In its 2022-23 end of biennium report, released earlier this month ahead of the 77th World Health Assembly currently underway in Geneva, Switzerland, the World Health Organisation (WHO) observed that there had been a decline in the use of tobacco. Considering that the other health-related targets of the Sustainable Development Goals appeared to be off track, the WHO expressed optimism at this. It stated that statistics from 150 countries had revealed a decline and furthermore 56 of them were making progress towards achieving the global target for reducing tobacco use by 2025.
The WHO, as well as other global stakeholders, has been making reference to a ‘tobacco endgame’, which that agency defines as smoking prevalence per country of less than five percent. It believes this is achievable, particularly by low and middle-income countries, and has therefore been urging governments to adhere to the WHO Framework Convention on Tobacco Control (FCTC), which involves setting goals and instituting policies that will lead to that result.
Big Tobacco has other ideas. The world’s largest producers (collectively called Big Tobacco) have been sued and held up for censure over their role in intentionally making cigarettes addictive and lying about the impact on health. However, the US$206 billion so-called ‘global settlement’, shared among some 46 states in the US in 1998 touted as “landmark” for its time, was a mere fraction of what the industry generates in revenue annually. Furthermore, it was not even required to pay all of it at once. Up to two years ago, states were still to receive their portion of the payout.
Meanwhile, producers show no sign of cutting back on their output. Annual production of green tobacco is 6.3 million tonnes. This year, the industry is expected to generate US$965.1 billion in revenue; 88% of sales come from cigarettes with 10 million sold every minute. Globally 1.1 billion people smoke tobacco products and 330 million people use smokeless tobacco products. Furthermore, 80% of smokers are daily users.
In response to health stakeholders concerns, Big Tobacco touts itself as part of the solution to smoking. Philip Morris, a major member of that collective, reports that e-cigarette use is expanding.
On offer are heated tobacco devices which do not involve fire, or produce ash or smoke; e-vapour (e-cigarette) products most of which contain nicotine; and pouches designed to be placed in the user’s mouth so that the nicotine in them can be delivered orally. These items, they claim, are better alternatives to cigarettes. Perhaps to avoid litigation, a caveat that they are not risk free is provided, along with the admission that nicotine is addictive.
Both the e-cigarette cartridges and the pouches have fruit and or menthol flavours, which make them attractive. Some countries, like the US, have since banned the fruit, as well as the candy flavours that once proliferated these products, heightening their appeal to children. However, they are still being produced and sold elsewhere.
Tomorrow’s observation of World No Tobacco Day focuses on protecting children from tobacco industry interference. This is in view of the fact that the most recent data (2022) revealed that at least 37 million children aged 13 to 15 years old were using some form of tobacco. The current most prevalent products targeting children are the e-cigarettes and the nicotine pouches. Many countries do not have an age stipulation on the purchase of nicotine pouches or products for vaping, which are often presented in advertisements as less harmful.
Globally, Big Tobacco spends billions annually on advertising, promotions and sponsorship. Although banning tobacco advertising is one of the FCTC strategies, many countries have completely not taken that step, but have instead only restricted promotion and sponsorship. Unfazed, the companies have turned to using social media influencers who have huge followings, particularly among the young, placing them right where they want to be.
The tactics employed by Big Tobacco indeed resemble a game of chess. The trouble is that this one is deadly for the pawns and governments must move to protect them. There is no escaping the fact that smoking kills more people every year than suicide, drug overdoses, car crashes, and alcohol, combined. The health issues caused by smoking include heart disease, emphysema, acute myeloid leukaemia, and cancers of the mouth, oesophagus, larynx, lung, stomach, kidney, bladder, and pancreas. It can also reduce fertility and result in low birth weight in newborns. All of these also place a significant financial burden on healthcare systems that far exceed the estimated US$400 billion tax revenue earned annually. Weighed in the balance, the choice could not be easier. Governments must heed the call to act now.
