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Chair
Secretary of State for Health and Human Services
Colleagues, Friends
It is a great pleasure for me to be with you all here today.
We gather with a sense of optimism. Firstly, because overall smoking
figures are showing positive trends in the US and in other
industrialized countries. Secondly, because the terms of the fight
against tobacco has changed dramatically.
The battle has been underway for over 50 years. The first big change
occurred thirty six years ago, when Luther Terry introduced his landmark
Surgeon General report. The damaging health effects of tobacco were
clearly stated. Tobacco gives rise to cancer. Tobacco kills. This became
the foundation for policies to curb the tobacco epidemic in a number of
countries around the world.
The second big change took place in the last three years. Through a
number of court verdicts and inquiries, another fundamental principle
has emerged. Tobacco companies should be accountable for the harm caused
by tobacco use. This principle will guide policy and public opinion in
the future. It is also a principle which the tobacco companies will have
to consider when they plan their future strategies.
Unfortunately, optimism about progress is not universal. Anyone who
believes that we are winning the battle against tobacco should take a
look at the global figures.
What they will see is an emerging epidemic. As we have already heard,
worldwide mortality from tobacco is likely to rise from about 4 million
deaths a year in 1998 to about 10 million a year in 2030. An epidemic
increasing to ten million deaths per year. In public health terms, this
is comparable to the HIV epidemic. Over 70 percent of the deaths will be
in the developing world.
The implications are obvious. Tobacco is not only a human tragedy.
Tobacco also burdens our health systems. It costs taxpayers money. It
hampers the productivity of our economies. We have seen this happening
in the U.S. and in Europe. But now, these burdens are hitting developing
countries, countries which need all their resources to build their
social and physical infrastructure. They have no money to spend on the
unnecessary costs of a man-made epidemic.
Tobacco companies know that to develop a market, they have to capture
the young, during the years when habits are shaped. This is why we these
days see the companies using the same brutal marketing tools that they
had to give up decades ago in the U.S. and Western Europe. Disco nights
where the "entry ticket" is empty cigarette packets. Pretty
girls who give out free cigarettes where teenagers meet. Sponsoring of
sports and cultural events for the young. Lifestyle advertising clearly
aimed at the young.
It takes place in Sri Lanka, in Kazakhstan, in China and in Cote d’Ivoire;
in every country which does not have the legal and economic system in
place to keep out the billion-dollar marketing machines of the tobacco
companies. They make a mockery of the industry’s claims that they are
concerned about smoking among the young; that they only market tobacco
to adults who, they say, can make "free choices" about their
smoking habits.
Let us look at some of the findings of the "Global Youth Tobacco
Survey", an international project launched by a number of agencies,
including WHO and the Centers for Disease Control and Prevention. This
survey will provide baseline statistics on youth smoking that will help
us establish the trends of youth tobacco use. We have published some
early findings in the latest issue of the WHO Bulletin.
Among 50,000 children aged 13 to 15 in 12 developing or transitional
countries the findings are revealing: 24% of them had tried smoking, 9%
said they were current smokers. A quarter of those who smoked said they
had started before they were 11 years old. It is significant that 68% of
them said that they wanted to kick the habit.
Tobacco companies could show they are serious about not wanting youth
to start by committing themselves to reducing brand-specific smoke rates
among youth in all countries. Let us see companies compete to achieve
serious reduction in consumption among youth – and consider how to
react to those who fail to do so.
The latest WHO Bulletin also points to the other main target of the
tobacco industry: women. Women make up one sixth of all smokers
worldwide, and half a million out of the four million people who suffer
tobacco-related deaths are women. Tobacco companies see this as an
underdeveloped market and appear to be trying to raise the percentage of
women who smoke.
All this is bad news. In the words of a recent statement from the
British House of Commons: "It would be a hollow victory if, as a
result of more stringent action taken on tobacco control in the
developed world, smoking related deaths were merely exported to the
world’s poorer nations."
Yet, the picture is far from bleak. Globally, we have seen a
sea-change over the past few years. A groundswell of local, national and
global actions is moving the public health agenda ahead. This is
occurring through the development of innovative partnerships, networks
and alliances.
Two months ago, I watched as 10,000 health volunteers gathered in
Bangkok to mark this year’s World No Tobacco Day.
World No Tobacco Day is now both a process and an event. The process
of getting ready for the event in May builds capacity in the
international public health community to raise the quality of the global
debate on tobacco control.
"Tobacco kills – Don’t be Duped’’ was this year’s
theme with a special focus on tobacco advertising and promotion in
films, music and sports. It allowed the world to get a better picture of
tobacco-industry backed duping of science, public health and government
policy packaged as freedom and fun. The right information in the right
hands lead to unprecedented visibility for tobacco control.
On the same day, here in the U.S., the Surgeon General co-hosted a
meeting with Reverend Jesse Brown in Philadelphia to highlight the way
in which tobacco advertisements target minority groups.
In Lebanon, the First Lady urged action against tobacco promotion and
advertising.
The Brazilian Minister of Health launched a massive multi-media
campaign and announced increased excise taxes on tobacco products.
The South African Health Minister announced that cigarette sales
would be regulated, free distribution of cigarettes would be prohibited,
and that all advertising would be banned. The laws came into effect last
month.
In Canada, the Health Minister used World No Tobacco Day to unveil
new cigarette packaging. The labels show, as many of you know, in
graphic detail, the effects of smoking - not only in the lungs, but also
oral cancer, gum disease and clogged arteries.
Sports and media stars also voiced their support for anti-tobacco
measures.
Imran Khan, former captain of the Pakistan cricket team called on
international sport – both players and organizers - to stop accepting
sponsorship from tobacco companies. He said that: "sports symbolize
health and vitality and tobacco causes disease and death. These two
cannot be associated."
Here in the USA, Eric Karros, of the Los Angeles Dodgers, joined a
high school rally against tobacco promotion. He unveiled a public
service advertisement featuring himself and other baseball players from
the New York Yankees, Cleveland Indians, New York Mets and Boston Red
Soxs talking about the importance of staying tobacco-free. Smoke-Free
Soccer is another campaign gathering momentum.
Super Model Christy Turlington and the music group Boyz II Men backed
WHO’s call for stars to end tobacco promotion and glamorization.
These are not one-off events. They are examples of a growing global
movement that demands tobacco-free policies to be the norm. And we see
results.
On the World No Tobacco Day, David Byrne, European Union Commissioner
for Health, called for strong support for new European Community
regulations aimed at tobacco products. In June, the European Parliament
voted for a range of tough new measures: warnings that cover 50% of the
space on cigarette packs; removal of misleading information such as ‘low
tar’ ‘mild’ and ‘light’; and reductions in tar and nicotine.
The Health Minister of Malaysia recently called for a ban on all
forms of cigarette advertising and promotion, arguing that smoking among
Malaysia’s teens was rising due to the influence of deceptive
advertising.
Switzerland has legislated sharp increases in excise taxes and set in
action a series of new measures aimed at preventing youth from beginning
smoking.
In Uganda, the parliamentary committee on social services has called
on the Ministry of Health to introduce bans on smoking in hospitals and
confined places, to ban tobacco advertising, to tax cigarettes heavily,
and to force the industry to place conspicuous and clear warning labels
on their products.
In Korea, antismoking groups have urged the government to totally ban
cigarette advertising in order to protect youth and adolescents from
becoming addicted to tobacco.
In Australia, the government unveiled graphic new anti-tobacco
advertisements aimed at young women. The new advertisements track
cigarette smoke inhaled by a young woman through to her lung. A healthy
lung is shown. A large quantity of liquid tar, representing the amount
of tar a smoker would inhale during a lifetime of smoking, is poured
into it.
Mauritius and Spain launch court cases against the tobacco industry.
Norway is preparing to do the same.
In many countries, all over the world, grass roots activities are
inspiring governments to take action.
That action centers on a few well-tested and effective measures:
increased prices, a total ban on tobacco advertising and sponsorship,
strong counter-advertising, better access to quitting methods,
smoke-free areas and controls on smuggling. This prescription is also
the basis for the advice to developing countries that is contained in
the latest World Bank/WHO book which will be released Wednesday. It
shows that increased tobacco taxation both reduces smoking rates and
increases revenue. That is really good news, and a finding governments
around the world need to take on board.
A truly global debate on tobacco, such as the one unfolding around
us, is possible only when meaningful interaction occurs between all
constituents who have a stake in health and are willing to stand up for
it.
Strong support from the NGO community is essential to secure a robust
and meaningful global movement which will make a concrete impact on the
tobacco epidemic. A growing global alliance of NGO’s is operational in
a large number of countries.
The United Nations Foundation, the Tobacco Free Initiative’s single
largest external donor, supports projects ranging from NGO and media
advocacy to youth and national capacity-building. The Rockefeller
Foundation has just announced a major grant for capacity-building in
South-East Asia, and pharmaceutical companies are providing support in
their area of expertise.
WHO has taken on a key role in this global effort. The reason for
this is clear. As the World’s Specialized Health Agency, we are
charged with working towards the best health achievable for all. Our
main priority is to promote health equity, and so contribute to the
well-being of all the world's people. We fight infectious diseases such
as malaria, tuberculosis and AIDS. But to fulfil our mandate we must also
go all out to reduce the terrible toll of tobacco.
All the global work, be it by NGOs, by governments, by the private
sector or by international organizations, is pointing in one direction.
Its logical conclusion is what now will take shape as the Framework
Convention on Tobacco Control.
The Framework Convention on Tobacco Control is the first
international treaty on public health ever proposed by the World Health
Organization. It is has been endorsed by the 192 member nations of the
WHO. Drafting of the treaty by the member states will start this
October. Like the Convention to ban land mines, the Tobacco convention
also seeks to stop a killer. The treaty will provide an international
framework to address both national health policies and to control the
global reach of big tobacco. It will set standard that countries can
adopt to control advertising, prevent smuggling and facilitate the
global exchange of knowledge.
For example, when Tobacco Companies confess in court in one country
that they knew that their product causes cancer and was an addictive
cause of death, that information will - thanks to the Convention - be
made available to people all over the world.
Adopting the Framework Convention will not be easy in some countries.
The talents and dedication of the people in this room today are
essential to this fight for better health. I ask you all to join me on
this ... to become partners with me and the World Health Organization on
this vital journey toward better health for all the people, everywhere!
In the global work against tobacco, what has been happening in the
U.S. stands as a profound inspiration and an important practical help.
The documents made public by the verdicts in court cases in the U.S. are
a powerful source of material for activists and governments who want to
see what the companies have been up to in their own countries. I know
from my own country, Norway that the documents freed by the Minnesota
case have led to discoveries on how companies deceived the government
and the public about the additives used in cigarettes and their health
risks.
Last week, we released the report of a committee of experts, that I
have convened, to consider whether tobacco companies have attempted to
adversely affect WHO’s policies and budgets for tobacco control. Their
work was based on these now-public documents.
Their conclusion was clear: "evidence from tobacco industry
documents reveal that tobacco companies have operated for many years
with the deliberate purpose of subverting the efforts of WHO to control
tobacco use. The attempted subversion has been elaborate, well-financed,
sophisticated and usually invisible."
I will carefully consider the committee’s recommendations and urge
governments, NGOs and other UN agencies to do the same. We must ensure
the integrity of the public policy process.
Let us use this information to guide public action at all levels.
Let me conclude by emphasising that you, the anti-tobacco
movement, represent an enormous resource in knowledge, experience and
enthusiasm which should be put to use globally.
To the representatives from over 100 countries around the world who
are here today, I say: share your successes, as well as your
frustrations, with each other. Urge your governments to act decisively
for the sake of future generations. Repeat to decision makers again and
again that we have a simple formula that is effective: increased tobacco
prices combined with action against smuggling, banned marketing and
sponsorship, smoke-free public spaces, access to quitting methods, and
counter-advertising. It works!
We have a common goal: reduce tobacco use worldwide and by doing so
save millions of lives.
We have a common focus for our work : a strong and effective
Framework Convention for Tobacco Control.
Let us all work together to change the scene for coming generations.
I sense that when we meet again, in three years time, there will be real
progress.
We will have an effective Framework Convention.
We will have seen the effective implementation of anti-tobacco
policies by at least 100 countries.
And, in several of these countries, there will be significant
reductions in tobacco use - particularly among the young.
Thank you. |
