Warsaw
18 February 2002

WHO European Ministerial Conference for a Tobacco-Free Europe

Honourable Deputy Prime Ministers, Health Ministers, Secretaries of State, Deputy Ministers of Health, Deputy Secretaries of State, Directors-General for Health, and distinguished representatives of Member States, international organizations, ladies and gentlemen.

I am honoured to meet so many of you here in Warsaw. We are here to continue to strengthen political support for the international response to the tobacco epidemic, and to facilitate rapid progress in developing, and then implementing, the Framework Convention on Tobacco Control by European Member States and the European Union.

An important goal of this conference is to review the work done on giving effect to the recommendations of the WHO European Conference on Tobacco Policy, held in 1988, and the three consecutive Action Plans for a Tobacco-Free Europe. We now need to put forth guiding principles for the development and adoption of the Fourth Action Plan in 2002. The Conference aims to strengthen the partnerships between European Governments, the European Union and a number of nongovernmental organizations involved in tobacco control. I hope it will prove to be another important milestone towards a Tobacco-Free Europe.

Since many of us last met in Chicago for the 11^th World Conference on Tobacco or Health, in August 2000, nearly 6 million people have died due to tobacco. So quite frankly: any delay in implementing effective policies means more deaths.

Remember: the threat posed by tobacco to global health is unprecedented. Tobacco kills about 4.2 million people every year, constituting the single largest preventable cause of death world wide. A staggering 1.2 million of those deaths occur in Europe. As tobacco consumption increases all over the world, especially among young people and people in developing countries, it will kill 10 million people a year by the late 2020’s.

Europe has done much to control tobacco consumption. But smoking prevalence is still high, with 38% of men and 23% of women using tobacco. There are eleven countries in Eastern Europe that have male smoking prevalence rates above 50%. As recently as 1996, 52.3% of physicians in Bulgaria smoked. Only five countries in Europe: Finland, Iceland, Italy, Slovenia and Sweden, in recent years, were able to reduce smoking prevalence below 25% for the adult population.

In addition to high prevalence rates in men, another concern emerged, with women and youth taking up smoking in higher numbers. Now more than ever there is a need to contend with the marketing and promotional activities of the tobacco industry targeting women and youth. The original focus of the tobacco industry has shifted. It was men in high income countries, now it is women in high income countries and men in low income countries. As a result, today, in most high income countries, women smoke like men and are starting to die like men.

According to the Global Youth Tobacco Survey, developed by WHO and the US Centers for Disease Control and Prevention, school children, aged 13-15 years, report very high exposure to second hand smoke. Here in Warsaw itself, 7 in 10 students live in homes where others smoke and are exposed to smoke in public places. The Global Youth Tobacco Survey, which covers 75 sites in 43 different countries, reports that nearly 25% of students have smoked their first cigarette by the age of ten. The data also show that six out of ten students who smoke want to quit, demonstrating the importance of targeting cessation, not just at adults but at young people as well.

The message is clear: the marketing of the tobacco industry must certainly not be mixed with any youth activity. It is essential not to take money from tobacco companies for youth prevention campaigns. I know many of you have already been approached.

Why do I say this so starkly?

Youth prevention programmes funded by the tobacco industry focus on telling youth that smoking is an adult habit. The mothers and fathers among you know there is no greater inducement to smoke than to have it presented as an adult activity. Industry-supported youth campaigns are biased toward increasing overall consumption. Do not unsuspectingly become part of the tobacco industry’s attempts at whitewashing their tarnished reputations.

As I mentioned, tobacco use is responsible for 1.2 million deaths in WHO´s European Region annually. During the last 10 years, countries who implemented strong tobacco control policies saw a fall in the death rates. But in countries where the marketing and promotion of the tobacco industry remains uncontrolled, the danger remains and really cries out for solutions.

Europe remains a major target of the tobacco industry. Recent examples of clever marketing abound. British American Tobacco (BAT) launched a chain of retail tobacco shops called "Lucky Strike" in Amsterdam, targeting the market of 18-25 year olds. In addition to tobacco products and smoking-related accessories, the stores also sell magazines, newspapers, beverages and food. A rest area with music and free coffee is also offered. If the Amsterdam stores are successful, the concept will be expanded internationally. As an example of potential ways to counteract this aggressive marketing, California has tackled the problem of reaching the critical 18-25 year old age group by banning tobacco use in bars and pubs.

The industry continues to exploit sport to sell its deadly products. In Hungary, despite an advertising ban which went into effect on 1 January 2002, sports sponsorship such as the Marlboro Hungarian Grand Prix continues. Sports sponsorship also continues as Imperial Tobacco sponsors a motorcycling event in Northern Ireland.

I would like to repeat that tobacco is a communicated disease - communicated through advertising and sponsorship. A particularly pernicious form of that marketing pitch is found in stadia and sports arenas world wide. Tobacco companies claim that they do not target youth, but in practice they ensure that sponsorship and advertising flourish at events attended by and attractive to youth.

People are now demanding action. In response to the global appeal for action, WHO has launched a campaign to clean sports of all forms of tobacco. That means tobacco consumption, and exposure to second hand smoke, tobacco advertising, promotion and marketing. I was at the 2002 Olympics in Salt Lake City to celebrate the event being tobacco-free. Kofi Annan, Secretary-General of the United Nations, and Dr Jacques Rogge, President of the International Olympic Committee, joined me in this quest.

This year, World No Tobacco Day, May 31, coincides with the opening of the Football World Cup in the Republic of Korea. The whole event in the Republic of Korea and in Japan will be tobacco-free. I urge you all to join this movement for Tobacco-Free Sports and to protect your people from the deadly marketing of tobacco companies.

We also need to be vigilant about other marketing techniques used by the tobacco industry. In addition to youth and sport programmes, the industry attempts to buy goodwill through other means. Its promotional activities include targeting educational and scientific institutions. Nottingham University in the UK recently accepted 3.8 million pounds sterling from British American Tobacco to create an International Centre for Corporate Responsibility. In protest, Richard Smith, editor of the British Medical Journal, resigned from his post as Professor of medical journalism at the University. The media is also not exempt. A UK journalist, Roger Scruton, has recently been exposed for receiving payment from Japan Tobacco International to place articles criticizing WHO and tobacco control, revealing a concerted campaign against the global treaty you are now negotiating. He failed to disclose his links to Japan Tobacco in his authorship on articles against tobacco control for The Financial Times, The Guardian, The Independent, and Wall Street Journal Europe.

Many countries in this region have addressed the death toll of tobacco in a tough way. Here in Poland, strong legislation has been implemented, including the promotion of smoke free environments, strong health warnings, and a ban on advertising. Recently, the Austrian Parliament adopted legislation to protect workers from second hand smoke, banning smoking inside the majority of workplaces. Revenues from increased excise taxes in the United Kingdom are used for smuggling control enforcement. In the Russian Federation, new legislation banning smoking in public places has gone into effect. Tobacco companies were also required to start placing health warnings on the fronts and sides of cigarette packs and meet new standards for tar and nicotine levels. Canada and Brazil have led this movement by requiring health warnings and realistic pictures on the packs, and by eliminating misleading descriptors on packages of cigarettes.

You have taken many steps, but there is a need for more.

Passive smokers in Europe need to become active in demanding their right to clean air, and not be fooled by the industry’s self-regulation policies. Environmental tobacco smoke legislation needs to be prioritized by governments as a tobacco control tool.

We encourage you to take action in the economic field as well. The World Bank has concluded that tax and price increases are the most powerful mechanisms for reducing the demand of tobacco. Increasing the price of tobacco products is the most effective method of curbing the prevalence and consumption of tobacco products. It can also induce current users to consume less tobacco or persuade them to quit. It can help prevent ex-users from starting again.

Increases in tobacco prices affect most of all the behavior of the young and the poor who tend to be more responsive to price changes than older and wealthier individuals.

Recently, several countries such as Canada, France, Ireland, South Africa, Thailand and the United Kingdom have acknowledged the impact that increases in tobacco prices can have on the health of their population and raised tobacco taxes to improve health outcomes.

The fact that one billion Euros are spent every year subsidizing tobacco production needs to be addressed. I join David Byrne, European Commissioner for Health and Consumer Protection, in calling for the phasing out of tobacco subsidies in this region, as a key element in developing a comprehensive and coherent European tobacco control strategy.

The recent Report of the Commission on Macroeconomics and Health highlights the importance of tobacco control. The report shows that just a few health conditions are responsible for a high proportion of the avoidable deaths in the poor countries and that well-targeted measures could save the lives of millions of people every year. Tobacco-related diseases are among these health conditions, making tobacco control a cost-effective investment for governments.

The Framework Convention on Tobacco Control you are here to discuss is part of the global solution to the global problem posed by tobacco. The aim of the treaty and of the negotiations you are undertaking is to save lives. That is the only bottom line the world can afford.

We urge you to keep the negotiating process transparent and to prevent the undue influence of the tobacco industry. All should work together to have an effective FCTC that protects all countries. Accession countries and developing countries around the world can lead some developed countries still tied to tobacco. Never lower your sights for short-term reasons: raise the bar: that means healthier people and healthier people means less poverty.

As Commissioner Byrne said recently, "the more progress we can make at global level on tobacco control, the more lives we can save from this epidemic and some tough decisions will need to be made along the way by all the parties concerned". We are confident that governments will complete negotiations by 2003 with a strong Framework Convention on Tobacco Control ready to be implemented by every single Member State.

Every 8 seconds someone dies as a result of tobacco.

Let us all work together to take positive action to control tobacco - for our countries’ health, and for the health of our children and grandchildren.

Thank you.