1211· ;OOSi 1162
I:'" AUSTAAUA TOO
f'ioi!i:p Mi:>r"*, n.,. """'s-., .....,tlft'M b!t~I_ ~C....t tkakh
INFOTAH. 1985, R1mdd~ J. (u (0 V\'1:oT."B &un! Mtmt"",... II OcIoM19$8. Bri1Lh ru.~k.m Te>I",«n C«"'_) i02iSS41;'i417. C""lIdtonlr~,t"IU"""II( Ih~w.-r
..,....nxr
n )brd, 191;. , ed ifll_ctJ_ c..II_ 1.t.~2Q1116S1;1_
QUOTESU_:\II:SS COUl\-rr.RVAlUr-oC snl'S ...1\' ftqnooac.. document, 1978. I~ (<<1'""'11tI..1ilo No. SOCII)
1111. SOO8~ll'1.\VIIAT ARE \\'ETRYto.:C TO ACCOMPU$III
Doculll(lit Type: Rtpurl. t),II~: 0)/20/1990. AudlOt: N/A. 1l1k: Top 5«r~ Ojl'lT.tlion 'blnllukt. Site: Ph,I., Motflo!; ~I.oc'tm_tIIIl(, R.t1("JNo. lCHI)()1217111 )I)
IIItp: II 11> ......... p'~.(QI111 geuIUII'J"*II)}OOao.1(HS )()ll2i Ill)()
BUYINC INFlUENO:\".M(h. J'ubllor CI'rJ,('n, USA, 1".8
http://wYl"w.dti1.lln.(lrg/C.Ongm"../~;UJ/procUiall l ../tlobt.rm/anid( .. d.m llJ)=YfJS
I~UYIN(; Il."·OURS
( .... ""'" G.-..III1JI".oJ 'r1!.-.Stlhrtg 1lNr'. I..M~"1OO1
'fUXT
(".-noon ( ......,,: BliJ''V J~fllNtf(t. S411.lrtg IlNI1, I" tobl'tb 1001Nellmlll M. 8ilw. A. GLnIYS. 1uhlC'l'U indlutry )tn;l~k. for innuendog
&'"'1)11'..1"C",u"l'I"flli'Y tol>af('J .. f'I,_"I'lJtfor~ k}..... ~iUIII. n., ~n(f' 2001. ).;9.
1J2.1-10httpt 11 ...". 'w.~l.norf1.roml joorn.lIl\'01~591iu9.I I'/fuJlJllu.,159.' 11...«1.uri.ll_,Uld_.e~·~·.20711.1
20 Smokers' Rights Organisations
PWli'rl.bri'~llll'kc:o:to.t.er. I,sa ~t.ml_c..n.m...;lOll ;:96421.202Ii96412: 7
UndlNll A. 16 ".,Mdt 1001. eornnw:..tI ~ to 811_ No. 2'O-i57~1 in.1;:1'
21 Tobacco Industry Documents
~tAIN~IAf'
Au~".Md. us",'=r:ourrt1'Y~. utkJ' r~OOr! ,;it.t: •• '1.... 1001,t.~p.1"'lcy.IitIl'JI)'.d.edul
ClJI"8OARDSOUR\\'OflK IN ~[<OAt.. ..\\".,. \. l'hIlip Mol'N M~Ift. 17~ I•• ~ So.
202 ... 1I401/14(lI;
hltp.II_-..:.~ .. ko.wm/l:etalJim&.~OOCJO"102 i>l), "OIl' <106W'QRI( TO OE\'ELOI' ...
1·lill!pMlwrh.I987.M~~tn ~.JTr,u" ~'1
A LA"' PROIUWT~C ...
W11iM A... I'hOIip,\\uNb"tltlllUf .. cb...... 7 ~ 1'8(i_ILA(:.]I:.:a,201S.JI.&(II/I~
httplll .... _ ~n.'Im/,ctaJirn&-MP~)()CID= 1OlS4 J I~ II, '()6
ASIA IS r:O''\! ..•()(,lIiuon J. fYlp Mlnb lnd ~ ~ l'to01I..IIJoll. J- 19" «mI.
fl.r.IC!II No. '1;0(1101 JII/I)l)hup: II ..... ""tdftO.rom1 t'ull"''''....,~,.pAcl .... DOOD.2 SoOO0,I ) 11II )
11
NATuRAU'· ..•,'lAIN MAl' ~"IC";tJI-I. T~I ..IIlI!
l.."..~......,.~.
.... AI~I~
TVAtCCo"N'J: 1Jtt 011/".. T-..a. w)TJ"pNu. Seu-ch 11 fdttwt) 1002.
bl.lp.//I S'.l .11.11.'.5/0:,1.bin/_'il(_"''lih,,; ...t"b=C\r&CaI~,...,:;'frA'~1Q.OOunt}''.41O'K2li~)(hIlI'l)(Wll'~jA":AUdal_iQnM2~2Owg&nil'.MtiortJ
,\f..Id..ty J. ~..,-,b 11 r,,!.bn...r.y2002, llu.p!IIISa.1J2,12.95/c".L,fl,K( w,1 see ... ttlbcuo.:h=-CA'ratC.k"llrt=-'1W~~ldoltrf'UO"i16'h.H.hllnXlrl(""" JAAJ('OtlI,.-bl.lum~1~2(1o'llIlll'.Mio~
ASH UK. 1Urt, S"m ,\',._,.,71" u..m,1...tu.7' hltp./I ..-w"""M.otg.WdrotL'\I&I} 2001
Dhi.olon ",'tW Amabll Jt'oo'bIL Corwm ...... .: Clef II Dctanbon< 1"'. &.e.No. "Ml"o"(J()!h4611..t-66l.
htl:pll, .. ·".'..·.lobKrndOol1ollf'lelll.,orC'lit. diaJMrod=1lJr,tl'oo~SII"'2.~~~ln~=)"'"
OOCUMQ\'T R£1l:h,'T10N roUcy ...
Krnmnet C. US.erb r.ac:u un..dt~. ,r.t Alt •• , April 1001httPlll ..........w. ~.ronII..../ ~/1OO11QJ./11I/IOI90J.06.IJ'm.1mftJ
40 MJI,UOS ('AGf,5&INch W. Cat:1or RJ. ILlrtlUU I....,. M«'H.arrl. f"Iptt': ~ in:J ry
c.:1J1·1K")AftD~
TO SlL" 1I1'..•
1'IIIJIp .\\urrlJ.. 'I'lw: "~l'Iproj~'e vr f'M Ulll:nutM. .. 1un Snklk .. , u.III~Ilr.
1>$1l~2. 7 "br(:h 1'3S. (jUUft'd I. LlII'lInM c.lkcdm '-b,w.llOJ.l].bS!SI.
Il36<4. I""" 8FlltST \\'1l"'1U~'·...PMIII' ~\ut'b: Th" ~\'ul)f(U~'of I)~' Irf''''I1'",'''_'d (Itt SnIo)\Jt\, .,"" l-inllh
b.,wo. 17 """rtf, Ins. '1\11l11inlt'1l.Nt4_ (.Jr",·wlllland_flun/201 Ubi], I.
l:I6J"wn TRY 1'0 KI.lY I'IIIIJJ' MORRIS O\IT or rur MEDIA, ••
\\',db T. I;'Urp MUI·,b_ Gr.w-10f» G~If'IIICIU flrl'llon •• jO ,loW-dl I" J. '''-IbN". 101.OIJ1S11 JlbS.f'1I1"11 ,.·.. w.llnldo.b,{'Uml '1'...._11i~ luutn): 201402 j]. S2t H6S
doN~I.: ~rVlg ,h..'"~ I~toltf...,._' lr:o!t'm('1~'. w...m.c...,,.J ](J()J. 11,68-12
TEXTCJ.n1l- SA. St. J. lkYo 1",\. II ........... I~ .. ~ IX l~). n,. c.,.-.._ "t-t.
Unh·I',ui!yofc.ll'"r..u r,_. 1'"AIlIIA ,,~: I k;ro.' to 1("", tot..m:o iIIdu,.". duc:wnr.mu.. hNtr. r.-I
lWl.II:d9
121
Lux<mbou19M.c:<doni a, fwm<r Yugos. Rep. Of
315 Madagascar123 Il'lb M,lawi
910 M.I.ysi.
1,441 M.1dNcs
.. ·t. 432 MownblqueMyanmar
N.lmibiaNauru
K..:""jl 37.8'lb 619 N..,.I2.323 Nt:tht:rtands
_;1" t:244
"'po.Pan.ma
New Gul ....1.748 1';119U>v
2!).0'lb 195 WI!> Pt1v5a2'lb 1.849 Ptlillppin es
.'
.
•
-.
4 ) (JYouth ."po.cd to Cis_rene qululns (A;:,unlrlc.
pa."tSive Slnoking at bonie J cOluumplion Jk-TttI~l"~vi pn>p.~",·ho quit ",nuking
perttnugt:S 111"\1.11 ~ pc:non by 1002
.~' ltsotho
r'····:t lobonon
J; 89 IJDeria1.482 Ubyan Anlb Jamahiriya
If ~. UtbUJAia:
~~ 1~'-. t..'1..':
:rGO.5'Ib 223 Mali
~I. 2.668 M.lta··Marshall Island<
1:1'.. l 317 Mauriun_ia1.28' Miu-ritius
fJf~·.: 'l 4S.5'Ib 754 15'1b MexicoMicronesia, Ftdrrated States of
~- II: 2.640 Mold ..... R<pobli~ or
1£0. :-.M.... co
',f Mongotl.BOO Morocco
~;, ~L
E"a
~.
jJ;', 1.213 N<wZa~d793 HIQf'ilgu~
j~,.:' ij• Mig..-•
34.3'lb 189 Nigcr~
.~., ,.:.e Njue
725 l'loow>y
~ • .!Jt OmanS64 Pakistan
~"! Palou
•••••EW:~ 67.0'lb 2.061 ""land
2.079 Portug.1
fir"
~.~ OowI.G7G Romania
t ~ 5S3<1b 1.702 1'Ib Ruman FtcIrration135 Rwanda
1 f(lr ,~NJ COIInI""''', ,b1J .",·1I0Il.....1 fln''Oli"lh ~"n',-. '" ""I(lr nUM(If P"""1IIo-., 99Mid .'l' 1101;{'.~ .... ,111 "·I_·nI..th •• 1l1t1OJ ~I"''''h,.
e
.-..
o..
-cQmpr~hensivt set
anti-loba=advtrtising mCSSigcs1S'IOo( 10101101>0«0od>tttising mruag<s
f'ttctn13g. ttductionin smoking
of ~d\'trtislngbaM 2000
Incr('5(S .nd dtcrtlstS In adult cig.rttte: ('O(Isurnption1991r:ompo'tdwll~ 1981
OtcrcastS
• ml)f( than 2()Q.\ deerease
• 1Mb - 2oq1:,declta)(:
r~ less than 1mb decrease
• no thange
Increases
• less than ,()qb lncrcJSC
• morc (han ,()qb lnett-Is(
no dltl
comprche.jlv. ad>trtislng ban, during Ihls I"','od
77
••Health warnings
health warnings on patU of ogare nesr<quirt<! bV law
no health warning$ r<qulrtd
public suppon for viSIble:Iltalth warning m"sag"20(H """'Magesin stlect.ed countries
-. .-.•.-..-..
Health warnings in Canada
Impact on lmokcrs of the flew Cil".~la"hea llh warnings 2002
Canadian warnings are the most vt~d rn the v.·orld and serve's the model for other c:ountrlc.s
wttt mott COI'lCtfft('d~boIItt\r,llh dfms
or ""ok!l'g
Idt itlCfclSotO II"IOtl'VitlOl"lto qv t r.trO\J"9
79
w,II.
<I,.
Anti-tobacco campaigns
.,,01..,SWIllI1<""'
J I
..""'.~USS'''H
f-EOfJlAIIOH
2CJ()2
~9ufltrjts partidratin! In :
\Voold N. Tob.<tO Day
Quit & Winas Wortd No Tolla= oay~ GUll 8 Vlin progfOmmc. in addItion to hdfMngsmoirfi quit. IS otse an ett:fllenr vth;eJt fIX<OtIlmunkodn9 1M hozDrdsof ,,"oling, ond oftenstrVtS as on oppor:un,ry for publ~ ad\ooracyagainst 5mol:,"ng,
•V· \1)1 .<.
~
CHI H A
1999 2000 2001 2002
Ctsutlon The Sccclrd>:I'l'l&1tatllnm""" )mokc ItllI$.
Indu$lty lc~,the: ,i,
Toba= Fr« Sportl: Play
ude:,n
81
25 Legislation: Advertising Bans
The tobacco industry denies th.t advertising plaY$ a role in encouraging people to smoke or incrcouing the amount smoked. but the research ruggcsu otherwtse. As governmentsacknowledge the harm caused byIOlxtCCO and the need tv discourage iL~ U..'iC. restrictions
and outright bans on tobacco;)(h'crtising arc becomingcommon. Partial restrictions arc notorious: for le~ding to other fonns of marketing supplantingthe restriction. Because of theshift of marketing doll ... from one: medium to another. the evidence $uggd'l~that comprehensive bans on all forms of tobacco promotion can be effective in reducing tobacco usc, while partial restrictions have ltmtted or no effect.
Cig.trcltc 1)3ckaging pla.y~ anincreasingly Important role as ad\'crtising restrictions arc Implemented. P.1ckct design pi,,)'!
an Important role in (:5lablL~ing brand im.gery and competing for potcrnlal customers. l\<1.1ny
counrrles arc .lll\,ocatln&plainp.,lckaging. Some 31.S0 propose the bJJlning or certain words such as"Light" or "~1ild'" as these olaycon\'cy the Impression that the1.'igarcttc5 arc less harmful or cnntatn fewer harmful consuwcnes.
76
...-......
.- .
.
*
.
'
I *"
Tobacco """ITol res~a,J, projedscomplcl<d Global Youth Iobaeco SUN<,/>tGYl5)n.tionilty or in at least one site 2002
CUfT~nt foundation grant rtcipicftts RlmMcountrirs
Dtvtlopmenl Rtsearth Centrt -
I @m;;-,..81 ColMluelty Fv.nd
forbard'lWId..I,I\,"f'I"I'I
A"It"i.,
"''I'"''''*
RUSS,,t.N'"OEfI"TION
InternationalResearch rOf Intcm.tion;1 Tobac:t'O Cont~
* United Nations Foundation
Rodefcllcr foundation
Fogarty Intemational C<n'tt
oth er foundations
*....
-
""',
*," *IN*DIA
'-5 journals devoltd 10 tobac(()
conltol
- '***CHINA
*..-
--=•
*".. -* *
,Ir
•I,
How much research?Numixt of timts ktyWords found in sta.rch 0"
of 45.000 mrdk., research P3pt"April 2002
71
1st 2nd 3rd 4th 5th 6th 7th
1967 1971 1975 1979 1983 1987 1990NowYor1< l4ndon New YOIt< Stockhohn Wlnnlpog Tokyo Ptr1llUSA UK USA Sw_ C.nlda J,P'" A"'trali1
Po... HclsI...,France 01-1"_ USA fin .....
\
o Wcnld Heal1h Organl'-..8'lon and reg~.1
and associatC!d offi(n
o intemationaJ organigtioflJ
o 'tgoon.l organls'lIlons
\
\\
e.... kol'ObStMIOlre du tabactil AfrlQt.Ie(qn('()9hone
o Ha"rt ARID1
Joh .. 9.t.'1l-ln1('rn.tlorl.1
tlon Gcwttn.mtntal littOn"'91h111 lobKtO
I'Mhmmcft'Oftetll'fnlt01\
Allal'ltt
•World conferences on tobacco or health
-- ~j.'" o.itagO
8th 9th 10th 11111 12111
1992 '99. '997 2000 2003
"rgontina
- 73
••
-:/:
Smoke-frtt al'9s at work
smo~ng iii prohibh~in som:e areas
smobng tS rC'StnC1td in some ~rra5
• 1'10 bins Of no data
public support (or ftSlnttionson whert pcopfean ~ok:('100' pt:rcent2gtS in Stlected ceenrres
.... ;;1729 Shuun
, R"t document'"Icgi$lltionbans tobacco usc 1niilll rtligio\ls places.
The cost of workplace smokingEuros 2000
,. company "I) 10,000 employers
of which 3,000 smokec3t.h "motet VI'Iotcs6 dtanttt:s pt":t d.ay at wort
I ~tt1te brUit '~ru 5 """utat~chsmoker wastes 30 mlnuto ~ry wortlng 4rt
an empl<JVf=t on €&64 ptt hcMir ('0\1$ the mmJNI"V£1.037 pu .,,"um Iht 3,()(X)5IN)kctScost the com~""
£,,1 million ptr 'MVJI'I
~ wnic::h is still ~, •• , today.
/'1"....
"70 SingaporeSrnDting b.tnn'" In bu ses,cinemas, theatresand Othtf spccifi(dbolldin9'
No loss of restaurant and bar sales and an er
S2.7b"
•R", quarter ,.Ie. beloresmoking bans in restaurants and ~rs$Crvlng (ood and olroholCalilDrnl. 1992-2001USS billion.
smokingbanned
in rest~uranlS
I
smoking~nn(din bars
I
SI.lbtI Sl.eb" S1.lbn
" , t
1998
199' 1993 19)'
75
-*
I) ICIWID **"-""",'"
Ex-$mokcrs
Pvtent>ge of people who used 10 smokewho ha~ quit smoking Iottst avoilob!c data
• 4O'A> "' mort
• 3~-3~20% - 2S'!b NRT
10% - 19<1> *(nicotine replacement
RUSSIAHfED(I\""IO~
fewer than 1oe. Ih<13py) available ovtt-the~unter
no data z001
SUOAN
I~
,
~
C H' N ~
xu s*r .. ,,' 0Effect of smoking
restrictionsat home and at workUSA '992-93 pc:rcc.l'ltagtS
~ .ltempled Quiltingr~still not smoking six months later
72"
Impact of interventions on starting to smoke and quitting
Type of Quittingintervention
"'iore than 10::. ~ incrt.a~ in quittingpd~increase
Anti-smoking media IntrCiSed numbc1 of atkmpts
,,-_
*at home:
35'"
52..at woric
SlOb
and succtSS
Bans Q(I promotion Complete ban ((duCtsCOI1$U mpIlon by GlIb
RestnCtJOn5 on nomdtncryouth access
Smokfng ,tstrictions. Worl< and householdrc5trietions most dfr<:tive
no ban partial lotalban ban ban in ban in
wone arei .11 areasNRT Highu numbtr of atttmpts to quit
83F>
PARI 6WORLD TABLES
~An<lmake lint )our ow n hand, coniributc to your de-trucuon,"Qur'.ln (1 19;~
93
•
Andorra
.•
.-:
,
-.
.-
. !
yout), eX,PORd (4)
p.wiveSDC>king •• borne'
;Ciga.rette
consumption
.nnw.! per per_
i.j: ......i.~.,:.!-~.i!J:e. '
. ~ .... .0:21·':"_ r"_,,
~. '\ > ~'.~71
•Quitting
J'<"""l"S'" 0( p«>pl.\o\M quit ImOktbg
by 2002
-;_"i;.:~Antigua and Birt>.d.
;e;~ti ..Armt:nia
. ~.150-'~_' , .
28.7'11>
1-_"'""' "':;'<- i1(- ~'!,". '. ':1$12,073
613,,~,17'
245
18'lb
1S'lb
t ._.:~Australi~Austria
~~~Bahamas
-, Bahra;"
, Binglad<shz» ;'542 '.- '81tboi1os
-.J. •,
.-'- ~
2,S71.<i;42B
1,092
; ..8<loru,
,::~iBetize
-'~ '
! , .J..::l.~OJ...'''''''''''i' "
'." .Bsa
Bosnia and Hc:rz-tgovina•.,;.:~ no
Btozjl
'1Inil1.<1 OolllS5llam2,S74
•'i- ,1"<2:21
86
652
! '
Burundi..~~.~
Camaoon
. ~-;;'·,;:.nti.adacape Ifmj.
.. , :, ~ _c:a,tral ~~Chad
3~ -, :~,,~ "~Chilt1001> Olin;
~ • 'if!' _c: '. - 0.....,., . ....-..".' =.-"
Comoros
" " !
•~
ll'ib ~
eTc
~::~~;:lr.~.;.~;~.J.
'~'-''2,366- I 1,919
~ For JOm~OOlnu1c:s, drt3 an: baed on )Olltb'I,.l"~llll nujoI clUd or PfO"i'Icu.UIII .~ $I( n«UIiU1ly UiIl'UO;lIUtJ,'I: (or the CXIUr'try.
, '!. c..~CrechR~ Il<nmorl<
95B al dcng'" p
•
"t
~
Youth exposed topMlim mint al hlJ(Il~I
5Cig.rette
Wmllmpli9n
6Quitting ylfl'lnl'{fl
'If fll'fl< "ho ,cit
Wltlklngby 2002
Countries
27.4'111 --..
-.....
;,;,
-....
DjiboutiDomina
154
232
11... " '.;W'
• -'3)-.., • t ,. ,:-
Dominican R.-publieust TImor
Edlado<1.275
4295<Ib~ '", .:-
EgyptB Salvador
Equatorial Gulnea
49.4<;0
22.2<;0
Jl.~31.3'10
1.98387
976
1.3512.058
481171
1.702161
4.313
G09
90590172
595
-, -, ~. •
•-, <.
Is... .,;
.,.........
EtitrN Es.tonia Ethiopia
FijjAnland Fran« Gabon
GambiaGeot-gi.
G<nnany Gl>ana Grcttt
GrtnadaGuatemala
OUlneaGuinea-Bissau
GuyanaHaiti
Honduras3.2651,915 ...
HungaryIt<lond
34.3'10 129 India63.0<11> 1.742 Indonesia
765 20<11> Ira .. 151. Rep.1.430 Iraq2.236 Ireland2.162 Isratl
3o.8<ib1,901
735 ,Italy
J'mJic:a3.023 Japan
61.4<;0 1.832- Jordan2.160 Kauth,,,.
29.~ 200 Kt11yaKiribiti
2.918 Koru. RtpubII< ofKorea. Dtm. f:WpIC'$ A,tp. of
3.062 Kuwait
1.886 Kyrgyzs ...
400 lao !'topic" D<m. Rcp.
, r~...~..!neOOUfIUleo, d..t •.. ,~ t,_' uri ~v"tb _.. \~,.. ,.. fI"'joa' LlUb UI'
p",,,tocc.o •.. li0ii1 _ "',,' 11«.......,11) ,~prt!WI!oI..dll· cit tI'It _lilt! oourll'1.
latvia
97
lotJ.cco·s Sh_"~of 91~1 de:lth aruf disllblilty inmllses 10 9~
8~ Of smokersl(yt (n poor cwntrits.
Sp«"cutal ad"an('d in inYdtigation. dilgnosls and ttC.itrnttlt of .~rcJat(deneeses, bl.ll ul'11i~dyto .ffttt gtobal t'I'Io"allt\'.
Htw global virvs pandemic tttnllOf1rily fItlSht,$tobllcto mIltS eomplttdy off tM agenda.770 million children t.postd to paui'o'tsmoking at homt..
Nu'T'lbtr of c:u.'nUI.~ deaths tfOlI'!,oba«o:- if p:rt$ttlt trtnM COfttlnl:e: S20 milioa-11 pro:ponTol\ of young ,dl.llU li~ up smoUIlJ hal¥tS by 2020. SOl) mltl~• if adult a:lnMIf1l.ptlon ~ by 2020:3'0 million
Tilt ~p betw«n tkh 1)1Id poor rounrtie1groWl as health stMtes in poetcountri" collapse under the Urain of tobacco dist.aK .nc! deaths.
GlobaJ annual ttOnomlc C'MUof t_teO:~$1 trillion a yrtilr.
Mllth of tk dt'Veloptd ~orlcf m.oves to, managed teeeeee Industry, withtobactO-att,fbtttabte heallh eare t'OStstdmbul1~ and COmJl(lUItJon plid to indiVidual sfflOktl1 and non..ynottfShanncd by tONC't'O.Ciglte:ues onlv ''I'.IIIbll( ()(I prescriptionIn fiat countries.
The tobacco irl4hlWy h fully re9u~ted. witI'!lictnsing of niootlne .s In .dcfictiw dnlg. IJIdffI.Mlfa!Ctl,lrt,.prcmodon.net sale und« strietregulltOty t:OtIllOl by 9CMfM'Itt!t IttndC$.
Hug.e.dvan«S .rt mld~ in 9enetia. Ihe tob.aa::o pbnl betotntS '-ty to producing wetlncs I~d other bt:Itd''ICi.1ml(d"itJIprod"en.Warid's top tobacto ('Ofnp.lnics nowbased I" Asia.Almolt tIO tobaoeo Is 9roWft In ,til( USA.
Ntw. ~l!IettilUy ptOfltable~Kt:oftarco 1ft: hMd.
'*(<0 C'Onlrol fundtd ftc", I pcrt'tnl'gc of r,o\I.ttO 1'11I, n m.nv countries.·Outy frte" (001«'0 no lOnl)t' e.ins. Health ((Ju(atlon m~Sa9ts are mortstllful, hald·hlnlng, and drl1e:mlnutdmo,e e:ffmi'ffiy.
In M'V ('OUntIYta~ OtIIOOI«O ts 1~of rttall priet.
91
•
0-,.
.
c
v
c
z
Tax as a proportion of cigarettt pril:e
2(J()Oor/attn 1l\'Illlobi. data
• 75'11> or mere
• 50"0-74ll11
25'1'0 - 4gq"
24* 01 tess
no data
(ountne. or StaId wIth IOb.atto ta~6drdlcaloito tobKco control, health pmmotion or gene~J heatth eare
ceumrles \'Ilth tax of S2 or mole: (or 20 C:IQaretttS
UIUIOOll1o
-e
"e"""'"
_.
CH lilA
:e~,..,:.;. \_-
~.Iat\n
,
f-;
t.-I" ....,
:~.:
'Ot 4ll thothereis One
- t4Jc4tiontha.t ola -
n .uu,
~.:;..;.
u
.... ~ u.sthe most .•
Ph-ili PHarris1985 '
:E ~ u
'" ~ <'"i
Government income from tobaccoCCUMlties with the highest pt.rcent:.gt: of tobac:c:o tax as a proportion of total govtfnment f(Ven,ue 2000
6 a 8!;j
Lawsuits
legal aClion against the tebacce indu.tty 2002
II personal injury lawsuits
• pubJic intl!rtSt lawsuiu
~ non~smokm' lawsuits
~ govtmmtnt liJIwsuits
no lawsuits
cases brought by the teeaeee induS1ry2002
~....., -I'tlt
:;.f
ColumbiaCanada
Europran Unionand m,cmbtr states
Ecuador
Smuggling litigationCasrs brought by national govtmments 39ainst the rceecce indu'stry to rcC'OVtt lost tall from smuggling
816 a:
-
.
Projt'C1ed r.1td of growth at'Id decline2008 compaml with 1998
Ineeese
• ... r3Mb
• 2Mb-29'1b
• 1Mb-19'1bunder 1()qb
deerease
• under10~
• 1Mb-19'1b
• .. cr2o<1bother countrits
RUSSt"" fEDtltATION
CHI N A
The best of times and tire worst of times
Projected (egional increasts and decreasesfor cigarette consumption2008 compared with 1998percentages
+1L1Cf1
Amerit'8S
no ehanse Afria andMiddk Eall
&rtt:rn &m:!pe and former Sovkt Ul'lton
, Asia. AortraJ~p. and Far Eat1
urgest predicted rtgionll inertalt /6«::rc.a.se
Btazil."o.2<!b Norwty .30.5l1;1 Zimbabwe S5.7!fb laM •• 2&.SqbUSA-tll1ll Uk-l'.6~ SouthAfm-17,JQb Ct«hRcpl;jblic-2,.5qb
'Itchta" +35..9* UtW Zt~od: -2.~
/~ 89FL.o • .;;;.; ~i h
9. DeathsMajid Ezeau, Resources for the Future, US/\;
II. Costs to the SmokerLuk Joo ssens. Belgium; Kenneth E Warner.University or Michigan, USA; Anna. wblte,Partnership Programme, E'SCnli<11 Action's "raking on Tobacco c.mp.ign; Ayd. A. Yurekli, The World funk;
12. Growing Tobacco and 15. Tobacco TradeTom Capeh arr, USDA;
14. Tobacco CompaniesGene Dorio, Nc'\v York Cit)'. USA;
16. Tobacco SmugglingCampaign Ior Tobacco Free Kids. liSA; luk joossens, 8clgiuln; Eric LcGrcsJc)'. Tobacco Control Consultant, Ottawa. Can;1tll;
18. Internet Sale.Chri5 Banthln, NorthE:u:tc:rn Unh'crsity. Boston,
USA; Greg Connolly. Mass Dept of Public Health, USA; Kurt ],,1. Rihisl, Unh'crlity of North Drolhu3t Chapel Hill, llSAi Kenneth \V.1rner, Universityof 1Io1ichigan, USA;
19. PoliticsSibylle Flcirmann, European Network for Smoking Prevention, Hclgiunl; Anne Landman, Doc-Alert, Colorado, USA;
21. Tobacco Indu.try Document~Lisa Bero Unh'ersily of California. San Francisco. USA; Anne Landman. Colorado. USA; jonathan Liberman. vtcl+eahh Centre for Tobacco Control, Auttnli3i
22. Rcse.lrchLinda \V,1\'erly flrigdcn, II)RC, Onawa, Can.1r1Jij Sihylle Fletunaun. European Network for Smoking Prevenuon, Bclgh.un: )\O\\"CI1 .. Jacobs. University of York, llK: Rosemary Kennedy, lORe, OU3\"'",Canada; Gerald Kcusch. Fogarty International Center, NIl-I. USAi Aron Primack, r"OgolrlY International Center, NII.f, LISA; Anthony So, Rockefeller, NYC. LISA; Jacob Swclry, wellccme Trust. London. UK;
14
21. Tobacco Control OrganisationsSibylle Fleturann, European Network fer Smoking Prevention, Belgium: Belinda Hughes, Framework Convcndon AIUana-, Auslr.llia; Ruben lsra <1. GLOBALink. International Union Against Cancer (UICC); Yu•• uf Saloojee, INGCAT, Soutb Afri.,.;
O.. -id Simpson. Intcrnatiorul Agency on Tobacco and Health, UK;
24. Smoke-free Are~5Melanic wakefleld. Anu-Cancer CouncilorVictoria. Australia;
27. Health EducationP~trick Ssedsrrom, Quit &. Win, Finland; EevaRlirta V3rtiaincn. Quit &: Win. Finland;
28. QuittingMarlo Corrao, American Cancer Society, USA; GlaxoSmithKline; David Graham, World Self Medication lndustry: Pharmacia; Jerr), Reinstein, World Self Medication Industry; Pharmaeia:
29. Price PolicyGene Bono, NYC. USA; Frank Ch.loupko. Uni"cr:l:it)' of Illinois, USA; Anne Jones. ASH, AWl ra IIJi; Arnauda Sandford, ASli UK; Mlchc.le500110. VicHealth Centre for Tobacco Control, Awtrali.; Jo)' Townsend. London Scbool or Hygiene and Tropical Medicine, Unh'croity or London. UK.
For the.ir general contributions, we would like to thank Kjcll IIj.",odt. John Crofton. Nigel Gray, Ruth Roemer, ~1lchaeJ Pertscbck and \\'eng Xinzhi; and. especially. John M.cko),.
For their ereauve and editorial experuse, diversetalents, and individual as well :as collectivecontrtburlons, \\'C: would like '0 tNnk the ream JitMyri.d Editions: Candid. Lacey. Poul Jeremy.Isabelle Lewis and Corinne Pearlman.
Finally, \\"C: want to thank our respective fiUTtllies for their .support during the preparation of this adu.
MEND~aths from rebaeee use
a' ~(t"u9t 0" :Ot.1 o~:rsJ..,.cr iii "'("'1 art! ,',tnt" 11.t"" 351cXXIr~3(1'11t'o! ,.,.,a·~
• 10 -1 •
• 5 -"
Dyin9 in you, primel'I'IDft'INI'I,'" or3S - G9 vear o esI • r.q ;'1)0.(" lttw J ~... I CJC from :O~«O ¥\("
WOMEN 37
~
- ~.,
24
Banning sl110king in publlc placesb a sound public health measure to protect the health of non- smokers.
The issue of workplace bans is primarily one of labour legislation to protect the health of workers, who arc exposed to passive smoking for long periods during their work shifl.'i! \ vhether this be in public or office buildings. restaurants or public transport,
Workplace smoL.;ng bans .a rc effccttve in r(:fiudng exposure 10
passive smoking. Smokers "thoare employed in workplaces withsn10king bans arc Iikt:ly to COI\
SUlne fewer cigan:ttc.\ per day ... re more bkcly to consider quitting. and quit 3{ a grcilt~rrate, than smokers employed in workplaces whh no or weaker-
policies.A total ban works better than
J. partial ban. ~"OSl airlines arc1\0\'" smoke-Free and the global trend is towards a safer, cleaner indoor environment in the home and in public and work places.
.,12..4 ~
Legislation: Smoke-free Areas
'.:!.!.A.~
9.5
... 7.9..-.~I
.....
.~
,I!'
~2.
8
~
2.2
0.9 0.7 Polluttd spaces
r.. r.AI0.0 Nicottnc (on«:ntralion in publk plattS
restaurants s«ondarv ttous~hold school smok~rs
large underground medical hoSpitals houStholdstores subway stations S("hoot non-smoking
Sarrelona. Spain 1OCOmicrogQ ms pc" cubic metre
74
u&fiJ\
b,to_
Hlnn caused by passive smoking Htllt~ dfrct1 on ad.lts
HAIR• Strlt.1
BRAII4AND MENTAl EFFEC15
• Strokes
EYES• Sting. water and blink mort
NOSE"NII~ujon
RESPIRATION AND UJNGS I 0• Lung caflCtf
• WOrl<'nil"l9 of p't·cxi~tlI"'9cllc>1problcm~ WC'II ..
.sth,.~. eIIron;' ObIWCIl ..pul."..,.'Yd
_a.netrmph't)Cft'l
HEARl• Harms. Ciog5 "t~~tn' IneriC's
• He.n IIlIC\:. 1"91nl
UTERUS• low blnhw'lghl or
lrnDlI for gfslation,laue• Cot detlth or Sudden In rani
Oe"h Synd,omeISIOS)~ftt'b,rth
BURNS• From firt' (I"Std by lob.1C'('O
Hann ausedby passive smokingH,allh tff«ts on d 4rtn
HAIR• Smell
8RAIN• POSSIble associ:a11on w,th broil" tumours:
a"d long·t<lm mental "f«ll
EYES• Stlr:g. wa1cr and reere
Y I EARS• ~Aidc!:tear 1fIftcn0llS
«t"... -e o"bI rn«!"1
o I RESPtRAOON MD I.UNGS• RcsprnItory 'n~
.r.I.'.d._..d.i.n.g... 0IId
• Asthfl\a {nductionand <JCIttrbition
• ChroniC respiratory symplOtM(",heeling. covgh, bIl:.thtesSA'\C'i,\)
• Dtcrtasaf lun9 Nnction
HEARl• Dcltlenous cfftttS on oxygcfI.
anenes• lnaea~dnjmti~ rcttptors
BLOOD• ~~t ~)SOICi3t<ln
WIth t,1'tpllOl'NI
Numbers affected by passive smoking in the USAannua' 1990,
lung eaneer 3.000Ilchlemi. heart dlsu .. 35.000 10 62.000
Infants and c:hildren
Low birthwcight 9.700 to T8.600Cot death (SlDS) 1,900 10 2.700
8,ond'litk or pneumonia tn lnfInts 150.000 to 300.000
~flt..., cffCCb In child ....Middle c.r infect'''' 7OQ,000 to 1.600,000
Asthma inducDon (new ..... ) 8.000 to 2G.OOO
RDlfMOoa• Gre .... likdihood or becoming
a wnokt>, as a let.N9t'
Asthm" tio. 400.000 \0 '.000.000
35
I .,----~Ol) .'
T
• Lung caneee
T
e
HAIR• ~m~1~I ndd~;nino
BRAIN AND MENTAL EFFECT~
How smoking harms you
Eyes sting, W1i~.nd blink mo",• Suokts (ctrebrovascul;r ic:c:idtnts) • Blindness (macular dtgenmtion)
• Addiction I withdraw;Jl • Cataracts• Ailmd blain ehcmistry ~ SKIN
• Anxiety about harm taU'Sed by smoking Wnnl-fes.
• pt'emJIUft: a9ting
N~
cs.pctiallyatfeoctf'dbV tobacco U:St:
• tess sense of sm,lI
TEETH• Discoloration and Slains
• Plaque• toese teeth
• Gum diseaSt (gingivitis)
"1-~--040;) 0HANDS
• POOf Circulation (cold fingers):peripheral ""scular dis<.~
• Tar stained fingers
T oMOUTH AND THROAT t-------
• Cane." of lip~ mouth, throat and larynx• Sort throat
• Reduced sense of 111SIC CO,...---..... HEART• Breath smells of smoke T r • Harms. b~\s and weakens
art";tS ofth, heartRESPIRATION AND LUNGS .1-----01
l ~----- ...H.eart "!
lI,k
• Cough and sputum_ shortn,,,, 01 breath 1 CHEST• Colds and ny. pneumonl .., asthma • can~to' f otSOPhigUS
• Chconic obstructrvt: pu!moni3ry di5CiStand emphysema
• compli~;~~e",u~~
KIDNEYS and BlADDER .-----I• Cancer
MALE REPRODUCTION I------!• Sperm: deformltv, loss of motility,
reduced number• Infemlity
c.O..-.-----t1 ABDOMEN• Sto_h and duodenal ulet"
• Canctl of stomach. P'!ncreas. cofon• Aortic anturysm
1.. ... BONES
• Osteoporosis• Spint. and hip fra<:1\lrts
f£MALE REPRODUCnor.• "'rled pains
• Earlier mtttopauR• Impotence WOUNDS AND SURGERY
• Wounds ~k:t longet [0 heat• OpcrJtion wounds take longer to heal
• lOf'l~r to ftCuptf1le (rom SUrgfty
DIMETES• NonlrlSulin dependent dlabeltS (ncilltus
!IV!>< 2, aduIH,nset)
LEO'> Ind A:El
• Canct.r of cavix• Inrertillty .nd del.y in conception
BUOOO'lrubcmra
BURNS• From fifes au~d bv teeeeee
smoking is responsible for
0/0ofchro":}150frJhystma
• Increas,d leg pain and gangrene:peripheral ""stUl.r disease
• Butfgcr's DtSCi~
IIMMUNE~M
• Weakened
33
-----------------r;rr-?'T---- --
i
• 'I.',"Whdhtt it b inhaled. sniffd, IUCb.d
chewed.. or whdhtr it is tnixtd with otIIc:r ingredients. thert is flO
Aftof
.'Y usiftg tobIc:co.
W, :
tftuTft IfffilJUiIn SoulhtaSt As~ d.iY p:pes known as suipa, th.ilum and
hoo\li are widely used.
Chewing tobacco is also known as plug. loose-leaf, and l\\'tsl.
Pan masala, or betel quid conslstsof tobacco. areca nuts and staked lime wrapped in a betel leaf The), can ..l.so contain other s\\'eeteningsand na"ouring agents. Varieties of
p>n include k.ddil'udi,hogcsoppu, gundi, kadapam, zarda, pattiwala, kiwam, mishri, and pills.
1\\0;5t snuff Is taken orally. A
srna11 amount of ground tobacco is held in the mouth between the check. and gum. Incrc.ulngly manufacturers aTCprc-packaging moist snuff into small paper orcloth packets" to make the product euler to use. Other producesinclude khainJ, shammaah and nas!
or naswa.
Dry snulTis powdered tebscee thai is inhaled through the nose or taken by mouth. Oncewidespread, its usc is DO\\' in
decline.
23
6 a, "'J v
""""
Table A The Demographics of TobaccoCountries
1Population
2Adult smoking
JYouth tobacco use I
.A(9l\1nistonAlbania
;\e!9~.21.71;53,134 39.O'!b
~i=. ~'-1f=',-,,_ ..,Md.".:~Q~
Antigua and Bariloda·,~~ntin.Armenia~liaAustria,Y.tijloijanBahamilS
.~h"inBanglad"h
8613;13-t I
6537,iQ2
3,787
lt1.llf· .8,080
.~~304&l_O'
137,439
35.9'Ib
1I.~·1"....~.38.7'1b
53.6'IJ:I 23.8'1b
12.6'Ib
')Ia_~qos '.2~ - ' . ... .. .._~- :. '.
....." , '
Belarus·~)giumStlizt
,~inBhutan
~Yi.Bosnia and HentgovinaBOtSwlnaBrazilB(Und OaruualamBulgaria Burldnl Fas. Burundi c.t"boc!l. Cameroon.<;ahldlCape Verde
~,~t"l African Rep.Chad
.C!I~eChina
.~oJoln~ioComoros(;pogoCongo. O(m. Rep.
. C.091t IsIl.IIdsCosta Rica'c:l6t.d·l .... i..Croatia
10.18710,l49
226
~n2,085~.3,9771,541
170.406.328
7,9<911.5356,356
q.l0414,876 ilO,157
427
3.?177,885
.15.211·1,282,437
42,1057tl6
3,QJB50.9<8
~4,024
16,Oj34,654
• !,,~-; _!~ _': "'t,oo
54.9'10 4.6'Ib
.fQ.~J".48.O'1b'2_~~;"33.8\lb21~:36.5'11>
~7~'3S.7'!b
2li.:g,;~.: i'
.: .; jI~:
2~'35.6'Ib
'.. 2-·-:.1.3.'«..
.
•• "'!:,
~~ .17.6'Ib~i.I'II;·33.O'1b
Qjbo ,~Republi
c 11.199
10;272 3.J~ . '2~1
3.·......· ~.~.'i_-..~Cyprus 784 23.IClb 38.~ 7.6Clb 7_.-_Otnmark 5.320 3o.~
_. ~32.O'1b 29.0C!b
.. --,...~
94 I !'or _e CICIUIIUid.,..uuArC; batd Oft,)'O'UUo~ Ie ~dOc:I_~ •....d ~Iy ~ o(w ~ C':IIIUnCI!.
-""h ....... ,.
""
•
';;-_.-
. Annual c:igarctk consumption
"""" pel pCl$On'998 orloresr avoilablt doro
• 2,500 .nd .boY(
• 1.500 - 2.499
500 - 1.499
1 - 499
ec data
h-·".'M..
..,..::r
........ _.- •• _...or
-•-
Rising num~rs Avt"Iage number of manufacrured cig;arnttS smolccd per man per dayin "'ina1996
...""""
1950 1960 1970 1980 1990 2000
1952 1972 1992 1996
316 a
Part Three: THE TOBACCO TRADE
12 Growing Tobacco 46Land devoted 10 gron'jng, tobacco hy country. Leadlnf;! producers of tol).lCCO leaves. Dcforcst.ation dlle 10 lolWNX>
IJ htanufacturing Tobacco 48Nurnber of tohacco \\'Orkcrs hy country. Wherethe tobacco dollar gOC$. Less tohacco pc:r cigarette. Additivc5
14 Tobacco Companies 50Leading manufacturers by country. The IIig Five,
revenue and mlrkcl sh~re of leading transnational tobacco companies. 'Iobaeco industry quote.
15 'robaccQ 'Trade
Cigarette exporu by country. 'lop 10 cigolrette Importers. TOI' 10 leaf importers and exporters. US Import and export of tobacco leaves and
cigarettes.
16 Smuggling 54E..'Iurnatcd Slnugglctl dgue-tlCS AS a percentage of ,lomclIlt-ic nles. "Illjor recent or current$nluggling route'!. Global 5lnuggling. Tackling tobacco .muggling in the UK: project",1 percentage
of market mare: If aci'JOI1 is or is not taken. Lost revenue In EU. Tobacco industry quote.
Part Four: PROMOTION
11 Tobacco Industry Promotion 581\10$1. popular c1garClh! brand hy oounlfy. world's In051 popular brands. 1-10\\' the 3d\"Crtising dollar i. spent in the USA. Changes in dg~rcltc m;arketing expenditure. Tobacco Indu .~. tT)q' uote.
18 'ntrrnet Salcs (,0
Internet sales. Internet search for shes. Internet
cigarctlc vendors In the USA. Test ordering from
12 websites. I-{~tCustoms and Excise quolc. Usercommeru posted on webslre.
19 Politics 62Bu)ing tnlluence: expenditure on lobbying in the USA. Buying favours: tobacro companies'
ronldhllliOo$ 10 ('1'1rrn! candidalM in 'be liSATobacco industry Quotes.
20 Smokers' Rights Org.ni ....tions 64Location of smokers' rights groups worldwide.
Tob.coo induSITy quotes.
21 Tob.,cco Industry Documents 66Number of documents found on the LA-gacvwebsite by country. Tobacco industry quotes.
Part Five: TAKING ACTION
?2 Research 70
Global Youth Tobacco Surveys completed by country. Current fou"c'l~tio" gnnl reclplents. Eemparative Nationalln..rututc or Health
expenditure 00 tobacco compared with other health problems. Published research, l'ubMed
SUTch for tobacoo compa.red ,vim other journal topia. loum:.).! de\"Oled 10 lobacco oonrroL
23 Tobacco Conll'()1 Organisations 72WHO, lnternauonal and region.ltobacco control org,lIli.. tion.. Locations of .11 World Confercnocs. Tobacco industry quole.
24 Legisl.lion:Smoke-freeAr~. 7. Where snloking is prohibited or restrtcred in
scme areas at work, and where employer. voluntarily prohibit or restrict smolting. Sales
before and aIter smoking bJns in restaurants and mrs in ~lirorni:a. NiCOline conceetrntcn in public places InBarcelona, SJUin. The cost of workplace 5moklng.Tobacco industry quote.
IS Legislation: Adv~rli5jng DAM 16Increases aed decreases in aduh cigarette ccnsurnption, and countries wlth comprehensive
ar!\,crtuing hAN in the SAme period. Effect of;advertising ben •. Tobacco industry quol,ct.
B
.
•
......
."-
Smoking prevalence for women
.,..... Stnokfl'l9 amOt\Q{rmales aged 15 and OYer
IQt~f OVDI/abie' dora
• SOQb,r.d,bo,",
40'1>- 49%
• 2o<ib-2~
• lo<ib- 19'!b
no d.tli
women smokeas much as men
btlow 1()Qb
rlt men smoke t(n or mortU times mort Hun womt_n
AUSSI~N FEDERATION
CHtNIt(j
Smoking trends 0 0pt:rcttlr:lgc of ftm:.lr smoker'S .2-0 l'_ 0
_.._....... i'."'"
1960-2000S(lcctcd tountritS
• ,...I,GO 44"1b 0 IOCl5
1910 37'10
>2,",1970 0
30'10>1G11b14'"
0 0 0 019aO2." 1979
23 .. 01970 1980 ,19
90
2000 1990 1990 22'101999
J.pan15 and ove,
UK16and over
USA18 and ever 27
30 Litigation
"Utig.tion will keep coming until (the industry goes belly-up.·Prof...",. Rich.,d Dlynlrd,
Northcastffn Univerloity. USA. 2002
T obacco litigation began with ::I
personal injury lawsuit in the USA in 1954. For more than40 ye~rs, the tobacco industryboasted it had not lost a single case but this hilS ch.mged. One CiUC In ~tinnc.<K>la that began in1994 ruled that millions of p"ges
of internal tobacco indwll')' documents (sec: map 2]) be put into the public domain. These shewed that the industry has: concealed tnformauon on the true harmfulness of smolclng andmisled go\,cmnlcnts, the media and their clients - smokers.
Utig.tion has pUI the industryon the political defensive, forced tobacco companies to the b.rgaining table •• nd h.. resulted in some I.l.rge settlements. with the tndustry p.)ing US states billions of dollars a year.
Outside the US.~, tobacco litigation ts a new phenomenon. and clear patterns do not yet exist. HO\\'C\'CT I some recentCJ.5C5 shew the potential fer litigation to advance tONCCO
control. ,\uslraUa has seen amajor ruling on the dangers orpassive smoking. Public interestwrit litigation in India has
prompted the Supreme Court orJodi" to require nationwide implementation of broad restrictions on public smoking_
Cases now \~ry frcrn smokersand non-smokers filing ford.m.ge to health: public interest lew suits seeking to force the industry or go\,cmluent to comply with leg.l or
86
BATfaced
,lawsuits
in the USA alone at the end of 2001
eonsutuuonat requirements; governments .suing (or tobacco- attributable health care costs or for lost taxation due to smuggling; to cases brought by the tobacco industry ag.tinstIndividuals, orgolnisations or evengovernments.
The judge in an AustralianIi)\\'$uit against B.AT. in 2002found "'that gh-en the filet that not a Single document was in fa.ct
.>
discovered in thaI calegory (pharm=loglal dTects of nicotine) the Implication se:c:rru overwhelming that disco"cry has been fund..nenully thwartedunder this Cllcgory by '1tinue orthe 1998 destruction prognmme.·
6 a h
1Im
29 Price Policy
~t. Nm and tobactO Jrt CJ:)ftWnC)Cjtticswhich OIft nowhtft nec:tSSariel of lift, whid'l
art btexlme objtcts: of almost u.~ttlmum¢kw\. Jnd .hld! art dlettfort
c.atmMly proper subjttIs of taxation.·Adam Smltt. Nt IfVlviry kI:o 1M Uotll'l'e OfJd
o,l/Sdo(fltto IVtclflidUotiom 1776
The price of tobacco is the single largest t~Clor inl1ucncing shorrturn consumption pattern!, More importantly. price plays a major role in determining bow mOl"Y
young people wlll start snloking, and thus profoundly tnrlucnoes longltfffl ccnsuurpucn trends.
There is a dear Inverserelationship between tobacco taxes and tobacco consumption. For C\'cry 10 percent Incre .a.se in cigarcHc taxes, there is onave ..,.,&c .t four per(""Cl1t reductionin consumpuon, Youth, mincritlcs,
..lIU) IO"'-inCOI11C smokers are l\VO
to three t1111e$ more likely to quit or smoke le.s than other smokers in rCJpOnl'C toprice increases.
Tobacco laXC5 are an hnpol1anl source or revenue (or countrles.
but the pCrCCl1lJgc or total government revenues accounted for hy tobacco taxes is relatively
Smoking goes down as prices go up Re.al cigarette primand dgatetlt consumptionin the UK 1971-95
tJlptndlturr on d~'f't1t\'" mlllion~ of pound\ ~lt,nng
p,itt of20cigaftHM
84 1971
CA.~D&
UHITED STAfES OF AYE.leA
.(..9...
"".....small. leu than 10 percent in ;)11 EBcountries, and less than 2 percent In most coumrf .".S. Higher tobacco lJX\'S arc also c.uy to implement,and nCOIrly alwaj s provide mere g0\,crnlucnt revenue, despite Ute riJCl th31 people- arc: l'moking less.
,~oo
t974 '977 '980 '983
5''''
'''''•'.!'''iJ21.,'.l',A'",l,,,,
(-! ~-~0 ~!" l:Tax down - but prices up Declining cigarrtte 13)(in the USA as a p(fccntagc of retail price:Smolen Ofttfl QSWmt shot CIgOrr:rtes haV't b«Omt so u.ptflj.h~ b«ouk offftcottOldtC,ft1'" f«t.'" Utt USA. whIlt tilt' prittof C'f9off'rtts has rt'IO'tOSf'd.flit proponlon go;,., fO to. IS ht)tf of whofu ~"CSjn 1965.
'986 ,... '1192
'IllS
.J
.""'"'Land devoted to growing tobaccoArt-a In neetares
MM• ovtr 100.000
• 10.000 - 99,999
5.000 - 9,999
1.000 - ".999
under 1.000
00 tobocco grown
RUSS'~NfEOe .... 110H
(obattO is 9ro\\I" on mort'thin one pcrC'tnt of.gricullurallalld
.".... _-. 1''''1
, .~
.')
--
Luding produccn of tobacco !elvesThousindi 01 mctnC ton1
;01)1
-,.7-132-130
-120
103 101
ChIna India Bra11l us... Turkey ZImbabwe IlIdon.. ,. Italy Or.... Malawi Pallo,.n Argen1ina
47
The Tobacco Atlas
"When one has. thorough knowledge or both tbe enemy and oneself. victory Is assured. When one has • thorough knowledge
of both beeven and ear th. victory will be complete."
- General Sun Tee The An ~1I&r: A Trearis< on Chinu< MiUra'}' Sd<ntt
c. 500 B.C.
IIII_III.IIIII~IIIII'I.J77W-RXB-WYDZ "
FOREWORDA message from
Dr Cro Harlem Brundtl3ndDlreeeor-GcneralWorld Health Organization
"More people: !mokc tod3.),than at .lny other rime in human history. One perl'On dies every len seconds due to ~1nokJng.related diseases.
Research evidence. in the past flve years shows a bleaker picture of 'he health danger of smokingthan previously realised. Tobacco ts the biggestkiller, much bigger in dimension than all other forms of pollution.
Children arc the most vulnerable, I"loiliiustart Inyouth. The tobacco industry knO"'\tS it and .lets
accordingly. This iii .l medical ch0111cnge.but clso a cultural challenge. Let us all speak au" tobacco l<. killer. It should no' be advertised. subsidised or glemouetsed.
Adolescents should not be allowed to mortgage::their lives 10 the seductive advertisements or theindustry. GirJs and women arc being urgeted 111 over the world hy expensive and sodecrive rehacco ad\'ertising imJgcs of freedom. ern ..ncipation,slimness, glanlour and wealth, Tobacco companies should he aeeoun rablc (or the hum caused by t01>3(""<:0 usc.
The (I:.)' I took office I launched the Tobecee free Initiative (fFI) to spearhead the struggle to reverse the ,,'orJcning trends in health caused by tOb3CCOand to add momentum to a erlticOlIpublic health $trugglc. The initial-h'c aim, ;at hC:lghtenlng global aw ..reness of the need to a<ldress tobaccoronsumption, It aiM) seeks to huild newpartnerships a.ntl $tI'cnglhcn existing P..rtnershipJ for action agil,;"!t tobacco: to ccmmtseton policy research to fill g"pSj and, to accelerate nation.ll and glohill policy to Implement nr-.ltcgicJ,
The \vay It ' v·orks illustntes the "'ilY "'C wtsh WI~O 10 work in thr future making ,he "lOSI of our nwn resources and kno,vlcdgc and dra\ving he.,,'lIy On the IuUJ\\flctlgc and expertence or othen.
Our gMI! are to:
• build ", vibrant .lIimcc" between WHO. UNICEF. the World &nk, and "parmershtps with • purpose- with non go\'crnment;ll orgmiAlions, the private sector, academtc/researeh institutions snd donors,
• try to gel morc people to work on andsupport tobacco control ~hities and ensure lb.t more resources are committed to tobaccoresearch, policy and control.
• develop the Framc\\--ork Convenucn onTobacco Control (FCTC), the world's rom publichealth treaty. The ''''''y \\ill only be effecth .. i( i, works In conjunction whh, and builds upon. sound domestic Interventlons.
The good ne" .. is Uul the epidemic (Ioes nOI haveto continue this "'a)'. There is I political solution to tobacco - a solution routed through ministries of nn.nce and .gricultu"" .. well as he.11I> and education.
\-\le knO\,· tNt tobacco control matures canlead to 3 reduction in _moking as wlmessed .tnlong some member 't.)(('.I. WHO, the '''orld &nit and public health expertJ bave identified a c::ombim1ion of the rollo"'ing U N'ing a measurable andrurulned hnpact en tol»c:co use:
• increased excise taxes;• l)4n, on tobacco ad"crtislng. sponsorship and
9
PROMOTION
Toni Osdcnc,oI\Vby ODt smokcst.
quoted in l.tow Db}"U S~I1l)tc:}).
C.mpoign forTooocco Free KidJ.Washington DC. 200 I
"Smoking a cigarette for the bcginner is a symbolic act, I am no longel' my mother's child, l'm tough, I am an adventurer,I'm not square. Whatever the individual talcm, the act of smoking remains a symbolic declaration of personal identity •... As the force from the psychological symbolism subsides, thepharmacological effect lakes o,oer LO sustain the habit."
576 a
31 Projections by Industry
The lob3CCO industry predicts a global expansion of the tobacco epidcmtc in the next few years. The Increases in ccnsumpticn lie
principally in the developingnations, while consumption in theindustrialised countries will be
static or in decline.
In all die countries surveyed,the higgest gro\\'lh between 1998 and 2008 is expected to he in Zlmbcbwe, followed by Cote d'Ivolrc, Brazil, Morocco, venezuela. Pakistan, United Republic Of·rJn7 ..ania and8.1ngl.ldcsh.
11,C grc.at(..~l cleclint! t~expected to New Zeal.locl, followed hy the UK. South Arne>. Hong Kong. Au:u:ralia, Singn.porc and Finland.
In Africa, only UU!South AfriC.lf1 marke; is expected to decrease,
In the AlllCr!C,'A$, gro\\rth In Lattn A'l1crlc4 is cxpcctcd ro compensate for declines in t-he USA and Canad a, will, Il,C greatest Increases in Brazil,venezuela, Mexico. Peru, Chileand Urugu'y.
In Europe. the forecast is
mixed, wtth Increases in some markels and decreases in others. The biggest Increase L~expected in Nor-way, and the greatest decline in the UK.
In the Michl": 1!a5t region, the
high .. , gro",h is expected for Morocco, followed hy Pakistan and Tunjsta. N(, couolry in thisrcglvn IIIcxpecrcd to experience a decline In consumption.
In South East A.lIiil, Oang)<ltlel,hwill sec the higllc~t gro\\·th.
followed hy Thailand, while cousumpuon remslns static In lndl a,
In 1111\:V: CSh'rn pjl(:inc, VICln,ull
88
UNtfED SJAr(sDr AUERICA
tops the gro\\>'th charts. while New Zealand. I-Jong Kong. Austr~li~ and Singapore shew L11C greatest decline.
This transfer of the epidemicfrom rich to poor countries, with
it$ hc~hh and economic consequences, L", one thatdC\'cloping countrtes can ill •.O·ord. As long ago '5 1986. theWorld Health Organiution pre(licted that the differential in
wealth between rkh ;tnfl puor eouutrtes would wtden further a~.1 resuh of t()l~coo, leading toccrnpromlse in sustainabledevelopment.
These projections are nOt h\e\'it3ble; tOb3CCOcontrol iluer\'Cn1ion§ can make :I.
difference.
Pt-rttr.ugtof 1l-lSvealoOCS1oI\<!"i9 tob.Jcco1001 Of lo'ot """ lob","0"0/10'. ft9l()(lO/ OI't'ifytlaZD
• JIRIt and tMr
2~ - 29'lO
10'" - 1900>
under lQQb
• vlnablt:JCllb - 6()qb
nodal •
•• 'to ".,"0' AIII',(A
.....
--~
.._
....._
GIRLS
29
t
$~(LERSWgRUDWID
INTERNET CIGARETTE SEARCH Google, 2002
---,
Search term
I disrount cigortHt
Ichtop cigortHt Itox
frtt cigortttt I mall
ordu cigortttt
/'
Rtsults found
9,070
5.510
1.540
INTERNET CtGARETTE VENDORS, USA 1000.I
'Wow!!!!!I!!!!I!!!!!What a gltat
website for dgs. I can't believe I havebeen looking all over
the web for cheap dgs and here
you were all the timewith a
complete list of companies. Thanks
a lot I'
--/- IUser ccmment posted on discount cigarette site, 2002
intunet cigartttt vendor sites 188 Isitu with Surgeon-Gene .. I'! warning 24:J!!
silts stlling bidi! 8%
sitts wilh special promotions 33%
situ with age waning 8 7%
typtS of ogt vtfificotiDn Icquilcd:
euste e er self-reporting they are over 18 I ~99b Ityping in a birth date 115% • I
entering driving license information 19%
US teenager,s with internt! accus lover 50% I
61Ba:al n'J3fl 1
,
III
RlRE5T: Frtedom Organisotion fo, Ih. R~hl10 Enjoy Smoking Tob.=
RlRCES: Fighl Ordm.nco:s I!Ro:stri<tions10 ContrOl a Binlinal( Smoking
~-, U",... EI,'lherla
-rirat ve aUIt. work horder at qettlnq aeokera to help t,he induatry. It we A,rO to have any luCC81S atchanging tho climato ot
opinion, we have to qet the anokers moee on our side, or at leaat enou9h of thea
to start to .. te adifforonce.-
'We try to keep Philip Korrl$ out ot Dedi. 1•• u.I like taxation, 1:.oUng ~,n.
ond marketln9 restriction •• Inlt••d, ve t,ry to provide the media with Itote~nt.in support of our positlon.from third party loure ••
, which carry DOre credibility than our cocpany and bave no
apparent v.lt,ed intereat."
PhilIp Horr! .•, 1993
·Smoker. oro not 0constituency that CADbeeasily rallied. They u.defen,ivo, often self-
deprecat1n9, .cmewhat. IharMd. Hay .eo them •• lvee engaged in4 habit thoy wish they could
qu,it. They ore a passiveq-roup. Expr••• ing very lit.tl. anger or r••en~nt. There t. no lign ..on9 thea of any significont doterainatlon to
assert their rights a....okoto."
RJ Reynold., 1918
Philip Horrie, 1985
-In Au.teal1. ~, thrOu9h POREST, we have awakened
the public In the tax area, vith carofully
orch.atratedC'UlpA19n •••
Philip HOrri., 1985
L ._.. ._ ..... ; "I!I I..II
-
Cigarette exportsmillion of cigattltts 2000
• cwtl 100,000
• 10,000 - 99,999
5,000 - 9,999
IftAlll
'--'
1,000 - 4,999 betew 100
100 - 999 no data
25.1bn
-- ....."
Cigarette importsTop '0cigan::tt~importing countritS2O(J() numbtts of cigartnes
,.,fr.~, #
_\~
Cigarettesmttric tons 2000
IOlallmporttd: , 5,27'total c)(po(1td: 14S,533
us Import.
US exports
~-V"\~
• '"..•..".
53
:
u_ ~
Smoking prt'Vlllence for men
~mOl;"9 Amono MIIII~<:.gl"a It.:a,vJ tlvtf
lor .. r OYDilobl. dora
• 6O'!b and above
SOOb - S9'lb
30'!'0- 3~ no dati
10,"-19ClO
b<low 201!>
Top ~nhigh~[ overall $mOkingratesof men .nd ""'omen comblntd
-....-.
,...,.......,•
... .....
-""" .
AUSTRALIA ._.-.--!r
Physldans who smoke
Smo\ing pr<VaICtlCCa"lOng physicians1000 Cllolest",'Oiloble doro.sdect~ countriespc:tttntagcs• women• men .!!
it'.!"!g ~
I0
~ e ~
o E 2 ...u i! ,;t
_~
~
~
u
~
r.':l ti1l~ :S ~
<: !i
0 1!
2~ II ~
e•.
;; = -u
e e
1> .0.E"
it ~'"
~ ... u es:~ '"
.>! u ~ ~'" 25n ;3 .,
27
Education is essential for sustained progrc$!I in tobacco control. Many legultlt:i\'c or tax Interventions \\;11 not he
effective if there is no public understanding. support anddemand for such changes_ Peoplesupport tux tnereases whcu they understand that the rationale is to reduce youth .5Illoking: an ,,\'{'rage of 87 percent of respondents in
Health Education
--C"ffADA programs support
lourl objoctive ofdiscouraging unlair end counterproductive fedoral, state And
localrestrictions on
Argentina, India, Japan. Nig('ri~tand the Russian Federation were in favour of international efforts to create a set or rules and regulaljon!l to curb tobacco use.
Schools can provide an ideal venue not only to leach about the
harmful effects of smoking. hut.dso to teach students refusal skillsand an understan<ling or Utebehaviour of the tobaccoindustry. This includes .1oJ.lysing the mantpuladon ()f young I)(:()ple by Inarkcting which equates,srlloking with gro\\'ing up. freedom ~J1dbeing cool.
The first step with school prObTr.lmmc.!l is: to increase knowledge about the harm caused hy SlnokJng and 10 Ch.lIlgC beliefs. anitudes llnd Intention .". Thlsalone is not sufllcicnt to changebehaviour. A school tobacco
control progr:unnu:: must :.1£0Incorporate prohibiting 10b.<.OOusc: at afl scbccl facilitirs andevents, helping student.! and st3ff
to quit smoking. and Ide.lI), In.ldng the course part of a eoordlnated school health programrne, relnforced b~·communtty-wtdc efforts.
To improve its public imilge. the tobacco industry has recently become active in .moking prevention programmes for young people. '111t:seprogr;unmes panfil)' .sllloklng as an adult decision, and that young people should wait until they are gro"'n up to decide to .smoke. Stnceyoung people .upirt' 10 be youngadchs, Ihis Iype of Inc:~s;age mJlYitclually make smoking more appealing 10 youth.
u S • ci
advertisin9_-
US Tobacco Institute,
1991
.......
1988
Tol>&o<o
1989
Women
1990
GrowIng up
1991
Tobacco in
1992
teeaeee
1993
Hullh
1994
The Media
1995
The
1996
Spo",..6
1997
The U.II<1I
199B
Gro...-ing upor Htalth' and without Public II lhe XNKt'S. .g-llnst Ec:onomlcs The Arts Nations and VWllOO>Jt
Choo" Tobacco lob.ern Places aria WortptaCt including Tobam o(lobo« WlthoulHtalth on Public Hullh teeseee
rrlnsport PCl'$onncl.
SpcC.,liztd-Agt"CI~Against
Il>tlo«o
'gainH Tobaccoteeeeee "United fOl
• ToOo«o-0 hot W.. ld-
-
World No Tobacco DIY: 31St May annual themes
8
PART .2
THE COSTS OF TOBACCO
"I'll tell you why I like the cigarette business. It costs a penny to make. SeIJ it For a dollar. It's addictive.And there's Fantastic brand loyalty."
396 a
Multo 98.8n 34.8'lb 51.2 ... 18.4'IbMic:ronC1ia, Federattd States of 123Mold .... Rtpublic of .,295Monaro 33M..,goll. 2.533 46.7'Ib 67.11... 25.5'l!IM()(OCl'O 29.878 18.1'M> 34.S'" 1.611>Mozambique 18.292MvanmarNamibia
47.7491.757
32.9'Ib5O.0'1b
43.5'M>65.0'111
22.3'M>36.O'1b
Nauru 12 54.0CI> 61.0'lb 47.0'1bNepal 23,()43 38.5'l!I 48.0'111 29.ll'1b 7.8'lb 12.O'1b 6..O'IjNelhttlands 15.8&4 3J.0CI> 37.0'lb 29.ll'1bNew Zeal.nd 3.778 25.0'1b 25.0'111 26.O'1b ..'\.
....
-
-
"'
Table A The Demographics of Tobacco2 1
Countr-ies Popubtion Adult tomo1cing Youth tobacco use I
tbOWMIW pc":rt'COugt;, P"""""'Pto!.d ~Io (vaalc 'ow r......
lebanon 3.496 4O.5'l!I 46.O'1!1 3S.O'lbLesotho 2.035 19.8'lb 38.5'l!I 1.0'1bLiberia 2.913Libyan Arab Jamahiriya 5.290 4.0'1bUthuania 3.698 J3.5'l!I 51,OC1b 16.0'1b
luxembourg 437 33.0'1b 39,OC1b 27.0'1bMaetdonla. Forn'ltr Yugos. Rtp. of 2.034 '6.O'1b 40.0'1II 32.O'1b ,Madagascar 15.910Malawi 11,308 14.5'l!1 ~ 9.ll'1b 16.M1 16.O'1b 16.O'1bM<llaysia 22.218 26.'''' 49.2'110 3.5'lb
Maldlvts 291 26.0'1b 37.ll'1b l!i.O'1bMall 11.351Malia 390 23.9'11> 33.1'" 14.611>MDIshalllslands 51-Mauritania 2.665Mauritius 1.161 23.9'" ".II'" 2.9'Ib
32.0'1b 18.0'1b
21.7'Ib 21.9'!b r~.
•
,
~Nltaragua 5.071Niger 10.~2 ~Nigeria 113.862 8.6'Ib l!i.4'Ib 1.7'Ib 18. I'M> 22.O'1b 16.ll'1bNiue 2 37.5'l!I 58.0'111 17.ll'1b Norway '.469 31.5'l!I 31.0<10 32.O'1b
Oman 2.538 8.6'Ib l!i.5'lb 1.5'l!1
PoIklstan 141.256 22.5'M> 36.0<10 9.ll'1b
Polau 19 15. I'M> 22.3'1io 7.9'!b 58.S41o S6.O'1b ~j.:Panama 2.856 38.0'lb 56.0'lb 20.ll'lb PoPU' New Guinea 4,809 37.0'lb 46.O'1b 28.ll'1b
"",.gu.y 5.496 14.B'1io 2'.1'" 5.5'l!1
I'tnI 25.662 29.6'Ib 41.5'l!I 15.7'Ib 19.5~ 22.O'1b 1~.~Philippines 75653 32.''M> 53.8'1io 11.0'111 23.3'M> 31.2'1io 17.2'1io Poland 38.605 34.5'l!1 44J)'Iio 2S.ll'Ib 24.o111lt 29.ll'1b 2O..o:Ma>i- Pon"gal 10.016 18.7'M> JO.2'M> 7.1'"Oalar 585 18.8'lb 37.o'1io O.5'l!lRomania 22.438 43.5'" 62.0'111 25.0'lbR""'an r.dmtion 145.491 36.5'l!1 63.2'M> 9.7'Ib 3S.1'M> 4().lI'Ib ~RRwanda 7.609 S.5'lb 7.0'lb 4,OC1b
98 S4Hlrt'bl JC'~ 1M.... 124 I lu IIOfrM: rowlU~ diu ll't ~ oo,om. ~nY'lln m.a.u '*-'..: ~MIdIre oo( 1I00I''''''1 noptaomUth~ cIthe mcm CWlIb)'.
/ Tobacco manufacturing workers
Number of worttrs
....... )DWallarm OViJ1IDh~aOfD• ave. 200,000
• 10,000 - 100.000
• 5,000 - 9.999
• 1.000 - 4.999
1 - 999
no data
India:6 million children,
ages 41014. work: full time in the bldl ,"dustty
filTER tlG4RE
Less tobacco per cigarettetstlmau;d Ibs of leaf used
pet '.000 clgarctttSIn tho USA'961H999
ADDITIVESS,I.<1cd addi,l ... and offm,
thingn pH Ind m.vInOclst nicotine .bsorphon
Flavouring,SweelC'ntn Eugcnol .nd MontholCoe<>.Othen
(,,"anet tas-Iemake mOlt pilat~bft numb IhrQ.a1 and fatil1tatt Inh.lallon dIlate ilfWilVirna~t sm(1I 'I'd Invisibilityof stdcstltam smokt
o1hcr Itddlrrves: ammon'l ... mmQn~lJm nydrO)l;idc. beta-eeeteee, gentian rOOI l".XHKt. Itvuflnlc aCID, patchouli oil, urn, melhy1cyc:lopt'ntenolcne, $Nl:troot otl
49
I
I
'6million>
*'
28"&try nicotiM patch told MUll)
200 cig.rrtta not soN. .. Oiw IIta.ASH UK, 2002
The nuin d.lOgers or smoking decrease wben smolccn quit. n'cn in those who have smoked for 30
Quitting
~ the' UK. ~Rr e nalJItIk ttl all c:itiztm U!"dcr tht1UliOoaI1I .. ltlo _
Mdkm~oft-"tr.Y .
oth.er
or more ye.lrs.Smokers move through .uges In
reution to quilting: or pre-contemplation. contemplation, resdte ... then >dion, fcllcwed by maintenance or relapse. ~'1iU'1y move through thi< cycle >e,'er>!tim es before they fin.lIy quit, while others report they round It easier 10 quh than the), expected. The se stages are influenced by tncreased CQSl5 from lax increases or reduction of sn,uggling. illnes. in the smoker, farnlly or friends dying from robscco, the media,he ..hh profCl5lon. hans on promotion, ereauon of smoke- frce areas anti, whllc lUO~t
smokers sull quit on their 0\\'11,
a\'ailahilit)' of support anel treatment,
There are now technique. to lLul.!1t these who want 10 'lull smoking, .Ithough th ese are not
Quitting CaiendarThe: ""n<fits of slo9Ping ImOIdng
.".iI,bl. in _II paru or the world:
.od~l"upJl'ol1. dlniCl, quilHnca,
Intemet .lte.; .leJII. t.. lnln&:ntcoune replacement thenpy r~(NI\T) and other l'lohanll.1.CCullcalIfC4.uncnu.
If hucr\'cndons only focus on prevention or initiation, and donot addrt':" CCJs<1tion. lhtn160 million ""dldon.l.mo.o ... "III dl. bef ore 2050 (see below).
IIlAZll
-
.•
.•
1 ct.y Iltll:'
1yea, lalt'
Sto 15Y''''lilt'
Hearl. blood ",<$W't. and the bloodshow WI! pf'OVtlMft IS
Ex<m ruJt of ......... 'Y hurtd.staSt tt h.lf U,JI of I conlIn", IIfsmoW
RI'" of • st"*, " ,_ to Wtof ntYtf·lo~t"
Effects of starting .nd quitting smoking on d~.thsTotal.CX\Imula1cd tobacco .... tIK1000, 1025 ond 2'OSO fJI'Oi<c,ed
lOY''''1.1,c.,
Rill of lungCIMlttl "mfU(td to tN" half that of ""'t'""'ng
>mO''''': ruJtlof ",."., ot....~,,_,_lit pi""'"
w11..'..,......".,.. ..
., Nttt C*4M • de ;w......
15 yca"
laltr
82
ancttS d«rfl~
Rls.k of torot\lry heart dlit.Sf ,~ slmll.. to that of ntV<">mOt,rs, and the OYfrali ,Ilk of deJth .tmost tnt same. t~lllly.t tht l~(,f qu,t~ btrOf'r llinm dtvt'lo,"
5lOn1 50000
PART 1
PREVALENCE AND HEALTH
"". tobacco is the only legally available consumer productwhich kills people when it is entirely used as intended."
21
32 The Future
"'he vse of tobacco. whi('h h~s made Its way thanks to the sptrit of imitation. as
wen as to Its PC:C1J.1II' eff«ts. has.lnqyiVitd humanity .nd will CQntin..,c: to
,elgn untilltle end or tht world." LouiJ l.ewin, nw"tIlHiro: ","CO rIc om!
Stimulorjng Drugs. 1924 Number of smokeDassuming ('onstont
"Thcfe will be' , billion de.ths fromtobatto In the 21st «ntury unleU strong
and s"mined mion is uttn now,"
pre'JDltn~ and medium 't'Oriont proj«ttd populoDon
nature speculative but someNumber of smokers .~:..,fI-J--:-:--:-=--=-_::=-=-=-~==f=t~=
Ridtlrd Ptto 'nd Ala" I..opf.z, 2002
Future prcdlcttons are by their
billions 1.6
O$$uming rtdtJCXd 1.4thjngs arc certain: the tobacco
/N<volenc.o(-7.OCIbp.a .. medlum ., 1.4
epidemic, with its attendant health and economic burden, is both inCrC.1..iing and also shifting from developed 10 <Icveloping nations nations; and more women
aTC mloldng.The industry is consolidating.
and also shifting from the west to (Ie,'eloping regions, where there may he less go\'cmmcnt control and puhlic debate abom the role of transnational tobaccocompanies.
The future looks bleak: the globallohacco epidemiC is worse
voriant prajtcted 1.3populationbillions
Health Tobacco's s!\itt of global dt:athand disability Is]qh
100 miflion c:tIlIClrtn Vlpostd '0 paulY( vnotlng i1 1'101'1'1(..
82_ of smours fivt in d('vttopingC'Ot.lntTio.
Eeonomla Global annual rcooorn1C' rests 0'toOactO:USSSOO billion a yr.lr by 2010.
IndMMk 9C"cdc:ally prone '0 t*«o-ttltttlS distasts un be idc"t~ at birth.CiIlttl'S, (!UlTtfttly ulItrt;,hlblt. ooukl betrtate4.
Htw trtMoio9Y (01 diI9~.lId tttatlfleftl wfll be: ~"siY(.nd hIIvt IItt1C' Ifflpa(1 on glob;,1 momUry $tatl.stks.
fObaCtO-ftbttCl iUl"ltiSts nSot totop !'ItllthuptnClitufc in malry countries.M»y governmc:ftU condudc tilt e<.'OI\OfI'IlctoS~ of tobKto Q{"Itwdgh atly bcfIc:fit.A SC'IttC t(OftI)rI'IiC' dqwt:s:siO.ft Ind/or • Njoc intc:m.t'CftaI ~rity 0'1s1s eI\I5t tbbacto ls$I.ItS to U1"poqril, dlmillll$h in Importal!l("t:.
today tJ\olll it was 50 years ago. And it wtll be even worse in another SO YCOlr.sunless An extT.lordinary effort is made now.Several countries have Ollrcady shown that snloking rates can be reduced. These successes can be reproduced hy any rcspcnslble nation, hut only through Immediate, determined, andsustained gO\'emmenlll and comrnunity action. The future epidemic depends onundcn;t-;tncling of the blue. and1>oIiciciI, politics ancl ;1ctionslaken lo<by.
90
Tob.«o industry
ActionUkt.n
AUtmptl to procIuct gt:ntoolty modified tobX't'O 'MUllowtl nicotint.
Sotnc tobla-o C'Ompal"l!~buy phan'NIttlltK-a1 C'OfI'Ip.I"it's.
Tht indu\trv tritI to tt·position iu publlt image: " a mponSible: COtpootion.
'lit indlntJy ~b ttg\llltio"on itsown tt.rms.
framCWOtl CotIYtndOfl on reeeeeeControll'ltititd.
SoIT\lf oollntrits bin smoki~ InWHI'I'CS tOl
QIoIllting IncfudcI'ftOnCtJry savi~ UII~OhrrOalCS and kMer Malth Insurance: prmll'llms.
Doubts abollt ~'m Nlilr.,toUS"
or tobltc:O
prodlJttS IntrtlStS.
In dCYdocl<d countries. theft Is.Drld\.l,l Shih in the Ptlttpdon ot$tnQklAg Ii It COtI'<$ to be: letn H,ntl·sodat.
Industry tonsolicb~ ka-ds to 2 or lllugr:C!Of9ommto ICCDlI "ting for tbe buCk et,toNI satts.CondrlUC'cJpri'vitisation Jtt$ (tid Gf sta1~"tcbattO C'CII'I'Ipi81t\.
tlitk mlfkrtl ltill aiu for smaller plIyerSf... 19'", ItIItffl.UbmliiAtiolli of glob" trJdt (\lIes wel<omtdby the: Il'Idl4tlY.
s.nllggltd dg.ltttrs 0Yffta\t 11:911sa,"-
.El
_im
lln
oltiM
f
t WOtIdoldc. .dvtttlsing Inc! Vacant procfvctd to switch oft lIicotiM ttrtpton.1.1«1... 1,.;,_ Vlobilllynu_ "",""'tkttlthlng on toba«o.
Slt'lOk~'r" ,raj will be: odI'~ tot not'I.~"'Oklll9btint the norm.Cig,ardle: Pltkti Will be: pI.in bUdI.IId white: .nd tonUln ontvbrand n.amc Ind expllt:ltht.lth Mm.
TobICUI dependent ((:C)tIOI'NtI 1ft .uistcd In dl,.",,.,,~Nkotlnt Rtpl~t Thmpy sold OWf thecountc:r wortICtllYlck.
-.lNol·ld's worst forest fire caused by cigarettts
300 lclllrdmadl: homeltsS
;•.
every year
• percentage of all fire deaths: 1()C)b• t.L'lIIclII,d by firts c.U$ed by .moling: 300.000• tctet (Ost of rues caused by smoJ:if'lg: USS,27 billion
Every year
l PlliUppl ...
~~. :$;6'0'0i-mi-Bi-on---_'
Annual cost of lossS16.5million from time off work
T(ltCOm AustriliaC'mploytts1994Austl'iflin S
$5.5 million
41
50 900 1.775 5,67'750 !1.500
25 20130
.926 32' 15,go5 6,.930,133 2.5.175 25.615 SJ.B95
-:I: :
~
Yemen 5,209 0.26% 12,S81 2.000 150 ..
Table B The Business of TobaccoI 1
Cro,,·ing1"ob.lcco Tobacco Teade, (;CMLfttrb
Un.ft Agricuhur.ll Tob.t,('01XJd~"OI~ re t~l1cJ de"01NI 1,n)(lullC!C1gro""nt 10 icbacco T(.~c;(!o Tob..n>utobacco (.J:rming aCudtt:!l Gc....... I",r 1",(
1>0«_ ..0(."
'
0.".'j
mell'"ic lOlU""f""'S
mtU'ICCcw.
Silln1 Kitts and UcvisSalnlluda 20.
5.ln1 Vincent .and Gr~n.adin~ 70 0.55'10 85 30Samo ...·San 'Aarino
<I) 0.03% 135 3.250 25
Sao T~(_'nd PrinciptSaudi Alibi. 150 20.000 2 622
Senegal 3 500 366 1.6475<)<",11 es 15 40Sierra Leone: <I) 1l11% 20 200 13 100 saoSingapore: 0.30% 58.745 49,350 2.266 12.158Slovakia 1.134 OA7'oI> 1.870Sto'ltnia
So"'!,lia 250 M2'11> 100 I29,700 ISouth Alri", 14,100 O.ll9'¥o
Spain 133SO 0.09%Sri Lanka 4,780 0.45'\11 <IlO 50 2.37' 3.825
Sudan 100 70
SurinameSwaziland 194 0.()4'11> 7~ I 20 420
2 7
Sweden 400 2.000 1.m 111789
Switzerland 651 0.17% 1.182 I 23.400 200 7,372 31.486I Syr;.~ Arob Ropubllc 16,726 0.25'1b 26.112 sao 2.000 2.315
Tajikistan 5.200 0.54% 1),500 1,000 7.000
, T,manl a, United Republk: of <0,000 l.oG011 26,670 12.265 21,350 2SOTNiland 51,800 0.21'11> 74.200 1.500 8,000 25,025 10.177T!)go 4,000 0.1611b 2.000 1,000 3TongoTrinidad'and Tobago 0.Q4% 2 2.065Tunisia 3,100 0.08'11> ),400 2,000 218 8.013
Tuitev 290.000 0.17'01> 260.000 111.006 30 129,28' 48.846TURmrnistan 800 0.07 .... 2.000 1.500 800
TuvaluUganda 1,500 0.11 .... 10.000 4,71-' 144
Ukraine 4.300 ~ 3.000 20,000 1.579 1MOO
Unit~Arab Emiraln 50 0.07% 608 8.000 60 236
Unit~ Kingdom or Gr. Dr. & N b. 2 '5,018 9.945 128.569Unittd S10IttS 0' Amtrica 191,176 0.1 so.tJ 471.630 148.261 15.064 19o.538 WJl62UrugulY 830 O.()6llb asoo 22.950 40 7' 8.954Uzbttistan 10.500 0.11* 19.000 15 7.500 5,.50
Vanuatu .Venezuela 6.000 0.23'" 11,288 250 50 186 10,507
I Viet ~m 24."00 0 .. 1.... 21.200 2.000 96 16.0008.502
, YugOslavia 9,858 0.26% 11,341 l.250 101,500 3.710 2.700
Zambia 2,900 0.06'\0 3,200 3,(;()O 1,100
21mbab we. go,769 2.56% 227.726 2.000 163,933 6.723
108 ~r<":_IU£"< Il~ " 1
w.
-Small shopke.pors were enlisted to write
protests to member. ofp4rli4Den~, ~h. letter.'Ione with d.liberato
cypogrophical errore to create ~h.aura of authenticity,' were
prepared by the(tobacco) indu.try for
the shopkeepets.-
Philip Horri8, 1990
~e have got the union.to aupport indultry in
several countries.Prcmlnent have been the efforts they have madeon t,he t,ox isaues in the OX where they vere
very involved in 4 letter writing campaign to
Members of Parliament.-
Philip Morria, 1985
·Phil1p Morris and the industry are positivoly~pactin9 the governmentdecisions of 8ehrain,
~uwAit, oman, Qatar, Saudi Arabia and the UAE throu9h the creative use of market specific studiea, position
papers, well briefed distributors who lobby,
media owners andeonsult4nta_ -
Phi1ip Morri., 19.7
-TUrning nov to primary ond passive IDOk1nq_To
get mor,. favorable prOI.,
we are conte~pl4tin9 organizing anothor
journalists' con terence similar to the oneput together in Madrid
tor Laein ~rican journalist. in 19".-
Philip Korril. 1985
Buying favoursTop lObatto contnbutions
to federal clndidittSlISA 1955-2000
·The International TObacco Grovers
AssociatIon could'front· for our ~hird world lobby activitiea
at WHO, and 9.10 auppor't from nation. hootil,.
to multinat1.onel corporiltion'_·
rNFOTAB. (tobacco induatry
pressure qroup), 1988
63
q
/
23-robe 111ft of wk10ty eM .hot in warflre
see to it (h,t they rltSt h.IW • rtrong InOttI Ollto( and th.t the: '""Y t. wetl
6l,qpil.td. •0er!~"'1St." r.lf. 1htArr4lf~Vor.A TrH_
O!') rnr "t,rorr~. c.SOO8C
-ToI»«o k I kiner. Wt ntr4 • btoIodallilMe Dgll!r\t tobattO, ttll"'" on • wick
t.nge: 0' ~"flnt"100h.U the rtkntkuInertll( '1'1 glo.bal tobt«O ~"wmpUo,,"
~Tobacco ControlOrganisations
1 Or 0'00 Harlem a'Vndl"'I'~.~~"i ~_uO,'"tOor.O«I'I""I, \"'.10. l'
Tlu:: lollJ-cc.J control network iJ ceenmfued .lilt.! far.re~ching.The World H•• lth Org.nl7.>rlon 'J
Tobacco Frc~ Inlll>l"'o (TR);"ceodceied fh'm ~<ldqu.arten InGene ..... eI I~'rtgIonol ond mtion",1 Hmt(~~round the world, There uno'" , WIIO Foc.al Poinl on Tobscee or lIe.lth In.1Iccurnries. and \)Il"'", i, supported by. number of olher inlcnladOnal.lg'nc.;c;j sueh as Unicef, the W"~<II1,nk, IARC and the UN I·HIII\d.Hlun.
"u: nllll g'" l'rI\"""IU,,1org.niulian. (NlIO.) highlightedon thi) molp arc lhp't' whOit
remi; II tOO ~J'(\'nt ,oI)"ltt"O related. There are dO/\"I1" more InlC'm.atlon.&1 NGO$ \\ I'kl,~1cJrc:sJ tobAcro con,rol ~J PIn (if their .cthill •• , r anging rrom the WorM Medlc.1 , .. >Od,,'on 10
Coruumt.n Inl{'_malion~J. Ac.ldcmi,ll ..150 .II v ..Iuible partner, .u many unh'(':rJitiCli cJrry out research end pron,otepolicy Inltl;"ht~8In lohl('c(.control.
There O'.I"C ;tlw Inany n,nlonal tobacco control org;aniloltionJ whose ilnpilct b not restrtcted to thlt oounlry but .1.., rohworld.,.;d., Tbese Include ASH Inthe UK, Th.oiHuhh In Th.oll.nd..nd the Campaign ror T oI"emfree KI.b In Ih. USA, In .. Idillon,Inlny I",tional NCO. \\ nrk I"'rt
72
time on tobacco iuu~. Numerous other ~rtncr. include orgl\nlsaliof\~ itn'ul\'cf! )'lfl" women, youth, f'11\lrl'lllnu."nt,14\\'" economles, 1.wllla,1I righi"religion and de. elopmenr.
~tOJIIObACtO controlorganiPtioru OU"C! acrioUJily undt:r· Nndcd gwen the fCOpc ohhe lobxco <pi<lcmic. The better On.nttd, sud> .. 11WHCilth, .,... funded by • pcrct'n .. gc of100>aOCI> LlJ(.
26-Plain P.dta9;"9 Ii Important ~eI\ISC: it
ctiminatu the poshlvrt Imagn'Y assodatfCIwith the bnnd and pottlttiJlly disrupts
dI~P~" of smoIcing i"iti~tionwhtrt{)y
thUd ,mote" b«ontt twal'ld loyal."Rob Cun"igham and
Ken Kyte. 1995
Health \vamings about tobacco have been in existence for four
hundred years, starting with King James Iin England and Fang Yizhiin China, both in the 17th cen,ury(sec map I).
Clgarelle packs fi rs , carried health \\'amings in the 1960's follo\ving scientific reports on the hazards of smoking in the USAand the UK. These early \\tamingswere weak and inconspicuous. Contemporary Canadian \\'arnings are the most "hid in the world
L
Health Warnings
/I
.-
and arc serving as the model forother countries. such as Rr.lzil, While man)' countries have some
t}1>e of health \\'aming on the pack. these arc net universal and
many tlut do exist arc not as unequivocal, simple and stark as is neccssary; some arc not in the loa.ll:angu.lgc nor on all tobacco
products.Reports (rom Canada and
Awtralia suggC$t that plain packaging may increase both prominence and believability of health \varnings. That is, no use of colour, logo or graphic design. but simply a generic pack of dgarcne,s. with the brand name.
Health authorities now
recommend that cigarette packages should not contain tar and nicotine levels as measured
by smoking machines ... these do not reflect the actual inhalation of
tar-and nicotine due to Cigarette design (primarily ventilationholes), and individual smoker behaviour (3 tendency for
78
smokers to compensate to getmore nicotine from each cig.1-f'C-tte) and arc thwmisleading. Others suggest that arange of values should be presented that better resembles bow smokers actually smoke, and
"
to include this Iefcrmatioe on tbc pad< of cigarettes in • section on toxic constituents, ","hich alsoincludes levels of carcinogens andcarbon monoxide exposure.
Sa a de hal< C P
Sao Tome: and Principe: 138 «.I'l1>5audr.~rabla 20.346 11.so. 22.011 1.1J11bSeneg.' 9.421 4.6IlbSeychel,es 80 22.1J11b 37.1J11b 6.9'lbSitrrl leone: 4.405 18.5'ib.Singapote 4,018 15.1J11b 26.R> 3.1. 9.1 •• .Slovakia 5.399 42.6Ilb 55.1C1b 30.lJllb _. _:..SIOYtnl. 1.988 25.2'111 3OJl'Ib' 20.3'11> -"Solomon 1~land$ «7 23.1J11bSomalia 8,n8Soulh Afric. 43.309 26.5'ib 42.0'lI> 1I.0'lI> 24.3'l1>Spoln 39.910 33;4'111 42.1ii> 24.7_ ~-."Sri lankaSud ••
18,92431,095
13.7%12.9'111
25.7'*>2.......
1.7'l1>1.4_
9.!RI -, 5.8'l1>
Suriname: 417 14.J1lb 18.5411 10.1111tSwaliJand 925 13.4'111 24.7CIb 2.1"Swtden.5wilmland
8.8427.170
19.0'lI>33.s..
19.0'lI>39.IJIIb
19.0'lI>28.0'lI> ":.-... ;
Syrian Arab RepublicTa]lk"tan
16,1896,087
30.3% SO.6'I> 9.911b ....Tanzania, Uniu:d Rtpublic of 35.119 31.0'IlI 49.5'ib 12.4111>Th.il.nd 62,806 23.4'111 44.I111t 2.6'1>Togo 4.527Tonoo 99 38.J1lb 62.4 14.2IIIt e,
.2M ..
-
-
_~
Table A The Demographics of Tobacco2 3
Ccuntrtes Population Adult 5mok_ing Youth tobacco usc: I
...,und. I"""'""&'" ,_m......Saint Kitts and N.vis 38Saint lucia 1<411
total .... le r~lc tow ... 1. fem&le
_ ..Salot Vincent and Grtn.dfnts 113 • 15'!b 26.~· 3.so. ;Samo;o 159 23.3'l1> 33.!RI 12.7'l1>San Marino 27 U.so. 28..016, 17 JlIIIi.
'~-~1
.'
..29.1)qb.
~ "..
Trinidad and Tobago 1.294 25. 1'10 42.1'l1> 8.0'lI> 14.2'Mo 1o.2'l11Tunisi. 9.459 34.R1 61.9'111 7.1'MITur1<ey 66.668 '4.IJIIbT~r1<meni'tan 20-24%
4,137 14.1J11b 27.cw. 1.IJIIb U~Tuvalv 10 41m, 51.0'IlI 31.0'lbligand. 23.300 34.S'I!I 5UJIlb .. 17.()111oUkralnt 49,568 35.3'10 51.1'" 19.4'10 34.6'1>United Arab Emirates 2.608 9m, 18.3'Ib <I.()IIIoUnlled Kingdom 59,415 211.5'10 27.0'10 26.0'10Unlttd Stat es of America 283.230 23.6'1> 2S."" 21.~ 2.S.....Uruguay 3.337 23m, 31.1'MI 14.3'11> 23.9CIbUzbtklstan 24,881 29.oqo 49Dlb 9.IJIIbVanuatu 197 27m, 49.0'lI> SO'lbVtno.d. 24.170 4O.so. ".8'111 39.2111t 14.8'111Viet Nam 78.137 27.1'lI> SO.7'*> 3.5'10YtmCft 18.349 6Q.IJIIb 29.1J11bYugoslavia 10.552 47.1)qb S2.1)qb 42.0'lI>lImbla 10.421 22.~ 35.1J11b lo.o'Ib ...Zimbabwe 12.627 17.8~ 34,,,*, 1.2'10 18.3C1b 19.O'1l1 17.0'Ib
100 Sou~ "'" I""'"~114
I r lot ctIIIJMM. dIou.- b..W.Ift youtt. '";wVt)'t in m.p dda or~.-' _ rIOII IW'ftMUIJy ~.uw: crI the -we~.
""""
Most popular cigarette brand by c:ountry
-..j~silOtts!
~USSIAN~ED£ft"'10N
-
INDIA[wlti, GoI' FI.G':
• Marlboro
• !klmont
• Statd"pros 555
• Senson a Hedges
II Bristol
• casino
• Ddt>
fHINA
...•.....•-etoMl \II
• Jo~nPlaytl
Prima
Prin(e SpOfUman
• Winston
ot~brin6s
The M.,(boto Mvt wa$ the lOp ad
teen of the
20thcentury
~ accordlng to
...~..~ AdvertisJng Age
• 11100 to: f $ I '"
"'JIk
~""
AUSlRAllA •-Changes in cigarette marketing expenditure in the USA 1970·99
clgareite consumption per ptoon
• amount spent US $miUion
4,095 3,858
3.400
59
d~'Ottd to I.. nd devoted I""oouttdgrowing to lob.accotobacco rllTn)ing Cig.lteu~
P"""'oog< ~f'0ruheet ..... 0( toul mrtriet(W. nnlholU ~t(1ftIo """""
TTable B The Business of Tobacco
I 1CrO"'ing 'tobacco Tobacco Trade
Count';,..-l.3nd Agricuhunil TQb.lcoo
TONCC'OCig.amlt). I~r .. ..ri:r.,;: C$JIO,l:t iml>ort,
Afghanistan 1,500Alb,nl, 1,300 0.,88'10 8.000 ',000 l,soo 34
Algeria 5,700 0..0.3<11> 1,153 18,000Ando<",AngOla 3,100 0.,11% 3,000 <00 ISOAntigua and BarbudaArg,nrina 57,300 0.,18% 114,156 2,<00 2,<00 72,51lO 6,80.3
Armc-nia 2,528 o.o.4'l!! 4,577 2,200 319 2,537Australia 3,185 0.Q1"" 7,762 4,000 1,600 1,_ 14,355
Austria 111 0,01'10 230. 1I.S03 1.681 931 10.,404
Aztr~ijan 7.789 0..51% 17.2581 500 3,<00 11.870Bahamas 55Bahrain 40Ba~gl.desh 31,161 o.'"'*' 35,000 <00 892 2,839
Batb.dos 55 20 •BClint.$ 800 0..0.1'10 1,<00 4,000 10.,347
B,lglum '380. a.o.5'!b '1.300 '14.000 '8,200 '16,666 '41.0104
Bdit. 20. 155 8'Benin 917 o.a3'!b 702 500 50Bhutan 110. 0..07'10 160 •Bolivia 1,060 0.0.5"" 975 530.Bosnia and Hmegov.na 2.000 o.25'1b 3,600 1,000 550 890Bot)wana 900 56 618B",rll 300,989 0.4SllO 578,451 700 343,029 2.647Srunel Oiruss.alam 800Bufgaria. 42,000 G.3211b 70,000 8,728 1,000 21,000 7,400Burtina Faso 800 0.03'10 .:00 590Bl.llundl 360 Q.041lb 350 1,IlS'cambodia 9,669 0.351lb 7,665 1,051 890Camtroon 3,<00 Q.031lb ',700 100 5 220 2,400 canada 25,000 0.060;0 71,000 1,600 396 23,015 3,2.91
cape Ifttd, 40CentlOll Arrl~n Rep. 600 OJ)41!b 500 140 350
O1ad 145 <0,1"" 210 55 100Chile 3,508 0.16'!\> 10.521 230. 135 915 1.837Chinli 1.441.147 1.1'4> 2.563,510 41,566 '7,740 131.980 27,018Colombia 18,250 a,3'!\> 33.216 5,500 13.260 10.217 3.331Cornaro!Congo 2SO 0.19'!\> 100 3 30 270Congo, Oem. Rep- 7,700 0.09'11> 3,600 G80Cook 1,I.nd,Costa Rica 108 0.200b 200 960 890COte d'lvolre 20.,000 0.28'10 10,000 400 500 70 UOO0 .. 11. 6,100 D.5S'1b 8,600 5,S.5 IS 5.899 3.002
Cub. 45.185 0,85"" 30..562 100 6.<00 4.000
Cyprus 76 0.05'*' 374 3,550 147 420Decl'! Repubhc o.a~ 16.500 4,000 761 2Q2420.,,01311< 6.000 2.000 isso 16,0.50
102 Srn"r ... : .ff ~sC' III -~1'f~fl.rll~
••Smuggled cigamm
"'....
Eslirnal«l ,,"U99'«1d9orrttt5 as pm,nla9' 01 dOm<Slic .. 115 1995
3~ortno,e . h ~
W>o- 29'0> reeent or currenl
1QI!b - 1gq"
smug;1 ng rolJtowhmAnowtt
RU$StAN
5'1'> - 9<Ib
FfDER" liON I'll> - 4~
-.......(H I U"
nod.a
.
-.
,$1.8 billion
"...t:ranait._i& eoeentially the illegal import otbranda_upon which no duty hoe been
paid .•
axr. 1989
Global smugglingNumbcl'5 of smuggled cigarc.ltu 1993~o( VI'Orld cigarette SOI(S Dft smuggled
reit of the world98 billion
Asia·P,c::ific85 billion
For ovary
20clgDrette.
sold
1151muggled
!Mall bun"$54.000
'Io2DQGOD
55
The Toba«o Alias C World Hulth Orgmization 2002
AU rights reserved
Aut publlshed 2002109876543
ISBN 92 +156 209 9
Produced for the world Health Orga.nintion byMyri.d Editions Limited&-7 Old Steinc, Brighton BNI IEJ, UKhttp://www.MyriadEditions.com
Edued and co·ordin ••ed for M )'Tild Editions byPaul jeremy and Clndid. '-'eey Design and graphia by Paul jeremy and Corinne Peulm..,M.p' creaed by l..helle Lew"
Printed and bound in Hong Kong Produced by Phoenix OfTsel Umit.ed under the lupcrvidon of Rob Cu~ls. The Hanway Press, London
11,;, book is sold ,ubjec. '0 the condition that it shall not by..vay of ,,,:ull: or otherwtee, he lent, ee-seld, hired out, orotherwise cireulated without the publisheros prior consentin any form of binding or cover other than that in ,\-hich it i.< publlshcd and without I simi"" condition including this condllion being imposed on the subsequent purdwer
... S
8 Passive Smoking
..Art hour I day in i room with I smokt:t isnt:#t1'( a hundttd limet. more: likely to
cause lu"9 ~.n"r il'l :I non-1moker th,n20 )'ttlt5 ,ptel'lt in a building containing
,*uos. ~Sir Ricb.inf 0011.1985
The first conclusive evidence on
the dJ.ngcr of passive silloking carne from Takcshi f JiraYJlnJ's
Slu(l), in 198 I on lung cancer in non •.smoking Japanese women married to men who smoked. Although the tobacco industry Imrncdiatcly launched .1 multi ••nillion dollar Cln11)a.i!:,1T1l0 discrt~lit rhc evtdcnee, dozens orfurther studies have t'()nfiml{!tlthe liuk. Rescarclt thcn broadened
into other areas and new scientific evidence continues to accumulate.
t\ complex mixture of chemicalsIs genera' cd front the huming and
snln'dog of tobacco, As a passive smoker, the non-smoker breathes "sldcstream" smoke from rhoburning tip of the cigdrClll! "ltd "malustrcam" smoke uuu bas been inhaled and then exhaled by the smoker,
The r-isk of lung cancer in non ..
smokers exposed to pils..'i\i\'~· s'l'Ioking is Increased hy between20 a_ul 30 percent. and the CXC'CSS
rillk ofheart dlseasc is 23IH'rC;:t~nl,Children aI"(' at j):trlicul:'ll" ruk
front adults' ~moking. Adverse hCOllth circe....include pncumoni:t
lr &~*r :i!..*~~
,~..,.,.*.~.
sclKted tountriesXJOr Orltlltsr olOl/abftdpfO
p<rCtn~ts
*and bronchuls, coughing ;lIul\\,hcC'l.lng. \\'nrselling ur asthma,Iltltlcllt: car cll~41~c, alltll)()~slhly
r-;~e ~
.".... ."....ucuru-bchavlcural lntpalrtneru31111 cardiovascular disease ill
adulthood.A pregnant woman's cxpoulrc>
c.2
~~ ~ ~
,),,,, .p>'l:.
c ... 'i'J C ~to ruher f)CUI,Il!'s snluklng C31t .a ~ft
Ce !!
~ :;; e -•t:
harm her roetus, "(11L'(-'lTl'('ts 31\'
.:11
~ t l s: is ~ is :& ~ SiI~U ~ .Ecompounded when the dtllt! i~ exposed to 11A,,<isl,\'I'cHlolting after
blrth.
34
'" '" :c
THE TOBACCO TRADE
"Lying j" done \\ ith \\urd, and ,,1,0 with silence,"A<i,k-nnc RlLh. 1'1"
45
ABOUT THE AUTHORS
Dr Judith Mackay is • medical doctor~nd Senter- Policy Advisor to the
World Health Org.niution. She is
hued in Hong Kong" he", she is theDirector of the Afim Con..cultancy onTobacco Control. After an carly career as a hospital physician, she became 3-
health advocate, She is • Fellow of theRoyal Colleges of Physicians of Edinburgh and London and the Hong Kong Academy of ~"edicine and author of TbeS,are of Heal,h A,lat an d The Pmgul. All", if Huma. s..ualIkhavior. Dr Mackay has received mmy internationllawards including the \VHO Commemorative r-ledOll, the Fries Prjze for ImpTO';ng Hea hh. the Luther Terry Awar d for Outstanding ladlvidual Leadcrshlp, the International Partnering for \\Todd Health A\\41rd. aad the FoWlding International Achievemeer Award from the Asia P.Jdf'ic Association (or the Control ofToI»cco.
Dr ~'fjchael Eriksen is former Director of the U.S. Office on Smoking and Health and is currcn~y• Distinguished Consult.lnl at theCenter. for Disease Control and Prevention in ALimta. Since 2000, Dr. Eriksen ha.s served .JS an Advisor
10 the world Health Organiution in Geneva, I-Ic: is a recipient of the "'HO Ccmmemcrauve Medal. He is a Past President and Distinguished FeU"wof the Society for Public H.11th Education an d is • thirty-year member of the American Public Health A.$SOCi.ltlon.
6 a: 17
PREFACE
"when J was young, I kissed my first woman and smoked my Or-SIcigarette on the same day. Believe me, never stoce
ha\'e Iwasted any more time on tob.lccn."
- Arturo Tosanini (1867-1957)
T!ll5 book is intended for anyone concerned with
personal or politial health. g",'Crnancc, politics, economics, big business, corporate behaviour; smuggling.
tax, religion, Internet, allocation of resources, hummdevelopment and the future.
The ;tdas nl:lpS the his1,ary, OJrTen\ Jitllation and some
prediction. for the future of the tobacco epidemic up 1.0
the yo.r 2050.It illustrates 110\\, tobacco is not just a simple health
Issue, but mvolves ecoaemtcs, hig business. politics, tnde and ernnes sueh as snluggHng, litigation and deeen.
The atlas also shews the importance or 1tnuhjfacetcdapproach to rwudng the epidemic - by \VHO. other UN l.genciC5. NCO., the private sector and. in fact, the wbele of civil society.
The publication of this atlas marks a criucal time in theepidemic. \Ve sund at a crossroads, with the future in our- hands. \Ve can choose to stand aside; or (0 take. \\~k and tneffecuve measures; or- to Implement robust anti enduring measures to protect the he a lth inti weahh or nations.
JUDITH MACl(AY. Hong Koog~11C1IAO. EAIl:.stN, Gc:nc,'a
June 2002
1 1
Americas
''''''''''9
lim. sale of
t"
_
J
Europe and Middle East
UK rtl'lit Report e"tlof th' Brililh
Ro(al Colle!< ofPIIy!lcbns of
USA 0:0. of London Smo4ing ('igareae tompaNts end HrotlhtHtifv Mfa"CongrtSS U!a\ It Is
UK~.I Tob.aemCoa.pa ..., al"l1 BntlshArrrmca~ tobaccofo.ndcd
Fnnt't Fmftric0>09'" mis1lm.\_f\c a.","~ee
I~r oplnio.t\ UUt UKFim m.jor0 1950 ~e~bcarl'lf:nkodne it not ftporbOfl 'addlc:tM 'limolil'lg (Oofl
tfI,e_ first WO!N'I ttl
smob:m~
1900 1,913USA 8lttt. of U,cand.. III
l,u,·modffn" dgarc:tte: 6crftl.ny(2) 1195II! R_'d, Sammutl ThomaslnuodlJCC:S U~(' YOI! 5«mtnc:ringCamdbrand rtportS(11'1(ttS
USA Invtl'ltion of
[L,-
I
UK l'I>o5p"""" frittion nua:bcsblt'_." co"ntr.cn:ial JOlt. ". ,ling smoI>ngl'Jt.O'1~nIol'lW'l'lktil
of the lip
Iin plpt:
lBOO cigarette machinemokers
Engl~nd rnst0'1611710 Rust" Pttef lilt
Qff-.I a'lC'Olingn1000 CJn.d. stucty of tfftt'tS
rotlac('o I'lrsl grown of tof)a,t'C'O Oohn 1700commctei;lIy Hili); '!i,.uff ~
war1\Cd they ri1t1612 AmtriCis "~SlIt'.ItlC'C'~
1700 r~ttO t1~t9rown(Ommcrti:Jlly
15'31 Santo ~ll'lgo Turtcy Ot.lh 0'631Europe." ~ltJtB pCMltyfotIKgin tobat<'Ocultivation
hts COUf1;ct$ to$Cd.t tobKro~dtri: mfftt. \ctn.as-
f.sII>onabIc "'"pnI~EuroptJn
&.gland lOOO
tobomI """" Of>'"wrth'Arg1ri._
FnItCtJ~1 GOO Engtand 0'6();1
(ing J.mtll\OIo'tl1u
A eocmtelblo:srcIOrobom>
Africa
2000
'linn stfIcb YllIff UI~ Clthtrifle-dtI~d to lfUl bc:rmig'aiM
Evn>pc I.,.,.""pllnt btoug"h! 10~Attc",p'tsIt adtMtlon blJ
tarty t>4JC1d!t EKt1500<1_ ....
il'ltnac!UttO.htn Tlorts 11)0\It:O [gr;n
1700
111»1 Africa-US Afritln sJa-vcs Initblt, u$t-d to work:'ft too .. eee fide" .. not on conon pl'I'Hatlohs
-1650S South AfricaEtlropta" sertlers9tOw tob.ceo and: I.IUIt ., • form oftunOftCY
IS60 Afrka PortugUtlt.fld Spanl.rds slllptOblttO re EaSl"ftic<l. where It'tIft.d 10 Cffttflll.ndWt1lAf,ic.
19
For tnt' price of20 Marlboro
kilograms ofcucliMbus in .... a_neggs .Jour p;oin; of
a.tton sOcks incoc:onuU i" Papua.New
offish in mnce,Ghana or'
you could buy ... Geo<gia .., in Panama ... O1ina ..• Guinea ... Moldova ..,
43
•
-~
Cost or a pack or 20 Marlboro dgartttl'S01 an t'quivalt":nt intc:mational brandUSS 'dtctcd counlrics z001 or /01<s1_ilobl< dolO
'''r'n''>''' $5 and above
$4 .. S4.99
S3 .. $3.99
•• S2 .. S2.99
\iii 20 imported
RUSSIANffOEflAIION
cigartttes costs$1 .. SI.99 mere than half
IIIfJ! ..... ragcd.ilyICSSlhan $1 income:
no data
Smokers inMinhang, China
spent an average
•• DONISIA
of their personal income on cigarettes
A pack of Marlboro or equivalent international brand will buy... .7
•..a dottn _onetilogtam
~
.'.:
.
RUSSIAN f-EOf IIAfIO~
(rrJapan TobatcO
Intem~tiC)nil
"'IJI~
R J Reynold.
I........ ........,. .....
, ....~.~
" BAT531.1 billion
::
.f f •• "
16.4'!b
_ ..•.
m$21.6 billion
leading tr~nst'lationa1tobacco comparUts1999
11<"""1>9< of globolmarlctt sha~
Philip Morris BAT m Rc(ltlSta Altadis
rt't'tI1U(
USSbiliioM 51
Tobacco product - Any product manufactured wholly or partly from tobacco and intended for we by!moking, inhalation, chc\\'ing, snifftng or sucking. withthe exception of medicinal preparations containingnicotine.
Tobacco production - Tobacco Ieaf production in metric Ions refers to the actual tobacco leaves harvested from the field, excluding harYCSling and threshing losses and any part of the tobacco crop not harvested for any reason.
Tobacco usc - The consumption of tobacco productsby burning, chc\\ing. inhalation. or other fonn. .. oringcrtion.
112
Water pipe - A water pipe. or hookah. consists of a receptacle for water which has an opening on the top 10
which 3 long wooden stem is fixed, the lower end being below water level. AI the top of this stem, a sm'!l bowl is attached for tobacco. The tobacco is drown throughthe water and inhaled through. long rube fixed to an outlet on the side of the receptacle. Cut, shredded tobacco moistened with molasses or other sweeteners, is kept in the bowl and burned with eh.reo.1.
B al dcngan hal<cpa
GLOSSARY OF TERMS USED IN THE TOBACCO ATLAS
Ad,tcrtising - Any commercial effort to promote, including the usc of sponsorship activities, the use,
image or awareness of. tobacco product, its trade mar"". hr3n<1 name or nl:u\ufaClurer.
Are<.'a nut -l1te fruit of the Areca Catechu tree. Areca nut is oornrllonly combined with betel leaves, sl ..kcd hme, and tobacco and chewed as betel-quid,
particularly in areas of Southeast A5iJ. In Northeast India, U1C use of fermented areca nut [tamcl] is001nn10n.
Betel-quid - A mixture which typically consists of areca nut, tobacco, slaked lime lnd S\\'cctcning or
na\'Ouring agenl~. ,,'r.tppcd in :a betel Ieaf Betel-quid is chewed in .na.ny countries in Asia. such as India, SriLanka, &ngl.dcsh, Cambodt a and M.laysi a.
Bidis - COnSiJl of J small amount of tobacco. hand- wrapped in dricd tcmburnl ICJ.fand tied ,vith string.I)e.spitc their snlall size, their tar and carbon monoxide deltvertcs can he higher than manufactured dgaretlt$ because of the need to puff harder 10 keep bidis lit.IIIdls are used extensively in are as of Southeast Asia and;;Ire .he 1I1",';t (;ulnlTlunly !>Jlll)kcd tul •acco produce InIndi a.
Chilum - A «night, conical pipe made of clay. Chilum smoking i5 practiced mostly among males in thenorthern rural areas flf Inelia, 'rite pipe is held vertically, and to prevent the tohacco Ieom entering the mouth, it
pchhle or stopper is inserted into the top of the chllum,'rite entire pipe is U5U.lJly filled \\'ith tobacco • and the mouth-piece is \\rr.tpl)cd with " wet piece of cloth to protC!ct the mouth from the heat and to serve as a filter,
Cigars - ~'adc of air-cured .nul fermented toh3CCOS with a tobacco \\'T.lpllCr, they come in In;tny shapes and Si1.('S, from dgarette.sj7.e~1 dgarillos, double coronas, cheroots, stumpcn. chultu anti dhurnlis, In reverse chuua and dhumt! lI"ll1oldng the ignite(1 end of the cigar ill pleccd in)idc the mouth.
Clove cigarettes - ~e Kretoks
Consumption -lel,al c..;gan:ue ('ons-ulnptinn i~ the nunlhcr of ClgiU'CUc:f soltl nnnuilly In it countr)\ USU;lUy
In tllillions of :UIC'M. Total Ligill'eue OOI'bllrnptlon is
110
calculated by adding a country's cigarette produaion and imports and subtncting 6ports. "Per adult"
cigarette consumption is calculated by dividing totaldg:r.rcn,e consumption by the lobi population of mrue
who are 15 years and older. Smuggling may account forInaccuracies In these estimates.
Excess mortality - The amount by which dc.lth rates for a gi.en population group (e.g. SlnOWS) exceed that of another population group chosen as jJ reference or
standard (e.g. non-smokers}.
Health \varnings - Vcrb.1.I, written or \isuaJ\varnings, required by gm'ernmenU on pad.eu or advcrttsemems or all tobacco products.
Hookah - st< Water pipe
Ingredients - Every component of the product that issmoked or chewed, including ,U additives and flavourings, contents such as~ paper, ink ~d flhers, md rnatertals used in the: manufact.uring proces. (such
as adh es h·" erc.) pr eseent in the finished product in burntor unburned form, and whether the tobacco has beengc.nctJaUy.noc.Hnetl.
Kreteks - Clove-Ilavocred cigarclteJ, They (Onwn a wide r.l.nge of exotic nl\'ourings and eugenol, ,\~ch has an anacsthctilting effect, 1110\\",ng for g~:3(er and deeper inhalation,
Manufactured clgarertes - u,ruist or shredded or reconstituted tobacco, pl"OCC$S('dwith hundreds of chemic. I., wrapped in paper, and cltcn with. flher and manuranurcd by. machin e, They are d", prcdominontform of tobacco used wcrldwtde.
Nicotine - nicotinic alkaloids.
Niootine repl~""ment therapy CNRl) -" 1)1><: of phannaoologiQ] treatment used as an aid to Jmoking (.~..!s~tion, It includes devices such as transdermal1)J.lchel, nicotine gum" nicotine nHal sprays andInhalers.
Pan maAla - Pan tn~ala or betel (Iuhl ron.sinj of (our
Inaln Ingrcdicnt.s: lobiCCO, irea nuts oJnd ~Iikedlime"'''.-pped in a bctclleaf. It can AIJOcontain other
It
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""I..I.A".,,_,,~,,~_"""'.~'I.ral!),I-"~(1001) T~ t:_,...." Toloomo ContrGi""p.oo-l1~J ~~'" "'"ThirclARlm 1'1." for, '~'''" 1"",,.. ''''''-1001. C~ladl. 1[1." C_'Y f'rolJu,. :OO~1",,,, ........... 'I,AII. c....1fJ "","1 ... , 10.'11
1,..IlI''''''''ot.rr of I kilt!! ~~I ~~"'. II! "'1"'"td ill t:""n-a )~tfT_.:I 1('-':0
C'Ullllol rr.GIt ( .., :«InI~'"I ('..-roo! ~ "'IO.I997~ ~'''' ht-o!ofo • OIl.'''' trpwl. ("_.,.IrtobDtl kt~ "'~I OC-c.1t."'*-'I _1IIIrf'Od by Sur-.y &f1.klt)lt. AllItI.tk.nod !'loAf I""",. ()r1"'l;IOw",~ Ik"... d~~'N«Ioo.I"""""''1 ...r,",,",.t. (I"'"
\\1fOQ- ~It()]Ot' ••• tt'J"""1..d ... ~\Jl ('0-"'1 1'mI<1.... 100JSflbtrt.1Mh CWlftJltdoarw~; YtUWlktM. O:JlIIiu_ ~IUOIfir>., r.[""lOC (2001). ,lit [~ u..,_..,. C~ ~O!IIU'~ .ri~t. ee,. ... "'"_" (-,." T.......... .-r_",.. 1"""- :'OO1.<'.,....,..c-...."'" lit'''' ~ .".,.,1 ,""...cry '" Ikaillo.ml."(l,t,'I. 0,-. -.u.,..-oJ" ~ Swoto II",. ~ ..r ~_;,
.'f'_ _1'" ......".'r......., ......... ,,'*"-1 J1t ..."" C.-ur'MOS.,,,,, 0I'I..u., .-..~ ~w ..:toe \\'f1tO f'ro(~. KIll)
!"o.... "-! Cw_, luI.tw _~ hh Or ......... fl.l:re-t0R0c1l b ("'"'1"
lM N",in""ll~ ~o,o:Il_•..,I,, .s.n.,. OJii"/c::.I ..·.,.! f",l, 11,ft.t,
11001 •• nw r... .,.-_~c. ..~.
II.rport ....-- "'....,... ....... ,u.I
hnd tau """,id C""lfft;IICIl'_ 'I~()R 1"""dI:!Abtu-aru \'blll~ III KIlOl""lt tI.or'-", "C... tIc -.u.", .._ .. nll". mAT .k ..... N_ • ...,40 5.0........ ). It.olj" ~ltlMol&.!lf!k.ll" .. I_~ A,.II:OOi, .... 1010.""" ""'>b!c o)j'dC'" A c!t<tffi", "" 10"., .. bdt"" Ik uc"',_. \\',,,.
""-"-'iurl ft~fn.tot""~ 1W7-»l'.~0 ...... GoJI' • ...u;-t ........ s..._ t"'i •• ...,.. ....... ~~._"...,. ...c..._1 rwAllr ( ...t...., XOlI,.,kl" .. ~.01 Hu'Q ~ ........ ft1'O"t4 .. L¥ItnI Mtdi.-- ....
SIl (I,,"). "' ..'.Ift ..~....1,..,~.....d ...........1••~'_1IIn TIw II...
~ .........-.I-',,~ c..,,,..Irn.R"t""'" lOOZ)cLllnlt. (',,",I , .... 11.......,_ ~ ........
IIIW' C•• f'fti, MnOb-wd l(Odl.~'~«r _ b ~ pHI_" -'-_ .... '"II., 1lorN.ollo~v..-""'",", $ufo.,.t '""I to........,.JII ...l{.I, _. \Io'rlt- "..",. N..~ ...... )
lftlkilth I" JII"II. 1m ~m""'1 ollln"lIJ"o 1;*,0
'_(SA"" ht".. A rVl~"..........c. ::--., _""*", "''110 r_ ............1.1.."",1llo s...n-...n., """,11"".'. Su",,,,-~("~ ...I_"_".'''''''
'Of;U".~","-I ~rw) fI 'Ii.kv ... Mun. lorn... rty.ol' ..... I....c. n tottd"ft_
,..,,"'. N"w G."'",. 19"'Uf'o".u_1 ~~ $won. UI'fJI'$w.d ... \\,,.0 c-.,.
T'"'- .... c.. .."', ~ t""'""ylOlllKIIukh.ti." C."'1I1 "'~'1U'00fI1(>~ "«f,IIWdI OreU"Aotlull ~'"tI 0I'Il!.-. ,,..-
r,.,a ... l'OOI)
h".ru~r('_ ....l~
"""! "..-"..,I ~ •• tko-IlWbfo:IIo ..... ......,""_
1.11"'1'(":tOI, ,ht tllolro('<!"'lloA~ C""'"" .........,1.. ftOWoo ./1mI~~Iut,J_
ffl~.bSokMl. \\'''0,. ... ~"t,ItI!Ort.w .I"'I.ltA
'tw,I A..'.!I.-,11M ~. Thl",[u) I~"..I ""1M ,""7 )001. c..,or,II.""", l't"'ldo:, Iuo ... I...... ,
"'1() .........'
_s....dIo, ...... '.
"~"""j'~--..w...~·_tl,...
_1lo-"' ..
k ... \\".01""" .... , DCK"",.·khn .. "w in lito""""" \10'.",01, I" (1(IfO) 1~ ... ill tlwri'1niN ......... !ft~...'_'<1,lffIro,/ha:I-. )II},' ~-1OKi".,.II'1.,..''''-''''' ... 1OIoktk , _I ~w.I"'.I,..AIo_~.M.' •• I)I....t •..- ••( ,...w,.. ,,",",,,I"I..,." KilIo\wIi I'o' .. ~ t.ot.I """"'" f... 'ioI.no .. or 1101111.A. n'J'l.orl(d ~ till: \\'''IlQ~t' '~,Ieo.:000"0' .... "'INbll'f (jrC mt -..:4_''''' rill\, Il. I\~!fllXJOto, TrtII'Ioof o.1f"'01W .. 1M"""d ..",I.IItO ........."" _I cr 1,..,....._ ..... KaT. lido "u.1d C........... " ~OK ,..,..." .\I .. lt ..-, ..... , 1 (ChIf ...C',.'"1(",,,, .11 r.. .t1 "~.ll,~O~)•• ,1011. 'II'H>; ..... Coo''''ft_, )olt..lo....... !oI..,. ltIlll ..."',,,,,1"11,, r""'n-.Io~IoUffOllr. Ttobl«.,C_,.,1 tot.rd~ • ...,.~ XIOl')"1'C""." ~~ .. hbIll.d. ."-"""111 U. C.ud.l_ ..(I,." ~oIow 01p,iW("M,i"'''), \\110. (1""1 ~-w \I' I,uhlo "1!1~'8I,'" "-qM..1.,t.
I ",""ole'" 'Io."~ ~rl'" I"'i No. MOld.\.'~~ A. "PO"''''''' !tor \1,'1"'0 c-......
"'"""c;....,..,~-.tt...~I""I"'Io!n,.,.II.o., <':"~~ .... >11OOO.J"",'t'; A.t.~,",,""'II'ILcioI \--. t.olf........ ....tJ,",1JI11';_""'I""'Not...-i'(~w--.. "'~I""" W·PIlOc..-, Pn.G..,
1'\)I."d Oin,,'" " .... cc.. ' .. ~. \'.UU II~ o,~..ow..... ~ 0Il10.;. r.., r-..41001, n... , ... .,..._1i C_ .... 1I..tpootl""'_ "'..,....._ ...... , .....An_ ..... c.. .ld!.:"" ~ 1""_1001.C~"''''1101~,,.1..,. ~,!'I~IW.s..-_~~ ....... "....."."II"""'''' d ,-;""""""> _,a.,to (1'1"1. 0[0) It..)....1~1IlIt~" 0\ C....,..-wO(' til' ('_._ 1('0 MO\I•I• ou;nI'IItt-rto kl(IIIC'wMI-I"'rlld ..' ..... ~ I _._.SunftI'-'" ~ ...~ ~t 100O"""!'(:.,.,.,. .....h- .... """,-",,,,-"_1. " ........G-,Q~••• II.-..d Mod.-'C"'''''' .... (un ...., I""" ... ~ ..... I-..._..... "'"'~ 1~
c-...I.I .....IIIr.._..n'100111~1 ... 1WO
(:00'1,1,.1. _ It;I..t'-CuIlf ..1~ , •• ".w-. ..1."_ ""public or lIh.lodfOO. C'w_ ,..........._ lloop \lot .... l&t,.)d,()o~'II..yIo_l
I,., ..l. c- to""""" .",.~ \\, .... " 0'1'"" .... ," " a.I ...,.
".roy'"C)ff'H'.r..-ho ....... (mJI; 'norl-.....,_ 1"'~C--'~l ,..._J""'_"'_
AcOo_., rWol", .1<"""-UO r,n 1!""'I'" 199' lOOI ("~'II
101110. 11111" .tw'\tI'd~I'toIl ..".~I_ .....1""....,*I,~'~_~ .... c"'''''' ......... -.ol.tf;, ~-...ulk.i,1ron.,. oL. "'I~
tebtM!(l1i ~_II>fto) ""'f) '/So~. I~ ... ~t4 .. t;wt_ ~_ .. 1fJf~
114
(10Ul, ,"" 1... ".._ lI.,.....,.c(-'Ilrport· ~ .t ~...,.. .. tlw''''"'
nh
devoted togrowiegtobacco
hwtares o
I
I
Table B The Business of To bacco
,:
71
ICro'ringTob.3c(l_O'-::-7' _
,.._ -r-
2'Iobacco'Irade
u.ncl r-'
1 Agrieuhunl Tob.accoland devoted produced
10 tobaccofarmingP""""'i"ux&l
DjiboutiDominic.Dominican Republic
-East TImor13..250 1.28<1fo 17.229
8030
14,640
EcuadorEgypl
1,725 0.02% 3,461 1001,400 500
883 24655,040
EI Salvador Equatori.1 Guinea EritreaestoniaEthiopia
, AJiFinland
I France:Gabon Gambia Georgia GcrmanyGkana Greece Grenada Guatemala GuineaGuln,a-BissouGuyanaHalll Honduris Hunga'Y Iceland'ndiaIndonesialro.. 1st R,p.Iraq1"I.ndIsracl""IVJamaicaJap.nJordan
. Kazakhstan Kenya KlriballKorca. Republic ofKatel. Oem. ~pfe:'s Rep. ofKuwaitK'I'1I'fZ$unLao I'toplc's O,m. Rep.
latvia104 s..tI"_: ~ Il.lgt'\
114
600
4,500180
9,254
1,801
3.000
4,200
62,917
8.374
2.000
100
I400
11,214
5,764
463,200
223,000
20.000
2,400
46,900
1,175
23,1)913,099
4.5004,500
24.300
44,000
14,4656.700
0.10'lI>
0.05'1b0.07'
1b
o.05'
1b
0.1I'Ib
o.Ol'lb o.OG'Ib
1.6~
o.43~o.13'1b
o.02'1b o.05'1b0.47llbo.14'1b
023Qb
o.72'lb O,Q7'Ib0,04Qb
O.OSlli>046'1>0,44'1»
0.6'1>
1.06'1>0.01'1110.19<1b
1.62'lb2.10'l1>
0,64'1»
0,87'1»
1,100
3,000150
25,534
1,8558,5002,500
136.593
18,6301,800
90550
4,31810.485
701,100
145.00021.000
2.250
132.2001.800
6O,8OJ2,6679.0007,000
68,19863.000
34,61333,400
12193
23.300
90.637
17.000
1.800
2363.500
1,50017,500
2.00020019340
13.961300
12,600550
6,712
600200
141.700
67.571
1,50033.604
3511.000
60020
20
soo600200140
8,000
4502,400
56.4751,780
83.478200
3.00050
9.378
1.0001.000
1.000
8'
1.30746,D23
116
41,430255
100,889
9.043
2,547759
119.64337.097
1,516
8310
93M213031
4837,5214,423
5,6185.000
35.000
448
4200130
3,90470,528
100793
2.000189.669
56
19.55430
643
70
660
3.20517,539
1.50040,913
8422.4005,6504,700
38,830450
98.9191,4006.129
50
12,781576
6260
1.544
Part Five:TAKING ACTION
Samet J. Ilmunond SK, ~ to ftI.~ tob.«o NOOk iII,.wepbor:f in 8¥cdON. Spin Ul!romo c-nl1OO1. II: IJ.....Mbt.tp:lI .._. ,t~lI-troI,alm(~/hV:1rM/fuJJ/ll/l/lil
NO LOSS OF flESTAURANT ."'ND lIAR SAW22 Research B«'~.and "fur Snd('oflTt 1 .. Ant Qu..:1n- T...".... s.Ir.e ~ for
,\1AL'< M.A.!'
en'S: ~ Comoll ...... tloI •• \\'kk \\''''feh, COC, 29 Marth. 2002
~Mt" !'ttll('onlleon"'rM'Ileltioo wilh Grr.1d ):nI~h, ]8 ~t.y 100'
COMPARA11vE RESEAKCII~h ~apmodit\ln'. us N_ktfUI t~ll\ltelo (I( lIo:"!th. XlOI. Rc;w..-rn
'''ltI<llh~./~lU aflllltf'Ut
bUp:II .. ·.. ·....• ~LIIIII.lV"J4)Ir.~lUd~/r-unJi-t:RDeatchlt.tuo.htm.OO',I\Io.~*"I2'9 MMrlllOOl
oCAnrs~tlnlDO AM. Slrlitl! SL. ~; I .. dj~,ill.lry~ r.. lOOO. "' .... "'''', 1'1I.. J
s,,,un:kJ ~. \'0'.9. No 11.Tallie 1. 9 O«fAlt1lOO1. N"OOIW Cmter for
1I",,,1tIt s..tirtln. C:!ntn-J f"r o;",,,toI! Ccont.ouland Ptr .... r.dll ..lI.
IIO\V MlIef! flf..S£AJtCIU
•" .... Ufll' " ....Mt"d. USN,tiorul Ub""ym M~ldnt'. I "f1'\I lW2
'f1!.x"l'&ri, rt .1. keteneh pliariDo rOt' loNclOO rontrnlln ~'(;I(lptng QNMrw,: A
fto4U.UIt. " Ran, Sule or c.Jito.-ab 1"1 1m. ~ Cdlornia Dqlt..
ailkdth: c.womY &.anJ ~~. -.: ~ J. c,.,. ~CoMJ'OI ~UM Smol"ieI d~ I~ Ino:btry1.'_ 2ooo,"c<m:l:J4, hup:JJ......,~nII'n
C.lifQrnI.IlJo;an) clliqualit..doe>. 1997,199$.1"'.1(0),2001
~ttr:II-._.ca.J:O' Jrw:-"/IIq99i.Mmhnptll_.bot:.Q.p/nc. ....I. 'II~l.mkttpd J- ..·..hor_.Q.£U"/Dl"'"' .. /ptI"tTlllfOl.pdI'. de
"II.E COST OF \\'OR':,L\CE ~tOKINCGrir",1w, J. CriM~ k, "~s-l"'l• tlw 1I_"""'.u..t....,..t. ~ G.t.It.
\\'110 Europun P#'Uln..... ~C'(.'lto)R~~ ~1OO1:}
CUPBOARD
1 Ueronill'l\ll) J. MUIM)rM'lliQlII. Raotric:d,,,,,: b..u • ."npL- MnIlliaC
,,"trin-..; ~ptkIn •Rall'\ No.: 101.w'''21110/4284,hllp;II_ ...·I~~/~_c.-.pN(;~;-2OlJ'14210141'"', 1:1UIM1pur,b. us.o\, 12Odo:oba 1,.,2
ngWiNI _r'lJrolchto. t'obi' cun....l.bh¥lll r~" r",lOOO.
C_..J 9, 217_11.25 Legislation: Ad,'crtising Bans
Il'8litll'lo: uI M«I\eIrll' (I99'S). c-x.I ~r."D ,'" ~ ~fI""" Nak.na) An!"',"), 1'IuJ, \\'.ubi"'l'tlQ I>C. U~
23 Tobacco Control Organisation.
~WSMAr
Jb. I~ OWouru rJ, ~~I I. ~ _lIftlft. OdoreS U.nlftnhy1'nA.l'OOO12}1-1}Z
r.f.FtCT OJ! AD MNS
ClJI'IM)t\ROIk.nlmmtl C"UINIl U. Philip ,\\oorriJ,./u,n{tthl: .tlftUlln, ~ndlto::.alth
1II""'11/Sc!ot","",* <k''''''r_fth in Au,lnlu. 1m r<d,.--ry.lUlo ... MISC10149711(117/10049.<MIP:II"' ...-... ,.wbk~mn'ta.(.."..I, ..bfl·~ ...f.mtSe.tc:LK.,J<.....flltlbu-.
Jb.t P.. ~u ,:,~.
~, 2000:114.1)1
CUI"BOARDSAcnONM_",N ...
twlfnl'JI M'~ _flUId, Q.,1ord UaI«nIlY
til",,,\1O.anI1\\201l1lti-l&l-tj,j(0tn,ment::::\'ES#(I)i,,I.a)'Form .. =-GII:&t»rmtillej9~J» 1;'.u:
<NIP: J I"'V,w.I<Jl............"orj!./Ooc:UlIIl·nuJ 71102 .. ta1t.l~Jllrll» Tdt.acoo ess,
1'1lX1'1If ... !dtJ w:1cu. OIK'C1t)r (karr..J r......1.lw. \\bf\1 flr.ahh Or~.
('.ene Sl'ecc:illfJ tk Sill \\'",Id 11(..J1bA~U,. ,) "tt, ,"8
24 Legi.lation: Smoke-free Arc..,.
.\tArN MA I'
C(ltr.o fIoV.. GmJo" CE. Sh..rm~ N, SlJUi:l)d~ OF (f4), T~ C_II"c-.II)
hoilttt, A","on C.,.cTr Suclf'Y. Allarl". (;,\. USA. 2000R«I'I'IToI(!n R(.', 1I-,1IdntoI)I~ \"~~I" ,\\A. EffmJ '" Smol"'J Rntrlttlfom '"
tlMt \\'v,~, ..1_' ""»,,1"""''' lIolJd, 1001, 1):J))-14.
,,,,Mk: SuP'llO)r1 - ",,.lrot\kJ R~",oJ\ GnAlp, -CMvflI_. fmftl r-...'." Colt'."'''''
Ctll~I""UI 1bb.n~l. C.IJ I!)r 'Juughl.f l~kMt- JO Ortllf..,. 1001,
h1III:1I"f);-M.-irOlllicll.rllrl/_.IM.I,II, a~aIO~81
I'()LLUrtu S.'.\Cf.s (lLARC£LONA)
J- M, f'\d!t:tt "'. ttllj.tr.n X. Atlalt", L. s-",)., J. Fo!m",,--t,., f.. ~o ~t
122
TEX
RI Rq'nOkJ" Tobacxo"'_ Su~f'I1o 10~"'_' It". LkJ No. .)076()4S96rr IS FEL.T...
MlDet L. I'rindp,", J I~ J ,bloW ~ '" ,*,J. dnap. Aqui I'O'Q. fl.0 2Ul' fl.eMrirttd. Gnlql ftf!KUm Ii ~t
Centrc:.IIri.w. Amtr~ ~ Co.l.td, )hy)t 19S6..JIt..Jm No. lOl699)41.I02'99S00
Jh:. P. OlablJ'lla I,), Jiio«g c-,., III l)t..,.., c-n"", O:Uord UIliO'ft'liI,
1,,"-, 2000;2l9\\'.lc:f}d.j"", ft .1.Tht dr._'W' pad .... I~ _."~ (rcn. wNa.
jrd.P'r) dou.mc:l1b. 1tb.Kn CmrnJ /001. 1I~ l)d7l-i8OSJT'l:J U. ~ f}. n,.. t'iTt'O cI ado,,"kin, Q1111ob.cx. ~pem.J_""1 IHJJJ>&-JoJOOO11,.1117-)1
'
26 Legislation: Health WMnings
MAIN.MAI'
CoITMi MA. C.1doa CD, Slli.nN N, SholtlMI OF (..dl) • ...._ c-...r r-),.,;;14. t\mcr-k'al ~ Soot'!' AllaAU. CA, USA, 1'000.
Vobl'lrd I k-4hh c:n-,ultAlic.I, 'JOOacn ftf't InitWth~, LT.wM MCWoIta..dol'cf'd by \\'110 )kmbtr A "-'-:i.Itm s.c.~ 14 Mar xm. (~)
Uberialibyan Arlb J.m,hl,lya 6SO 0.03'111
2001.~ 2.200 3.100
lithuania 1.500 2.915lUllC'mbourg '390 '1,300 '1<.000 '8.200 '16,666 '<1.01<Macedonia. Former't'ugos. Rep. of 25.000 1._ 32.000 500 9.900 2.100Madag • .scar 2.110 0.11_ 2.000 1 40 362Malawi 113.823 6.18C!O> 12Q.000 30 90 93.000 800Mal~ 12.500 0.1.... 7.260 1Q.609 lJ)37 21< 19,514
Maldivo 10Mali 230 Cl.ImII 110 60Malta 250 SO 7Ma.wll bl.nds~uritania 800Mauritius 440 0.62_ 100 89
Mexico 22.614 0.0s... <S,105 20 5 10.509 8.623Micron,sli. F«I'fll«I
St.tes OfMoldov •• R,public of 18.608 0.92'11> 22.401 5.300 400 21.811 2.652MonacoMongoliaMOt.... 3,500 0.03'" 3,~ 3,100 8.021Mozambique 7.000 0.08'" 9.<10 40 600
Myanma( 3Q.000 Q.31_ .a.260 800 800 622U,m,bfaH'UNH,pol <.283 0.21)q1o 3.109 3,100
Hc1h<Ii.ndJ 101.5SO 1•• ns 19.630 112.607New Ze,l,nd 75 20 36 UlOHialraguo 1.395 o.ow. 2.000 1.24.3 nsNiger 1.000 0.03_ 850 800 '13 100
N1gerj, 22.000 om .. 9.200 8.500 110 1.500Niue:HolWay SO 1.000 364 6.4.10Om.n 270 0.18C!O> 1.300 51. 321
P1kfstl" 56,<00 0.22_ 101.700 400 '.000 V·6 110PalauPtnama 1.100 0.1,_ 1.800 100 152 2
P2PU.:I New Guinta 5 140Paraguay 7.000 0.2_ 11.000 2.500 2.500 • .625 s.sooPt,. 13.500 0._ 17.231 10 1" 621
""flippin« 40-169 o.sg.,. <9.<93 3,IOS 2.101< 11,639 28.7tO
Poland 14.OS7 0.1'-' 29.545 7.716 104 4,955 6Q.218
I'orwgII 2.132 ~ 6.183 3,800 1.606 3.505 7.a<OOala, 10
Romania 10,970 0.1.. 1.,800 s.soo 838 25.257R",u~nr"tdtf1tjOft 1.100 <0.1_ I.GOO 900 .s.ooo 470 763."9Rwanda 2.800 Q.2.... 3,800 3D 3D
TTable B The Business of Tobacco
I 2
.-Coo._
CrmvingTob.acco Tobacco lhld e
Land Agricultural Tobacco
deeeted tc Lmd oJ<,,,, ed prod""'"
l~non 9.700 2.02C!O> 13.~ 1.400
-3-
.'00
-2-10
gT01'ing lOl~ Tobaccor~natnc 0&........ Cig>rm .. Ia( Ia(
.......,.. '":r::r ..- ..... :~r ""J'O'1> 1-
.......Lo,uho
106 St~lrff-* ..... f:'<i'r I'. • ... Ie. ""'r'- .........
'lm
s--.u.
..J..,...... ,,_.,..
CtOIJ,lL S.\llICGU~G'IICKkIlJ I.. , ..... !#-M 4~ -11''''1~'' ~ 1111(0.",."",t
c-..<Io.lI!l till TI!NI'tIl G'tll".J,llf"f"W'Iluuon.u lilt Sc«:IIId \\'(JfW C:lnkfcn« on
MockTQ Cri",l:I ..ll".'nClg~ioo. Or),~ilf'll Crime ¥1d Ulln\;Ut Rigbu. Durlwt.. SooutltAflln. 1 ~Id' 1001
CIUNA.:oroLi T. T." "'"1,IU W 0Irt. rigMrttt _~"~. S«.IIb OIuw JI:.w1ltAj f~
(PI~'IO..' ,,,,,,. S 11.1.-,. 1'191; I. In MoIICl"l J4 ~",*,I" it! o.iN: -t.I.. IknrtJ or
$IMI.'t'-.I"'~(Irl&l1 T.~ Co"fI"I, Summer 1'197: \:01 6.1'00 ';TI_11}
CU''IiQARD
nAT ~IQ('. JOlOOOO21. 1'1,119,11I)/I,~J ",".11~Jl~ ./lIp fn1JU. n~Na ("l"'tJu
('"ftI/"' • ...,.mJ fnt_n_.~1!-.l.'~IC..._ ... _", (or Tob.<Tn Ffft Kidol:4,
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Part Four:PROMOTION
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6 Cigarette Consumpuon
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7 Health Risks
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CUPBOARD
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US--\, ,. April I"'
8 Pas.si\'c Smoking
MAINGRAHIIC
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IU
2~ Tobacco Industry Documents
·0" May 12, 1954,." "",oUdtcd boJ;0' wtl.llppeJmI' to be- tofliK(O ~
'o('l;IJM"'b.'" Ik4lwrc4 t. ,"fenorSt.,..lo" Gl,fltL-Thc CIoc:Y_.tlb, the: boo...
datfCI ftom the: carly 19501, to the: urt,1980"'~ Thry COtIikttd pttm,rily Gf
cont'idcntj,a1Inlcmll mC:MOrI"d. ~latt1f1.0Bnw ."d BAT. MarlY cf Ut, dOalmc"b
C'Oflt.inotd ink"",1 di.I(VuioM ef tilttobacco incI~rt:r(' plJbbc rtb1ion' .Ild
kgal n:ntqits om' tft' Y't'n. and tMy wtrt otttfllabttk4 ·('OftfWt"d.1'" 01'
'prl'l'lltttd: TM frtVm teNt"" Oft me: bo •°Mr IMU ....
So starts Tlte C'g"'dlt P"pc.r:1, theOr'S' r('pon chronicling the release or pre,;owly &<a"C'lobocro Inclunry documcnt~. Pubherelca ..c or these doruments clearly
exposing tobacco h,t1u~lr)'
Mi"l'IflOC': Philip Mot",
Brow.
&.~...."..'........-JIA'Tht: TobKt'o 'flJ1rtutt
The Council for T otIiK'CO Ac.wltt'h.'
=:r...IIlus-tr.llt,:fl their pO\\'cr In
- -._(!orpor-,uc bc.h.lviour. arut theyl)rOroundl~'influc:nad public opinion.
I=ollo\ving the rclc.l.e or ,he13,\or dOCUmCnL\ and .15 1\ result of Illigation and leg.ll tlcttll.'nu'!nt
agrernlents in the USA.._lcx'ufn~nitnstroc.lu(~tdhroughl<gil dlscevery II..ve lwl '0 h.",adt publicly a,'all.ble hy thetelhlocO indu,try in ph)'lli("~1 llcl~horie.t in Allnn('aptllb, USA
ancl Gutldford, UK,As. result o r the 1998 M.. IOT
Sculclncnt Agreenlc.n\ 1~\\CU'I
~6 r.\,,'CIi" and the lHh,,((.o
Iudunry, the dO('"UI1I('nt'l or thelo.'lnllelW'ua DCI)C.'lIitory are to be duplkared cettne \ i:. seaeehable "Ch.dIH m.J.inulnc'Ct by ('X'h or\ht OOlnplnif'$,
"OurSenegal re.ulted 1.na nov adverti.inq
decree whichrevetled A total
millionpagesof onco sec rot
lnternat tobacco Industry
documents are now in the pubhc
domain
-Kork to develop. ly.teD by which Philip HOrti.
CAn .e •• ute trends on the i ••u. of Smoking And
I.l~, Identify(a1omic religious leader who opPOIO interpretation.
of theOur&n which would ban ~h.
u •• of tobacco and encourage support for
.....1.1f).~-,......
.......0-
-A law prohib~tin9~obaeco advertS.ing va. paa.od 1n Ecuador bu~, after a mobilization of
journoliltl froa
lntarftat.l0na1
org4nlzoLion •• iL YO._-.
66Phil-ip -Mo-rrlo-,
-198-6
Horri., 1981 Philip Morrl., 1986
odvorti.in9 bon.~ these 1••dorl.·
Philip
vetoed by the Pre.id~n~.·
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ANNUAL COSl' Of' tOSS OF ru.IF. OFF \\'OR~JlJJ«JJ-rwJ, t .. , .....l.I.I!I't4.Hil:407_I. ~ 1.... 'Iro\ .........
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Part Three:THE TOBACCO TRADE
12 Growing Tobacco
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1--.,.1OOl, "-1.rll"f'f"" 1_"'I' ....KO/.,."T•. ~.en,...........,~=su.,
1>EFORf.ST4T1Ot..cn.'t. <W...,_.. Jr.:(.. ... ft'Ltc,i _ ....... ~ ...._.
c-.t'''''.'I' l'tEADINC fItOOUCEkSOfTOtJACCOLU\'ES.,.,.-,J.,A",nl.wt v-n........_...(............,,_,.
l'OOl.fAOsr.'T I~ Redtt. r.o\O..m.;u. ~ J...,. lOOl. LUp11 J 'WI, (~cwa'InSOO/ ..~
WI'lIP' ,,,1fItod1lCtI.:.,Cropo PrilI.W'".~-sw.
=,-c.....MA.C l-,_s. -.....Df( ...~. -c-Jc....r
"+J-. c-... _,. ....... CA. 1&. ""'"~. ~_..., u--,.A£k-7'lt, ~~~.
............. ""'"C_ U.S1M~. .
.. ~. ~~C9-'I01)T"""IS4.
s-......, 0. CIo.., dc¥rtW' \UU""" pn«'*. AI.,,'r ",tAJl Oc~t .. Priu
M1d1lM..JT.a,.,..pt,...d.~COU ...fkt.r~ 11.'"",_ltrv_, "Hh~ tin.... ho!","""",,,. Apr" 50.I~1
\\lW," A. A ,.,-:1. 0' "w'll:._ UMU •• " Plnlln'ohIp r'ns" .... ~. I_nt"-'A,"!Io••'.1iI1..h._, ....I ·,;"I.....~n c•• 'f,oJ.n. S.u ."." I" (fJ .... tlln, Ik. 1000.
<iI'¥otll"@,~"'f',\tUJ,u.,>
A IIA"n IMY'" .,..0 ...11~ .....c.r.....S lhI .. i. '01(11It Tf'o:ftIJ_. . .&.d.bill,l' ul4~ .. rt ...~.
...... "*"~h.Wft_ •..t1"( ..... w.M.,_ w..~.WJ,II"""
w;ww....t..: ... ..:rtillfl. -'T.a.1S7. ~ ....... ~ ......
co..alrln.IMG--ltH,USllA_"(~~lOOJ, hnp!ll""w"'fT' IIIda J:i"1d.uJ""'~ .,.!t'=~("'0121
It...PMIIi ~,.b rl • ,.,.._ (.-HI. ""_.,,...C_ .... 0",",
U"h''-'''''r rm..1OO(), pp. 1110 JI7
GkWll..t..t, 1M,,,, ''''' ... J YJII( c.j {TIlN«t lew lCtlll(W
f'n.r Kld_, USA XlII
U M<Ulur.auring Tobocx:o
A PACK ()f "'IA'''' tIOMO OR fQUf\'.\LL''T ..
~N\'
......~ o..dopNall 0 , (lL'''mO,. ~ . ....._.,_ "......""". ' .....W~~ A A pov' 0( Md-=-o fi)I'-.. f'V~r Pwv-. 1_,....,
A" ..... ••T......l .. rutw(O Qmptip. Sv.r,...,. I" t..-.,tn, """ 1000. 1cod oIlS1CC...... U...., N...-. IIWIuNlioNJs.-t..N ~<.""hlt,@V IoiI,\IfJ> C~II\aI ~R,,"hlo.. 2, IIIllw ~ip J,rvd. JI4 -u...n ... 1001
klll,'1 I IM-./k/WI14 ..hbllh
MINIIA.N(l. C1UNAc..'e I,Y, ~'f"'11 JI~ rl'." \v, Chtc" ClI, 7.] •• ", r,llul!. JR. etc.,. lie 1II1(4_"~ \\'lItalllll(! 'fOtlACC() DOlLAR COtS. I",
ill OIi!u.J-WIItf''' .... NlII.IJdvafAaNl"_'''S, '74 11"...4 USl)'.I~_'N"""'' J.MI_ ...G_AI,","-l.
''OCT
~ ""'.1 \;~.~"'"C1f'dlu. Q.-.lo.~ "'-', ~ ,990 10118
.,.... ..C.pdw.rtT "_"'_'~~''''-' m.r_"'~~
Estonia[Ethiopia < •
1,393
62;9oa32.!11b15.8'Ib
".!11b 20.!11b
._Fiji 814 20.5'" 24.!11b 17.!11b 15.11¥o 19.3'10F"nland'
• . " 23.5'10 27.!11b 2Q.O'Ib
France 34.S'" 38.8'Ib Jo.3'IbOabM.r
~ ~~, !1"~' '.2.30 ~ :"'_ -.;,!Gambia 1,303 17.8'1<0 34.!11b 1.5'lIJG.o!')i. 5,262 " 37.5'" 6O.!11b : 15.!11bGermany
82.017 35.!11b 39.!11b 31DlbGha ••_ .' , " 19,306 16,!11b 28,4'10 3.sqo 16.8<11> I~ 17~Greece 10,610 38.!11b 4.7.Qi14) 29.O'!b
I(uw~tt,:.,).}~ • 15.8'Ib 29.6'lb I.S'IoKyrgyzst.n1.10Ptoplt'$ .Qtm~t¢""
37.S'lb";38.QClb
6O.!11b41_
1S.6'lb1S.00b :-,lI
latvia 31,0'Ib 49.!11b 13.0CJ0
.-
....
.
Table A The Demographics of Tobacco1 1
Counu-ics Population Adult smoking Youth tcbecoc use I
tMU$.t.nd, per«nt*ges puttnugeotot.d m.u< (,"-m~l(' 101.1.1 m.ue (Ccm.a.)~
Djfboutt _ ,. 632 .31.1'" S7.5'Ib 4.7'i> ,
Dominjc~ 71 19.3'" 23.8'Ib 14.sqo
Dominican RcPublic~ ., .~ oJ" 8,373', 20.1 ... ·24.3'1b • 17.1~East TimorftuOdor g646 ·31.S'Ib 45.5'1b 17.~ ~Egypt 67,884 18.3'" 35.!11b 1.8'Ib
EI salvador 6,278 25.!11b 38.1J'1b I~Equatorial Guinc::a 457Erit,.. ~ 3,659
10.9'\':)
,
Grcnada; .•. ~; ~ , - ;. 14.4'M>·. 17.!11b 11_
Guatemala 27.8'Ib 37.8,¥< 17.7'i>Guinea ~ ~ .~.
.",;;ln11~\ _~ • 'sf.N> • 59.5'" : 4JA·
Guinea·Bissau
~ - ~r>~ r;.: • .
15.3'10 21.6'Ib 11.1'l1>
Haiti ~. 9.7,," 10.7'" 8.8'Ib 20.7'¥o 21.!11b 20DlbHonduras • .... ~ 23.SCJo 36,!11b l1DlbHungary 9,968 35.5'Ib ".0'Ib 27.O'!b
Ic:tli.d I 279 . 24,O'!b 25.1J'1b 23DlbIndia 1,008,937 16.O'!b 29.4% 2.5'!b variable V3ri.Jblc: variable
Indonesia 212,092 31.4'1<0 59.1J'1b ~ 22..O'1b 38.O'!b 5.JC1b trao, lsi, Rep, 70,330 15.J<!b 27.2'lb 3."""
lraq~-.• 22,946 22.SCJo 4O.IJ'1b 5.!11bIreland 3,803 31.5'10 32.!11b 31.O'!b
··1I; . 6,040- !2&Ylb 33_ 24.O'!b· "':~
2,576 ~""14.6IM)121,096 33.1,*, 52.S% 13.4'M>
19.3'1b • 24.4'1<0 14.5'Ib
~F- ... 4,913 .Or«. ' .. 48.1J'1b lQ.OQb '20,6'lb 27.oC1b • luqr,~zakhStan 16,172 33.5,," 6O.0'lb 7.0CJ0
Kenya; • -:', '49,4"" 66JI'lb 31.9'!b 13.1J'1b lfiO'!b. lQ.OQb
Kiribati 42.0CJ0 56.5% 32.Jqo
1«>.... RepubliJ: of." r , 46,140 _ '35.0'Ib 65.1"" 4.8CJo ,Korl~a, Dern. Ptople's Rtp, of 22,268
96 SoUfC'n: see p.ti~124 I for ~ OOUntfld. tbu lore bbcd 0:11 ;<O'Ith.....,.cys 11'1 ~ dtlet.,. p-volllC'D... :i <An: not f><:tt~",~-ry(tk')1lItk-,~tr).
...".....,~theW-...
"
22Basie scientific cpidemiologaC"oll resear ch over W 1.. , 50 yeu.1us proved the Iunnrutnt'.u ortobacco.
Reducing toh~cco usc reqelres kno\ving ,,,hilt works, ill1(1
applying thl. Infom'''lon SY"CIl1.'IC3Uy. Uulhling Il,Cscientific base ;$ :a prerequisite for
there !wi been no Shot.:agl· or (1.1..1
Research
efl$1.f.r.lr,I.-~.. ~
............._..'.*
-~ ..,..II_..,.,.ir,Io.o.a.b..I.I ,...aa. h.<
lit tI:*lIU.O
C_OlI: ........
Prob'l"css. In developed countries, _",III 01 the Sodtty '0/1 o.to.1on tobacco 11s. e. Th an", In p>n toin'oesuncnts hy JnlcrmllONt development .geodes .nd rotm<L.lion s. tob.t«o control...... reb In the dc, doping worldis .bo beginning 10 Ilcweb.\\'hile i~ ..~(1 run•.lingI'
import;mt. oorrierl continue '0exist, A recent rellO" highlighted rc<',\lrring rcsl'ard, Ihenh~$for dc\'cioping (,'uuntrfe",. InclutHng Ihe laek or ".HllArdISt~1 ,I.... absence or .. network for ccmmunkatton, bek ef robsceowntrol rescarch coIPit_'it)',l..nd the
need for human and nn.mdal resources.
The seuree or Ihe (undlng i. of"lu>I impon.""". lIutori.,.U)'.tob.K:co coulp.micl bave
sponsored rcx.arda. prontising
cemplete indep endeece. only 10hury unf.n·our;ahle nnt,ling • anddelete words sueh a'l "c..n.
ccr." lmprove rhelr publle In'''gc.
tohilCCO COIHI\tUlltJ ",rc once ag.alnotTering ~ul'st ..ntI31 research funding 10 Ilc.,delulc In ..thutlOI1J worldwide I promlJing complete Independence, Acoadc.mlcr"",.rd,eTS """uld ron.hlor thl. opuen caullou,I)'. ghen w hbtOI')' or nll,uJ< of
u~.
_.:<'
Complrltivt rtStlrc:l1 upcnditurt Nationallnstitu'le:I of Htalth sptrwfing on rOC:Jrch fundlng for mJIor dl~USS pet "Io,td duth 2001
SLOGO StO.ooo STt.ooo
.,..
_.
1:t*.IAIIL
*-
$t, •.ooo
.teIollifir fincJing.,
70 S • .ooo S'AOO
12.000 _
.////
INDEX
additives :1:2,ld"crtising 1 J Q
bans 76-Tl direct mail i.8. in USA SJiinternet ~ 6!! nlagazJne 5.8 outdoor 5.B. newspaper 5.8 point of sale >8publie transport 58Je~ ullO promotion
Africa, history 12Alladlli. clgareu(' manufacturer .illAmertcas, history 1.8areca nut ll., u.o.ASH UK 52A$ia. history L8Astra, cigarette brand 52Australian AS50ci3tCtI Press 60Austria Tabac, dg;,l.rctte
manufacturer iQ
Ilaisha, dgarcl1c brand 52
1.1.\''''', Clive 52Belmont. dgarcl1(: brand 5.2Benson & f-Icdgc.s.
cigarcue brand S9 betel qutd, 23. UJ)
hldi.(."('I1SUI11ptlulI In India 11description ll. UJ)
Orblol, cigarcne manufacturer i2British American Tobacco (llAT)
ad b.los 1Jj
cigarette manufacturer 50Gulldforcl depository 61litigation 8fiJilnugglillg sswomen's lInlokJng 2.6
Oro"'n and \Villia,nson. cigarette menufacturer Minnc~JQl3 (Icpos:itor-y 6.6. nicotine 12poll'lcs 63
Brundtlaud, Gro HarlemForeword 2.
126
on female smoking 26
on tobacco control 22boys, tobacco usc 22
8uff." WJrrtn 12Burson-Marsteller, public relations'
compon)' 6!
Camel, cigarette brand Clcancer
in passive smokers ISin smokers 13
Cerpan, cigarette brand 59C asa Sports, dguette b ra nd 59Casino, cig:a.rcne brand 5.9: chemicals in tobacco smoke 12 cheroots UcheWing tobacco 23 chilum ll. UJ)
Chteadg.rct\c brands 59d.ily male consumption 11forest fire i.lmale smokers 25RQtJuna.ns on HPhilip 1t1orris on 2i
cigarette consumption 30-31o,ino1Jduly worldwide 30
cig>lT't'ttct:
costs to smoker 42-43rl1"rkcl(n& expenditure In liS."59lax as proportion Or priceS:I:::&5tobacco content ~
cigmll.. WlCleopatra. dgarfltt brand 59Columbus, Chrlstophcr 1.8Commodore, clgal"'Cltc brand s.9 conscmpucn, definition Ull Cook, Cap .. in '.mes 18costs
or workplace ~mok:ing 25
'0 the economy illd.I10 the smoker 42-41
Cr ..ven oIA '.. clg<lrcttc brand 5.BCunnlnghanl, Rob 18
Curie, .\bric 62Cyprus 60
D.ymrd, Ricb.rd 8fideaths l6:IZ
future 2Q. 2.Jmen and women 12 pas' and future 16 quilling and 52
deforestation :YiDel .. , ciga",,"e brand 59Derby, dguell. brand >8dhumtis UDiplomat, dg ar eue brand 59Doll, Sir Riclurcl
on passive $molclng 11Dunhill, cig.rclle brand 59
Embus)" cigarelle brand >8 eugenol, in krc'cb ll. ill Europe, history Clexports
cig.rcttes 5.3tobacco lear i2
ex-smckers 8.3
F.ng Yizhi 18, 78 female smoking 2&::l1On:,iJFog.rlY In,eroational Center 11FORCES6S FOREST6Sf'Ortuna Ret:I. dgarette brand 52FrlmC\\'Orx Con\tention on Tobacco
Con Il"OI J.!!future, the 90_91
Gallaher, cigareu. manufacturer 5.0girl" tobacco use 2.9Glanl1., S,an,on
on litigation 66 glo .. .,,. 1 to-II? gO'f~rnment
income 8.5 growing ,00.000 ~
derorootJ.don attTibuuble co:4bland nea devoted '.0 :Yile.ding producers i1
B
smokers' righl-ll organisations 65Rockefeller Foundation (USA):zJRoper Orgolnization y_Rothmans, dgJrcl"Ic brand 52
on Chinese ~nloking2.i
school health programmes SOSG, cigarcltc brand 59shish. 22smoke-free areas 74-75 Ulsmokers' righu organiSJtions
M-655ftloking
female prevalence 26:21female trends 26in pregnancy 12male prevalence 2k2.5male trends 24t-ax and consumpuon 8.:l workplace iL 7±.. 1S. worldwide projections 8.S
smuggling ~5.5.nuIT !!, 23, U1Soptanac, cigarette brand i2Sportsman, dg.lrcttc brand 5.2State Express 555, cigJrctle brand
~state manuf ..cturing monopolies SOStella, cig.rette brand S!l
Streitfeld, David 60
"urnpen 22Sun T7;U, General t, 12Surgeon General's Report 1964
(US/I) LB
128
tar 78, ill",x
and cigarette price 84-85 dccllnlng proportion in USA S± revenue lest by 5muggling 55
Tckcl. cigarette brand saThis. dgarct-tc brand ssThree Rings, cigarette brand 59Time. dgarcnc brand 5.2Tobacco AdVisory Council 16 tobacco
chc\\'ing 23content per cigarette 49health risks g, 13tyJ>C"2b23youth. users 29
tobacco companiesby country 5.£biJby muket share 51
t,oh:.cco control organisations2l=Zl. ill
tobacco indurtry promotion
ss.sstobacco leaf
cXllOrtcr!l 52Importers 51 producers i1
tobacco trade Sl::S.3dg.lr'Ctt,c cxpor15 S3 dgarctte imports 53 tobacco lear trade 5.2
tobacco U$C, t)1'C' of 22-23'loscanlnl, Arturo. Utrade route."
legal i2S111Ugglillg 54-55
Trescr, cigorettc brand 59
United Nations Foundaucn :zJUSA
COstsof workplace smol:!ng i.l1J.aSSi\'C: .smoking in 15politics g, til
US Tobacco Institute SO
Victor)', cig>rette brand 59
Washington. George 13Ilds.hingron Post 60water pipe 22\Va\,(';Snct 6!lWill .. Gold FLtke
dg;arcttc brand l2. Winston. cig.rette brand 59 workers in JTWlufacturing tobacco
:IJ!d9«orkptaee smoking 2iworld conferences 72-73World Health Organiution
prediction On \\wth and tobacx:oIll!regional offi= 72-73 smuggling ij.
World No Tobacco Day Slb:8JWorld T.bles 2l=1.Q2
youth 2.8::22passive smoldng l! Philip Morris 1lI R.J. Reynold. 28. tobacco users 29
Of~\
Pr""'
~i."'If
c-lOOO:~
CUI'IK)AltU
s..,,''V gtlllllOl,. kI"i.Jttm. PLilip l\t«ri. In~.I. 198;, ~ ,,11m,,"
lOlJl6SJl949
nxr
1F.>;T1.-kI L. ,.,..,. .... oI! ,'lIim!dc..J Su.W.1'l1 ar..". n- U"_""-. 191••
InMhtni..,. PlI.' \\'irtb, 1911
Loptt l\l), ptl"Mll'\ll rotot....uoOOn 11 ArrilOOlAd.llli SmIth. An '1Ii1d'l ~... lAwl\'Jffltf ,,-, COII,W.JJIM Jliutr. !l1\'
1776 Part Six:J"" ~ Ctu-10ti1*" FI, r..IwNo (<<mill III ~tk:p.n, UUllfHd, O.o;rord UnhTOO)
f'~. XIOO, 1iII:4t 14) 1.)nIi T"tJ,. 11.~; 2"-}40. "11
JO Litigation
MAI;'Ir.' ,\lAP $ 5;\lUGGLI."\G uncsno»r'U~na1tUlUlfunlt"~ .,dtll rru(o_ RkLnI O,,}"'.lrd. (1/
t.-. N(Irtl!e ... tl:m U.lhtT»I!. liSA. 1001
IJAT I!ACI:o 4."19'tnll.ll ",ncrt._ ToIwrn. AnnUolKJt"Y_· mel SIlmIt'UJ f'in.r.nd.iI: ~I
lOIn. us liltgl1km: J8
WI'IIC),\RO
Ed""nl~ I. Report from P,,jl!p l\\(Jn"lt eou,_11G !'IIltip Mu,ri. Coun..dR"'t'"1ins A,_,irtit .... () N' ..,·...tw~ 19:16. Ilot ... N... :101)1,)0;)46/)).67,
11111.: II" ...."'-,',i>&trooiocull'mlIol .. C.'l:t.it ....dm~&dJ= 2S1S6aunp;IOIW«=8
UIJ:Yllrlmp:sm..·h~:,.n
TIlXT1)..,.,..'11" fl.A. 6.lto C. fr.wttq' N. TuW«o tIliCIOo,,", "'UtIrd.. iI:~.an'toA ,lIde"I
"'IM".,/. 8 J.ln\l.l:t) ]ex», )]Q; 111_11 J
\\·..1.1.... Rn. Tht pro~ fut &lukll.dll&I~ Iiti£.Ilion. \\'110'.
1"1ftNlkwW C<m.fUC'ftrt31 Cllll~ 'I(,I"n» c.;"lIoll .....1 '-It" 11110
WORLD TABLEST.hle A The Demographics of Tobacco
I. POPUUnoN
t.u¥:II.· ......... t.u.iDt/ .. br/.lOOl/rn.lillJ/cra/umaJlII6O I.bt..2. ADULT 1.\tOKISGMlt fO~ f_ mar S: ,\lIin "'-'r1. "OUTII S<\IOKIKC~ l'Q~ (01" tlYp .i: ,\1.Ipt
•• YOUTII EXPOSEO TO P.'SSI\'E SMOKING .-\T HOME..,...Kt~ (Of"..up 11 Otildrrn ~ to ~ ~ at t.:.r-.s. OCAREITE CONSU.MmONsee toUrn:I rOf nwp 6: M-. )\Ip
6.QUml}l.·Gu.o r• ...." 21.!M"',).I."
Table B The Business of Tobacco
I. GItO\\'lNG TOIl.-\CCO~jf:""n' 1 eo: !: see ~ b MAp Il: "~InI'OIu.mn J: _ ~ I'cw'\~ 12·l.ftdinc pmoJwu. JTMwntI..ut'f!ll1. TOa.\.CCO TRADe
roIwnn, I • 1:.MlC' lI>OWCo for Map IS • .)t.in~u.mnJ ) • ": -ee ~ r.. "tlp 1S.T~ I",*,,"in."
1ro_.,~1 C..... ""' ~ ... (f'fI"./. N_ DrIhI.lndA. 7 J-.., 2000 ). ~lA,'IIUf'.AcruRlNC TOBACCO
8t.r.kv 01). ~olI '~.1fJ. "i,il,,,.,"·',,,p_ """rulJ" '''i' ....,.., I.J.~ub.t«. COI'Iutl. \\'otld Ilt.lth Org.lnlt..ltion (\\'110), IS ~\&r(h 1002
h..u.p..l.llot ...w, ..bo.intl'qoml,ul)'1.1J,,9/nNl_loI\
Wl_h':J1(;>I'1·IMW'ID:
31 Projections by Industry
~\"IN(0,\""f:RC. 1k lI",tJ ('-IPlft1f Iltnrht· n.c t~'1 $"",,],, I·Ke c,""'P lIAr. l«O
IT..XT
\\',,,,-III(.iI\ll OfgMlll.illo,.l. GtrlCu.l)rw rcf,r.~. \VHQI1:lb,I.I'86
32 Future
11M[I.L"'E
M.I("i..y J, t_~.frnmtlw GrtIjtlClIiltl Tilt ,,"',., JS ,_" l(kh \\' .. 11d CM,r~'t1lft
')Illi'AtMT(l(I' IInl1h .. Hcotj~. ChiN. J4-1~ "I'K"~1Mf'VtuIl' ~ l'klWJ" TJo..rr. C_,J Nt;· 111wH.111,..J ...... "t..
(NtiV_oI lit" \\\)rld c..r~ Ilf' lOO.orfJ or II~h. ctl""fO mil~.6-11 "u~1000
CQI_ 1: 01,'1( _l'" fvr ""'P 11: "t .... ,\l4pnIoIwnn l: uSO.\. ~ IW~ Scr.~. ~o.ac.w ~ (9-4102)'LMt
161. \\blte! CIc",,"1f' F'If:o:NMbI. Stk-ned Coufilrir.t" 19ro--t"i. USD.\
.dor.itt: ~)In_" 1001 .Ilttp.II ......_'.u-s ..-t.-ro Id..t..f "'),,1 riI;-wo....,.?f~~I: 1)401 2.1
',comalIllrMIt , '" 1: fft IIOIIfn!'lI fOf M,.. II. M... M..pwllllWlt] ..... '" tOIAft fur ~t.p II. A 1"'" 0.,. 'f Smtolt:5. T....x('uI1II'MI 1: f«' o(JW'l," 10",. ~~.19. j,1I1no M1IadllrM 2: W't tnUI"f"eI I(.,. M.",19.C~ intor!W' &or. T.ol.m... TOIlAC(.'O lNUUSTkr OOCU.)l[%\.'TSsee ~--o r(ot M~ 11:M.I~"I..,
Glossarj'
s.w. C. O\kNriU A. Ju-'''' M. (ir.,. M. 1lw fut_ 0( ~ proJat""",!.t1On .-I1.iI:d~eIn li~ Impl~ ~ d'e r~1ne~III UniondIi"'rth~.I~c-M 'ffl.l: 1l.Wi5
Clml7. S. MIoU ...... 1'.JwM._ «pJ- .....\'~ ': r"'_" ).1999~11oJ~Iot'IwIuujL r-J. Ltoa:c. C-"" O.bd Uaf .. :...ky
I-'rot,
MUI"rlyCJI, 1~'f""'AI). ,Itt C,1.>NI'IItM 1"-. \\'01-1.:111(.""
O,~ i.Ytbt. II.,.-.n! ~ ull~-.I .. I kJtJ,. \\~!.Ib.&nl. 1996!.SI-'Tto I~ l»jll:tAJ). pd~ ('I)11)",,,"klllvll 11 A,,1111001
124
\\'C.1d I tNh.h Ort-t ...,..,.. r-Im_}« rNIOfJI., ..J _,..."..., ...,I....tr,J-. \\'1I0.Ct:nro....lmtl]) us
r~"., IWA;A GW>.II$t • ., AqoIo't. \''110. ~ ... 1m
B
