Arresting a global killer
Historic antitobacco treaty comes into force as 40 countries ratify it. Just how much can it suppress the smoke of death?
By Deborah Haynes
Agence France-Presse
A historic treaty aimed at saving millions of lives by curbing tobacco sales will come into force on February 28 after Peru became the 40th country to ratify it.
Iain Simpson of the World Health Organization (WHO) described the Framework Convention on Tobacco Control (FCTC) as "a major public-health treaty that will give people protection from tobacco for the first time."
Forty countries needed to ratify the treaty for it to come into force and the signatures were collected relatively quickly, said Simpson. "This reflects the fact that it is hugely important," he said. "There are 40 countries at the moment but we hope there will be many more."
Denis Aitken, a director at the WHO, described the development as "a historic moment because it is our first and the world's first significant health treaty."
One person somewhere in the world dies every six-and-a-half seconds from a tobacco-related disease and five million people die every year, Aitken said, warning that this number will double by 2010. As a result, the upcoming implementation "is not only a historic moment, it is a moment that we hope will change global health," he said.
The FCTC was agreed by 192 WHO member-states in May 2003 after years of negotiations and a tussle between tobacco multinationals and antismoking campaigners. It obliges countries to ban advertisements and sponsorship promoting tobacco products, forbid sales to minors, force firms to print larger health warnings on cigarette packs, use taxation to cut consumption, and fight smuggling.
"The population will no longer be exposed to misleading advertising, people will be able to live in smoke-free environments, governments will have the legal instruments to counteract the tobacco industry," said Vera Luiza da Costa e Silva, director of the WHO Tobacco-Free Initiative.
The price of cigarettes would rise as a result of the new law, making them less accessible, she said. In addition, smokers would be guaranteed medical treatment, she explained.
But even with the ratification by 40 countries, it is up to the individual governments to ensure that the correct mechanisms are put in place to implement the new framework.
The onus is on the many other nations, including the United States, that have yet to sign up, the WHO said.
With the number of smokers in the world set to rise from 1.3 billion people to 1.7 billion by 2025, much is at stake, the health body warned.
More than 280 million smokers live in the 40 states that have ratified the treaty, which include big tobacco consumers such as Japan, India, and France, said da Costa e Silva. "This means that if you consider one in every two smokers will eventually die because of tobacco-related diseases we could say that with implementation of the treaty in these countries we would save 140 million lives," she said. "Tobacco is the second cause of death in the world so it is a global killer."
"This treaty has the potential to save over 10 million lives per year," said Patricia Lambert, FCTC negotiator for the South African government. "We must now work to ensure that the countries of Africa, which led the way through the negotiations, ratify and implement the FCTC as quickly as possible," she said. "In the process, we will cut many target markets for the global tobacco industry, and hopefully, turn the tide on the spread of entirely preventable disease and death on the African continent."
"Now that this global treaty has become international law, it is no longer business as usual for Big Tobacco," said Akinbode Olwafemi of Environmental Rights Action in Nigeria. "But with millions of lives at stake, we urge countries that have not yet ratified it to do so without delay," he said.
The upcoming implementation of the treaty proved that countries working together had the power to overcome the tobacco-industry giants such as Philip Morris/Altria, said US-based Corporate Accountability International, urging the US to ratify it as well.
Antitobacco laws, flows, and flaws
The Philippines has yet to ratify the Framework Convention on Tobacco Control (FCTC). As long as we have not, we remain outsiders to a movement that seeks to save millions from the dangers of tobacco use.
The international treaty does have our signature of approval (September 23, 2003). But the World Health Organization (WHO) points out that signing the treaty only represents "an expression of political support and good faith in the interim period until ratification. "
When a country ratifies, it becomes legally bound to implement the conventions and protocols contained in the treaty.
So where are we now in terms of ratifying the treaty? For any treaty to be ratified, it needs to be deliberated upon exhaustively in the Senate: three readings and a period of debates prior to any resolution.
The Senate foreign relations committee, chaired by Senator Miriam Defensor-Santiago, is prioritizing the FCTC over other treaties submitted by the Department of Foreign Affairs to the Senate, reports the senator's office.
The first public hearing was conducted on January 18. Reportedly, the resource persons, health secretary Manuel Dayrit, WHO officials and heads of various institutions like the National Tobacco Administration, Philippine Tobacco Institute, FCTC Alliance Philippines, and Institute of Health Policy and Development Studies, were "unanimous in their support for the FCTC."
The different manufacturing firms were invited but none made it to the hearing, the committee says.
Why is ratifying treaty so important, anyway, when we already have the Tobacco Regulations Act (RA 9211)?
According to staunch tobacco-control advocate Dr. Daniel Tan, the current law is flawed. It has too many loopholes that the big tobacco companies are quick to take advantage of. The pulmonologist cites a few:
o The establishment of no-smoking areas just maintains the habit of smoking and hardly protects nonsmokers from exposure to second-hand smoke because monitoring and implementation of ideal room setup nationwide are lax.
o There may eventually be a ban on tobacco advertising on radio and television, but the law allows indirect advertising like "point-of-sell promotion," in which tobacco companies promote their products directly to sari-sari stores. It has also nothing against promotion through use of designs suggestive of cigarette brands on clothing, sports equipment, and other youth-oriented items.
"Basically the law said that [the industry] will not market to children, will not come up with any advertisement or promotional activity that is appealing to children--[but] WHO defines what is appealing?" he asks. "It is again left to the tobacco industry and advertisers to say their intention was not to appeal to children," he laments.
o Cross-border advertising, through cable TV for example, and smuggling are not addressed
"I believe the FCTC can help tobacco- control or public-health advocates to close some of the loopholes in our local laws," Tan argues.
He fears however that "legislators may feel it (FCTC) is redundant when in fact it is going to compel the government to enact more stringent laws and restrictions. Our tobacco law then would become at par with the international standards mandated by the United Nations and WHO Assembly," he explains.
The Senate foreign relations commit-tee also points out that the Philippines needs to prove its commitment to public health. Besides, it adds, only parties to the treaty can have a vote on the issues for discussion in next year's "Conference of Parties" and access to the financial and technical assistance from international organizations to states and parties adversely affected by the treaty.
M. Ciriacruz
A PACK OF LIES
PARIS
A lab owned by American tobacco giant Philip Morris uncovered evidence in the early 1980s about potential risks from passive smoking but its findings were never made public, a study published in The Lancet charges.
The German laboratory was discreetly used by Philip Morris as a way of gaining scientific evidence about smoking that could rebut or undercut its critics, the study says.
The lab, INBIFO, carried out intensive studies into the effects of smoking on test animals. As early as 1982, INBIFO told corporate chiefs that rats which had been exposed to "sidestream" (passive) smoking suffered worse lesions to the mucous lining in the nose when compared with rats that had directly inhaled the smoke, says the study. There were also high rates of nasal cancer among the passive-smoking rats, the scientists allegedly warned.
However, none of these findings was ever published in a scientific journal or made public, say the authors. Instead, INBIFO focused on publishing papers that were "useful to the [tobacco] industry" by attacking some of the scientific assumptions and methods for exploring the link between smoking and lung cancer, they charge. In one case, INBIFO even published an epidemiological study that suggested drinking green tea caused lung tumors, they say.
The research is based on internal documents that Philip Morris and other tobacco companies have been obliged to post on the Internet as a result of litigation in the United States.
"Philip Morris was, contrary to its contemporary public statements, aware of the greater health risks posed by sidestream smoke from the early 1980s," The Lancet study says. "However, the company appears to have chosen not to publish this even as it was conducting research to refute emerging evidence about the dangers of passive smoking."
The authors--Martin McKee, a professor at the London School of Hygiene and Tropical Medicine, and Pascal Diethelm and Jean-Charles Rielle, two Swiss experts WHO work with antismoking associations OxyRomandie and CIPRET-Geneve--said Philip Morris went to extraordinary lengths to ensure deniability about INBIFO's work.
The company acquired INBIFO [Institut fuer Industrielle und Biologische Forschung GmbH] in 1972 via a Swiss subsidiary, Fabriques de Tabac Reunies, according to the internal documents.
The scientists always reported their work to a "coordinator," a Swedish professor with close ties to the tobacco industry, WHO then gave his assessment personally to a small handful of senior Philip Morris executives WHO knew about INBIFO, it is alleged.
"Stringent measures appear to have been employed to maintain the secrecy of these arrangements, extending to consideration of establishment of a 'dummy' mailbox and the dispatch of documents to the home address of a senior Philip Morris scientist where they could be acted on or destroyed."
Philip Morris products include the top-selling brand Marlboro, as well as Chesterfield and Virginia Slims. They are owned by the New York-listed Altria group, which was known as Philip Morris until a corporate restructuring and renaming in January 2003.
AFP
They lied about the gene, too
The strategies used by the tobacco industry to counteract research linking tobacco smoke to cancer-causing mutations in a gene called p53 are detailed in a study published online on January 14 in The Lancet.
Damage to the p53 gene leads to uncontrolled cell division. Mutations in this gene are found in over 50 percent of all human tumors, including 60 percent of lung cancers.
Benzo[a]pyrene, a potent carcinogen, was identified in cigarette smoke in 1952. In the 1990s, studies demonstrated patterned changes in p53 after exposure to benzo[a]pyrene. A 1996 landmark study showed benzo[a]pyrene's interaction with p53 mirrored mutations found in actual human lung tumors. This finding provided strong molecular evidence of the direct carcinogenic effect of a tobacco smoke constituent.
Prof. Stanton Glantz of the University of California in San Francisco and colleagues examined 43 previously confidential tobacco industry documents relating to p53 and tobacco smoke. They found that prior to 1996, several tobacco companies supported research projects investigating the mechanisms of p53 mutations. Following the 1996 landmark study, tobacco companies planned a number of studies in response and supported studies that appeared to cast doubt on a link between p53 damage and benzo[a]pyrene in tobacco smoke.
In two instances, research arguing against a connection was undertaken and published by individuals with links to tobacco companies in a journal WHOse editor in chief has an extensive and undisclosed history of working as a tobacco industry researcher and consultant.
The Lancet Press Office
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