GLOBAL PARTNER SHIP FOR TOBACCO-INTRODUCTORY PACKET
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- Title
- GLOBAL PARTNER SHIP FOR TOBACCO-INTRODUCTORY PACKET
- extracted text
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RF_PH_13_SUDHA
•
I
’
Close down the bidi factories through phases.
This includes, restricting harvesting of tobacco to
produce bidis.
•
I•
\
E
Discontinue advertisement of tobacco products
and forbid any show or program that propagates
smoking beyond the period of the existing
contract/agreement.
Prohibit import of tobacco "within a reasonable
. period” and impose heavy tax for the import; all
imports must print statutory warning legibly in
bold words in Bengali.
•
•
Ban any promotional ventures like "Voyage of
Discovery'".
Ban smoking in public places including transport
and publip gatherings.
PUBLIC EDUCATION
BATA members produce a range of materials to
educate the public about the dangers to health.
economics, and appearance from tobacco use.
include posters, stickers, and pamphlets.
PUBLIC MOBILIZATION
BATA encourages the public to take a stand
against
activities
include
and
use.
rallies
and
LAW & POLICY
marches for WHO's South East Asian Anti
Drafting of model legislation
Tobacco (SEEAT) Flame for Freedom from
After compiling laws from various countries.
drafted
a
set
laws
of strong
submitted them to the government.
cover such .issues as
promotion
of tobacco.
dedicated tax; for anti-tobacco education on the
media.', The I government
is
BANGLADESH
ANTI-TOBACCO
ALLIANCE
Tobacco; human chains, and marches.
and
The laws
smoking in public places, pack labeling, and a
mass
promotion
tobacco
Mobilization
BATA
These materials
and on how to quit smoking.
SEMINARS
BATA has held two seminars to date;
□
to
respond
to
the
“Voyage
of
Discovery”, at which legal and mobilization
currently
discussing legislative options.
How
activities were planned.
□
members to learn
A seminar for BATA
more about The Framework Convention on
Tobacco Control (FCTC).
ECONOMIC ANALYSIS
In July 2000, BATA held a press release to
>
release the study. 'Hungry for Tobacco, which
shows the
burden’ of tobacco
use
on
poor
families in Bangladesh.
NEWSLETTER
BATA
produces
Bengali
and
a
quarterly
English,
with
newsletter
updates
on
in
its
activities and important national events.
FINANCIAL SUPPORT
. Report summary
if tobacco were no longer consumed in Bangladesh,
the following economic gains would be anticipated;
♦
Savings in foreign exchange for import of
tobacco of oyer $ 14 million US per year.
♦
A net "increase in employment of almost 19%.
♦
Large increases in household investment
housing, education, and health care.
♦
♦
10.5 million fewer people going hungry.
350 fewter deaths from malnutrition of children
under age 5 each day
BATA
receives
assistance
from
financial
PA TH
and
Canada
Government of Bangladesh.
technical
and
the
Members have
received support to attend conferences from the
Rockefeller Foundation, the American Cancer
in
Society, and the WHO.
Bangladesh Anti-Tobacco Alliance (BATA)
67 Laboratory Road, Dhanmondi
Dhaka-1205
Bangladesh
tel. (8802)966-9781
fax (8802) 966-0372
e-mail: wbb@pradeshta.net
Member organizations
The Law and Society Trust works to protect
Our fifteen member organizations represent a
the legal rights of the underprivileged and to
broad range of interests.
represent individuals against corporations.
>
Naripokkho
ADHUNIK
is an anti-tobacco organization
involved in policy work and public education.
Bangladesh Cancer Society' addresses issues of
cancer awareness, education, and treatment.
Consumers’ Association of Bangladesh seeks
to protect the rights of consumers in a difficult
is
a
women’s
organization
focusing on women’s health, status, and rights.
POROSH is an environmental organization.
The
Student
Anti-Smoking
Committee
(SASC) is run by students of Dhaka University.
Social Advancement & Solidarity Center
(SASTER) is a social service organization.
Ahsania
Conduct
research
to
tobacco
use
its effects,
particularly
among.
development
>
works in health,
development, education, and the environment.
National Non-Smokers’ Forum is the oldest
anti-tobacco organization in Bangladesh.
Welfare Association
for
Cancer Care
(WACC) is a forum of UICC’s ‘’Reach to
Recovery” focusing on breast cancer counseling.
Work for a Better Bangladesh focuses on
issues of environment and on tobacco control.
Young People for Social Action (YPSA) works
on education, health, and environment.
Seven of our member organizations focus on the
problem of drug use:
Atish Dipankar Gobeshana Parishad
BADSA, Ghas Phul Nodi, MANOBIK
Manosh, Pratyasha, Sonarang
In addition to our members, other organizations
contribute their time and energy to working with
BATA.
Raise
awareness
Continue to be a strong united
control
Formation
force in
. nationally.
BATA ACTIVITIES 1999-2000
campaign for its John Players Gold Leaf brand.
ADVOCACY
The campaign involved the sailing of a yacht to
17
in
countries
170
days,
the
with
destination being Bangladesh.
final
The campaign
BATA
regularly
legislative
holds
changes,
events
including
calling
a
for
signature
was obviously meant to encourage youth to try
campaign to provide non-smoking carriages on
the
trains, and protests against tobacco advertising.
brand,
by
it
connecting
to
images
adventure, wealth, and excitement.
slogans
of
adventure”.
the
campaign
of
One of the
"‘Join
was
the
Various groups interested in doing
BATA also organized a series of events to
protest BAT’s marketing campaign the “Voyage
of
Discovery”.
BATA
is
also
urging
the
something about the campaign began to hold
government to negotiate for and sign a strong
meetings in September 1999.
Framework Convention
As the result of a
writ petition filed by many of the members, the
on Tobacco Control
(FCTC).
Bangladesh High Court ordered a staying order
promotional
events on
and
the
from
boat’s arrival
publishing
in
further
During the
newspaper ads promoting Voyage.
course of the anti-Voyage campaign, the groups
Objectives
r-
Voyage of Discovery decision
BAT from holding planned
Chittagong,
As a result of a court case about the Voyage
campaign,
issued
a
strong
production.
reducing
•
tobacco
the
damage
and
to
personal
health,
and
the
national
economy from tobacco consumption.
r-
Court
the dangers of tobacco.
Reduce
environment,
The Institute of Allergy and Clinical
Immunology of Bangladesh provides advice
High
Educate the public and policymakers about
by
consumption.
>
the
response, urging the government to:
•
Ban production of tobacco leaves in phases,
giving subsidies to the farmers to produce other
agricultural products, rehabilitating tobacco
workers with other jobs, and
imparting
vocational training to them.
Restrict permission and licenses for establishing
tobacco factories, and direct the owners to switch
over to other products in phases, compensating
them if necessary.
Persuade owners of tobacco factories not to
continue with production of tobacco products
beyond a reasonable time, by banning such
Contribute to the health and well-being of
Bangladeshis
The Disadvantaged Adolescents' Working
Network (DAWN) Forum brings together over
and treatment to asthma and allergy sufferers.
locally,
regionally, and internationally. [
involved agreed to start an alliance.
twenty NGOs working with adolescents.
about
»
to become involved.
>
British American Tobacco (BAT) advertising
Bangladesh
Women’s
Health
Coalition
(BWHC) focuses on women's reproductive
health, legal rights, and advocacy.
more
BATA was started in order to counter a major
which prevented
Affiliate organizations
learn
organizations about the importance of
tobacco control, and encourage more group^:
tobacco
Mission
and
economic effects.
environment.
Dhaka
Help strengthen the nation’s tobacco control
policies and legislation.
>
•
Global Partnerships for Tobacco control O
Essential Action
P.O. Box 19405. Washington. DC 20036
Tel: (1)202/387-8030 ❖Fax: (1)202/234-5176
awhite@essentlal.org ❖ www.essentialoctlon.org/tobacco
Sttyyeated Activities
What types of activities might partner organizations work on together? This menu
provides a sampling of possible joint projects, covering a wide breadth Of issue areas. You
and your partner can pick and choose according to your particular interests or think of your
own. We will be developing modules for some of the activities listed below. In the meantime,
if you would like further information on any of them please contact us. Also let us know if
you come up with any creative ideas of your own. We will share them with everyone else!
TOBACCO ADVERTISING & PROMOTION
> Local Surveys
Each partner could survey their local environment for: tobacco advertisements, promotions,
merchandising approaches and retailing outlets; tobacco control and public health messages,
treatment facilities, etc.; and tobacco control ordinances (local taxes, smoke-free regulations,
etc.). The partners would exchange information and compare results. Are promotions within
1000 feet of schools banned in Milwaukee but permitted in Manila? Are newspaper
advertisements for tobacco banned in Bangkok but permitted in Baltimore? The survey results
should be newsworthy, and may spur local policy initiative follow-ups. <Further
Information Provided in Packet>
> Women and Tobacco
Women are a primary target of the tobacco industry all over the world, nowhere more so than
in the developing world, where smoking rates among women is traditionally low. Partners
might examine industry promotional activities targeting women, comparing and contrasting
the industry efforts in different countries. In addition to elaborating how the industry hopes to
lure more women into smoking, they may highlight the double standards that permit certain
promotional activities in developing countries that cannot take place in the United States or
Western countries because of reasons of law or custom. Simply focusing on how women are
being targeted may help to inoculate women from the industry's deadly seductions, especially
if partner investigations spur media interest and are followed up with educational activities for
girls and women.
> Celebrity accountability
While most American entertainment and sports celebrities would refuse as a matter of course
to endorse cigarettes or tobacco products in the United States, many seem to feel differently
when it comes to markets overseas. Several sports and music stars either endorse tobacco
products directly, or participate in entertainment events that are showcases for a sponsoring
tobacco company. These arrangements enable the Americans to protect their image in the
United States, while cashing in on tobacco dollars. In developing countries, de facto celebrity
endorsement supports the romanticization of smoking and the association with perceived
American traits of wealth, freedom, etc. Working together, partners could document the role
of U.S. celebrities in overseas tobacco marketing, and then make binational, direct requests to
the celebrities to terminate their association with Big Tobacco.
> Going to the Movies
Hollywood specializes in glamour, and when Hollywood movie characters smoke — as they
so frequently do - they glorify smoking. There is little doubt that this glamorization of
smoking entices young people into smoking and lessens the social stigma against smoking.
The problem is severe in the United States, but is probably more intense outside of the United
States, where Hollywood movies have an even larger cultural influence — and where
Hollywood norms may be perceived to be those of Americans. Efforts to convince Hollywood
writers, directors, producers and actors to limit on-screen smoking time have met with limited
success. But stepped up, organized international efforts might do better. Partners could work
together to document and explain the harmful effect of smoking in movies, and then convey
those findings to Hollywood principals. Hearing from overseas tobacco control groups, and
their characterizations of how smoking in the movies affects tobacco consumption in their
countries, may be particularly influential with some Hollywood figures.
GOING SMOKE-FREE
> Smoke-free Hospitals
Partner hospitals could share information on the transition to smoke-free status — the public .
health imperative, how to address employee concerns, how to change the medical culture,
how to address patient protests. Or medical association or NGO partners could
campaign to make hospitals smoke-free.
> Youth and Tobacco-free Schools
Partner student groups in particular schools (a high school in California and one in Nigeria,
for example) could together share information on tobacco message prevalence in their schools
and surrounding environs; survey student smoking rates; work together to analyze how
industry promotional messages target youth; coordinate anti-tobacco messages in their
schools; and perhaps jointly develop or share anti-tobacco songs, plays or artistic displays.
SPOTLIGHT ON TRADE PRACTICES & POLITICAL INFLUENCE
> Tobacco Industry Documents
Partners could jointly research the tobacco industry documents for material related to their
communities or areas of interest. Because of technological limitations among many groups in
the South, even reviewing the documents available on the internet may be impractical. But a
tobacco control partner in, say, Minneapolis could easily do a computer search for a Kenyan
partner. This would truly be a joint effort, because the nature of the documents and the
inadequate indices publicly available requires that those conducting the search be informed
about key terms and names - information that only the Kenyan partner might have — both for
the purposes of finding and interpreting the documents. Such joint efforts clearly offer rich
possibilities, as the steady stream of blockbuster stories based on the documents hit the media.
> Smuggling
Groups that identify smuggling as among their issues of priority concern could benefit
enormously from sharing particularized information about smuggling in their countries and
communities. Partners might jointly explore how smuggling occurs, its impact on tobacco
consumption and tobacco control regulation, policy tools to curb smuggling, how to convert
their findings into policy proposals at the national and international level, and work together
to plug into negotiations over a smuggling protocol to the Framework Convention on Tobacco
Control.
> Evaluating Industry Political Influence
Partners could work together to do local or national surveys of tobacco politics: Do tobacco
companies contribute to political candidates? How much? Do they employ lobbyists? Who
are they? Did they previously serve in government? What kind of ties exist between
government officials and the tobacco industry? Does the industry target charitable giving to
influence government officials? Do cities or countries have mechanisms in place to ensure the
industry does not exercise improper influence? Are different kinds of tobacco industry
support for politicians disclosed to the public?
TAPPING NEW RESOURCES
> Giving teeth to U.S. State Department's tobacco directive
When the Clinton administration instructed embassy outposts to cease lending support to the
tobacco industry, it also stated in its directive: Embassy "posts are encouraged to assist and
promote tobacco-control efforts in host countries." Partners could strategize about how to
work together to encourage embassies to support overseas tobacco control efforts. In Senegal,
the U.S. ambassador has issued a statement on tobacco control on World No-Tobacco Day,
and donated old computers to local tobacco control, groups. <Further Information Provided
in Packet>
INTERNATIONAL CAMPAIGNS
> WHO “Clear the Air” Competition
The World Health Organization has designated second-hand smoke as its theme for World
No-Tobacco Day 2001. It is inaugurating a "Clear the Air" competition among cities in an
effort to inspire mayors and city governments to address second-hand smoke problems with
smoke-free spaces. Partners could work to ensure their cities participate in the Clear the Air
competition, and share ideas and strategies for expanding smoke-free public spaces —
3
workplaces, restaurants, schools, hospitals, government offices, etc. <Further Information
Provided in Packet>
> International Days of Action
Organizations in over 40 countries organized events for an international week of action in
October 2000 which highlighted the role of the multinational tobacco companies in spreading
death and disease <see www.IWR2000.org>. Other days of action are certain to follow.
Partners could plug into these plans, holding demonstrations, news conferences or other
creative actions. To capitalize on the partnerships, partners might want to coordinate their
activities, perhaps highlighting double standards in the industry's activities in Western
countries and in developing countries and Eastern Europe and the former Soviet Union.
> Framework Convention on Tobacco Control
The member states of the World Health Organization are now undertaking negotiations on a
Framework Convention on Tobacco Control. The Framework Convention is expected to
establish a set of global tobacco control guidelines and policy objectives. Specific protocols
will contain binding agreements in particular areas, such as smuggling and advertising.
Partners can work together to learn about the Framework Convention; coordinate efforts to
pass local resolutions in support of a convention; share information with government officials
to ensure they understand the importance of the Framework Convention; and join an
international alliance in support of the Framework Convention.
MISCELLANEOUS
> Congregation pledges
Religious group partners could undertake a joint effort to collect pledges from congregation
members to stop smoking. The collective nature of the pledge may assist smokers to quit. The
congregations might also pledge to venture into the community and undertake parallel
campaigns to gather pledges to quit smoking, or to support smokefree ordinances for public
places in the community.
> Web Development
Partners could work together, and with the wonderful assistance of Globalink, to ensure that
both partners have a satisfactory presence on the web. Depending on their computer capacity,
they could post pictures of local conditions, organization members, and organizational
activities; or, if the developing country partner did not have access to a scanner, the U.S.
group could perhaps post photos on behalf of the developing country partner.
4
Tobacco Advertising Materials
> Tobacco Advertising Survey Tool
> Tobacco Advertising Survey Protocol
> Permission Slip
What to Count
A GENERAL RULE OF THUMB ON WHAT TO COUNT:
We are counting the number of tobacco names and logo impressions on advertising and promotional items
provided to the store by a tobacco company.
COUNT ALL:
•
SIGNS
•
CHANGE TRAYS
•
CHECKOUT SIGNS
•
BANNERS AND LITTLE FLAGS
•
COUNTER MATS
•
SIGNS ATTACHED TO DISPLAY RACKS
•
DIVIDERS
•
SIGNS HANGING FROM CEILINGS
•
CLOCKS
•
COUNTER/REGISTER OPEN&CLOSED SIGNS
•
ASHTRAYS
•
SPECIAL SALES: 2 PACKS FOR THE PRICE OF 1
•
LIGHTED SIGNS
•
CATALOGS OR SIGNS FOR PROMOTIONAL ITEMS
•
HAND BASKETS
•
ADS ON CIGAR OR CIGARILLO BOXES
•
DECALS
•
ALL STICKERS WITH BRAND LOGO ON THEM
•
DOOR MATS
•
ANY OTHER ITEM WITH BRAND NAME OR LOGO
HOW TO COUNT SOME TRICKY ONES:
INTERIOR ADVERTISING:
•
•
•
•
•
•
•
If poster has multiple types of the same brand (e.g.: Merit Light, Merit Menthol, etc.), count it once
If poster has multiple brands (e.g.: Marlboro, Winston, Parliament), count once for each individual brand.
Ashtrays - count all the visible logos you see.
Hand Baskets - count all the visible logos you see - don’t lift up baskets to count ads.
Dividers - count all the dividers you see - don’t go into each aisle to count.
Catalogs - count the catalogs that you see - if there is a stack only count the top one
Special sales: count all the images that you see on each special sale package (so if you see 3 images on the
package, count all 3; if you only see 1 package and others are stacked behind it and not visible, only count £
the images on the package you see.
PROMOTIONAL ITEMS:
•
Count all images on each gift-with-purchase package that you see - if there is a stack of packages only count
those images that you see.
ANTI-TOBACCO SIGNS
STAKE Act signs must have 1-800-5ASK-4-ID on them. They may be state issued yellow-and-black-on-white
signs or signs made by the retailer.
Other signs may include: WE CARD, ITS THE LAW, hand made signs that convey that the store does not sell
tobacco to minors, thank you for not smoking signs.
DO NOT COUNT:
INDIVIDUAL PACKS OF CIGARETTES, CIGARILLOS, OR SMOKELESS CONTAINERS
CIGARETTE CARTONS OR SMOKELESS MULTI-PACKS
SALE STICKERS ON INDIVIDUAL PACKS OR CARTONS
Tobacco Advertising Survey - February, 2000
Store name,etc label
Project
Name:______________________
Date:
fhrterior^^bacc^Advertisin^e^gT^posters^special^al'es^docks^decals^Ttc)^^^^^^^^^
Number of ads in English:
Number of ads in Spanish:
plumber of ads in other language:
Specify language:
Number of ads in English:
Number of ads in Spanish:
Number of ads in other language:
Specify language:
^Advertising location:
Any tobacco ads located next to candy? (circle yes or no)
1 Yes
2 No
Any tobacco ads located 3 feet or below? (circle yes or no)
1 Yes
2 No
^[nterio^jntbVobaccoMtessages^^^
Number
STAKE Act (1 -800-5ASK-4-ID) signs
Other Signs (about not selling to min
pH -
U.S. State Department Directive
> U.S. State Department Directive
> How to make the U.S. State Department’s
Directive work for you: Senegal’s case
News analysis
How to make the
US State
Department’s
tobacco directive
work for you:
Senegal’s case
It is laudable that the State
Department issued a directive on
American international policy on
tobacco in February 1998. At the
same time it represents no real change
in policy.
Old fair trade rhetoric and a new
pro-health
agenda
aren’t
easily
squared, as the directive clearly
indicates. Wrought with the old
misguided logic of the “legal”
product, its policy objective of
ensuring American companies “equal
access to a shrinking global market for
tobacco” echoes the old USTR
(United States trade representative)
mentality: “We know cigarettes are
bad, but hey, we’ve got to help ‘poor’
American companies get their ‘fair’
share of the pie!” This ignores die fact
that these companies’ marketing tech
niques are often more aggressive. The
result? American companies end up,
not only hogging the pie, but also
increasing its size.
Furthermore the policy suffers
from a lack of “teeth”. Although the
first guideline of the directive
explicitly states: “Posts [embassy offi
cials] are encouraged to assist and
promote tobacco-control efforts in
host countries,” there is no mention of
how exactly posts might do so. Ameri
can embassies are not in the business
of providing financial assistance to
local non-governmental organisa
tions. That’s the job of the United
States Agency for International
L&M hats, Lucky Strike shorts, Marlboro baby i
the size of the market pie in Senegal.
341
Development (USAID), but USAID’s
five-year plan focuses on family
planning, child and maternal health,
and AIDS prevention—and not
tobacco control.
There is little evidence so far that
local anti-tobacco movements have
benefited from the measure—except
in Senegal. Perhaps the Senegalese
example can give tobacco control
groups elsewhere ideas on how best to
approach
their
local
American
embassy and make the directive work
for them.
The key for tobacco control groups
is to think of ways American
embassies can lend support without
using American funds or compromis
ing their integrity as a front for official
United States policy. Perhaps the folks
in Senegal have a good deal:
Ambassador Dane F Smith is a mem
ber of Action on Smoking and Health
(USA) and confesses to “biting his
tongue” when forced to deal with
American tobacco companies. In a
brief meeting with the ambassador, he
acknowledged having read a New York
Times article on American corpora
tions selling cigarettes in Senegal
through liberal use of American
imagery. Familiar with the State
Department’s directive, he was openly
receptive to the idea of lending
support to Senegal’s anti-tobacco
movement.
Although the ambassador could not
endorse any specific organisation, he
agreed to issue a public statement on
the occasion of World No-Tobacco
Day: “Growing up Tobacco Free” (31
May 1998). This statement ran in at
least one local paper and served as
important foreign political support for
the local anti-tobacco activists’ cause.
After World No-Tobacco Day, the
new anti-tobacco federation wrote a
letter of introduction to Ambassador
Smith, -also thanking him for issuing
the public-statement, and inquiring as
to whether the embassy had any old
computers available for donation. The
response was favourable and two
months later a shiny new-looking
computer found a new home at the
federation. This generous donation
will allow the federation to establish
itself much more rapidly, by making
everything from letter writing to elec
tronic communication much more
efficient.
ANNA WHITE
Federation des ONG et OCB
Lullant Contre le Tabagisme (PLOT),
do 103 Radcliffe Drive,
Newark , Delaware 19711, USA,’
wunipworld@holmaiL com
EU/UK: ad ban
busting plan
Tobacco control advocates in the
United Kingdom and other western
European countries which have not
yet banned tobacco promotion are
busy trying to ensure the effectiveness
of legislation being drafted under the
European Union’s ad ban directive.
Of greatest
concern
is
some
governments’ apparent weakness of
resolve. The cause of this is unclear,
but may be presumed to be
exacerbated by budgetary restrictions
and the near certainty of the
industry’s now routine twin proce
dures of (a) legal challenges and (b)
deliberate “breach-and-see” tactics to
test out the government’s commit
ment to its new law.
The big loophole in the EU ad ban
is on branding of non-tobacco
products. However, the wording does
not give an unqualified exemption as a
right. The relevant article in the direc
tive (98/43/EC, 3, para 2) says that the
ad ban “shall not prevent the member
states from allowing a brand name
already used in good faith for both
tobacco products and for other goods
and services traded or offered . . .
prior to July 1998 to be used for the
advertising of those other goods and
services.” This wording does not
require member states to exempt brand
stretching, but merely allows them the
U.S. DEPARTMENT OF STATE
DIRECTIVE ON TOBACCO POLICY ABROAD
GENERAL POLICY
The opening of international markets to U.S. products, non-discriminatory
treatment for U.S. exporters, and removal of barriers to international trade are
high priorities of the U.S. Government and the Clinton Administration. At the
same time, the U.S. respects the rights of foreign governments to establish and
maintain sound public health practices, encourages them to do so, and, where
appropriate, may support such with multilateral and bilateral assistance. Given
that tobacco use will be the leading global cause of premature death and
preventable illness early in the 21sTcentury, there is a need to distinguish
between protectionist policies and legitimate health-based actions, so as not to
undermine other countries’ efforts to reduce the consumption of tobacco and
tobacco products and to improve the health of their citizens.
In light of the serious health consequences of tobacco use, the U.S. Government
will not promote the sale or export of tobacco or tobacco products or seek the
reduction or removal of any foreign country of non-discriminatory restrictions on
the marketing of tobacco or tobacco products. At the same time, the U.S.
government will continue to seek elimination of discriminatory trade practices and
will strive to ensure that U.S. firms are accorded the same treatment in a foreign
country as that country’s own firms and firms from other countries. The overall
objective of this policy is to ensure equal access to a shrinking global market for
tobacco. This policy also conforms to the provisions of Section 618 of the Act
making appropriations for the Departments of Commerce, Justice, and State, the
Judiciary, and related agencies for FY 1998.
GUIDELINES
The following guidelines are consistent with the administration’s overall approach to
reducing the negative health impact of tobacco while protecting the rights of Americans
overseas:
(1)
Posts are encouraged to assist and promote tobacco-control efforts in host
countries.
(2)
Posts should not challenge host country laws and regulations based on sound
public health principles applied in a non-discriminatory manner to both imported
and domestic tobacco and tobacco products, and for which sufficient notice has
been given. If a post has reason to believe that such regulations may, in fact,
I/mele/state
discriminate against U.S. firms or individuals, the issue should be referred to
Washington for consideration by trade, health and other appropriate agencies.
(3)
Posts should not promote the sale or export of tobacco or tobacco products, and
should not assist the efforts of U.S. firms or individuals to do so. Ambassadors or
embassy staff should not attend or otherwise support receptions, trade promotions,
or any events sponsored by individuals or entities involved in the export,
manufacture, promotion, distribution or sale of tobacco or tobacco products where
their attendance could be construed as United States Government support for the
sale or export of tobacco or tobacco products.
(4)
Posts should continue to provide routine business facilitation services to all U.S.
citizens or firms such as the provision of publicly available information on foreign
country conditions and policies, information or assistance that may help U.S.
firms or individuals to comply with foreign government laws or regulations, and
assistance in resolving business problems - such as customs or port clearance,
trademark violations, or phytosanitary restrictions that are potentially
discriminatory.
END GUIDANCE
Text of Section 618
Begin Test:
None of the funds provided by this act shall be available to promote the
sale or export of tobacco or tobacco products, or to seek the reduction of
removal by any foreign country of restrictions on the marketing or tobacco
or tobacco products, except for restrictions which are not applied equally
to all tobacco or tobacco products of the same type.
I/mele/state
pH - I3..SO Global Partnerships for Tobacco Control O
Essential Action
P.O. Box 19405, Washington, DC 20036
Tel: (1) 202/387-8030 ❖ Fax:+1 202/234-5176
awhlte@essential.org ❖ www.essentialaction.org/tobacco
GETTING TO KNOW YOUR “I3UDDY” ORGANIZATION
Developing close, trusting relationships are fundamental to the Global Partnerships
program and key to its long-term success. Since participants represent such a wide range of
organizations, activity interests, countries, cultures, and ages, there can be no single method of
getting to know each other. Instead, we recommend the following list of questions, grouped by
category, to guide you through the process. How you decide to share the information is up to
you. You might communicate back and forth by email over the course of several weeks. Or you
might put together a scrapbook about your organization to send to your partner—an activity that
youth organizations and schools might find especially fun.
The questions are designed to help you get to know each other personally, as well as to
give you insight into your partner organization’s social, cultural, economic, and political reality.
They should also help you obtain basic practical information, e.g. the time zone difference
between you and your partner, and be conscious of some of the inevitable cross cultural
differences that may arise. Not all questions will be relevant to all partnerships. For example,
due to U.S. domination of global media, international groups are likely to know more about the
U.S. than American groups know about their partner organizations’ countries. On the other hand,
American groups may find that their partners have a very narrow idea of what the U.S. is like
and may want to offer insight into the diversity of cultures within the country that rarely make
the international news or scenes in Hollywood movies. As with all cross-cultural encounters,
you made find that you learn more about your own culture and experience through exploring
another’s. The partnership may give you a new perspective on your tobacco control activities and
add exciting new dimensions to your work.
We realize that this is very long, but certainly not exhaustive, list of questions. Feel free
to add your own questions. And don’t worry - we do not expect you to ask or answer all of the
questions (with the exception of those in the “Important Practical Issues" section)! Pick and
choose as you wish. Instead of spending an inordinate amount of time tracking down answers to
some of the questions, you or your partner may want to consult references, such as Tobacco
Control Country Profiles distributed at the 11th World Conference on Tobacco or Health in
Chicago (August 2000) or the older WHO Tobacco or Health - a Global Status Report. If you
are able to meet in person or talk on the phone, be mindful of some of cross-cultural differences
related to communication styles that may exist. Try not to dominate the conversation. Be an
active listener. Let your partner know if you don’t fully understand something he or she has
said. Ask follow up questions. And don’t worry, we’re not going to quiz you on the answers—
so go ahead, feel relaxed, and have fun getting to know each other!
The questions are organized into the following categories:
1.
2.
3.
4.
5.
6.
7.
8.
Your Partner’s Country and Culture
Tobacco-Related
Your Partner’s Organization
Personal
Cross-Cultural
Important Practical Issues
General Discussion
Partnership-Related
Occasionally a question will be followed by a
symbol, indicating a related joint activity. At
the end, we suggest a few ways you might follow up on the knowledge you gain.
Your Partner’s Country and Culture
Where is your country located?
What other countries border it?
How long has your country been in existence?
What does its flag look like?
Has your country ever been colonized? If so, by whom? What impact do you think it has had
on your culture? What other historical influences have shaped its culture, commerce, and
national identity?
□ How many ethnic groups live within your country or community? How many languages do
they speak?
□
□
□
□
□
Ask your “buddy" how to share some basic phrases in his/her native tongue e.g.
"Hello, ’’ “Goodbye, ” “My name is..., ” etc. Practice using them when you communicate
with each other.
□ What are the most popular religions?
□ What are the most important holidays in your country? What do they celebrate or
commemorate?
c? Write down the dates of important holidays, e.g. Christmas, Ramadan, Independence
Day, or personal/family holidays, e.g. birthdays. Send a note to your partner
organization on these days to let them know you are thinking of them.
□ What sorts of food dishes do people in your country like to eat?
£5 Exchange recipes (or search the web) for popular dishes from each other's countries
and prepare them for others in your organization.
□ What type of music is popular in your country?
Send each other mixed cassettes of some of your favorite music.
2
□ How do people dress in your country? Are there any materials or fashions that are specific to
your area of the world?
□ What are the most popular forms of entertainment? What were the some of the most popular
movies last year?
□ What form of government do you have? Is it stable?
□ What have been some of the major current events in your country this past year?
□ What is the climate like? Hot or cold? How many seasons do you have?
O Check the world weather report periodically to see how hot or cold it is in your
partner's region.
□ What rough percentage of the population lives in cities? In rural areas? Is there much ruralurban migration?
□ What are the most popular forms of transportation?
□ How do people make a living? What are the most common occupations?
□ What is the approximate per capita GDP? What is the breakdown of wealth between rich and
poor?
□ What is your country’s national currency? What is the exchange rate between you and your
partner’s currencies?
□ What is the cost of living? For example, how much does a kilogram of rice or a three room
place to live cost?
© Pick 10 commodities available in both ofyour countries and compare and contrast
their cost in US$ in each ofyour communities.
□ How healthy are your country’s citizens? What is the average life expectancy? Infant
mortality rate? What are the most common health risks? Does your government provide
universal health coverage? If not, how do people pay for medical costs?
Tobacco-Related
□ Does your country grow tobacco? If so, how much? How does it affect farm workers?
□ Is your country a net exporter or importer of tobacco?
□ Which multinational tobacco corporations do business in your country? Do they import their
products or make them in country?
□ Do multinational tobacco corporations have licensing agreements with local manufacturing
companies? If so, what share of the national cigarette market do they have?
□ Is smuggling a problem?
o Search online industry documentsfor mentions ofyour partner organization’s
country. See activity menu for more information.
□ What forms of tobacco are used most often in your country, e.g. cigarettes, chewing, bidis?
□ What cigarette brands are most popular? What themes are associated with them, e.g. youth,
adventure, sports, freedom, “America”? What images are used in advertising to invoke these
themes? Which brands are most popular with youth? With adults? With women? With the
wealthy? With the poor?
fS Exchange photos of advertisements and marketing promotions for various cigarette
brands. Compare and contrast the themes with those in your own country. In particular,
note the images, colors, words, languages, race used. See activity menu for more
information.
□ How much does each brand cost? An average pack of cigarettes is equivalent to what
percentage of the average person’s daily salary? How much rice, eggs, or vegetables could it
buy?
□ Are cigarettes sold singly or by the pack?
□ How extensively do tobacco corporations invest into sports and cultural events?
□ Have tobacco corporations operating in your country tried to change their image or
marketing strategy recently due to the lawsuits they are facing internationally? If so, how?
□ Have tobacco companies tried to establish “anti-tobacco ” youth education programs in your
country? If so, how?
□ Do tobacco companies have a favorable relationship with your government? If so, how is this
relationship manifested?
□ For how long have people smoked in your culture/country? Was tobacco ever used in
religious ceremonies? How have smoking patterns changed over time? Is there a taboo
against women smoking? What percentage of men and women smoke?
□ When and where are the most popular times and places to smoke?
□ How familiar are people in your country with the short and long term health effects of
smoking? Of exposure to second hand smoke?
□ What anti-tobacco laws has your country passed? Are they enforced? How?
□ Is smoking allowed in public places, e.g. schools, hospitals, government buildings, public
transportation?
□ Are there warning labels on cigarette packets sold in your country? If so, what do they say?
£5 Compare and contrast the warning labels in each ofyour countries. Which are
stronger? How could they be improved?
□ Are there any tobacco advertising restrictions? Bans on sales to minors?
□ What is the tax rate, if any, on cigarettes, both domestic and imported?
□ Have any religious leaders in your country spoken publicly against smoking and/or the
tobacco industry? How do they connect the issue to the basic tenets of their faith?
□ How many cigarettes are sold each year per person? Assuming an average cost, how much
money does this equal? In comparison, how much money is spent, per capita, on health?
□ What are the most common smoking-related diseases in your country? How has their
occurrence changed over time, e.g. the age and gender of those affected? Are these problems
increasing, decreasing or staying the same?
□ What sort of support exists for people who develop a smoking-related disease, such as cancer
of the lung or larynx or chronic emphysema? What are their short and long term chances of
survival?
Your Partner Organization
□ How long has your organization been in existence?
□
□
□
□
□
□
□
□
□
How many staff, leaders, and/or volunteers do you have?
Where are you located?
What subpopulations do you work with?
What have been your primary activities?
What accomplishment are you most proud of?
What do you think you could do better?
What are your ambitions in the future?
What specific political, social, cultural, financial etc. barriers do you face?
What aspects do you feel you have at your advantage?
Personal
□ From which part of your country are you from?
□ For how long have you worked in tobacco control? What other kinds of work, if any, have
you done? What led you to get involved with tobacco control work?
□ Do you have a family? If so, what are the names and ages of your children?
□ What language do you use to communicate with friends and family?
□ What other countries have you lived in or visited?
□ What’s your typical daily routine like?
□ Do you have any interesting stories related to your work in tobacco control?
Cross-Cultural
□ How do people address each other in your culture? By first or last name? Does this depend
on the age, gender, and/or social position of those involved? How would you prefer to be
called? What title do you use? Are you comfortable with someone you don’t know well using
your first name?
□ What are relationships like between men and women? Is it appropriate for men and women
to be friends? What are gender relationships like in your culture?
□ Is there anything inappropriate for a man or woman to wear?
□ How much personal space do people like to have in your culture? How close or far away do
they usually stand from each other when talking? Is it acceptable to make eye contact?
□ How do people view time? Are people generally prompt to meetings? What priorities do
people place on their job, friends, and family?
□ How do people in your culture view someone who smiles a lot? Or who makes a lot of facial
expressions?
□ How do people deal with conflict in your culture?
□ What is the highest form of praise? Of insult? in your culture?
□ How are decisions made among members of a group? By consensus? Voting? One person
taking initiative and others following?
□ What qualities do you admire in a leader?
□ Are there any parables or folktales that are popular in your culture? Any adages that give
insight into social norms or values?
5
Important Practical Questions
What is the time zone difference between us?
What is the best way to contact you?
Do you have access to a fax machine? To the internet? To email? A CDrom?
How often do you check your email? Is it expensive or time consuming to download?
Can you open large attachments?
What is your phone number and country code?
How much does it cost to send or receive a fax, make a phone call, or send a letter? This
amount represents what percentage of your daily salary?
□ How reliable is the mail system? How long does it take to receive mail from overseas? Do
you have to pay any fees to pick up a package at the post office?
□ How comfortable are you speaking/writing English? Other languages?
□
□
□
□
□
□
□
General Discussion
□ It’s not always easy being a tobacco control advocate—what keeps you going?
□ If you could say one thing to the CEO of Phillip Morris to his face—what would it be?
□ What stereotypes do people in your country have of people in my country or area of the
world (be honest!)? Where do you think these stereotypes come from?
Partnership-Related
What attracted you to the Global Partnership program?
What do you think you can offer your partner?
What do you think your partner can offer you?
What activities and projects would you like to work on? Which are highest priority?
What guidelines should we set together? What are our expectations of each other, in terms of
how often we communicate, the amount of time we commit to a joint project etc?
□ What short and long-term goals can we set for our partnership?
□ Is there anything that we haven’t shared already that it is important that the other know?
□
□
□
□
□
SUGGESTED “GETTING TO KNOW YOU” FOLLOW UP ACTIVITIES
Make a scrapbook or poster about your partner organization using information gleaned from
your communication in addition to photos, newspaper articles, and other research to display at
your organization and share with visitors -or- make a scrapbook about your own organization to
send to your partner organization. Include photos of staff, your office, activities you work on
etc.
o Your partnership is newsworthy. The international dimension adds a new twist to discussions
of domestic lawsuits and policy, and the human interest side makes a compelling story. Contact
your local newspaper to tell them about your new partnership and see if they will do a story on it.
Essential Action can offer advice and assistance as needed.
6
After getting to know each other, you might write a joint opinion piece or letter-to-the-editor
of your local newspaper about a tobacco control issue near and dear to your hearts, emphasizing
the cross cultural nature of the problem—whether it be advertising targeting youth people, rising
cancer rates in women, or the need for smoke free public places.
fS Write a letter to your country’s delegation to the World Health Organization’s Framework
Convention on Tobacco Control. Emphasize what you have learned from your partner
organization about the global nature of the tobacco epidemic.
© Host a party with the purpose of introducing others to your partner’s country and culture.
Decorate the room with photos from magazines. Serve food and place music from their country.
Invite local people from the country to come teach some words in their language, sing songs, tell
stories and/or show photos from their country. Take pictures to share with your partner
organization.
Do you have any suggestionsfor how we might improve this document? Any questions we left out
that you think are important? Any fun, creative activities we omitted? Anything that you feel is
not culturally appropriate to ask? Let us know! We welcome any and all recommendations you
have to offer. Contact Anna White at awhite@essential.org , 202-234-5176 (fax), 202-387-8030
(phone).
pH - 13-
O Global Partnerships for Tobacco Control ©
Essential Action
P.O. Box 19405, Washington, DC 20036
Tel: +1 202/387-8030 ❖ Fax:+1 202/234-5176
awhlte@essential.ora www.essentialactlon.org/tobacco
A Guide to Building International Tobacco Control Partnerships
If we were to ask each group that has signed up for the Global Partnerships for
Tobacco Control program what their idea of a “partnership” is, we would probably get many
different answers. That’s a good thing, because the partnerships will - and should - evolve in
diverse ways. But it is important too that we all begin with some common understandings and
expectations.
Partnerships should be mutually supportive and beneficial relationships between two
groups working together on a common project. While regular communication will play an
important and valuable role, to succeed the partnerships will go beyond the “pen pal”
relationships. Successful partnerships will identify common interests, devise and carry out a
joint project, and ultimately achieve positive results.
It is crucial groups consciously work to insure that their relationships are balanced.
The partnership program is not an international mentoring program. While one organization
may have more experience in a certain tobacco control area and should impart their
knowledge as appropriate, to succeed the relationship between organizations must be twoway. Each organization has a different set of knowledge, experience, and skills, which may
be particularly unique given the specific geographical, economic, cultural, and political
context in which they work. We can learn a lot from each other.
It is important to emphasize that the partnerships should be rooted in a sense of
international solidarity, not charity which tends to lead to imbalanced relationships. Groups
should enter the partnerships to help each other, and to push forward the common agenda of
promoting tobacco control. Finally, the partnerships are not intended to be a funding
mechanism. Essential Action is not not a funding agency and it is not our objective, nor in
our capacity to fund individual groups associated with the partnership program. Likewise,
American and Canada groups - many of which themselves function on tight budgets - are
neither expected or encouraged to directly fund their partner organizations.
Some Basic Guidelines for Building and Sustaining International Partnerships
Because each partnership will involve different sets of countries, issue areas, and
project objectives, each will be unique and inevitably experience specific concerns that will
have to be dealt with on a case-by-case basis. There are some general guidelines, however,
that should be helpful. Since we know of no other program quite like this one, we assume
that all participants have little, and probably no, prior experience with an international
partnership of this nature.
Leadership. Partnerships between two organizations require at least two people, one from
each organization, who are willing to take on the responsibility of making the partnership
work. Part of the leaders’ challenge is to find ways to involve other members in the
organization in the partnership, so that it is not simply a relationship between two people, but
a relationship between two organizations.
Vision. A positive vision of the future can be a powerful motivating force. What do you
dream of that drives you to work so hard on tobacco control, day in and day out? A tobaccofree future for all children, in your home country and abroad? A day when lung cancer cases
in you and your partner’s hospitals will be rare once again? A world where international trade
organizations don’t treat tobacco just like any other commodity—where people’s health is put
over the rights of corporations that market products that kill when used as attended? Partner
organizations might want to share their visions and then come up with a common vision that
defines their interest in working together.
Mutually agreed upon goals. While we have tried hard to match organizations with common
backgrounds and project interests, each organization will bring to the partnership their own
agenda and goals. This is to be expected. The challenge will be to come up with goals and an
agenda that benefit both organizations. If each organization does not feel that it is getting
something out of the partnership, it will be harder to keep it going. Each group must have an
invested interest in seeing that the partnerships works.
Agenda setting and project planning. An agenda helps give focus and direction to a
partnership. What joint activities do you think would suit your partnership? What specific
tasks are involved and how will they be divvied up? What is a reasonable timeline for getting
them done? Sometimes when one organization has a specific local need, they may take the
lead on a project and offer their partner a supporting role. Remember, when working on
behalf of a partner, let them set the agenda. Agendas evolve over time, and long-term agendas
don’t have to be established right away. But it is important to have one!
Enthusiasm. Enthusiasm is contagious. If you have it, you’ll spread it to others in your and
your partner’s organizations. People who are excited about the partnerships are more likely
to put energy and effort into them and inspire others to do the same.
Commitment. Commitment requires a certain level of energy and persistence. Dedicated
anti-tobacco advocates often have a lot of projects on their platters. As a result, an
international project may not take priority when an urgent local issue comes up that needs
immediate attention. Still, your ability to remain committed to the partnerships, despite
changing personal demands on your time and energy or unforeseen difficulties associated
with a partnership project, are crucial to the long term success of the partnership.
Humility and Balance. Be careful not to dominate your partnership, either by monopolizing
conversations or controlling the agenda. The ability to listen is important. Given the different
backgrounds partners come from, one shouldn’t automatically assume that what works well in
one country will work well in another. Be conscious of this when offering advice and
acknowledge the limitations of your expertise. Each partner should feel that they have
something important to contribute. American groups, in particular, should be aware of
paternalism.
2
Reliability. Can you count on your partner to come through when you need them to dash off
a quick letter of support? Can they count on you to respond to an urgent request for
information? Responding promptly to requests and diligently following through on agreed
upon tasks are important to building trust between partner organizations. A promise to do
something without following up, on the other hand, will lead to distrust and frustration.
Ultimately, it is your actions, not your words, that will prove your sincerity.
Regular contact. Staying in touch with each other on a regular basis is crucial to building a
strong partnership relationship. Regular contact represents a commitment to the partnership.
Groups should decide how often, at a minimum, they should communicate and then make a
point of doing so.
Pay attention to personal details. While the Partnership Program is focused on
strengthening international tobacco control, this does not mean that the only topic of
communications between partners must be tobacco! Taking the time to pay attention to
personal details is an important part of developing strong interpersonal bonds. A note of
congratulations on the birth of a child, a thank you card for being especially helpful gathering
data promptly, an email inquiring whether recent severe weather has affected your partner’s
community, or a letter of goodwill on the occasion of an important national holiday are some
of the ways that partners can show that they care about each other. Notes needn’t be long.
It’s the thought that counts!
Flexibility and Patience. Partnerships will inevitably be faced with certain challenges at
some point or another. Perhaps it will be a language translation problem. Or a technical
difficulty with the phone or fax lines. Or a difference of opinion on how to carry out a project.
Maybe a project will take longer than planned or you’ll have to put up with the slow pace of
international mail, but if you are able to take these difficulties in stride and make do with the
resources available, the partnership will go much more smoothly. Whether big or small, most
challenges are surmountable with a little flexibility and patience. Part of being flexible is
being receptive to new ideas and ways of doing things that differ from your own. It’s all in the
attitude!
Sense of humor. It’s been said that humor is one of the things that translates worst across
cultures. What seems funny in one country may be incomprehensible in another. A good
sense of humor, however, doesn’t necessarily mean understanding and appreciating your
partner’s jokes. Rather, it is the ability to chuckle instead of getting frustrated when things
don’t go as planned, to laugh at a cross-cultural misunderstanding instead of getting angry, to
smile and work through difficulties that arise. Tobacco is serious problem, but it doesn’t mean
we have to take life too seriously!
Cultural sensitivity. No existing culture is global. Take an effort to learn more about the
social, cultural, and economic contexts in which your partner organization works. While it is
impossible to understand where your partner comes from without staying an extended length
of time in their country and community and learning to speak in their native language, it is
helpful to be consciously aware that their way of doing things may be different than yours.
For example, is it important to be on time? Do people prefer friendly or formal
communication with someone they have just met? How important is space and privacy?
When working cross-culturally, it is easy to misinterpret behaviors. Be conscious of your
3
reactions to issues that come up, as well as how your partner might perceive your own
behavior and ideas. Respect your partner and their ideas, and tty to avoid imposing your own
ideas on them. Related to cultural sensitivity is an appreciation that your partner may operate
under very different economic situations. In some developing countries, the cost of sending a
letter to the US may equal an entire day’s wages. Try not to be too quick to assume anything!
Fun! It’s much more enjoyable to work on a project if there is some element of fun in it. So
be creative and think of ways to make your activities fun for those involved. Reward yourself
with a small upon achievements, whether large or small.
EXPECTATIONS OF GLOBAL PARTNERSHIP PARTICIPANTS
Our expectations are rather simple, but they require a certain degree of commitment. If you
feel that, for whatever reason, you are unable to meet this level of commitment at this moment
please let us know. It would be disservice to your partner to begin a partnership and then drop
out after a few months. In addition to the guidelines outlined above that we hope you will try
to follow, we expect all partners to:
•
•
•
•
•
Get to know each other, using our suggested questions and activities as a guideline
Communicate regularly
Treat each other as equals
Find ways to incorporate your partner into your activities and work in solidarity
Work on a mutually beneficial joint project
4
| Bangladesh Environmental Lawyers Association
Vol.7,Issue4
BELA^^^
Environmental
. Constitutionalism:
A Need of the Time
I am happy to note that this Workshop of
a Is- ( T <5 (I ( A L
Needling Wefiwork of
Environmental Lawyers
26 Judicial Officers have been organised
by the joint collaboration of the Ministry
The need felt for the protection of
prestigious award for extra-ordinary
of Environment and Forest, Government
environment is universal. The concerns
contribution in the field of environmental
of Bangladesh, UNDP and BELA. I an
that led to such necessity emerged from a
protection has already been given to
confident that the judicial officers who
wide spectrum of realities. The actors
lawyers, an achievement that the
attended this work-shop by now has a
clear understanding of the existing
pursuing environmental causes also
prevailing trend of environmental
belonged to different professional
advocacy has to duly respect.
environmental laws of Bangladesh and
community having a common goal. A
have realised the importance of the
noticeable mode that is becoming a trend
in common for environmental activism in
All these achievements have indeed
justified the need for further action.
implementation of those laws in our
Particularly in a scenario where scarce
country.
Most of us live in the city of Dhaka which
many part of the world is due emphasis
has a population of 10 Million people who
enthusiastic is the role being played by
lived in an area of 1,353 Square Kilo Meter.
the legal community in advocating and
in the increase, no every achievement will
have to be treated as a beginning itself.
The problem of pollution in Metropolitan
upholding environmental justice. Some
Contd. on page 11
City of Dhaka is enormous and it needs
immediate and meaningful solution.
The effects of human development of the
environment are wide spread, such as air
and water pollution, climate change,
deforestation, loss of biological diversity,
degradation and soil erosion. Thus,
necessary and effective laws keeping
pace with time must be made in these
Contd. on page 15
• Judges for Environment
• Environment in the Court
• Global Biodiversity Crisis
• Smoking not Addictive
• World Women Day
BELA
5
on the regulatory regime. What is more
resource availability, increased poverty
and disempowerment of the deprived is
BELA
jMgOgjes for Environment
Founding Editor
Dr. Mohiuddin Farooque
Editor
Professor K. A. A. Quamruddin
Executive Editor
S.
Rizwana Hasan
Research Team
Ehsanul Habib, Iqbal Kabir, Tahsin
Farzana, Taslima Islam, Abu Raihan
M. Khalid
Cartoon
Nazrul
Compose
Nazimuddin Pradhan
Published by
Bangladesh Environmental
Lawyers Association
Mr. Justice Latifur Rahman, hon’ble Chief Justice of Bangladesh amongst the participants of the
Workshop on “Environment, Environmental Law and Justice”
on
of environmental justice having gained a
“Environment, Environmental Law and
momentum in various part of the world
Justice” was organised by BELA between
and the same being realised by the
A
two-day
long
Workshop
10-11 March 2000. The programme
Government in Bangladesh, measures
participated by 26 judicial officers was
have been taken to establish environment
organised with support from the Ministry
court, said the hon’ble Minister.
Price:20.00Taka/US$2
of Environment and Forest (MoEF) and
Mr. H N Ashequr Rahman, hon’ble State
With the support of UNDP
and MoEF under SEMP,
component no. 4.4
the UNDP under the Sustainable
Minister, Ministry of Environment and
Environment Management Programme
forest said that the natural resources of a
(SEMP).
country being are the common property
The Workshop was formally inaugurated
of all people, every sovereign government
Printed by
Dana Printers Limited
Announcements
• BELA offers training on
Environment
and
Environmental Law. Please
contact us for dates and
details.
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subscription. Please write for
copies.
• Use BELA’s specialised
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by Mr. Abdul Matin Khasru, hon’ble
as trustee of those should conserve and ’
Minister, Ministry of Law, Justice and
maintain them for the benefit of all. This
Parliamentary Affairs as the Chief Guest.
ethical bias should form the basis of all
Mr. H N Ashequr Rahman, State Minister,
our state policies and judicial thinking and
Ministry of Environment and Forest as
enactment. Environmental justice at its
the Special Guest also attended the
core, meaning fairness to all should
inauguration session.
override narrow interests, narrow groups,
In his Speech the hon’ble Minister Mr.
narrow time frame, cutting across the
Abdul Matin Khasru touched upon the
borders of the nations to protect the health
prevailing legal regime on environment
of human beings and the ultimate
and opined that the same was adequate
productivity of ecological systems.
the
major
The programme was concluded on 11
environmental problems. He stressed on
March, 2000 with a certificate giving
the need for sensitising the judicial
ceremony that was graced by the presence
officials on the environmental legal
of Mr. Justice Latifur Rahman, Hon’ble
domain for ensuring environmental justice
Chief Justice of Bangladesh. The
to
address
many
of
so often sought by the deprived
enlightening speech of the Hon’ble Chief
community of the society. The concept
Justice is being printed for our readers.
BELA
Environment in the Court
those affected by the offence and such
fine or compensation shall be recoverable
from the person so punished. If the claim
The Parliament in its 17th Session has
into matters for the purpose of trial by the
for compensation is so associated with
approved the Environment Court B ill, 2000
Environment Court. For individuals to
on 10 April 2000. Revolutionary and over-
an offence that both need to be tried in
prefer a suit before such Court would
optimistic as viewed by many, this Act
has proposed the establishment of six
require a written report from the persons
one suit, the Courts may, in such cases,
try the offence first, and if compensation
turns out to be not proper against the
offence, then deal with the application for
environment court initially at six divisional
so authorised by the DG. Speedy trial,
being the main objective behind the
headquarters. The Environment Court
shall consist of one judge to be appointed
proposed establishment of the Court, may
suffer a setback with such requirement for
compensation separately.
An appeal against any judgment of the
by the in consultation with the Supreme
which no time limit has been set.
environment
Court. The judge so appointed shall be
However, this is not to suggest that this
compensation or fine as may be imposed
either from the existing Sub-Judges and
Act is without any progressive thought.
by such courts shall be preferred before
Assistant Session Judges.
court,
decree
for
Rather it has corrected a few of the
the Environment Appellate Court. Such
anomalies that existed in the Environment
Conservation Act, 1995. For example the
appellate court shall be constituted with
established, would try the offences
concerning environmental pollution
provisions of this new law allow citizens
a District and Session Judge to be
appointed by the Government in
leaving untouched the definition of
environmental offences. This may deal to
to file suit subject to certain conditions
but the earlier law barred such activism
consultation with the Supreme Court.
It is important for an institution to sustain
a great deal of confusion as soon as the
on their part. It also gives the Courts a
the spirit for its establishment. The village
) Court would start functioning. The
discretion to entertain cases from citizens
if it is satisfied that the complainant has
court system never could become a
The
environment
courts,
once
Environment Court may take cognizance
of offence on the basis of complaint
popular judicial system in our country and
preferred under the environmental law.
failed to procure the Report from the DoE
as required and that there are reasons for
all efforts taken in different regime to
popularise the same also went aborted.
The Court proposed to be established for
such complaints to be entertained.
trial of environmental offences is yet to
be clear on which laws would be treated a
While trying an offence, the Environment
Courts shall follow the Code of Criminal
The environment court system once
introduced would need to support wide
environmental law for the very purpose
of its jurisdictional administration and
Procedure, 1898. However, in dealing with
compensation cases, the Code of Civil
The new law may be seemed to discourage
such activism as it has not exempted the
limits. The confusion has its very basis in
Section 2 (b) of the Act that defines
Procedure, 1908 shall be followed. No
requirement of court fee that can rub it
hearing shall be held back for more than
the wrong way so far people are
“Environmental Law” to include the
three times and the Courts are under a
concerned. The victims of environmental
Environment Conservation Act, 1995 (Act
I of 1995) and as well as other laws wherein
statutory obligation to dispose of cases
degradation in most cases being the
within 180 days.
The Environment Courts may, in
deprived and the poor, the requirement of
matters may be prescribed for trial by such
Environment Court. This particular
section that gives the court the very basis
for functioning leaves ample scope for
interpretation that should be cleared prior
to offing of the new judicial system.
’ The Act in section 5 elaborates the
jurisdiction of the Environment Court. The
said Section requires all cases for trial and/
or compensation for environmental
offences under the Environmental Law to
be directly instituted in the Environment
Court which shall be the only judicial
forum to take cognizance of such offence
and initiate necessary measure for trail and
disposal. The Environment Courts shall
have the power to impose penalty and in
appropriate cases pass decree for proper
compensation.
At the very outlook, the Court seems to
have proposed to deal with matters that
would be forwarded by the Department
of Environment. Thus in Section 5 (3) it
has been stated that only persons
authorised by the DG, DoE can inquire
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appropriate cases, direct that the fine
imposed be treated as compensation for
activism to gain credibility for its agenda.
court fee would very normally be an
impractical idea for them in pursuing a
cause.
GOVERNMENTS SEEK ACTION ON
GLOBAL BIODIVERSITY CRISIS
The 177 member governments of the
Convention on Biological Diversity met
at the Nairobi headquarters of the United
Nations Environment Programme from 15
- 26 May to promote a more sustainable
relationship between humanity and the
Earth’s dwindling biological diversity.
The Fifth Meeting of the Conference of
the Parties to the Convention on
Biological Diversity brought together
some 1,500 government officials and
observers. The meeting examined the
progress made to date in addressing the
threats to biological diversity with the aim
to identify practical solutions, which
would be implemented at the international,
national and grass root levels. It also
reviewed the effectiveness of the
institutional framework of the Convention.
A highlight of the meeting was the
opening for signature of the recently
adopted Biosafety Protocol. The Protocol
aims to minimize th'e potential risks posed
by international trade and cross- border
movements of living or genetically
modified organisms (LMOs). 67 state
parties including Bangladesh have
reportedly signed the Protocol.
The destruction of
global bio-diversity
In recent years, biologists, ecologists, and
other experts have gained a growing
appreciation of the interconnectedness
and complexity of the world’s biological
resources and the importance of this
richness for human society. The
Convention on Biological Diversity is
based on this science. It defines biological
diversity as “the variability among living
organisms from all sources including, inter
alia, terrestrial, marine and other aquatic
ecosystems and the ecological complexes
of which they are part; this includes
diversity within species, between species
and of ecosystems.”
Although the total number of species
remains unknown, estimates suggest that
there are at least 14 million, of which about
1.7 million have been scientifically
described. The rate of species extinction
today is unprecedented and is largely
influenced by human activities. According
to the United Nations Environment
Programme’s Global Bio-diversity
Assessment,
produced
with
the
participation of approximately 1,500
scientists, species extinction since the
year 1600 has occurred at 50 - 100 times
the average estimated natural rate, and it
is expected to rise to between 1,000 and
10,000 times the natural rate. At present,
more than 31,000 plant and animal species
are threatened with extinction.
The Global Bio-diversity Assessment
cites the five major causes of bio-diversity
loss as the fragmentation, degradation or
outright loss of habitats; over-exploitation
of biological resources; pollution; the
introduction of non-native (alien, or exotic)
species; and climate change. Forests,
marine and coastal areas, and agricultural
and inland water ecosystems are among
those facing the most severe bio-diversity
losses.
The World Resources Institute estimates
that from 1960 to 1990, one fifth of all
natural tropical rain forest cover was lost.
As much as 10% of die world’s coral reefs
- the aquatic equivalents of tropical rain
forests - have been degraded beyond
recovery, and an additional 30% are
predicted to collapse over die next 10-20
years. The world’s coastal mangroves, a
vital nursery ground for countless
species, are also at risk; 50% of them have
already been cleared.
According to the United Nations Food
and Agriculture Organization, countless
crop varieties are disappearing from
cultivation each year. Over 30% of animal
breeds are threatened. At the same time,
clearing land for agriculture is a major
source of biodiversity loss. From 1700 to
1980 the amount of cultivated land grew
from 5% to 35% of total land area. It is
estimated that a growing world population
and a shift in preferences from staples to
luxury foods will require a 40% increase in
grain production by 2020.
While die current wave of extinction and
destroyed ecosystems is an irreversible
environmental tragedy, humanity’s
dependence on food crops and other
biological resources also makes it
dangerous to our species. By the 1970s,
scientists were sounding alarm bells that
started to be heard by both policymakers
and the general public.
Source: Dr David Duthie (Programme Co-ordinator)
UNEP/GEF Biodiversity Planning Support Programme
Bio-safety Protocol:
Bangladesh Perspective
A biosafety act is being drafted to
remove the last obstacle to genetic'
research in the country. Once passed by
Parliament, the act will give legal cover
to the already prepared biosafety
guidelines for safe genetic research and
engineering and scope for legal
protection against their probable fallout
on environment and ecology. Funds have
already been allocated for setting up of
a National Institute of Biotechnology at
Savar and a task force have been formed’
comprising the Ministries of Science and
Technology,
Law,
Commerce,
Environment & Academia and Experts.
Protected Tibet Deer
Following a petition filed by the Wildlife Protection Society, the High Court of Jammu
and Kashmir has prohibited the hunting of the endangered Tibet Deer. The total of such
surviving deer now stands at 75 thousand only whereas the population was 10 lack half
a century back. The Court has directed the State Government to fulfill its obligation
under the CUES.
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Smoking not Addictive?
Smoking in front of others (passive smoking) particularly at public places and emission
of smoke from the vehicles of two-stroke engines are also responsible for the lung
cancer. About 6 lakh new cases of lung cancer were detected across the world last
year that was the second-leading cause of all cancer-related deaths.
This figure was revealed in a symposium on “Advances in the Management of Lung
Cancer” held on 18 May, 2000 at the City.
The world-wide anti-smoking movement, however, suffered a setback when the US
Supreme Court opined in a 5-4 majority decision that smoking is not a adducti ve and
that the Government cannot regulate its consumption as such substance. The tobacco
producers consider this as a victory against the innumerable suits preferred against
them for compensation by suffering smokers.
Arsenic : The Deadly
Threat Continues
Q The Arsenic contamination is highest in
Bangladesh amongst the 20 affected
countries, demanded a study conducted
by the Community Hospital of Dhaka and
the Jadabpur University of India. The
Study surveyed 918 villages and revealed
that almost 11,000 thousand villagers that
constitutes 90% of the total population
are suffering from such contamination
while 3,688 villagers have skin disease.
The study conducted upon 22 thousand
tube well of 64 districts further revealed
that underground water in 54 districts
contained arsenic more than 0.01 milligram
per litre. The limit is 0.05 milligram per litre
in 47 district while in 918 villages the limit
crossed 0.01 milligram per litre.
In another study supported by the UNDP
under the title “Emergency Programme for
Mitigation of Arsenic Contamination of
Ground water”, more than 7000 people of
200 villages were claimed to have been
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suffering from arsenic cancer. The Study
covered 200 villages in 48 selected thanas
in 11 districts.
The 11 districts with severely arsenicaffected tube-wells showing more than the
permissible level of 0.05mg/L include
Pabna, Faridpur, Chandpur, Noakhali,
Laxmipur, Satkhira, Narayangonj, Khulna,
Gopalgonj, Jessore and Bagerhat.
An estimated 85 million people in the
country are at risk of drinking arsenic
contaminated water. Of the 64 districts, 54
are affected by the contamination
problem.
World Water Day
Observed
Bangladesh observed the World Water
Day on the 22 March, 2000 with the Theme
of ’’Water for the 21st Century.” The day
is being observed on every 22nd day of
March ever since 1992 after the United
Nations General Assembly adopted a
resolution in this regard in its 47th session.
World Meteorological
Day Observed
Following the Water Day, the Bangladesh
Meteorological Department of the
Ministry of Defence on the 23 March,
2000 observed the World Meteorological
Day. The day has special significance for
a country like Bangladesh which is so
frequently visited like natural calamities
like flood, drought, tornado, tidal cyclone
costing live and property, said the
Hon’ble President in his message. The
message called upon the meteorologists
to work with the scientists of the rest of
the World to improve the system of
forecast to lessen the possible damage
caused by such calamities.
The WMO that started its journey in 1950
now has a total membership of 185. The
November Cyclone of 1970 costed 300,000
lives in Bangladesh. This led to the
Tropical Cyclone Project (TCP) of the
WMO in the year 1971. Subsequently this
project became a programme that has five
regional divisions. Each such regional
division is being assisted by Regional
Special Meteorological Centre (RSMG).
This programme is contributing in tracing
the origin of tropical cyclone, arranging
for improved forecast and easy
communication, creating awareness
amongst the people at danger zones and
co-ordinating activities amongst the State
Parties. Such co-ordination have
successfully lessened the loss as would
be evident from the fact that tropical
cyclone with same might cost respectively
300,000 and 138,000 lives in 1970 and 1991
whereas the loss of life counted to 200 in
1994.
In 1979 the WMO started with the World
Climate Programme (WCP) that observes
and provides information on climate for
sustainable development. Such activities
as claimed are ten times cost effective. An
improved system of forecast is
contributing to socio-economic activities
while pre-disaster forecast is checking the
adverse impact of weather and climate
changes.
Every year natural disaster cost 250,000
lives while the loss of property is worth $
50-100 thousand million. To meet the
challenges of the 21st century, the 170
members of the WMO and the regional
members approved the Geneva
Declaration in the 13th session held last
year. The Declaration emphasised on
improving
knowledge
base on
meteorological service for national and
international need aiming at protecting the
air of the earth.
flir Pollution
IN SEARCH OF THE TRUTH
A regular inhale of hazardous smoke from
the vehicle can lead to:
Asthma, repeated infection of respiratory,
wheezy bronchitis, bronchitis, repeated
asthma. Experts fear that in the City of
An estimated 6-24 crore dollars are spent
a year for treating the victims of air
the Bangladesh Petroleum Corporation
was importing Petrol with 95 Octane since
death and 1 crore 10 lakh cases of
pollution in the Cities. The World Bank
July 1999. The Refinery blends gasoline
respiratory infection occur in a year.
Resident Representative revealed this in
and reformat with the Petroleum with 95
Octane and produces petrol with 80
Dhaka atleast400 people embrace untimely
Octane which is then supplied to the
Still Malnourished
selling stations. At present all petrol tank,
The National Nutrition Council has
that the lowest level of suspended
line meaning the supply system of the
revealed that some 600-700 children die in
particulate in the air of Dhaka is 300
Refinery is totally lead-free. The refinery
Bangladesh everyday due to malnutrition
microgram per cubic while the highest is
has the country’s largest laboratory for
although overall infant mortality rate has
2,400 microgram. The situation is
aggravating with an annual increase of
10% in the number of vehicles. The sell of
standard regulation and products are only
dropped. The country’s 57.4 per cent
children were malnourished while only 10
adulterated fuel by unlicensed dealers is
a major threat to such horrifying state of
laboratory.
The statement of the Refinery, however,
air pollution although there is hardly any
passed the liability of storing and
supplying lead free petroleum at the filling
cent cases in this part of the world,
station on the shoulder of the oil selling
companies. The control as required for
accessibility to economic benefit and less
a technical session on State of Air
Pollution organised by the environmental
journalists on 6 May’2000. He further said
stringent measure to check such sell that
counts to more than 10% of the total fuel
consumption.
Statement of the
Eastern Refinery
The Eastern Refinery does not import,
export or sell any crude oil or petroleum
products. This has been claimed by the
Refinery in a press release that purported
to clarify the confusion in public about
supply of lead free petroleum in the
country as has been directed by the
Government. The confusion arouse from
supplied to the marketing companies once
the same gets approval from the
less
BBS on Child Labour
3 million child labourers ageing under
6.
The Akthat Oh
14 are employed in various establishment
in Bangladesh. These include, hotel and
restaurants, shops, automobile factory,
bidi manufacturing units, garments, shoe
Children under the age of fifteen years are
growing children. 45% of the population
of Dhaka constitute of such growing
children. Moreover, 3.2 million people
under the age of eighteen reside in Dhaka
growth.
The air pollution can result into headache,
petroleum the supply of lead-free petrol
burning of eyes, running nose, nausea,
fatigue feeling etc. The lung gets badly
affected with the emission of hazardous
could not be ensured, claimed a press
fume. The normal functioning of lung gets
release that has been termed as misleading
hampered increasing alarming the number
of asthma patient. Between February-
the standard of the BSTI, it has been
supplying lead-free petrol regular with 80
high morbidity,
the Refinery.
countries such supply require some extra
measures. The Refinery has no separate
storage facility for lead free products and
the Government and in conformity with
in
life expectancy.
could not be cleared by the statement of
who also continue to grow. This suggests
that 3.2 million people are affected by the
severity of air pollution in the City that
causes various diseases and hamper their
by the Refinery.
In its submission, the Refinery has claimed
that in accordance with the decision of
malnutrition was endemic in 17 to 25 per
resulting
ensuring marketing of environmentally
sound petroleum products, therefore,
the fact that the selling stations do not
offer any special facility to provide leadfree petrol whereas even in developed
hence even after importation of such
per cent had been enjoying normal
nutrition standard. The level of
April, 2000 the outdoor of the Dhaka
manufacturer, furniture shops, electric
factory, tailoring shop, glass and ceramic
industry, motor garage, ice cream factory, |
transportation sector, tea stall and many
others. The Bangladesh Bureau of
Statistics (BBS) has disclosed this
information on the basis of a nation-wide
survey report on child labour.
Night Blindness
Reduced
The
Institute
of
Public
Health
Nutrition under the Directorate of
Health Services has claimed that the
night blindness prevalence among the
Shishu Hospital recorded that out of 13025
patient, 52% (6807) had been suffering
from lung problems. 33% (8303) had
children in Bangladesh was sharply
reduced from 3.53 per cent in 1982-83
wheezy bronchitis. 63% children had
to 0.67 per cent in 1997-’98 under the
Octane and lead-free petrol premium with
wheezy bronchitis that suggested the
impact
95 Octane since July, 1999. Accordingly
prevalence of asthma.
implemented over the years.
6
of
intense
programmes
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World Women Day
In 1857 the women workers in the textile sector brought out a procession
in demand of proper working condition, acceptable working hour and
wage in the USA. In 1908, the workers of the textile sector again
demonstrated for voting rights and against inhuman working condition
and working hours. In the chronology, Clara Jetkin, the leading feminist
of German called upon the world community to observe 8 of March as
the Women’s Day. Since then this particular day that was subsequently
given formal acceptance by the UN in 1977, has special significance in
the history of women’s movement.
This year also the day was observed with much enthusiasm and elaborate
programmes.
Three-Fourth of them Require Aid:
0
On the eve of the World Women Day, the World Food Programme of the
United Nations has revealed that three-fourth of the women and children
population of the world are in need of food aid. In the year 1999 a total
of 8 crore 80 lack people were given aid in the form of food of which
majority were women and children. The reasons for such devastation in
their condition include war, natural disaster and extreme poverty.
Women in Decision Making:
Proportion of women in the parliament averaged 15.3 per cent for the
Americas, 14.3 for the Asia, 13.3 per cent for Europe (without the
Nordic countries), 11.1 percent for Africa and, as expected, a mere 3.6
per cent for the Arab States. With 30 out of330 members, Bangladesh
havejust a little more than 10 percent women members in the Parliament.
Women & Poverty:
Worldwide poverty of women has increased in an alarming rate. Since
1970 there has been a 50 per cent increase in the rate of poverty of
women. On the other hand the increase is 30 percent for the men.
Violence against Women:
In Bangladesh, the National Action Plan for the Advancement of Women,
developed for the implementation of the Platform for Action (PFA), the
term violence against women have been defined as “any act of gender
violence that results in or likely to result in physical, sexual or
psychological harm or suffering to women, including threats of such
. acts, coercion of arbitrary deprivation of liberty whether occurring in
w public or private life.”
UNICEF has stated a horrifying picture of violence against women in
the SAARC countries. Their report suggests that acid bum or killing for
dowry has become a regular phenomenon in this region. The rate of acid
bum in is the higher race in Bangladesh. While in 1996 there were 47
incident of acid bum it rouse upto 200 in 1998. Following is a picture of
miscellaneous form of violence against women as appeared in the daily
newspapers from January-December’ 1999.
Sex Workers Profession
“not illegal; their eviction unlawful”
The evicted brothel tenants won a long legal battle as the High Court
declared the profession of sex workers “not illegal” and their eviction
from Tanbazar and Nimtoli brothels unlawful. The judgment came
following a writ petition filed by five human right organisation on
behalf of the sew workers who were evicted in the early hours of 24
July 1999 by the police. The Government claimed that such eviction
was aimed at rehabilitating the sex workers and bringing them back to
normal life.
The Court in its judgment observed that the profession of sex workers
is not illegal since they do it to earn a living and they could be
rehabilitated if they so desired. “The right to livelihood of the sex
workers is enforceable as a fundamental right” said the Court holding
that the “right to life" as guaranteed by the constitution under Article
31 could be treated as inclusive of the right to livelihood that cannot
be taken away except in accordance with due process of law.
In a judgement dated 14 March, 2000, the High Court also declared
the confinement of a part of the evicted sex workers in the government
vagrant homes as unlawful and ordered their immediate release. “Sex
workers, being citizens of the country, are having freedom of
movement and their rights of movement should not be curtailed by
confining them to the vagrant home or any other forcible means” held
the High Court.
A division bench of the High Court comprising Mr. Justice Md.
Fazlul Karim and Mr. Justice Abdul Wahab Miah delivered the
judgment.
The Court, however, observed that there is no scope of restoring the
possession of the evicted sex workers of Tanbazar and Nimtoli in
writ jurisdiction. Rather, the evicted women could approach the civil
courts to get back the possession of their houses.
Misc. Forms of Violence Against Women 1999
Age
Nature of violence
not mentioned
cases filed
Suicide________ __________
30.42
Attempted Kidnap
2.15
Kidnapping_____________
31.64
Torture by terrorist
353
Murder by terrorist
102
12.14
Forced prostitution
0.46
Cause of death unknown
19.66
Total
97
39
100
Source: Ain O Salish Kendra (ASK)
The Police stations of the country receive a total of 800 cases related violence against women. A source of the Ministry of Home has
stated that in 1997 the total of cases against such violence was 5,434 while in 1998 the number rose to 6,210. The year 1999 recorded
even a higher entry with a total of 9,572 cases.
According to the Police in India, a total of 6000 women lost their life for failing to meet the demand of dowry while Pakistan rather has
a tradition of killing women for protecting family allegiance.
BELA =
EW FROM'
THE MAP OF'
Advancing the Cause of Environment
The Indian Experience
Prior to the United Nations Conference
convened in Stockholm in 1972, the protection
of environment was considered as a constraint
to development but today the scenario is totally
changed. The Environment and Development
Conference held at Rio in 1992 has made the
policy makers realized that the degradation of
the environment and depletion of valuable
natural resources not only impede economic
development but threaten human survival.
International Environmental Laws today
occupy the centre-stage among all efforts
towards environmental protection and
conservation. India, being a developing country
has been concerned about environmental issues
such as land degradation, water pollution, air
pollution, noise pollution and desertification,
which together cause deterioration of the
environment. Indian Judiciary has played an
effective role to protect the environment. If
you compare the Pre-world war II scenario
with the Post-world war II scenario, it would
be evident that there was total lack of
governmental concern for environmental issues
during the Pre-world war II. There were
scattered provisions in several statutes like
the Factories Act, the Forest Act, the Fisheries
Act, but the thrust of those provisions was
peripheral and limited to prevention of air and
water pollution and preservation of forest and
wild life. The laws were piecemeal and
fragmented and its implementation was tardy.
On the conclusion of the Second World War,
the people of the world woke up to an uncertain
dawn of a new era, uncertain because humanity
was shocked by the miseries which the war
had heaped upon it, particularly by the parting
blow on Hiroshima and a new era because of
its faith that it would with the use of the new
found technology be able to build a better world
by removing the debris of the past. Amid the
numerous problems of a world bleeding from
death, destruction and human sufferings,
environmental wounds inflicted by the use of
technologically sophisticated weaponry
strengthened the resolve of human race to offer
a better and healthier world to the next
generation. This resolve brought to the
forefront a global concern for improving the
living conditions of human beings by the use
of the scientific and technological knowledge
derived during the war.
The post-war era, therefore, has witnessed an
increasing environmental consciousness, a
growing concern for preventing environmental
abuse and depletion of the natural resources
and an awareness for maintaining nature’s
balance. In the past, the danger of polluting
air, water and land was not fully realised but in
the last three decades, humanity has shown a
greater concern for avoiding environmental
pollution. The indifference in the past was
possibly because of the fact that problems
had not attained alarming proportions. The
development of law on this front was rather
slow and hence the level of consciousness was
equally low. The rapid industrialisation and
consequential material gain with the keen desire
to lift the standard of living ultimately resulted
in depletion of ozone layer and there has been
a global warming on this score. Environmental
impacts on mankind no longer remain a concern
only of the developing countries but has
become issue of global concern. Mankind today
faces the worst ecological crises. Man has
ruthlessly disturbed the balance of nature by
cutting down forests and indiscriminately
converting grasslands into areas of habitation,
levelling and tunnelling mountains and changing
landscapes. Man has destroyed many
ecosystems, generated chemical and radioactive
pollution and has produced non-biodegradable
matter like plastics, endangered plant and
animal species, dumped lakes, rivers and
oceans and sewage and industrial wastes. The
possibility of greenhouse effect warming the
globe and of damaged ozone layer affecting life
on earth haunts us like a ghost. The increase of
deserts, the shrinking of forests, the alarming
pollution of water, air and land, extermination
of endangered species and indiscriminate use
of exhaustion of natural resources are the main
problems which every nation will have to face
and solve in the coming years.
Necessarily, the battle against
environmental assault will have to be
fought on many fronts. It will have to
be fought from the forums of
international
and
regional
organisations from within national
boundaries, from state boundaries
within a federal system from densely
populated regions, from state capitals,
growing cities and towns, industrial
belts, villages, beaches and mountains.
Every nation will have to evolve devices and
strategies on these lines for the maintenance
of environmental safety and achievement of
sustainable development. India as a developing
nation, is trying its best to evolve legal policy,
norms and standards for better environmental
regime and management. The awareness on the
need for protecting the environment is steadily
growing and several measures are being taken
in our country to meet the challenges of
pollution and sustainable development. We are
gradually heading towards gross environmental
damage due to widespread land degradation,
water pollution, air pollution, mushroom
growth of slums and population explosion.
The existing administrative and institutional f'l
framework is in fact ineffective to handle the
challenge of environmental protection, which
threatens our survival.
Thus, there is a need to have a new
environmental ethos to meet the challenge and
this is precisely the scenario where the superior
judiciary in India has been playing a very
effective role notwithstanding the adverse
criticism ofjudicial activism. There has been a
threat of depletion of ozone layer and there
has been a global warning that the entire planet
is getting warmer and if on account of ozone
depletion the planet gets warmer and
consequently is substantially damaged, then
nobody knows how much time it would take
to again assume normalcy. The new
environmental threats, therefore, warrant new
norms and strategies for shaping a healthier
global order. There has been a general feeling
that emphasis on environmental issues would
limit the growth of a nation. The feelings may '
be justified in the light of economic growth.
Economic inability of the developing countries
has become stumbling force in enforcing the
fundamental norms relating to environment laid
down at the international level. It is, therefore,
imperative that international environmental
norms should comprehend within themselves
the solutions in answering the various
difficulties faced by different developing
nations. The environmental resurgence will
remain a distant dream unless and until the
feasibility of the adoption of the international
norms by all is taken into account. Human
activity operates within an ecological
framework in which any action in a particular
setting may set in motion forces that work
through a complex chain of causation to injure
human interests in the environment. The world
ecology needs a protective cover. The legal
framework intended to protect the world from
environmental hazards should, therefore,
BELA
increase its area of operation. With the Court,
taking the lead, the focus has now shifted from
traditional individual locus standi to the
community oriented public interest litigation.
After the humanity woke up from its slumber
to protect the environment, the legislature on
their turn have come forward with a large
number of legislation which have a direct or
indirect bearing on environmental protection.
Articles 48 and 51 A (g) of the Constitution
make it imperative for the State as well as
every citizens of India to do all, that is possible
to protect and improve the environment
including forests, lakes, rivers and wild life of
the country. In the recent years, several
legislation have been enacted, covering areas
like water pollution, air pollution, wild life,
forests and environmental protection.
When the Indian Parliament enacted Wild Life
(Protection) Act, 1972 and Water (Prevention
and Control of Pollution) Act, 1974, certain
doubts had been raised regarding Parliament’s
" power to enact such laws and, therefore to
have the Constitutional support, 42nd.
Amendment to the Constitution was brought
in and subjects like “Forests”, “Protection of
Wild Animals and Birds” and “Population
Control and Family Planning” were transferred
from the State List to the Concurrent List in
the VII Schedule to the Constitution, thereby
empowering Parliament to make laws dealing
with the said subjects. Armed with these
Constitutional provisions, the Parliament
enacted the Air (Prevention and Control of
Pollution) Act, 1981 and later on, a more
comprehensive legislation called the
Environment (Protection) Act, 1986 with a
view to implement the decisions taken at the
Stockholm Conference. The landmark
publication “Our Common Future” introduced
the concept of sustainable development, which
was reiterated at the Rio Conference in June
992. Under the Environment Protection Act,
1986, though sufficient provision has been
engrafted for enforcement by closing down
offending units but the enforcing authorities
have not been geared up so far to discharge
their obligations under the statutes. Though
the Environment Act, 1986, allows citizens to
file suits but such a citizen must notify the
State Board of the problem and give it 60 days
to file its own suit or notify the citizen, not to
file a suit. There are obvious impediments even
for citizens to file suits directly in the Courts
to control pollution under Air and Water Acts
though under Section 133 of the Code of
Criminal Procedure an action for prohibiting
nuisance can be brought for. The higher
judiciary in India particularly, the High Courts
and the Supreme Court have been struggling
over the last decade to bring the law into the
service of the poor and the oppressed and under
the banner of Public Interest Litigation and
the enforcement of fundamental rights under
the Constitution, the Courts have been trying
| 1
BELA
Mr. M C Mehta, renowned Indian environmental lawyer addressing the gathering in the Seminar
on Advancing the Cause of Environment: the Indian Experience organised by BELA.
to rebalance the distribution of legal resources
and increase access to justice for the
disadvantaged.
For filing such Public Interest
Litigation, rules have been liberalised,
procedural flexibility has been brought
in, creative and active interpretation
has been given, remedial flexibility has
been observed and ongoing judicial
participation and supervision is being
effective.
The judiciary has also shown its willingness
to alter the rules of the procedure where
necessary. Actions may be commenced not
only by way of formal petition, but also by
way of letters addressed to the Court of a
Judge, who may choose to treat it as a petition.
There have been instances where a letter written
to a Judge has been treated as a Writ Petition
and the Supreme Court has taken action on the
same. The environmental Policy making is a
never ending process and the Courts will
always be intimately involved in this process.
The increase in environmental awareness since
1980 has triggered a spurt in the environmental
cases, reaching the Courts. The environmental
petitions are generally based on the plea of
violation of fundamental rights. India is one of
the very few countries, which in its
Constitution has engrafted a commitment to
environmental protection and improvement.
The attitude demonstrated by the Supreme
Court of India in attempting to evolve the right
to a healthy environment in India is
noteworthy. In Municipal Council of Ratlam
vs. Vardhichand, 1980 (4) SCC 162, The
Supreme Court held that by Article 47 of the
Constitution, the improvement of public health
has been stated to be a paramount principle
for governance and, therefore, has to be treated
as a human right. In Mussoorie Hill’s case,
1985(2) SC 142, where the instances of
limestone mining was disturbing the ecological
balance in the area and was also causing damage
to the perennial water streams in the hills, the
Supreme Court had observed:
“It brings into sharp focus the conflict between
development and conservation and serves to
emphasize the need for reconciling the two in
the larger interest of the country.”
The Court had directed the closing down of
the quanies and further directed that there
should be reclamation for afforestation and soil
conservation programmes. While giving reasons
for the earlier directions issued, the Court
observed in 1986 (Suppl.)
SCC517,:
“We are not oblivious of the fact that natural
resources have got to be tapped for the
purposes of social development but one cannot
forget at the same time that tapping of
resources has to be done with requisite
attention and care so that ecology and
environment may not be affected in any serious
way, there may not be depletion of water
resources and long term planning must be
undertaken to keep up national wealth. It has
always to be remembered that these are
permanent assets of mankind and are not
intended to be exhausted in one generation.”
When the complaint was made by Shri M.C.
Mehta, who is present today amongst this
august gathering that the tanneries located at
Jajmau area of Kanpur have been polluting
river Ganga by releasing effluents, the Court
had observed that the effluents discharged from
a tannery is ten times more noxious when
compared with domestic sewage water and
prohibited discharge of such effluents without
proper treatment plant. Later on, the Court
issued appropriate directions for construction
of effluent treatment plants. When it was
brought to the notice of the Court in the recent
past that the motor vehicle has become a cheap
source of pollution in the capital city, the Court
issued appropriate directions that the
pollution control device brought out by the
National Environment Engineering Research
Institute, should be introduced as an in-built
mechanism in every vehicle manufactured after
1st of July, 1991. Under the Court’s orders,
lead-free petrol was made available in the
metropolises of Delhi, Calcutta, Bombay and
Madras and by subsequent directions, the
manufactures of the vehicles are being required
to manufacture vehicles with EURO - II
standards. Thus, through the Court’s
intervention, it is hoped that the pollution
caused by vehicles will be considerably
reduced. The concern of the Indian Judiciary
in maintaining and improving the ecology is
depicted in the urgency and ingenuity by which
the Courts have handled the issues relating to
environment. The right to pollution free
environment has been treated as a fundamental
right and an integral part of right to life
guaranteed under Article 21 of the Constitution
in Subhas Kumar’s case. Interpreting Articles
21,48 and 51 (g) of the Constitution of India,
the Court has said that it is the duty of the
State to take effective steps to protect the
guaranteed Constitutional rights. In Surajkund
and Badkhal lake’s case, the Supreme Court
directed the Haryana Government to plant
trees and maintain a two kilometre green belt
around each of the lakes and further directed
that there should be no new construction of
any type within five kilometre radius to the
two lakes and all open areas will be converted
into green belt. When it was brought to the
notice of the Court that Taj Mahal at Agra is
being damaged and deteriorated, the Court
intervened and ordered for closure of all the
industrial units located near the Taj as those
industries by use of coal as fuel are responsible
for the deterioration and damage to Taj. When
the forest resources were getting denuded by
indiscriminate felling of trees throughout the
country, the Supreme Court intervened and
prevented felling of trees in the forest
throughout the country. But by mere Court’s
intervention and passing of judicial
orders, it may not be possible to prevent
the country from environmental hazards.
What is necessary, therefore, is to
develop awareness among the general
public and until and unless such
awareness is developed, it will not be
10
possible to eradicate the evil, either by
framing laws or by passing prohibitory
orders through the intervention of
Courts. Man is a part of environmental
system and man has been interfering with the
environment in order to achieve the so-called
developments of economists. The need of the
hour is to evolve an environmental strategy.
Development is undoubtedly needed for
a better standard of life but it has to be
sustainable for integrated development
and protection of environment. The
main tasks would be an integrated land,
soil, water and forest management,
control ofpollution, development ofnonpolluting and renewable energy
resources, water-utilisation through
recycling, conservation of biological
diversity, slum removal and
development of healthy human habitat,
environmental awareness and
education, population control and
healthcare, and above all a combined
will of the Government and the people
to bring about a harmonious
development through rehabilitation and
optimisation of environment
The Supreme Court of India suggested the
setting up of a high power Committee by the
Government of India in consultation with
Central Pollution Control Board, for overseeing
the functioning of hazardous industries with a
view to ensuring that there were no defects or
deficiencies in the design, structure or quality
of their plant and machinery. The court
impressed upon the Government the need to
evolve a national policy for location of chemical
and other hazardous industries. The Court
urged Government of India to set up an
Ecological Sciences Research Group consisting
of independent, professionally competent
experts in different branches of science and
technology who would act as information
banks for the Court and Government
Departments, and generate new information
according to the particular requirements of the
Court or Government. There is a proposal for
setting up of an Environment Court. The
Supreme Court has been monitoring the cases
relating to pollution of Ganga, Yamuna and
Gomti. Environmental Policy making like other
controversial areas of public policy is a never
ending process and the Courts will always be
intimately involved in this process. Most of
the actions in environmental cases are brought
under Article 32 and 226 of the Constitution,
since the litigants and the lawyers prefer direct
access to the nation’s highest Courts. While
directing closure of the tanneries, polluting the
river Ganga, Justice Kuldeep Singh had
observed: “We are conscious that closure of
tanneries may bring unemployment, loss of
revenue, but life, health and ecology have
greater importance to the people.” It is the
legitimate duty of a Court as the enforcing
organs of Constitutional objectives to forbid
all actions of the State and the citizens from
upsetting the environmental balance. Several
High Courts in India have taken the view that
the environmental degradation violates the
fundamental right to life. Today, the challenge
before the Indian Courts is to achieve
development without damaging the quality
of environment. The right to environment
and right to development are both recognised
by the Court. Conversion of natural resources
into material goods which improve human
health, welfare and comfort without depleting
and damaging them over a foreseeable period
of time, the question for consideration is,
would one calculate in the appraisal of the
project or policy, the drain and cost of national
resources and yet adopt a technology that is
resource-effective and time-effective. A
strategy for conserving or resource-effective
use of non-renewable natural resources is the
imperative demand of modem times. It is the zc
Indian Judiciary, which introduced the concept ’
of Environmental Jurisprudence and made
continuous serious efforts to make the people
aware about the dire consequences of
environmental pollution. Keeping in view the
dangerous consequences of environmental
pollution, some theories have been pre
pounded to keep strict vigilance and control
on the polluters and offenders. The Judiciary
in India has made tremendous efforts to protect
the flora and fauna and the beauty of the nature
by jumping from one principle to another. As
a test measure, the Court has issued certain
directions for garbage clearance within the
Municipal Corporation of Delhi. The Courts
in India have been successful in implementing
the directions pertaining to environmental
hazardous because of the fact that the people
of the country have reposed full faith and trust
with the Courts. While the citizens are being
disillusioned with the other State organs
namely Legislature and the Executive, because C
of inefficiency and corruption, the judicial wing
has still maintained its status and confidence
in the judicial system.
In Upanishad, one stanza has been devoted,
the meaning of which is that the entire universe
together with its creatures belongs to the Lord
i.e. the nature. It is implicit in the aforesaid
thought that no creature is superior to any
other and human being should not have
absolute power over nature. Let no one species
encroach over the rights and privileges of other
species. One can enjoy bounties of nature by
giving up greed. If the human race follows the
aforesaid advice given in the Upnishad, then I
have no doubt in my mind that the threat of
environmental hazards will no longer be there.
This speech of hon'ble Mr. Justice G. B.
Patnaik, Judge, Supreme Court of India was
read over in the Seminar organised by BELA
on 22 April, 2000 on Advancing the Cause of
Environment: the Indian Experience.
BELA
d
f T <2 ® C
(=
INleecdinnniig' Network of
Environmental Lawyers
Contd.from page 1
behind. Rather they have demonstrated
considerable enthusiasm in establishing
the fact that law, lawyers and the judiciary
can all be instrumental in a fight for
ultimate security. Abuse of power, being
a common phenomenon almost in every
corner of the globe, the lawyer activists
The role of the legal community that has
all political rights has close relation with
so long been supporting the movement
for human rights can take a dynamic turn
the enjoyment of other social, economic
the common concerns, worries, failures,
and cultural rights. If politics is about
victories and successes. Counting from
in protecting the precious resources of
people, it is also about participation by
the state to the civil society, legal experts
environment that in turn would protect
many important human rights. This fight
for environment and not only for human
will protect everyone, every single entity
and all inanimate objects to whom human
existence is surely indebted.
The move for human rights has emerged
from the very urge of performance of
human duty. It is this human duty that is
; now evolving serious questions with
regard to complete justice. These
questions
are
access
have always shared amongst themselves
the people in the decision-making, a
have led numerous agencies to advocate
process that gives a strong sense of
coherent concerns and have never been
ownership in management of wealth and
a mere watcher.
resources. When people are given a sense
BELA as an organization has duly
of ownership, it results in better
emphasized in raising awareness amongst
management. When people claim right to
the lawyers and getting them involved in
information, they mean transparency and
supporting environmental activism. In the
accountability. And all of that is for
process a good number of lawyers have
security of survival and sustainability.
recorded their names in the list of BELA
Today, the economic planning is also
supporters and this they are doing with
criticised for not being environmentally
the spirit of public service and for
and
sound. This is because many process and
upholding the rule of law in defending at
participation. The main thrust of
systems that were introduced over the
all times, without fear or favour, the rights
environmental justice is also about the
times have just resulted in temporary
of the citizens. Our thinking necessarily
about
two. Environmental justice would
benefit and not yielded sustainability. It
comprehend equitable access to resource
is sustainability that has turned out to be
to serve better humanity and civilization.
and demand participation in policy making
the core question of today’s planning for
Being a part of the global network of
and management of such resources. A
any system. The legal system must prove
environmental lawyers, it strongly feels
society’s power structure and values
worth in reflecting all these concerns and
the necessity to have such a network at
must necessarily coincide with such
that is where lawyers owe a responsibility
notion ofjustice. If environmental justice
of social engineering.
least a few of the pro-active legal minds
is ensured, can there remain any branch
The debate now is that whether poverty
together to work for a system that would
of right that would stand abused? Let us
or environment will be the concern for the
coincides and we are for a greater cause
the national level. It is important to get at
accord justice to million. These minds will
search for the answer.
new century although many see a vicious
look into the social environment to accord
The very right to survival is conditional
circle between the two. Whatever
social justice and equity, strike a balance
upon access to certain resources. In other
conclusion is reached at, the need for a
in the power system to allow everyone a
words, livelihood is dependant upon
holistic approach in countering prevailing
stake in the political decision making,
exercise of rights over the resources. Any
miseries about humanity and civilization
emphasize on the cultural rights to protect
- arbitrariness in managing them will
cannot be denied. When the present
cultural values, evaluate the economic
destroy their resource value affecting
civilization cannot fight back against
decisions to benefit the deprived and
necessarily the livelihood of many. The
discrimination and dismay, such a holistic
legal domain has, therefore, purported to
approach would seek a system with justice
above all protect the national resources
to safeguard the interest of both the
protect these resources for the welfare of
as the underlying factor. A search for
present and the future generation. The
mankind. Ignorance to the same has led
justice will require careful analysis of the
hardest job perhaps is not to get people
to a devastating consequence, both about
existing right and power system. And
involved but to keep up the momentum
the existence and utility of the resources.
such a system will aim at empowering the
and the enthusiasm. An effort for such a
Many complicated issues about right to
distressed, preach a notion of equality and
networking
property, profession and life are closely
is
necessarily
to
universality and promulgate and/or
institutionalize the present course of
connected with the management of these
activate safeguards to protect the rights
action of environmentalism. An ism that
resources that are essential components
of those unheard. Many judicial systems
would protect the society and its members
of environment. All these rights are
are already showing willingness to protect
from all forms of exploitation, give them a
purported to be legally protected to which
inanimate objects.
stand to speak and embed them into a
the lawyers must be able to attach a
The legal community has always led the
sense of responsibility- a duty towards
definite meaning through their express
movement against violation of rights and
all creatures, be it animate or inanimate,
ability and also insight.
The politics of a country regulate the
experience. Regarding environmental
generations.
enjoyment of certain rights. The quest for
justice also, the lawyers are not lagging
From here begins the journey!
BELA
abuse of power. This has been a global
whether of the present or the future
A Note on Precautionary Principal
The Review of US Laws
By
Professor John E. Bonine
E-Law US Board
The “precautionary principle” has come
back into international legal discussion
recently as a result of the use of the term
“precautionary approach” in the
Cartagena Protocol on Biosafety, adopted
in Montreal in January 2000. I started to
ask myself about the origins of the
precautionary principle in international
law and then started thinking about its
origins in national law. As a result, I put
together the following materials.
It is possible to trace the Precautionary
Principle as far back as Principles 21 and 7
of the Stockholm Declaration in 1972, but
in a very nascent form. Many have noted
this fact. One easily accessible source on
the Web is “The Precautionary Principle,”
by Wybe Th. Douma
Of course, the precautionary approach
became articulated in international law in
Principle 15 of the Rio Declaration in 1992
as its most famous locus. That Rio
Principle states:
Principle 15
“In order to protect the environment, the
precautionary approach shall be widely
applied by States according to their
capabilities. Where there are threats of
serious or irreversible damage, lack of full
scientific certainty shall not be used as a
reason for postponing cost-effective
measures to prevent environmental
degradation.”
The article cited above asserts that the
precautionary principle can be found to
have originated as a domestic legal norm
in Germany in the mid-1970s. Mr. Douma
says:
“The origins of the precautionary principle
are to be found in Germany, where the
principle formed one of the basic
principles of environmental policy already
since the mid 1970s, together with the co
operation principle and the polluter pays
principle. It has to be stressed that the
German equivalent of the precautionary
principle, the Vorsorgeprinzip, is used in a
specific setting, whereby a difference is
made between human behaviour, which
12
causes dangers on the one hand, or risks
on the other hand. When dangers are at
stake, the government is to prevent these
by all means (Gefahrenvorsorge). If there
is only a risk of effects occurring, the
possibilities of risk prevention have to be
investigated and if the risk is high enough,
preventive measures can be ordered
(Risikovorsorge). “He goes on to write (as
others have also noted) that the
precautionary principle came into
international law during various
conferences concerning the North Sea:
“The protection of the North Sea was
discussed at a number of international
conferences held in Bremen (1984),
London (1987), The Hague (1990) and
Esbjerg (1995). (5) It was at these
conferences, that Germany introduced the
concept of precaution at the international
level.”
Other articles agree on 1987 in the second
North Sea declaration as the first use of
the term, but point out that the concept
was used in the 1982 Law of the Sea treaty
as well, though the exact words were
different.
As for a domestic origin, I would trace the
precautionary principle further back than
German law.
The precautionary principle can be found
in the legislation of the USA starting as
early as 1969 and 1970 and in judicial
interpretations of that legislation in the
early and mid-1970s. Legislatively, we can
see the principle in the terms of the Clean
Air Act of 1970 and in other U.S. legislation
adopted in that era. Judicially, two cases
in particular show the emergence of
articulations of the principle.
Judge Carl McGowan talked of questions
“on the frontiers of scientific knowledge”
in the case Industrial Union Dept. AFLCIO v. Hodgson in 1974. In resolving such
questions for regulatory purposes, he said
that a government agency could logically
rely to some extent on its views of sound
policy.
Judge J. Skelly Wright in 1976 took this
concept a step further. He observed in
the seminal case, Ethyl Corporation v.
EPA, that in the laws of the US,
government agencies, “unequipped with
crystal balls and unable to read the future,
are nonetheless charged with evaluating
the
effects
of
unprecedented
environmental modifications, often made
on a massive scale.” Then he went further,
and interpreted part of the Clean Air Act
of 1970 to be a “precautionary statute”
and made it clear that the EPA may err on
the side of safety and caution in deciding
upon regulations.
There are other origins as well. This
analysis will give some of the background.
Precautionary Principle as the Basis for
EIA
Perhaps the earliest modern example of
the
precautionary
principle
in
environmental law was the enactment of
the National Environmental Policy Act
(NEPA) in the USA in 1969. NEPA was
the first law in the world to require
“environmental impact statements” (now
called environmental impact assessments,
or EIAs, elsewhere in the world). Since
that time, nations all over the world have
enacted laws requiring EIAs before major
government or private actions that might
affect the environment. This has also been
elevated into international legal
documents as well.
Environmental impact statements (EISs),
or assessments (EIAs), are by their very
nature “precautionary” because they seek
to predict environmental effects BEFORE
government or private actions are taken.
One important way to ensure that they f ■
are precautionary is the use of a “may
affect” test instead of a “will affect” test,
as the threshold for deciding on
environmental effects. Early in the history
of the legal interpretation by court
decisions in the USA, regarding when an
EIS was required, the U.S. courts started
saying that an EIS must be prepared when
an action “may effect" (rather than “will
effect”) the environment. These
decisions, in the early 1970s, made
precaution a matter of national policy as
an analytical (assessment) matter.
Precautionary Principle as a Legal
Norm
At the same time, precaution became a
matter of national policy as a controlling
legal norm (not merely an analysis or
assessment) in the mid-1970s in four other
areas of US law, again partly as a matter of
BEL4
judicial interpretation: worker protection,
air pollution, water pollution, and
pesticides.
US Occupational Safety and Health Law
Perhaps the earliest statement of the
precautionary principle in U.S. regulatory
law came in 1974. A case was filed by
labour unions against the Secretary of
Labour, regarding regulations for
protection against asbestos dust, enacted
under the new Occupational Safety and
Health Act of 1970 (OSHA). The labour
unions had filed an administrative petition
to the OSHA agency and Secretary of
Labour asking for emergency action.
When the final regulations were
promulgated they contended that the
Secretary of Labour had enacted a
timetable for control that was too slow, in
light of the dangers. Industrial Union
Department, AFL-CIO v. Hodgson, 162
U.S. App. D.C. 331,499 F.2d 467 (1974).
In the Industrial Union case, Judge Carl
" 1 McGowan of the U.S. Court of Appeals
for the D.C. Circuit, wrote that “OSHA
sets forth general policy objectives and
establishes the basic procedural
framework for the promulgation of
standards, but the formulation of specific
substantive provisions is left largely to
the Secretary. The Secretary’s task thus
contains “elements of both a legislative
policy determination and an adjudicative
resolution of disputed facts.” Judge
McGowan wrote further:
“From extensive and often conflicting
evidence, the Secretary in this case made
numerous factual determinations. With
respect to some of those questions, the
evidence was such that the task consisted
primarily of evaluating the data and
drawing conclusions from it. The court
can review that data in the record and
. determine whether it reflects substantial
support for the Secretary’s findings. But
some of the questions involved in the
promulgation of these standards are on
the frontiers of scientific knowledge, and
consequently as to them insufficient data
is presently available to make a fully
informed factual determination. Decision
making must in that circumstance depend
to a greater extent upon policy judgments
and less upon purely factual analysis.
Thus, in addition to currently unresolved
factual issues, the formulation of
standards involves choices that by their
nature require basic policy determinations
rather than resolution of factual
controversies. Judicial review of
inherently legislative decisions of this sort
is obviously an undertaking of different
0
dimensions.”
Judge McGowan traced the concept of
using policy discretion, in the face of
inadequate factual evidence, back even
BELA
further, to an U.S. Supreme Court case on
setting prices (rates) for oil transportation:
“Where existing methodology or research
in a new area of regulation is deficient, the
agency necessarily enjoys broad
discretion to attempt to formulate a
solution to the best of its ability on the
basis of available information. Permian
Basin Area Rate Cases, 390 U.S. 747,811,
88 S. Ct. 1344,20 L. Ed. 2d 312 (1968). “
Two years later, the D.C. Circuit
interpreted the U.S. Clean Air Act of 1970
as requiring EPA to lean in the direction
of caution. This case, Ethyl Corporation
v. EPA, is the single most important judicial
interpretation in the history of the early
development of the precautionary
principle.
US Air Pollution Law - A “Precautionary
Statute"
The U.S. Clean Air Act started as the Air
Quality Act of 1955. In those early years,
the emphasis was on research and there
was an apparent belief in government that
regulatory action could not occur until
science provided answers. During the
1960s the law (called the Clean Air Act
starting in 1963) slowly evolved toward
national regulation, but still had two major
touchstones: knowledge about pollution
needed to be found before goals could be
set, and knowledge about technology
needed to be created before rules could
be established.
In 1969 and 1970, for the first time, new
voices started asking why action had to
be delayed until there was perfect
knowledge. In particular, the law’s
restriction of control measures to those
that could be shown to be “technologically
feasible” was challenged by critics. In
April 1970 an outburst of environmental
activism swept the nation, as “teach-ins”
about
the
environment
and
demonstrations were organised on the
first “Earth Day.” Soon thereafter, the U.S.
Senate Committee, which had been
considering the amendments to the Clean
Air Act, closed its doors to outsiders
(industry
lobbyists
as
well
as
environmentalists) and went into secret
session to redraft the amendments. When
the doors opened again in August 1970
the result was shocking. The committee
had thrown out most mentions of the
restrictive terms “technological and
economic feasibility” and it set strict
deadlines for action.
The new scheme for nationally mandated
and uniform air quality standards
contained words whose precautionary
nature bursts forward from the statutory
page.
The Problem of Lead Contamination
In the field of air pollution, the U.S.
Environmental Protection Agency (EPA)
decided in the early 1970s that it must
reduce the amount of lead (Pb) in gasoline,
using its authority under section 211 of
the Clean Air Act of 1970. That section
allowed EPA to control additives to
gasoline if it found that the additives “will
endanger” human health. There was
plenty of information that lead harmed
human health, but the contribution of lead
to the problem from gasoline additives
was more speculative.
Government Use of a Precautionary
Approach
EPA decided to require a progressive
reduction in lead levels in gasoline, using
the legal authority in the Clean Air Act,
since reduction of the lead in other
sources such as paint, water, and food
was already the subject of other
regulations. It was also requiring one
grade of gasoline to be offered “lead-free”
in order to protect the newly required
catalytic converters that were being
installed on new automobiles to control
photochemical oxidant (smog) and carbon
monoxide pollution in cities, but this
separate regulation required lead levels
to be reduced in all other grades of
gasoline as well, for direct health
purposes.
In a statement (“regulatory preamble”)
accompanying its enactment of the new
regulations, It said, EPA discussed the
seriousness of the problem, and the
potential contribution of leaded gasoline
to the health problems.
EPA also explained the point of view of
industry, as well as EPA’s own point of
view:
“Many of those disagreeing with the re
proposed regulations based their
comments on EPA’s failure to show
sufficient evidence of adverse health
effects specifically caused by the use of
lead additives in gasoline. While most
agree that the combustion of leaded
gasoline causes an increase in the amount
of lead in the environment, they do not
believe that lead in gasoline represents a
sufficient endangerment to health or a
sufficient risk to the environment to
warrant promulgation of controls. “
The industry’s demand for “evidence”
contrasts with EPA’s belief that it is
sufficient to regulate on the basis of a
reasonable “hypothesis,” even though it
cannot necessarily proceed or be
disproved, using the EPA’s thoughtful
“judgment.”
Among other things, EPA explained its
view that “while co-relations between
blood lead levels and air leads at lower
exposure levels are not always good, the
evidence indicates that air lead does
contribute to general population lead
13
Judicial Interpretation of the Law as a
"Precautionary Statute’’
The Ethyl Corporation challenged EPA’s
new regulations in court. Since lead had
been used as an additive in gasoline for
50 years (for its quality in reducing “engine
knock”), Ethyl fought long and hard. Since
children’s intelligence was being
adversely affected by lead in their
bloodstream, EPA fought equally hard.
In Ethyl Corporation v. EPA in 1975, a 3judge panel of the U.S. Court of Appeals
for the D.C. Circuit split 2-1 in overturning
EPA’s regulations. But this was too
important for EPA to give up. EPA knew
that the proportion of “conservative” and
“liberal” judges on this particular U.S.
Court of Appeals was approximately even.
EPA petitioned the full Court of 9 judges
to re-hear the case.
Upon reconsideration, the full Court came
out the opposite way: 5-4 in favour of
upholding
the
regulations.
The
“dissenting opinion” by Judge J. Skelly
Wright in the first decision became the 5vote majority decision in the second “en
banc” decision.
unappreciated by their supporters. Such
agencies, unequipped with crystal balls
and unable to read the future, are
nonetheless charged with evaluating the
effects of unprecedented environmental
modifications, often made on a massive
scale. Necessarily, they must deal with
predictions and uncertainty, with
developing evidence, with conflicting
evidence, and, sometimes, with little or no
evidence at all. Today we address the
scope of the power delegated one such
watchdog, the Environmental Protection
Agency (EPA). We must determine the
certainty required by the Clean Air Act
before EPA may act to protect the health
of our populace from the lead particulate
emissions of automobiles.”
The differing points of view of industry
and EPA are captured in the following
excerpt from Judge Wright’s decision:
“In making his threshold determination
that lead particulate emissions from motor
vehicles “will endanger the public health
or welfare,” the Administrator provided
his interpretation of the statutory
language by couching his conclusion in
these words: such emissions “present a
significant risk of harm to the health of
urban populations, particularly to the
health of city children.”
By way of further interpretation, he added
that it was his view
‘That the statutory language does not
require a determination those automobile
emissions alone create the endangerment
on which controls may be based. Rather,
the Administrator believes that in
providing this authority, the Congress
was aware that the public’s exposure to
harmful substances results from a number
of sources which may have varying
degrees of susceptibility to control.’
“Ibid. It is petitioners’ first claim of error
that the Administrator has erroneously
interpreted Section 211(c)(1)(A) by not
sufficiently appreciating the rigor
demanded by Congress in establishing
the “will endanger” standard.”
Judge Wright’s Precautionary Opinion
Judge Wright’s decision in Ethyl Corp. v.
EPA, 541 F.2d 1 (D.C. Cir. 1976), is one of
the most eloquent as well as earliest
statements of the importance of precaution
as a legal policy in matters relating to the
environment. Judge Write wrote:
“Man’s ability to alter his environment has
developed far more rapidly than his ability
to foresee with certainty die effects of his
alterations. It is only recently that we have
begun to appreciate the danger posed by
unregulated modification of the world
around us, and have created watchdog
agencies whose task it is to warn us, and
protect
us,
when
technological
“advances”
present
dangers
Judge Wright further wrote:
“Petitioners argue that the “will endanger”
standard requires a high quantum of
factual proof, proof of actual harm rather
than of a “significant risk of harm.” . . .
Since, according to petitioners, regulation
under Section 211(c)(1)(A) must be
premised upon factual proof of actual
harm, the Administrator has, in their view,
no power to assess risks or make policy
judgments in deciding to regulate lead
additives. We have considered these
arguments with care and find them to be
without merit. It is our view that the
Administrator’s interpretation of the
standard is the correct one.”
But here is the key move that Judge
exposure. Failure to find consistent co
relations does not in the Administrator’s
judgment
invalidate
the
above
conclusions.” Regarding lead from
gasoline, EPA said, “the contention that
lead contamination of dust and dirt by
automotive emissions is a significant
source of lead exposure is a hypothesis
consistent with information provided by
a variety of studies. However, at this time,
not all links in the argument have been
established beyond dispute and no single
study has collectively inter-related all
steps in the exposure process to
conclusively prove or disprove the
hypothesis. Despite the existing
uncertainties, comments received from the
majority of scientists not affiliated with
industrial or environmental groups
support the contention that dust is an
important source of exposure.”
14;
Wright made in his written decision:
“1. The Precautionary Nature of “Will
Endanger.” Simply as a matter of plain
meaning, we have difficulty-crediting
petitioners’ reading of the “will endanger”
standard. The meaning of “endanger” is
not disputed. Case law and dictionary
definition agrees that endanger means
something less than actual harm. When
one is endangered, harm is threatened;
no actual injury need ever occur. Thus,
for example, a town may be “endangered”
by a threatening plague or hurricane and
yet emerge from the danger completely
unscathed.
A statute allowing for
regulation in the face of danger is,
necessarily, a precautionary statute.
Regulatory action may be taken before the
threatened harm occurs; indeed, the very
existence of such precautionary
legislation would seem to demand that
regulatory action precede, and, optimally,
prevent, the perceived threat. As should
be apparent, the “will endanger” language zkx
of Section 211(c)(1)(A) makes it such a’
precautionary statute.”
Judge Wright’s opinion became an icon
for the
precautionary
principle.
Furthermore, the U.S. Congress started
the process to change the Clean Air Act
to make it crystal clear that a precautionary
approach for EPA decisions was desirable.
In the Clean Air Act Amendments of 1977
(a year later), Congress replaced the “will
endanger” standard with terminology that
clearly endorsed the EPA Administrator’s
right to make a policy-based (not only an
evidence-based) judgment in enacting
regulations.
U.S. Pesticide Law
In the mid-1970s die U.S. EPA decided to
cancel the registration of several pesti
cides on the basis of their POTENTIAL to
cause cancer in humans. The only evi
dence was that the pesticides caused^''
tumours (some of them benign tumours) in
test animals. But the D.C. Circuit upheld
EPA’s right to use policy judgments to ex
trapolate from those facts the possibility
that the chemicals could cause cancer in
humans and to regulate in a precautionary
manner by banning the chemicals.
U.S. Clean Water Act
The Federal Water Pollution Control Act
of 1972 (later renamed the “Clean Water
Act”) was interpreted in the mid-1970s to
allow EPA to regulate less-chlorinated
PCBs (polychlorinated biphenyl’s) with
out any evidence whatsoever of harmful
effects from these particular PCBs! EPA
did have evidence on more-chlorinated
PCBs, and the Court allowed EPA to use a
precautionary approach by assuming that
similarities in chemical structure would
lead to similarly harmful effects.
BELA
Environmental Constitutionalism
A Need of the Time
law which will take all these aspects and
prevent ecological deficits.”
In conclusion, I urge the Government to
look into the matter of environmental
Contd. from page 1
fields. It is undeniable that with the advent
of technological development and
one such Bench along with the Chief
Justice of Madras in 1995. In India before
advancement of human knowledge, the
1984, the Indian Judiciary made very little
environment is bound to be affected. But
contribution in the area on environmental
protection. The “Bhopal disaster case” is
an example of that. But during late 1987,
Indian Supreme Court has started a
vigorous role in preventing environmental
degradation. I must put on record my deep
we must make an effort to make a balance
between the two, so that the human health
hazards due to technological civilisation
may not corrode adversely on out
existence.
As a Judge, I must say a word about the
Environmental Constitutionalism. I will
refer to the constitution provisions
regarding “environment protection” in
SAARC countries such as, India, Sri Lanka
and Nepal. In India, Articles 48A and
51 A(g) of the Indian Constitution make it
f imperative for the State as well as for every
citizen to do everything to protect and
improve the environment including
forests, lakes, rivers, wild life and to have
compassion for living creature. In recent
years, in India more than 200 central or
state laws have been passed on water
pollution, air pollution, wild life, forests
and environmental protection. Sri Lanka’s
present Constitution provides that the
state shall protect, preserve and improve
the environment for the benefit of the
community. In the new Constitution of
Nepal in 1990, some new Articles have
been incorporated as Directive Principles
of State policy to preserve the
environment and reduce adverse impact
on environment due to physical
development activities. A new era of
A environmental constitutionlism has
- ushered in through the constitutional
dictates and policy decisions in many
countries of the World.
Strictly speaking, in our Constitution,
there is no such Article with regard to
the protection and preservation of
environment. A time has come to
ponder over it and to incorporate some
provisions in our Constitution to
protect environment and ecology for
all. _____________________________
In our country, environmental cases are
very few. India being a vast and
industrially developing country, the
increase in environmental awareness
since 1980, has triggered a large number
of cases in various courts. In India, every
provincial High Court has a Bench dealing
with environmental cases. Luckily, I sat in
BELA
appreciation for BELA in improving
environment in Bangladesh. I recall with
respect the contributions of late Dr.
Mohiuddin Farooque who was a public
spirited lawyer in this regard. Hope the
members of BELA will keep up the spirit
of late Farooque. I hope that public spirited
lawyers in our country through various
discussions and seminars will motivate the
people and will put pressure on the law
givers to make effective laws for the
protection of environment in Bangladesh.
The Government must declare policy
decision and enforcement mechanism to
help prevent further damage to our
environment. I am sure, the Judges and
lawyers of a country can be an effective
tool to maintain a balance between the
environment and development. I must
mention that right to healthy environment
should be considered as a fundamental
right as because the very existence of
human life depends on the environmental
conditions around us. If we cannot lead a
healthy life all our endeavours will end in
futility. So I urge the Government and the
people
to
be
conscious
of
the
environmental degradation and find out
possible solutions of the same. For that
end the Judges must be imbibed with a
sense ofjudicial activism.
Gentlemen, the Supreme Court of India
held that the right to life is a fundamental
right under Article 21 of the Indian
Constitution and it includes the right to
enjoyment of pollution free water and air
for full enjoyment of life. The importance
of law in environment protection may be
summed up by quoting Justice P. N.
Bhagawati, the former Chief Justice of
India who said as follows:
“Environmental protection includes
maintenance and preservation of
ecological balance and conservation of
non-renewable as well as careful
exploitation of renewable resources. It
is necessary to have a comprehensive
problems with great care for the well being
of the city dwellers. The trainee Judges
should be conscious to implement the
environmental laws in Bangladesh.
Note: This speech was presented by the hon ’ble
ChiefJustice ofBangladesh at the concluding
session of the judicial workshop.
Keep Our Air Free of TB
Alarming, but true! According to the
UNICEF source, one in every ten minutes
die of Tuberculosis (TB) in Bangladesh,
while one in every 2 minutes gets infected.
There are 600,000 existing cases ofTB with
300,000 new cases reported every year in
Bangladesh. In 1993, the country
accounted for 3.6 percent of the TB cases.
An estimate has revealed that one million
women die from TB each year. Around a
third of the world’s population s infected
with Mycobacterium tuberculosis, which
can lie dormant in some cases for many
years. But it is estimated that some eight
million people a year suffer from the active
form of the disease in which granular
tumours develop in infected tissues, most
often the lungs.
TB and its causes are closely linked with
malnutrition, crowding, poor air
circulation and poor sanitation- a vicious
cycle established by poverty that riddles
the poor as the worst victim.
Under such frightening picture the World
Tuberculosis Day was observed on 24
March with a pledge to keep the air free
from the danger of TB. It was claimed to
be a priority for the country adding that
the fight against such disease must be an
integral part of the country’s poverty
eradication strategies.
The Ministerial
Environmental Forum
Meet in Sweden
The 6th special session of the Governing
Council of the Ministerial Environment
Forum was held at Sweden on 29 May’2000
at the auspices of the United Nations
Environmental Programme (UNEP).
Cabinet members of about 100 countries
attended the Conference where
Bangladesh was represented by the
Minister for Environment and Forest
(MoEF) Syeda Sajeda Chowdhury. The
session was organised as part of drafting
a global environment policy basing on the
recommendation of the report of the UN
Secretary General on Environment and
Human Society.
BELA
BOOK POST
Printed Matter
Published by
BELA
Bangladesh Environmental Lawyers Association
House-9, Road-8, Dhanmondi R/A, Dhaka-1205
Bangladesh. GPO Box No. 3015, Dhaka
Tel: (880-2) 8614283,8618706 Fax: (880-2) 8612957
E-mail: bela@bangla.net
Environmental
Governance in Khulna
With support from the MoEF and UNDP, BELA has launched a
three-year programme for the Khulna Divisional Headquarter
under the name of Good Governance at the Divisional
Headquarter. The object of the programme is to form a core group
of civil society who would pursue the cause of environment with
a legal knowledge on respective rights and duties.
The programme has started with good support from a considerable
number of civil society representative who all attended a
discussion on Environment and Governance. The discussion
held on 20 May’2000 provided the inhabitants of Khulna with a
chance to identify their own major environmental problems that
they like to be addressed in the next few years. The interactive
programme grouped the participants and the feed back of the
group discussion identified inadequate supply of potable water,
crisis over waste management, sewerage disposal and unplanned
urbanization as the four major problems.
The Discussion inaugurated by Professor KAA Quamruddin of
BELA arranged for a lecture on the Major Concepts of Good
Governance. The daylong programme was formally concluded
by the Mayor of Khulna Sheikh Tayebur Rahman who assisted
BELA of all possible co-operation is pursuing the cause. He
congratulated BELA for the timely effort and emphasised the
need of the involvement of local people in setting their priority of
demand. The initiative to train the local people on environmental
law was also highly praised by the participants who decided to
have another discussion on July 1 ’2000 to set an action plan for
advancing the causes identified.
Litigation: Follow-up
RAJ UK to submit Report
on Compliance
A Division Bench of the Supreme Court comprising Mr. Justice
KM Hasan and Mr. Justice Khademul Islam Chowdhury has
further issued an injunction on 24 May 2000 upon the Chairman
of Rajdhani Unnayan Kartripakkha (RAJUK) to suspend all
construction and filling-up of the water body and lake side areas
in Gulshan, Banani and Baridhara Model Towns in particular at
16
plot number 26 of Road number 71, Plot number 28,10 of Road
number 76, Plot number 9 of Road number 78 of Gulshan Model
Town; Plot number 76C of Road number 11 of Banani Modelg
Town and western side of Plot Number 56 of Road number 11 and ’
Plot number 45 ofRoad number 12 of Baridhara Model Town.
The Court ordered to suspend all activities connected with
construction and/or filling-up of the Lake and/or lake-side areas
in the Gulshan, Banani and Baridhara Model Towns, in particular
at Plot number 8 ofRoad number 78 of the Gulshan Model Town;
by the eastern side of Road number 118, 121 and 123 of the
Gulshan Model Town till the disposal of the Writ Petition;
It also ordered to submit a report on compliance with this order
within two weeks.
The court issued this injunction upon hearing an application
filed by Bangladesh Environmental Lawyers Association (BELA)
and Gulshan Banani, Baridhara and Welfare Society (GULB AB)
challenging the unlawful activity of RAJUK by allowing
constraction work and filling up of the lake in Gulshan Banani
and Baridhara. It is worth mentioning that original petition was
filed and heard on 2 May 1999 against the Lake fill-up.
Environmental Reporters
in Investigation
1
Bangladesh Environmental Lawyers Association (BELA) with
support from the Ministry of Environment and Forest and UNDP
organised the second Workshop on “Investigative Reporting
into Environmental Issues” between 2-... May 2000). Journalists
from national daily, weekly and electronic media attended the
Workshop. Renowned environmental journalists, academics of
the Department of Journalism and Mass Communication from
the University of Dhaka and environmental lawyers delivered
lectures at the .Workshop.
The Workshop was concluded with an evaluation of the field
reports prepared by the participants on the topics assigned. The
evaluation resulted in nomination of 5 participants to engage in
detailed reporting. The issues selected for such reporting
included, Emission at Jamuna Fertiliser Factory, Mitigation of
Compensation Claims by the Ghorashal Fertilizer Factory, Status
of Vehicular Pollution and Implementation of the Relevant
Decisions, Ship Breaking Operation: A Threat to Coastal Ecology
and Open Spaces of Dhaka. These reports are expected to form
the information basis and/or support for BELAs legal advocacy.
BELA
FOREIGN
POLICY
T'NT E?
11M T
On The Web At: hftp://www.foreignpolicyinfocus.org/
cus
Vol. 3, No. 17 • revised October 2000
International Tobacco Sales....
By Robert Weissman and Ross Hammond
The human costs of tobacco use are staggering and rising
dramatically. Every eight seconds, someone in the world
dies from tobacco use— 4 million deaths a year. If current
trends continue, that number will soar to 10 million by
2030, according to the World Health Organization
(WHO), with 70% of those deaths occurring in the third
world. Given these figures, over 150 million people will
die from tobacco-related diseases over the next 30 years—
exceeding the toll from AIDS, automobile accidents,
maternal mortality, homicide, and suicide combined.
As the worlds biggest cigarette exporter and as home to
the world’s largest multinational cigarette company, Philip
Morris, the United States has a special responsibility to
address this catastrophe. Facing declining markets in
developed countries, the U.S.
tobacco industry has aggressive
ly expanded overseas, particu
larly in recently opened markets
Tobacco use is a growing global
in Asia, the former Soviet
epidemic, hitting the third world,
Union, and Eastern Europe,
Eastern Europe, and the former Soviet
where the bulk of the world’s
Union the hardest. Ten million people
smokers live. Philip Morris now
will die each year from tobaccosells more cigarettes abroad
related diseases by 2030.
than it does in the United
The U.S. government has long
States. Philip Morris currently
assisted the international expansion
earns half of its cigarette profits
of U.S. tobacco multinationals
overseas, garners almost twothrough promotional trade policies
thirds of its tobacco revenues in
and tolerance of double standards in
foreign markets, and sells more
industry behavior.
than three-quarters of its ciga
rettes outside the United States.
Negotiations on a global tobacco
The company’s international
treaty could help rein in Big Tobacco's
gains come after two decades of
global expansion.
heavy overseas spending to
advertise its products, buy
newly privatized cigarette companies, set up joint ven
tures, and build distribution and sales networks.
Key Points
•
•
k
•
Philip Morris is now a truly global company, exporting
not only cigarettes but the slick advertising and marketing
strategies that successfully addicted generations of people
in the United States. The tobacco multinationals hook
kids and unsuspecting adults—especially women—
around the world on tobacco by using exactly the sorts of
promotional and marketing techniques that have largely
been abandoned or outlawed in the United States—free
cigarette giveaways, television advertising, promotional tshirts and hats, sporting events and rock music concert
sponsorships, etc. Other than laws of general proscription,
such as those prohibiting bribery, there are no U.S. laws
or regulations specifically governing the overseas activities
of Big Tobacco.
In fact, multinational cigarette companies like Philip
Morris have long relied on the U.S. government to help
them promote smoking overseas. Official U.S. promotion
of tobacco exports to developing countries started in
earnest after World War II. Under the guise of providing
assistance to needy countries, the federal government’s
Food for Peace program shipped hundreds of millions of
dollars worth of tobacco to developing countries until the
end of the 1970s. In the 1980s, the Office of the U.S.
Trade Representative (USTR), working hand-in-glove
with U.S. cigarette companies, used the threat of trade
sanctions to pry open key markets in Japan, Taiwan,
South Korea, and Thailand. The Thai case went to the
General Agreement on Tariffs and Trade (GATT), where
a trade panel stated that Thailand must open its tobacco
market but—in a rare move for the trade body—it also
said that Thailand could maintain stringent health regula
tions. How that decision will impact potential future
trade and tobacco decisions at the GATT's successor, the
World Trade Organization (WTO), is unclear.
The Clinton administration ended the Reagan/Bush prac
tice of using trade threats to force open markets to the
U.S. tobacco industry. But the U.S.-China treaty that pre
ceded the granting of Permanent Normal Trade Relations
(PNTR) to China included a provision requiring China
to slash its tariffs on imported cigarettes.
Wherever U.S. cigarettes go, teen smoking rates rise, espe
cially among girls. The opening of Asian markets to U.S.
cigarettes escalated Asian smoking rates 10% above what
they would have been, according to one econometric
study. Price competition and advertising were largely
responsible for this rise. With the long lag time between
increases in smoking prevalence and smoking-related
mortality and morbidity, these countries will experience
severe and growing economic and human losses for some
time to come.
In 1999, member states of the World Health
Organization unanimously agreed to launch negotiations
on a global tobacco treaty. The Framework Convention
on Tobacco Control (FCTC), as this treaty will be called,
represents a historic effort by the international communi
ty to promote a coordinated international response to one
of the most deadly epidemics of our time. The negotiation
and implementation of the FCTC could make an enor
mous contribution to stemming the growth of the global
tobacco epidemic by fostering multilateral cooperation on
aspects of tobacco control that transcend national bound
aries, such as tobacco smuggling and the global marketing
of tobacco products. The FCTC process could also raise
awareness, as well as mobilize technical and financial
resources, for effective national tobacco control measures
that would help rein in Big Tobacco. Unwilling to coop
erate in this global health effort, the tobacco industry is
trying to undermine the negotiations by lobbying devel
oping country governments and spreading misinformation.
Problems with Current U.S. Policy
In a variety of ways, current U.S. policy fails to restrain
the operations of U.S. tobacco multinationals or to pro
mote international tobacco control. In 1997, Congress
passed the Doggett Amendment, which banned the use
of government monies from the Commerce, Justice, and
State Departments to promote the sale, or export of
tobacco overseas or to seek the removal of any nondiscriminatory foreign-country restrictions on tobacco
marketing. Early in 1998, after considerable delay, the
Clinton administration issued a directive to U.S.
embassies to implement the law. Although a positive
step forward, this weak amendment is subject to annual
renewal, does not cover all federal agencies, and leaves
compliance responsibility in the hands of agencies (such
as the USTR) that have historically been oblivious or
antagonistic to public health concerns.
Meanwhile, the Clinton administration insisted that
China open its market to foreign tobacco imports as one
condition in its 1999 bilateral trade negotiations with
China, despite the concerns of public health groups that
such an opening could lead to hundreds of thousands of
additional tobacco-related deaths in China. Smoking
rates among Chinese men are already astronomical;
opening the market to U.S. and other multinational
tobacco companies will likely induce a surge in smoking
rates among Chinese women, very few of whom
currently smoke.
Domestically, U.S. tobacco companies have historically
operated in a deregulated environment. One of rhe few
regulations, the Cigarette Labeling Act, has actually pro
tected the industry by providing it with a defense in law
suits (the warning labels, which are of little value, pre
vent plaintiffs from claiming they did not know about
the dangers of smoking). The tobacco companies
accepted some national controls on their operations in
1998, when they agreed to settle lawsuits brought
against them by the U.S. states. This compromise,
known as the Master Settlement Agreement (MSA),
imposes certain limitations on Big Tobacco’s marketing
techniques. The restrictions—on the companies that
signed the settlement—include: a ban on cigarette
advertising on billboards; an end to the use of cartoons
to promote tobacco; a ban on t-shirts, hats, and apparel
bearing a tobacco product name; limits on athletic and
music sponsorships; a prohibition on free samples to
underage consumers; and a ban on packs fewer than 20
cigarettes (which are more affordable for kids).
The terms of rhe MSA do not apply overseas, however,
where U.S. tobacco companies have been much more
brazen about luring youth into tobacco addiction and
where the companies are often free to engage in the
Foreign Policy in Focus is a joint project of the Interhemispheric
Resource Center (IRC) and the Institute for Policy Studies (IPS). The pro
ject depends on sales and subscription income, individual donors, and
grants from foundations and churches. In Focus internships are available,
and we invite article queries and comments.
ISSN 1524-1939
Editors
Tom Barry (IRC)
Martha Honey (IPS)
Asia-Pacific Editor
John Gershman
Communications Directors
Tim McGivern (IRC)
Erik leaver (IPS)
Project Administrator
Nancy Stockdale (IRC)
most shameless marketing tactics, such as cigarette give
aways featuring scantily clad women who seductively
light cigarettes in the mouths of teenage boys. The
industry’s slick promotional strategies work especially
well with unwary consumers who are less overrun with
commercialism. The tobacco multinationals’ promo
tions explicitly link cigarettes with perceived American
values of sophistication, freedom, and “hipness. ’
The impact of the entry of U.S. tobacco pushers into a
new market can be shocking. After South Korea opened
its market to U.S. companies in 1988, for example, the
smoking rate among male Korean teens rose from
18.4% to 29.8% in a single year. The rate among female
teens more than quintupled from 1.6% to 8.7%.
Overseas, concerned governments and nongovernmen
tal organizations (NGOs) often lack the resources to
fight the predations of the tobacco industry, which uses
its significant economic and political clout to fight
advertising restrictions, fund political parties, sponsor
bogus research, and obscure the truth about the health
effects of smoking. The U.S. government has been of lit
tle help in this area, providing scant funding to WHO’s
international tobacco control
efforts and absolutely no fund
ing to NGOs who monitor
Big
Tobacco
overseas.
Although Washington has
engaged in some technical
assistance
programs
with
countries such as China, these
programs are dwarfed by the
USTR’s
market
opening
efforts.
Key Problems
• The Clinton administration continues
to promote tobacco interests abroad,
both directly and indirectly, through
actions such as its opening of China's
market to tobacco multinationals.
• The U.S. government does not apply
the same marketing standards and
other regulations to the overseas
Even before formal negotia
operations of U.S. tobacco
tions on the Framework
companies as it does to their
Convention have begun, there
domestic operations.
are troubling signs that the
U.S. government may push for
• Washington has provided meager _
funding for global tobacco control •
a weak convention, consisting
of little more than platitudes
efforts and has failed to show
on the harms caused by
leadership in current global tobacco
tobacco along with a few tech
negotiations.
nical assistance provisions.
Although the Department of
Health and Human Services is supposed to be the lead
U.S. agency in the negotiations, it has so far deferred to
the State and Commerce Departments, which are much
more sympathetic to business interests. The administra
tion has also been lukewarm about opening up the
negotiations to NGO participation, as has been com
mon practice in other UN negotiations.
Mall, PO B?xr«0r6 and subscriP‘ion information:
Volcer(505?
M“iC° 8”96-4506
Fax: (505) 246-1601
Email: infocus@irc-online.org
Editorial inquiries and information:
IRC Editor
--------IPS Editor
Voice: (505) 388-0208
Voice: (202) 234-9382/3 ext. 232
Fax: (505) 388-0619
Fax: (202)387-7915
Email: tom@irc-online.org
Email: ipsps@igc.org
Website: http://www.foreignpolicy-infocus.org/
Toward a New Foreign Policy ----------------------------------The Doggett Amendment is important for barring
heinous assaults on countries’ tobacco control regula
tions. It should be made permanent law, so that it no
longer requires annual renewal. Even if made law, how
ever, the Doggett Amendment needs strengthening. It
currently allows the U.S. government to challenge other
countries’ tobacco control measures if they appear to
discriminate against U.S. com
Key Recommendations
• Prohibit the U.S. government from
promoting tobacco interests abroad,
challenging other countries' tobacco
control regulations or demanding
"free trade" in tobacco.
• Apply a single regulatory standard—
both in the United States and
abroad—to U.S. tobacco companies'
marketing, labels, and products.
• Provide more funding to the WHO
and foreign NGOs for tobacco
control activities and play a more
constructive role in negotiations on
the Framework Convention on
Tobacco Control.
panies. Yet other countries
often must impose such con
trols to significantly reduce
smoking rates. The World Bank
has recently reiterated the find
ing that opening developing
markets to multinational tobac
co companies is associated with
a 10% increase in smoking
rates. U.S. policy should pro
hibit the inclusion of tobacco in
new bilateral trade agreements,
so that countries can have the
options of either blocking the
entrance of U.S. and foreign
brands or taxing them heavily.
More affirmative measures are
required, as well. U.S. tobacco
companies, primarily Philip
Morris, should be required to
meet the same minimal marketing, labeling, promo
tional, and performance standards in their overseas
operations as they must in the U.S. market. The U.S.
government also should increase its funding of interna
tional tobacco control activities to a level commensurate
with the harm being caused by tobacco. This funding
should go to the WHO—which has been reinvigorated
since former Norwegian Prime Minister Dr. Gro
Harlem Brundtland became director-general in 1998
and made tobacco a top priority—to foreign NGOs,
and to the U.S. Department of Health and Human
Services. Imposing a special licensing fee on tobacco
companies or earmarking a portion of new tobacco taxes
for international tobacco control would secure funds for
this effort without requiring annual debates over
funding levels.
Finally, the United States needs to display strong leader
ship in the negotiations regarding the Framework
Convention on Tobacco Control or at least not function
as an impediment to an agreement on a strong conven
tion. The convention should set a global floor for
national tobacco control efforts while in no way pre
venting countries from adopting measures that go
beyond what is in the FCTC. A strong and enforceable
convention is needed to hold tobacco companies
accountable for their actions, and the FCTC and its
protocols should include binding measures in areas such
as advertising/promotion and smuggling. The tobacco
companies must be barred from any role in the negotia
tion or implementation of the treaty, and NGOs should
be
fully
included
in
these
processes.
Robert Weissman is a codirector of Washington
based Essential Action and the editor of
Multinational Monitor; Ross Hammond is a
San Francisco-based economist.
World Percentage of Smokers by Region, 1997
Top Cigarette Consuming Countries, 1997
□ North America
□ Latin America 4 the
Caribbean
n Western Europe
□ Central 4 Eastern
Europe
■ Africa 4 the Middle East
□ Asia
in billions of pieces
Source: 11th World Conference on Tobacco OR Health, at http://tobaccofreekids.org/campaign/global/docs/facts.pdf
In Profile:
Phillip Morris
• Phillip Morris is one of the three largest multinational cigarette companies in the world (along
with Japan Tobacco and British American Tobacco); now each owns or leases plants in at
least 40 countries.
x
• Between 1988 and 1989, Phillip Morris' international Tobacco revenues increased 226% to
$27 4 billion, while profits from those sales rose 400% to $5.05 billion. During the same period in
the United States, the company's tobacco revenues increased 107% to $19.6 billion, while
profits increased by 40% to $5 billion.
• In 1999, Phillip Morris Chairman Geoffrey Bible collected $20.6 million in salary, bonuses and
stock options.
Sources for More Information ------------------------------Organizations
Advocacy Institute
1629 K Street NW, Suite 200
Washington, DC 20006-1629
Voice (202) ITJ-lSTi
Fax: (202) 777-7577
Website: http://www.advocacy.org/tobacco.htm
Campaign for Tobacco-Free Kids
1707 L Street NW, Suite 800
Washington, DC 20036
Voice: (202) 296-5469
Fax: (202) 296-5427
Website: http://tobaccofreekids.org/campaign/
global/
Essential Action
Box 19405
Washington, DC 20036
Voice (202) 387-8030
Fax: (202) 234-5176
Website http://www.essential.org/action/
INFACT
256 Hanover Street
Boston, MA 02113
Voice (617) 742-4583
Fax: (617) 367-0191
Website: http://www.infact.org/
International Tobacco Listscrv
http://lists.essential.org/mailman/lisiinfo/
inti-tobacco/
San Francisco Tobacco Free Coalition
c/o SF Department of Public Health
1540 Market Street, Suite 250
San Francisco, CA 94102
Voice: (415) 554-9154
Fax:(415)241-0484
Website: http://sftfc.globalink.org/
Tobacco News and Analysis
http:ZAvww.tobacco.org/
World Health Organization’s Tobacco-Free
Initiative
http://www.who.int/toh/
Publications
John Bloom, “International Interests in U.S.
Tobacco Legislation,” Health Science Analysis
Project (Washington: Advocacy Institute, 1998):
http://scarcnet.org/hsap/international.htm.
Ross Hammond, “Addicted to Profit: Big
Tobaccos Expanding Global Reach”
(Washington: Essential Action/SF Tobacco-Free
Coalition, 1998): http://www.essentialaction.org/
addictedZaddicted.html.
Richard Kluger, Ashes to Ashes: Americas Hundred
Year Cigarette War, the Public Health and the
Unabashed Triumph of Philip Morris (New York:
Vintage Books, 1997).
Multinational Monitor, July/August 1997
Available at: http://www.essential.org/monitor/.
Websites
Campaign for Tobacco-Free Kids’ Global
Initiatives Website
http://tobaccofreekids.org/campaign/global/
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HEALTH
PROMOTION
FOUNDATIONS
SUPPORTING REGIONAL (DISTRICT) AND
LOCAL (VILLAGE) HEALTH PROMOTION STRUCTURES
Health Promotion Foundations
Health Promotion Foundations with intersectoral governing boards can support the development of
regional and local health promotion bodies. Regional and local health bodies can develop programs
based on expressed community need and involvement This has been evaluated as the most
effective approach to health promotion1.
Health Promotion Foundations with a wide representation of community interests from different
sectors are necessary to provide the status and influence to support a high profile for health
promotion as demonstrated by government support. It is also necessary, to link national, state and
provincial perspectives to the needs of the communities where people live, work and play.
Health Promotion Foundations:
•
•
build governmental health promotion planning capacity
increase salience of health promotion issues among policy-makers (including environmental health, diet,
and tobacco use)
•
increase governmental appreciation of health promotion approaches to health policy
•
ensure an ongoing resource stream is sustained for health promotion
Health Promotion Councils
Health Promotion Foundations support the establishment of organisational structures for health
promotion at distnct/regional and village level. District/Regional Health Promotion Councils will
provide for the involvement of relevant organisations and communities in setting agenda and making
decisions. Representatives of these bodies sit on the Council or its specialist committees.
Health Promotion Foundations work in partnership with District/Regional Health Promotion
Councils to:
•
•
•
support the development of health promotion activities based on the perceived needs of local communities
build capacity in local organisations
ensure that health promotion action is integrated at a community and village level while remaining
responsive to national, provincial, and distnct/regional priorities and needs.
District /Regional Health Promotion Councils
•
offer management support for the establishment of organisational health programs in hospitals and
primary health care facilities
•
build capacity in district/regionol government and local/village services to offer:
-
health promotion services and health promotion education
health promotion policy guidance at district, regional, and local levels - especially relevant in the areas
of environmental health and immunisation, as well as smoking, HIV, etc.
fund demonstration community projects from small grants funding programs
VillagelLocal Health Promotion Committees
At the village/local level, committees can be formed by local communities. These committees can
involve such key community stakeholders as community leaders (religious leaders, workplace
executives, government representatives), primary health care agencies and workers, and women from
non-government organisations.
The task fortheVillage/Local Health Promotion Committee is to develop, implement and evaluate
health promotion projects such as'Healthy Villages','Health Promoting Schools', and 'Health
Promoting Workplaces'. The projects reflect the possibility at the local level forVillage/Local Health
Promotion Committees to develop activities which encourage healthy and supportive environments.
1
Village/Local Health Promotion Committees enable people to come together at the community level to identify their
needs, make financial and organisational decisions, create structures to manage village development initiatives, and
ensure cooperation with other donors, departments and agencies.
Village/Local Health Promotion Committees can ensure that the different single-issue health risk factor campaigns
cooperatively address fundamental issues of social and environmental health.
Village/Local Health Promotion Committees:
-
develop capacity within traditional authority structures to meet the challenges of new lifestyle options
-
strengthen health knowledge at the local community level relating to the key identified issues
-
support the integration of health promotion programs with primary health delivery systems to improve the health of
mothers and children in the identified priority areas
-
support integrated risk factor campaigns incorporating communicable diseases and non-communicable diseases (each
foster knowledge of health issues among families
affecting the other)
Village/Local Health Promotion Committees and Primary Health infrastructure
Village/Local Health Promotion Committees work with primary health care facilities to anchor health promotion
programs within the village/local context and to build long-term health goals into the functioning of medical care services.
The Village/Local Health Promotion Committee supports training programs for primary health care workers and
examines structural and procedural issues to ensure that the maximum use is made of existing resources at this level.
The Health Promotion Foundation facilitates training exchanges between District /Regional Health Councils to enable
cross-fertilisation of health promotion issues and approaches.This will ensure that sustainable skills are built into the
districts, regions, communities.
District/Regional Health Promotion Councils: Funding
Funds for District or Regional Health Promotion Councils can be obtained from the Health Promotion Foundation,
using the dedicated tobacco tax. In addition:
because this structure is relevant to the local and regional levels and builds on expressed community needs, funds can be
obtained from local partners - businesses, religious organisations, village/local service clubs such as Rotary, etc.
a wide range of government departments may fund specific projects relating to particular settings, and may provide core funding
District/Regional Health Promotion Councils can establish themselves as Community Foundations and raise funds from local
councils to support their work.
I
Kickbusch, I, 1996. Setting Health Objectives, WHO. New York
HEALTH
PROMOTION
FOUNDATIONS
HOW HEALTH PROMOTION FOUNDATIONS CAN
ADDRESS HEALTH PROMOTION ISSUES FORTHE FUTURE
The world is changing rapidly, and new challenges are presenting themselves. Health Promotion
Foundations are intersectoral, flexible, and able to take risks they can offer leadership at the cutting
edge of the field to address these changes.
New issues in health promotion
Health and globalisation
The economies, cultures and diseases of the world are now more than ever interconnected and
interdependent Health Promotion Foundations take the risk involved in creating, supporting, and
trialing the local models and can adapt international models to local cultures and circumstances.
Global risks from global marketing
There are now global marketing strategies in place for the multinational tobacco and alcohol
companies, allowing them to deploy vast resources on selling cigarettes to developing countries,
particularly targeting young women. Health Promotion Foundations generate resources for tobacco
control programs so that countries are in a good position to fight back.
Increases in social and economic inequality
The best predictor of a country's life expectancy figures is the degree of inequality in its population.
The more equal the economic distribution of wealth, the longer people live. Health Promotion
Foundations are well placed to generate and support the development of innovative programs and
strategies for promoting health within disadvantaged communities. Health Promotion Foundations
then support meaningful evaluations of these programs so that knowledge about strategies is
transferred from community to community, across nations, and with international exchanges.
The future of work
Developed countries are now facing the conditions of work that many developing countries have
faced for decades - constantly changing labour markets, short-term contract work, job insecurity,
part-time work and unemployment (where many young people will never be guaranteed full time
permanent employment. The very nature of work, and the skills necessary to enable people to gain
employment, are changing. What effect will this change, transition and insecurity have on health?
Health Promotion Foundations can tackle these issues by
• establishing partnerships with the education system to support a health promoting schools approach
that emphasises the building of skills in areas such as problem solving, developing a sense of self
esteem, and developing creative responses and resilience in the face of constant change
• establishing partnerships with workplaces to promote healthy, supportive, and safe environments which
treat workers with humanity and justice
• developing and supporting health promotion programs for unemployed people which emphasise
lifeskills and the development of selfesteem.
Changes in the nature of the family
Single-parent families, blended families, extended families - the range of what constitutes a family
structure has been inevitably altered by the new pressures of work and society. How will this affect
the development of children’s health? Health Promotion Foundations can support the embedding of
health promotion in areas of child and family development. They can support the organisation of
interdisciplinary programs across many settings to strengthen families in their present and future
structures and systems.
New technologies of communication
The Internet has made enormous quantities of information on health available to everybody with access to a
computer and has thus created enormous possibilities for health promotion for some people. On the other hand, it
has increased inequality for those without access to computers, who become the information-poor Health Promotion
Foundations can create a regional hub for world-wide information exchange and discussion about issues of
information-poverty as a central threat to health and well-being and can explore methods to alleviate it
Changing women’s roles
The position of women is changing across the world as women enter the workforce, defer child bearing, take on
new political responsibilities, and explore new possibilities. Because Health Promotion Foundations harness the
more responsive and humanistic modes of organisation that women bring to their roles, they are able to support
the building of women’s literacy via health promotion programs as the strongest single means of raising the health
status of populations.
Changing concepts of masculinity
While work roles are changing and there is no longer so great a demand for physical strength, men are still often
locked into historically determined roles that prevent them taking care of their health, or their emotions, or their lives.
Health Promotion Foundations enable cultural constructs of masculinity and femininity to be addressed in a range of
settings as the primary underlying issue in many male risk behaviours.
Building social capital
Society has been held together by the bonds of traditional social roles and relations, but these are now under threat
from the new economic and cultural pressures. Health Promotion Foundations support the building of alternative
systems of social support by integrating the goals of social capital development into their capacity-building programs at
the national, provincial, city, town and village levels.
Demographic change - the ageing of many populations
Many countries in the world have a flood of young people, while others have increasing proportions of elderly people.
How can societies and cultures change to take account of what these changes have to offer? Health Promotion
Foundations establish strategic planning models that systematically take account, from the outset, of the health needs of
population groups through the lifespan - mothers and infants, young people, adults and older people - in the places
they live, work and play. Health Promotion Foundations support systems that can be built to address factors which
affect people from birth to death with families, organisations, and communities.
Economic development and its impact on the environment
Much of the world has been wounded, stripped, chipped and processed unsustainably. Economic growth has been
taken as the only measurement In many places tourism has taken precedence over the interests of the local
communities. Health Promotion Foundations support advocacy to ensure that health and quality of life issues are high
on the agenda at national, provincial and local levels with programs that link health with economic and environmental
issues and with local communities.
Pioneering Health
A Health Promotion Foundation with funding from a dedicated tobacco tax can
•
invest in innovative research and development
• invest in experimental and innovative pilot programs
• bring together the best people across a wide area to focus on a particular issue
• focus on inequity and unpopular issues
•
take a long term approach
HEALTH
PROMOTION
FOUNDATIONS
FACING NEW CHALLENGES
Health Promotion Foundations and Poverty
In the developing nations of the world, millions of people have poor health because they are
malnourished, infected with parasites, poorly housed, or subject to epidemic or endemic diseases. All
governments need to address issues of poverty and should put in place effective public health
systems and accessible primary health systems to combat it
Communities that work together have the best hope of dealing with their public health and primary
health problems. They can ensure that the government considers their needs, that proper preventative
measures are developed, and that individuals and families will cooperate to implement them.
Health Promotion Foundations can support the strengthening of the community organisations and
institutions that provide a base for this work. Health Promotion Foundations can, for example,
support programs to prevent dengue fever, or HIV, or smoking by:
• providing support so that dengue/HMsmoking issues are firmly placed on the agenda of local, district,
provincial, state and national governments
• providing support to strengthen organisations and communities that work towards organisational and
environmental change to prevent dengue fever/HIV/smoking
• providing support for family and community involvement in such projects as mosquito eradication
campaigns, condom drives, or anti-smoking activities at the village level.
Health Promotion Foundations and Measurement of Risk
Even in countries that have good and readily accessible medical systems and sound public health, illhealth persists. In all countries the lower levels of society, the poor, are always the most unhealthy.
Even among British public servants, all of whom have comparatively adequate incomes, good medical
care, and little occupational risk, every level below the top has higher rates of mortality and
morbidity than the level above.2 Less than half of this difference can be explained by higher levels
of risk behaviour such as smoking, poor nutrition, or lack of exercise3. More than half is due to more
complex biopsychosocial issues.
Health Promotion Foundations can support the building of capacity for social epidemiology and
social health research.
Health Promotion Foundations and Programs to Promote Control over Individual’s Lives
l
Research conducted over the past twenty years leads us to conclude that once basic needs have
been provided for; the most important factor in people's health is how much control they have over
their lives. People who have a sense of coherence in their lives, who are able to set their own
directions, who are valued, and who have a source of help, can resist health threats that destroy
people without these protections.4
Health Promotion Foundations support population based approaches, including individual health risk
factor campaigns intended to affect such behaviours as smoking rates and eating habits. As well,
Health Promotion Foundations are able to support the development of programs focusing on the
underlying determinants of people's health. While other factors such as control may be difficult to
deal with, they are nonetheless proving to be one of the most important influences on health and
cannot be ignored.5 Health Promotion Foundations can support trial programs to tackle difficult
issues such as hopelessness and lack of control.
Health Promotion Foundations and Control in Practice
Evaluation now shows that health promotion initiatives that attempt to impose their wishes on a
passive audience cannot build people's skills to deal with other life challenges and may even reduce
their self-esteem.6 Some nutrition campaigns may even stigmatise overweight people and
encourage tendencies to eating disorders.7 Health Promotion Foundations can support alternative
approaches, funding programs that, for example, emphasise the value that can be added to life with
delicious and nutritious food consumed within generative and supportive families, neighbourhoods,
schools and workplaces.
Health Promotion Foundations and capacity building
Health promotion that works and is sustained begins by asking people what their own priorities for living are.2
8
7
6
5
4
3
People are then supported to meet those goals with community and workplace organisation. Health Promotion
Foundations can support the process by building skills that will give people the collective capacity in communities,
workplaces and families to deal effectively with issues that affect their lives, as they themselves perceive them. This
will improve their health.9
Health Promotion Foundations tackle risk situations
Risk behaviours cluster in risk situations. People who smoke are more likely to be poor than their fellows.1011People
who are poor and unemployed are more likely to be depressed and even suicidal.11 People who consider suicide tend
to have low self-esteem. People with low self-esteem are more likely to smoke.12 Because risk behaviours are not a
matter of taking particular decisions but instead arise from the person's total situation, single-issue health campaigns
that do not address underlying tendencies can be effective for general populations but may not affect disadvantaged
groups (who have the lowest health status). Because health is dependent on matters lying outside the health sector;
Health Promotion Foundations can support programs that draw in media, education, industry, agriculture, transport,
government, and community, and, most important, engage with people about their own concerns wherever and
however they live, work, play and love.
Health Promotion Foundations- moving on from risk factors to the underlying issues
Health promotion deals with solid, measurable factors like cigarettes, pills, and bacteria, where a simple cause has a
straightforward effect We also know that the health of individuals can depend crucially and centrally on something as
hard to measure and as difficult to foster as a sense of hope or as a sense of control over our lives.13 Health
Promotion Foundations face these new challenges and support the development of new evidence of a different kind,
based on the perceptions of the communities and individuals involved.
Marmot, M, et a/, 1991, Health inequalities among British civil servants; the Whitehall study, Lancet, 337, 1387-93
Ibid
Wilkinson, R., 1996, The Afflictions of Inequality, London, Routledge
Marmot et al, 1984, Inequalities in death - specific explanations of a general pattern, Lancet I, 8384, 1003-6
Syme, L, 1986, Strategies for Health Promotion, Preventative Medicine, 15,492-507
Dixey R. 1996, Healthy eating in schools and "eating disorders"—are "healthy eating" messages part of the problem or part of the solution? Nutrition
and Health, 11:49-58
8 Syme, L, 1997, To Prevent Disease, in Blane, Brunner and Wilkinson (eds) Health and Social Organisation, London, Routledge
9 Morgen, S. & Syme, L, 1990, The Wellness Guide, California Department of Mental Health
10 Marsh. A., & McKay, S. 1994, Poor Smokers, London, Policy Studies Institute
11 Jin RL; Shah CP; Svoboda TJ, The impact of unemployment on health: a review of the evidence, Can Medical Assoc J, 153:529-40, 1995
12 Patton GC; Hibbert M; Rosier MJ; Carlin JB; Caust J; Bowes G, Is smoking associated with depression and anxiety in teenagers? Am J Public Health,
86:225-30, 1996
13 North FM; Syme SL Feeney A; Shipley M; Marmot M , 1996, Psychosocial work environment and sickness absence among British civil servants: the
Whitehall II study. Am J Public Health, 86:332-40, 1996 Mar
2
3
4
5
6
7
HEALTH
PROMOTION
FOUNDATIONS
WORKING IN SETTINGS - A PARTNERSHIP APPROACH
"Health is created and lived by people within the settings of their everyday life: where they learn,
work, play, and love. Health is created by caring for oneself and for others, by being able to take
decisions and have control over one’s life circumstances, and by ensuring that the society that one
lives in creates conditions that allow the attainment of health by all its members." H
Research shows that the major differences in health status within populations are based upon
economic and social status.15 The primary determinants of health are:
•
income
• gender
•
employment
•
social support'networks
•
education
•
workplace factors
•
personal health skills
•
access to appropriate health care
•
the physical environment
The majority of these health determinants fall outside the health sector; and health promotion
programs thus need to be intersectoral. Health Promotion Foundations can build partnerships wrth
all community settings.
The Settings Approach - Promoting Communities
Five key settings cover the bulk of the general population. These in turn fit within the wider settings
of the city, district and village.
The Healthcare Setting
The Educational Setting
Healthy Cities
The Workplace Setting
Healthy Locality
The Recreation Setting
Healthy Villages
The Family Setting
Health Promotion Foundations, because they are themselves intersectoral and work with broadly-based
Boards and community networks, are in a good position to support collaborative work in settings.
An Organisational and Community-Based Approach
Health Promotion Foundations can support a settings-based approach which emphasises the
development of healthy organisational structures and systems that will build supportive
environments, provide healthier choices and incentives to the populations served, and eventually
ensure that health becomes a part of everyday life.
Environments supportive of good health are crucial in achieving greater equity in health. Health
Promotion Foundations use an ‘organisational change’ approach that emphasises the identification
and change of organisational systems and structures for the creation of healthy environments and
healthy people and creates strategic interdependencies among the key stakeholders in communities
and settings.
The Health Care Setting
Health Promotion Foundations can support health promotion programs which address those specific
systems and structures of health care organisations which impact on the quality of service and the
working life of staff and patients with health education and behavioural change strategies.
The Educational Setting
Health Promotion Foundations can support the integration of curriculum, school policies and
programs, and local community resources to provide students and employees with a contextual view
of health and the skills and support systems for sustaining better health. Organisational change
within the education system at both macro and micro levels assists in the development of cultural
change as well as creating policies and practices conducive to the health of teachers, students, and
the wider community (such as parents).
The Workplace Setting
The workplace setting provides Health Promotion Foundations with the ability to address organisational structures and
systems which impact on the overall health of the organisation as well as on individual health and safety needs.
The Recreation Setting (Sports and the Arts)
Sports and leisure settings offer excellent opportunities for health promotion, and Health Promotion Foundations have
focused on them with great success via their sponsorship initiatives. Sport and leisure’s natural affiliation with health
make it accessible to the promotion of health in a broader sense.
The Family Setting
Health Promotion Foundations can support families (including extended families and households), the most immediate
support network for individuals, and can make a major contribution to health promotion via the alteration of attitudes,
behaviours, support and readiness to access health services. Families require the support of their communities interdependencies with schools, the community and civic groups, and the workplace- in achieving and maintaining
standards for health.
Healthy Cities/Healthy Localities/Healthy Villages - Building bridges across the settings
Health Promotion Foundations can support the development of healthy localities, healthy cities, and healthy local
government programs to encompass all of the five settings at the local level, collaborating with all agencies and
mobilising all segments of the community to achieve change. Regional and district Health Promotion Councils can
coordinate the activities of different health agencies and non-governmental organisations.
14
15
Chu, C, & Simpson, R 1994. Ecological Public Health: From Vision to Practice. Watson Ferguson & Company. Queensland.
Evons, R. Barer. M. & Marmot, T, (Eds) 1995. Why Are Some People Healthy and Others Not? The Determinants of the Health of Populations. Aldine De
Gruyter: Melbourne-
HEALTH
PROMOTION
FOUNDATIONS
FUNDING SUSTAINABLE HEALTH PROMOTION
WITH A TOBACCO LEVY
Why a Dedicated Levy on Tobacco Products?
The development of a Health Promotion Foundation using funds from a tobacco levy is a way of
taxing the most harmful disease-creating product to promote good health.
Taxing tobacco and using the funds for tobacco control and health promotion provides many
positive health promotion benefits at once. A harmful substance is taxed, which increases the price
of cigarettes. This is in itself a disincentive for many people to continue to smoke, and particularly for
young people to take up smoking.
Often the initial small tax increase will lead to governments increasing the tax when they see the
popularity of the dedicated levy.
A percentage of the tobacco tax can be dedicated to fund the promotion of health throughout the
country. This levy can fund a range of public health initiatives including tobacco control, injury
prevention, food and nutrition, drug prevention, reproductive and sexual health, promoting mental
health and well-being, and environmen tal health promotion. The popularity of these activities creates
a political/economic climate in which even higher taxes on tobacco are possible.
Tobacco Tax: No Claim on the Health Budget
A dedicated levy from a tobacco tax means that the funding for the Health Promotion Foundation
does not come from the general health budget, and therefore does not have to compete directly in
the same budget bidding processes with all the other claims on the health budget, especially with
hospital and treatment services and high technology.
A Long-Term Investment in Health Promotion
Health promotion is a long-term enterprise, having its effects over years and decades, and needs
secure long-term support The funding for health promotion from a dedicated levy means that
longer-term investment in health promotion initiatives are possible. Because the funding for health
promotion does not come from the main health budget, it is more likely to survive, even in a
recession.
Other Countries with Dedicated Tobacco Taxes
The first Health Promotion Foundation funded from tobacco taxes was set up in Victoria, Australia, in
1987, with the establishment of the Victorian Health Promotion Foundation (VicHealth). Dedicated
tobacco taxes for health promotion or Health Promotion Foundations have now been established in,
for example,
• Australia (Australian Capital Territory, Queensland, South Australia, Tasmania, Victoria, Western Australia)
Canada
•
Ecuador
•
Finland
•
French Polynesia
•
Guam
•
Iceland
•
Korea
• Mauritius
•
Nepal
•
New Zealand
»
Peru
•
Portugal
•
USA (Arizona, California, Massachusetts)
•
Western Samoa
•
There is no doubt that the model of using a dedicated levy on a harmful product such as tobacco for health
promotion (including tobacco control) is proving to be very attractive to many countries because of financial and
organisational constraints. In many of these countries health promotion would not otherwise exist.
Public health research, health promotion in key settings, and the mobilisation of the population for health promotion
are much more likely to take place in those countries and states where a Health Promotion Foundation funded from
the tobacco tax exist
Who gains from a dedicated percentage of the tobacco tax for a
Health Promotion Foundation?
The gams for tobacco control, health promotion, public and social heal th research, sports and arts, health promoting
schools, healthy workplaces, healthy cities, local communities, and villages are considerable. But the biggest winners of
all are the millions of people - infants, young people, adults and older people - whose health and well-being are
enriched and enlivened by staying healthy through exposure to health promotion programs.
HEALTH
PROMOTION
FOUNDATIONS
OTHER MECHANISMS FOR FUNDING
A HEALTH PROMOTION FOUNDATION
AViable Health Promotion Foundation
A Health Promotion Foundation must have a sound long-term funding base that enables it to
support major projects that deal with the underlying determinants of health over extended periods
of time. A dedicated tobacco tax is in many respects the best means to fund a Health Promotion
Foundation. Levying other harm-producing substances such as alcohol may also be considered. If
the government has not yet been convinced of the need for such a foundation, then it may be
necessary to launch a public campaign to convince it
Such a campaign may be funded from many sources, which may also be used to fund a Health
Promotion Foundation in the period while it is still seeking full government funding.
Government Aid Organisations
Intergovemment aid programs provide program funds for health in developing nations, and the
governments of these nations are increasingly beginning to recognise the value of health promotion.
•
Development Assistance Committee (DAC), OECD
• Australian Agency for International Development (AusAID)
•
Canadian International Development Agency (CIDA/ACDI)
•
Deutsche Stiftung fur Internationale Entwicklung (DSE)
• Institute for International Cooperation I Japan International Cooperation Agency (/ICA)
• Ministry of Foreign Affairs and Trade - Development Cooperation Division, New Zealand
•
Department for International Development (DFID) (formerly Overseas Development Administration), UK
•
USA Agency for International Development (USAID)
Private Trusts and Foundations
Private trusts and foundations may be interested in your project proposal:
•
Rockefeller Foundation
•
WK. Kellogg Foundation
•
Thrasher Research Foundation
•
The Pew Charitable Trusts
•
The Ford Foundation
•
Carnegie Corporation of New York
World Health Organization
WHO funds regional and national meetings, projects, and research.
World Bank
The World Bank spends a large amount of money on health promotion projects, many of which
include funds for noncommunicable disease prevention, including tobacco control.
UICC (International Union Against Cancer/ Union Internationale Contre Cancer)
UICC sometimes provides money for national campaigns.
IOCU (International Organization of Consumers Unions)
IOCU has little direct funding, but has a considerable databank on smoking problems in individual
nations and may be helpful in analysing the issues and preparing a campaign.
IDRC (International Development Research Centre)
The IDRC is a Canadian government body that encourages, supports, and researches the problems
of the developing world, including health problems.
National and International Health NGOs
Anti-cancer and anti-heart disease societies and organisations, and associations centering around particular medical
professions or particular conditions, are aware of the toll taken by tobacco and are willing to cooperate in anti
smoking campaigns. Some may be willing to give small grants for particular projects.
Service Clubs
Organisations such as Rotary and Lons International can provide funding and access to management expertise and
networks of influence.
Sponsorship
It may be possible to seek a sponsorship from an organisation that will benefit from an association with health.
Sponsorships have become an important component of the marketing mix of commercial and, in some instances, "notfor-profit” organisations. Sponsorships are the basis of a relationship between a corporation and a sponsored
organisation in which there is an exchange of benefits.
In return for financial investment in the activities of an organisation, the sponsor receives benefits, including enhanced
profile within the market, access to target groups, product awareness, image building, and commercial credibility.
Alternatives to the Tobacco Tax
Even after a campaign, a tobacco (or alcohol) tax may not be politically feasible and it may be necessary to find
alternatives. The first line of investigation should be the organisations or sponsors that funded the campaign, who see
the value in a Health Promotion Foundation and will be prepared to provide bridging funding until such time as the
Health Promotion Foundation establishes its value. Even without a tobacco or alcohol tax, the Government may be
prepared to make a grant from general revenue (although this is not as secure as dedicated funding).
The Health Promotion Foundation can also
• tender for government-funded projects
• tender for NGO-funded projects
•
provide health promotion services to businesses
HEALTH
PROMOTION
FOUNDATIONS
HOWTO DEVELOP A HEALTH PROMOTION
FOUNDATION IN YOUR PROVINCE, STATE OR COUNTRY
If the government backs the proposal from the outset, this will reduce the work required in setting
up a Health Promotion Foundation. If there is resistance or lack of interest it will be necessary to
persuade the government and this may take the form of a public campaign.
Step I: Develop a vision
The first step towards establishing a Health Promotion Foundation is to develop a vision that can
inspire the hard work and commitment that will be necessary to mount the public campaign.
Tobacco Control and Tobacco Replacement Funding
The vision should include support for a vigorous and high-profile tobacco-control movement,
including opposition to tobacco sponsorship of sports and art events and organisations, and should
include a vision for an effective and vigorous smoking cessation campaign.
Step 2: Build a coalition to run the campaign
A coalition needs to be created to run and support the campaign. The coalition needs an inner
circle which includes key health agencies from the non-government sector - the national cancer
heart, alcohol and substance abuse, diabetes, arthritis, and asthma organisations - and doctors, nurses,
and key health bureaucrats. Some sports groups will support a dedicated levy for the replacement of
tobacco sponsorship, and medical associations and the public health research community from the
universities are usually very supportive. Sympathetic politicians, key members of the business and
corporate community, key church leaders, and key members of the media should also be included.
The inner circle should form a committee to manage the campaign and its members should network
outward to build links into all key areas of influence.
Step 3: Build leadership for the coalition
A lead agency - perhaps the cancer or heart disease organisations, the medical association, or a
university - should be identified and agreed to by all the interests involved. A coordinator should be
found to run the campaign with a desk inside the lead organisation.The coordinator should have
excellent organisational and negotiating skills, the ability to establish bases and networks, credibility in
the public eye, and the ability to inspire enthusiasm in others. The coordinator should work to a
campaign committee with representatives of all relevant agencies. A prestigious and credible
chairperson for the Committee should be appointed to be the public spokesperson for the campaign.
Step 4: Develop a campaign strategy
The campaign coordinator should take responsibility for developing the campaign strategy in close
conjunction with the campaign committee. Support from other organisations such as the World
Health Organisation, the World Bank, other Health Promotion Foundations, government and
nongovernment agencies, and private foundations should be developed. Significant letter writing
programs, meetings with key parliamentarians should be orgainsed by members of the inner circle.
A mutually supportive relationship with the media (and reassuring them that any drop in revenue
from a ban in tobacco advertising will be quickly made up from revenue from health promotion
campaigns about tobacco control, food and nutrition, etc.) should be established. Use high-profile
role models from sports and arts to carry the message on the need for a tobacco tax for a Health
Promotion Foundation, and use them as widely as possible in public relations events directed at the
print and electronic media.
Be prepared to deal with a vicious counter-campaign from the tobacco industry (including direct
influence on politicians). If at all possible, undertake market research to show the increase of support
for tobacco control and health promotion over the course of your campaign.
The campaign strategy may need to be maintained for a long time - up to five years - and the
coordinator and the campaign committee must be able to maintain the momentum and the
commitment necessary for long-term campaigning.
Step 5: Prepare draft legislation, including details of the tobacco levy
The final legislation will be drafted by the government of the day, but it is useful to have model legislation ready to
guide the government in its task. The legislation should ensure that a dedicated levy is created as a direct percentage
of total tobacco taxation. The levy should ideally be separate from the normal annual budgetary processes of the
government The exact mechanism for the levy - an excise duty a tobacco franchise fee, etc - will depend on the
actual administrative and legislative arrangements in place for tobacco taxation. The amount of the levy can be
expressed as a percentage of tobacco taxation, or alternatively as a percentage of tobacco sales. If the levy is
expressed as a percentage of sales it should be as a percentage of value rather than weight of tobacco so that it will
benefit from any price increases.The levy should be in addition to any existing tobacco taxation and should be not less
than 1% of the total annual health budget
Liaise with legislative drafting capacity inside the Department of Health.
Step 6: Work with the Government and the Health Department
Most Ministers for Health will appreciate the benefits of tobacco control and health promotion and be ready to carry
the legislation through the government. Where this is not the case, an active and committed back-bench Member of
Parliament can be used, but this is much more difficult. Where possible, ensure that the health promotion coalition has
all-party support Ensure that the relationship between the Campaign Committee and the Health Department is
cooperative, consensual, and coordinated. Many campaigns will set up a joint operation with the Health Department
Establish links where possible with sympathetic officers of the Ministries of Finance and Treasury.
HEALTH
PROMOTION
FOUNDATIONS
WHAT ARE THE TASKS OF A HEALTH
PROMOTION FOUNDATION?
A Health Promotion Foundation funded from the tobacco levy can lead a nation away from
domination by the tobacco industry towards a smokefree society, but it can also do much more.
Health promotion is a rapidly developing field, and new data and new concepts are providing the
basis for rapid and extensive change. A Health Promotion Foundation, being at the centre of
operations across all areas of research and practice, is in an excellent position to develop new
directions and new initiatives to extend and amplify the influence of health promotion on the
nation's health.
The first Health Promotion Foundation funded from tobacco taxes was set up in Victoria, Australia, in
1987, with the establishment of the Victorian Health Promotion Foundation (VicHealth) as a
statutory body funded from a guaranteed share of the levy on tobacco to improve the health of all
Victorians.
A Health Promotion Foundation has the following roles and responsibilities.
Strategic Planning
•
to develop statewide, provincial health priority action areas
•
to provide leadership in the development of policy in these areas
•
to develop appropriate health promotion methods to achieve policy goals and targets
•
to coordinate single-issue programs to work together within a strategic framework on integrated programs
Assessment and Development
•
•
•
to assist community organisations and self-help groups to develop project proposals
to advise grant-seeking organisations about design, evaluation, and dissemination strategies
to advise grant-seeking organisations about strategies for partnerships with disadvantaged groups
and communities
•
to assess project / program proposals against worldwide good practice
•
to be proactive in developing proposals where no group is yet working in the relevant areas
•
to fund projects and programs when they have been sufficiently developed
•
to monitor funded projects through their implementation management, monitoring and evaluation
•
to ensure that continuous evaluation is included in the conduct of funded activities
•
to ensure that meta-evaluations are conducted across whole areas of its operations, seeking common
factors in different gains or losses
Diffusion and Dissemination
•
to ensure that knowledge about strategies and results are transferred across all the organisations working
in these fields locally, nationally and internationally through:
-
organisational and community networks
-
publications, seminars, and training
the resources of the new electronic media.
A Health Promotion Foundation -
Replaces tobacco company funding in sports and the arts
A Health Promotion Foundation can work with thousands of sports clubs and sports organisations, and
arts organisations to eliminate tobacco sponsorship of sports and arts. The use of sporting heroes as
high-profile role models for the tobacco industry, tempting young people to smoke, can end. A Health
Promotion Foundation introduces health into sports and arts organisations by replacing tobacco
sponsorship with health messages, and uses sporting and cultural role models to promote health.
Enlists sports and arts organisations to promote health
By the use of strategic sponsorships, a Health Promotion Foundation encourages sports and arts
organisations to introduce smoke-free venues, low or no alcohol policies, sun shade against skin
cancer; and healthy food options. Sports clubs are contracted to recruit and support groups with lower participation
levels, including women, people with disabilities and chronic illness, and older people.
Develops programs to reduce tobacco consumption
A Health Promotion Foundation works with a wide range of specialist campaign groups such as Quit or the Smoking
or Health campaigns to devise and implement community development and organisational health approaches and to
develop social marketing programs that successfully reduce smoking rates, especially among disadvantaged groups (who
have the highest smoking rates).
Develops a culture of health
A Health Promotion Foundation creates a culture where health promotion is widely popular among the population,
where governments recognise the strength of support for health promotion, and where communities and organisations
have embraced health promotion as one of their prime responsibilities.
Develops environments to promote healthy behaviours
A Health Promotion Foundation also works with a wide range of other single-issue health campaign organisations such
as the Anti-Cancer Council, the Arthritis Foundation, the Asthma Foundation, the Diabetes Institute, the Schizophrenia
Foundation, or the Heart Foundation to reduce the country’s smoking rates, injury rates, and alcohol related disorders
and to promote healthy eating, physical activity, mental health, and environmental health.
Develops health status baselines
A Health Promotion Foundation conducts research to establish the health status of all groups in society - men and
women across the lifespan, people living in poverty, ethnic groups and minorities, people with disabilities - and can
establish benchmarks to demonstrate improvements in these areas.
Develops sustainable research capacity in public and social health areas
A Health Promotion Foundation develops new approaches to health promotion research by establishing Centres of
Research and Action in areas where there is little other research activity that leads to action. Examples exist in lifespan
areas - a Centre for Mothers' and Babies' Health, a Centre for Child Development and Health, a Centre for Adolescent
Health, a Centre for Older Persons' Health and a Centre for Women’s Health.
Develops pilot preventative health programs
A Health Promotion Foundation supports trials of screening programs in such areas as cervical smear programs and
breast cancer programs. Successful programs can then be developed by the government.
Promotes environmental health
A Health Promotion Foundation promotes environmental health by supporting organisations and communities to
develop the skills and confidence necessary to tackle such environmental health issues as mosquito control for malaria
and dengue prevention using a range of methods - social mobilisation, community and organisational development, and
where necessary, advocacy.
Develops health promotion with disadvantaged communities
A Health Promotion Foundation directs its priorities towards covering those underserved groups in the community
who have the lowest health status and the highest mortality - people living in poverty, ethnic minorities, people with
disabilities, the unemployed.
Reduces injury and trauma
A Health Promotion Foundation develops health promotion research and action programs in the field of injury
prevention - communities, homes, workplaces and roads - that are taken up at a state and national level to lower
accident risks in all areas.
Develops mental health promotion capacity
Mental health factors underlie risky health behaviours, and a Health Promotion Foundation establishes programs to
deal with these health risks by supporting programs which focus on early detection and warning signs for early
psychosis intervention and suicide prevention. Programs which promote mental health and emphasise school-based
child development and family health programs are designed to improve community, organisational, family and personal
health and wellbeing.
HEALTH
PROMOTION
FOUNDATIONS
HEALTH PROMOTION WITH SPORTS
AND ARTS SPONSORSHIP
The tobacco industry and sports and arts
As the cigarette companies have shown, sports and arts organisations provide powerful role models
and convincing advocates, cultural ambassadors capable of carrying ideas across the community. In
1987 it was estimated that tobacco companies in Australia were spending in excess of $21 million
on sports, arts and culture sponsorships.The Victorian Health Promotion Foundation -VicHealth broke this nexus by pioneering health promotion partnerships with sports and arts.
The 1987 Tobacco Act provided the opportunity for a Health Promotion Foundation to offer
replacement health promotion funds to evict tobacco sponsorship from sports and arts. The Health
Promotion Foundation then adopted and adapted the successful methods previously practised by
the tobacco companies by inserting tobacco control and other health promotion messages into
events and programs that people value and enjoy.
From tobacco sponsorship to health sponsorship
Health Promotion Foundations quickly learn how to maximise the value of replacing tobacco
sponsorships and integrate them into general health promotion planning. As well as utilising signage
rights, corporate entertainment, product endorsement and promoting health messages, health
promotion sponsorships can evolve over time to focus on the achievement of long-term health
improvements in sport and arts environments, while maintaining a commitment to promote health
messages to relevant population groups.
From unhealthy sports and arts environments to those that are healthy and safe
As a result of an ongoing relationship with Health Promotion Foundations, sport and arts
organisations become committed to introducing policies and practices that will provide for sustained
healthy structural changes in their environments. A recent survey into 25 sporting organisations in
Victoria indicated that 98% of them supported the introduction of smoke free facilities, safe alcohol
management, healthy food choices, sun protection measures and safe sporting practices.
Over 90% ofVictorian squash centres are now totally smoke-free, and guidelines introduced in 1990
established Victorian lifesaving dubs as role models for sun protection with over 80% of clubs
providing sunscreen on beaches, wearing of protective clothing by lifeguards and providing sun
shelters on beaches.The various football codes have provided leadership into sports injury
prevention and basketball has undertaken to introduce improved alcohol serving practices
throughout its network of clubs and facilities.
The Victorian Arts Centre, too, is now a best practice health promoting facility. In all these ways sport
and arts organisations can become health promoters and significant contributors to an expanding
health promotion culture.
Developing strategic alliances between health agencies and sports and arts organisations
In order to maximise the value of working in the sport and arts settings, Health Promotion
Foundations develop strategic alliances with the major health organisations such as the Anti-Cancer
Council, the National Heart Foundation, the Drug Foundation, the Arthritis Foundation, the Asthma
Foundation, the Schizophrenia Foundation, and the Diabetes Foundation.These alliances enable
Health Promotion Foundations to strategically integrate health promotion practice into these settings
while engaging with the health organisations to create organisational change with their relevant
target groups.
Those sports and arts areas traditionally supported by tobacco companies can become fertile
ground for the Quit Smokefree message. Sports such as football, netball, surfriding and motor racing
are enormously valuable for tobacco control not only because of the number of participants and
spectators but also because of the access they provide to a much larger audience through electronic
and print media.
Prevention messages such as the diabetes prevention message of'Heafthy Diet-Try It’ can be
integrated into racecourses, receiving in Australia a recall of 79% recognition (comparing favourably
to major corporate sponsors, where recognition of sponsor brand messages is around 35%).
Expanding participation in sports and the arts
Health Promotion Foundation sponsorships can ensure that disadvantaged groups such as people with disabilities and
older people participate in sports and arts groups. This breaks down social isolation (a major health risk) and
promotes the social and physical health and well-being of these groups.
Health Promotion Foundations can support activity in rural areas, ensuring that sustained results can be achieved for
health promotion. By working within sports and arts infrastructures, health messages are integrated into local clubs,
organisations, community cultural festivals, and local community primary health facilities.
The future
Health Promotion Foundations have pioneered partnerships with sports and arts settings for health promotion
as an innovative and cost-effective tool for improving people's health.The long-term structural outcomes of
tobacco replacement sponsorships offer lasting benefits to communities. The knowledge and achievements over
the years provide the basis for the transfer of these strategies to the organisations and networks which will
sustain these benefits.
•ftbncco and India
-
pH-WO
Tobacco is used in India in many ways. Tobacco use in .smokeless form is very common. It is
chewed with or without lime or as an ingredient of pan,'pan masala; applied in the form of
..tishri, snuff, tobacco toothpaste, etc. Tobacco is smoked in the form of cigarette, bidi, chutla,
dhumti, clay pipes and hookah. Main smoking material in India is "bidi". Although a bidi stick
has about 1/4 to 1/5 g of tobacco (as compared to about 1 g in a cigarette),- the amount of tar
and nicotine liberated by a bidi is equal to or more than a cigarette. Cigarette smoking (the
Commonest mode of tobacco smoking in the World) constitutes about 13% of the total smoking
consumption in India.
Magnitude of Tobacco Use : During 1980s. the prevalence of tobacco use among men above
15 years of age varied between 46% and. 63% in urban areas and between 32% and 74% in
rural areas. Among women it varied between 2% and 16% in urban areas and between 20%
and 50% in rural areas. Based on these studies, it has been estimated that in India about 194
million men and 45 million women above 15 years of age use tobacco. While smoking is more
common among men, smokeless tobacco use is more popular among women.
Mortality and Morbidity due to Tobacco: Annual deaths due to tobacco use amount to an
estimated" 800.000 persons in India, which equals to 2,200 deaths a day or one death every 40
seconds. The burden of illness due to tobacco use (prevalence figures) include 400,000 canc
ers, 1.3 million coronary artery disease and at least 7 million chronic obstructive lung diseases.
^Tobacco Control Scenario in India
Till 1980s, the major tobacco control initiatives were the necessity' of a warning on cigarettes
(under Cigarette Act of 1975), prohibition of direct tobacco advertisements on government
controlled mass media, and anti-tobacco education. In 1990. a warning on chewing tobacco
was also made necessary under Prevention of Food Adulteration Act. Cabinet secretariat by an
order in 1990, banned smoking and sale of tobacco products in health related and educational
institutions, domestic air flights, air conditioned trains and buses, and conference rooms. The
health hazards of tobacco were included as topics in the text bocks brought out by National
Council for Educational and Research Training, for the age group of 11 to 18 years. Teachers
training programmes also addressed hazards of smoking. A National workshop in 1991, identi
fied various tobacco control activities for the country.
Operational research projects related to control of tobacco were carried out by Indian Council
of Medical Research, using radio, health infrastructure, schools, and community volunteers.
These studies indicated that if motivated, all these facilities could be effective in bringing down
the prevalence of tobacco use. The nationwide programme through radio showed tobacco quit‘ng by 4% to 6% users after broadcast of 11 episodes on tobacco. Project on estimation of
ost of tobacco related diseases suggests that loss due to tobacco related diseases may be much
more than its contribution to Indian economy.
«
The Ministry of Health & Family Welfare is in contact with other concerned Ministries/ de
partments, to facilitate a holistic approach for tobacco control. A draft comprehensive legisla
tion for control of tobacco was prepared by the Ministry. An enhanced political will on tobacco
control has been the biggest achievement during the recent past. The twenty second report of
the Committee on Sub-ordinate Legislation (Tenth Lok Sabha) considered the rules/regulations
framed under the Cigarettes (Regulation of Production, Supply and Distribution) Act, 1975.
The committee consisting of Members of Parliament, made wide-ranging suggestions for
tobacco control in India, including substitution of tobacco with alternate crops. Administrative
actions have been initiated on many recommendations. The revised comprehensive legislation
in view of the recommendations of the Parliament Committee, is being examined by other
1
concerned ministries/ departments, before placement in the Parliament. A legislation banning
tobacco advertising and smoking in public places has been implemented in Delhi. A similar
legislation for Goa has been referred to the central Government for consideration.
The Ministry of Health & Family Welfare constituted an Expert Committee on Economics of
Tobacco in India, which is likely to help in decision making. The Committee is examining the
tax revenue and foreign exchange earnings, employment and consumer expenditure due to
tobacco on the one hand and the cost of tertiary level medical care facilities for treatment of
tobacco related diseases, losses due to fire hazards, ecological damage due to deforestation and
disposal of tobacco related wastes on the other hand.
The Directorate General of Health Services examined the health hazards of pan masala with
tobacco, through an expert committee. The Committee recognized pan masala with tobacco to
be an important cause of oral sub-mucous fibrosis and oral cancer. Based on the report of this
Committee, the Central Committee on Food Standards, recommended a ban on chewing tobac
co in India. An imer-rainisterial meeting considered the implications of such a ban, and the
modalities proposed by die Ministry of Health & Family Welfare for its implementation.
Various concerned ministries and departments are being consulted for initiating actions to deal
with the implications of notification of a ban on chewing tobacco in India.
Future Challenges for Tobacco Control in India
While political and administrative will is greater than in the past, it is important that the educa
tion of community, politicians and administrators is undertaken at a war-footing. Such a
campaign would help in according a better priority to tobacco control actions, and in genera
tion of a social atmosphere wherein non-usage of tobacco would be considered as the societal
norm. With a conducive social atmosphere, any legislative initiative for tobacco control is also
likely to be considered positives by the Parliament.
The need for providing support to tobacco quitters has been recognized all over the World.
Thus, if India is to implement initiatives for ban on tobacco products or tobacco crop substitu
tion, the current users would require support in their quitting efforts. It is proposed to initiate a
network of Tobacco Cessation Clinics all over the country. These clinics would utilize proven
modalities in smoking cessation for community and carry out research in understanding the
role of newer cessation support mechanisms and the role of existing modalities in quitting of
smokeless tobacco.
It is important that liaison and support is provided by the Ministry of Health & family Welfare,
to other Ministries/ Department in initiating/ enhancing their activities related to tobacco
control. Ministry of agriculture has started research work towards identification of alternate
crops. Ministry of education aims at better coverage to the subject in schools. Mass media is
conducive to initiation of major educational programmes. Other ministries/ departments are
considering programmes which could help in tobacco control. Currently, India is poised for
major steps for control of tobacco in near future.
2
ICIVIR’s Research Projects on Tobacco
Radio DATS (Drug, Alcohol & Tobacco Education)
A Joint Project of All India Radio and Indian Council of Medical Research on Integrated Broadcasting (1990-1992)
The project Radio DATE was a collaborative effort of Indian Council of Medical Research and
All India Radio. The acronyms DATE stand for Drugs, Alcohol, and Tobacco Education. The radio
programme was in the form of 30 weekly episodes of 20 minutes each. Ten episodes focussed on tobac
co. eight each on alcohol and drugs, and two episodes on legal aspects. The introductory and conclud
ing episodes touched all the three themes. The episodes were broadcast from 84 stations of All India
R.-.dio (out of 104 existing at that time) at prime time, simultaneously in sixteen languages.
The development of the radio programme was the main thrust of the project. The programmewas prepared after a thorough review and discussion. The first three episodes were pre-tested in the
field. The Hindi prototype was sent to selected radio stations of All India Radio for translation in re
gional language, as per the specified guidelines'. The broadcast was during a specified time (between
8.00 A.M. and 9.00 A.M. on Sundays, with a repeat broadcast during the week, generally in the
evening). While the name Radio DATE was used all over the country, different radio stations also
coined and used names in local languages.
Education on tobacco, alcohol and drugs received equal importance in terms of number of
episodes, the evaluation of the contents and preparation of the episodes.
It was proposed to evaluate the effect of the programme on knowledge, attitude and practice
regarding all the three components of the programme (tobacco, alcohol and drugs), on a group of regis
tered audiences. However, several recording errors as well as matching difficulties were observed on
pre-and post-broadcast proformae. In view of this, the data on registered audiences was not analysed. A
limited evaluation of the reach and effect of the tobacco component of the programme was possible
through two community based surveys, carried out after the broadcast of tobacco episodes (which was
the first topic to be covered). Two community surveys in rural areas of Goa and Karnataka, were car
ried out to assess the reach of the programme among persons above 15 years of age. No organized anti
tobacco programmes were being conducted in these areas at that time. The surveys showed that the
potential listeners of radio comprised 80.4% of the population in Goa and 59.1% of the population in
Karnataka. In Karnataka 31.6% of the potential listeners and in Goa 26.7% of the potential listeners,
heard at least one of the first eleven episodes (on tobacco). On univariate analysis, reach of the pro
gramme differed according to education, village and age in Goa; and according to education, occupa
tion, village, sex and type of tobacco used, in Karnataka. However, a bivariate analysis indicated
education to be a determinant in Goa; while education and occupation influenced the reach in Karnata
ka. The sample size was not enough to assess the role of occupation in Goa. Other factors studied, like
presence of tobacco habit, type of tobacco habit, sex, age, village, radio ownership, and caste (studied
only in Karnataka), did not significantly influence the reach of the programme among potential listen^s. The mean number of episodes heard by the listeners was 2.6±1.46 in Goa and 2.57 + 1.13 in
Karnataka. The factors associated with listening higher number of episodes included higher education,
male sex, non-usage of tobacco and radio ownership in Goa; and, higher education, radio ownership
and caste in Karnataka.
Most of the listeners considered the programme to be very good or good, and felt that it would
have effect on the tobacco users to quit their habit as well as on children to prevent the initiation of
habit. About 4% tobacco users in Goa and about 6% users in Karnataka quit their habit after hearing
the programme. About 98% to 99% of the listeners expressed that such programmes should continue.
The programme, the first of its kind in India, has .brought forth a very important aspect of
dissemination of information on harmful effects of drug abuse and need for adoption of healthy life
styles through the involvement of the audio media. The information available from the community
based evaluation strengthens this statement.
pH Cost of Tobacco Related Diseases
The revenue generated by tobacco has been a major reason for non-initiaiion of anti-tobacco
z activities in most of the countries. However, it is probable that the expenditure incurred by the Gov■' ..rnments and/or patients due to tobacco related diseases is much more than the revenue generated by
tobacco. This study was carried out to test’this hypothesis. A list of information that would be required
to compute the costs and benefit of elimination of tobacco usage in India, was prepared. After discus
sion, an expert group on the subject, felt the need for initiation of studies on measurement of costs due
to tobacco related diseases.
The study assessed the costs due to tobacco related cancers, coronary heart disease, and chronic
obstructive lung diseases. The study on tobacco related cancers was carried out at Institute Rotary
Cancer Hospital (AIIMS), New Delhi, whereas the other two aspects were studied at the Post Graduate
Institute of Medical Education and Research, Chandigarh, between 1990 and 1995. The studies deter
mined the direct (medical and non-medical; by the patients as well as by the treating institution), as well
as indirect costs (due to absenteeism and premature death), due to the diseases under study. The final
report of the study on tobacco related cancers is under review. The final report of the study on coronary
heart disease and chronic obstructive lung diseases is expected shortly.
The study on tobacco related cancers followed up a cohort of 195 patients of cancers of tobacco
related sites, for a period of three years with no evidence of disease or till death, to determine their
expenditure (medical as well as non-medical) on treatment of their disease: expenditure by the institu
tion on their management; and loss of income due to their absenteeism or premature death. The item
a ' wise expenditure made by the patients, their relatives/ friends, was recorded, under various headings,
" namely, consultation, investigations, treatment with different modalities, transport for the purpose, and
any additional cost incurred for lodging and boarding. The information was also collected on actual loss
of wages for treatment of the disease. Discounting at the rate of 10% per annum was used to convert all
the expenditure by patients to 1990 level. The loss due to premature death was estimated based on the
last income level and expected remaining age of the patient estimated from the standard life rabies
available fordifferent areas of the country. The institutional cost was assessed from the records of the
institution and the information on services used by the patient.
The patients in the cohort, spent an average of Rs. 17,965 (including loss of income due to
absenteeism), with ano±er Rs. 4,009 being contributed by the institution in the form of various servic
es. The loss of income due to premature deaths amounted to Rs. 112,475. Thus, the total loss due to
management of a patient of tobacco related disease diagnosed in 1990, was Rs. 134,449 (discounted at
1990level). .
Q
Direct cost of a case of tobacco related cancer (by the patient, and treating institution) amount
ed to Rs. 17,774 (Rs. 13,765 by the patient or their relatives, and Rs. 4009 by the treating institution).
This category included expenditure on consultations, investigations, treatment, travel & lodging for
treatment, and extra money spent for food during treatment time. Average indirect cost due to tobacco
related cancers amounted to Rs. 116,675 (Rs. 4,120 due to absenteeism for treatment, and Rs. 112, 475
due to loss of income due to premature death).
There was very little difference in expenditure by the patients on items related to direct medical
treatment, according to different demographic attributes of the patients. The few exceptions where such
differences were noted included a lower expenditure on chemotherapy among old patients; a higher
expenditure by residents of Delhi on consultation and surgery; and higher expenses on radiotherapy on
patients where the intent of treatment was curative. The direct non-medical-expenditure (on travel,
lodging, etc.) on treatment was influenced by personal characteristics of the patients, suggesting a varia
tion in expenditure due to their paying capacities. Better occupation, higher distance of the hospital
from their place of residence, younger age of the patient, and curative intent of treatment (probably
influenced by longevity and higher degree of follow up), resulted in higher expenditure.
2
Efncaey or im Anti-tobacco Community Education Programme
Cancer of (he oral cavity is (he most common cancer in India. Tobacco usage, especially
■‘hewing is known .to be the causative agent. Primary prevention is considered to be the most cost■ Jieciive strategy for control of oral cancers. The Council initiated demonstration-cuin-rcscarch pro
jects, to study the feasibility of involving health infrastructure in anti-tobacco community education.
The. study yeas carried out between 1986 and 1992 at Goa, Bangalore, Agra and Trivandrum. The Goa
centre studied the role of school children and teachers also. The Agra centre utilized community volun
teers for anti-tobacco community education.
The specific objectives of the study was to prevent the uptake of tobacco habit by non-habitues
in the community; and to stop the tobacco habit in h
""
’ ’ ■ it training
• • • priman
•
...
centre personnel to provide health education for p cvention of oral cancer through ami-tobacco pro
gramm.es; and to inspect the oral cavity, identify a to classify lesions into referable and non-referable
categories. The Goa centre included school childre :i and teachers among the categories to be trained.
The Trivandrum centre aimed at covering a district and at studying the changes in trends/staging at
which people present themselves for treatment of oral cancers.
The paramedical workers, Anganwadi Workers (AWWs) and school teachers were trained in
anti-tobacco educations! activities. For intervention through schools, Goa centre used two booklets on
tobacco, posters, stickers, enactment of drama and plays, a lung model, story and poem writing, radio
interviews, science exhibitions, and a comic book. The prevalence rates of tobacco habit was deter
mined through baseline survey, mid-term survey ;;;-.d a final house-hold survey. Effective participation
of health infrastructure could not be achieved in Goa. The overall reduction in the prevalence of tobac
co usage among men was 11.8% & 13.4% in two experimental areas and 2.0% in control area. De
crease in prevalence of tobacco use among women was 9.1 % and 13.3% in two experimental areas and
10.2% in control area. Based on the experience of this project. Ministry of Education, Goa, agreed to
include an 8 hour course on tobacco as a part of co-curricular activities for standard five and above.
Bangalore centre intervening through health infrastructure, showed a tobacco use reduction of
5.7% among men in experimental area, as compared to 3.8% increase in control area 1, and 2.9%
increase in control area 2. The prevalence of tobacco use among women showed a decrease of 6.9% in
experimental area, 7.8% increase in control area 1, and 4.6% decrease in control area 2.
As motivation of health infrastructure was found to be difficult at Agra centre, the anti-tobacco
education was carried out through community volunteers trained by the project staff. The one year
intervention resulted in 26.3% men and 10.5% women quitting the habit (user having left tobacco for
more than 6 months), and another 10.1% males and 4.3% females as likely quitters (quit for less than 6
months). The children and younger age groups were more influenced, in comparison with the older age
groups. Performance of younger volunteers was better, as measured by the quitting rate. Educated
volunteers and those attached with government agencies or panchayat showed better results.
The emphasis of the project in 6 blocks of Trivandrum district was on detection and prevention
fcf oral cancer by para-medical health workers, during their monthly domiciliary visits, resulting in
"linical downstaging of oral cancer. The project received a setback due to a very high transfer rate,
with some getting transferred even to control area. Due to limited overall involvement of the workers,
there was no difference in the proportion of oral cancer cases detected at early stages in experimental
and control areas. Since the methodology of referring the suspected cases to Regional Cancer centre by
health workers through the PHC Doctor did not work, the cancer detection clinics at sub-centre level
were initiated. The nine workers who worked on the project, referred 408 patients out of which 258
reported, giving a compliance of 63.2%. About 59% of these were found to have cancers (10) or pre
cancers. Of the 10 cancer cases five were in stage I & II. 29 old cases were also examined, out of
which four recurrences were detected.
3
International part 1
AUSTRALIA
ARGENTINA
Philip Morris
Marlboro
LeMans
Parliament
Philip Morris
L&M
British American Tobacco
Jockey Club
Derby
Camel
Parisiennes
43/70
Consumption (Billions)
% of Market
1998 1999
63.5
63.8
38.4
39.0
6.2
6.0
3.8
3.6
4.2
4.9
3.0
2.9
36.5
36.2
12.3
12.2
12.1
11.8
4.0
4.3
2.9
2.8
2.8
2.6
36.1
36.0
Imperial
Horizon
Escort
Peter Stuyvesant
Brandon
Consumption (Billions)
Philip Morris
Longbeach
Peter Jackson Super Mild
Peter Jackson Extra Mild
Marlboro 25's
Peter Jackson
British American Tobacco
Horizon
Benson & Hedges
Winfield Extra Mild 25's
Holiday 50’s
Winfield Virginia 25's
Rothmans
Peter Stuyvesant
Brandon
AUSTRIA
A.T.W.
Philip Morris
British American Tobacco
Reemtsma
R.J. Reynolds
Others
Consumption (Billions)
% of Market
1998 1999
57.0
55.6
28.9
29.3
4.0
4.6
3.6
3.5
2.2
2.3
4.3
4.7
15.1
15.6
BARBADOS
INDEX
page 27
page 22
' / Argentina ' ■
.- ■ ■■
. Jamaica . C
'
. Japan -.- ■ :'
Australia’
-•‘^Austria?,'
' -i /
Belgium
page 24
. .
" -..'Brazil
■■.. -, ; ■
- Czech Republic.. .
,
'.'/B..
/
Democratic Republic . ~
...of the Congo
-.
■ ■ ■.
Korea
'
.-■■Malaysia /
• Mexico". .
■■ 'Morocco .
:. Netherlands ■
:
'■
: .
page 28
Nicaragua
Sfisi^DcJfriinicanifRepublicfe^BK^Cy
‘‘,>>;Nigeria’y. ’e
IBBwBBIBH
PM®#
Ecuador
-^aMJRuerto
oaae 29
SM8O
page 26
Honduras'
he
British American Tobacco
Embassy
Benson & Hedges
State Express
Silk Cut
Du Maurier
Philip Morris
Marlboro
Rothmans
Dunhill
Rothmans
Japan Tobacco/RJ Reynolds
Salem
Winston
Others
Consumption (Millions)
% of Market
1998 1999
96.9
96.5
63.7
63.1
23.5
24.6
04
0.3
1.6
1.6
0.7
0.4
0.3
0.6
0.2
0.2
0.2
109.0
04
0.4
3.3
3.3
0.1
0.0
0.1
0.1
0.0
0.0
102.0
BELGIUM
PM Belgium (Philip Morris)
Marlboro
L&M
PM Super Lights
Others
Tobacofina (C)
Belga (filter)
Stuyvesant (filter)
Richmond Dolze (filter)
Johnson (plain)
Winfield
Others
British American Tobacco
Belga
Barclay
Boule d'Or (plain)
Others
Cinta (Reemtsma)
% of Market
1999
1998
44.0
41.6
24.8
26.7
14.2
14.8
1.6
2.0
1.0
0.5
9.5
25.2
15.9
2.4
. 2.2
L0
1.9
11.0
6.3
2.8
1.9
10.3
International Part 1
Bastos Rouge (plain)
Others
Seita
Gauloises
Gitanes
R.J. Reynolds
Camel (filter)
St Michel (plain)
Zemir White Tip (filter)
Others
Others
Consumption (Billions)
9.2
1.1
5.1
4.7
0.4
4.8
3.1
1.5
0.2
2.0
11.8
9.0
0.8
5.2
4.8
0.4
4.5
3.0
1.3
0.1
0.1
2.0
12.2
BRAZIL
Souza Cruz (BAT)
Derby Suave LS FTB
Free KS FTB
Hollywood KS
Carlton KS FTB
Plaza KS
Belmont KS
Charm 100’s (slim)
Ritz KS
Continental KS
Minister KS
Minister KS FTB
Philip Morris
Marlboro
Dallas Suave KS
L&M Lights KS
% of Market
1998
1999
84.6
85.1
40.2
39.7
17.8
18.3
10.6
10.6
7.8
7.7
3'9
3.9
1.3
1.2
1.2
1.0
1.0
1.2
0.5
0.4
0.2
0.2
0.1
0.1
14.5
14.0
5.4
4.7
2.6
2.6
1.4
1.5
Dallas Filter KS
1.2
L&M Lights FT
0.7
Luxor
0.6
Sudan Fabrica De Cigarros-Brazil 0.9
US Mild KS
0.6
• 0.2
Campeao KS
92.0
Consumption (Billions)
0.8
0.3
0.5
0.9
05
0.1
97.6
CZECH REPUBLIC
Philip Morris
Petra
Start
Marlboro
Sparta
L&M
Bakara
Other
Reemtsma
Mars
West
Delta
Astor
Inka
Other
Seita
Gauloises
Other Imports
Consumption (Billions)
% of Market
1998
1999
79.4
81.4
31.7
30.7
21.5
24.4
12.7
12.0
8.3
8.0
5.2
5.0
0.3
0.2
0.4
0.4
10.9
10.3
4.0
3.3
2.3
2.4
1.4
1.5
0'9
1.2
0.6
0.5
0.9
1.6
0.6
0.6
8.3
9.1
20.0
20.7
DEM. REP. OF THE CONGO
British American Tobacco
Stella
Tumbaco
Ambassade
Rothmans
Stella
Okapi
Seita
Fine
Others
Consumption (Billions)
% of Market
1998 1999
48.5
73.7
29.9
37.4
39.8
8.7
6.4
46.6
21.2
37.8
10.3
8.8
10.9
0.5
0.7
0.5
0.7
4.4
4.4
4’1
2J
DOMINICAN REPUBLIC
% of Market
1998 1999
E. Leon Jimenes (Philip Morris) 88.0
88.1
Marlboro
26.0
25.8
46.0
Naclonal
46.5
81
Marlboro Lights
7.4
65
6.4
Naclonal Menthol
0.5
Marlboro Lights Menthol
0.5
Others
1.2
1.1
11.9
Compania Anonlma Tabacalera 12.0
6.0
5.8
Monte Carlo
Constanza
3.6
4.0
Palace
0.7
0.8
0.7
0.9
Cremas
0.5
0.5
Hilton
0.3
0.1
Others
4.0
3.9
Consumption (Billions)
International Part 1
ECUADOR
FIJI
% of Market
1998 1999
Procesa (PM1) .
99.0
98.6
Belmont
36.1
31.7
Lider Suave
23.4
25.6
Lark
22.8
24.3
Marlboro
11.7
13.3
Full Speed
4.3
3.6
King
0.5
0.1
El Progresso (BAT & local brands) 1.0
1.4
Consumption (Billions)
3.2
3.2
FINLAND
EGYPT
Egyptian Tobacco Monopoly
Cleopatra KS
Cleopatra 100s
Cleopatra KS Box
Belmont 100s
Lite LS Box
Philip Morris
Marlboro Red Box
Marlboro Lights KS Box
L&M Lights KS Box
Merit KS Box
Merit Ultra Lights KS
British American Tobacco
Kent 100s
Consumplion (Billions)
% of Market
1998 1999
88.4
85.4
70.5
50.1
9.4
20.2
4.7
9.3
1.6
2.9
0.9
0.4
11.4
14.4
6.3
7.4
1.9
3.2
1.8
2.2
0.6
0.7
0.4
0.5
0.2
0.2
0.2
0.2
55.5
59.1
EL SALVADOR
Cigarrerla Morazan (BAT)
Delta
Free
Rex
Casino
Windsor
Tocasa/Tasasa (PMI)
Diplomat
Marlboro
Baronet
Consumption (Billions)
British American Tobacco
Benson-Hedges (KS)
Other
Rothmans
Rothmans
R/P Mall
Other
Consumption (Millions)
1998
58.9
44.2
9.9
1.5
0.9
0.9
41.1
30.4
10.2
0.5
1.0
1999
57.8
45.6
8.7
1.5
0.8
0.8
42.2
32.8
9.4
0.9
FRANCE
% of Market
1999
1998
73.2
71.8
71.3
72.9
0.3
0.5
26.8
28.2
14.3
14.6
9.3
9.9
3.2
3.7
408.5 317.1
% of Market
1999
1998
76.1
American Tobacco (Philip Morris) 74.4
14.2
13.8
Marlboro Red
14.0
L&M KS Box 18's
13.0
7.8
8.0
L&M Lights KS Box 18's
5'4
5.4
Belmont Extra Mild
5.1
5.1
Belmont 2002
5.3
L&M Lights KS Box Ment 18’s 5.1
4.8
4.4
Marlboro Lights
4.1
4J
Marlboro Box
3.0
2.8
Marlboro Lights Box
2.3
2.2
Marlboro Menthol
2.2
2.2
Marlboro Lights Menthol
1.1
L&M Ultra Lights KS Box18’s 1.1
1.0
1.0
Belmont 2002 Menthol
0.9
0.8
Belmont Filter
15.1
16.2
Suomen Tupakka (BAT)
6.4
5.9
North State Filter
1.8
1.8
Barclay KS Box Ment 18's
1.3
Pall Mall Lights KS Box Ment 18's 1.4
1.3
1.4
Barclay KS Box 18's
1.0
1.0
Pall Mall KS Box 18's
1.0
1.0
Pall Mall Lights KS Box 18’s
7.6
8.7
R.J. Reynolds
2.0
2.2
Colt Long Size
0.9
0.9
Camel KS
0.8
Downtown Lights KS Box 18’s 0.8
0.6
Ultra Kevyt 1
0.6
0.4
Kevytsavuke 5
0.4
0.4
Downtown Ultra Lights KS Box 18’s0.4
0.2
0.2
Amer Tupakka
0.1
Form Special KS Box
0.1
0.1
Swedish Tobacco Monopoly
0.2
0.1
0.1
Blend Extra LS Box
0.1
Blend LS Box
0.3
0.9
Others
4.8
4.8
Consumption (Billions)
Selta
Philip Morris
Marlboro
Chesterfield
Philip Morris
Others
Rothmans International
Winfield
Peter Stuyvesant Group
Golden American
Rothmans Group
Dunhill Group
Others
RJR
Camel filter
Winston
Gold Coast
Other
Imperial
Gallaher
British American Tobacco
Tabacalera
Consumption (Billions)
GHANA
British American Tobacco
Diplomat
Embassy
Tusker
London
State Express
Rothmans
London
Rothmans
Dukes
Super Star
Consumption (Billions)
% of Market
1998 1999
81.6
91.8
49.1
47.2
11.4
13.6
10.8
15.4
9.5
8.6
6.1
18.4
8.2
7.9
1.6
5.8
4.7
3.2
1.3
1.3
0.6
GUATEMALA
% of Market
1998 1999
Tabacalera Centro
Americana (PM)
Rubios KS 10’s
Rubios King Size
Rubios KS Ment. 10's
75.8
28.4
19.2
8.0
76.5
30.1
16.8
8.1
International Part 1
Rubios King Size M
Marlboro Long
Rubios Regular
Marlboro Lights
Tabacalera National
Casino KS 10's
Casino King Size
Casino M
Belmont KS 10's
Belmont King Size
Payasos
Consumption (Billions)
4.6
4.5
3.2
2.4
24.2
9.1.
4.7
2.3
2.0
1.7
1.1
1.8
Pall Mall
Others
Philip Morris
Multifilter
Helikon
Marlboro
Eve
L&M
Others
Reemtsma
Symphonla
Fonix
Mustang
Others
V-Tabak '
Pannonia
P20
Kossuth
Munkas
Hungaria
Japan Tobacco/R.J. Reynolds
Camel
Others
Consumption (Billions)
4.6
4.6
2.9
2.8
23.5
9.2
4.2
2.2
2.0
1.7
1.0
1.8
HONDURAS
British American Tobacco
Royal
Belmont
Imperial
Pinares
Record
Philip Morris
Marlboro
Consumption (Billions)
HUNGARY
British American Tobacco
Sopianae
% of Market
1999
1998
99.7
99.8
50.4
41.2
43.5
53.2
3.0
2.5
1.8
1.7
0.8
0.6
0.2
0.3
0.2
0.3
2.5
2.1
2.5
0.5
30.5
13.8
9.2
6.4
0.3
0.5
0.2
22.6
14.4
6.1
1.4
0.7
66
3J5
2.0
0.5
0.4
0.0
1.3
0.2
0.3
22.4
29
0J3
32.3
14.0
9.8
7.4
0.5
0.4
0.2
23.6
12.7
5.7
3.1
1.1
7.0
3.3
2.9
0.4
0.3
0.1
0.2
0.2
0.3
22.7
ICELAND
Japan Tobacco/RJ Reynolds
British American Tobacco
Scandinavia Tobacco Co.
Philip Morris
Consumption (Millions)
% of Market
1998 1999
36.6
38.7
35.7
33.4
0
% of Market
1998 1999
75.4
73.5
18.2
17.6
2.2
1.9
7.0
4.2
350.2 361.0
% of Market
1998 1999
78.2
India Tobacco Company (BAT) 65.0
20.4
19.1
Wills Gold Flake (plain)
16.9
16.2
Scissors
8.7
7.3
Bristol
6.9
Charminar (filter)
5d
5.1
Capstan (filter)
10.4
11.1
Others
12.8
Vazlr Sultan Tobacco Co.
7.7
Charminar (filter)
4.3
Charms Mini Kings
0.3
Others
12.3
Godfrey Phillips (India) Ltd. (M0) 12.5
5.4
5.5
Four Square Filter Kings
3.6
3.4
Cavenders Magnum (plain)
3.2
3.0
Red & White Filter
0.4
0.3
Others
9.3
8.3
Golden Tobacco Company
6.4
6.1
Panama (plain)
1.3
2d
Chancellor
0.8
0.8
Golden Filter Flake (plain)
0.3
0.2
National Tobacco Company
0.2
0.2
Regent
98.5
103.2
Consumption (Billions)
ITALY
Philip Morris
Marlboro KS Box
% of Market
1998 1999
58.3
59.9
12.0
11.8
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PRICES
International Part 1
Marlboro Lights KS Box
7.9
Diana KS Box
6.3
Merit KS Box
6.0
Diana Specially Mild KS Box
5.2
Philip Morris Super Lights KS 2.3
Diana KS
2.2
Muratti Ambassador KS Box
1.3
Monilal
35.2
M.S. KS
12.2
M.S. KS Box
4.6
M.S. Mild KS
3.5
M.S. Mild KS Box
-2.6
M.S. Lights KS Box
1.2
M.S. Extra Lights KS Box
1.1
British American Tobacco
4.1
Japan Tobacco/R.J. Reynolds
1.5
Camel KS Box
0.4
Camel Lights KS Box
0.3
Seita
0.4
Reemtsma
0.3
Austria Tabak
0.2
Consumption (Billions)
91.0
8.8
5.5
6.0
4.6
2.3
1.2
31.7
10.8
4.3
3.0
2.6
10
4.4
3.1
1.0
0.9
0.4
0.3
0.2
94.6
JAMAICA
Cigarette Co. ofJ'Ca. Ltd.
Craven “A"
Matterhorn Menthol K.S.
Rothmans K.S.F.
Benson & Hedges S.F.
Consumption (Billions)
KOREA
% ol Market
1998
1999
0.03
0.04
6.60
7.24
0.05
0.07
18.26 20.34
2.56
2.57
0.01
0.00
0.19
0.44
0.03
0.03
0.01
0.02
0.01
0.01
71.99 69.49
339.9 329.2
% of Market
1998 1999
86.6
87.0
31.4
37.2
15.5
14.8
16.6
11.7
7.9
7.6
7.1
7.5
3.4
3.7
3.7
3.7
4.1
2.4
13.4
13.0
6.7
6.2
%of Market
1998
1999
93.6
95.1
Office of Monopoly
50.7
47.3
This
9.1
88
10.8
7.8
6.6
Simple
2.4
4.8
Esse
7.0
4.0
Omar Sharif
5.5
3.0
Hanaro
3.0
2.7
Pine Tree/Sol
3.2
2.8
Lilac
6.4
Overseas tobacco manufacturers 4.9
106.6
95.5
Consumption (Billions)
MALAYSIA
JAPAN
American Brands
British American Tobacco
Others
Philip Morris
RJ Reynolds
Reemtsma
Rothmans
Seita
Austria Tabak
Gudang (Indonesia)
JTI
Consumption (Billions)
KENYA
British American Tobacco
Sportsman
Rooster
Champion
Sweet Menthol
Embassy
Crown Bird
Score
Rocket
Others
Consumption (Billions)
Rothmans
Dunhill KS Box
Dunhill KS Box 14’s
Dunhill KS Box 7’s
P. Stuyvesant KS
Perilly KS Box
Perilly KS Box 25’s
Perilly 100’s Box
Virginia Gold KS Box
Japan Tobacco/R.J. Reynolds
Salem KS Menthol
Winston KS Box
Salem KS Menthol 14’s
Salem Lights KS Menthol
Salem KS Menthol 7’s
British American Tobacco (MTC)
Dunhill KS Box
Dunhill KS Box 14’s
Dunhill KS Box 7's
P. Stuyvesant KS
Perilly KS Box
Philip Morris
Marlboro KS
L&M
Consumption (Billions)
10.4
18.3
3.4
13.8
5.6
2.3
17.0
MEXICO
Clgarrera La Moderna (BAT)
Raleigh
Boots
Alas Extra
Montana
Bohemioa
Fiesta
Tabacalera Mexicana
(Philip Morris)
Marlboro (LFCHL)
L&M
Benson & Hedges
Cigatam
Delicados Ovalados
Faros Ovals
Broadway
Consumption (Billions)
MOROCCO
Moroccan Monopoly
Casa Sports
Marquises
Others
PMI
Marlboro
RJR
Winston
Camel
Others
Consumption (Millions)
NETHERLANDS
Philip Morris
Marlboro
Chesterfield
Philip Morris
Runner
Others
Rothmans
Caballero
Peter Stuyvesant
% of Market
1998 1999
36.1
38.9
33.9
36.5
1.3
1.5
0.7
0.7
0.1
0.1
0.2
26.1
27.3
10.2
9.9
6.8
6.5
International Part 1
Pall Mall
Dunhill
Tivoli
British American Tobacco
Barclay
Gladstone
Belinda
Mantano
Lucky Strike
RJR
Camel
Others
Reemtsma
West
Davidoff
Others
Others
Consumption (Billions)
PORTUGAL
Philip Morris
SG
Marlboro
L&M
Portugues
Chesterfield
Rothmans
Golden American
Others
RJ Reynolds
Camel
Winston
British American Tobacco
Pall Mall
Others
Others
Consumption (Billions)
PANAMA
NICARAGUA
British American Tobacco
Belmont
Delta
Casino
Windsor
Philip Morris
Diplomat
Marlboro
Consumption (Billions)
NIGERIA
Nigeria Tobacco Company (BAT)
Three Rings
Sweet Menthol
Gold Leaf
High Society
L&B
Excel
Philip Morris International
Link
Green Spot
Target
Consumption (Billions)
% of Market
1998 1999
98.1
98.6
43.1
42.0
26.0
33.2
18.1
27.1
3.5
3.2
1.9
1.4
0.5
1.2
0.7
0.9
% of Market
1998
1999
Tabacalera Istmena S.A. (BAT) 63.3
70.0
Lucky
21.1
14.9
Viceroy
20.3
27.1
Kool
15.7
23.3
Record
2.5
Imperial
2.5
Tabacalera Nacional S.A. (PMI) 36.7
Marlboro
24.3
L&M
8.0
Mentolados
4.2
Others
0.2
Consumption (Millions)
607.6 833.0
PUERTO RICO
Japan Tobacco/RJ Reynolds
Philip Morris
Lorillard
Brown & Williamson
Consumption (Billions)
% ol Market
1998 1999
44.7
43.3
32.2
31.8
17.6
20.6
5.5
4.3
2.9
2.9
International Part 1
SPAIN
% ol Market
1998 1999
49.7
49.2
Tabacalera S.A.
16 6
18.3
Ducados FF Soft
18.0
19/1
Fortuna Red Soft
3.1
2.4
Nobel Box
1.6
1.4
Deltas F 85’s
1 6
1.4
Ducados FF Box
<6
1.3
BN Box
09
1.1
Ducados LTN
OJ)
0.9
Habanos Soft
0.9
1.0
Fortuna KS Box
28.7
28.7
Philip Morris
11.0
10.4
Marlboro Red Box
6.8
5.9
Chesterfield Box
5.0
5.1
L&M
2.8
4.5
L&M Lights
1.6
1.5
Marlboro Lt Box
0.3
0.3
Marlboro Red KS
8.9
8.2
Japan Tobacco/R.J. Reynolds
3.4
3.3
Winston Red Box
2.4
2.3
Camel Box
1.7
1.3
Gold Coast
0.4
0.3
Gold Coast Lights
6.2
5.1
British American Tobacco
3.4
3.3
Lucky Strike FF FTB
1.0
Golden America
0.5
0.4
Pall Mall KS
0.4
0.4
Royal Crown FF
3.9
3.7
CITA
0.5
0.7
Coronas KS Box
0.4
0.5
Reales KS
1.3
Rothmans
Golden American Classic KS Box 0.7
Golden American Classic Lights
0.3
KS Box
1.3
Imperial
1.7
0.8
JPS Am. Blend KS Box
0.7
0.6
0.9
Reemtsma
0.6
West KS Box
0.3
0.5
0.8
GTSA/Gallaher
0.1
0.1
Silk Cut
Seita
0.4
0.1
Brooklyn KS Box
0.1
0.1
CINTA
86.9
86.7
Consumption (Billions)
SRI LANKA
British American Tobacco
Bristol
Gold Leaf
Capstan
Others
Others
Consumption (Billions)
% of Market
1998 1999
99.8
99.8
65.5
61.5
32.9
37.1
1.5
1.3
0.1
0.1
0.2
0.2
5.2
5.0
SWITZERLAND
THAILAND
British American Tobacco
Philip Morris
R.J. Reynolds
Rothmans
JTI
TTM (Taiwan)
Consumption (Billions)
% ol Market
1998 1999
0.7
1.2
3.1
7.5
1.4
2.9
0.2
0.1
0.2
0.3
94.4
87.0
48.0
38.5
% of Market
F.T.R. (Philip Morris)
Marlboro Range
Philip Morris Range
Muratti Range
Brunette Range
F.J. Burrus SA
Parisienne Range
Select Range
Gauloises Range
Gitanes Range
British American Tobacco
(Suisse) SA
Parisienne Range
Barclay Range
Select Range
Mary Long Range
Japan Tobacco/RJR
SA Dagmersellen
Camel Range
Others
Sullana
Dunhill Range
Stuyvesant Range
Consumption (Billions)
TAIWAN
British American Tobacco
Philip Morris
R.J. Reynolds
Reemtsma
Rothmans
JTI
TTWMB (Taiwan)
Others
Consumption (Billions)
% of Market
1998 1999
68.9
70.4
Turkish State Monopoly
25.5
31.2
Tekel
19.8
17.7
Maltepe
18.3
17.5
Samsun
1.1
1.4
Ballica
1.8
1.2
Birinci
23.6
22.6
PMI
15.4
15.1
Marlboro
5.1
5.3
Parliament
3.0
1.5
L&M
7.5
7.0
Japan Tobacco/R.J. Reynolds
3.0
3.0
Monte Carlo
2.0
2.9
Winston
1.5
0.9
Camel
108.9 114.4
Consumption (Billions)
VENEZUELA
% ol Market
1998 1999
Sues. (British American Tobacco) 84.5
81.2
Belmont
50.8
49.4
Consul
32.9
31.0
Tabacalera National
(Catana) (PM)
15.5
18.8
Astor
10.0
14.5
Marlboro
5.1
4.1
Fortuna Filter
0.3
0.2
Consumption (Billions)
9.0
10.6
D-ty 2001
$*i*oltt.: Idl'i Q£ma.
th f\‘^
Second-hand smoke is a real and significant threat to public health. Supported by two decades of evidence,
the scientific community now agrees that there is no safe level of exposure to second-hand smoke.
Second-hand smoking has been causally associated with a range of life-threatening health effects,
including lung cancer and heart disease. For children, the situation is particularly disturbing, as
involuntary exposure to tobacco smoke has been identified as a cause of respiratory disease, middle ear
disease, asthma attacks, and sudden infant death syndrome (SIDS). Tobacco smoke is also an important
source of indoor air pollution, contributing to a noxious environment, and causing eye irritation, sore
throat, cough, and headache.
The evidence is in, let us act on it.
QJLlM. 1&Z
VM-d. ’tcJjACCH
The tobacco industry has two faces: what it admits in private, and what it denies in public. Despite decades
of scientific evidence that second-hand smoke is toxic, and despite confirmation by the industry’s own
scientists, the industry has been publicly denying that second-hand smoke causes death and disease. In
private though, the industry has identified second-hand smoke as a crucial battleground, one that could
threaten the viability of the industry itself. A secret study commissioned by the industry in 1978 concluded
that:
“What the smoker does to himself may be his business, but what the smoker does to the non-smoker is a
different matter...This we see as the most dangerous development yet to the viability of the tobacco
industry that has yet occurred," Roper Organization, 1978.
As part of its corporate strategy, the industry has consistently fought regulations and legislation that could
protect people from second-hand smoke. It has spent millions of dollars hiring lobbyists, attacking
legitimate scientific research, buying scientists, producing bogus studies, and creating controversy about
second-hand smoke.
A 1988 memo from a joint meeting of several tobacco companies confirmed that:
“[Philip Morris' world wide strategy is to] co-ordinate and pay so many scientists on an international
basis to keep the environmental tobacco smoke controversy alive. ”
We know their strategy, let us counter it.
(fOA. VJo'itd. N&ldte&o D*y
Pi^lici^c,
The World Health Organization and its partners have a responsibility to ensure that the truth about second
hand smoke emerges loud and clear. We have a responsibility to promote public health and protect people
from second-hand smoke.
We need to create a climate where second-hand smoke is recognized as an issue of major importance,
particularly among policy-makers, media, and local government officials. Mass media campaigns,
educational programmes, and partnerships with key organizations, including nongovernmental
organizations, the private sector and UN agencies, should be initiated. We need to stimulate policies and
programmes to tackle the problem with the seriousness it deserves. Smoke-free environments in public
places, workplaces, and homes through a combination of legislation and education should be promoted.
it
Reject
WNTD is organized by WHO and actions will be taken on a global level, but the key to a successful and
sustainable campaign will be local mobilization around the issue. Work with your local women’s
organizations, children's advocacy groups, business associations, trade unions, consumer groups or local
governments to initiate action on second-hand smoke. Pick an approach that is most appropriate to your
region and start planning your projects now.
Because local policies play a major role in determining public health, WHO is urging mayors of cities all
over the world to launch "Clear the Air" campaigns on tobacco and the persistent problem of second-hand
smoke.
Mayors of the cities that launch the most successful campaigns to “Clear the Air” will receive international
recognition, and wi 11 be the guests of honour at a special World No-Tobacco Day celebration to be held on
31 May 2001 in Montreal, Canada. At this celebration, WHO’s Director-General. Dr Gro Harlem
Brundtland, will present honoured mayors with special prizes for their achievements.
Even though passive smoking has been chosen as the theme for the 2001 World No-Tobacco Day
campaign, tobacco control is an ongoing process, and mayors are urged to begin their campaigns
immediately to ensure sustained results. Help your city and mayor shape the focus of the campaign on
second-hand smoke. Make your voice heard on what is appropriate for your city, whether it is an
implementation of bans on smoking in workplaces, restaurants, schools, hospitals, airports, government
buildings, or even a smoke-free city hall or legislature.
Mdu.
WHO’s 191-Member States will begin negotiations in October 2000 on the Framework Convention for
Tobacco Control, (FCTC), the world's first legally binding health treaty. The convention will provide
global protection for countries and people against the enormous health and social costs of tobacco-related
death and disease.
Local actions taken by you and your organization to protect people from second-hand smoke are an
essential complement to the international negotiations on the FCTC.
Throughout the year, WHO will be offering regular updates on the “Clear the Air” campaign as well
important information on second-hand smoke and clean air regulations through its website:
http://tobacco.who.int. For further information and registration for the “Clear the Air” competition, please
contact the Tobacco Free Initiative, WHO, tfi@who.int, tel: 4122 791 2108, fax: 4122 791 4832.
The Framework Convention
on Tobatto Control
A Primer
The FCK is no ordinary convention.
It is potentially a Public Health
Movement
World Health Organization
Tobacco Free Initiative
2 WHO Framework Convention on Tobacco Control
The spectacular rise anil spread of tobacco consumption around the world is a challenge and
an opportunity for the World Health Organization. The challenge comes in seeking global soltt\ tions for a problem that cuts across national boundaries, cultures, societies and socio-economic
strata. The unique and massive public health impact of tobacco provides WHO an opportunity
to propose to the world a first comprehensive response to deal with the silent epidemic.as the
tobacco menace has often been called.
On 24 May 1999, the World Health Assembly (WHA), the governing body of the World Health
Organization (WHO), paved the way for multilateral negotiations to begin on a set of rules and
regulations that will govern the global rise and spread of tobacco and tobacco products in the
next century. The 191-member WHA unanimously backed a resolution calling for work to
begin on the Framework Convention on Tobacco Control (FCTC) - a neyv legal instrument that
could address issues as diverse as tobacco advertising and promotion, agricultural diversifica
tion, smuggling, taxes and subsidies. A record 50 nations took the floor to pledge financial and
political support for the Convention. The list included the five permanent members of the
United Nations Security Council, major tobacco growers and exporters as well as several coun
tries in the developing and developed world which face the brunt of the tobacco industry’s mar
keting and promotion pitch. The European Union and 5 NGOs also made statements in sup
port of the Convention and the Director-General’s leadership in global tobacco control.
The Working Group on the WHO Framework Convention on Tobacco Control held its second
andfinal meeting in Geneva, Switzerlandfrom 27 to 29 March 2000. The tyvo meetings of the
yvorking group yvere attended by participants from a yvide range ofsectors and included repre
sentatives from 153 Member States (representing 95% of the yvorld’s population) and the
\ European Community, as yvell as observers from the Holy See, Palestine, organizations of the
United Nations system, other intergovernmental organizations and nongovernmental organiza
tions.
In May 2000, the World Health Assembly unanimously adopted a resolution yvhich formally
' launched the political negotiations yvhich will commence on 16 October 2000 in Geneva,
Syvitzerland. Resolution WHA 53.16 calls on the Negotiating Body to commence its negotiations
yvith an initialfocus on the draft Framework Convention without prejudice to future discus, sions on possible related protocols.
j In March 2000, WHO Director-General Gro Harlem Brundtland calledfor public hearings on
■ issues surrounding the Frameyvork Convention. The tyvo-day hearings in Geneva — the first
such hearings in WHO history - yvill take place 12-13 October 2000. The hearings yvill give
I the public health community, and also the tobacco industry andfarmers, their opportunity to
make their case before the public. All submissions yvill be made part of the public record as yvell
i as being made available to countries negotiating the FCTC.
he FCTC’s benefits to countries are many.
The most significant one is that with the
Convention as a pathfinder and coordination
vehicle, national public health policies,
tailored around national needs, can be
advanced without the risk of being undone by
! transnational phenomena (e.g. smuggling).
| While framework conventions obligate States
T
to cooperate in key areas, the process also
serves to forge important links between coun
tries and other potential partners. Countries
can participate in the central framework while
still deferring a decision on whether to partici
pate in protocols.
WHO Framework Convention on Tobacco Control 3
Framework Convention on
Tobacto Control (FCTC) 4 Primer
1.
What is the FCTC?
The Framework Convention on Tobacco
Control (FCTC) will be an international legal
instrument that will circumscribe the global
spread of tobacco and tobacco products. This
is the first time that the WHO has activated
Article 19 of its constitution, which allows the
Organization to develop and adopt such a
Convention. In fact, the FCTC negotiations
and the adoption of the Convention should
be seen as a process and a product in service
of public health.
This instrument will be developed by WHO’s
191 Member States so that their concerns are
adequately reflected throughout the process.
The framework convention/protocol approach
will allow Member States to proceed with the
process of crafting this piece of international
legislation in incremental stages:
♦ The Framework Convention will establish
the legal parameters and structures of the
public health tool. It’s a little like laying the
foundation of a building.
♦ The Protocols will be separate agreements
that will make up the substantive part of the
agreement - building on the foundation.
2.
When will it be completed?
World Health Assembly Resolution WHA
52.18 maps out a process for developing the
■ WHO FCTC and possible related protocols.
| This Resolution, which was adopted
• 1 Reference is made to the “Convention on the
I prohibition and restrictions on the use of certain
! conventional Weapons which may be deemed to be
■ excessively injurious or have indiscriminate effects ”
(1980).
unanimously by the World Health Assembly in
May 1999, foresees the adoption of the
Framework Convention and possible related
protocols by the World Health Assembly no
later than May 2003. It is likely that the
Framework Convention itself could be adopted
much earlier than this. Each negotiating
process is unique and has its own momentum.
The FCTC can be completed earlier if WHO’s
Member States so decide. Much depends on
political will and a sustained commitment to
the cause of public health. One option would
be to negotiate one or more protocols
simultaneously with the Framework
Convention.
In one case, for example, three Protocols were
negotiated along with the main body of the
Framework Convention.*
1
3.
How will the FCTC help
international tobacto control?
I.
The FCTC and related protocols will
improve transnational tobacco control and
cooperation through the following
avenues:
♦ The guiding principles of the Convention
could encompass both national and
transnational measures making it clear that:
tobacco is an important contributor to
inequity in health in all societies; as a result
of the addictive nature and health damage
associated with tobacco use it must be
considered as a harmful commodity; the
public has a right to be fully informed about
the health consequences of using tobacco
products; and the health sector has a
leading responsibility to combat the
tobacco epidemic, but success cannot be
achieved without the full contribution of all
sectors of society.
♦ Under the Convention, State Parties would
take appropriate measures to fulfil,
through coordinated actions, the general
objectives that they had jointly agreed to.
In this respect, the FCTC could include the
following general objectives: protecting
4 WHO Framework Convention on Tobacco Control
children and adolescents from exposure to
and use of tobacco products and their
promotion; preventing and treating
tobacco dependence; promoting smokefree environments; promoting healthy
tobacco-free economies, especially
stopping smuggling; strengthening
women’s leadership role in tobacco
control; enhancing the capacity of all
Member States in tobacco control and
improving knowledge and exchange of
information at national and international
levels; and protecting vulnerable
communities, including indigenous
peoples.
♦ The protocols could include specific
obligations to address inter alia', prices,
smuggling, tax-free tobacco products,
advertising/sponsorships, Internet
advertising/trade, testing methods, package
design/labelling, environmental tobacco
smoke, protection of children and
adolesents, product regulation, cessation,
and agricultural diversification.
Unless national and transnational dimensions
of tobacco control are addressed in tandem,
even the best comprehensive national control
programs can be undone. The national and
global thrusts of the Convention are interde
pendent.
II. The process of developing and adopting
the FCTC and related protocols will also
help to; mobilize national and global
technical and financial support for
tobacco control; raise awareness among
several ministries likely to come into the
loop of global tobacco control, as well
as various sectors of society directly
concerned with the public health aspects
of tobacco; strengthen national legisla
tion and action; and mobilize NGOs and
other members of civil society in sup
port of tobacco control.
In the run-up to the adoption of the FCTC,
WHO and its Regional Offices will work
with NGOs, media and civil society in
countries to focus on tobacco in all its
dimensions.
4.
What is the difference between a
treaty, a convention, a protocol and
a resolution?
♦ A treaty is an international legal
agreement concluded between States in
written form, and governed by
international law;
♦ A convention (and also a framework
convention) is a different name for a
treaty;
♦ A protocol is also a form of treaty. It
typically supplements, clarifies, amends
or qualifies an existing international
agreement, for example, a framework
convention;
♦ A resolution is an expression of
common interest of numerous states in
specific areas of international
cooperation.
5.
Which of the above is legally
binding?
Treaties are legally binding. The framework
convention usually entails more general or
limited obligations, while the protocols in
volve more specific legal obligations.
A resolution is non-binding and does not nor
mally entail any substantive commitments of
a legal nature.
6.
In this case wouldn't a resolu
tion suffice?
A resolution is not sufficient to deal
effectively with the public health threats
associated with the tobacco trade, its
marketing, and use. Over the past 25 years,
the World Health Assembly has adopted 16
resolutions on several aspects of tobacco
control with varying degrees of success.
Some Member States have sharpened these
WHO Framework Convention onTobacco Control 5
resolutions domestically giving them more
focus and bite. This piece-meal approach,
however, is too informal to be of any major
consequence, especially for tobacco control
where the international dimension of the
problem has a direct bearing on how the issue
is addressed domestically. However,
resolutions adopted in other international fora
will undoubtedly support and act as a catalyst
for the FCTC process.
The Framework Convention is about tobacco
control in the long run. The FCTC’s principal
advantage is that it will allow the WHO and its
extended family - which includes individual
countries and individuals in countries - to reap
the public health benefits resulting from the
control of tobacco and its spread through
society. This is a legal instrument in service
of health.
7.
What are the roles of the FCTC
Working Group and the
Intergovernmental Negotiating
Body?
objectives, principles and definitions, obliga
tions, institutions, implementation mecha
nisms and law-making procedures. The
second and final Working Group meeting
took place in Geneva from,27 to 29 March
2000. The meeting allowed delegates to fur
ther contribute to the draft text of proposed
elements of the Convention. A final report on
the output from the Working Group was deli
vered to the 53rc' World Health Assembly in
May 2000, where a resolution Was passed
launching the formal political negotiations.
The first session of the Intergovernmental
Negotiating Body will be held 16-21 October
2000 in Geneva, Switzerland. The
Intergovernmental Negotiating Body which
will be open to participation by all WHO
Member States, regional economic integra
tion organizations, and observers (as speci
fied in Resolution WHA 52.18) will be char
ged with the responsibility of negotiating the
text of the Convention and possible related
protocols.
8.
World Health Assembly Resolution WHA
52.18 maps out an integrated process for
developing the FCTC and possible related
protocols with the full participation of
Member States. During the May 1999 World
Health Assembly, Member States established
both a FCTC Working Group and an
Intergovernmental Negotiating Body. The
mission of the FCTC Working Group, which
was open to participation by all WHO
Member States, regional economic integra
tion organizations and observers, was to
prepare proposed draft elements of the FCTC
and to submit a report to the Fifty-third World
Health Assembly. The first meeting of the
FCTC Working Group took place in Geneva
from 25 to 29 October 1999 during which
delegates made recommendations for
proposed draft elements of WHO’s
Framework Convention on Tobacco Control.
The Working Group proposed draft elements
covering the Convention’s preamble,
Who is going to pay for the FCTC?
The budget for the FCTC is being funded
through a combination of extra-budgetary
and WHO regular budget funds. These costs
include WHO technical support, support for
intergovernmental technical and negotiation
meetings, and support for the establishment
of FCTC national commissions to provide
support for the process within countries. In
the medium to long-term regular budget
funds will be required to ensure sustained
implementation.
In particular, developing countries will require
financial and technical assistance to partici
pate in the process of formulating the FCTC.
Resolution WHA 53.16 passed at the 53rc'
World Health Assembly in May 2000
specifically encouraged the Director-General
to facilitate developing country participation
throughout the negotiations process.
6 WHO Framework Convention on Tobacco Control
Resources will also be required during the
implementation phase. Funds will be neces
sary to help countries build capacity and par
ticipate in global and national tobacco control
activities.
9.
Will resources from on-going
tobacco control be diverted to the
FCTC process?
New extra-budgetary and regular budget funds
will need to be committed to the FCTC
process, but no previously allocated funds for
tobacco control will be diverted to support the
FCTC process. Support to the FCTC should
be seen as an integral part of supporting
national and global tobacco control. In reality,
the successful adoption of the FCTC will like
ly result in a marked increase in financial
resources for tobacco control both within
countries and at the international level. The
FCTC, when adopted, will ensure that tobacco
control is given a higher political profile. The
adoption of the FCTC represents a barometer
of success or failure in placing tobacco control
front and centre on the global stage.
The environmental movement has been suc
cessful in having numerous multilateral bind
ing agreements adopted at the international
level, and as part of some of these agreements,
for example the 1987 Montreal Protocol on
Substances that Deplete the Ozone Layer, sig
nificant financial resources have been made
available to assist developing countries.
Similarly, the FCTC could facilitate global
cooperative actions, including the flow of
additional financial resources.
10.
What will happen to economies
that depend on tobacco?
The widely held perception that tobacco
control will lead to loss of revenues is really a
perception. In reality, the numbers are heavily
in favor of moving away from tobacco
cultivation. Recent economic analyses, for
example World Bank data in "Curbing the
Epidemic - Government and the Economics of
Tobacco Control", as well as the publication,
“The Economics of Tobacco Control: Towards
an optimal policy mix", showjhatthe social
and health' cOsts of tobacco far outweigh the
direct economic benefits that may be possible
because of tobacco cultivation.
The tobacco industry relies on'the argument
that there are no real crop or other substitu
tion options. It is reasonable to assume that
consumers who stop smokingAdll reallocate
their tobacco expenditure to other goods and
services in the economy. Therefore, falling
employment in the tobacco industry will be
offset by increases in employment in other
industries. However, in the medium-term,
for countries which rely heavily on tobacco
exports (i.e. the economy is a net exporter
of tobacco), economic/ agricultural
diversification will likely entail employment
losses.
The FCTC takes a long-term view of agricul
tural diversification. The framework-protocol
approach provides for an evolutionary
approach to developing an international legal
regime for tobacco control, and thus all issues
will not need to be addressed at the same time.
Further, the need for a multilateral fund to
assist those countries which will bear the high
est adjustment cost needs to be established.
The FCTC will probably be the first instru
ment seeking global support for tobacco farm
ers.
Also, it is worth noting that if the prevalence
of tabacco use remains the same, the current
1.1 billion smokers in the world are predicted
to rise to 1.64 billion by 2025, mainly due to
population increases in developing countries.
Therefore, tobacco growing countries are
extremely unlikely (over the next several
decades) to suffer economically from any
tobacco control measures such as the FCTC.
Even if global tobacco control efforts are high
ly successful the world will likely have 1 to 1,2
billion tobacco users by 2030.
WHO Framework Convention on Tobacco Control 7
11.
Which ministries are expected to
be involved in the negotiations?
In addition to the leading role of the Ministries
of Health, Ministries of Foreign Affairs
typically take a lead role in the negotiation of
conventions/treaties. Ministries of Finance,
Environment, Labour, Justice, Foreign Trade,
Education and Agriculture will also be
expected to come into the ambit of the
negotiations at some point.
12.
Do internationally binding
conventions/treaties lead to action
and tangible results?
♦ establish review mechanisms that focus
pressure on States by holding them up to
public scrutiny;
♦ articulate legal rules that may be
enforceable in domestic courts;
♦ provide supporters within national
governments with additional leverage to
pursue the treaty’s goals.
Thus, while treaties rarely cause/a state to
immediately reverse its behaviour, they can
produce significant shifts in behaviour, both
because they change a State’s calculation of
costs and benefits, and because most states
feel that they ought to comply with their prom
ises.
Adopting an international agreement can make
a significant difference. For example:
♦ Production and consumption of substances
that deplete the stratospheric ozone layer
have declined dramatically over the last
decade, as a result of the Montreal Ozone
Protocol.
♦ The General Agreement on Tariffs and
Trade has brought down trade barriers and
promoted the expansion of international
trade.
♦ Arms control agreements have limited
nuclear weapons proliferation and have led
to a substantial reduction in the arsenals of
the nuclear powers.
13.
Can international agreements
affect the behaviour of States?
In some cases, international agreements estab
lish meaningful enforcement mechanisms,
such as the World Trade Organization’s dispute
settlement system. But even in the absence of
such mechanisms, an international agreement
can:
14.
Why should the FCTC be
developed and negotiated under the
auspices of the World Health
Organization, rather than, for
example, under the umbrella of the
United Nations?
The World Health Organization is the only
international multilateral organization that
brings together the technical and public health
expertise necessary to serve as a platform for
the negotiation and effective implementation
of the Framework Convention on Tobacco
Control. Although the United Nations also has
the legal authority to sponsor the creation of
international instruments on tobacco control,
the UN has neither the specialized
technical expertise nor the time to engage in
negotiating complex standards on tobacco con
trol, particularly if extensive negotiation of the
Convention is required.
Complex technical standards on tobacco con
trol should be established and monitored by
WHO, the primary specialized agency in pub
lic health. In WHA 49.17 Member States rec
ognized the unique capacity of WHO to serve
as a platform for the adoption of the FCTC by
calling upon the Organization to initiate the
development of the Convention.
However, in so far as the ultimate goal of glob
al tobacco control may require the regulation
of areas falling within the mandate of other
United Nations’ Bodies, the establishment of a
joint negotiating mechanism, especially with
regard to possible specialized protocols, could
be considered as an option.
IS.
What linkages will the work on
the FCTC have with other regional
/international agreements, whith
could have added value for the
FCTC?
been conducted under the WHO/UNICEF proj
ect, “Building alliances and taking action to
create a generation of tobacco-free children
and youth, supported by the United Nations
Foundatioii^In/respect to TFrs"work'fen
strengthening the role of women in global
tobacco control, possible links between the
FCTC and the United Nation’s Convention on
the Elimination Of all Forms of Discrimination
Against Women'(CEDAW), are being
considered. Links between the FCTC and
other international treaties addressing issues
such as smuggling are also being examined.
Furthermore, all efforts will be made to build
on proposed and existing regional tobacco
control agreements.
A review of the Convention on the Rights of
the Child with respect to tobacco control has
The Framework Convention on Tobacco Control
(FCTC) will be an international legal instrument
that will circumscribe the global spread of tobacco
and tobacco products. In fact, the FCTC
negotiations and the adoption of the Convention
should be seen as a process and a product in service
ofpublic health.
AN ANALYSIS OF THE ECONOMIC
IMPACT OF TOBACCO
ON THE POOR IN BANGLADESH
WORK
FORA
BETTER
BANGLADESH
DEBRA EFRQYMSON
SAIFUDDIN AHMED
Hungry for Tobacco
An analysis of the economic impact of tobacco
on the poor in Bangladesh
Debra Efroymson, MS, Regional Advisor, PATH Canada
Saifuddin Ahmed, President, Work for a Better Bangladesh, and
Coordinator, Bangladesh Anti-Tobacco Alliance
PATH Canada
Work for a Better Bangladesh
Dhaka, July 2000
Summary
Poverty in Bangladesh is widespread,
affecting half the population and causing
daily suffering to tens of millions of people.
National development is slowed by the poor
health of the population: UNICEF estimates
that Bangladesh loses the equivalent of more
than 5% of its GNP in lost lives, disability,
and productivity caused by malnutrition.
Tobacco consumption further aggravates
poverty both on the individual, and national
level, and tobacco control policies are
imperative to improve the life of the poor and
the economic development of the nation.
A reduction in tobacco consumption in
Bangladesh would lead to several significant
gains as people switched from purchasing
tobacco to other goods. If tobacco were no
longer consumed in Bangladesh, the
following economic gains would be
anticipated:
♦ Savings in foreign exchange for import
of tobacco of over $14 million US per
year.
♦ A net increase in employment of almost
19%.
♦ Large increases in household investment
in housing, education, and health care.
♦ 10.5 million fewer people going hungry.
♦ 350 fewer deaths from malnutrition of
children under age 5 each day.
While tobacco will not disappear overnight,
its use could decline sharply if strong policies
were implemented. Significant declines in
tobacco use would translate to significant
gains for the country: more jobs, more
individual investment in basic needs, and
fewer children needlessly going hungry and
dying of malnutrition.
Contributors
The research with rickshaw pullers and poor
families discussed in this paper was carried
out by a team of Work for a Better
Bangladesh (WBB) researchers:
Syed
Mahbubul Alam, Amit Ranjan Dey, Ronjit
Saha-, Biplob Dhar, Aminul Islam Sujon,
Kayum Uddin Ahmed, and Aliur Rahman,
with further assistance from Apaur Ahamed.
Acknowledgments
The authors would like to thank Simon
Chapman, David Sweanor, Sian FitzGerald,
Flora Tanudyaya and Stephen Hamann for
their comments and encouragement.
Contents
Section 1
Bangladesh, land of poverty and tobacco......................................................4
Section 2
Tobacco and the national economy............................................................... 7
Section 3
Survey of Dhaka rickshaw pullers................................................................ 10
Section 4
Expenditure on tobacco versus basic needs.................................................. 11
Section 5
Expenditure on tobacco versus food............................................................. 17
Section 6
Trends in consumption of tobacco versus food and other basic needs....... 22
Section 7
Tobacco and malnutrition............................................................................. 27
Section 8
Conclusions and BATA Recommendations................................................... 30
Section 1
Bangladesh, land of poverty and tobacco
Sophisticated cigarette advertising and dire poverty: are cigarettes ads meant to offer people a false hope
of freedom from the daily struggles of life?
ads. British American Tobacco (BAT), which
owns the controlling share of Bangladesh’s
former tobacco monopoly, is a ubiquitous
presence through its glossy media advertising,
cigarette display cases, storefront signs, and of
course cigarettes. In 1998, BAT reported pre-tax
profits of 771.4 million taka (approximately
U$15.4 million), while it spent 167 million taka
(US$3.34 million) on brand promotions and
development.5
Bangladesh, with a population of about 130
million people, is one of the poorest countries in
the world. While life expectancy has increased
over the past decade, it is still only 60.5 for
women and 60.7 for men. As shown in Table 1,
nearly half the population of Bangladesh in 199596 was below the poverty line, and about half of
the poor were below the “hard core” poverty line.
While the situation has improved somewhat in
rural areas, it has actually worsened in urban
areas.
Most households spend less than 4,0001
23taka each
month? Thirty percent of families are classified
as very poor, 22% as poor, and less than 1% as
rich." While the government and many NGOs are
looking for solutions to the problems of hungry
and poverty, the problem remains: day after day,
millions of Bangladeshis do not get sufficient
food for their daily needs. Their troubles are
compounded by their lack of resources for
adequate housing, education, and health care. For
the half of the population that is poor, little hope
exists for a better future, a future in which
children will be adequately fed, clothed, housed,
and educated.
Chart 1. Distribution of
households by monthly
expenditure (in taka), 1998
a<1000
■ 1000-2000
□ 2001-3000
□ 3001-4000
■ 4001-5000
□ 5001-6000
■ 6001-7000
□ 7001-8000
■ 8001 +
BAT heavily markets its expensive brands
through campaigns utilizing images of wealth and
sophistication. These have included a contest to
win gold coins, and the sailing of a luxury yacht
under the name “Voyage of Discovery”, to
promote its John Player Gold Leaf brand. Gold
Leaf, at about U$0.76 a pack for regular and
$0.94 for light, suggests wealth from its very
name. Cheap but colorful signs promoting Gold
Leaf cigarettes are displayed all over Bangladesh,
even on village stores built only of tin and thatch.
Co-existing with this devastating poverty is a
thriving tobacco industry. The use of chewing
tobacco, bidis, and cigarettes is widespread.
About 15 local companies compete for the lower
end of the cigarette market, utilizing billboards,
banners, and newspaper and satellite television
1 Bangladesh Bureau of Statistics,
Statistical Pocketbook Bangladesh 1998. Dhaka: 1999, p. 157.
Figures are for 1998, the latest year given.
"The current exchange rate is about US 1.00=50 taka.
3 Bangladesh Bureau of Statistics, Analysis of Basic Needs
Dimension of Poverty Volume III. Dhaka: 1998, p. 92.
Bangladesh Bureau of Statistics, Analysis of Basic Needs
Dimension of Poverty Volume 1. Dhaka: 1995, p. ix.
’British American Tobacco Bangladesh, Reports & Accounts 1998.
4
Chart 2. Percentage of rural
population living in poverty
Chart 3. Percentage of rural
population living in poverty
Table 1. Number and proportion of population below recommended calorie intake and "hard core" poverty lines by
residence, 1995-96.6
Poverty line I: recommended intake
Poverty line II: "Hard core" poverty
(2122 calories/day/person)
(1805 calories/day/person)
Rural
Year
Urban
%
1991-92
Absolute
number
(millions)
6.8
1995-96
9.6
%
Urban
Rural
Absolute
number
(millions)
26.5
28.3
23.9
24.6
46.7
Absolute
number
(millions)
44.8
47.8
Absolute %
number
(millions)
3.8
26.2
49.7
45.7
47.1
5.2
Bangladesh Bureau of Statistics, Statistical Pocketbook Bangladesh J998. Dhaka : 1999, p. 391
5
27.3
%
Chart 4. Distribution of families by poverty classification,1995
□ very poor
□ poor
□ lower middle class
□ higher middle class
□ rich
But irony is appropriate here, since the false hope
of wealth, and the unnecessary expenditure on
tobacco that results, may remove any hope the
poor had of a better life.
BAT’s other high-priced brand, Benson &
Hedges, at about U$ 1.50 per pack, is even more
expensive than Gold Leaf, and also capitalizes on
the image of wealth, from the gold color of the
pack to the slogan “Be gold” on billboards in
major cities. The use of the image of wealth in
promoting cigarettes is particularly ironic given
that in most countries around the world, the poor
smoke far more than the rich.
6.
Section 2
Tobacco and the national economy
Millions of dollars lost in a negative balance of trade, huge potential increases in employment if
other goods replaced tobacco: is tobacco control a case where health and economic objectives
converge?
Tobacco companies argue that tobacco benefits
national economies and individuals employed in
the industry. Others argue that tobacco, far from
benefiting economies, represents a net drain, and
constitutes a further burden on the poor.’
tobacco: over 996 million taka (U$ 19.93 million)
worth for the same fiscal year.’
The tobacco industry is currently seen by the
Bangladeshi government, as well as those who
believe the advertising, as a source of wealth.
The mayor of Chittagong, Mohiuddin
Chowdhury, attended a celebration when the
Voyage of Discovery reached his city; according
to one newspaper account, he said that “although
cigarette smoking is injurious to health, he
welcomed the yacht as foreign investment was
welcome to Bangladesh.”8
Rather than making money exporting tobacco,
Bangladesh continues to lose huge sums of hard
capital through its import.
Thus in one year, Bangladesh incurred a net
loss of 726 million taka (over U$14.4 million),
from a negative balance of trade in tobacco.
Charts. Import vs export of
tobacco, in millions of US dollars
□ Imports
I ■ Exports
Following are the major arguments that tobacco
companies put forth to support their claim that
tobacco is economically beneficial, and an
analysis of those arguments for Bangladesh.
Generation of foreign exchange through
export
Generation of revenue through taxation
BAT is a major taxpayer in Bangladesh. But an
increase in taxes would actually mean an increase
in government revenue, as not enough people
would quit to offset the gains from a higher tax
level. A tax increase would have a huge
beneficial effect, as youth and the poor are also
the most sensitive to price increases. A portion of
the tax could be used for smuggling control
measures, such as tax-paid markings that can’t be
counterfeited, and stronger police control of
smuggling.
Other measures, such as
Bangladesh produces and exports tobacco,
thereby generating much-needed foreign
exchange. The earnings for the fiscal year July
1997 to June 1998 were over 270 million taka
(U$5.4 million). But as the smoking rates in
Bangladesh are high and locally-produced
tobacco is insufficient to meet the demands of
the population, Bangladesh also imports
'Mary Assunta, “Tobacco and Poverty” in Together Against
Tobacco, Proceedings of the INGCAT International NGO
Mobilisation Meeting, Geneva,
15-16 May 1999, pp. 25-29.
^Enamul Huq, “Arrival of Discovery celebrated.”
Bangladesh Bureau of Statistics, Foreign Trade Staistics of
Bangladesh 1997-1998. Dhaka: 1998, p. 28 (exports) and pp. 276-7
(imports).
The Independent, 23 November 1999.
7
Even if tobacco use were to decline sharply, the
economy would not suffer. When people stop
consuming tobacco, their savings do not
disappear from the economy. Rather, they spend
the money on other items, items that involve labor
in their production, transportation, and sale.
When their money is spent on locally-produced
items, it can actually have a greater beneficial
effect on the economy than if it were spent on
tobacco.12
stronger penalties for smugglers, and better
international control of the flow of cigarettes,
would reduce smuggling while maintaining
government profits and health objectives.1011
Creation of jobs for farmers, factory workers,
shopkeepers, and others
Tobacco company executives argue that if people
stop consuming tobacco, huge numbers of people
will lose their jobs. They fail to mention that
cigarette manufacturing grows ever more
mechanized, and thus hires ever few people, over
the years. In their list of those likely to be
affected, they neglect to mention firefighters,
doctors specializing in cancer, heart disease, and
respiratory ailments; and other health care
workers. They also imply that the money
currently spent on tobacco, and the jobs that are
thereby generated, will entirely disappear from
the economy if tobacco use ceases.11
Tobacco is not a major agricultural crop in
Bangladesh, and thus decreasing production
would not be likely to affect many people,
particularly given the economic viability of
alternate crops.13 Not only could farmers grow
other crops, but factory workers could also
produce other goods, and shopkeepers and
informal vendors sell those crops and goods.
Those goods include food, the purchase of which
would have beneficial effects well beyond
employment. Planting of more trees to supply an
increasing demand for fruit would benefit the
environment. The production, distribution, and
sale of food and other other items, create jobs.
Food production remains far less mechanized
than does cigarette production, and thus has the
potential to employ more people.
More
consumption of food and less of tobacco would
mean a huge shift from illness to health.
In fact, tobacco consumption will not disappear
overnight, nor is it likely to diminish rapidly.
Even a decline in the percentage of smokers of a
few percent a year would be offset by population
growth, so that large changes in the quantity of
tobacco consumed are unlikely for any time in the
next couple of decades—giving people sufficient
time to readjust and find new sources of income.
Individuals currently employed in the tobacco
industry are thus unlikely to be harmed by any
decrease in consumption.
The World Bank has estimated that the extent
of this benefit for Bangladesh would be
enormous: an 18.7% increase in employment
if all domestic14 tobacco consumption in
Bangladesh ceased, as people switched to
buying other goods that in turn generate
A recent report by the World Bank examines a
range of economic issues in arriving at its
conclusion that tobacco control benefits national
economies. According to the report, tobacco only
benefits the economies of the handful of countries
currently highly dependent on tobacco export.
Bangladesh, as the numbers show, is not one of
those countries.
jobs.15 What is unique about tobacco is not its
ability to generate employment, but rather its
ability to kill its users.
Muzaffer Ahmad, “Tobacco and the Economy of Bangladesh.”
Bangladesh Cancer Society: Key note speech delivered on the occasion
yj World No Tobacco Day, 31 May 1995.
While tobacco is imported for local production, virtually all cigarettes
y^nsumed are “domestic”—made in Bangladesh, albeit often by BAT.
Prabhat Jha and Frank J. Chaloupka, Curbing the epidemic:
governments and the economics of tobacco control. World Bank: 1999,
p. 70.
10Luk Joosens and Martin Raw, “Cigarette smuggling in Europe:
who really benefits?” Tobacco Control 1998; 7:66-71.
11 Kenneth E. Warner and George A. Fulton, “Importance of tobacco to
a country's economy: an appraisal of the tobacco industry’s economic
argument” Tobacco Control 1995; Vol. 4, pp. 180-183.
8
What is the value of health?
The third leading cause of death in Bangladesh,
after diarrhea and all types of heart and
cardiovascular disease, is asthma18. Since 72% of
households in Bangladesh have only one or two
rooms19, in most households many people must
share each room. If one person smokes, several
people, including infants, young children and
women, are likely to inhale that smoke. Given the
high mortality from asthma, we see just one more
way in which tobacco kills. Tobacco is also a
major cause of heart and cardiovascular disease,
thereby contributing to the second leading cause
of death as well.
Even if one believed that tobacco was beneficial
to the Bangladesh economy, would the economics
override the tremendous health concerns of
tobacco use? Even several tobacco company
executives—under the pressure of lawsuits and
release of formerly private documents—now
admit some of the dangers of tobacco
consumption.
A Canadian tobacco executive acknowledged,
“You increase the risks for a list of diseases as
long as both your arms if you are a smoker.”16 A
manager for British American Tobacco in New
Zealand was equally direct: “You would really
have to be sticking your head in the sand to deny
[the health risks from smoking]. The evidence is
very convincing. If you are going to smoke you
are really going to increase your risk of lung
cancer, emphysema or heart disease.”17
Tobacco is clearly harmful, to smokers and nonsmokers, to individuals and to the nation, in both
the short- and long-term. This report focuses on
the economic aspect of tobacco at the household
level, as each taka spent on tobacco represents
one taka that could have been spent on food and
other household necessities. What sounds benign
at the level of one taka is no longer so when one
considers actual tobacco expenses, and multiplies
those expenses across the huge number of
impoverished tobacco users.
The list of tobacco-related diseases is long
indeed, and includes not just lung, but many other
kinds of cancer as well as other ailments, for a
total of twenty-five different diseases. Passive
smoking—the inhalation of the tobacco smoke of
others—causes lung and breast cancer and heart
disease, as well as exacerbating asthma, in nonsmokers. Fetuses exposed to smoke in the womb
run higher risks of being bom underweight,
having mental, physical, and psychological
development problems, and being miscarried or
stillborn. Tobacco smoke is a major cause of
Sudden Infant Death Syndrome (SIDS). Would
these diseases become tolerable if tobacco were
perceived as economically beneficial?
16 Robert Parker, president of the Canadian Tobacco Manufacturers’
Council, quoted in the Edmonton Sun, 23 April 2000.
'^Bangladesh
17Vickie Curtis, corporate and regulatory affairs manager for British
Bureau of Statistics, Statistical Pocketbook
Bangladesh 1998. Dhaka: 1999, p. 367.
American Tobacco in New Zealand, quoted in “Listen up smokers:
life is about to get a whole lot harder”, The (NZ) evening Post/B&W
Industry Watch, 15 April 2000.
'^Bangladesh Bureau of Statistics, Analysis of Basic Needs
Dimension of Poverty Volume III. Dhaka: 1998, p. 55.
9
Section 3
Survey of Dhaka rickshaw pullers
A grueling job for men, a tough existence for their families, and yet another money-making
opportunity for the tobacco companies.
also tended to eat better than their families, so that
the high-protein foods they sometimes consumed
were less frequently consumed by their wives and
children. It was clear that, for this group of lowincome men, tobacco expenditure represented a
sizeable portion of their income, and a significant
diversion of that money from food for themselves
and their wives and children.
In order to understand the personal side of
tobacco economics, we conducted a small survey
among tobacco-using rickshaw pullers in Dhaka,
and interviewed poor families in Dhaka and in a
village near Comilla (a small city about 90km
from Dhaka). For the rickshaw pullers, a survey
form was developed and pre-tested. The
researchers received a brief training in the use of
the forms, then gathered the information over a
short period in April 2000. The families were
interviewed using an open-ended guide. The
results were then analyzed by the research team.
The stories in boxes are taken from this research.
Chart 6.
Distribution of daily tobacco
expenditure in taka
The rickshaw puller survey involved interviews
with 123 men aged 15-70, of whom 17 were
single and 106 married. Researchers asked the
men about their daily income, and their
consumption of and daily expenditures on
tobacco.
□ <3
□ 3-5
□ 6-10
□ 11 +
Half of the rickshaw pullers said they were
illiterate. More than half smoked cigarettes alone,
while some smoked bidis and a smaller number
smoked both. The most popular cigarette brands
were Navy and Star. Expenditure on tobacco
ranged from one to 35 taka per day, with an
average of eight. Fifteen of the men reported
spending less than' three taka daily on tobacco; 37
3-5 taka, 42 6-10 taka, and the remaining 29
reported spending 11 taka or more each day. For
many, tobacco represented a significant portion of
their income. The range was from 1% to 40%,
with an average of 12%20.
Slim hopes of marriage
At age 24, Korim* is already thinking about marriage.
He earns 100-120 taka per day as a rickshaw puller,
but he must also support his family. His father is
retired, and his brothers live elsewhere. Three of his
sisters are married, but the family still must find
money to marry the other two. Korim explained that
he needs about 5,000 taka to marry, a seemingly
impossible sum. Meanwhile, he smokes both bidis
and Scissors cigarettes, which cost him 8-10 taka a
day. He was astonished when we pointed out that if
he saved his tobacco money, in about a year and a
half he would be able to marry
The staple diet of the men was rice, vegetables,
and to a lesser extent fish and lentils. Men
reported eating meat, eggs, and milk rarely if
ever—weekly, twice a month, or less. The men
’ All names have been changed.
The four highest percentages were deleted from the analysis.
10
Section 4
Expenditure on tobacco versus basic needs
Per capita spending on health and education is dwarfed by the sums spent by users of tobacco.
When an addiction becomes a “basic need”, what hope remains for our future?
The poor in Bangladesh spend nearly all their
money on basic needs, and are still unable to
purchase the essentials for themselves and their
families. In a situation of dire need, every taka
wasted represents a further decline in standard of
living. But despite the tremendous poverty in
Bangladesh, smoking rates are quite high. Across
the age groups, smoking rates are much higher in
men than in women21. Rates increase with age,
though they decline dramatically after age 50 in
both men and women. Men aged 35-49 have the
highest rate, at 70.3%.
Chart 7. Smoking rates
by age and sex, 1997
80
60
40
20
0
In terms of income groups, smoking rates are
highest among the poorest, as shown in Table 2.
The highest rate, 58.2%, is among those with a
household income of less than 1,000 taka/month.
The rates decline proportionally as income
increases, with the lowest rate, 32.3%, being for
those with a monthly household income of 5,000
taka or more. Those who can least afford to
10-14 15-19 20-34 35-49
50+
Table 2. Male smoking rates by income
group23
purchase tobacco are the most likely to
consume it.
Expenditures for tobacco vary greatly depending
on the type of tobacco, with men spending far
more on tobacco than women. In 1997, tobacco
expenditure ranged from a low of almost 58 taka
a month for women smoking hukkas, to a high of
325 taka a month for men smoking cigarettes.
For both sexes, cigarettes are the most expensive
form of tobacco consumed, followed by bidis,
with hukka, pipes, and other forms the cheapest22.
Cigarettes are also by far the most widely
advertised tobacco product.
"Bangladesh Bureau of Statistics. Statistical Pocketbook
Bangladesh 1998. Dhaka: 1999, p. 366. This represents the daily
figure multiplied by 30.4.
’’Bangladesh Bureau of Statistics, Prevalence of Smoking tn
Bangladesh. Dhaka: 1996, p. 10.
Statistics on smoking prevalence do riot unfortunately clarify
whether they refer to smoking only, or to smokeless tobacco use as
well. If they do not include smokeless tobacco, then the rates shown
for women are far lower than actual rates would be.
11
Chart 8. Male smoking rates by
monthly houshold income group (taka)
□ <1000
60
■ 1000-1249
50
□ 1250-1499
40
□ 1500-1999
■ 2000-2499
30
□ 2500-2999
20
■ 3000-3999
10
□ 4000-4999
0
■ 5000+
Per capita expenditure on clothing, housing,
health, and education totals a mere 131 taka per
month, which is only 40% of the average male
monthly expenditure on cigarettes.
In Table 3, we compare average monthly
expenditures for tobacco to those for basic needs.
In 1997, average monthly expenditure on tobacco
for those who use it (an average over all types of
tobacco products) was 155 taka for men and 85
taka for women.
Table 3. Per capita monthly expenditure on basic needs, 199724
Tobacco spending as percetage of expenditure on basic needs
Average
monthly
expenditure
(taka)
Bidismen: 88
Cigarettesmen: 325
Hukkas/pipeswomen: 58
Cigaretteswomen 207
Monthly per
capita
expenditure on
tobacco: 8.7
Food
376
23.4
86.5
15.4
55.0
2.3
Clothing
36
244.9
903.6
160.4
574.2
24.2
Housing
61
144.5
533.2
94.7
338.9
14.3
Health
18
498.8
1,807.1
320.9
1,148.4
48.4
Education
16
551.0
2,033.0
361.0
1,292.0
54.5
Other
133
66.3
244.6
43.4
155.4
6.6
Total
640
13.8
50.8
9.0
32.3
1.4
Note: The second column shows the average monthly expenditure in taka for the items listed in the first column.
The next five columns show average monthly spending on various forms of tobacco for men and women as a
percentage of the average monthly expenditures for basic needs. “Total” refers to the percentage of total monthly
expenditure that each form of tobacco represents. The percentages are not additive—that is, for men smokers of
cigarettes, the full sum of 325 taka is compared to each item in column one.
"^Bangladesh Bureau of Statistics. Analysis of Basic Needs Dimension of Poverty Volume II. Dhaka: 1997, p. 108 (basic needs) and p. 130
(tobacco). Columns show rounded figures for tobacco, whereas unrounded figures were used in calculations.
12
Chart 9. Distribution of
monthly expenditure for
basic needs, 1997
Chart 10. Men's monthly bidi
costs vs. per capita monthly
expenditure for basic needs (taka)
□ Food
□ Clothing
■ Housing
□ Health
□ Education
■ Other
■ Food
■ Bidis
□ Clothing
□ Housing
■ Health
■ Education
The typical male cigarette smoker spends over
5 times as much on cigarettes as the per capita
expenditure on housing, 18 times as much as
for health, and 20 times as much as for
education. For women, the figures are only
Since the figure for per capita expenditure on
tobacco is an average over the whole population,
not just for those who use tobacco, it seems quite
low, at less than nine taka per month. But even
that figure is significant when compared to other
per capita expenditures. The average monthly
slightly less striking; women who smoke hukkas
spend almost as much on tobacco as the per capita
expenditure for housing, and over three time as
much as the per capita expenditures for health and
education. Men spend almost 2'A times as much
per month to smoke bidis as the per capita
expenditure for clothing.
per capita expenditure on tobacco is almost
half the per capita expenditure for health, and
more than half for education.
Table 4 re-allocates average monthly tobacco
expenditure to basic needs, following the
expenditure patterns shown (e.g. 61% for food,
5.7% for clothing). This represents the way a
typical person might be expected to spend the
money otherwise going to tobacco.
Monthly per capita expenditure on food was 376
taka, less than twice what women spend on
average for cigarettes. Men spend more than
86% as much on their cigarettes as the average
per capita expenditure on food.
Chart 11. Men's monthly cigarette
costs vs per capita monthly
expenditure for basic needs (taka)
n Food
■ Cigarettes
□ Clothing
□ Rent
■ Health
■ Education
13
Table 4. Distribution of per capita monthly expenditure in 1997 on basic needs, and additional taka
available for each item if tobacco not purchased25
_____________________________________
Per capita monthly expenditure on basic needs, in taka and as percentage of total
expenditure (% given in parentheses)________________________________________________ ______________
Total
Food*
Clothing
Housing
Health
Education
Other
Rural
597
364 (61.0)
34 (5.7)
47 (7.9)
17 (2.8)
13 (2.2)
122 (20.4)
Urban
958
464 (48.4)
50 (5.2)
165 (17.2)
25 (2.6)
41 (4.3)
213 (22.2)
National
640
376 (58.8)
36 (5.6)
61(9.5)
18(2.8)
16(2.5)
133 (20.8)
Place of residence
Average
expenditure for
men***
Type of tobacco
expenditure**
Tobacco-rural
155
Tobacco-urban
155
.
Additional taka available
(tobacco/cigarette expenditure re-allocated across items)
94.5
8.8
12.2
4.4
3.4
75.1
8.1
26.7
4.0
6.6
31.7
'
34.5
Tobacco-nat’l
155
91.1
8.7
14.8
4.4
3.9
Cigarettes-rural
325
198.2
18.5
25.6
9.3
7.1
66.4
Cigarettes-urban
325
157.4
17.0
56.0
8.5
13.9
72.3
Cigarettes-nat’l
325
190.9
18.3
31.0
9.1
8.1
67.5
32.2
The allocation to food is lower than the 69% figure given above, since we are not here distinguishing by
income group.
**
“Tobacco” refers to the average across types of tobacco, while “cigarettes” refers exclusively to cigarettes.
*** Monthly total calculated as daily expense for users of tobacco from Table 13 multiplied by 30.4.
Chart 12. Per capita monthly expenditure: actual
and with men's monthly cigarette expenditures
allocated across categories (national average)
600
500
400
300
200
100
0
■ + cig
□ Actual
Food
Cloth
Rent
Educ
Hlth
14
Other
The greatest difference is in the area of greatest
expenditure: food. As an average across income
groups, people would be likely to spend from 75
to 198 additional taka per month for food, with
similar but smaller increases across other
categories. For cigarette smokers, this would
mean an average increase of over 50% in their
monthly food expenditure. Rural cigarette
smokers would have an additional 9.3 taka, or
over 50% additional money available for health
care, and an urban cigarette smoker an additional
13.9 taka, or 34% more for education (percent
increases not shown in table).
urban tobacco exp. allocated to food: 75
taka/month (additional 400 calories/day)
8,000 calories of rice = 35.2 taka
1,100 calories of greens = 6.9 taka
1,000 calories of lentils =11.1 taka
1,000 calories of oil = 7 taka
800 calories of potatoes = 7.8 taka
200 calories of fish = 5.5 taka
100 calories of bananas = 1.2 taka
Total: 12,200 calories for 74.7 taka
rural cig. exp. allocated to food: 198.2 taka/month
(additional 800 calories/day)
14,500
calories of rice = 63.8 taka
5,000 calories of lentils = 55.5 taka
1,500
Utilizing the expected allocations of tobacco
money across different expenses given in Table 4,
we now calculate what food a man living in a
rural or urban area could purchase, given the
typical spending patterns shown.26 For rural and
urban men who use tobacco, food expenditure
would be expected to increase by 94.5 and 75 taka
per month, respectively. These figures are
sufficient to purchase an additional 400
calories/day of fruit, vegetables, fish, and so on.
For rural (198.2 taka/month) and urban (157.4
taka/month) men who smoke cigarettes, food
values could easily double, to 800 calories/day of
high-nutrient foods.
calories of oil = 8.7 taka
1,000 calories of greens = 6.3 taka
650 calories of fish = 17.8 taka
600 calories of eggs = 19.6 taka
600 calories of milk = 19.9 taka
500 calories of banana = 6.1 taka
Total: 24,350 calories for 197.5 taka
urban cig. exp. allocated to food: 157.4
taka/month (additional 800 calories/day)
17,000 calories of rice = 74.8 taka
3,450 calories of lentils = 38.3 taka
1,800 calories of oil = 10.4 taka
1,100 calories of greens = 6.9 taka
350 calories of eggs = 11.4 taka
350 calories of milk =11.6 taka
300 calories of banana = 3.6 taka
Each man giving up smoking and spending his
money according to established patterns could
add 400-800 calories to his children’s diet,
while also contributing significantly more to
their health, education, clothing, housing, and
other costs.
Total: 24,350 calories for 157.1 taka
rural tob. exp. allocated to food: 94.5 taka/month
(additional 400 calories/day)
6,500
calories of rice = 28.6 taka
3,000 calories of lentils = 33.3 taka
1,000 calories of oil = 5.8 taka
900 calories of greens = 5.7 taka
200 calories of eggs = 6.5 taka
200 calories of milk = 6.6 taka
200 calories of fish = 5.5 taka
200 calories of banana = 2.4 taka
Total: 12,200 calories for 94.4 taka
“^Distribution of money, but not food prices, are differentiated for
rural and urban areas. Also, food costs arc for 1995-1996; but since
lower-cost foods than those used are available, and food prices do not
rise consistently, or vary consistently between rural and urban areas,
substitute food items would compensate for inflation and rural/urban
price differentials.
15
Although we would not label various electric
appliances as basic needs, it is interesting to
compare the price of luxury items to that of
cigarettes. Table 5 shows the percentage of
households possessing various consumer goods,
and the price of those goods in packs of BAT
cigarettes.
Who can afford an education?
Kanailal lives with his wife and two girls in a slum
in Dhaka.
His income is 2,500 to 3,500 taka a
month, of which he spends 750 to rent a house of
tin and bamboo.
He spends 70-80 taka a day on
food for his family:
mostly rice and vegetables.
Kanailal explained that his two daughters can’t go
to school, because they live in a slum and there is
Only a fourth of Bangladeshi households own a
radio, an item which could be purchased with 12
packs of Gold Leaf or 6 packs of Benson &
Hedges. Only one-tenth of households have an
electric fan, which costs the same as 29 packs of
Gold Leaf or 15 packs of B&H. For those who
aspire to various consumer goods, quitting
smoking would be one way of achieving those
goals.
nowhere to send them. Neither can he afford their
other basic needs.
Kanailal smokes bidis and
chews tobacco, spending 10-15 taka per day to
maintain his habit.
How much better would his
family live if he spent the 300-450 taka a month for
tobacco on a better home, food, or education for his
daughters?
Table 5. Price of consumer goods relative to cigarettes.
% of households
owning21
price (taka)
price in packs of
Gold Leaf regular*
price in packs
of B&H*
radio
24%
450
11.8
6.0
black and white TV
9% (includes color)
6,500
171.1
86.7
17,500
460.5
233.3
33.3
consumer item
color TV
cassette player
8%
2,500
65.8
electric fan
10%
1,100
28.9
14.7
electric iron
6%
350
9.2
4.7
refrigerator
2%
18,500
486.8
246.7
* price in packs of Gold Leaf; one pack = 38 taka
** price in packs of Benson & Hedges; one pack = 75 taka
^Bangladesh Bureau of Statistics. Analysis of Basic Needs Dimension of Poverty Volume III. Dhaka: 1998, p. 64.
16
Section 5
Expenditure on tobacco versus food
Per person, more money is spent each day on tobacco than on milk. One pack of Gold Leaf
regular cigarettes costs more than a dozen eggs.
The poorest households spend the highest
proportion of their income on food: 66-73% (see
Table 6). They are also the most likely to have
malnourished children in their household. As
spending on food increases, malnutrition
decreases.2’ Thus, they would benefit the most by
shifting their tobacco expenditures to food.
Chart 13. Percent of total
expenditures going to food by
monthly household expenditure
group, 1997
The minimum daily calorie requirement varies by
age and sex, from 1,094 for children aged three
and under, and 1,405 to children aged 4-6, to over
2,000 for adults (see Table 7). A significant
portion of those calories could come from a re
allocation of tobacco expenditures.
Table 6. Per capita monthly expenditure on food
by monthly household expenditure group29
E 0000-1999
■ 2000-4999
□ 5000-9999
□ 10,000-14,999
■ 15,000+
Table 7. Per capita daily calorie requirement
by age and sex30.
Calorie requirement
Percent of income
spent on food
Age group
Male
0000-1999
73%
0-3
1,094
1,094
2000-4999
66%
4-6
1,405
1.405
Monthly household
expenditure group
Female
5000-9999
52%
7-9
1,784
1,784
10,000-14,999
39%
10-12
2,413
2,172
15,000+
26%
13-17
2,671
2,327
Rural
61%
Urban
48%
All groups
58%
18-29
30-59
60+
2,782
2,707
2,349
2,544
2,297
2,054
^Bangladesh Bureau of Statistics, Child Nutrition Survey of
Bangladesh 1995-96. Dhaka: 1997, pp. 50-51.
"’Bangladesh Bureau of Statistics, Analysis of Basic Needs
Dimension of Poverty Volume 11. Dhaka: 1997, p. 107. Figures not
available for monthly household income group. However, for the
poor, monthly expenditure is nearly as much as monthly income.
^Bangladesh Bureau of Statistics, Analysis of Basic Needs
Dimension of Poverty Volume III. Dhaka: 1998, p. 104.
Table 8. Average daily expenditure on tobacco,
1995.32
In Bangladesh, most of the calories consumed
come from rice.3' Table 8 shows average daily
expenditures for tobacco in 1995 for men and
women who use it, by type of tobacco product,
and the number of calories from rice that each
sum could purchase.
Type of
tobacco
Average
expenditure on
Equivalent in
calories of rice”
tobacco (taka)
Male
Female
Male
Female
419
Average for
The average expenditure on tobacco for men
would purchase 721 calories of rice per day,
and for women, 419. For bidis, the figures for
all types of
men and women respectively are 372 and 302, for
hukkas, 698 and 233, and for cigarettes, 1,837
and 2,837.
tobacco
3.1
1.8
721
Bidi
1.6
1.3
372
302
Cigarettes
7.9
12.2
1,837
2,837
Hukka
3.0
1.0
698
233
men’s cigarette expenditure: 7.9 taka/day
(55.3/week):
800 additional calories/day
But people can not exist on rice alone. Nutritious
foods that are more expensive than rice, and thus
less commonly consumed, would be highly
beneficial to malnourished children or adults.
2,000 calories of lentils = 17.4 taka
1,000 calories of oil = 5.8 taka
900 calories of rice = 3.9 taka
700 calories of greens = 4.3 taka
350 calories of eggs = 11 taka
350 calories of banana = 3.8 taka
300 calories of milk = 9 taka
The money a typical male smoker spent each
day to buy cigarettes could buy an additional
800 calories of a variety of foods including
lentils, eggs and milk for his children.
Total: 5,600 calories for 55.2 taka
An additional 400 calories/day would provide
37% of the daily calorie requirement of a child
aged 3 or under. An additional 800 calories could
supplement the diets of two children. If the
money were spent on rice alone, about 87% of
one adult’s daily caloric need could be met.
men’s tobacco expenditure: 3.1 taka/day (21.7/week):
400 additional calories/day
800 calories of rice = 3.4 taka
800 calories of lentils = 7 taka
400 calories of oil = 2.3 taka
400 calories of greens = 2.5 taka
300 calories of banana = 3.2 taka
100 calories of eggs = 3.1 taka
The average daily expenditure on tobacco for
men in 1995 was just 3.1 taka, or 21.7 taka per
week. But even such a small amount was
sufficient to pay for an additional 400
calories/day from a range of nutritious foods.
Total: 2,800 calories for 21.6 taka
women’s tobacco: 1.8 taka/day (12.6/week):
200 additional calories/day
550 calories of lentils = 4.8 taka
350 calories of oil = 2 taka
200 calories of greens = 1.2 taka
100 calories of rice = 0.4 taka
100 calories of milk = 3 taka
100 calories of banana =1.1 taka
Even the smaller amount that the typical
woman spent per day on tobacco (1.8 taka) in
1995 was sufficient to add 200 calories/day of a
variety of foods to her children’s diet.
Total: 1,400 calories for 12.6 taka
Bangladesh Bureau of Statistics, Prevalence of Smoking in
Bangladesh, Dhaka: 1996, p. 12.
^The figure for rice is calculated using the price in 1995 of 4.3 taka
^Bangladesh Bureau of Statistics, Analysis of Basic Needs
for 1,000 calories of rice, Bangladesh Bureau of Statistics, Statistical
Pocketbook Bangladesh 1998. Dhaka: 1999, p. 376.
Dimension of Poverty Volume III. Dhaka: 1998, p. 10.
18
The most heavily-advertised cigarettes on
billboards and in large-circulation newspapers are
Gold Leaf and Benson & Hedges. Some of the
cheaper brands, such as Navy, are also heavily
advertised. The men shown in cigarette ads are
always strong, healthy, and well-fed. The ads
suggest that rather than harming one’s health,
cigarettes will make you stronger.
Table 9. Prices of various food items,
Dhaka, April 2000
Table 9 gives the year 2000 prices of various
foods, and Table 10 of popular brands of
cigarettes. Cigarette prices vary considerably,
from four taka for a pack of Sun Moon to 75 taka
for a pack of Benson & Hedges. By comparison,
a pack of bidis costs three taka.
Food items
Unit
Cost (taka)
Eggs
1 egg
3
Potatoes
1 kg
8
Milk
1 liter
22
Lentils
1kg
36
Beef
1kg
70
1 dozen
14
Small bananas
Dark leafy greens
Soybean oil
1kg
7
1 liter
36
1 Kg
I4-
Rice
Table 10. Prices of various cigarette brands,
Dhaka, April 2000
Even the cheap cigarettes are expensive when
compared to foods. In Table 11, we compare the
price of food to that of cigarettes. A pack of Gold
Star costs more than an egg. A pack of Navy
# of sticks
Cigarettes
costs almost as much as a liter of milk. Less
than two packs of Scissors would pay for a
kilogram of lentils. One and a half packs of
Senor Gold would purchase a dozen bananas, and
1.6 packs would buy one kilogram of rice. Less
than two packs of Navy would pay for a liter of
soybean oil.
1
2
Gold Leaf light
1
2.5
Sun Moon, Gold Star, Good Leaf
10
4
Senor Gold
10
9
Scissors, Star, Navy
20
20
Gold Leaf regular
20
38
Gold Leaf light
20
47
555
20
68
B&H
20
75
Chart 14. Year 2000 prices
of food vs cigarettes
H1 stick GL light
■ 1 egg
□ Sun Moon
□ 1 kg potatoes
■ Senor Gold
■ Navy
■ 1 liter milk
® 1 kg lentils
■ GL regular
■ 1 kg beef
□ B&H
19
price (taka)
Gold Leaf regular
Table 12 compares per capita monthly
expenditure for tobacco to that for lentils, meat,
leafy vegetables, oil/fats, and milk. Per capita
expenditure for tobacco—averaged over the
whole population, not just those who use
tobacco—is 7.9 taka/month in rural areas and
14.7 taka/month in urban areas, with a national
average of 8.7 taka/month.
As for Gold Leaf, the figures are even more
dramatic. One and a half regular cigarettes or
1.2 sticks of light would purchase an egg. Three
and a half sticks of regular would buy 1 kg of dark
leafy greens. Four sticks of regular would
purchase a kilogram of potatoes, 7 sticks would
pay for a dozen bananas or a kilogram of rice, and
11 sticks would buy a liter of milk. A pack of
Gold Leaf light could pay for 3.4 dozen small
bananas, 6.7 kg of leafy greens, 1.3 liters of
soybean oil, or 3.4 kg of rice. With 38 taka—a
few hours’ wage fora rickshaw puller—one could
buy half a kilogram of beef, five and a half
kilograms ofdark leafy greens, over a kilogram of
lentils, a dozen eggs, or one pack of John Player
Gold Leaf regular cigarettes.
70% of the cost of a packet of Star a day: 20 taka x
30.5 days*0.7 = 427 taka/month (year 2000 prices)
10,600 calories of lentils = 111.4 taka
6,300 calories of potatoes = 56.7 taka
5,600 calories of fish = 159.9 taka
1,400 calories of beef = 86 taka
500 calories of greens = 12.9 taka
Total: 24,400 calories for 426.9 taka
Where will the money come from?
For those buying cheaper tobacco, one taka for a
cigarette may sound insignificant. But when
people become addicted and begin to need several
cigarettes a day, the price quickly escalates. A
smoker of a pack a day of Star or Scissors spends
20 taka each day, or over 600 taka each month. If
he spent 70% of that money on food instead, he
could easily add 800 calories each day to his
family’s diet, in the form of lentils, potatoes, fish,
beef, and dark leafy greens.
Hasan, a rickshaw puller, estimates that he spends
about 10 taka/day on cigarettes and bidis.
When
asked if his three children ever eat eggs, he
exclaimed, “Eggs?
Where will the money come
from to buy them?” If Hasan didn’t buy tobacco,
each of his children could eat an egg a day, or other
high-quality foods, and the whole family would be
healthier as a result.
The unattainable could
become a reality for this poor rickshaw puller’s
children
Table 11. Food for cigarettes, in year 2000 prices34
Food items
Number of packs of various cigarette
brands needed to purchase each food item
# of sticks of
Food that could be
Gold Leaf needed
bought for one pack
to buy food *
of Gold Leaf
Regular
Light
Regular
Light
1 egg
0.75 pack Gold Star
1.5
1.2
12.7 eggs
1 kg potatoes
2 packs Sun Moon
4
3.2
4.8 kg
5.9 kg
1 liter milk
2.4 packs Senor Gold or 1.1 packs Navy
II
8.8
1.7 liters
2.1 liters
15.7 eggs
1 kg lentils
1.8 packs Scissors
18
14.4
1.1kg
1.3 kg
1 kg beef
3.5 packs Star or 1.03 packs B&H
35
28
0.5 kg
0.7 kg
1 dozen small bananas
1.5 packs Senor Gold or 0.7 packs Scissors
7
5.6
2.7 dozen
3.4 dozen
1 kg puishak (dark
0.7 packs Senor Gold or 1.75 packs
3.5
2.8
5.4 kg
6.7 kg
leafy green vegetable)
Good Leaf
1 liter soybean oil
4 packs Senor Gold or 1.8 packs Star
18
14.4
1.1 liters
1.3 liters
1 kg rice
3.5 packs Sun Moon or 1.6 packs Senor Gold
or 0.7 packs Scissors
7
5.6
2.7 kg
3.4 kg
♦Calculated as price/stick as sold in stores, rather than as a fraction of the pack, as many people buy cigarettes one stick at a time.
34
Prices collected at New Market, Dhaka. Food prices in rural areas would be lower.
20
Per capita monthly expenditure for tobacco is
higher in both rural and urban areas than that for
milk, and higher in urban areas than for leafy
green vegetables. People spend nearly as much in
cities for tobacco as for lentils. Nationally, for
each of the high-nutrient foods shown, tobacco
expenditures represent more than half the
expenditures for food.
Table 12. 1997 per capita monthly expenditure35
tobacco
lentils
oil/fats
leafy vege
meat
milk
taka
taka
%
taka
%
taka
%
taka
%
taka
%
rural
7.9
13.1
60.3%
12.5
62.9%
10.1
78.0%
14.7
53.6%
6.4
122.7%
urban
14.7
15.4
95.6%
26.6
55.3%
11.9
123.4%
18.2
80.6%
13.0
113.3%
national
8.7
13.4
65.3%
14.3
61.2%
10.3
84.4%
15.2
57.5%
7.2
120.6%
Note: Under each food item, the first column represents per capita monthly expenditure for that item. The second
column represents per capita tobacco expenditure as a percentage of that food item.
Chart 15. Monthly per capita expenditure on
tobacco vs food items (taka), 1997
30
25
□ Rural
■ Urban
□ National
20
15
10
5
0
Lentils
Meat
Veggies
Oil/fats
Milk
Tobacco
^Bangladesh Bureau of Statistics, Analysis of Basic Needs Dimension of Poverty Volume II. Dhaka: 1997, p. 130. As elsewhere, unrounded
figures used in calculations.
21
Section 6
Trends in consumption of tobacco versus food and other
basic needs
During the year 1992, people consumed on average 17 eggs and 100 cigarettes. Three years later,
egg consumption had dropped to 12 per person per year, while cigarettes had increased to 133.
While the average expenditures for bidis were 1.6
and 1.3 taka/day respectively for men and women
in 1995, they had risen to 2.9 and 3.3 in 1997.
Women’s expenditure on cigarettes fell from 12.2
to 6.8, while men’s rose from 7.9 to 10.7.
Expenditures for tobacco in general rose from 3.1
to 5.1 for men, and from 1.8 to 2.8 for women.
As shown in Table 1, poverty worsened in urban
areas from 1991-1996“, though it improved
slightly in rural areas. Since most of the
population lives in rural areas, this indicates a
small improvement over time in the general
population. Presumably that improvement could
have been greater, and the decline in urban areas
reduced, if people had consumed less tobacco and
more food. We believe that development gains
Meanwhile, the price of rice fell. While the
average male smoker could have purchased an
additional 1,837 calories of rice with his cigarette
money in 1995, the figure rose to 2,942 calories in
1997. The average male tobacco user in 1997
could easily have purchased 750 additional
calories each day from his tobacco money.
over the past several years have been
significantly offset by diversion of income to
tobacco.
Figures for average tobacco expenditures in 1997
are shown in Table 13. Comparing the 1997
figures for those for 1995 in Table 6 above
demonstrates that the general trend is towards
increasing expenditures for tobacco.
possible purchase for men’s 1997 tobacco expenditure:
5.1 taka/day (35.7/week):
750 additional calories/day
2750 calories of rice = 11.8 taka
1200 calories of oil = 7 taka
500 calories of lentils = 4.4 taka
500 calories of greens = 3.1 taka
300 calories of eggs = 9.4 taka
Total: 5,250 calories for 35.7 taka
Chart 16. Men's average
expenditure on tobacco (taka/day)
Chart 17. Equivalent in
rice calories of
men's tobacco expenditures
■^Figures are not available for more recent years.
22
For women smoking bidis (women are about 6
times more likely to smoke bidis than
cigarettes37), the figure tripled, from 302 calories
in 1995 to 907 in 1997. The potential in calories
of rice for the average tobacco user nearly
doubled for both men and women, from 721 and
419 respectively in 1995, to 1,402 and 770
calories in 1997.
Table 13. Average daily expenditure for tobacco and
equivalent in calories of rice, by sex and type oftobacco, 199738
Type of tobacco
Average
expenditure on
Equivalent in
calories of rice39
tobacco (taka)
Male
Female
Male
Female
5.1
2.8
1,402
770
Bidi
2.9
3.3
797
907
Cigarettes
10.7
6.8
2,942
1,869
Hukka/pipe etc.
2.6
1.9
715
522
Average for all
types of tobacco
While spending on tobacco—and the food value
of the money thus spent—increased, consumption
of many major food items decreased over several
years, as shown in Table 14.
One of the biggest increases in the period was in
cigarettes—a 33% increase over the 3-year
period. A similar increase occurred in the
consumption of cabbage (though only from 0.6
kg/person/year to 0.8) and to a lesser degree of
milk and fish, while per capita consumption of
many other items increased only slightly, or even
declined. Rice, the staple of the Bangladeshi diet,
increased by only 1% over the period, while
banana consumption dropped by six percent and
eggs by 29%.
Chart 19. Equivalents in
rice calories of women's
tobacco expenditures
(cigarettes excluded)
mi
1995
□ Average
■ Bidis
□ Hukka
1997
Chart 18. Women's average
expenditure for tobacco
(taka/day)
Bangladesh Bureau of Statistics, Statistical Pocketbook
Bangladesh 1998. Dhaka: 1999, p. 366.
39
The figure for rice is calculated using the 1997 pnee for coarse
rice, in Dhaka (the price is lower in the other cities). While it cost
4.3 taka for 1,000 calories of rice when the price per kilogram was
14.73 taka (1995/96), it would cost only 3.6 taka for the same 1.000
calories in 1996/97, as the price fell to 12.46 taka per kg. Unrounded
figure for price of rice used in calculation. Price of rice over time
from Bangladesh Bureau of Statistics, Statistical Pocketbook
Bangladesh 1998. Dhaka: 1999, p. 313.
■^Bangladesh Bureau of Statistics, Prevalence of Smoking in
Bangladesh, Dhaka: 1996, p. 12.
23
Table 14. Per capita consumption of selected food items and tobacco40
Unit
1992-93
1993-94
1994-95
1995-96
Rice
kg
151.3
151.8
154.1
153.4
% channge
1992-96
+ 1%
Potato, sweet potato
Meat
Fish
Milk
kg
14.9
3.4
8.4
8.1
15.0
4.2
9.0
8.0
15.0
14.9
3.7
10.0
10.1
+9%
+ 19%
+25%
17.0
5.2
16.0
12.0
5.0
0.7
Item
Eggs
Banana
Cabbage
Cigarettes
kg
kg
liter
no.
kg
kg
sticks
5.0
0.7
107
0.6
100
3.6
9.5
9.0
145
12.0
4.9
0.8
133
0%
-29%
-6%
+33%
+33%
Chart 20. Change in per capita consumption
of cigarettes and selected foods, 1992-96
----- Rice
----- Cigarettes
Eggs
Potato
----- Fish
----- Milk
----- Banana
----- Cabbage
Meat
^Bangladesh Bureau of Statistics, Statistical Pocketbook Bangladesh 1998. Dhaka: 1999, pp. 385.6> 38g
24
What if over the same period, cigarette
consumption had remained at 100 sticks/capita?
What if cigarettes had not been purchased at all?
Table 15 gives the equivalent in food (kg of rice
or meat, liters of milk, or number of eggs) and the
percentage of actual purchases (in parentheses)
that could have occurred in the yearly totals, if the
cigarette money had gone to that food item.
that year had gone to food, Dhaka residents
could have consumed almost 15% more meat,
14% more milk, or 79% more eggs.
Reallocating all expenditures just from the
increase in cigarette consumption to eggs would
have increased egg consumption in 1994-95 from
12 eggs per person per year to 21.5, whereas
reallocating all cigarette expenditures to eggs
would have raised the total to 42.6
eggs/person/year.
If cigarette consumption per capita in 19941995 had remained the same as in 1992-1993,
and the money that was spent on cigarettes in
♦
Table 15. Per capita consumption of various food items in Dhaka by year, and increase in quantity and
change in percentage of yearly total (in parentheses) of each food item if cigarettes not purchased41
cigarette equivalent
cigarette equivalent
cigarette equivalent
hem
Unit
93-94
7 sticks
107 sticks
94-95
45 sticks
145 sticks
95-96
33 sticks
Meat
Eg
4.2
0.1 (102%)
1.2(129%)
3.6
0.5(115%)
1.7 (147%)
3.7
0.4(110%)
1.6(142%)
Milk
litre
8.0
0.2(103%)
3.0(138%)
9.0
1.3(114%)
4.0(145%)
10.1
1.0(109%)
3.8 (138%)
Eggs
no.
16.0.
1.6(110%)
24.7 (255%)
12.0
9.5(179%)
30.6(355%)
12.0
7.0(158%)
28.1 (334%)
133 sticks
Note: Calculations use national per capita consumption of food and cigarette items, and Dhaka prices of all items. For price of
cigarettes over the period, Star was used, as the cheapest cigarette given. The price of one stick of Star was 0.7 taka throughout
the period in Dhaka, and 0.8 taka in Rajshahi. Prices are for superior quality beef and medium quality rice, as price for coarse
on (used elsewhere) is not given for Rajshahi.
Chart 21. Potential change in
annual per capita egg consumption, Dhaka
41 Per capita consumption (nationally) and prices of foods and cigarettes in Dhaka and Rajshahi from Bangladesh Bureau of Statistics,
Statistical Pocketbook Bangladesh 1998. Dhaka: 1999, pp. 313-316, p. 385.
25
As the economy of Bangladesh improves, people
cannot afford to spend their additional money on
tobacco rather than food. If the country is to show
strong gains in nutrition and health status, then
people must be encouraged to spend their money
in positive ways, and tobacco companies must not
be allowed to advertise their products freely to an
uneducated public.
Even more marked changes are seen in Rajshahi,
where over the same period cigarette prices were
higher and food prices lower than in Dhaka. In
Rajshahi, if per capita cigarette consumption
levels had remained as in 1992-93, then in 199495 people could.have consumed 20% more meat,
27% more milk, or 97% more eggs. Eliminating
cigarette consumption and spending that money
on eggs could have led to more than a
quadrupling of egg consumption per capita in
1995-96, from 12 to 49.6 eggs per person per
year.
Chart 22. Potential change in annual egg
consumption, Rajshahi
Table 16. Per capita consumption of various food items in Rajshahi by year, and increase in quantity and
percentage of yearly total (in parentheses) of each food item if cigarettes not purchased42
cigarette equivalent
Unit
93-94
7 sticks
Meat
kg
4.2
0.1 (102%)
1.6(137%)
Milk
litre
8.0
0.4(105%)
5.6(170%)
Eggs
no.
16.0
1.9(112%)
29.1 (282%)
12.0
107 sticks
cigarette equivalent
cigarette equivalent
Item
45 sticks
145 sticks
95-96
33 sticks
133 sticks
3.6
0.7 (120%)
2.3 (164%)
3.7
0.5(114%)
2.1 (157%)
9.0
2.5(127%)
8.0(189%)
10.1
11.7(197%)
37.6 (413%)
12.0
94-95
See note to Table 15.
^'Bangladesh Bureau of Statistics. Statistical Pocketbook Bangladesh 1998. Dhaka: 1999, pp. 313-316, p. 385.
26
6.8(167%)
1.7(117%)
8.7(172%) ~| 34.9(391%)
Section 7
Tobacco and malnutrition
How many millions of people would have enough to eat if the poor spent their money on food
rather than tobacco? How many thousands fewer children would die each year?
The consequences of malnutrition are manifold.
Malnutrition contributes to more than half of all
deaths of children under age five in developing
countries. For those who survive, lifelong
impairment can result, including poor physical
and mental ability, more illness, and little ability
to be economically productive.
UNICEF
estimates that Bangladesh loses the equivalent of
more than 5% of its gross national product in lost
lives, disability, and productivity caused by
malnutrition.43 Malnutrition is blamed for the
deaths of over 700 children under age 5 each day
in Bangladesh.44 In 1995-96, more than half
(59.7%) of Bangladeshi children aged 6-71
months were malnourished.45
for those with a monthly expenditure of 2,0004,999 is 66%. This averages out to over 69% of
household monthly expenditure going to food.
Nearly 78% of calories in the Bangladesh diet are
supplied by cereals, while 6% come from
vegetables, over 4% from oil, 7% from lentils,
fish, meat, fruits, and milk combined, and 4.6%
from other foods.47 We can therefore assume that
the poor would spend most of their increased food
budget on rice, while smaller numbers of calories
of less commonly consumed foods could have a
huge impact on children’s diet.
As shown above, the average male tobacco user
in 1997 could purchase 750 calories/day of
various foods with his daily tobacco expenditure,
or 1,400 calories each day if he spent the money
on rice alone. Even if he used only 69% of his
tobacco money—that is, allocated the money
previously spent on tobacco according to the
typical pattern of the poor—he could still
purchase 517 calories worth of various foods, or
over 960 calories of rice. The average female
tobacco user could purchase 770 calories of rice
with the full sum, or 530 calories with 69% of it.
Nearly twenty years ago, a researcher suggested
that if the condition of malnourished children
deteriorated “as a result of income being used for
smoking rather than for food, then each year the
prospects of survival of some 18,000 children
would be halved. Should these estimations be
anywhere near correct, the nutrition-mediated
effects of smoking, in terms of chronic
undemutrition as well as survival, are likely to be
far more important than the direct consequences
of smoking on health.”46 The situation has only
worsened since.
As we saw in Table 1, half of the poor consume
between 1805 and 2122 calories per day. For this
group, 400 additional calories or less per day
would bring them into sufficiency. For those
consuming less than 1805 calories, more than 400
additional calories are needed. In either case, the
average tobacco user could provide sufficient
calories to cross the poverty line as measured by
caloric intake. This means that each tobacco user
represents one or more people—whether the
smoker or his or her child—who is needlessly
going hungry.
As shown above in Table 6, those with a monthly
expenditure of less than 2,000 taka/month spend
73% of that money on food, whereas the figure
'■UNICEF, The Slate of the World’s Children 1998. Oxford and New
York: Oxford University Press for UNICEF, 1998, p.13.
“"Over 700 children dying everyday, claims NFB study.” The
Bangladesh Observer Saturday, April 29, 2000.
'■Bangladesh Bureau of Statistics, Child Nutrition Survey of
Bangladesh 1995-96. Dhaka: 1997, p. 26.
"Nicholas Cohen, "Smoking, Health, and Survival: Prospects in
Bangladesh." The Lancet May 16, 1981, pp. 1090-93.
47Bangladcsh Bureau of Statistics, Analysis of Basic Needs
Dimension of Poverty Volume III. Dhaka: 1998, p. 10.
27
the percent of poor women who smoke by age
group is not available, but as with men, the rates
are likely to be even higher among poorer
women.
Calculations of the number of poor smokers in
Bangladesh are shown in Tables 17 (men) and 18
(women). To calculate the number of poor males
in each age group, the figure from Table 1 of 47%
for rural poverty is used, since about 80% of the
population is rural. The actual figure would be
slightly higher, given the higher rate of poverty
among the urban population.
The figures yield a total of 9.87 million poor male
smokers and 612,000 poor female smokers aged
15 and over, for a total of over 10.48 million poor
smokers, each of whom, if they redirected 69% of
their tobacco expenditures to food, could add over
500 calories each day to their or their children’s
diet. Given increases in population, smoking, and
expenditure on tobacco, the figure for the year
2000 would likely be significantly higher.
The percentage of poor men by age group who
smoke utilizes the rates for those with a monthly
household income of less than 3,000 taka—the
category into which 40% of Bangladeshi
households, and presumably most poor families
and malnourished children, fall. The calculation
is slightly different for women, as breakdowns of
Table 17. Estimated number of poor male smokers, 1996
age
male
population
by age
group48
number below
poverty line
(previous
column*47)
15-19
20-34
35-49
50+
total
5,979,000
14,695,000
9,620,000
8,028,000
38,322,000
2,810,130
6,906,650
4,521,400
3,773,160
18,011,340
% of poor
who
smoke, by
age
group49
18.1
57.3
72.4
56.5
number of
poor smokers
(applying %
shown in
previous column)
508,165
3,958,662
3,274,247
2,131,207
9,872,281
Table 18. Estimated female population by age and smoking rates, 199650
age
population
smoking
rates (%)
number of
smokers
15-19
20-34
35-49
50+
total 15+
5,826,000
14,161,000
8,853,000
7,079,000
35,919,000
0.9
3.3
6.6
2.8
52,434
467,313
584,298
198,212
1,302,257
number of
poor smokers
(previous
column* .47)
612,060
•"Bangladesh Bureau of Statistics, Statistical Pocketbook Bangladesh 1998. Dhaka: 1999, p. 151.
"Bangladesh Bureau of Statistics, Prevalence of Smoking in Bangladesh, Dhaka: 1996, p. 10. Statistics are broken down into income
categories, with the highest income given as 5,000+. We averaged the figures for the six income categories representing less than 3,000
taka/household/month.
"Bangladesh Bureau of Statistics, Statistical Pocketbook Bangladesh 1998. Dhaka: 1999, p. 151.
28
Given that about half of those who are under the
poverty line are under the hard-cosre line of less
than 1805 calories/day, about half of those saved
from malnutrition would be saved from severe
food shortage.
I can't afford good food
for my children
Mahmud Ali is a 40-year-old rickshaw puller
living in Dhaka.
His wife, three sons, and
daughter reside in the countryside.
He sends
them money home out of his daily income of
If the poor stopped using tobacco and re
allocated their tobacco expenditures to
other items, following the typical pattern
for the poor, then in the year 2000, almost
10.5 million fewer people would be
malnourished, about half of whom had
been below the “hard-core” poverty line.
120-150 taka.
Since he has little money, his
family eats only rice and vegetables. Meanwhile,
he smokes 6-7 Star cigarettes a day, at one taka
per cigarette, and spends an additional 4-5 taka
per day on chewing tobacco, or a total of 10-12
taka/day—almost 10% of his income. Mahmud
said that he would like to quit, and spend the 300360 taka/month savings on his children.
What about deaths averted? As mentioned above,
700 children under age five are estimated to die
each day in Bangladesh from malnutrition. The
rates of smoking among the poorest are over 50%.
An additional 500 calories per day could easily be
enough to save a malnourished child from death.
We estimate that over 350 young children
per day could be saved from death by
malnutrition, if their parents redirected
some of their tobacco money to food. This
translates to 127,750 fewer deaths of
children under age 5 per year.
29
Section 8
Conclusions and BATA Recommendations
The Bangladesh Anti-Tobacco Alliance (BATA) recommends banning advertising, raising taxes,
and providing protection to non-smokers, so as to reduce the economic toll of tobacco
consumption.
More research on this issue could help define the
scale of the problem, and update the figures for
the current year. However, the evidence
presented here is already sufficient to take action.
Future research could focus on understanding the
effects of various tobacco control policies, after
they are enacted, in achieving their desired aim of
reducing tobacco use. Research could also focus
on understanding what is needed to help the
poorest to quit smoking, and in understanding
how best to reach groups in which consumption is
not declining.
The warnings merely state that tobacco harms the
health. Even if the more than half the population
that is illiterate have absorbed the message, as
research indicates they have, what do they
understand by it? While over 90% of men and
about 85% of women say that “smoking is bad for
health” (the same message as on the pack), less
than half of smokers know that smoking causes
cancer, and less than 17% of smokers know that it
causes heart disease. For other diseases, the
figure was 4.6% for male smokers and 3.2% for
female smokers.52 So much for informed choice.
Why focus on tobacco? Certainly it is not the
only way in which people waste money. Lottery
tickets, other forms of gambling, alcohol and
other drugs, and prostitution also eat into the
scarce resources of the poor, and, particularly in
the case of alcohol and prostitution, can have
other, serious effects on the health and wellbeing
of the individual and his family.
The study did not ask about addiction, but we can
only assume that the addictive nature of tobacco
is not well understood either, particularly by
young smokers. The difficulty with addiction is
that what began as a choice—though by no means
an informed one, given the lack of basic
knowledge of the harms caused by tobacco—
becomes a behavior that is difficult, often
extremely so, to stop.
What is different about tobacco? Unlike the other
items mentioned,51 tobacco is heavily advertised
in Bangladesh. The tobacco companies are given
free rein to target the poor, with no more by way
of warning than the tiny message on the side of
the pack and similarly small warnings on
billboards, newspapers, and satellite television
ads.
Tobacco is sold and consumed almost
everywhere. It is a drug of easy availability and
social acceptability. By not passing strong
legislation to control it—to make it more
expensive, to greatly reduce the number of places
in which it can be consumed, and to stop the
promotion of it—the government is seen to
condone it.
Since tobacco consumption constitutes such a
large economic burden for poor families,
shouldn’t tobacco prices be kept low, so that
people will waste less money on their habit? If
the price of anything is to be kept low, it should
’’Alcohol is only legally sold to foreigners, and is not advertised. In
other countries, certain tobacco control policies—such as high
taxation and a comprehensive ban on promotion/sponsotship__ could
be applied to alcohol as well, and thus further reduce the diversion of
income for the poor away from food to addictive drugs.
Bangladesh Bureau of Statistics, Prevalence of Smoking in '
Bangladesh, Dhaka: 1996, p. 12.
30
4
be of food, education, or other essential goods.
Low prices encourage more people to consume
tobacco. The poor rarely eat meat, because it is
expensive. Tobacco is perceived as cheap, and
users may become addicted before they discover
its actual cost. High prices discourage people
from starting and encourage others to quit. One
of the best ways to keep the young from
becoming addicted, and to help the poor to quit, is
thus to raise the price of tobacco products.
The tobacco companies argue that high taxes are
regressive; that is, that they disproportionately
target the poor. It is true that rates of tobacco use
are higher in the poor. It is also true that they can
least afford to pay more for their products.
However, a tax rise that causes the highest-priced
cigarettes to rise significantly more than the
lower-cost ones would decrease the “unfairness”
of the tax. Meanwhile, the goal of the tax is for
tobacco to become less affordable to the poor.
The young and the poor are most responsive to
price changes, and thus most likely to avoid
tobacco if the price increases. It is no service to
the poor to continue to encourage them to become
addicted on tobacco products, by allowing
advertising and maintaining a low price. When
the poor—those most likely to smoke—smoke
less, industry profits decline. That is why the
tobacco companies balk at any move that will
discourage the poor from purchasing cigarettes.
Concern about harming the poor is due to the
addictive nature of tobacco, and to the fact that it
is often the non-consumers of tobacco—the wives
and children of smokers—who suffer most when
income is diverted from their basic needs. But
since wives and children also suffer when they are
exposed to tobacco smoke, and are already
suffering due to income diversion, the solution is
not to make the product cheaper and thus
encourage people to smoke more. We have
already seen the tremendous increase in per capita
consumption of cigarettes from 1992-1996. As
living standards increase, if tobacco products
remain the same price, then they actually become
more affordable, and thus more popular, over the
years. Despite—or in fact due to—tobacco prices
remaining fairly stable in Bangladesh, per capita
expenditure on tobacco has actually increased
significantly. A tax increase would have the
effect of reducing expenditures as more people
quit, while maintaining government revenues.
A few simple measures can address any concerns
about harming the poor through raising tobacco
taxes. These include using a portion of the tax
for:
1)
Public education campaigns which target the
poorest (most of whom are illiterate), using
radio and television to communicate about
the economic as well as health effects of
tobacco consumption;
2) Offering free services to the poor to help them
quit; and
3) Subsidizing other services for the poor, such
as health or education. This could include
providing nutritional supplements to young
children and pregnant women, or subsidizing
a food that is consumed only by the poorest.
While the tobacco companies argue for the right
to smoke, we wonder who will argue for the rights
of people—children and adults—to eat. We have
shown that, among poor smokers, about 70% of
what they spend on tobacco is money they would
otherwise have spent on food. Men are far more
likely to smoke than women. Men who use
tobacco spend far more money on it than do
women. Men also purchase most of the food for
the household, and usually eat before the children
and women. It is likely that men suffer the least
from the diversion of their income to tobacco.
This is a gender issue. This is a children’s rights
issue. This is an issue of poverty, of malnutrition,
of human rights. This is an issue we cannot afford
to ignore.
We do not wish to suggest that other, underlying
causes of poverty do not need to be addressed.
Issues such as land ownership, employment, and
access to education and credit are critical in
improving the status of the poor in Bangladesh.
However, while addressing those areas, it is
important not to forget an issue that could have an
immediate and large impact on the lives of the
poor: access to significantly larger amounts of
money if tobacco consumption declined.
We strongly urge all organizations working on
child survival, health, nutrition, food security, and
poverty, to support efforts for tobacco control in
Bangladesh. We encourage them to promote both
public education and sound policies that can
result in lower consumption of tobacco, and
hence more money spent on food and other basic
needs. Bangladesh needs a healthy, educated
population in order to develop soundly. Better
nutrition and more money invested in health and
education will contribute greatly to the
development of individuals, and hence of the
nation.
While the government bears
responsibility for investment in these sectors, it
can also have a huge influence on individual
investments. Strong policies in tobacco control
would encourage individuals to shift their
expenditures from tobacco to essential goods.
What neither the government nor the
population of Bangladesh can afford is to
continue to choose tobacco over basic needs.
The health and survival of our children, and the
economic development of the nation, demand
strong action.
Policy options
Benefits
Higher taxes on all tobacco products.
Higher prices keep the poor and youth from
becoming addicted to tobacco, and help
motivate them to quit.
A portion of the tax going to support programs
on the electronic media to inform people about
the harms to economy, health, and appearance
from active and passive tobacco use.
Those who consume tobacco, and those who
are affected through exposure to tobacco
smoke, have the right to understand what
tobacco does to their and their family’s health
and economy.
A comprehensive ban on all forms of
promotion (including advertising and
sponsorship) of tobacco products.
This helps keep youth from starting to smoke,
and makes it easier for adults to quit.
Protection of non-smokers by bailing smoking
in public places (transportation, workplaces
including restaurants, universities, etc.).
Not only does this protect the health and rights
of non-smokers, but it leads to large reductions
in tobacco use
Bangladesh Anti-Tobacco Alliance (BATA)
BATA consists of fifteen member organizations active in
tobacco control. BATA's purpose is to contribute to the health
and wellbeing of all Bangladeshis by educating the public and
policymakers about the dangers of tobacco, and by helping to
strengthen the nation’s tobacco control legislation. BATA
members are committed to work to reduce the damage to
health, the environment, and both personal and national
economy that result from tobacco consumption.
Design & Fringing : IHEX Motta
Tobacco and
Developing
Countries
Millions Dying
is the
According to the World
Health Organisation,
tobacco use is set to cause an
epidemic of heart disease and
can
cer in developing countries.
Currently, 4 million people die each year
from tobacco use, but that number is set to
rise to 10 million a year by 2030. In
addition to premature death, smokers
su^Qr from an ongoing degradation of
their health due to smoking. Yet few
countries are taking concrete actions to
stem this epidemic. This is in part because
of the political and economic power of
multinational tobacco companies which
have tried to define tobacco control as
solely an issue for rich countries in order
to protect their enormous profits from the
developing world.
■
Tobacco Transnationals Target
Developing Countries
Tb^aggressive marketing tactics of the
multinational tobacco companies have
greatly contributed to the tremendous
increases in smoking in developing
countries, particularly amongst women.
These companies use their enormous
political and financial power to influence
governments and promote their products
in every comer of the globe.
The
expansion of these companies into the
developing world has meant that in the
near future it is developing countries
which will carry the majority of the
burden of disease due to tobacco use.
The Rich get Richer
and the Poor get Poorer
Currently, approximately 80% of the
world's smokers live in developing
countries where smoking rates have risen
dramatically in the past few decades. Yet
it is the poor who can least afford to waste
money on the purchase of tobacco
products. Much of the tobacco industry is
dominated by multinationals, so profits
flow from poor to rich countries. Since
most poor countries are net importers of
tobacco, precious foreign exchange is
being wasted. In addition poor countries
are less able to afford the medical and
other costs attributable to tobacco use.
A Pariah Industry
The tobacco industry has become a pariah
industry. For decades it has denied the
truth about the harmful effects of tobacco
addiction in order to protect its profits.
However whilst it has come under attack
in the courts and the parliaments of some
countries, the majority of countries have
felt powerless to restrain the industry with
effective legislation and litigation. In fact,
many continue to offer the industry tax
breaks and other incentives.
Jobs--But at What Price?
Whilst some jobs are created by the
tobacco industry those which are offered
to people in developing countries are
usually dangerous and badly paid.
Tobacco farm workers are often exposed
to dangerous pesticides and other
chemicals and small fanners are often
chained to a cycle of debt by a tobacco
industry system whereby loan schemes
are run to help farmers start farming
tobacco, but then low prices are offered
for the tobacco. In a number of countries
the tobacco industry exploits the poor and
powerless, employing children and
paying starvation wages.
Framework Convention for
Tobacco Control
What is the FCTC?
The Framework Convention on Tobacco
Control (FCTC) is a global treaty
currently being negotiated by
governments which will address
transnational and trans-border issues,
such as global advertising, smuggling and
trade. Yet the FCTC will also serve as an
important catalyst in strengthening
national tobacco legislation and control
programmes. The process of negotiating
and implementing the FCTC will also
help to mobilise technical and financial
support for tobacco control and raise
awareness among many government
ministries about tobacco issues.
What could the FCTC achieve?
If properly negotiated, the FCTC could
help turn the tide against the tobacco
industry by weakening its political power
and helping to end its reckless behavior
through regulation and legislation. But
this will only occur if the voices of the
people are heard.
What will happen next?
The next FCTC negotiation is scheduled
for April 30 to May 5 2001 in Geneva,
Switzerland. At this meeting, WHO
member states will debate the draft treaty.
It is paramount that NGOs from around
the world lobby their governments and
mobilise public support for a strong
FCTC.
How can NGOs get involved?
To ensure the success of the WHO FCTC
in combating the global tobacco epidemic,
non-governmental organizations must
play a key role in the development and
negotiation ofthe treaty.
□
□
□
□
□
Join the Framework Convention
Alliance;
Educate yourself and your
constituencies about global tobacco
issues and the FCTC the Alliance
Website (www.fctc.org) has links to
many good resources;
Inform and get the support of the
media in your country;
Get resolutions passed in support of
the FCTC;
Find out what your country's
delegates to the FCTC have said so
far and meet with them in order to
influence their future positions.
ivention
,
S
Building Support for
Global Tobacco Control
What is the Framework Convention
Alliance?
The Framework Convention Alliance
(FCA), a coalition of over 90
organizations and networks from over 36
countries, serves as an umbrella for
networks and individual organizations
working on the FCTC. The Alliance
facilitates communication between NGOs
already engaged in the FCTC process and
reaches out to NGOs not yet engaged in
the process (especially those in
developing countries) who could both
benefit from and contribute to the creation
ofa strong FCTC.
I
i
Framework Convention Alliance
Website: http://www.FCTC.org
E-mail: FCTCalliance@inet.co.th
36/2 Soi Pradipat 10,
Pradipat Rd., Samsen Nai,
Phayathai, 10400,
Bangkok, Thailand
Tel: (66-2)278-1828
Fax: (66-2)278-1830
pH - \3
Fact Sheet
Produced by :
Tobacco and Employment
Will tobacco control cause all
those currently employed in
tobacco suddenly to lose their
jobs?
Are those currently
employed in the tobacco sector
better off than those employed in
other areas? While fear ofjob loss
is causing great concern in many
countries, the facts indicate that
such concern is misplaced.
Massive job losses?
The number of people around the
world using tobacco is currently
increasing, not decreasing. The
WHO estimates that, if current
trends continue, the number of
smokers around the world will
increase from the current 1.1
billion to 1.6 billion in 2025.' In
countries where tobacco control is
quite strong, as in Thailand,
tobacco use is declining by about
l%ayear. But in most developing
countries, the population is
increasing by more than 1% a
year. If population growth is
greater than the decline in tobacco
use, than the number of tobacco
users will increase.
That effect is further enhanced by
the fact that, in many developing
countries, most of the population
is under age 15. Those who are
quitting tobacco use or dyingthe
middle aged and olderrepresent a
much smaller portion of the
population.
So the pool of
potential tobacco users is growing
even faster than the population.
PATH Canada
Work for a Better Bangladesh
The question, then, is not how
quickly will tobacco workers lose
their jobs, but how many years it
will take before the tobacco
industry stops growing.
It is thus highly unlikely that
anyone currently alive will lose
their job due to tobacco control
— and the eventual slow decline
in consumption will allow ample
time for farmers and others to seek
alternatives to tobacco.
Meanwhile, mechanization of
cigarette production has meant
that jobs are shrinking within the
industry not due to reduced
consumption, but due to greater
efficiency in production.
Is tobacco work always good for
the employees?
Employment in the tobacco sector
in developing countries often
means low wages and health risks.
Workers in the tobacco industry
would benefit if spending patterns
switched from tobacco to other
products, as this would potentially
create better paid and safer jobs in
new sectors.
Low wages
Workers generally receive
extremely low wages—as low as
35 cents a day to roll bidis in
India,2 and 6 cents for 5 hours
work in one site in Bangladesh.2
Since adult men refuse to do such
low-paid work, women and
children are often recruited. Due
to the long work hours, children
are forced to drop out of school.
In some bidi-rolling areas, men
take multiple wives and force
them to roll bidis, keeping the
profits and refusing to care for the
women when they become unable
to continue the work.3
Far from being well off from
tobacco farming, 52% of children
in one tobacco-growing district in
Kenya are malnourished.2
In Malawi, tobacco farmers
remain poor despite their many
years growing the crop. Due to
the high cost of inputs, they may
even go into debt if crops fail or
the auction price is low.4
Difficult working conditions
In addition to the low wages
— common not only to many of
those growing and producing
tobacco, but to many of those
selling it as well—are the health
threats faced by tobacco workers.
Tobacco workers become ill from
exposure to green tobacco while
picking the leaves, from tobacco
dust while manufacturing tobacco
products, and from the inhuman
postures in which bidi workers are
expected to remain for hours. All
of these exposures can result in
poor health that reduces the
productivity of workers.
Combined with illiteracy from
lack of school attendance, tobacco
work can contribute to lifelong
poverty for present and future
generations.
the hours were such that children
could attend school, then the cycle
ofpoverty might be broken.
Are there alternatives to
tobacco?
In different countries, people have
shown that those working in
tobacco can actually benefit from
switching to other work. Many
crops prove more profitable than
tobacco, such as roses in
Zimbabwe6 and sunflowers in
Bangladesh7. Some bidi workers
in southern India have discovered
that food processing generates far
more earnings than bidi work.8
Given the concentration of wealth
from tobacco in a very few
transnational companies, it is
hardly surprising that in many
contexts, other products would be
more economically beneficial to
the workers.
If tobacco consumption declined,
people would buy other goods
instead. Those other goods could
include food items that would
both benefit their and their
families' health, and provide the
former tobacco laborers with
potentially higher paid and less
dangerous, grueling work.
The World Bank has calculated
that in many countries, this switch
in expenditures would result in a
net increase of jobs.5 Even if the
pay of other work were
comparable to that of tobacco, if
Conclusion
While many people currently are
employed directly or indirectly
from tobacco, their jobs are not
threatened by tobacco control. In
many countries it will take
decades before any significant
decline in total tobacco
consumption occurs, so there is no
threat to those currently employed
by tobacco. Moreover, many of
those making their living through
tobacco would actually benefit
from a shift in,spending to other
products, so that they could find
better-paying and less grueling
jobs elsewhere. There is no
question of choosing between
what's best for the economy and
what's best for health: tobacco
control will greatly benefit both.
' 11"' World Conference on Tobacco OR Health Tobacco Fact Sheet, "The Economics of Tobacco Control: Exploding the
Myths."
' Mary Assunta, "Tobacco and Poverty" in Together Against Tobacco, proceedings of the INGCA T International NGO
Mobilisation Meeting, Geneva, 15-16 May 1999.
J Therese Blanchet, Child Work in the Bidi Industry. UNICEF: Dhaka 2000.
4 John Kapito, "Tobacco Farming And Public Health In Developing Countries The Case Of Malawi," 2001.
‘ World Bank, Curbing the Epidemic: Governments and the Economics of Tobacco Control, 1999.
6 Edward Maravanyika, "Do financially viable alternatives to tobacco growing exist in Zimbabwe? " in The Economics of
Tobacco Control in South Africa, 1998.
' Muzaffer Ahmad, Tobacco and the Economy ofBangladesh. Bangladesh Cancer Society, 1995.
‘Personal communication, Babu Matthew and Prakash Gupta, April 21, 2001.
Essential Action
P.O.Box 19405
Washington, DC 20036
November 2000
Dear Global Partnerships Participant,
We would like to once again thank you for your interest in the Global Partnerships for
Tobacco Control program. To date, over 270 groups from more than 80 countries and 30 U.S.
states have signed up to participate - a phenomenal response to a few emails we sent out to
various networks of tobacco control advocates!
Participating groups include anti-tobacco organizations, youth groups and schools, lung
and cancer associations, hospitals, universities, faith-based networks, medical associations, local
governmental agencies, and ministries’of health. Collectively, we speak over 50 languages, from
Hindi to Ibo to Thai and represent a wide range of interest areas and expertise, from smoke free
hospitals to to youth prevention.
As you know, the Global Partnerships program is designed to support and strengthen
international tobacco control at the grassroots level. The basic building blocks of the program
are the partnerships formed between groups in the US and Canada and groups in Asia, Africa,
Latin America, Pacific Islands, Eastern Europe and the former Soviet Union. It is our goal that
over time, partner organizations will develop strong, balanced, and mutually beneficial
relationships that will lead to the regular exchange of advice and information and to effective
joint campaigns.
We began this program as a response to multinational tobacco corporations’ behavior
around the world and the epidemic of death and disease they seem intent on continuing to spread.
Halting this global epidemic of preventable tobacco-related disease, projected by the WHO to
kill 10 million annually by the year 2030 (70% in the developing world), will require a genuinely
global effort that combines the strength and wisdom of organizations around the world.
We have a lot to learn from each other and immense amounts of creativity, energy, and
enthusiasm to share. In the next few years, the battle between the tobacco industry and
international tobacco control advocates will intensify, and we believe all of us have an important
role to play.
Some people have asked us what a partnership program provides that already existing
programs do not. In our opinion, the value of partnerships is in their ability to foster deep
relationships over time that should serve different purposes and facilitate different kinds of
collaboration than centralized, loosely linked networks and international coalitions. While
Essential Action will play a coordinating role, the real action will go on between partner
organizations.
The Global Partnerships program is an endeavor that is both ambitious and, so far as we
know, unprecedented. We have high expectations for the program but also anticipate that there
will be some obstacles to overcome and learn from, particularly early on. We are counting on
you to let us know what does and does not work well. Your open and honest feedback will help
us improve the program for all.
Basically, we are here to help you and do what we can to make the partnerships work.
We will send periodic email updates to all participants to share news, suggest activity ideas, and
offer encouragement. We will regularly check in with each of you individually to make sure
everything is going okay. We will also be setting up a webpage for the program. If you have any
questions, comments, or suggestions along the way, please don’t hesitate to contact Anna,
resident “cheerleader,” at awhite@essenlial.org , +1 202/387-8030 (tel), +1 202/234-5176 (fax).
We hope you and your organization are as excited as we are about the opportunity to be
part of such an international program. We look forward to getting to know each of you
individually and to working together on meaningful projects in the near future. If we succeed,
wherever tobacco corporations go, they won’t be able to hide from the partnerships’ eyes!
In solidarity for a tobacco-free future,'
Robert Weissman
Co-Director,
Essential Action
Anna White
Coordinator,
Global Partnerships for Tobacco Control
Please find enclosed:
■
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*
■
■
■
■
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Getting to Know Your “Buddy” Organization (yellow)
A Guide to Building International Tobacco Control Partnerships (blue)
Humorous Cross-Cultural Communication Gaffes (green)
Menu of Suggested Activities (pink)
More Information on Specific Activity Ideas:
> Advertising Survey
> How to Get the U.S. State Department Directive to Work for You
> WHO Clear the Air Campaign
> Two Concentration Games
Essential Action’s report Addicted to Profit: Big Tobacco's Expanding Global Reach
Copy of Cigarette Brand Market Share by Country, Tobacco Reporter - June 2000
“The Crazy World of Tobacco” poster
Information on how to sign up to Essential Actions’ International Tobacco listserv
GLOBAL TOBACCO CONTROL TREATY: INDIAN WINNERS
GEAR UP FOR THE THIRD ROUND
The progressive stand of the Indian Government delegation at the Second Round of Negotiations
on the Framework Convention on Tobacco Control (FCTC), fetched them the Orchid Award
on its final day at Geneva in April 2001. In contrast, the US delegation was awarded the Dirty
Ash Tray Award for dragging its feet on this significant public health treaty.
The Orchid Award signifies positive contributions to tobacco control while the Dirty Ash Tray
Award goes to those who promote tobacco interests. The Awards have been instituted by the
Framework Convention Alliance, an international coalition of non-governmental organizations,
advocating for a strong treaty.
The Framework Convention on Tobacco Control is an international public health treaty
proposed by the World Health Organization (WHO) for curbing the rapidly increasing tobaccorelated diseases globally. In 1998, for the first time in its history, WHO invoked its prerogative
to frame international conventions on health matters in order to address the transnational
tobacco control issues amongst its 191 Member States. The treaty is being negotiated through
the Intergovernmental Negotiating Body (INB) which was established by the World Health
Assembly through resolution WHA 52.18 in 1998. The key issues addressed in this treaty
include Tobacco Advertising and Promotion; Smuggling; Packaging and Reporting, Research
and Surveillance that are beyond the regulatory scope of individual countries.
As the tobacco industry explores fresh ways to recruit new and vulnerable customers and
evade existing national laws, it is imperative that countries in the South East Asia Region
take a firm stand on various clauses of the FCTC that protect the public health interest of
Member countries.
As the Third Round of negotiations of the INB has been held in Geneva from the 22-28lh of
November this year, non-governmental organizations from the women’s movement, youth
groups, consumer activists and cancer care and prevention centres across the country have
issued a joint declaration calling for deeper commitment from the opinion leaders of the nations
favouring public health and well being over transient commercial gains. They have expressed
hope that the Indian Government would continue to play a proactive role in leading the SouthEast Asian countries towards a strong FCTC.
For details contact:
Bejon Misra, Consumer Voice, Delhi. Tel: 9811044424 Email:< consumeralert@id.eth.net>
Shoba John, Mumbai. Tel:+91-22-4219241. Email:<shobajohn@hotmail.com>
-1-
INDIAN NGOs DECLARATION ON THE
FRAMEWORK CONVENTION ON TOBACCO CONTROL
Reaffirming the commitment to tobacco control measures enshrined in the World Health
Assembly resolutions on tobacco control,
Alarmed by the steady increase of tobacco-related diseases and deaths globally and specifically
in India,
Concerned by the negative consequences of tobacco production and use on the economy
and environment
Alarmed by the aggressive tobacco advertising, sponsorship, and promotion campaigns,
Conscious of the importance of civil society's active participation in the negotiation and
eventual adoption and implementation of the Framework Convention on Tobacco Control,
Noting the cultural, linguistic, and religious diversity and the vastness of India, and the multitude
of agencies involved in the framing and implementation of tobacco control policies, we, the
undersigned NGOs,
• Reaffirm our support for both the Jakarta and Thimphu declarations on FCTC.
• Declare complete support for the tobacco control bill currently in the Indian Parliament.
• Reaffirm the need for NGO participation in the Framework Convention on Tobacco Control
process both at national and international levels.
• Call on the Intergovernmental Negotiating Body on the Framework Convention on Tobacco
Control to ensure that the final negotiated text of the Convention prioritizes public health
over everything else.
• Urge the central and state governments in India to raise tobacco taxes and allocate a
portion for the enactment and implementation of tobacco control policies that have been
proven effective in reducing tobacco use;
• Urge the government to impose a total ban on all forms of tobacco advertising, promotion,
and sponsorship;
• Encourage measures to protect the public from exposure to tobacco smoke and
• Support international actions to control smuggling of tobacco products.
Endorsed by:
1. National Organization for Tobacco Eradication, Goa
2. Goa Cancer Society, Goa
3. Action Council Against Tobacco - India
4. Voluntary Organization in Interest of Consumer Education, New Delhi
5. No-Tobacco Organization, Nagpur
6. Cancer Institute, Chennai
7. National Association for Environment and Health, Madurai
8. Health Foundation, Mumbai
9. Tata Institute of Social Sciences, Mumbai
-1-
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
Association for Consumer Safety and Health, Mumbai
National Organization for Tobacco Eradication, Bhopal
Joint Action Committee for Anti-Tobacco Bill
Regional Cancer Centre, Thiruvanathapuram
National Organization for Tobacco Eradication, Patna
Sarv Jeev Mangal Pratishthan, Pune
Consumer Education & Research Society, Ahmedabad
Consumer Guidance Society of India, Mumbai
Action Council against Tobacco, Jaipur
National Organization for Tobacco Eradication, Kerala
Anti-Tobacco Cell of Karnataka, Bangalore
School Health Action Network, Delhi
HRIDAY, Delhi
Women’s Action Research and Legal Action for Women, WARLAW, Delhi
School of Preventive Oncology (Action Council Against Tobacco, Patna, Bihar)
Released to the Media at Delhi on 17 December 2001
-2-
jpK-V3
FRAMEWORK CONVENTION ON TOBACCO CONTROL (FCTC)
Introduction - International Treaties and Conventions
There is no dearth of international conventions and laws. There are a lot of them around and
everyone is directly affected by at least some of them. To give a few examples, there is a
Convention on the Rights of the Child, Convention on Climatic Change, Convention for
Protection of Ozone Layer, etc.
Such international conventions are first negotiated by government representatives within the
United Nations System. The negotiated international convention does not become a law
automatically - it has to be ratified by the competent legislative body of the country. In India,
for example, international conventions and treaties need to be ratified by the Indian Parliament.
The proposal for starting the process of an international treaty or convention can be initiated
by any of the permanent organs of the United Nations System. Until 1998, the World Health
Organization (WHO) had not used its constitutional mandate to propose an international treaty
or convention. It had no problem in getting its policies and recommendations in the interest
of public health accepted by everyone.
Why a Convention on Tobacco?
Smoking has been recognized as a major cause of lung cancer, other cancers, heart diseases
and lung diseases for over 40 years. It has been identified as a major global public health
problem. Until about 1990, each year tobacco-related deaths numbered 3 million globally of
which 2 million occured in developed countries. But since then it has been affecting developing
countries far more than industrialized countries. As per current estimates, by the year 2030,
tobacco will cause 10 million deaths globally of which 70% will be in developing countries.
Despite these well-established scientific facts the recommendations made by WHO and other
scientific bodies for the control of tobacco in the interest of public health have not been readily
accepted or applied in all countries. As a result, smoking and tobacco use is increasing
globally every year.
The reasons are not difficult to identify. Unlike other disease causing agents, tobacco use
and smoking are promoted globally by a powerful multinational industry that is a big business
in every country in the world. This industry opposes almost every meaningful recommendation
for tobacco control even though the validity of such recommendations in reducing tobacco
use and improving public health has been well established scientifically. The recommended
policies include a ban on advertisement of tobacco products, increase in taxes, no smoking
in public places, detailed consumer information, appropriate trade practices and others.
Several of these (e.g. advertising, smuggling) are transnational in character necessitating
an international approach.
FCTC - Current Status
For these and other reasons, the World Health Organization used its prerogative to propose
the Framework Convention on Tobacco Control (FCTC). In response to an invitation from
the FCTC Working Group, over 500 submissions were made by the public health groups as
well as in the tobacco industry worldwide. Public hearings on these submissions took place
in October 2000 in Geneva. Following this public hearing the first session of the Intergovernmental
Negotiating Body (INB) was held during October 16-21, 2000. The second session was held
during April 30 - May 5, 2001 and the third in November 2001. As per the current timetable
the FCTC would be adopted by the World Health Assembly during its session in May 2003.
Issues under Consideration
The objective of the FCTC is to reduce the health hazards of tobacco use through collective
international action and cooperation on tobacco control. Issues that will be part of the
negotiation discussions include:
Tobacco smuggling: Currently, recorded world cigarette exports exceed imports by about 400
billion cigarettes, implying that over seven per cent of world cigarette production is smuggled
from one country to another to avoid statutory taxes.
Tobacco advertising: Bans or restrictions on tobacco advertising in one country can be
undermined by advertising spillover from other countries.
Reporting of production, sales, imports and exports of tobacco products: Improved standards
of international reporting of tobacco production and sales would facilitate international monitoring
of this product.
Testing and reporting of toxic constituents: Improved and more effective international standards
for the testing and reporting of ingredients and toxic constituents in tobacco products and
tobacco smoke would facilitate the monitoring of the degree of hazard of tobacco products.
Policy and programme information sharing: More effective sharing of information among
nations about the state of their national tobacco control legislation and programmes would
help improve both national and international tobacco control measures.
FCTC and Economies of Tobacco Growing Countries
Part of the propaganda unleashed against FCTC is that it would affect the economy of tobacco
growing countries. After a careful analysis a World Bank report states that: "...the negative
effects of tobacco control on employment have been greatly overstated. There would be no
net loss of jobs, and there might even be job gains if global tobacco consumption fell. This
is because money once spent on tobacco would be spent on other goods and services,
thereby generating more jobs”. A small number of countries in Sub-Saharan Africa might be
an exception but aid adjustment, crop diversification, rural training and other safety net systems
would take care of the problem.
Other Benefits from FCTC
The process of developing the FCTC is likely to be very important for strengthening tobacco
control in many ways, for example it could:
•
Enable and encourage governments to strengthen their national tobacco control policies
by providing greater access to scientific research and examples of best practice; motivating
-2-
national leaders to rethink priorities as they respond to an ongoing international process;
and, engaging powerful ministries, such as finance and foreign affairs, more deeply in
tobacco control;
•
Raise public awareness internationally about the unscrupulous strategies and tactics
employed by the multinational tobacco companies;
•
Mobilize technical and financial support for tobacco control at national and international
levels;
•
Make it politically easier for developing countries to resist the tobacco industry; and
•
Mobilize non-governmental organizations (NGOs) and other members of civil society in
support of stronger tobacco control policies.
FCTC and Non-Governmental Organizations (NGOs)
Non-governmental organizations must play a key role in the development and negotiation
of the convention to ensure its success. There are several ways in which NGOs can support
the FCTC. They can:
•
Join some group of NGOs working on FCTC. The largest such group is the Framework
Convention Alliance;
•
Educate themselves and their constituencies about global tobacco issues and the FCTC;
•
Keep the media informed about the FCTC and get their support;
•
Provide the media with regular stories on the tobacco problem, suggesting the FCTC as
part of the solution;
•
Find out what the country’s delegates to the FCTC have said so far and meet with them
in order to influence their future positions;
•
Contact the FCA Regional Contact to find out what regional action is occurring in the
region;
.
Get resolutions passed in support of the WHO FCTC by the boards of respective NGOs;
•
Adopt a declaration modeled after the Kobe Declaration; and
•
Meet with and send copies of resolutions or declarations to representatives involved in
the WHO FCTC negotiations in respective countries.
More resources and information on FCTC is available at www.fctc.org
Prepared By: Dr. P. C. Gupta, ACT-India
-3-
ORAL TOBACCO USE - ITS IMPLICATIONS
FOR INDIA AND THE WORLD
MEASURES TO PREVENT ITS USE,
SALE AND MARKETING
Tobacco-related diseases are now a global epidemic. Each year, about 4 million people die
due to tobacco consumption throughout the world. Today, India is the second largest producer
of tobacco and also the second leading seller in the world. Most of the tobacco produced in
India is used within the country. The percentage of tobacco exported to other countries is
very low. However, approximately 2,200 people die of tobacco use every day in India. Yet,
the tobacco companies are persisting with their aggressive marketing. They are targeting
adolescents as future customers.
Presently, there are 60 cigarette-manufacturing factories, about 1000 gutkha and pan masala
manufacturing units and over 1 million women engaged in the hand rolling of bidis. Approximately
600 children between the age group of 10 to 18 are recruited every day by the tobacco industry
to keep their business growing.
Smokeless tobacco products are easily available and at a price that even children can buy
it from any tobacco or pan shop. Children do not simply choose to consume tobacco but are
influenced by their environment with the glamorous advertisements endorsing their acceptance.
They are influenced by the sports personalities, movie stars and people around them consuming
tobacco and because tobacco products are easily available.
What is Smokeless Tobacco?
Smokeless tobacco consists of dried leaves and stems of the plant Nicotinia Tabacum,
containing the drug, nicotine. Nicotine is toxic and has been classified as the most addictive
drug in existence. In India industrially manufactured chewing tobacco, Gutkha, is easily
available in sachets and most popular among youth all over the country. Chewing tobacco
is the major cause of oral cancer.
There are mainly two forms of smokeless tobacco used in different parts of the world.
1.
Oral snuff - also commonly known as dip available in moist, dry and sachet forms.
2.
Chewing tobacco - available in loose leaf, twist and plug forms.
Any form of tobacco used in the world has been established to cause oral cancer, which is
the commonest cancers in India among men.
Contents of Smokeless Tobacco
Smokeless tobacco contains dangerous chemicals, which result in addiction leading to death.
Nicotine is the main deadly substance in smokeless tobacco. It is directly absorbed in the
blood stream and leads to addiction. Smokeless tobacco has similar or higher levels of nicotine
than smoking tobacco.
Smokeless Tobacco Causes Cancer
Smokeless tobacco use may increase the risk of oral cancer four times. Smokeless tobacco
users, specially those consuming snuff for a long time can develop cancer of the lip, tongue,
floor of the mouth, cheek and gum. The chances of oral cancer are higher in users than in
the non-users of smokeless tobacco.
Warning Signs:
•
A mouth sore that bleeds easily or fails to heal, often appears where the tobacco product
•
is placed.
A painless lump, thickening or soreness in the mouth, throat or tongue.
•
Soreness or swelling that persists.
•
•
A white or red patch in the mouth that persists.
Difficulty in chewing, swallowing or moving tongue or jaw.
Preventive Measures
There are a number of organizations working for tobacco control worldwide as well as in
India. Many preventive measures have been taken and are being planned targeting users
as well as non-users. Many preventive campaigns have been carried out to make the general
public aware of the dangerous and harmful effects of tobacco use. There is a long way to
reach the goal of tobacco control but we must keep making efforts.
1.
Control over Glamorous Advertisements and Marketing of Tobacco Products:
Advertisements through the media are one of the effective ways of spreading messages
across to the public and tobacco industries have chosen it for the promotion of their
products and its sale. It immediately affects the adolescent group as this is a very inquisitive
age group and can easily be influenced. Studies have shown that in some countries,
tobacco advertising is twice as influential as peer pressure in encouraging children to use
tobacco. However, the advertisements are misleading and must be stopped as well as
marketing of tobacco to the youth to protect them from becoming future consumers.
2.
Protect Children from Becoming Addictive to Tobacco:
The two main smokeless tobacco products, gutkha and pan masala (containing tobacco),
are very easily available in India. Children are always interested to try out new products
seen in the advertisements. Often, the small and cheap sachets are given free to children
in cinema halls, outside schools and colleges and even during some events. There should
be an age limit at which tobacco products can be sold legally to children. If someone
breaches the law, a heavy penalty should be imposed.
3.
Increase in Taxes on Tobacco Products:
The government has to make efforts to increase taxes on tobacco products, to make them
unaffordable to children. This will not only reduce sales but also increase revenue generation
to be used for other tobacco control activities in the country.
-2-
4.
Generating Awareness Regarding the ill-effects of Tobacco Use:
Designing of strong and very clear messages is necessary. Many organizations have done
similar work in other health awareness areas very successfully. Equally important is to
generate awareness about the dangers and harmful effects of tobacco use specially
focusing on adolescents and children. It has been proved that mass media programmes
and educational programmes produce better results and a quick impact.
5.
Declaring Public Institutions, Specially Schools and Colleges as Tobacco Free:
It is necessary to develop school and college health programmes in order to completely
stop the sale and consumption of tobacco within and outside educational institutions.
6.
Involvement of Health Personnel in Awareness Campaigns:
Health personnel like doctors, nurses, health volunteers and so on can be of great help
in tobacco control activities. They should be appropriately trained as they directly interact
with patients and the community.
7.
Eliminate Sponsorship by Tobacco Companies of any Public Events:
Tobacco companies sponsor major events like sports, awards, festivals and so on. These
sponsorships should be discouraged in order to control the advertisement of tobacco
products.
8.
Showing Prominent Warning on Tobacco Products:
The statutory warning mentioned on tobacco packets and even on cigarette packets is not
prominent. It is necessary that the warnings are prominently depicted on the packets so
that they leave some impact on the mind of the user. For example, a picture of a new born
with disability, pregnant women, oral cancer pictures and so on.
Conclusion:
Smokeless tobacco is a growing addiction especially amongst the youth of India (as high as
55%). If not effectively controlled, it will soon become an epidemic and also a major cause
of deaths in India. It is important to invest in the future - on youth and children. They are being
targeted by the tobacco industries for giving employment as well as the future customers.
Many organizations are working in the area of tobacco control and legislative measures have
also been adopted. Tobacco Products (Prohibition of Advertising and Regulation of
Trade, Commerce and Supply) Bill, 2001 has already been introduced in Parliament and
efforts are required to pass the bill. In order to control the tobacco epidemic, effective smoking
cessation programmes are required to be implemented along with awareness programmes.
Only when this is done will significant progress be made in combating what has become a
truly global epidemic.
Prepared by: Ginashri Datta, ACT-India.
-3-
References
1. Sinha D N, Gupta P C - Tobacco and Areca nut use in Male Medical Students of Patna-The
National Medical Journal of India-Vol. 14, No. 3, 2001
2. CDC - Tobacco and Young People - A Fact Sheet
3.
The Tobacco Epidemic - A Crisis of Startling Dimensions - A fact sheet
4.
Confronting the Epidemic - A Global Agenda for Tobacco Control Research - WHO July 1999 - Geneva
5.
Monitoring the Tobacco Epidemic - Past, Present and Future - By Mario Ann Corrao,
Emmanual Guindon, Steven M. Tobin
6.
Cancer Facts - Questions and Answers about Smokeless Tobacco and Cancer - Fact
Sheet - 3.63
pv(.13
HEALTH HAZARDS OF TOBACCO USE
Tobacco use is a serious and growing problem in India. It is estimated that 65% of all men
use some form of tobacco- about 35% smoking, 22% smokeless and 8% both. Prevalence
rates for women differ widely, from 15% in Bhavnagar to 67% in Andhra Pradesh. Overall,
however, the prevalence of bidi and cigarette smoking amongst women is about 3% and the
use of chewing tobacco is similar to that of men at 22%.1 Since the 1980s use of pan masala
and gutka has increased at a phenomenal rate.2
This extraordinarily high use of tobacco products is having a devastating impact on the health
of the people. The World Health Organization estimates that 8 lakh persons die from tobacco
related diseases each year in India alone.3 Currently, approximately 50% of cancers among
males and 20% of cancers among females are caused by tobacco. In a World Bank collaborative
research project conducted in Chennai on 50,000 subjects the following key findings were
made: 50% of smokers died due to smoking, 25% of deaths among males aged 25-69 years
were attributable to tobacco use and the risk of dying among smokers with tuberculosis is
about 4-fold higher than the nonsmokers with tuberculosis. Another study showed that smokers
have a 3-fold risk of developing tuberculosis compared to non-smokers. This shows that at
least 65% of tuberculosis seen among smokers is attributable to the habit of smoking.4
Chronic Obstructive Lung Disease (COLD)
Chronic obstructive lung disease (including chronic bronchitis and emphysema) is a progressively
disabling disease that is rarely reversible. It can cause prolonged suffering due to difficulty
in breathing because of the obstruction or narrowing of the small airways in the lungs and
the destruction of the air sacs in the lungs due to smoking.
Smoking is the main cause of chronic obstructive lung disease: it is very rare in non-smokers
and at least 80% of the deaths from this disease can be attributed to cigarette smoking.5The
risk of death due to the disease increases with the number of cigarettes smoked.
Pneumonia
Pneumonia is not only more common amongst smokers, but is also much more likely to be
fatal.6
Lung Cancer
Lung cancer kills more people than any other type of cancer and at least 80% of these deaths
are caused by smoking. The risk of lung cancer increases directly with the number of cigarettes
smoked. In 1999, 22% of all cancer deaths related to lung cancer, making it the most common
Chatterjea, A., 'Role of the Media and Global Responsibility: A Review of how the tobacco industry has used advertising and
media in India to promote tobacco products', Unpublished paper, World Health Organization International Conference on Global
Tobacco Control Law, September 1999.
ibid
WHO. Tobacco or Health Country Profile: India, A Global Status Report WHO Geneva, 1997, Country presentations at various
regional meetings on tobacco 1997-98. Regional Health Situations in South-East Asia, 1994-97.
Pers. Corres. Gajalakshmi Vendhan, Cancer Registry, Chennai.,
The UK Smoking Epidemic - Deaths in 1995. Health Education Authority, 1998.
The UK Smoking Epidemic: Deaths in 1995. Health Education Authority, 1998.
-1-
form of cancer.7 One in two smokers dies prematurely: of these, nearly one in four will die
of lung cancer. The risk of dying from lung cancer increases with the number of cigarettes
smoked per day. Smokers who start when they are young are at an increased risk of developing
lung cancer. Results of a study of ex-smokers with lung cancer found that those who started
smoking before age 15 had twice as many ceil mutations as those who started after age 20.8
Cancers of the Mouth and Throat
Smoking cigarettes, pipes and cigars is a risk factor for all cancers associated with the larynx,
oral cavity and oesophagus. Over 90% of patients with oral cancer use tobacco by either
smoking or chewing it. “Oral cancer" includes cancers of the lip, tongue, mouth and throat.
The risk for these cancers increases with the number of cigarettes smoked and those who
smoke pipes or cigars experience a risk similar to that of cigarette smokers.9
Breast Cancer
There is growing evidence of a link between both active and passive smoking and breast
cancer. Seven of the eight published studies examining passive smoking and breast cancer
suggest an increased risk of breast cancer associated with long term passive smoke exposure
among women who have never smoked.1011
Cervical Cancer
A study in Sweden investigated whether behavioral/lifestyle factors such as smoking, nutrition
and oral contraceptive use were independent risk factors for cervical cancer and found that
smoking was the second most significant behavioral/lifestyle factor after Human Papilloma
Virus (HPV).11
Coronary Heart Disease (CHD)
Cigarette smoking, raised blood cholesterol and high blood pressure are the most firmly
established, non-hereditary risk factors leading to Coronary Heart Disease (CHD) with cigarette
smoking being the “most important of the known modifiable risk factors for CHD", according
to the US Surgeon General.12 A cigarette smoker has two to three times the risk of having a
heart attack than a non-smoker. If both of the other main risk factors are present then the
chances of having a heart attack can be increased eight times.13 Men under 45 years of age
who smoke 25 or more cigarettes a day are 15 times as likely to die from CHD as non-smokers
of the same age.14 Even light smokers are at increased risk of CHD: a US study found that
women who smoked 1-4 cigarettes a day had a 2.5-fold increased risk of fatal coronary heart
disease.15
7. CRC Cancer Stats: Mortality - UK. Cancer Research Campaign, June 2001
8. More warnings given to teenage smokers. The Lancet April.171999. VoI353, p!333
9. Cancer Slats: Oral - UK. Cancer Research Campaign, July 2000
10. Johnson, KC. Letter: Electronic responses to Clinical Review, British Medical Journal, 12 September 2000
11. CRC Cancer Stats: Cervical Cancer - UK. Cancer Research Campaign,December 2000
12. The health benefits of smoking cessation - a report of the Surgeon General, US DHHS1990.
13. Doll, R and Peto, R. Mortality in relation to smoking: 40 years' observations on male British doctors. Br Med J. 1994; 309:901-11
14. ■ Doll, R and Peto, R. Mortality in relation to smoking. Br Med J. 1994; 309:901-11
15. Bartecchi CE, et al. New England Journal of Medicine 1994; 330:907-912
-2-
Peripheral Vascular Disease (PVD)
Smokers have a 16 times greater risk of developing peripheral vascular disease (PVD)
(blocked blood vessels in the legs or feet) than people who have never smoked.16 Smokers
who ignore the warning of early symptoms and continue to smoke are more likely to develop
gangrene of a leg. Cigarette smoking combines with other factors to multiply the risks of
arteriosclerosis. Patients who continue to smoke after surgery for PVD are more likely to
relapse, leading to amputation, and are more likely to die earlier.17
Stroke
Smokers are more likely to develop a cerebral thrombosis (stroke) than non-smokers. About
11% of all stroke deaths are estimated to be smoking related, with the overall relative risk
of stroke in smokers being about 1.5 times that of non-smokers.18 Heavy smokers (consuming
20 or more cigarettes a day) have a 2-4 times greater risk of stroke than non-smokers.19 A
recent study showed that passive smoking as well as active smoking significantly increased
the risk of stroke in men and women.20
Reduced Fertility
Women who smoke may have reduced fertility. One study found that 38% of non-smokers
conceived in their first cycle compared with 28% of smokers. Smokers were 3.4 times more
likely than non-smokers to have taken more than one year to conceive.21 A recent British
study found that both active and passive smoking was associated with delayed conception.22
Cigarette smoking may also affect male fertility: spermatozoa from smokers has been found
to be decreased in density and motility compared with that of non-smokers.23
Male Sexual Impotence
Impotence, or penile erectile dysfuntion, is the repeated inability to have or maintain an
erection. One study of men between the ages of 31 and 49, showed a 50% increase in the
risk of impotence among smokers compared with men who had never smoked.24 Another
US study, of patients attending an impotence clinic, found that the number of current and ex
smokers (81%) was significantly higher than would be expected in the general population
(58%).25
16. Cole, CW el al Cigarette smoking and peripheral arterial occlusive disease. Surgery 1993; 114: 753-757
17. Myers, K A et al. Br J Surg 1978; Faulkner, K VV et al. Med J Austr 1983; 1:217-219
18. Shinton R and Beevers G. Meta-analysis of relation between cigarette smoking and stroke. Br Med J. 1989; 298:789-94.
19. Smith, PEM. Smoking and stroke: a causative role. (Editorial) Br Med J1998; 317:962-3
20. Bonita R et al. Passive smoking as well as active smoking increases the risk of acute stroke. Tobacco Control 1999; 8:156-160
View abstract
21 Baird, D.D. and Wilcox, A.J. JAMA 1985; 253:297972983.
22. Hull, MGR et al. Delayed conception and active and passive smoking. Fertility and Sterility, 2000; 74:725-733
23. Makler, A. et al. Fertility & Sterility 1993; 59:645-51.
24. Mannino, D et al. Cigarette Smoking: An Independent Risk Factor for Impotence, American Journal of Epidemiology. 1994; 140:
1003-1008.
25. Condra, M. et al. Prevalence and Significance of Tobacco Smoking in Impotence. Urology; 1986; xxvii: 495-98.
Foetal Growth and Birth Weight
Babies born to women who smoke are on average 200 grams (8 ozs) lighter than babies
born to comparable non-smoking mothers. Furthermore, the more cigarettes a woman smokes
during pregnancy, the greater the probable reduction in birth weight. Low birth weight is
associated with higher risks of death and disease in infancy and early childhood.26
Spontaneous Abortion and Pregnancy Complications
The rate of spontaneous abortion (miscarriage) is substantially higher in women who smoke.
This is the case even when other factors have been taken into account.8 On an average,
smokers have more complications of pregnancy and labour which can include bleeding during
pregnancy, premature detachment of the placenta and premature rupture of the membranes.27
Some studies have also revealed a link between smoking and ectopic pregnancy 10 and
congenital defects in the offspring of smokers.28
The Hazards of Passive Smoking
Non-smokers who are exposed to passive smoking in the home, have a 25 per cent increased
risk of heart disease and lung cancer.29 A major review by the Government-appointed Scientific
Committee on Tobacco and Health (SCOTH) in the UK concluded that passive smoking is
a cause of lung cancer and ischaemic heart disease in adult non-smokers, and a cause of
respiratory tract infections such as bronchitis, pneumonia and bronchiolitis, cot death, middle
ear disease and asthmatic attacks in children.30 More than one-quarter of the risk of death
due to Sudden Infant Death Syndrome (cot death) is attributable to maternal smoking
(equivalent to 365 deaths per year in England and Wales.31 While the relative health risks
from passive smoking are small in comparison with those from active smoking, because the
diseases are common, the overall health impact is large.
Benefits of Quitting Smoking
When smokers give up, their risk of getting lung cancer starts decreasing so that after 10
years an ex-smoker's risk is about a third to half that of continuing smokers.32
Prepared by: Dr. Gajalakshmi Vendhan-and Ms. Shoba John
with assistance from Ms. Belinda Hughes
26. Royal College of Physicians. Smoking and the Young London, 1992
27. Poswillo, D and Alberman, Effects of smoking on the foetus, neonate, and child. OUP1992,
28. Haddow, J.E. et al. Teratology 1993; 47:225-228.
29.
Environm™lal lobacco smok,: exposure and ischaemic heart disease: an evaluation of the evidence BM11997315:973-80. [View abstract] Hackshaw AK et al. The accumulated evidence on lung cancer and environmental tnbarrn cmoVp*
BMJ1997; 315:980-88. [View abstract]
b
environmental tobacco smoke.
30 Report of the Scientific Committee on Tobacco and Health. Department of Health, 1998. [View document]
31 Royal College of Physicians. Smoking and the Young London, 1992.
32 The Health Benefits of Smoking Cessation - A Report of the Surgeon General. US DHHS, 1990
pH - \ 3
TOBACCO ADVERTISING AND
PROMOTIONAL ACTIVITIES IN INDIA
Tobacco Advertising—The Global Scenario
The power of advertising as a function of consumer choice and market expansion has long
been recognized and exploited by the tobacco companies. The tobacco industry constitutes
the largest advertisers in the world. In 1996, Philip Morris, the world’s largest multinational
cigarette company spent $ 3.1 billion advertising its tobacco and food products while British
American Tobacco its major competitor, spent $459 million on advertising its cigarettes alone.1
Tobacco Advertising in India
Tobacco advertising alone contributes Rs. 300-400 crore to the Rs. 8000 crore-strong Indian
advertising industry. Manufacturers of gutkha and other oral tobacco products are catching
up with their increasing advertising budget as is evident from the increasing print and television
advertisement of chewing tobacco products. The following table indicates the astronomical
figures the cigarette companies spent annually on advertising their various brands against
the proven health and social problems that they raise:*2
Cigarette Brand
Advertising Expenditure
Gold Flake
Rs. 50 crore
555
Rs. 10 crore
B&H
Rs. 10 crore
ITC brands
Rs. 40 crore
Forms of Tobacco Advertising in India’s Direct Advertising
Newspapers and Magazines: There is no estimated figure available on the advertising
expenditures of cigarette and Gutkha companies though they are frequently seen in all the
local dailies and television channels. A very recent phenomenon has been the cigarette
companies sponsoring the sports page of newspapers in the wake of the proposed ban on
tobacco sponsorship of sports events.3 Except for health-related magazines, few have any
policy prohibiting advertisement of tobacco products. Disturbing reports on Gutkha advertising
spotting the cover pages of school notebooks are pouring in from Nagpur District in Maharashtra.4
Outdoor Advertising: International and domestic cigarette brands compete with each other
in billboard advertising while oral tobacco brands resort to transport vehicles. Point of sale
advertising flourishes adjacent to schools and colleges as also in restaurants and kiosks.5
1
2.
3.
4.
5.
Hammond, R. (2000). Tobacco Advertising and Promotion: The Need for a Coordinated Global Response. Geneva: World Health
Organization.
Italia, R. in Times of India, 9*h February 2001. "Advertising to be a No-Smoking Zone, No Comment, Says Ad Industry". Geneva:
World Health Organization
Indian Express Sports Page, 6,h July, 2001
Personal Communication with Venkatesh, V. Cancer Patients Aid Association.
Print Advertisements Archive of Association for Consumers Action on Safety and Health, Bombay.
-1-
Promotional Activities
Sponsorship of Sports and Cultural Events: The last decade of the past century witnessed
the tobacco companies vying to conquer sponsorship rights of various sports and cultural
events. Subsequently, the Indian cricket team came to be sponsored by Wills, the flagship
brand of ITC until its recent withdrawal in March 2001. For every test match that India played,
Wills (ITC) doled out Rs. 33 lakh, for every one-day match, it paid Rs. 32 lakh. The major
Tennis tournaments in the country were sponsored by Gold Flake and boat racing by Four
Square cigarettes.6
On the cultural front, Manickchand, who catapulted the tobacco market with their Gutkha
brands, patronizes Filmfare Awards giving away the annual film awards in the country.
Ironically, the national bravery award recognizing heroes for courage, adventure and
spontaneous physical action is being sponsored by Red and White cigarette brand, capitalizing
on the positive image and good will the event fetches. In several parts of India, major State
festivals like Ganesh Chaturthi and Navratri have come to be celebrated with great fanfare
at the behest of Gutkha companies.7
Surrogate Advertising in Television: Gutkha companies like Simla, Goa 1000 and Pan
Parag skirt the ban on tobacco advertising in Television channels by resorting to surrogate
advertising in the name of Pan Masala bearing the same brand name. Cigarette companies
do it likewise through transmitting tobacco sponsored cultural events as in the case of Red
& White Bravery Awards
Contests: The Wills “Made for Each Other" campaign of the Eighties with lucrative offers
including a holiday abroad had courted much controversy over glamourizing and minimizing
the dangers of smoking filter cigarettes.8 In December 1999, Four Square brand from Godfrey
Philips India, an affiliate of Philip Morris Inc. ran the “Gold in Gold” Contest offering Gold gift
options, on the stipulation that the entrants in the contest, besides being tobacco users, were
to collect 4 inserts from Four Square Gold Cigarette packs.9
Product Placement in Movies: Several leading filmmakers and popular film stars have fallen
prey to this hidden trap and have indirectly promoted cigarette brands by consciously placing
cigarette packs or brand names/ logos in movie scenes as was observed in movies like God
Mother, Tere Mere Sapne, Chasme Baddur and Katha.5
Free Sampling: Earlier, this tactic of initiating the young with tobacco use was restricted to
handing out free samples of cigarettes. Recent press reports from Nagpur indicate that even
Gutkha sachets are being given out freely near schools and colleges.4 Strategically, youth
in outfits bearing tobacco brand names and logos are engaged in these promotional campaigns.
In Mumbai, several discotheques and restaurants witness regular Benson & Hedges promotional
activities including giving free samples..
Brand Stretching and Diversification: Perceiving an imminent ban on tobacco advertising,
several tobacco companies are promoting other consumer products, which bear the same
6.
7.
8.
9.
Sawai. A. in Times of India. 10,h February 2001. "MG Confident of Finding Sponsors".
Video Archive of Association for Consumers Action on Safely and Health, Bombay.
Srivastava, A. (2000). The Role and Responsibility of Media in Global Tobacco Control. Geneva: World Health Organisation.
Times of India, 13lh December 1999. Four Square Gold Contest Announcement.
-2-
brand name or logo as their popular tobacco products. These logos or brand names can
easily be spotted on clothing, sports apparel, hats, trays, posters and stickers affixed to sports
vehicles and backpacks.
The Indian Tobacco Company, already holding investments in the hotel and tourism sector,
is on a spree to set up 125 lifestyle stores selling apparels in the country in the immediate
future. The plans include spreading out to greeting cards business and experimental kitchens.10
Manickchand, the domestic Gutkha major has diversified its products to tea powder, windmills
and construction industry.
Corporate Philanthropy and Public Relations: The earthquake that ravaged parts of Gujarat
have well been exploited by gutkha manufacturers by distributing food packets along side
gutkha packets to build up their social image10. All the major guktha firms are actively engaged
in supporting local youth clubs in organizing their annual sports events and religious festivities.5
The Indian Tobacco Company claims that they invest in education, immunization and family
planning programmes in communities attached to their factories.
State-patronised Tobacco Promotion: Though lamentable, the State responsible for the
health and well being of its citizens, also often acts as a vehicle of tobacco promotion. The
obvious examples are the BEST buses plying in Maharashtra and the Railway station premises
and bus stops across the country displaying huge tobacco hoardings. Doordarshan, the
national television channel transmits advertisements of Cavenders Cigarette brand disguised
as adventure gear as also sports and cultural events sponsored by tobacco companies.7
Trends in Tobacco Advertising
Following the announcement of the recent Tobacco Products Bill proposing a ban on tobacco
advertising, there has been an upsurge in surrogate advertising and sponsorship of entertainment
events. Recent marketing figures indicate that while the market spending on tobacco products
declined by 2 % over the year, the spending on tobacco brands grew by 28 %. This is
illustrative of the increasing reliance of tobacco companies on sponsorships, restaurant and
hotel programmes, public relations and direct marketing programmes these days.8
Impact of Tobacco Advertising and Promotional Activities
In a study conducted in Goa among students immediately after watching tobacco-sponsored
cricket matches, 15-20 per cent students surveyed felt that smoking and Ghutka improves
memory. Some students even felt that if you smoke, you will become a better cricketer.11 A
1992 review of 19 studies of cigarette advertising by the British Department of Health revealed
that advertising does have a positive impact on consumption. A 1995 study indicates that
advertising is more likely to influence teenagers to smoke than even peer pressure while a
1996 study published in the Journal of Marketing found that teenagers are three times as
sensitive as adults to cigarette advertising.1 The escalating annual advertising budgets of
tobacco companies themselves are enough proof of the impact this component of marketing
has on increasing consumption rates.
-3-
Existing Advertising Regulations in India
Cigarettes Act, 1975-merely stipulates the statutory warning on cigarette packets.
Cable Television Networks (Amendment) Act, 2000-prohibits direct and indirect tobacco
advertising on Cable Channels.
Advertising Standards Council of India Voluntary Code, 1998-envisages prohibition of
advertising targeting underage consumers; suggests that using tobacco products is safe,
healthy or popular; enhancing courage; or featuring the young. Being a voluntary code, it has
little enforcement value.12
Tobacco Products (Prohibition of Advertising and Regulation of Trade, Commerce and
Supply) Bill, 2001-announced by the Cabinet, pending enactment in Parliament provides for
banning direct and indirect tobacco advertising in various media, prohibition of tobacco
sponsorship of sports and cultural events, banning smoking in public places, banning sale
of tobacco products to persons below 18 years of age and repeats the existing labeling
provision. The States of Goa, Punjab, Uttar Pradesh and West Bengal have agreed to adopt
this Bill which is currently before a Rajya Sabha Standing Committee.13
Goa has an Act prohibiting smoking in public places, but it is poorly enforced. The same fate
has been suffered by the Maharashtra Government Resolution banning sale of gutkha within
100 meters of schools, hospitals and government offices. Goa, Kerala, Madhya Pradesh and
Karnataka have a ban in place on smoking in public places.
FCTC and Tobacco Advertising
Advertising being a transnational issue in the information age, beyond the regulatory scope
of individual countries, the efficacy of stringent provisions thereof in the Framework Convention
on Tobacco Control (FCTC) is undisputable. Efforts should therefore be geared at motivating
geographical regions en masse to opt for tight provisions in the Convention. Individual nations
could also be prevailed upon to tighten their national laws to match with International standards
to be set out in FCTC.
Interventions
•
Effective lobbying strategies to enable the enactment of the Tobacco Products Bill, 2001.
.
Activating State level advocacy to overcome the jurisdictional restrictions on policies
regulating oral tobacco products and Bidis .
•
Building a vigilant civil society to provide effective monitoring and prompt reporting of
violations under the existing laws.
•
Addressing transnational advertising through strong provisions in the Framework Convention
on Tobacco Control.
.
Mobilising Support from Entertainment-Celebrity endorsements of Anti-Tobacco policies.
•
Involving youth icons in spreading anti-tobacco messages.
Prepared by: Shoba John, AC ASH / PATH CANADA
12. Business Tunes, 26th March 1998. Bombay.
13. Times of India, 7th February 2001. Bombay. "Government proposes to ban Sponsorship of Sports, Cultural Events bv Tobacco
Firms .Bombay.
J
G.
WHO FRAMEWORK CONVENTION ON TOBACCO CONTROL
Overview of the status of the WHO Framework Convention on Tobacco Control
59.
Tobacco use is increasing worldwide. In response to the globalization of the epidemic of
tobacco-related disease, WHO Member States initiated negotiations on the WHO framework
convention on tobacco control in October 2000. The Framework Convention on Tobacco Control WHO’s first treaty - was unanimously adopted by Member States at the Fifty-sixth World Health
Assembly in May 2003.' In adopting the treaty, WHO and its Member States recognized that the
Framework Convention is a powerful global public health tool for combating tobacco use and the
ravages it causes.
60.
As of 26 March 2004, 100 Member States had signed the WHO Framework Convention on
Tobacco Control (see Annex I).1
2 With the 29 June 2004 deadline for signature approaching, WHO
takes this opportunity to remind ministers of health and other Health Assembly delegates of the crucial
tobacco control work that remains to be completed; delegates are urged to encourage their respective
governments to sign the Framework Convention. Signature indicates a State’s intention to be bound by
the Convention at a later date (see Annex 2 for a model instrument granting full powers to the
signatory). Ratification, acceptance, approval or formal confinnation are international acts by which
1 Resolution WHA56.1.
2 In addition, nine of these Member States had already ratified or approved the Convention.
A57/I8
States or regional economic integration organizations that have already signed the Framework
Convention formally agree to be bound by it.1
61.
WHO encourages those Member States and regional economic integration organizations that
have signed but not ratified, approved, accepted, or formally confirmed the Framework Convention, to
do so as early as possible (see Annex 2 for a model ratification instrument).
62.
After 29 June 2004, the WHO Framework Convention on Tobacco Control will be closed for
signature. Beyond that date, Member States may still become a party to the Framework Convention by
means of accession, a single-stage process equivalent to ratification. The WHO Framework
Convention on Tobacco Control will enter into force on the ninetieth day following the date of deposit
of the fortieth instrument of ratification, approval, acceptance, formal confirmation, or accession.
Although 40 is the minimum number of ratifications for entry into force, the goal is to have the
greatest possible number of Member States ratify, accept, approve, formally confirm, or accede to the
Framework Convention in order to exploit the treaty’s full potential as a global public health tool.
WHO’s activities as interim secretariat of the Framework Convention
63.
Since the adoption of the Framework Convention, WHO has supported subregional Framework
Convention awareness-raising workshops aimed at providing support to Member States in their efforts
to sign and ratify the treaty, and prepare for its implementation. Three workshops were held in
November and December 2003 in Nairobi (for Member States of the WHO African Region in East
Africa);*
2 in Cairo (for Member States of the WHO Eastern Mediterranean Region in the Gulf);3 and in
Bishkek (for Member States of the WHO European Region in Central Asia).4 More awareness-raising
meetings are planned between March and May 2004 in Kathmandu (for Member States of the WHO
South-East Asia Region that are members of the South Asian Association for Regional Cooperation
and for other Member States in the Region, in Nadi, Fiji (for Member States of the WHO Western
Pacific Region from the Pacific island States), and in San Jose (for Member States of the WHO
Region of the Americas from Central America and for other Member States in the Region). National
consultations on the Framework Convention with parliamentarians took place in Argentina, Brazil, the
Czech Republic and Kenya.
64.
WHO’s web site has detailed information on the status of the Framework Convention on
Tobacco Control.5 In addition, WHO has prepared and disseminated background material on the treaty
and on national capacity-building processes to prepare countries for treaty implementation. Finally,
WHO is available to respond to requests from diplomatic missions in Geneva and other government
representatives regarding the Framework Convention and other technical questions related to tobacco.
“Acceptance” and “approval" have the same international legal effects as ratification. Formal confirmation is the
equivalent of ratification for regional economic integration organizations such as the European Community.
2 The 10 participating countries were: Burundi, Comoros, Ethiopia, Kenya, Madagascar, Malawi, Rwanda,.
Seychelles, United Republic of Tanzania and Uganda.
The seven participating countries were: Bahrain, Egypt, Kuwait, Oman, Saudi Arabia, United Arab Emirates and
Yemen.
The five participating countries were: Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan and Uzbekistan.
5 Internet address, http://www.who.int/tobacco/fctc/signing_ceremony/country/list/en.
14
A57/18
The next step
65.
Pursuant to paragraph 7 of resolution WHA56.I, the first session of the Open-ended
Intergovernmental Working Group on the Framework Convention will be convened from 21 to
25 June 2004. The Working Group is responsible for considering and preparing proposals on those
issues identified in the Convention for consideration and adoption, as appropriate, by the first session
of the Conference of the Parties.1
ACTION BY THE HEALTH ASSEMBLY
66.
The Health Assembly is invited to note the above progress reports.
' Sec document A/FCTC/IGWG/1/1.
A57/1S
G. ANNEX 1
MEMBER STATES AND REGIONAL ECONOMIC INTEGRATION
ORGANIZATIONS THAT HAVE SIGNED AND/OR RATIFIED THE
WHO FRAMEWORK CONVENTION ON TOBACCO CONTROL
(AS OF 26 MARCH 2004)’
WHO African
Region (23)
WHO Region
of the
Americas (18)
WHO Eastern
Mediterranean
Region (8)
WHO
European
Region (28 +
the European
Community)
WHO SouthEast Asia
Region (8)
WHO
Western
Pacific Region
(15)
Algeria
Botswana
Burkina Faso
Burundi
Cape Verde
Central African
Republic
Comoros
Congo
Cote d’Ivoire
Ethiopia
Gabon
Gambia
Ghana
Madagascar
Mali
Mauritius
Mozambique
Namibia
Senegal
Seychelles
South Africa
Uganda
United
Republic of
Tanzania
Argentina
Belize
Bolivia
Brazil
Canada
Chile
Costa Rica
Ecuador
El Salvador
Guatemala
Haiti
Jamaica
Mexico
Panama
Paraguay
Trinidad and
Tobago
Uruguay
Venezuela
Egypt
Iran (Islamic
Republic of)
Kuwait
Lebanon
Qatar
Syrian Arab
Republic
Tunisia
Yemen
Austria
Belgium
Bulgaria
Czech Republic
Denmark
European
Community
Finland
France
Georgia
Germany
Greece
Hungary
Iceland
Ireland
Israel
Italy
Kyrgyzstan
Lithuania
Luxembourg
Malta
Netherlands
Norway
Portugal
San Marino
Slovakia
Slovenia
Spain
Sweden
United
Kingdom of
Great Britain
and Northern
Ireland
Bangladesh
Bhutan
Democratic
People’s
Republic of
Korea
India
Myanmar
Nepal
Sri Lanka
Thailand
Australia
China
Fiji
Japan
Malaysia
Marshall
Islands
Mongolia
New Zealand
Palau
Philippines
Republic of
Korea
Samoa
Singapore
Tonga
Viet Nam
1 The nine Member States that have already ratified or approved the Convention arc highlighted in bold-face type.
16
A57/18
G. ANNEX 2
(This instrument is to be signed by the Head of State, Head of Government or
Minister of Foreign Affairs)
LETTER OF AUTHORITY GRANTING FULL POWERS
I, [name and title of the Head of State, Head of Government or Minister of Foreign Affairs],
HEREBY AUTHORIZE [name and title] to sign subject to ratification, acceptance, or approval on
behalf of the Government of [name of country], the WHO Framework Convention on Tobacco
Control, which was unanimously adopted on 21 May 2003 and deposited with the Secretary-General
of the United Nations on 13 June 2003.
Done at [place] on [date],
[Signature]
(To be signed by the Head of State, Head of Government, or Minister of Foreign Affairs)
INSTRUMENT OF RATIFICATION
WHEREAS the WHO Framework Convention on Tobacco Control was adopted on 21 May 2003 in
Geneva, Switzerland,
AND WHEREAS the said Framework Convention on Tobacco Control has been signed on behalf of
the Government of [name of country) on [date of country’s signature of the Framework
Convention on Tobacco Control],
NOW THEREFORE I, [name and title of the Head of State, Head of Government, or Minister
of Foreign Affairs] declare that the Government of [name of country], having considered the abovementioned Convention, ratifies the same and undertakes faithfully to perform and carry out the
stipulations therein contained.
IN WITNESS THEREOF, I have signed this instrument of ratification at [place] on [date],
[Signature]
17
WHO
Why is tobacco a public health priority?
Tobacco is the second major couse of death in the world. It is currently responsible for the death
of one in ten adults worldwide (about 5 million deaths each year). If current smoking patterns
continue, it will cause some 10 million deaths each year by 2025. Half lhe people that smoke
today - thot is about 650 million people - will eventually be killed by tobacco.
Tobacco is the fourth most common risk factor for disease worldwide. The economic costs of
tobacco use ore equally devastating. In addition to lhe high public health costs of treating
tobacco-caused diseases, tobacco kills people al the height of their productivity, depriving
families of breadwinners and notions of a healthy workforce. Tobacco users ore also less
productive while they ore olive due to increased sickness. A 1994 study estimated that the use
of tobacco resulted in on annual global net loss of USS 200 thousand million, a third of this loss
being in developing countries.
Tobacco and poverty ore inextricably linked. Many studies have shown that in lhe poorest
households in some low-income countries os much as 10% of total household expenditure is on
tobacco. This means that these families have less money to spend on basic items such as food,
education and health care. In addition to its direct health effects, tobacco leads to malnutrition,
increased health care costs and premature death. Il also contributes to a higher illiteracy rote,
since money thot could hove been used for education is spent on tobacco instead. Tobacco's role
in exacerbating poverty has been largely ignored by researchers in both fields.
Experience has shown thot there ore many cost-effective tobacco control measures that con be
used in different settings and that can have a significant impact on tobacco consumption. The
most cost-effective strategies are population-wide public policies, like bans on direct and indirect
tobacco advertising, tobacco tax and price increases, smoke-free environments in all public and
workplaces, and large dear graphic health messages on tobocco packaging. All these measures
are included in lhe provisions of the WHO Framework Convention on Tobacco Control.
The World Health
Organization’s response to the
tobacco epidemic
offices for Africa, the Americas, the
Eastern Mediterranean, Europe, South-East
Asia and the Western Pacific. TFI-HQ
works closely with its regional advisers to
The Tobacco Free Initiative (TFI) was estab
plan and implement all activities. Its
lished in July 1998 to focus international
regional advisers, in turn, collaborate with
attention, resources and action on the
WHO's
country
representatives
and
liaison officers to facilitate tobacco control
global tobacco epidemic,
activities at regional and country levels.
Most of TFI's major activities are coordi
TFI’s objective
nated by its regional offices and decen
TFI's objective is to reduce the global
tralized to country level.
burden of disease and death caused by
tobacco, thereby protecting present and
future generations from the devastating
TFI's activities
health, social, environmental ond econom
WHO Framework Convention
ic consequences of tobacco consumption
Tobacco
and exposure to tobacco smoke. To
SECRETARIAT
Since the adoption
accomplish its mission, TFI:
Control
Framework
of
Convention
on
interim
the J&HO
on
Tobacco
Control (see box), the interim secretariat of
□ provides global policy leadership;
□ encourages mobilization at all levels of
the WHO FCTC has been concentrating
its efforts on ensuring that as many coun
society; and
□ promotes
(FCTC)
the
WHO
Framework
tries as possible sign and ratify the Treaty.
Convention on Tobacco Control'(WHO
Awarehe'ss-raising
FCTC), encourages countries to adhere
policy-itiakers,
among
politicians,
health professionals and
to its principles, and supports them in
society al large is essential to this process.
their efforts to implement tobacco con
TFI is also providing technical support to
trol measures based on its provisions.
countries to assist them in their efforts to
strengthen their infrastructure and lake the
necessary steps towards the signature,
flficalion and implementation of the
TFI's global structure
TFI
is part of the Noncommunicable
WHO FCTC.
Diseases and Mental Health |NMH) clus
ter
at WHO
headquarters
(HQ)
in
Geneva. Regional advisers for tobacco
control are based in WHO's regional
Research and policy development
TFI collaborates with an international
network of scientists and health experts to
promote research on various aspects of
tobacco production and consumption and
this reality, WHO's Member States unani-
mous.y
adopted
a
resolution
(WHA
their impact on health and economics.
54.18) calling for transparency in tobac-
Policy recommendations are developed
co control. TFI monitors tobacco industry
based on this research and in accordances
activities so as to provide essential infor
with the provisions of the WHO FCTCJ
mation to countries, as they work to devel
These recommendations cover different^
op national tobacco control strategies.
aspects of tobacco control, including regu
lation and legislation in relation to cessa
Training and capacity-buildinc
tion, second-hand'tobacco smoke, smok
In order to encourage and help countries
ing and children, smoking and gender,
Io sign, ratify and implement the WHO
FCTC, TFI is working on projects that aim
economics and trade.
to strengthen national capacity in tobacco
Surveillance and monitoring
control by building on existing national
TFI monitors and evaluates international
public health systems. With that objective
reviewing
in mind, TFI is organizing a series of
structural elements (existence of task forces,
regional, sub-regional and national work
commissions, nongovernmental organiza
shops using evidence-based training mate
tobacco-related
issues
by
tions (NGOs)), process developments (laws
rials to help counlries develop and imple
behaviour,
ment tobacco control measures tailored Io
exposure, advocacy) and epidemiological
their local needs. A series of case studies
and regulahonsjSeconomics,
data (prevalence, morbidity, mortality).
from different countries on successful tobac
co control interventions is in production
Current surveillance projects include the
creation of a Global Database, based on
Communication and media
a common standard, to maintain tobacco
Public awareness of tobaccos harmful
control data worldwide, and the joint
effects is essential Io lay the foundations for
WHO/CDC (US Centers for Disease
acceptable tobacco control policies and
Control and Prevention) Global Youth
regulations. TFI works Io ensure that tobac
Tobacco Survey (GYTS), which aims to
co remains in the public consciousness by
monitor
consumption
trends
funding anti-tobacco media campaigns
among 13 to 15-year-olds and evaluate
and workshops undertaken by local,
tobacco
youth tobacco control programmes.
national and international groups. World
No Tobacco Day, celebrated around the
Understanding the tobacco industry's
world on 31 May each year, is the culmi
practices is crucial for the success of
nation of TFI's advocacy activities.
tobacco control policies. In recognition of
TFI’s global network
TFI
is
expanding
network
its
WHO Collaborating Centres.
of
WHO
TFI collaborates closely with other WHO
Collaborating Centres are a network of
departments at all levels in cross-cluster
national institutions designated by WHO
initiatives to facilitate the integration of
that carry out activities in support of
tobacco control into other health pro
its
grammes (e.g. child and maternal health
Collaborating Centres workvpn research,
and tuberculosis)- Outside WHO, TFI
training and advocacy. Working with
works with Member States, other interna
international
work.
health
TFI's
national institutions is an effective way of
tional organizations and civil society
increasing national capacity and paving
NGOs working on J tobacco
the way for self-sustainable programmes at
through
control.
country level
The United Nations Ad Hoc Inter-Agency
Tobacco
Task Force on Tobacco Control was estab
availqblS.commercial products that are vir
lished by the Secretary-Gen^BI? of the
tually unregulated. At the same time, it is
is one of the
few openly
United Nations in 1998 Io, coordinate
the Only legally available'.^oduct thol kills
the tobacco control work being carried out
one half of its regular users when con
by different United Nations agencies.
sumed as recommended!™ its manufac
It is chaired by WHO and comprises
turer. To address this issue, the Director-
17 agencies of the United Nations system
General of WHO has established a Study
and two organizations outside the UN
Group on Tobacco Product Regulation.
system.
Theigroup, which includes leading scien-
lists in the field, carries
out
WHO-HO, Geneva
NMH, TFI
Member States and
regional economic
integration
organizations
International agencies
Other WHO-HO
departments
research
and
drafts
recommenda
tions
for
Member
WHO's
States
on
how Io establish regu
,
'
TFI regional advisers at
WHO regional offices
Other deportments
in regional offices
Civil society, NGOs
latory frameworks for
the design and manu
facture
Collaborating Centres
WHO country representatives
and liaison officers
products.
Study Group on Tobacco I
Product Regulation
TFI's work is only possible thanks to the collaboration with other
institutions and the financial support from several donors.
of
tobacco
WHO Framework Convention on Tobacco Control
The WHO FCTC wos unanimously adopted by WHO's 192 Member States in Moy 2003. If is the
first public health treaty negotiated under the auspices of WHO. It represents a turning point in
addressing a major global killer and signals a new era in national and international tobacco
control. The WHO FCTC reaffirms the right of all people to the highesf standard of health. In
contrast to previous drug control treaties, it asserts the importance of demand reduction
strategies, as well os supply issues.
The Convention has provisions that set standards and guidelines for tobacco control in the
following areas:
□ tobacco advertising, promotion and sponsorship;
□ packaging and labelling;
□ regulation and disclosure of contents of tobacco products and smoke;
□ illicit trade;
□ price and lax measures;
□ soles fa and by minors;
□ government support for tobacco manufacturing and agriculture;
□ treatment of tobacco dependence;
□ passive smoking and smoke-free environments;
□ surveillance, research and exchange of information; and
□ scientific, technical and legal cooperation.
The WHO FCTC is deposited in the United Nations Headquarters in New York and is open for
signature from 16 June 2003 to 29 June 2004. Member States that sign the Convention indicate
that they will strive in good faith to ratify if, and show a political commitment not to undermine
the objectives set out in if. The ratification of the WHO FCTC binds a Member State Io implement
its provisions.
Counfries wishing to become a party to the Convention after 29 June 2004 may do so by means
of accession, which is a one-step process equivalent to ratification. The WHO FCTC will come into
force of low 90 days after it has been ratified by 40 Member States.
Headquarters
TFI/NMH/WHO-HQ
20, Avenue Appia
1211 Geneva 27
Switzerland
Telephone: +41 22 791 2126
Rec ional Offices
WHO Regional Office for Africa
WHO Regional Office for Europe
Mozoe Street, P.O. Box BE 773
8, Srherfigsvej
Belvedere, Harare, Zimbabwe
DK-2100 Copenhagen
Telephone: +263 912 38563
Denmark
Telephone: +45 39 17 17 17
WHO Regional Office for the
Americas / Pan American Health
WHO Regional Office for
Organization
South-East Asia
525,23rd Street, N.W.
World Health House, Indraprastha Estate,
Washington, D.C. 20037
Mahatma Gandhi Road
U.S.A.
New Delhi 110002
Telephone: +1 202 974 3000
India
Telephone: +91 11 2337 0804 or 11 2337 0809
WHO Regional Office for the
Eastern Mediterranean
WHO Regional Office for the
P.O. Box 7608
Western Pacific
Abdul Razak El Sanhoury Street,
P.O. Box 2932, (United Nations Avenue)
(off Makram Ebied St),
1000 Manila
Nasr City, Cairo 11371
Philippines
Egypt
Telephone: +63 2 528 80 01
Telephone: +202 276 5373
World Health Organization
Tobacco Free Initiative
20, Avenue Appia
1211 Geneva 27
Switzerland
Telephone:+41 22791 2126
Fax:
+41 22 791 4832
E-mail:
tfi@who.int
Website:
http://www.who.inl/tobacco
©WHO, 2004. AU rights reserved.
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