Tobacco use is injurious to health and kills around six million people each year. Efforts to control tobacco as a public health threat have escalated
as clinicians and public health advocates have coalesced to beat back
threats from tobacco companies through public advocacy, public health,
and pension reform.
Public health advocates from Brazil,
Malaysia, Ireland, Australia, and Uruguay presented different strategies
that have effectively reigned in the global threat of tobacco companies
at a press briefing held at IASLC 17th World Conference on Lung Cancer
‘Global public health advocates presented different strategies that have effectively reigned in the global threat of tobacco companies at a press briefing held at IASLC 17th World Conference on Lung Cancer (WCLC).’
As a young doctor treating lung cancer patients at the Peter
MacCallum Cancer Center in Melbourne, Australia, Dr. Bronwyn King was
dismayed to see the impact of cigarette smoking on her patients - many of
whom had started smoking as children. However, her surprise grew when
she discovered that her hospital's pension fund had invested her money
in the very tobacco products that were killing her patients.
"Once I discovered that through my compulsory pension fund, I was
invested in and actually owned a part of several tobacco companies, I
couldn't just do nothing - I had to take action," she said.
To accomplish this, Dr. King founded Tobacco Free Portfolios to
collaboratively engage with leaders of the finance sector to encourage
tobacco-free investment. She soon found that finance executives were
also alarmed at the scale of the tobacco problem and have deeply
re-considered the role they can play in addressing this pressing global
"Because of this, there are now 35 tobacco-free pension funds in
Australia - just over 40% of all funds. Many more will soon
follow and each tobacco-free announcement is met with resounding public
support," she said.
"Tobacco is everyone's problem, not just the doctors who provide
the care and treatment. We should all feel obliged to do something about
it and all those with investments, including those through compulsory
pension schemes, have a role to play," she said.
In Ireland, the tobacco industry claimed that environmental
tobacco smoke was not harmful to public health, but the Irish government
rejected this claim and instituted a comprehensive workplace smoking
ban that included bars, restaurants, bingo halls, and casinos, according
to Dr. Luke Clancy of the TobaccoFree Research Institute in Dublin,
Ireland. Ireland was the first country to enact a country-wide ban.
"The 2004 smoking ban in Ireland has shown a positive impact on
public health and has served as a model for other European countries to
follow," said Dr. Clancy of the TobaccoFree Research Institute in
Dublin, Ireland. Clancy's talk was part of a tobacco prevention theme
today at the IASLC 17th World Conference on Lung Cancer in Vienna,
Clancy reported that the planning and investment paid off, as the
national Irish smoking ban was associated with reductions in early
mortality. Studies on the effects of the smoking ban demonstrated a 13% decrease in all-cause mortality, a 26% reduction in
ischemic heart disease, a 32% reduction in stroke, and a 38% reduction in chronic obstructive pulmonary disease.
Since introducing its comprehensive, national smoke-free
legislation, Clancy reported that all 27 EU member state countries have
initiated some form of a smoke-free strategy. To date, 14 EU member
states have enacted laws which ban smoking in all indoor workplaces
including bars, restaurants, and clubs. However, several countries with
significant populations, such as Germany and Poland, have only limited
"Unfortunately, I was surprised to come to Vienna - this beautiful
city of art, music, and culture - to see people smoking in the lobby of
my hotel. It is hard to understand," Clancy said.
Clancy admitted there is much work still to do.
"Despite this progress, the prevalence of smoking in Ireland is 18.5%. The prevalence of smoking in Europe as a whole remains at
approximately 29% of the adult population, and seems to be
increasing among females in some European countries," he said. "Ireland
hopes to be tobacco free by 2025. Full implementation of the World
Health Organization Framework Convention for Tobacco Control (FCTC)
recommendations may not be enough to achieve this in Ireland."
While King and Clancy battle tobacco interests in their countries,
Dr. Zarihah Zain of Lincoln University College Malaysia is carefully
examining global trade agreements to make sure tobacco products are
treated like the dangerous, addictive products they are.
"The main objective of any global trade agreement is to encourage
the free movement of goods and service between countries by removal of
any forms of tariff and non-tariff barriers. However, when this
principle is applied to tobacco products, public health may suffer in
the countries governed by these very agreements," Dr. Zain said.
"Tobacco is not like any legal commodity, it is highly addictive,
causes deaths, precipitates serious debilitating morbidity, and accounts
for about 30% of all cancer incidence. An industry such as the
tobacco industry should not be given any privileges and should not be
allowed to benefit from trade agreements to gain hefty profits at the
expense of public health," Dr. Zain said.
The control of tobacco is one of the most cost effective public
health strategies, and tobacco is the only legal consumer product that
has an international law to curb its supply and demand via the WHO
Framework Convention on Tobacco Control (FCTC). However, Zain pointed
out that there are clauses in many free trade agreements that can
override the WHO Framework.
As an example, Dr. Zain cited nine specific clauses in the
Trans-Pacific Partnership Agreement (TPPA), which was negotiated by 12
countries of the Pacific Rim including Malaysia. She cited Chapter 2 of
the TPPA that requires tobacco to be treated like any other product in
terms of tariff reduction.
"We physicians have a role in our country's trade policies," she
said. "We should be consulted and we have to make our voices heard by
our governments about tobacco in global trade agreements."
Vera da Costa e Silva from the WHO Framework Convention on Tobacco
Control began the press briefing by providing a global perspective on
tobacco control and initiatives to counter tobacco company efforts to
create trade treaties that are bad for public health.
"I hope everyone in the world is soon free of tobacco smoke and that
people encounter bars, restaurants, and public facilities that are
smoke-free," she said.
Tobacco control plays an important role in the IASLC 17th World
Conference on Lung Cancer. The IASLC is proud to have a committee
comprised of world-renowned tobacco control experts from so many