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Tobacco control: when economics trumps health
Tobacco makes a lot of people a lot of money. This mantra should be repeated often during any discussion of the epidemic of tobacco use. Today's discussion arises because WHO released a report on the global tobacco epidemic, stating that 2·3 billion people in 2012 were reached by at least one measure to reduce tobacco use, including warning labels, advertising bans, or high taxes. The report shows increases from 2010 in effective communication of the message that tobacco use is bad for health.
Gaps in coverage therefore exist for two-thirds of the world's population. 37 countries do not dissuade cigarette use with suitable taxation, and 130 have minimal or no policies covering use of warning labels. Even in countries with nominal bans and control measures, lax enforcement and corruption eviscerates their effectiveness. Increasing the number of people covered by comprehensive control measures, such as WHO's Framework Convention on Tobacco Control's MPOWER, will need strong political will.
Such political will—especially moves to restrict advertising and sale of tobacco products—is vehemently opposed by the tobacco industry on the grounds of free trade and intellectual property rights. New Zealand's ambitious plan to reduce smoking prevalence to less than 5% by 2025 and Australia's introduction of standardised packaging, which was targeted by cynical legal opposition, have set benchmarks in tobacco control. By contrast, the UK Government's decision to pause the consultation about the introduction of standardised packaging (citing sparse data, economic grounds, and fears of rises in illicit trade) is a disgrace.
Effective strategies and strong leadership are needed to influence those countries without adequate tobacco control measures. What does the UK Government's decision say, if not that economics trumps health? Despite proportional decreases in use, more people worldwide smoke now than ever before and tobacco use still kills more than 6 million every year. The UK should join Australia and New Zealand in setting an example to the countries looking to strengthen their resolve against the tobacco epidemic.
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