DR JUDITH MACKAY

WORIO

IlEALTH

Et DR MICHAEL ERIKSEN

ORGANIZATION

3 Male Smoking
S'noking has been portrayed hy its

sellers as a 013nl),. masculine

habit, llnkcd to health, happiness.

Gi\IDAM-D

fiU1CSS. wealth, po\\'cr and sexual

success. In reality, it leads to

"

sickness, prcm.lturc. death and

sexual problems .
Almost one hill ion men in the:
world smoke - ..bout 35 I)t!rcent
of men in developed
and 50 percent

countries

of men in

UtJITEO

dcveloping countries. Trends in

both developed

Of

SlAIES
A"'E~ICA

and devcloping

countries show that male smoking

rates h.1\'C now peaked and.
slowlj- hut surely f arc declining.
However, this i5 au extremely

---.

510\\' trend over decades. and in

the meantime men arc dying in

their millions from tobacco. In
general, the educated man is
gh'ing up the habh first. so th:n
srnoklng is hcco,nlng a habit of
poorer, less educated males.
(nina deserves special mcnucn
because of the enormity of the
problem.

Comprising

9BRAZIL

over 300

millicn male smokers. this huge

market is. accorcHng to Philip
Morris, "'the most important

feature.on the landscape."

Smoking trends
pe:rtcnlage: of male: smoktfS
1960-2000 wecled ceumrtes

'0C~
81"
1900

78%
19}'O

70~O

eO
6t ..
1960 S~

1980 61qtO

million

1990 $4CIb

o
.,..0

1970 4~

1965

1980 ll~

....

1910l8llt

197928<MJ

.. 90

2000

men in China
- equal to tho
ontlre population
of tho USAare smokers

24

Japan
15 and ever

UK
16and over

USA
18 ind ovct-

------------

10
The .ohacco indY"r}, uses
economic argument.s 10 pcr(uiule
go\-crnmenu.

_.

Costs to the Economy

Smoking accounted
for over

the nu:di.a .Ind the

genc:r.tl populauon lh"'t -,",oking

benefits the cconorny. It cuimJ

th.>t if

tobacco control

m.uurcs

introd1JCt"d. t.a.x rMTnUCJ will

fall, Jobs "ill be Iosl .and there
"ill be g"'.IIu"I<hlp 10 tbe
Me

econom}.

In 1999

But the indwlry greo"l}'

cxolggeralC51hc

"CUflOfnic

of total he.hh ""r.

expen".
In the USA

lu~,

if .my. which loWcco control

measures \\;11 QUSC and they
never nlt.IHI(ln the eeonomle ro~LS

which robaoco Inflict:.. ul)un e'er)

country.

H
e

Tobacco's cost to go\'crnlnen~.

to employe r s and to the
environment

includes soci aI.

welfare and health care

JlI>eluJing.
loss of foreign cxch.lnge In
in11)4)rting cigdrCth:.s; lu~suftuut
that could gru\\1 food: <:':):-l$ of
Ilres and dJJo.lgc to hUihliugs
caused by careless .'Illtuking;
environmental

deforestation

costs """ging froln

10

collection of

smokers' litter absenteeism,

decreased 1"'o"u<l1> il)'. higher

numbers

or 3ccidcnll

and higher

insurance premiums,

Trash collected
in the USA
43 st31'" 1996
oga~l1t b~tts
);,_ , 20'l10

;Co< ~

t : f r .

! i : : ,:l:_"r

40

6.16

Average days off sick

per year in the USA
1001
4.53

H
a
2
0
c
N

1t

Costs to the Smoker

The economic costs of snloking to

smokers and their Iamillcs include
rnoncy spent on buying 10000::0,

\\'hidt could otherwise be used on

food, clothing and shelter, I'mil),
holidays Or a car.
A. smoking kills. quarter of .11
smokers In the.ir \\'orklng ye ..rs,
Jimoking deprives the ltmokcr's
(amity of ,nan), yean of income.
Smokers also suffer loss of income
through illness. FoUo\\ing a
smoker's prenlluurc death, a
partner. children or elderly
pJ.rcnt5 can be Jcli destitute.
Folmlly members of smokers

Jose toccme througl1 (line taken

looking afeer smokers when they
are sick, and time lost lOlking
them to hospital. In some
de\tcloping countries a hospital
\fi~it can 1:3k(: days,

Smokers also have to shoulder

flightr health Insurance
premiums. and nlany other

mlscellaneous costs, sudi a5

Ina'CAscd wear and tear on .heir
home, IS \\('11as increased fire
risk.

Minutes or labour wortcd

to purchase 20 cigarettes
2000 stlectt:d c:itits

tID

internalional
brand

EEB

10<01b",nd

62 62

20

23 23

IIIrm UlJII
Abu Dhlbl

United Arab
Emirates

42

~I
20 20

IIIlIII Imll

Copenhagen Jak.rta Johannesburg

Denmark Indonesll South Africa

19 16

Montrial
Canada

Mumbal
Indl.

Nairobi

Kenya

Santiago
Chile

ShlngMI

W ......

~il'\l

Poland

2 Types of Tobacco Use

Manufactured cigarettes
consist of shredded

or

rcconstitut c'<1 tobacco processed

wuh hoodrcds of chemicals. Ofcen
with ,\ Iiltcr , they are
manufactured

by a machine, and

are Ute predominant form of

tobacco used worldwide.
Bidis consist of

.I

small amount

of

in dried

tobacco,

hand-wrapped

tcmbuml

leaf and lied with string.

Despite their sn1311 size. their Car

and carbon mnnoxlde

deliveries

can be higher than manufactured

cigarcuC$ because

or the need

to

!,ulT harder 10 keep bidi. lit.

Cigars

arc made of air-cored

fermented

lob.1OCOS

and

whh :. tobacco

\\"-"ppcr, and come In 11lany

$Ilap~..: and sbcs. from dgart!lh:-

.IIi1..cclcigarillWi.
cheroots.

double

stumpcn,

COrOllA!,

chuuas and

dhumns. In reverse chuu.) and

dhumtt sllloldng, the ignited end

of the cigar is placed inside the

mouth. There \\'~Sa revival or

cig..u-sllloking at the end of the

20th century .... nong both rncn

.'

legion and
parbof Asi a,

'

Cigartttts

arc: aViilable

lhrOlJ9hout the world.

Filter-tipped d9afcu~ art

usually more populir than
unfil'tled cigirettc:s. Hind

(olled cigarc:ttc:s ate also

widctv smoktd in many

countries.

anti women.
KrClck8

arc clove-flavoured

cig~rCltcs. They contain a wide

rJ.nge of exotic na"ourings and

cUSl:nol, \vlti"" ha." an

AnaeSlhctising effect .;tllo\\'ing for
deeper smoke inh.13lion.
Pipes

are made oflu;.1f, slate,

- tobacco

Regional varialions indudc:

the bowl and inh ..lcd

cheroots ~nd stumpc_n

twol'(rn ind central
Europe) ind dhumtis
(conlc~1 cheroots) used

Cl.l)' or other substance

Is plnccdln

through the stem, sorncumcs

tJ1fough ,"at cr.

Sticks ere 11l,.ulc frOIH sun-cured
tobacco 1:nO'\'11 a~ hrus ;a11(1
wrapped

Cigars arc smolted

throughout the world,

in <:igolfCUC paper.

in India.

T~t'CO is ust'd orally

Ihroughoul Ih. wo~d. but
princ1pitly In Southeast Asia,

In Mumbai.lndia,

SGqt,

of

women chc.w tob~ctO.

22

Deaths

Cigarette, kill half of all lffeume

users. Half die in middle age -

between J5 311(169 yC.lrs old.

No other OOI1!IUnICr product is
as dangerous, or kills as many
people. Tobacco kills more than
AIOS, leg.11 drugs. illegal (frugs.
road accidents, murder, ':UH)

women
industrialixd countrio
0.5 million

men
dt'Ytloping cecrnrles
1.B million

suicide ccmblncd.
T obacco already kills more men
in (Ic\'cloping

me"

countries than in

lndusrrlaltsed countries. and it h:

IikeJ)' that deaths 31'I1ong women
will won he the same.
While 0.1 billion people died
from tobacco usc in UIC 20th
centur),. ten rimes as Illan), will

wom~
dcvt:loping co'Jntrits --0.3 million

Total deaths
Prcmaturc dc:.ths
from tobar:t'O

worldwide:

die in the 21s1 centur),. ~1atcrnal

J",oklng during pregnancy is

2(}(J()

responsible for rnan)' foetal deaths

and hi a 150 a major cause of
Sudden Inf,nt Death Synclromc.
Passive ,uloking in the heme.
workplace,

-indu!llnaliSfd c:ounlri~
1.6 million

,otold .. ths
4.2 million

men
3.4 million

or in public places

w"""'"

also kill!!. although in lower

0.8 million

numbers. However, those killed

,10 nol die Ircm their own hahlt ,

but feorn someone else's.

Cbtklrcn lire Jl particular risk

of everyone alive today

Ircm cdclts !lIuoking. and even

slnC)king IJYother adults around
it

pregnant

woman has a harmful

effect on a foetus.

will eventually

Past and future

Annllil deaths due to tobacco
cltitNted wOf'ktwide
'950-2030 pro),td

1.3

2.1
million

be killed by tobacco

3
million
pro),.d

2025
'0
2030

2.1
million

Industrialised countries

to

2030
0.2
million

2000

negligible 1975
1950

36

7 million
proj<Cttd

dtvcloplng counlries

13 Manufacturing Tobacco
&.ch )"c')r, ever fht: trillion
cig~r('tlCJ.a~

m.anUr~ClUraJ.

China is b), r.. the brgeSt

dg~reltc rnanUf.lClUrcr. folln\\'etJ
hy the: USA. Chinc,\c agarel"'!
production tncrcascd from 225
billion dgm:llCJ annuall), in 1960
to 1.7 trillion II. ycar in 1995 .1
seven-fold iucreasc. The
value of toh.1cc:o
products I~vast , tOlllling
hundred. orhillion. or us doll ....
,) YC.Jr. Very Ihtle' o(,hi .. Illon'1 b:
spt:nt on \ol\KCU ibClr. ~'ore is
spent on fNpa. nher,. ~ntl
~ng
1Iw. on tol"""",.
NCMly 2 million people .lU
employed In d~ tnJnufoKture of
tohacco prndllM~. t\\oddrdJ of
whom are "'orklng In China, Indl~
and hlllol1f'!oloa.Joh In~!i('$ whlch
would rc~uh flVnn 3 reduction In
loilolrol ("lnSutnllllnn are estimated
to be fairly small.
'cchnoIQgic.l1 ,uJv.lnOCJ ill hoth
filnlling ,uul Ill.anuf.lcturing have ;)
",uch IArgtr Iml~r.'t nn JOMthan
lob.lcco control ('ITort"
l-IUI1Jr-cd~ d,elnk;al.) .aft'
",lcJaIto tob.acc:o in the
mlnufocture
dg.arell es,
CCOI1QIT1ic

.....
....""

or

or

Addlti\~s make ,",,,kr

e.ldcr

lD

Inhale into the lung nd .lIow for

le~~ tohOlCQlIn be ueed in ciU:h
dg.1rcttc. 'roda)" ~ ciwarcu.J Art

Wh~~ the tobacro dollar goes

For ~ry dollar spent on tobattO In Ihe USA.,.

highly englnecl'(.I. c.qul.ltcly

deli:lgncll"lIicotlnc dclh(ry
devtees".
[ksldCJ mlng h~J' tcbaecc per
dg;arctlc, the l"'tJlnpo~ltlon of , he

s.c..,.

of the
.,. of lddlll..s

ItId of.tl.tr

tcdtnologlcs. sud!
IS "'nllmng- .,.

"l
dgOlr<'ttc b 011\0 ch..1nging.
~l;,nur.lcturl'nlllr('

rccoll,thutC'.1

udng mon'

tub..1t'CtJ. "hieh

lhc UiC or

;
nlakC':s it (',"Ier 10 ..dd cllClnic.lIJ
.&n(110 inclu.k-Ic .. r alrln ....uu.l

dust

hich h.d

"

1'(.'\iolly been

dlJC.n1ed.

48

.. .
-.
. ~ .......
e

-. _

llIl

C<l

...

II>

Imondlm
dptllt.

14 Tobacco Companies
Philip Morris is the world's larg(!
tobacco colllpaJ\y.

$t transnational

whose Marlboro brand

is the world leader. In 1999 the
conlpany had sales of over
llSS47 billion. However,
excluding the US domestic
market, BAT sells the most

cigareut>.5 worldwide and has the

largest network in the most
countrlcs.

The. tobacco industry is a

mixture

of some

or the

most

powerful tr.lnsnational
comrnc ..cial companies in the
world. T OblCCO cornpanlcs,
whlch frequently merge, own
other huge industries and nan an
intricate vartery or john Ventures.

State tobacco monopolies have

been in decline slnce the 19805.

About 7 .000 medium
lilrge

state-owned

enterprises

'0were

privauscd in the 1980 s and 3

further 60,000 in the 1990 .. Ircr
the collapse of the former Soviet
Union. From the late 1990s. the
lr.-iF has pressurised countries
such "-'I the Republic of Korea, tile
Republic ofMoltlol", Thailand
end Turkey to prlvettse their state
tobacco industry lL'la condition

"We see the new

:t'
..,."..,L markets openinq up

--,., in Central Asia and

the Commonwealth
of
Indepondent Stato.
A8 really belnq the
future ot BAT vell
into tho noxt

century."

of

BAT.

1994

I03N.

The remaining

monopolies

repre!W!nt i\ cemhlned
cousumptlon of 2 hili Ion dgJrctttS
or -40 percent of the world's
total cigarette consumption.

leading manufacturer

headquerters location of
major uansntlllontll
tobacco companies

Since the carly 1990s, Ute

cigarette

companies

lta\'c

m;ul,h'cly incrc;)~ccl ,heir

1l1"lluf3cnlring capaol)' in
tlC\'c1ol'ing countries and eastern

Europe. where once the rich

c:ountrie:t c-xpurh .-.d ..death I1ntl
disease", inlTcasingly these arc
manufactured

50

loeaJI)'.

by country

A
u

Philip Monil

British Amcnc.n

reeaeee (BAO

Japan teeaeee Inu:rnation.1 UTIJ

R ... ta

Altadls

CONTENTS
Eor:eword

Dr Gro Harlem Brundtland,

Director-General.
wo-ld Health Organization

6 Cigarette Consumption
30
Annual ciga.rette consumption per person.
Top 5 countries. GlobaIlncreues from 1880 to
2000. Increases in the .a\cruge number of cig.rettes
smoked ill China between 1952 and 1996.

Preface

II

Ackno'''')cdgmcnts

13

7 Health Risks

Photo Credits

15

How smolting har"" )'ou. Smoking in pn:gnancy.

Deadly chemicals. Proportion of lung cancer,

About the Authors

17

12

COPO and ischaemic heart disease. Tobacco

I The History of Tobacco

18
The global.pread oftob.cco from the Americas
to the rcst or the ,,'orld. Hi~lorjcal h.ighlighu: of
kc~' c\'cnlS aud action taken to curb the epidctnic.

Part One: PREVALENCE AND HEALTH

2 Types of Tobacco Usc
Different forms of srnoking and other forms
of tobacco, Inc]uding cigarelle5, pipes, bid
Is, kretcks.

22

3 Male Smoking
24
Smoking prevalence among men. Trends in
$cle<.1CdCQuntric:r,Srnoking among physidans,
-'01' 10 countries. Tobacco industry quote.
4 Female Smoking
Snloking prevalence

26
anlong women. Trends in

selected countries. Where women smoke ;\1

mllrb ,)S W,'I)
Wh"rc Olcn smoke IPO rimes
as much as women. 'Iobaceo industry quote.
5 Youth
28
Tob .. ceo use prevalence lIlnQng male and female
)'0\1111. 1'.."lvo smoking. Youth perception of
,moking. 'Iobacco indw;try quotes.

Industry quo,es.
8 Passive Smoking
H .. m caused by pass;"e smoking. Chi.ldren exposed
to

paw"f!

'molting.

Numbers

~fT~ed

by push'e

smoking. Tobacco industry quotes.

16

If Deaths

Deaths from tobacco use In men and women.

Dying In your prime: 35 to 69-year-old., \vho die
from tobacco, PaSI and future deaths from tONeco:
1950 to 2030. Deaths in developed and developing
countries. Number of people alive t.O<iay ,,-ho
will c\'Cnlwlly die from tobacco, Tobacco industry
quote.

Part Two' THE COSTS OFTORACCO

10 Costs to the Economy
Heehh care com attributable to tob.tcco_
\Vorking cb)'f lost due to tONCCO. Co$1& of rires
and liner collection. Tobacco industry quo, es.
I J Costs to the Smoker

Or

42

Cost
I, pack of Marlboro
dga.n.-nes or equlvalent
international brand. ~"inu(cs
labour worked to
buy. p.ckel of dgM'Ctlcs. The CO>l of. peek of
,P\1arlboro dg;u-eucs or equivalent intern.ltiorul
b rand compared with food or clothing.

or

19

Politics
us Congressluve

The tobacco industry spends

the

million. of doli ars trying '0

Influence public policy. It makes

over SS million

major contributions

nearly six out of ten have

from tobacco companies,

to elected

officillis and political parties,

p.l)ments (,0 go"cmmcnlS to
support

infrastructure

accepted

such is

mass tT.lnsit and large investments

in sophisticated public relations
campaigns. Tbe industry also
gives money to civic, educational
and charitable organJ~tlons and a
host of other s.
Since 1995 US tobacco companies
have donated more than S32
million in political contributions
to state and federOlI
candidate, and political parties in
the USA, with over 80 percent

of

this paid to influence federal

elections

~ntl ofllceholders.

received

in contributions

From

1995 to 2000 current members of

and

tobacco nloney.

The tobacco industry snug!lt to

delay. and eventually defeat, the
EC directive on tONCCO
advertising and sponsorship by
seeking the aid of figure5 at the
highest levels of European
politics while ill times attempting

fundnisers. As well .. ampaigo

contributions.

tobacco companies

conduct direct lobb)ing and

sophisticated public relauons
campaigns. induding paid medl
to influence the opinions of
political decision-makers,
Comprehensive

tobacco

legid.tioD was dcf .. ted in the US

Senate in 1998. Those who voted
against thelegl,!ation Iud
received on average,

nearly (our

Parliamentarians in Europe have

times as much mooey from the

tobacco industry in the two yeal'S
before their last election, as these

accepted

\\'ho

to
conceal the Industry's

role.

money and even senior

positions in tobacco companies.

T obJCCO companies .1150 .lttcrnpt

voted in favour of the bill.

Bu}ing Influence and f~\'oun

through polttical conttibudons ls

to influence the political process,

by sub,ldising the air travel of

common

practice;

countries

do not require

candidates and their .talT. funding

political convemions and

mandatory

inaugurations,

however,

most

reporting.

and bosting

Buying influence

Exp.nditurt on lobbving by
US lobaeea comP~l'IjtS
USA 1997

Smok,l", Iebaeee COlIn';l S,l;BI.... -_~

teeeeee In.Stitutf $2~ 1 m

~.JJ
I

$3.7m
Brown Eo WIII1.mson (BAn

-r-rll'
.~

$4.1m

'III"

US Iobaeco Company
S5.4m
RJ RcyooldS

loll': $35.5 million

62

legacy w~bsit~

N_mba of docu01C1ln <d.ting 10 tach to_nlIY found

on thr Legacy wtb~tr of tobacco industry docvmcnts 2002
"'. high., 111<figun:.lh. morr:impc$nllht
to

.... nlry is

tht induslly.

5.000 ond ._

1.000 ',999

500-999
100.'99

IUSS'"

ffOIIATIO"

"nett 100
no dit'il

Of

othtr countries

.- -

_ "

........

'_

- --

.
-

_..J.'

- --

-A.i. 1a nov tbe

priority tarqat tor the

world anti-tobacco
movement.

W. Ihould re=-mb,r that .1

U.S. cigArette oxport. to
AI:itl account for 010 to

70' of our volume and

97\ of our profit
The 1,nplicatlonl

bUlino,._'hould

for our
this lOBqua

be succe ful,

ftre
aignificant.*

-Naturally,

.o~

pooplo

vill suspect tbat we at

the Tobacco Institute have

.pent .0 long fi9hting the

cl;.rette controveray that

w. hAve become 4 little

paranoid.

But let me aure

you that paranoia i.

justified. They are

out there: they are out to

c;et U-

policy,

Tobacco Inatitute,
USA,

1979

BAT'. description ot
-document
retention

....

P.hi1 ....

iioir.ri.ii.1.9.89

I11

the policy und.r

which tbou nd. of

incrinJnatin, docu=ent.
wer'e destroyed.

1.

67

16

m,,,v

"_pritt Is only OM of
radon that
influmcc: ""u9gling rates. Other mort
importlnt f.ctOl'l include: 1M tobllXJl)
Incflolrtr(s own role il'l '1c:l1itating
smuggling; th~ I,el. of ,ppf09riatt

controls Oft tobattO ptocfucts in

l"kmltJonal tn6e; ,rld the txi1.tcfttt of
ttmenctltd s.muggfil'lg MtWorits,
unUttnstd dlstritwtion.
1&lCanti~

P''''99lin9 l.awl,wtil" cn(on:~tnt and

otrtd.1 corruption. WHO. 2000

Between 300 and 400 billion

ciglrettc.J were smuggled in
1995. equal to about one third of
.11 the leg.lI), imported cig.re" es,
ClgareLtes are: the world's most
"'idel), srnuggled legal consumer

UNITEO S1ATl'S
Of AMERICA

product. They are smuggled

J.CTOj$

almost c\'cry national

border b), constantly changing

routes.
Cigarette snluggling ColUSCS
Immeasurable harm. lntcrnatlonal
brands become affordable to lowIncome consumers and to inlage.
conscious young people in
developing countries, Illegal
dgarettes evade lcg.u restrictions
end health rcguJation3, end while
the tobacco companies reap their
profits. govemnlents lose tax
revenue.
Some govc,mlncnLot arc now
!lulng tobacco coulpanics for
revenue lost due to sinuggling
,cti"itic. allegedly condoned by
the companies. ]\ie:.tS'UfCll needed
to control ,muggllng should
include "lonitoring dgilrctte
routes, using u:.chnolc)giCllly

..

Projtct1:4 ,h.re
if no .ttion taIc~n

sophlsttcared tax-paid m ar king'

un tobacco predccu. printing
unique serial numbers on all
p.ckagt. of tobaceo
products, and

jf

new rMuym;

taltm

US$ 1997

lIvt. ,nlm.1s
$24.000

Tackling tobacco smuggling

...

.-t

.nd dllty InCft.st4 by ~

incre:ASlng pcnaltles,

54

Tax few:nue lost for am kIny 50ad

smugglC'd Into the EuroptJn Un.ion

ProjmrdWft

Ciga/cues smuggled Into the UK

~s perccntage: of markc:t $hIre
1996 - 2004 projttd

Mllk powd.,
$36.000

t8
"'The .....

..-

to 5<11

shI,.

cWiM wwW k easy to ,.ck ...

be: IIIIUth dtt.., thM .IuY, cN,rfed
at dte. rttall co..ettf. and be cn'ttt!
d by tent .f ",UItOflS .f ptOf* C'Vtrf
..,.
orrttn. the inttmet w "" .. fot you."
OrAd 5t:ttltfrt;, lVog,jngfOtl fort. 2000

Internet Sales

WHERE ARE THE 600DS?

\.

Ciga.reue vendors ;'Irr "cry e.uy to

locale: onUnc;: by tht' jhnplcst

5CarciJ medt.1ni~l1ui.
1"hi. mode
perch e
tnnslatcs tnte global penetratfon

or

of tobacco produets,
unprecedented ..ccev or
dg~retteJ
minon, chc~p
eignett es through I.... oklonce
.u>d smuggling .... 1 unfettered
ad venWng. mukcting.u>d
promotion.
It is often In'f'Ouiblc t.o identify
the country of origin of sneh

'0

vendors, The m'jorit)' '1'1"''' to

be In Europe .n,1 the USA, btlt
counrrtcs as \'.rletl .loS C)'llnl~anel
P4.nanlll JI50 offer Internet Ales,
Str.1ngely, some vendor eke
credit card dct.II, from
prospecttve purchlJer'lC hut then
neither chugc ItOr ,U'p'tch .ny

Iert orduing (rom 12 websilts

which claim 10 orrer low prite ciguetles
10 the UK mutet 1001

12]

situ

sut

ciglreltu

lite chuged
situ

toot

but did Dot srld

10 ..

oary and srot

cigutttes
10

cigurttu

Pritu

quoled for 200 ciglreltu

I'ClO - 271

Rcllil

pricc in UK

138.60

Prier In UK If Inluceplcd

by Customs

I (38.

IS

dglrctte.t:.

The Internet 1"1,,, used by

tob.acco intc.rc.u to undc.rulc.c
sophisti .. ted public rclatioru. to
denigrll,c pro.ht,hh o~lit..ationJ
and Individual., to undermtne t~
science of'tobscec, and 10 "U;'Ick
tobacco ronlro11cglsliatlnn (see

m,l' 20). Legislation has not yel

Qught up ,,'htl this new threat to
health.
Sale. of dgolrclICIIllnd other
forms or tol~(!oo over the
internet

started

in (,.lme~t In the

mid.I990s, and ".

rise In (uture.

prrtllct1 to

"Most
sites
off~ring
cheap cigardtes are a rip
off. All cigarettes bought
via the lnternet
must
bear UK taxes. There arc
no allowances or loopholes.
Cigarettes bought from
sites that do not arrange
payment of UK taxes arc
liable to forfeiture.
In
the last year Customs
have destroyed over 10
million such cigarettes:
HM Customs and Excist. UK
2000

60

Philip Morris admits

being behind Wav~sn~t
website.
an internet
company set up to run
fashion parades and
rave parties where
cigar~tt~s are sold at a
discount."
Australian
Associated
Press. 2000

20

Smokers' Rights
Organisations
F O M :l S
.. .. . ". .'.- - " t

'

-.~"Ift

"""-

Stidldf'lg Rolen

VJ,,'''Roum
$_

_r o
d

kLlngm

kt(f

tJ On

ttta

lISt
rcw;es ta~

..

Amf'ric:a.l'l StnoUft-

AD~t

tu\)Of\ll Smolrl1
AlIl!

-"
Tobacco

.. ",'

A\WIC'!IlJOfW

Itallal'll hollla1Oti
rdcftlllOnC

J'NcoI

"'d
_Cl

ub

The

Indu\:lry h ..~ long

rhe In1)"'H'UnCC 4nd
difficulty "f rnohilbing smokers to
10h"(,NI

"ppl"CdIUt.~)

""",k QU' on !>d,.lf of .".ok ...

rigll ... Con sequ.n,ly the toln=
comj)o'nif'1 hj\(' 1nv~tig..ted ~Y.

developed world, 11", luh.atu)

inltwlry c)tK'\U\l('nl.l
IlIu'lr~lcth"t
w hile Itl.1.ll)'
IhclloC

or

org.lnlj,ltioru

purpon

'0

he incl<p<n<len. of

th.u th.), c;oulrl",tlmulote" the

the

development "f grouP" of

smoker ro .-" 10 I"" e the
~\lPIKII1,or at I....).. the
"ppe.lr ..nee
J"I'l'ort frOIl'
14moker. :Hul other "11111t1r,,u1r
thtrel p.\rty allie.".
'rh('rC': are fewer than two .Ic,zen

loNeco lncfu,"u'Y''''
'e.1~totOmt'

or

,S,tlokc'''''' rlgll1~ ol'g .. nl!loilll(I1)~ 111

the wcrkl, anti 1'11.1arc ill 11M'

.1t'f'

cft'~"d('nt on tob.K"ro

64

ctJ1npany funding. In 1 1988

docemeo t, the 1...4d of Philip
~'orri;: Aid. "Should "'C .trhc to
set up fOREST .~"., orgmis;1tioftJ
throughout our reg;orul".
A. the request of PlUhp MutT" the

public ",11I1ons flnn of

Erunon-~'arltell,)r formt'tl,hc N at
ion.U Smokers Alliance smokers
rights group, in 1993. Philip MorrlJ
Initi,lIy pro, hl.<I the N,tio",,1 Smok
.... Alii,,,,,,,
,\rlth

$+ milllen In s("("(1Funcllng.

l)oc\lInent5,ho\\' thiU I'hUlp l\lorris

ronntt'Il\i!nilar

grtHII." throughout

Europe. 11 ..- "gnwoo"" groups.

"ith ~l('ir
f.ad o(-independen",," from
the indwtry llowed ,r..,m.o do
.nd .. ,. thinG' pilltlid~
tobacxo ronlfW1lt"' could

.In.

",.t .

-TO .u= up, thon,

on using our natural
allies_ We have
~d. a start; we
hava provod that it

con be dono, we
have found that
the),con be 4 very
efrective

torce; and we
intend to
do more in the
future .-.
PhiUp "orrlo,
1985

7 I Health Risks
Tobsceo is ""eked
.md addlctive

Butane lighttt turl

cadmium Clr ~tttria
carbonmonode: Clr c,xhaust (umel

tobacco cause health probteus

'hrougholllilfc, frequen'ly

DOT In..ctitld.
Hydrogtn <yanid. 9" "".mbtn

resulting In death or disability.

Smoke rs hIV. markedly

and mouth.
Women JulTer .tddhioml hc::~hh
Ti,;". Smoking In pregn.ney b
d.lngcroulC 10 the mother ~4 well
as 10 the f<.ctu" espedAlly In I)oor

countries where health f.cllitie,

arc lnadcquate.
Malenl,.1 sll'Ioking II not only
hamlful during pregnancy. hut
Ius long.'erm dTcCtJ 011 the bobr
afier birth. Thl' b ofton
coml"'undrd by .. posure
p!i"e .moking rrom d~ mother.
f.,hor or other .dul .... "aking.

'0

While tobseeo kllls ",1111".,.

mere than I, help'.
it
under'''",y c.xamining Mly poJJiblc

re>cw

health bcnCnlS or nicotine anti

also tf)1ng
Ilnd fe use for
tobacco, por,lcul,,,I), In 'he Iletd
of gene1ic n'o~lIn(;uICin. 11,c aim
Is 10 prOdUL'C \'~{."Cincl or hUln311
protciru fc)r Il'I(!t,II,: ...1 use, or
even
'0 clean up loll lbo, h.u "<CI1
contaminated \,'Ilh C'.JCploJi\'el.

'0

32

paint Jtri pptt

floor dafter

Al>cnle ant polson

concluslvely ih ... 11rom .. of

'ongue

9) 3tt

Atttonc
AlTimonil:

SciendOc evtdence has Jho\\'n

,hey rl!k """",r of ,he lip.

over 4J)1JO~".
om,."_,cs
\nown 01 ~t:d
ca-rO~
C'Of"ta tIS

Tobatco smok. includes as feurld ,n

JUMl,Jr\CCj.

.md arc at f.Jf gr(!"l~r rlJk orhc.t.rt

disease straltct, emphy sem. and
m.lny other fat"l.Jnll nonf.ll.ll
dlse ases. I( ther chew tolwcoo.

reeeeee smo~

'0"'" of wlUcll ......." narted

Jl'!d ~

,,,th lurmful

increased risks or muluple

cancers, particularly lung cancer,

~adly dlemials

Babes in the womb

Smoking in pregnancy

Methanol

N.pthal...

Toluene

Vinyl_.

rodttt (uti

mou' bill.

,""

pI tics

tncrt.~~ riJb:

Sponta.""" ._

I ml>Clm.tg<

tttopcp<t<lN .....
AbnopbO plae<ftox
Pbctntl prHV'~
Pttmatu1't n,;pUltt of d\c ".cmbtana

Pr ....

"' bo""

FoetuJ.:
Small Infan' (for~,"""".I.i')
Stillborn Inrant
Birth d.rO<1S. '9 congenital limb redu<tlon
Incrc:aStd nicotine rt:pl011ln babY's brlin

Incr..

std IIltlihood of

Infanl smollng as. ,ren.g<l

Possible pliySl<a1.nd

10ng.'tmI.Heeu

1IIt",.1
Emy

cigar"'.

ta),67 tninliits

off)'OoJ' life:

5
"'If"..""" .. ttl

1InOkw.,. rht

twft ._.,

Youth
'"'-

id"'tty will ItdiM. jvrt a

popubrioft whic:h 6of:I ..of 9fw bil'tt'l
w,1I ",,",Nally chriadlt."
JU RcyrIold1rne.rtMr. " ..

The o\'Cr\\lltllrning n1.jol'l\), of

smokers begin tobacco U~ before
the), re ..eh Jidull_hood,

Arl'lung

those young ),)(:01'1(' \\ho S"lOL::c:.

nearly Qnco<lu.1ncr Jlnoked their
fir.!!l dgart"!ttt before: they reached
the age of len.
Several f"ClOrJ "'<TeASe the risk
or youth .. nuking. These include
tob.o<co induslTy.d ..,niIing.mel
promotion, ~y .aCU'U to tob.ac:co
producu .and 10", prices. Peer
prenurc pl"y. Animpon~t role
through rocnd' and .<lbling.

smoking. Other risk faCiors

aiSociatco ,,lth )'uulh inloldng

include having a hJ'''cr lk:lf.hni)gc

lhan peers, and pcrOliving that
tohilt.'CU u .. e h, norfH~1 (lr "CU(,'"

~'13.nystudies show tllli p",rcnl:.1

ft_ "'an SIlo of youngpcop1.

in 1Io1la ..... 110'-'
Cosu
Riel. Indonnia, Malawl,
Mon'.serrat.
fot.nd. Ru"lo, Singeporr.
and Vtnrzurla think gl,l. who

Ukn",)

stnOkt look mOft auracllvt.

of young peoplo
who continue to
smoke WIll dIe
from smoking

Euly smokers
0... 30'lIl of child ...
5moktd thd, first whok
Og.rrtlt

before age 10

in Ghinl, Grcn.cta. Guyana.

India. Jam.jca. PaI.u.l\)f.nd.
N M.rianailland<.nd 5t lucie.

.moking Is .<..oeh,,~1 with higher

youtt, )IHoklng.
While the most eeriou.
eiT...... ort~
we oo"nally
occur

.rtcr decades or smokIng. there

.a.rc alJO imnlnli ..te n~;a'h'c
beahh tiTccts ror young .mok .....
Most """'go
moke ... ar e a Ir
<ly adc.liC1('d \\ htle In le)olt'Sa".nCt".

The younger. I,,.. on ""gln, to

smoke, the gr('.lIrr
C\IC'HUoIlly

lht,

rbk

or

COlllr.1C1ll1g !lIloklng.

CJUlICJ ,IIJCIM!8

aueh 1&) cancer or

Ilc_,,,rt d!.(!:&set

The higllC't yo,lIh IIHoklng r.l1es

can be rounelln ern,rJI and
Ea.ntm Europe, M:ctl()nt ur India
lIltl some o( the \VC'.,crn p.lC,nC
bb.ncIJ.

of chlldr.n worldwldo

ar. oxpos.d

10

p..

slve smoking al

28

home

ACKNOWLEDGEMENTS
\Ve would like to tlpnk the Centers for Disease

Prevention

Control and Pre\'erltion (CDC). USA. for

providing financial upport for this atl ss.
Many people be e helped in the preparation of
this atlas. Firstly QUT Ih.mks to all those at the
World Health Org ieation:

Noncommunicable Diseases and Mental Health

Cluster (NMH);
Paula Soper, Tobacco Free Initiative (fFI),
Noncommunicable Di scases and Menul
Health Cluster (NMH);
Derek Yach, Noncommunicable Disuses and
Ment.1 Health Cluster (NMH).

Headquarters, ~encva:
Joycc Blecker, l'ionconlmu,niC3blc
Disease
Prevention and Hchth Promotion (NI)H),
Noncommunicable

Regional

IJisc.1SCS and Atcnul Health

Cluster (NMH);
Douglas Bertch r; Tobacco Fr(..'CInitiati\'e (1 FT),
Noncommunicable
Diseases and Menr ..J Health
Cluster (NMH);
David Bramley; Health Information
M.lnagclncnt and ~issemination
(lMD). Evidence
and Information fOf Polic)' Cluster (EIP);
0

Glan Luca

Bur . Office:: of the Legal Counsel

(LEG);
Vera Luil:! cia COsta e SiI,'., Tobacco Free
Initiative (TFI), Ndnoommunieable Di eases and
Mental Health Clutter (NMH);
Emmanuel Guindon, Tobacco Free Initiative
(Tf'1) Noncommunicable
Diseases and Alent")
Health Cluster (N'r'H);
Ewa Carlsson Hoppergcr, omce of the Logol
Counsel (LEC);

J>r.lbholt Jha. COmmission

on ~1~crocconomics
and Health (CMH), Evidence and Inform .. ion for
Polic), Cluster (Eli');
Ala.n Lopez, E~dencc and Informatinn for
Policy Cluster (EI~);
Garrett Mchl, 7onoommunrc.ble Dlsease
Prevention and Heahh Promotion (NPH),
Noncommunicable
Diseases and Mental Health
Cluster (NMH);
Dianra ~1uno,.tI.I Noocommunlceble

Diacoue

Prevention and H Ith Promotion (NPH),

Ncnccmruuotcabl
Dlseases and Mental Health
Cluster (NMH);
EI AtiO Musu~
Noncommuulcabl

Cluster (NMH);

I', Tobacco Free lnittatlve

(TFI),
Dbc.SC4I and Mental Health

Pekka Pwka, ~oncommuniahlC Disease

Prevention and H alth Prcmcrlon (NPH),
Noncommunicabl Diseases and Alent ..1 Health
Cluster (NMH);
Leanne Ililey. Noncolluflunh.:ahle Db.('<L~

Karen

and Health Promotion (NPH).

offices:

Kltmowski,

Charles

[\1"""ngo, AFRO,;

Fuimah M S EI AWa, EMRO;

Pats), Harrington, Haile: Nikogoiim. lone)J. Petrea,
EURO;
Heather Selin, Armando Perug., P.~HO;
Martha 0",,;, SEARO;
Huley Stanton. WPRO.
For their advice on particular nllps and subjects,
"'C would like to thank the: follO'oving:
2.. Types of Tobacco Usc
Sami .. Asma, CDC, USA; Prakash Gupu, Ta..
Institute or Fundamental
Research, Indla;

1. Male Smoking and . Female Smoking

MarlC) Corrao, Alnericiln Cancer Society. USA;
Amanda Sandford, ASH UK:
S. Youth
CYTS Coordinators; Wick Warren, CDC, USA;

6. Cig..reue Consumption
Tom Capehart, Economic Research Service,
USDA; Prakash Cup ta, Tal' Institute of
Fundamental
Research. India;
7. Health Ri.k.
Gary Giovmo, Roswell Park Cancer Institute, USA;
CorInne Pearlman, Ccmlc COlnpilny. UK;
Jonathan Samet, Johns Hopkins Institute for Glob.1
Tobacco Control, USA; Sun Shatensteln,
Collllnunic::ation. ccnsuhant, C"natia:

8. P... b-e Smoking

Chve Bnes, ASH UK; Corinne Pea.rlm.:Ln, Comic
Company, UK; Jonathan Samet, John. Hopl:ln.
Institute for Cloh.1 'robscce Conrrel, USA; Wick
W ... -en, CDC, USA:

13
['

rnarkcting:

controls on smoking in public places and

,,'orkpI3CCS;
expanded

aOCl'S:It:o effective means of

quitting;

tough oounterad\'(!rtislng;
tigln controls on smuggling.

Tbese nlust all be Implemented if the predicted

expansion of the epidemic as outlined in this aLlol$is
to be prevented.
The picture is f3.r from bleak. Glob"Uy. we have
seen a sea ch.Ulge over the past few years. A
gr()unds\\~11nr local, national and glohal actions is
mO\'ing the puhlic beahh 19O'ul41 a heat!'
DR GRO H.\RLE\l BRUNOn.,,,O
Genc' ...

June

10
B

2002

Publications of the world Health Organi7..atiou

C3n he obtained front:
MMketing and Dissemination
World Health Orgmization
20 Avenue "ppi,
1211 Gene". 27
Swnzerlend
tel: +41 22791 2+76
fax: +41 22 791 4857
email. bcxJkorocTS@\\'ho.int

Requests fOT permission to reproduce or

translate \VHO publications - whether for sale
or for noncommercial disrrfhution - should
be addressed to:
Pubhcaucns
acldfW as abo,.c
fax: +41 22 791 4806
email: pcrmissions,-,'ho. int
The designations employed and the presentation of
the matcrtal in 1,hispubltcation do not imply the
expression of any opinion whatsoever on the part
of the world Health Organi'l..3tionconcerning the
legal

IHatus

of any OOW'ltry, territory.

city or arei) or

of iu authorities, or con(."Crning the delimit.a.tion or

its Ieonncrs or boundaetes. Dotted lines on maps
represent appmxlmate border Jines for which there
may not yet be full agreement.
The mention of specific compsntcs or of certain
manufacturers' products does not imply that they
are endorsed Or' recommended
by the \\'or-iel
Health Or1,ranjzationin preference to others of It
similar nature that llrl! not mentioned. Errors and
omissions excepted, the names of proprieta.ry
product' arc distinguished by initi.ll C'Jpit<l1lcucrs.
The world Health Organi'l"ltion docs not
warrant

that the inforll1alion

contained

in this

pobhcarcn i5 complete and correct and ,hall not

he liable for .loy dllinolgcs Incurred ;1.\ it ~SU)l of its
lL"C.

The authors alone arc responsible for the

\~C\\'S

expressed in this puhlication.

'9

11

1 The History of Tobacco

wtIc:ft tH bfti ",-.as

..." MClC'ftt t~

,tama,.

blrrtn and the ~

Asia

wttt
Ihr
Ore'l $pili iC'ftt f."Jt # .... WI to j;It
".",.ftlty. ~ )IIc uMI('d Om' ,tic world
~hnt
h ritht hMId toud'lnf tf'Ic
loOlJ. thert gI'CW ,oblOb. Alief~""ft

h~ 'eft hJl'ldto~d
there

~pot'I

Hllron 1t,4,," '"yUI

Itlcit Journey

met

w,U, IJrfll mwflltudtJ of ptOplt. Mell and

WOl'lle" with n,tbrlnch In ilm, haneh a!'lel
hbt to smoke .tlc, ttltlr <vstom."

e NO'IC.mbtf 1-4'2
~'"g

It. antom IoItluomc 10 u'c

".ttf~1to the noM. hIt",r.,. tD the
bJ ....
tilt kM9I. .... 1ft III<
WICk. ftlflld.., 'lilac: thtfuf fltWUt
the hetTfIIolc Stn11J11 ."..,.
~

4..,. .....I.

mtfIIWI..,

USA~~I"

50:1:

...... . .......

Il<romoh """"

('OfluDi
of ttr: tobatto
"~Q\($

~...,l f 'I a

ClhllOS

theIOiLthm 9'c.

,rtW tob.ttO."

l*'" S,..nl.nh

t9~CthIU

,_
... ~...e'.,1i r

tqIOrt on dilng-trs

'''1(1

foft'9"

tompilr;.t:s

1900

Oft

Iffi~ml)

Chi Phol ..... "'"

f.ng Yilhi poi"tJ
Ogt loll, 'fD1l at

woli,.

L"se

G'~1100<,
1100

Oftt's

.,011 Q,.""f'I'I)

USAFim
0I1.... 1ttltyo(

r"")lft

""0:.,.be

~SlftCt
.Nt .._.

,,\_

0'K:!

011~50

11.)9

"

C2fftf'

t_

If''Iponedi<'!to
ChJtlI~frf'l:

b1It ..

Dot.

USA MJtO( '(pot!

s"'oliftt (W~1ldn

tig"lttUtl1..

.$CCIfdlC'l

It! Nil

USA_""

pelltvattci oy
fortig~ tob.ct"O

of

"'"' ea-ee

China .a1"l'lOS1
t:fltltdy

'GI

.f III< pit 1M' G ~ ...........

.10-. Iof Eoi ....

A Cbw'krtwftt to 10000 1504

r""

' ..... ifywc;ant

wfWI money. MMI~"

US

1100

"dlck", (ko'gc W.lhtngtOft"

rCllfJt:Uto he'" liNnet

the Am"fean Civil W.,. 171&

wnhln 150 )N'" ol l.:olu,"l>u"

nudlng ",ilr.lngt 1"lI\t'44-'n ,ht,
Nt'\\ \Vnrlcl. luh.w:(1) \\,l~being
used around the glub,. Ib rapid
spreed eud w1dCJoI)rc.kI." ('l'IAIl(_f!
chirilcterisc the .uJdlction cu tbe
plant .\t'(ot"'KI lob.Kvm. Onh: t.he

'5l<>-o.l"'

1&00 TobKu
Il\trochrc.':('d~b
I.PI" Of tilt
Ptuhppinf$

1600

mode of d<li ')' h .. du.ng<d. In

lhe 18th ernlury. ,"uO hrlct ~'\""1.};
.he 19th, M"II1') " ... Iw .!!~of

the dg>r: .Ilt '0.h ,,rtlury "'"

the rise of the 'n ..nllr.Kt\lrc~d
dl..reue ntl "lilt II. gr II)
Increased number
."lokers.
AI the beginning of'the lilt
centtlry a.hClUlone third of atiuhJ
In th" '\'nrlll, Inchulfng InCTCJilng
numhers (If \\ Olnen, uM'4I,uhaco).

or

OeSf1ltr. thuuurul" of "Iliclic~

sho\\,ing that loblcco In ~II its
(onn. kills it. UJet'S, anti Jilioking
c:ig ..rc:ues kill, nO"'UK'n,

pc:of)Jc

2000

Aunt.lt. ~
ftru pbct 10 ...

(2)1987

1001(0 I... to
f.tl.<>" ~.ttll

(.,,,d.Uo,, to

*'Utt

tON(.'(Q
1100
--

17

A.IIT.lla
TobktO
wltll ttlt
Act1

.m'tU

n".

C 'o o O _
p e ...

U JM:\

" " ' * ""

.. . , h

from

tofc:co

W('

conbnu~ Co

""""

_I"

""

condnue

lnac_.

18

10

.moke .lOd dC.ltht

..

Nf'W lc.1M4

llehl_

26 Legislation:

Health

Warnings

78

"'here health \\>arnings are required by Ja\\'.

fmpact on snlokcrs of Canadiin \\arnine,s. Public
support for I'isible health warnings. Tobacco
industry quote.
27

Health

proj~ctJOl\',
32 The Future

Education

8Q

\~'orld No Tobacco Day: partidpaling countries,

and themes from 1988 to 2002. Quit & \\'in
c.lItll,rugns. Tobacco industry quotes.

quitting.

84

Tobacco tax as 3. proportion of dgarcile price.

Cigarette price increases compared with
consumption

in the UK. Government

Income from

tobacco, Cigarene tax .1:1 a proportion of price in

the USA. Tobacco industry quolc.
]0 Litigation

86

Lt.galaction again!.t tile tobacco industry:

injury, puhlic intcrc.<rt. non-smokers'

(",,'suils. Cases brought by the

tobacco induslry. Smug,e..(in~ IitiJ!.J.tion. Toll.1COO
inclustrr quote.
and go"c;rlunent

92

Table A: The Demographics of Tobacco 94

Popu1ation. Adult prc\<altnce. Youth SJllOking.
Youth exposed to pusi\'c smokint. Cie:M'Cnc:
oonsunlption. Quitting.
T"bl,. R The Business of Tobacco

29 Price Policy

20

Epidemiology. he.lth. economics.the tobaoco

Industry, action taken projected to 2050.

Part Six: WORLD TABLES

28 Quitting
82
Percentages of cx-snlokers. Quitting calendar:
till:': benefits of l:itopping Sllloking. Ell'ccu on d~ths
if smoker. quit. E.ffect of 5nlOkint rcstrictiol\S III
home .lnd ,11 ,,ork. Imp~ct of inter\'cntlons on

perwnal

31 Projections by Industry
88
Projected ralts of groll1h and dedine of .obacco
consumption by country 19982008. Regional

102

Land area devoted to gro"'ing cobacco; quanti I)'

produced. Number of tobacco \\'O'r1..ers; number
dg~l"t:tles manufactured. C,jgarene Imports and

or

exports: tOblCCO leaf import! and exports. Cost

pack of Malboro cigar<:ucs or cquil .. lent
incemationJ.1 brand; minute! of labour needed to
buy a pack of cigarettes. Tu as a proportion of

"f.

cigarette price: tobacco tax revenues as a

percenug-t of tou.1 tu: I"C\-c:nue.Tobacco industry
dOOlmcntc;

Glossary

Wl

Source'

II,cCu) Contact"

us

12
T cbeccc u grown In ever 125
countries, on

O\"Cf

"

million

hectaru of land 'hin!

or which

i. in Chi .... lone. The glo ... 1

tobacco crop b worth

approxlmatcly USS 12 billion. a

Inl,1I rrJt.-tiul1 or the lotal amount
generated from the llJlc of
nllnufacturcd
tobaceo products.
Tcbacce iJ gro\vn on leQ than
one ~tcent of.he wceld's
'gricuhur.ll and. and on wid.
nriely or .toll, ;and ell mila,. Since
the 1960s, the hulk ofproduotion
hu reeved (ro"' the Amt'-ric..u to
Africa and As ... : I..,d dc, eted '0
tobacco growing h.u I,..", halved

Tobacco

but h .... Iono," deubled In Chin

a,
In the USA, C."od nd Me.loo,

.
.

Mal.wi and Unl, .. lllcpubUc of

Tanl.anfa.
111(:1production of tuhaccu ICI"t'
hill more tI"arl doubled alnce the
196():j, tou,Ulng nc;trly
7 "lillion "lelrlr ton. In 2000.
The gn.:.lIcr use or ((rlilbe .... and
pe>,ldd ..... well .. the tncreased
mcdunlwlion. th.u hot .. e
produced the", higher yield .or.
en,iroMlenully ,.. maglng. Tho
problem docs no' cnd with
gro"'ng tol""",: ,he P"""''-

used In curing '01>"""" I"....

1111,,!lvc defof'CSlation.
There arc rullllons of tobacco
fanncr. worhlwtde. 11,c: 101,11Ct."()
aUJC

countries
produc:e

of the
world's
tobac:c:o

induslry cxplolu them by

cQnlrihuting to the-Ir debt burden.
whlle u$lng Ihelr economle plight
to argue ag.ahul effort. 10 control

tobacco.

In the USA, ,he IKH1<I

between the: 'o~cco Induj'try ind

the toNeco ('rln~rflrully 1:1

beginning

'0 bro.k down, and

p."ncrshlp' .,c de .. loplng

between the rafmf'N.uw1 ,he
pubUc health cOlo,nuniIY.

46

[)c,fol'Htati 0"
1'n>portJon of ,otal a... al ckfo,tsudon
.ttribl.ltabtt to tobilo
'999 Kltflrd count,iH

--

17

Tobacco Industry Promotion

u..
u..

Cigarettes.", pos>ibly
most
eurketed prodUCt in
world.
While there I. no rc!bblc
estim'le of glol>.l cigu.ue
m .. keling expendnu .... , It I,
cleoarJy In the tenJ of billions or
doll .... year,

us

In the USA ..l.one Over

$10 billion" spent a ycar on
rnilrkcling clg;1.rcltcJ, and this at a
time wben ad\'c.nulng iJ
prohibited on lde,;.lon .nd
radio, when wre;1.1'C Umiutiont
on eertaln l)l"" of oUldoor

'
S
M
1
G
a
1
n
B

",h'eni';ng and sponJOMlp, and

w~ dguc"c .. Ies are filling,
AnnUAJ markedng C::J(pcndhurc I)
over 5200 per '"loker. and ever
46 cenu for evert p.ck sold.
Promotion",1 ,allo\v.lnJ. th.at b
paymutl made to rcrallers 10
facllit:ue 811es. QI(l('()\lnl for 4- 1
percent of lh. 101,,1expenditure

on cigarette rnarkclfng.
CIgore ue marketing" bolder
iU\(1 more aggn:1Jh'c.
coWllrie.

In dc.,c_loping

tl1.J.nh I. in the

developed world, Clg.r<"c

.d,cnlslng on ltl.,'don Ind radio
(I common, and 0 nrlct)' of oth.r
venues are esploued. These

IncllKle sporu, Ins, pop, f.,hlon

and ,tn:cl evenu ....dventure
toun. contt'Ju. gi,c.a\\"y' :.and
the. internet.
There ere alto ehe hidden

ad"ettJsemtnlS such .u the

plaoemcut ur (.".I.g.r\!lh~.lnoking
and tob.lO(.o prOdUCt8 In nl,ns. In
.uldltton there I" .,)()nlOf&.hlp of
universities, good.",iII don.uonJ
for c:onlmunhy eve:nll .md
id,ertI';ng of ou... goods and
producu bo.rlng the dg"."c
name, Such m.lrkcdng b seen

throughoul both lho developed

and the dC"doping world.

58

." .

PHOTO

CREDITS

front cover:

Boy

smoking, Seychelles

Credit: Harry An('tHlcn ~ \\fHO

back cover:
loy in the road selling packs to drivers and
p.uscogcrs, Philippines
Credit: D..,id T""
\Voln,!" tobacco worker, Vietnam

Credit: Judith Mackay

[\1(':0 smoking water pipes, S;audi Arabia
Photo: Garrell Mehl (!;I WHO
Pari I Prevalence and Health
Man and dlild smoking, China
reprinted

from .1/;oS Tho I1C\\'spapcr. liong Kong

CrccHt: Carol Bctson

Part 2 The Cost of Tobacco
Tobacco lea\'(:), TItailand
Credit: [udith Mackay
Part 3 The Tobacco Trade
Woman tagging tobacco, tobacco ranor)"
Virginia, USA
Credit: Ken Hammond CI USI).~
Part"

Prcmctlon

)Jo)' In ,he road st~lIing Paeks 1,0 ,1rhoa>

a,nd p.lSsengcrs. Phlllpplnes
Credit: Daniel Tan
P.1r( S Taking Action
'Smoking Is Ugly" l""'Itr,
erencd hy Olrlsty Turlington ..nd reprinted
courtesy or the Cemer.s ror Disease Control and
P",,'Colion (CDC)
I',rl 6 World Tobl es
Old 1\1;ln, Sri Lank,..
Credit: Garreu Mehl

15

Cigarette Consumption

"SIIort. ... "" ...ay .tttflptod......,

.....,..."'
.. jodt .. uslIy .......... bdGtt
COMpiIt't*t .. u.c dtaft"tt't k tht

5yWIboI of tht

Nc:hiM

N(,,,,Yort

.,t..

;im~'115

Global con.,;ullllltlon of dgll'e-tlt"!I

ha~ been rblng steAdily since
nlanuracturc:d dgafcucs were
introduced at the::beginning of the
20th century. Whil. consumption
ill levc:lllng olT lln(1 even
U.ltlD
STAffS
Of _U(I.C"

decre~ing in some countries,

\\'orld\\-;de more people are
smoking,
smoke rs are
smoking more dgarctt es.
'The: numbers of .."oken will
inacuc m~i"l)' due to cx-puuion
of !h. world', popubtion. By
2030 there ",,11 be ~t 1C:.Iit
another2 billion people In the world. Even
ifpf'C\'O\IC"nC'(' nte. rOlli, the absolute
number or snlokcr1 \\,111
increase. TIle expected

.".1

COllliJ1ujng

China

1,643 billioo

I
'

decrease In "lllJc:

5moking prevalence will be offset

by the InO"t:.lJC:in fcmOlle .moking
rates. e<pccially in de"e1oplng
countries.

Top 5 countries

s;u""" 01
'998

The """umpllon of Iobo= has

radl<d !h. proportioru
glob.! epidemic. Tobo=
computiu arc cr.anJdng OUI
dgarcttcs at
rate ort"", and a
h.lf trillion a y ear - n.orly 1,000
dgarcttes {or C\'uy man, "'Ormlt,

or

and .nlld Of' .h'I,lallc"

Ciguettu account for the
largcat share of nl,lnur.actured
tcbaceo producu, 96 percent of
total "a lee u)C!'. A,I.t, AUJlrOlli"

billion

cigarettes are
smoked worldwide

everyday

Japan
328 billioo

and the Far East are by far the

Iargesl consumers (2,715 billion
clg.rclt.cs), followed by !he
Americas (7~S billion), Easl,,",
Europe aod Former Soviet
Ecxmomks (631 bllUon) and
Wes lom Europe (606 billion).

- 15

I""

Global cigarette
Russia
258 billion

consumption
Bilions 01 Itkb
1.000

Indonesia
215 biaioo

30

-~
- -- -o

_!!_~~..!!!.-

300

'88G 1890 t900 .9.0 .920 .930 .940

Female Smoking

_the Ootmftllowtr k'IItI of tobaecD Ide

aIIIOft9 wontm in the wodLdon .. t
rt.flrtd: Iw.llth .w.f"t.M.U. IMIt rat11ft' sodJl
tnditioM ..,. WOftItfI'. to. ~
rnourttt.. Dr. Gro H.rtmt Irv~.
O;'trtor Ckner.I, WHO. ""

About 250 11111110n

\,'0111en

In the

n'ClrJd arc daJly smokers. Abbut

22

percent

or women

In

developed

couturics

:and 9 percent

or women

In de\'eloping countries

smoke tobscco. In addition. "'.10Y

women In south A~I.achen'

O'

AUU'CA

I~.

'fuokl"g .among women

is d.clining In m."y developed
oo"",rI es, no .. bl), Australi
CONdo. the UK .00 the USA. )Jut
lhi) Il"C'nd ,. nOI found
Cig~rcllr

-,

in .11 developed countrie . In

several MJulh~nl. cell, ....1;anti

eastern Europt'An countrlcf

dgi1rcttc .!ulloklng Is either .!itHI

increasing UlllUlIgwomen or haJ

not 1110\\'11 .an)' deellnc.
TIle tebaecc In4'hutry pro.nOlte.

dgarcttc. to women u~(ng

seduetlve but false h".ages or
,iu.)ity. slimnt'\J. modtmlty.
tmmdp.l~on. IOphlnlc.,lon ... d
ellure. In
II towe.
dbecc and de,th .. Tob.cco
comp.nja
h.a,~now produced ~

"""uI

,..,.II,y.

range ofbrlnd. aimed ~t wumen.

~tOJl notable are thc "womenonly-" hr,ln{I~: theM' (c",lnl'W!C'"
dgarC\lCI are long. extra-sllm,
10\\I.1r. light -culoured or
menthol.

-Snokln9 behavlour ot wo.tn

dUf

.r.

frOll that

of

men...

more hiqhly motlvated

amoto_

to

thoy find it harder

to atop Imokin9_ vomen aro

more neurotic than ~nthere ~.Y bo a ca.o for
launching a romal. orIented
cigarette with rolatively
high deliver i of

nicotine_"

1916 ra arch report,

8ritl.h Aaerlc.n Tobacco

26

The Tobacco

Atlas
Dr Judith Mackay

and Dr Michael Eriksen

"

nh

15 Tobacco Trade

Top 10

Leaf exporters

thousand metric Ions

1999

--

No>
... '" 0

..

;:

Top 10
leaf importe rs

thousand mttric tons

Tobacco trade is big business, for

both the raw material (tobacco
Iea ves) and the finished
product
(manufactured
dgaretles).
Brazil is the large.~t exporter of
tobecoo leaf. and the Russian
Federation an d the USA are the
Jargest importers. Some countries
th.t grow tobacco, such .. the
USA, also import (oreign tobacco
as well as exporting their 0\\'0
tobacco leaves. Interestingly, the
USA exports approxfmatcly the
same amount of tobacco that ii'
imports. Because US tobacco is
popul ar globally. and tends to be
more expensive than tobacco
from other countries, the value."of
US tobacco leaf experts are about
double that of the same quantity
of imports.

Manufactured dg arett es are ilia

traded glob.lly. Agoin, the USA is
the luges, ex poner of

manufactured dgueues,
accounting for nearly 20 percent
of the world total. ).1"" Is tbe
l.rgC5t lmporter of cigarettes.
According to gO\'cmment
reports. 846 billion cig>rettes
were exported, but only
619 billion were reponed to be
imported. Sutistics ouch as these
provide ~ sense of the size of the
dgorette smuggling problem.

Chin. is quietly emerging ...

s:lgnJncant dgaretle exporter
increasing from virtually no
exporu in 1980 to O\'C':T
20 billion cigarettes exported in
2001. worth abcur USS320
million. In 2005 the value of
Chin<t'$ export trade in cigarettes
1

is predicted to

be USS6(l()

million.

1999

AU55IA~
f!D1I4JIOH

TobattO leaves
tMtric: tons

2000

tol3l imported: 196. 597

tol3loport<d: 182, 519

US imports

--4.. US exports

52

us imports
...

and exports

PART

5
TAKING ACTION

"One never notices what has been done; one can only sec what
remains lO be done,"
M.,ie Curie (1867 19J.l)

69

Costs
l,t.lboru or
... ~u;, ..IC'r"

Og.u-rUt;

~umbe:r

.r

~nur~u,"l
t'luILm.

~'o,k~

~l

5
Tax

Man~"tUri"ti

lOIt'l'n.atfurYl

"' .... 1
br .......t

1:w"N)

~ru4('(1hl
(de 0)/

~~

OI'c:llilteu('

t.u

I"C'O'nUCl-"iI
IJ")pOI'tion

J" icc-

""""'"

dl}

.US pcr """

I~rt.on

or
C''tuh r...s.r.nl
il'l\ffna,ioNI
bnlod

I.iu...

'u~

tUb.

..."',.&
j\briboro

or tAX.&J

l.IX

~'f'oI'lUt

I"""""'P

~l

3.J5'1b

'.30

0.93
0.28
44!.lb

3.92

3.52 Singapore

3.7100

34'1b
63 ..

-I

37.795

1.34

9.277 1

79.000

2.16

1.34 Johlnn_1lI
) 15 Barctlona

1.78

21.4
1.56

23.11'
497

San Mirina

14

11
36

1 t-till!nd

19.5
21.1

331l!>

1.1 SOb

721l!>

2.37'1b

241l!>

~I

S60

-I

1.75

39.515

2.80
t.12

-I

3.64

as: I :
-

47.000

1.08

=,:"m

62'

21.504

7.000

0
6.4SO
27.3ool
39:[

2's~I
96.

114,300
716.500

1.89
0.80
1.77
6.24
3.71
3.14

Leon.

Si....

Slngapole

Slovakia

s_

..

Solomon lsI.nds
Somalia
s..thAfna

SpaIn

66
87

Sn unka

17
21

Suriname
SW11iland

S.dan

Swtdcn

1.63'1b

3.512

11.1

52'!'.!

1.69'lb

4,134

SWltzeti.and

71

Syrian Arab Republic

O.59I8i"9~ot

1,240

laJitistan
Tanzania. UnitC'd Rt"pvbl< of
Thailand

13

Togo

Tonga
Trmiltad and Tob>9"

53
35

621liD

089

I,"'nbul

30

+21liD

0.21'1b

7~

ILondon

39.7

0.2; 1 Abu D~abi

3.60 0\''''90

19.7
18
20

~5

LoIAn~d"
1.42
-

""

1.42

1.28

0.72

0.57

,28.5

U9inda
Ut:tarM

9.181

241l!>

0.44'11>

l-H
78.615

6OlI>

2.1Wlb

361liD

2.30'1b

TlMru

29
J.23'1b

501!>

Twt<y

Jurtmt.ntStan

33

.00
29

Car.lCO>

Tunisia

65
1.033
0
0

71;l

s.n.g.1

Sqdodlts

3.183

157
1.23

Sa.di Arabia

69'1

~l
1.96

Sao Tam e a rId I'IIIICIp<

27.6
12.5

166
3.554

Samoa

1
2BO ZlIfich

4.551

7
5
21

1
65

3,110

24.033

Saint Vincent ~ndGrtnadines

21
1.969

42.6

Sal" t lGtts and Nevis

Solnl LuC.

362

1.81>6
89

52~t

Uglier

..~ht

14

'~!

_."..."

~dM"

P'''''''''P

20

4~t

d_

10

o.n

(oumrio

mdUlU'y

0
1.145
329
28

Unit.d Klngdoo1> 0{ Gr. B<

a N ~.

Uni!I Arab Emiralts

Unittd Sialts of Amt.n(2

~.ay
UzoWmn
Varll,liltv

Vt-nuueb

Vict Nim
Yemen

4,9001
S03

4.290

0.94
2.03
1.15

Q2~1

Ja..

0.65

8(I'Ib

Cl.04 ..
1.17'"

522

y~

73
864

Zimbiab""t.

Zambia

109
Ba:a.

S\\'eclclllngs and nil\'ouring a1~t5. V.lriClic." or p.ut

indude kaddlpudl, Ilogesoppu, gundi. kadaparn. zard a,

paniwala, klwam, tnishri, ani pills. It is coJnmonty
chewed in parts of Southeast Si3. especially in rural
Indi a,
Passive smoking - lnh.lin& cigarettc, cigar. or pipe
smoke produced by another- individual. It is composed

Tar - 11l( raw anhydrQu.a:nleoune-Free oondcn.ulc

smoke.

of

Tar and nicotine yield - The amount of tar and

nicotine ill milligram$ in one cigarette,

i1$

determined

by. machine designed to measure smoke. ~lacbine

yields of tar and nicotine levels arc not necessmly wlut
smokers

actually inhale.

of second-hand smoke (exhaled by the smoker), and

smoke (\\'hich drif''' ofT the tip of the
cigarette or cig.r or pipe howl).
sidcstream

Pipes - Made of briar, slate, day or other rubs ta nee.

lotMCCO is placed in a bowl and smoke is inhaled
through the stem, scmeum
through water.

Tobacco ater+butable he~lth carr: cow - He.1hh

COSt.calculated on the .verage proportion of p>rricubr
diseases attributable 10 loNCCO usc.
Dirm cosu include: com related to the <ll"cr.1ge
proportion of the occurrence of dtsease attributable to
tobacco: health services costs such as ho!pi~1 services,
physiciill and outpatient

Prevalence

- Srnoking pn!\illcncc is the perccntage of

smokers in the total populati~n. Adult 5nloking is

u.su.lly defined

lIS

aged I S years and above.

- A representation about a product

or
service by :Uly means, \\'hcthfr directly or indirectly,
including any C()(nmUniCltiOtOf information 'lbout a
product or service and ns P" (."C and dlsrrfbutlcn. that is
likely to lofluence and shape unudes, beliefs and
behaviours about d,C produc or service.
Promotion

- A person who is cng~ged in .1 business that

includes the sale uf a tobacco product to consumers.

services,

prescfpticn

drugs,

nursing homc services, borne hcalthal't, allied

heahhcare: ct.anged expenditures from Increased
utilisation of services.
InJirm cons include: COsts imposed on a bousebold from
tobacco-related
illness or prcnuturc death; loss of

production and cuning.; household he.llh;

rsychol<>gk.1 <'O>~', such as the effec ts of grief.

Tobacco attributable
mortality - 10e number of
deaths attributable to tobacco use \\ithin a specific
population.

Retailer

11,"

Risk likelihood of in~rring a par.icul.r event or

circurnsrauce (e.g. risk of dikil!e measures the chances
of an indivi(lual (''Olil-ract-ing disease].

Tobacco control organisation

- A non-profit
organisation whose purpose is to reduce tobacco
ccnsumprlon and pro1CC'l nonsmokers (min the e.ffectS
of irn'oluntlry smoking,
Tobacco

Smoke-free areas - Arc;asi"'hcrc :nnoking or holding

a lighted cigarette, Cigar or pil)C is banned.
Smoker

- Someone

who, a tJ,C lime of the survey.

smoke ny '01,,= product either d.ily

Or

occaSionally.

Snuff - Moist ,"ulT Is taken orally. A small .moun. of

ground

tobacco

is held ill th

mouth between

the cheek

and gunl. Incrc;u:ingly, man flC1urcn ;U'Cpre

packaging nlo~.st &nun' into srOlin fl"lper or cloth I~keu
to make UIIC of the product ,asier and neater. Other
products include khalnf , $h~lrnlaah, na1S/It:lS\\~. Dry
,nulT I. powdered tobacco ~ .. is Inhaled .hrough the

n... 1 p''''.ges

or taken

industry

documents

- Previously secret.

internal intlustry P.lJ>Cf'S tNt have new been placed in

the public dctnalu M a reruh of court rulings,
'tobacco

t;a,Xc;5

Tol.XOI tevted

on tobacco flroducu.

Tbcre are 1\\"0 baslc meehcds of tobacco taxation:

nominal or specific 1oli,xCJ - taxes based on 011 Jet
.,.mount of tAX per dgareut' or gram of tobACCO.
Ad loal",.tm taxes - taxes assessed as a IKrcentagc nlarJc.ul' on 1I,e re ra illIing price of'tobsceo products.
1bul tebeeee tJX reft':rJ to a oonlbjnation
methods

pI",

appllcablc.

'"y ,..Iue added uX

of boUl

(VAl) wbere

orall

111

I The History of Tobacco

.. .,1.-..0.. 1m. \'01:\"),_1V:411_411

.~
NuwOllllt"

Jell,",

_..

",ia
"""_').Iv-n. 1

..HtlJhl-.(tt,. Hflhh ldwmlon A\ltho"11. UK. July

199&

IlfwIMhIJ liN_"

ltN, IC.. ,lwlWJot tW,,. _

If,

R.Au\" '.IIIM.t.; "_Koff

tJ"'II,jr~n'll.AU""

n.. u..,.,. ,u..-. ..~

)"'1,",I)B..

._,._

A Koopf. N~ 'r01'.I"'

u.s..
-...,

A.m..

LC. ,.,..

I.....

...

1'"

"fJ'O"'.,Ill.-

It.

w.n..

I . ,

~"

" ....

,~

",.,

0. s.IooIN

Y.~l,ltlt'ft

l.".,n. MttC.c.pr1i:Jw,-n,

0. s-linl

1I".!\It, OU_',

s..d

'''~'_ . I I ' ' f '7

Co_ .......

JI-W -

I t . . . ' , , _ . . . .. .

...... --...

'CfO"'o

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1.279,

150
14,2001
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1.J4llIo

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617

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105

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MfGrIllpt D. ~".

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.... tr)'-

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J...... IN,

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w. ,

JMrf"1

runI..,..

,.... {d.fo"WId ....

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,,~~

nc.

M..

..._W

I. r"'_'" 1001

t\:r .........1.romfllii"""'-ioII< "fIJIl.tI~ ~

MIl

[ftC'

1-IGn-.,.. XlOI

lAC.a INn lOti \("(,"() S,MUr.CIJN:C

w"-' u.m.~,

11MCu.lDIN

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,_.,_

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119

ltlRN1NC NO\V .
Phitip ~\orril:' 1"hc f'n1p0c6~~

or PM Inltn!.\OOrI'I

(JD

S.MOKERS ARE NOT ...

s"lOkmf _

RJ ~noldt docall)ertt 21 Dcttmbtt l!m.

Iiaid.
'''' ....... ]7,"'",,,,",

"'S, ,

('''''"'..."

I:'" AUSTAAUA
''''1 ............ /202 )26'

)SI

B.to.No. 50)3; 1211 ;OOSi 1162

TOO

f'ioi!i:p Mi:>r"*, n.,.

"""'s-., .....,tlft'M b!t~I_

~C....t

tkakh

IU6"

THI< 11\,.,'FR..~ATI()NAI_ TOkACCO

INFOTAH. 1985, R1mdd~

CflO\,'f.RS .

J. (u (0 V\'1:oT."B

&un! Mtmt"",... II OcIoM

19$8. Bri1Lh ru.~k.m Te>I",n C"'_) i02iSS41;'i417. C""lIdtonl

r~,t"IU"""II(

. , ..
. ..

n )brd,

191;. ,

ed ifll_ctJ_ c..II_ 1.t.~2Q1116S1;1_

Ih~w.-r

nxr
PWli'rl.bri'~llll'kc:o:to.t.er.
I,sa
lOll ;:96421.202Ii96412:
7
UndlNll A. 16 ".,Mdt 1001. eornnw:..tI ~
1;:1'

QUOTES
U_:\II:SS COUl\-rr.RVAlUr-oC

snl'S ...

1978. I~

1\' ftqnooac.. document,

(<<1'""'11tI..1ilo No. SOCII)

1111. SOO8~ll'1.
\VIIAT ARE \\'ETRYto.:C
Doculll(lit Type: Rtpurl.
Ojl'lT.tlion 'blnllukt.
()1217111 )I)
IIItp:

II

to 811_ No. 2'O-i57~1

in.

TO ACCOMPU$III
AudlOt: N/A. 1l1k: Top 5r~
Site: Ph,I., Motflo!; ~I.oc'tm_tIIIl(, R.t1("JNo. lCHI)
t),II~: 0)/20/1990.

p'~.(QI111

11> .........

~t.ml_c..n.m...;

)()ll2i Ill)()

geuIUII'J"*II)}OOao.1(HS

21 Tobacco Industry Documents

~tAIN~IAf'

Au~".Md.
us",'=r:ourrt1'Y~.
t.~p.1"'lcy.IitIl'JI)'.d.edul

BUYINC INFlUENO:

utkJ'

r~OOr!

,;it.t: '1....

1001,

\".M(h. J'ubllor CI'rJ,('n, USA, 1".8 http://wYl"w.dti1.lln.

(lrg/C.Ongm"../~;UJ/procUiall l ../tlobt.rm/anid(
I~UYIN(; Il."OURS
( .... ""'" G.-..III1JI".oJ

'r1!.-.

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1lNr'.

ClJI"8OARDS
OUR\\'OflK IN ~[<OAt.. ..
\\".,. \. l'hIlip Mol'N M~Ift.

.. d.m llJ)=YfJS

17~

So.

202 ... 1I401/14(lI;

I..M~"1OO1

hltp.II_-..:.~

.. ko.wm/l:etalJim&.~OOCJO"102

i>l), "OIl' <106

W'QRI( TO OE\'ELOI' ...

'fUXT

~.JTr,u"

1lill!pMlwrh.I987.M~~tn

(".-noon ( ......,,: BliJ''V J~fllNtf(t. S411.lrtg IlNI1, I" tobl'tb 1001

Nellmlll M. 8ilw. A. GLnIYS. 1uhlC'l'U indlutry )tn;l~k. for innuendog

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11...1.
uri.ll_,Uld_.e~~.20711.1

20 Smokers' Rights Organisations

A LA"' PROIUWT~C

~'1

...

W11iM A... I'hOIip,\\uNb"tltlllUf

1'8(i_ILA(:.]I:.:a,

.. cb...... 7 ~

201S.JI.&(II/I~

httplll .... _ ~n.'Im/,ctaJirn&-MP~)()CID=

ASIA IS r:O''\! ..
()(,lIiuon J. fYlp Mlnb lnd ~
~
fl.r.IC!II No. '1;0(1101 JII/I)l)
hup: II ..... ""tdftO.rom1 t'ull"''''....,~,.pAcl

1OlS4 J I~ II, '()6

l'to01I..IIJoll.

J-

19" mI.

.... DOOD.2 SoOO0,I ) 11II )

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NATuRAU' ..
,'lAIN MAl'

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w)TJ"pNu.

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1002.

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htl:pll, .. ".'...lobKrndOol1ollf'lelll.,orC'lit.

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diaJMrod=1lJr,tl'oo~SII"'2.

...

r.ac:u un..dt~.
,r.t Alt , April 1001
..........w. ~.ronII..../ ~/1OO11QJ./11I/IOI90J.06.IJ'm.1mftJ

40 MJI,UOS ('AGf,5

&INch W. Cat:1or RJ. ILlrtlUU I....,. M'H.arrl. f"Iptt': ~

c.:1J11K")AftD~
1'IIIJIp .\\urrlJ.. 'I'lw: "~l'Iproj~'e

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c...,,.J ](J()J.

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b.,wo. 17 """rtf, Ins. '1\11l11inlt'1l.Nt4_ (.Jr",wlllland_flun/201 Ubi],

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KI.lY I'IIIIJJ' MORRIS O\IT

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ry

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11,68-12

TEXT
CJ.n1l- SA.

l:I6J"

,h..'"~

in:J

u.III~Ilr.

I. LlII'lInM c.lkcdm '-b,w.llOJ.l].bS!SI.

Il36<4. I""" 8
FlltST \\'1l"'1U~'...

wn TRY 1'0

~rVlg

doN~I.:

TO SlL" 1I1'..

1>$1l~2. 7 "br(:h 1'3S.

&.e.

Krnmnet C. US.erb

JAAJ('OtlI,.-bl.lum~1~2(1o'llIlll'.Mio~

,.,71" u..m,1...tu.7'

Corwm ...... .:

No. "Ml"o"(J()!h4611..t-66l.

OOCUMQ\'T R1l:h,'T10N roUcy

w,1 see ... ttlbcuo.:h=-CA'ratC.k"llrt=-'1W~~ldoltrf'UO"i16

ASH UK. 1Urt, S"m ,\',._

rotL'\I&I} 2001

.... AI~I~

~~~ln~=)"'"

,\f..Id..ty J. ~..,-,b 11 r,,!.bn...r.y2002, llu.p!IIISa.1J2,12.95/c".

L,fl,K(

.....,.
~.

Jt'oo'bIL

Dhi.olon ",'tW Amabll

bl.lp.//I S'.l .11.11.'.5/0:,1.

bin/_'il(_"''lih,,;

..IIlI!

MEDIA,

flrl'llon jO ,loW-dl I" J.

'1'...._11i~ luutn): 201402 j]. S2t H6S

'''-Ib

St. J. lkYo

UnhI',ui!yofc.ll'"r..u
lWl.II:d9

IX l~). n,.

c.,.-.._ "t-t.

tot..m:o iIIdu,.". duc:wnr.mu..

hNtr. r.-I

1",\. II ........... I~ .. ~

r,_.

I k;ro.' to

1'"

1("",

121

Youth

pa."tSive

4
."po.cd

to

Slnoking at bonie

(J

Cis_rene

qululns
Jk-TttI~l"~vi pn>p.~

cOluumplion

(A;:,unlrlc.

",ho quit ",nuking

perttnugt:S

.~'

111"\1.11 ~

pc:non

by 1002

ltsotho

r':t

J;

If

~.

~~

~'-.

.'

. ..

. '1

lobonon
89

IJDeria

1.482

Ubyan Anlb Jamahiriya

UtbUJAia:

Lux<mbou19
M.c:<doni a, fwm<r Yugos. Rep. Of
Madagascar

315
123
910

':

M,lawi

Il'lb

M.I.ysi.
M.1dNcs
Mali

1,441
GO.5'Ib

223

:r

~I.

Marshall Island<

1:1'..

l
fJf~.: 'l

." .

~-

..
10.

Mauriun_ia

317
4S.5'Ib

II:
',f

:-

M.lta

2.668

1.28'
754

15'1b

Miu-ritius
Mexico
Micronesia, Ftdrrated States of
Mold ..... R<pobli~

2.640

M....

Mongotl.
Morocco

BOO
432

t.

Mownblque

Myanmar

~;, ~L

K..:""jl

E"

N.lmibia
Nauru
37.8'lb

jJ;'

~.

j~,.:'

~.,
~

.!Jt

~"!

N..,.I

619
2.323

Nt:tht:rtands

1.213
793

N<wZa~d
HIQf'ilgu~

189

Nigcr~

ij

,. :.e .

_;1"

or

co

t:

EW:~

Mig..34.3'lb

Njue
725

l'loow>y

S64

Pakistan

244

Palou
Pan.ma
New Gul ....

Oman

"'po.

2!).0'lb

1.748
195

5a2'lb

1.849

67.0'lb

2.061
2.079

1';119U>v
WI!>

Pt1v
Ptlillppin es

""land
Portug.1

~.~

Oow
I.G7G

5S3<1b

.'l' 1101;{'.~ .... ,111 "I_nI..th

Rwanda

135

fir"'

""I(lr nUM
~I"''''h,.

1 f(lr ,~NJ COIInI""''', ,b1J .",1I0Il.....1 fln''Oli"lh ~"n',-. '"

Mid

1'Ib

1.702

1l1t1OJ

Romania
Ruman FtcIrration

(If

P"""1IIo-.,

99

o..
.

anti-loba=
advtrtising mCSSigcs
1S'IOo( 10101101>00

od>tttising mruag<s

..

Incr('5(S .nd dtcrtlstS

cQmpr~hensivt set
of ~d\'trtislng baM

f'ttctn13g. ttduction
in smoking
2000

In adult cig.rttte: ('O(Isurnption

1991r:ompo'tdwll~ 1981

OtcrcastS

Increases

ml)f( than

2()Q.\

deerease

1Mb - 2oq1:,declta)(:

r~

less than 1mb decrease

less than

morc (han

,()qb
,()qb

lncrcJSC
lnett-Is(

no dltl

no thange

comprche.jlv. ad>trtislng ban,

during Ihls I"','od

77

Health warnings

health warnings on patU of og are nes

r<quirt<! bV law
no

health warning$ r<qulrtd

public suppon for viSIble:

Iltalth warning m"sag"

20(H """'Mages

in stlect.ed countries

-.

.-..-..-..

Health warnings in Canada

Impact on lmokcrs of the flew Cil".~la"
hea llh warnings 2002
Canadian warnings are the most vt~d rn the v.orld
and serve's the model for other c:ountrlc.s
wttt mott

COI'lCtfft('d

~boIItt\r,llh dfms
or ""ok!l'g

Idt itlCfclSotO II"IOtl'VitlOl"l

to qv t r.trO\J"9

79

Anti-tobacco campaigns
2CJ()2

~9ufltrjts

In :

\Voold N. Tob.<tO Day

SWIllI1<""'

.,,01..,

partidratin!

J I

w,II.,

Quit & Win

as
Wortd No Tolla=

..""'.

oay

GUll 8 Vlin progfOmmc. in addItion to hdfMng

smoirfi quit. IS otse an ett:fllenr vth;eJt fIX
~

<OtIlmunkodn9 1M hozDrdsof ,,"oling, ond often

strVtS

~USS'''H

\1)1

Ctsutlon

2000
The

&1tatllnm"""

Indu$lty

2001

.<.

CHI

1999

as on oppor:un,ry for publ~ ad\ooracy

against 5mol:,"ng,

f-EOfJlAIIOH

H A

2002

Sccclrd>:I'l'l Toba= Fr

<I,.,

)mokc ItllI$. Sportl: Play

lc~,
the: ,i,

de:,n

81

25

Legislation: Advertising Bans

The tobacco industry denies th.t

advertising

plaY$ a role in

encouraging people to smoke or

incrcouing the amount smoked.
but the research ruggcsu
otherwtse. As governments
acknowledge the harm caused by
IOlxtCCO and the need tv
discourage

iL~ U..'iC.

restrictions

and outright bans on tobacco

;)(h'crtising arc becoming
common. Partial restrictions arc
notorious: for le~ding to other
fonns of marketing supplanting
the restriction. Because of the
shift of marketing doll ... from
one: medium to another. the
evidence $uggd'l~that
comprehensive

bans on all forms

of tobacco promotion can be

effective in reducing tobacco usc,
while partial restrictions have
ltmtted or no effect.
Cig.trcltc 1)3ckaging pla.y~ an
increasingly Important role as

-.
.-

... ... ..

ad\'crtising restrictions arc

Implemented.
P.1ckct design pi,,)'!

an Important role in (:5lablL~ing

brand im.gery and competing for
potcrnlal customers. l\<1.1ny
counrrles arc .lll\,ocatln&plain
p.,lckaging. Some 31.S0 propose the
bJJlning
certain words such as
"Light" or "~1ild'" as these olay

or

con\'cy the Impression that the

1.'igarcttc5 arc less harmful or

cnntatn fewer harmful

consuwcnes.

76

Tobacco

"""ITol res~a,J, projeds

complcl<d Global Youth Iobaeco SUN<,/>tGYl5)

n.tionilty or in at least one site 2002
CUfT~nt foundation

'*

@m;;-,.. "''I'"''''

81 ColMluelty Fv.nd
forbard'l

.. , ," "
""

WId

I I\

f'I I'I

*
*
"*

RUSS,,t.N

'"OEfI"TION

A It i.,

RlmMcountrirs

International Dtvtlopmenl Rtsearth Centrt Research rOf Intcm.tion;1

Tobac:t'O Cont~

United Nations Foundation

Rodefcllcr

foundation

Fogarty Intemational C<n'tt

'

grant rtcipicftts

oth er foundations

journals devoltd 10 tobac(()

""',

*,"

....

conltol

* * '***

- =

IN

DIA

*
*..

* ..
"

CHINA

Ir

I,

How much research?

Numixt of timts ktyWords found in sta.rch
of 45.000 mrdk., research P3pt"
April 2002

0"

71

\
o

Wcnld Heal1h Organl'-..8'lon and reg~.1

and associatC!d offi(n

intemationaJ organigtioflJ

'tgoon.l organls'lIlons

e.... ko

l'ObStMIOlre du tabac
til AfrlQt.Ie(qn('()9hone

o
Ha"rt
ARID
1

Joh ..

tlon

9.t.'1l

-ln1('rn.tlorl.1
Gcwttn.mtntal

"'91h111 lobKtO

I'Mh

littOn

mmcft'Oftetll'fnlt01\
Allal'ltt

World conferences on tobacco or health

1st

2nd

1967
NowYor1<

1971
l4ndon

USA

UK

3rd

4th

1975
1979
New YOIt< Stockhohn
Sw_
USA

5th

6th

1983
Wlnnlpog

Tokyo

C.nlda

1987

J,P'"

7th
1990
Ptr1ll
A"'trali1

-8th

1992

"rgontina

9th
'99.

Po...

France

10th

~j.'"
'997
01-1"_

o.itagO
11111

12111

2000

2003
HclsI...,

USA

fin .....

73

Smoke-frtt al'9s at work

smo~ng iii prohibh~

in som:e areas
smobng tS rC'StnC1td
in some ~rra5

1'10 bins Of

no data

public support (or ftSlnttions

on whert pcopfean ~ok:('
100' pt:rcent2gtS in Stlected ceenrres

1729 Shuun

.... ;; ,

~
, ,

/'1"

R"t document'"

Icgi$lltion

bans tobacco usc 1n

iilll rtligio\ls places.
wnic::h is still ~
today.

....:/:~

The cost of workplace smoking

Euros 2000

"70 Singapore

SrnDting b.tnn'" In bu ses,

cinemas, theatres

and Othtf spccifi(d

bolldin9'
of which 3,000 smoke
c3t.h "motet VI'Iotcs6 dtanttt:s pt":t d.ay at wort
I ~tt1te brUit '~ru 5 """uta
t~chsmoker wastes 30 mlnuto ~ry wortlng 4rt
,. company "I) 10,000 employers

an empl<JVf=t on &64 ptt hcMir

the mmJNI"V1.037 pu .,,"um

('0\1$

Iht 3,()(X)5IN)kctScost the com~""

,,1 million ptr 'MVJI'I

S2.7b"

No loss of restaurant and bar sales

and an er
R", quarter ,.Ie. belore
smoking bans in restaurants and ~rs
CalilDrnl. 1992-2001
USS billion.
Sl.eb"

"

, t

199'

1993

banned

in rest~uranlS

$Crvlng (ood and olrohol

SI.lbtI

smoking

I
S1.lbn

smoking
~nn(d

in bars
I

1998

19)'

75

Ex-$mokcrs

I)

ICIWID

Pvtent>ge of people who used 10 smoke

who ha~ quit smoking Iottst avoilob!c data

4O'A> "' mort

3~-3~
20% - 2S'!b

"-""",'"

NRT

10% - 19<1>

fewer than

RUSSIAH

1oe.

no data

fED(I\""IO~

(nicotine
replacement
Ih<13py) available

ovtt-the~unter
z001

*
~

C H'

SUOAN

N ~

--

I~

xu s

Effect of smoking
restrictions
at home and at work

still not smoking six months later

72"

at home:

Type of

Quitting

"'iore than 10::.

pd~increase

Anti-smoking

IntrCiSed numbc1 of atkmpts

and succtSS

intervention

.ltempled Quilting

r~

media

at woric
52..

SlOb

Bans

Q(I

promotion

35'"
RestnCtJOn5

youth access

on

Smokfng ,tstrictions.
no ban

partial

lotal

r .. ,,'

Impact of interventions on
starting to smoke and quitting

USA '992-93 pc:rcc.l'ltagtS

ban
ban

incrt.a~ in quitting

Complete ban ((duCts

COI1$U mpIlon by GlIb
nomdtncr
Worl< and household
rc5trietions most dfr<:tive
ban in

ban in

0
*

,, _

wone arei

.11 areas

NRT

Highu numbtr of
atttmpts to quit

83

F>

PARI

6
WORLD

TABLES

~An<lmake lint )our ow n hand, coniributc to your de-trucuon,"

Qur'.ln (1

19;~

93

yout), eX,PORd

Quitting
J'<"""l"S'" 0( p>pl.

Ciga.rette

(4)

p.wiveSDC>king borne'

consumption

\o\M quit ImOktbg

by 2002

.nnw.! per per_

i ~.,:.!-~.i!
J:e. '

i.j: ...... .

. ~ .... r"_,,.0:21

Andorra

-;_"i;.:~

':"_
~.

'\

Antigua and Birt>.d.

~'.~71

>

;e;~ti ..
Armt:nia

-'~ '

_,

. ~.150
28.7'11>

1-_"'""'

"':;'<- i1(-

18'lb

~'!,".

t ._.:~Australi~

'. ':1$1
2,073

Austria

1S'lb

~~~
Bahamas

613
,,~,17'
245

-.
.J

-, Bahra;"
Binglad<sh

;'542

'.-

2,S71

..

. c.
.<i;42B

. '- ~

1,092

-'~

'." .
'i-

8<loru,

,::~i
Betize

, .J..::l.~OJ...'''''''''''

-.

"

'81tboi1os

'

i'

Bosnia and Hc:rz-tgovina

.,;.:~

Bsa

no
Btozjl

'1Inil1.<1

.-

2,S74
,1"<2:21

OolllS5llam

! '

86

Burundi

.-: ..~~.~

652

Camaoon

. ~-;;',;:.nti.ada
..

, :, ~

cape Ifmj.
_c:a,tral ~~
Chad

-,

3~
,

1001>

:~,,~
'if!' _c:

"~Chilt
Olin;

'. - 0.....,.
. ....-..".
' =.-"

~
!

Comoros

"

"

~
ll'ib

~::~~;:lr.~.;.~;~
'~'-''2,366

eTc

.J.

1,919

~ For JOm~OOlnu1c:s, drt3 an: baed on )Olltb'I,.l"~llll nujoI clUd or PfO"i'Icu.

UIII .~ $I( nUIiU1ly UiIl'UO;lIUtJ,'I:
(or the
CXIUr'try.

, '!.

c..~Crech R~

Il<nmorl<

B al dcng'"

95

Youth exposed to

pMlim mint al hlJ(Il~

5
Cig.rette

Wmllmpli9n

'If fll'fl< "ho

Wltlklng

by 2002

27.4'111

-..
154
232

1.275
429

-'3)-..,
5<Ib

Is...

1.351
2.058

<.

EtitrN

Es.tonia
Ethiopia
Fijj

.,;

Anland
Fran

Grcttt

G09

Grtnada
Guatemala

.,.........

OUlnea

590
172

Guinea-Bissau
Guyana
Haiti

595

Honduras

3.265

Hungary

...

129
1.742
765

1,901
735
3.023

29.~

Gl>ana

20<11>

1.430

61.4<;0

.:-

161

1.8322.160
200

It<lond
India

Indonesia
Ira .. 151. Rep.
Iraq
Ireland

2.236
2.162
3o.8<ib

'" ,

4.313

1,915
63.0<11>

Edlado<
Egypt
B Salvador
Equatorial Gulnea

1.702

90

34.3'10

:-

Dominican R.-publie
ust TImor

Gambia
Geot-gi.
G<nnany

171

Jl.~
31.3'10

t ,.

Djibouti
Domina

Gabon

481

22.2<;0

'.;W'

-,

-,

87
976

;,;,

....

1.983

"to

11... "

,cit

.....

-,

49.4<;0

Countries

Quitting ylfl'lnl'{fl

Isratl
Italy
J'mJic:a
Japan
Jordan

Kauth,,,.
Kt11ya

Kiribiti
2.918
3.062

Koru. RtpubII< of
Korea. Dtm. f:WpIC'$ A,tp. of

Kuwait

Kyrgyzs ...

1.886

lao !'topic" D<m. Rcp.

400

latvia
, r~...~..!neOOUfIUleo, d..t .. ,~
p",,,tocc.o
.. li0ii1 _ "',,' 11.......,11)

t,_'

uri

~v"tb _.. \~,.. ,.. fI"'joa'

,~prt!WI!oI..dll cit tI'It _lilt! oourll'1.

LlUb

UI'

97

lotJ.ccos Sh_"~of 91~1 de:lth aruf disllblilty

inmllses 10 9~

8~ Of smokersl(yt (n poor cwntrits.

Sp"cutal ad"an('d in inYdtigation.
dilgnosls and ttC.itrnttlt of .~rcJat(d
eneeses, bl.ll ul'11i~dyto .ffttt gtobal t'I'Io"allt\'.

Htw global virvs pandemic tttnllOf1rily

fItlSht,$tobllcto mIltS eomplttdy off tM
agenda.
770 million children t.postd to paui'o't
smoking at homt..

Nu'T'lbtr of c:u.'nUI.~ deaths

,obao:

tfOlI'!

- if p:rt$ttlt trtnM COfttlnl:e: S20 milioa

-11 pro:ponTol\ of young ,dl.llU li~ up
smoUIlJ haltS by 2020. SOl) mltl~
if adult a:lnMIf1l.ptlon ~
by 2020:
3'0 million

Tilt ~p betwn

tkh 1)1Id poor rounrtie1

groWl as health stMtes in poet
countri" collapse under the Urain of
tobacco dist.aK .nc! deaths.

GlobaJ annual ttOnomlc C'MUof t_teO:

Mllth of tk dt'Veloptd ~orlcf m.oves to,

managed teeeeee Industry, with
tobactO-att,fbtttabte heallh eare t'OSts
tdmbul1~ and COmJl(lUItJon plid to
indiVidual sfflOktl1 and non..ynottfS
hanncd by tONC't'O.
Ciglte:ues onlv ''I'.IIIbll( ()(I prescription
In fiat countries.

The tobacco irl4hlWy h fully re9u~ted. witI'!

lictnsing of niootlne
In .dcfictiw dnlg. IJId
ffI.Mlfa!Ctl,lrt,.prcmodon.net sale und striet
regulltOty t:OtIllOl by 9CMfM'Itt!t IttndC$.

~$1 trillion a yrtilr.

.s

Ntw. ~l!IettilUy
ptOfltable~Kt:of
tarco 1ft: hMd.

Hug.e.dvanS .rt mld~ in 9enetia. Ihe

tob.aa::o pbnl betotntS '-ty to producing
wetlncs I~d other bt:Itd''ICi.1ml(d"itJI
prod"en.
Warid's top tobacto ('Ofnp.lnics now
based I" Asia.
Almolt tIO tobaoeo Is 9roWft In ,til( USA.

'*(<0 C'Onlrol fundtd

ftc", I
pcrt'tnl'gc of r,o\I.ttO 1'11I, n
m.nv countries.
Outy frte" (001'0 no lOnl)t' e.ins.
Health ((Ju(atlon m~Sa9ts are mort
stllful, haldhlnlng, and drl1e:mlnutd
mo,e e:ffmi'ffiy.
In M'V ('OUntIYta~ OtIIOOIO ts 1~
of rttall priet.

91

Tax as a proportion of cigarettt pril:e

2(J()Oor/attn 1l\'Illlobi. data

75'11> or mere

50"0-74ll11
25'1'0 - 4gq"

24*

01

tess

no data
(ountne. or StaId wIth IOb.atto ta~6drdlcaloi
to tobKco control, health pmmotion
or gene~J heatth eare

ceumrles

\'Ilth

tax of

S2 or mole: (or 20 C:IQaretttS

UIUIOOll1o

CH

lilA

0-,."

:e

~,..,:.
;.
-e

\_~.Iat\n

"e"""'"

_.

'Ot 4ll tho

there

is One
-

t4Jc4tion

tha.t ola
the
n

:E

.:

.. .

; ;

'"

<'"i

Government income from tobacco

CCUMlties with the highest pt.rcent:.gt: of tobac:c:o tax
as a proportion of total govtfnment f(Ven,ue 2000

Ph-ili

.... ~ u.s
most .

PHarris
1985
'

-;

t..... ,
"

I ..
:~.:

6 a

8!;j

Lawsuits
legal aClion against the tebacce indu.tty 2002

II

personal injury lawsuits

pubJic intl!rtSt lawsuiu

non~smokm' lawsuits

govtmmtnt liJIwsuits
no lawsuits

cases brought by the teeaeee induS1ry2002

~I't .....,
:;.f
lt

Columbia

Canada

Europran Union

and m,cmbtr states

Ecuador

Smuggling litigation
Casrs brought by national govtmments 39ainst the
rceecce indu'stry to rcC'OVtt lost tall from smuggling

a:

81

Projt'C1ed r.1td of growth at'Id decline

2008 compaml with 1998

Ineeese

deerease

... r3Mb

under10~

2Mb-29'1b

1Mb-19'1b

1Mb-19'1b

.. cr2o<1b
other countrits

under 1()qb
RUSSt""
fEDtltATION

CHI N A

The best of times and tire worst of times

Projected (egional increasts and decreases
for cigarette consumption
2008 compared with 1998

+1L1Cf1

percentages

Amerit'8S

no ehanse

urgest predicted
rtgionll inertalt /6::rc.a.se

Btazil."o.2<!b
USA-tll1ll

Afria and
Middk Eall

Norwty .30.5l1;1 Zimbabwe S5.7!fb

Uk-l'.6~
SouthAfm-17,JQb

&rtt:rn &m:!pe
and former
Sovkt Ul'lton

laM 2&.Sqb
CthRcpl;jblic-2,.5qb

Asia.

AortraJ~p.
and Far Eat1

'Itchta" +35..9*
UtW Zt~od: -2.~

/~

FL.o .;;;.;

~i

89

9. Deaths
Majid Ezeau, Resources for the Future, US/\;

II. Costs to the Smoker

Luk Joo ssens. Belgium; Kenneth E Warner.
University

or Michigan,

USA; Anna. wblte,

Partnership
Programme,
E'SCnli<11 Action's "raking
on Tobacco c.mp.ign; Ayd. A. Yurekli, The World
funk;
12. Growing Tobacco and 15. Tobacco Trade
Tom Capeh arr, USDA;
14. Tobacco Companies
Gene Dorio, Nc'\v York Cit)'. USA;

21. Tobacco Control Organisations

Sibylle Fleturann, European Network fer Smoking
Prevention, Belgium: Belinda Hughes, Framework
Convcndon AIUana-, Auslr.llia; Ruben lsra <1.
GLOBALink. International Union Against Cancer
(UICC); Yu uf Saloojee, INGCAT, Soutb Afri.,.;
O.. -id Simpson. Intcrnatiorul Agency on Tobacco
and Health, UK;
24. Smoke-free Are~5
Melanic wakefleld. Anu-Cancer Councilor
Victoria. Australia;

27. Health Education

P~trick Ssedsrrom, Quit &. Win, Finland; Eeva
Rlirta V3rtiaincn. Quit &: Win. Finland;

16. Tobacco Smuggling

Campaign Ior Tobacco Free Kids. liSA; luk
joossens, 8clgiuln;
Eric LcGrcsJc)'. Tobacco
Control Consultant, Ottawa. Can;1tll;
18. Internet Sale.
Chri5 Banthln, NorthE:u:tc:rn

of 1Io1ichigan, USA;

19. Politics
Sibylle Flcirmann, European Network for Smoking
Prevention, Hclgiunl; Anne Landman, Doc-Alert,

29. Price Policy

Gene Bono, NYC. USA; Frank Ch.loupko.
Uni"cr:l:it)' of Illinois, USA; Anne Jones. ASH,
AWl ra IIJi; Arnauda Sandford, ASli UK; Mlchc.le
500110. VicHealth Centre for Tobacco Control,
Awtrali.; Jo)' Townsend. London Scbool or
Hygiene and Tropical Medicine, Unh'croity or
London. UK.

USA;

21. Tobacco

Indu.try

Document~

Lisa Bero Unh'ersily of California. San Francisco.

USA; Anne Landman. Colorado. USA; jonathan
Liberman. vtcl+eahh Centre for Tobacco Control,
Auttnli3i
22. Rcse.lrch
Linda \V,1\'erly flrigdcn, II)RC, Onawa, Can.1r1Jij
Sihylle Fletunaun. European Network for Smoking
Prevenuon, Bclgh.un: )\O\\"CI1 .. Jacobs. University of
York, llK: Rosemary Kennedy, lORe, OU3\"'",
Canada; Gerald Kcusch. Fogarty International
Center, NIl-I. USAi Aron Primack, r"OgolrlY
International Center, NII.f, LISA; Anthony So,
Rockefeller, NYC. LISA; Jacob Swclry, wellccme
Trust. London. UK;

14

Marlo Corrao, American Cancer Society, USA;

GlaxoSmithKline; David Graham, World Self
Medication lndustry: Pharmacia; Jerr), Reinstein,
World Self Medication Industry; Pharmaeia:

Unh'crsity. Boston,

USA; Greg Connolly. Mass Dept of Public Health,

USA; Kurt ],,1. Rihisl, Unh'crlity of North Drolhu
3t Chapel Hill, llSAi Kenneth \V.1rner, University

Colorado,

28. Quitting

For the.ir general contributions, we would like to

thank Kjcll IIj.",odt. John Crofton. Nigel Gray,
Ruth Roemer, ~1lchaeJ Pertscbck and \\'eng
Xinzhi; and. especially. John M.cko),.
For their ereauve and editorial experuse, diverse
talents, and individual as well :as collective
contrtburlons, \\'C: would like
tNnk the ream Jit

'0

Myri.d Editions: Candid.

Isabelle Lewis and Corinne

Lacey. Poul Jeremy.

Pearlman.

Finally, \\"C: want to thank our respective

for their .support during the preparation
adu.

fiUTtllies
of this

MEN

D~aths from rebaeee use

a' ~(t"u9t 0" :Ot.1 o~:rs
J..,.cr iii "'("'1 art! ,',tnt" 11.t"" 35
1cXXIr~3(1'11t'o! ,.,.,a~

10

-1

-"

Dyin9 in you, prime

l'I'IDft'INI'I,'"

or

3S - G9 vear o es
I

r.q

;'1)0.(" lttw

... I CJC from :O~O

WOMEN

J~
\("

37

24

Legislation: Smoke-free Areas

Banning sl110king in publlc places

b a sound public health measure
to protect the health of nonsmokers.

The issue of workplace bans is

primarily one of labour legislation

to protect the health of workers,

who arc exposed to passive

smoking for long periods during

their work shifl.'i! \ vhether this be

in public or office buildings.

restaurants

or public transport,

Workplace

smoL.;ng bans .a rc

effccttve in r(:fiudng exposure

10

passive smoking. Smokers "tho

are employed

in workplaces

with

sn10king bans arc Iikt:ly to

COI\SUlne fewer cigan:ttc.\ per

day ... re

more

bkcly

to consider

quitting. and quit 3{ a grcilt~r

rate, than smokers employed in
workplaces

whh no or weaker-

policies.
A total ban works better than
J. partial ban. ~"OSl airlines arc
1\0\'" smoke-Free and the global
trend is towards a safer, cleaner
indoor environment

in the home

and in public and work places.

., . ~
12.

. . . -...
A.
9.5

' :! !

.....

,
~

.~

~.

7.9
..-.~I

,
~
I!'

2.2
0.9

0.7

Polluttd spaces

2.

~
restaurants

sondarv ttous~hold
school

74

smok~rs

r..

r.AI

0.0
Nicottnc (on:ntralion in publk plattS
large underground medical hoSpitals houSthold
Sarrelona. Spain 1OCO
stores subway stations S("hoot
non-smoking
microgQ ms pc" cubic metre

Hlnn caused
by passive smoking
Htllt~ dfrct1 on ad.lts

Hann aused
by passive smoking

HAIR

Strlt.1

H,allh tffts on d 4rtn

BRAII4AND
MENTAl EFFEC15

HAIR

Strokes

u;

EYES

8RAIN
POSSIble associ:a11on w,th broil" tumours:
a"d longt<lm mental "fll

Sting. water and blink mort

NOSE
"NII~ujon

RESPIRATION AND UJNGS

Lung caflCtf
WOrl<'nil"l9 of p'tcxi~tlI"'9

cllc>1problcm~ WC'II ..

.sth,.~. eIIron;' ObIWCIl

a.netrmph't)Cft'l
HEARl

He.n

EYES

Stlr:g. wa1cr and

&fiJ\\

reere

EARS
~Aidc!:tear 1fIftcn0llS
-e o"bI rn!"1

t"...

..

pul."..,.'Yd
_

Harms. Ciog5 "t~~tn'

Smell

RESPtRAOON MD I.UNGS

.r. . . . .. b. ,. to_'"
. ...

RcsprnItory 'n~
I'd_ ding

0IId

Asthfl\a {nduction
and <JCIttrbition

IneriC's

IIlIC\:. 1"91nl

ChroniC respiratory symplOtM

(",heeling. covgh, bIl:.thtesSA'\C'i,\)

UTERUS
low blnhw'lghl or
lrnDlI for gfslation,laue

Dtcrtasaf lun9 Nnction

HEARl
Dcltlenous cfftttS on oxygcfI.
anenes

Cot detlth or Sudden In rani

Oe"h Synd,omeISIOS)
~ftt'b,rth

lnaea~dnjmti~ rcttptors

BURNS

BLOOD

From firt' (I"Std by lob.1C'('O

~~t

~)SOICi3t<ln

WIth t,1'tpllOl'NI

Numbers affected by passive smoking

in the USA

RDlfMOoa
Gre .... likdihood or becoming
a wnokt>, as a let.N9t'

annua' 1990,

Ilchlemi.

lung eaneer 3.000

heart dlsu .. 35.000 10 62.000

Infants and c:hildren

Low birthwcight 9.700 to T8.600
Cot death (SlDS) 1,900 10 2.700
8,ond'litk or pneumonia tn lnfInts 150.000 to 300.000
~flt...,
cffCCb In child ....
Middle c.r infect'''' 7OQ,000 to 1.600,000
Asthma inducDon (new ..... ) 8.000 to 2G.OOO
Asthm"
tio. 400.000 \0 '.000.000

35

HAIR

How smoking harms you

~m~1~I ndd~;nino
BRAIN AND MENTAL EFFECT~
Suokts (ctrebrovascul;r ic:c:idtnts)
Addiction I withdraw;Jl
Ailmd blain ehcmistry

Eyes sting, W1i~.nd blink mo",

Blindness (macular dtgenmtion)
Cataracts
~
SKIN

.,----~Ol)

Anxiety about harm taU'Sed by smoking

.'

Wnnl-fes.

N~

pt'emJIUft:

"1-~--040;) 0

tess sense of sm,lI

Cane."

a9ting

HANDS
POOf Circulation (cold fingers):
peripheral ""scular dis<.~
Tar stained fingers

TEETH
Discoloration and Slains
Plaque
toese teeth
Gum diseaSt (gingivitis)

cs.pctiallyatfeoctf'd
bV tobacco U:St:

t-------

MOUTH AND THROAT

of lip~ mouth, throat and larynx
Sort throat
Reduced sense of 111SIC
Breath smells of smoke

RESPIRATION
AND LUNGS
Lung caneee

.1----- T
01

CO,...---.....

HEART

Harms. b~\s and weakens

art";tS ofth, heart

~-----

...H.eart "!

lI,k

Cough and sputum_ shortn,,,, 01 breath

Colds and ny. pneumonl .., asthma
Chconic obstructrvt: pu!moni3ry di5CiSt
and emphysema

compli~;~~e",u~~

KIDNEYS and BlADDER

Cancer

c.O..-.-----t1

ABDOMEN
Sto_h and duodenal ulet"
Canctl of stomach. P'!ncreas. cofon
Aortic anturysm

.-----I

1..

Osteoporosis

Infemlity

WOUNDS AND SURGERY

Wounds ~k:t longet [0 heat
OpcrJtion wounds take longer to heal
lOf'l~r to ftCuptf1le (rom SUrgfty

DIMETES
NonlrlSulin dependent dlabeltS (ncilltus
!IV!>< 2, aduIH,nset)

smoking is responsible for

0/0

ofchro":}150frJhystma

... BONES
Spint. and hip fra<:1\lrts

MALE REPRODUCTION I------!

Sperm: deformltv, loss of motility,
reduced number
Impotence

1 CHEST
can~to' f otSOPhigUS

LEO'> Ind A:El

Increas,d leg pain and gangrene:
peripheral ""stUl.r disease
Butfgcr's

DtSCi~

fMALE REPRODUCnor.
"'rled pains
Earlier mtttopauR
Canct.r of cavix
Inrertillty .nd del.y in conception
BUOOO
'lrubcmra
BURNS

From fifes au~d

bv teeeeee

IMMUNE~M
Weakened

33
-----------------r;rr-?'T----

--

it b inhaled. sniffd, IUCb.d

chewed.. or whdhtr it is tnixtd
with otIIc:r ingredients. thert is flO
Aft
of

Whdhtt

'.

.'Y

I ',"

usiftg tobIc:co.

W, :

tftuTft IfffilJUi
In SoulhtaSt As~ d.iY p:pes
known as suipa, th.ilum and
hoo\li are widely used.

Chewing tobacco is also known

as plug. loose-leaf, and l\\'tsl.
Pan masala, or betel quid conslsts
of tobacco. areca nuts and staked
lime wrapped in a betel leaf The),
can ..l.so contain other
s\\'eetenings
and

na"ouring

agents. Varieties of

p>n include k.ddil'udi,hogcsoppu,

gundi, kadapam, zarda, pattiwala,
kiwam, mishri, and pills.

1\\0;5t snuff Is taken orally. A

srna11 amount of ground tobacco
is held in the mouth between the
check. and gum. Incrc.ulngly
manufacturers

if

Dry snulTis powdered tebscee

thai is inhaled through the nose or

taken by mouth. Once
widespread, its usc is DO\\' in

decline.

aTCprc-packaging

moist snuff into small paper or

cloth packets" to make the product
euler to use. Other produces
include khainJ, shammaah and

nas!

or naswa.

23

a,

"'J

Table A

The Demographics

.A(9l\1niston
Albania

;\e!9~.
Md.".
:~Q~

Antigua and Bariloda

Population

21.71;5
3,134

Armenia

~lia

lt1.llf

Austria

,Y.tijloijan
BahamilS
.~h"in
Banglad"h
')Ia_~qos
Belarus
~)gium
Stlizt

,~in
Bhutan

~Yi.
Bosnia and Hentgovina
BOtSwlna
Brazil

Costa Rica

'c:l6t.dl .... i..

Croatia

'

...

....."
!,,~-;

..
,

.._~-

' _!~

_':

54.9'10

~n
2,085

~.

.fQ.~J".

3,977
1,541

'2_~~;"

170.406

14,876
ilO,157
427

(;pogo
Congo. O(m. Rep.
. C.091t IsIl.IIds

- .

53.6'IJ:I

10.187

q.l04

Comoros

""""'

38.7'1b

10,l49
226

Cameroon

.~oJoln~io

1"....
~.

&l_O'
137,439
'.2~

12.6'Ib

1I.~

304

c.t"boc!l.

China

.~~

11.535
6,356

.C!I~e

35.9'Ib
I

8,080

B(Und Oaruualam
Bulgaria
Burldnl Fas.
Burundi

.<;ahldl
Cape Verde
~,~t"l African Rep.
Chad

39.O'!b

86
65
37,iQ2
3,787

,~~ntin.

.328
7,9<9

3.?17
7,885
.15.211
1,282,437
42,105
7tl6
3,QJB

48.O'1b
33.8\lb
21~:
36.5'11>

~7~'
3S.7'!b

2li.:g,;~.: i'
.: .; jI~:

2~'
35.6'Ib
'.. 2-

-:.1.3.'..
.

50.9<8

~
4,024
16,Oj3
4,654

"'!:,

~~

17.6'Ib
~i.I'II;

Qjbo

~'-1f=',-,,_ ..,

~i=.

13;13-t

J
Youth tobacco use

2
Adult smoking

Countries

of Tobacco

,
~Rep

33.O'1b

ublic

11.199

23.8'1b

:.

'.
"'t,oo

4.6'Ib

10;272

Cyprus
Otnmark

94

3.J~
.
784
5.320

'2~1

3.......

23.IClb

_.

3o.~

38.~

7.6Clb

~
32.O'1b

!'or _e

~.~.'7_.-_i_-..~
.. --,...~

29.0C!b

CICIUIIUid.,..uuArC; batd Oft,)'O'UUo~

....d
~Iy
~

Ie ~dOc:I_~

o(w ~

C':IIIUnCI!.

';;-_.-

Annual c:igarctk consumption

""""

pel pCl$On
'998 orloresr avoilablt doro

2,500 .nd .boY(

1.500 - 2.499
500 - 1.499
1 - 499

ec data

..,..::r

""h

" 'M

..

....... ,.,
........

--

_.

_ or

..."""

Rising num~rs
Avt"Iage number of
manufacrured cig;arnttS
smolccd per man per day

...

""""

in "'ina
1996

1952
1950

1960

1970

1980

1990

1972

1992

1996

2000

6 a

31

Part Three: THE TOBACCO TRADE

12 Growing

46

Tobacco

10 gron'jng, tobacco hy country.

Leadlnf;! producers of tol).lCCO leaves. Dcforcst.ation

Land devoted

dlle

62

19 Politics
Bu)ing tnlluence: expenditure
USA. Buying favours: tobacro
ronldhllliOo$

10

on lobbying in the
companies'

('1'1rrn! candidalM

in

'be liSA

Tobacco industry Quotes.

10 lolWNX>

IJ htanufacturing

Tobacco

48

Nurnber of tohacco \\'Orkcrs hy country.

the tobacco dollar
Additivc5

14 Tobacco

Where

Less tohacco pc:r cigarette.

gOC$.

50

Companies

Leading manufacturers

by country.

The IIig Five,

revenue and mlrkcl

sh~re of leading transnational

tobacco companies.

'Iobaeco industry quote.

Importers.

exporu

rights groups worldwide.

induSITy quotes.

21 Tob.,cco Industry Documents

66
Number of documents found on the LA-gacv
website

by country.

Tobacco industry quotes.

ACTION
70

?2 Research

by country. 'lop

TOI' 10 leaf importers

US Import and export

Tob.coo

64

Rights Org.ni ....tions

Location of smokers'

Part Five: TAKING

15 'robaccQ 'Trade
Cigarette

20 Smokers'

10 cigolrette

by
country. Current fou"c'l~tio" gnnl reclplents.
Global Youth Tobacco Surveys completed

and exporters.

of tobacco leaves and

Eemparative

cigarettes.

54

16 Smuggling
E..'Iurnatcd Slnugglctl dgue-tlCS AS a percentage
of ,lomclIlt-ic nles. "Illjor recent or current

Nationalln..rututc

or Health

expenditure 00 tobacco compared with other

health problems. Published research, l'ubMed

SUTch for tobacoo compa.red ,vim other journal

topia. loum:.).! de\"Oled 10 lobacco oonrroL

$nluggling route'!. Global 5lnuggling. Tackling

23 Tobacco

tobacco .muggling in the UK: project",1 percentage

of market mare: If aci'JOI1 is or is not taken. Lost
revenue In EU. Tobacco industry quote.

WHO, lnternauonal and region.ltobacco

control
org,lIli.. tion.. Locations of .11 World Confercnocs.
Tobacco industry quole.

Part Four: PROMOTION

24 Legisl.lion:Smoke-freeAr~.
7. Where snloking is prohibited or restrtcred

11 Tobacco Industry Promotion

58
1\10$1. popular c1garClh! brand hy oounlfy. world's
In051 popular brands.

1-10\\' the 3d\"Crtising dollar i.

spent in the USA. Changes in dg~rcltc m;arketing

expenditure.
Tobacco Indu .~. tT)q' uote.
18 'ntrrnet

(,0

Salcs

Internet

sales. Internet

search for shes. Internet

cigarctlc

vendors In the USA. Test ordering

from

12 websites. I-{~tCustoms and Excise quolc. User

commeru posted on webslre.

Conll'()1 Organisations

72

in

scme areas at work, and where employer.

voluntarily prohibit or restrict smolting. Sales

before and aIter smoking bJns in restaurants and
mrs in ~lirorni:a. NiCOline conceetrntcn in public
places In
Barcelona, SJUin. The cost of workplace 5moklng.
Tobacco industry

quote.

Legislation: Adv~rli5jng DAM

Increases aed decreases in aduh cigarette
IS

ccnsurnption,

and countries

wlth comprehensive

ar!\,crtuing hAN in the SAme period. Effect of

;advertising ben . Tobacco industry

quol,ct.

16

. .....

Smoking prevalence for women

.,

Stnokfl'l9 amOt\Q{rmales aged 15 and

OYer

IQt~f OVDI/abie' dora

SOQb,r.d,bo,",

40'1>- 49%

2o<ib-2~

lo<ib- 19'!b

no d.tli

btlow 1()Qb

rlt
U

women smoke
as much as men
AUSSI~N

men smoke t(n or mort

times mort Hun womt_n

FEDERATION

CHtNIt(j

.
......_
..
0

Smoking trends

1960-2000S(lcctcd tountritS

..

1G11b14'"
1970 1980

I,GO 44"1b

"-

1990

.2-0

pt:rcttlr:lgc of ftm:.lr smoker'S

...

,
2000
0

.. .
..

l'_
0

1910 37'10

IOCl5

1990

>2,",

1970

19aO2."

.. i'.

0
0
30'10>
1979

0
23 ..
1990

22'10
1999

"'"

J.pan

15 and ove,

UK
16and over

USA

18 and ever

27

30
"Utig.tion

Litigation

will keep coming until

the industry goes belly-up.

Prof...",. Rich.,d Dlynlrd,
Northcastffn

Univerloity. USA. 2002

T obacco litigation began with ::I

personal injury lawsuit in the
USA in 1954. For more than
40 ye~rs, the tobacco industry
boasted it had not lost a single
case but this hilS ch.mged. One
CiUC In ~tinnc.<K>la that began in
1994 ruled that millions of p"ges
of internal tobacco indwll')'
documents (sec: map 2]) be put
into the public domain. These
shewed that the industry has:
concealed tnformauon on the true
harmfulness of smolclng and
misled go\,cmnlcnts, the media
and their clients - smokers.
Utig.tion has pUI the industry
on the political defensive, forced
tobacco companies to the
b.rgaining table nd h.. resulted
in some I.l.rge settlements. with
the tndustry p.)ing US states
billions of dollars a year.
Outside the US.~, tobacco
litigation ts a new phenomenon.
and clear patterns do not yet
exist. HO\\'C\'CT I some recent
CJ.5C5 shew the potential fer
litigation to advance tONCCO
control. ,\uslraUa has seen a
major ruling on the dangers or
passive smoking. Public interest
writ litigation

in India has

prompted the Supreme Court or

Jodi" to require nationwide
implementation of broad
restrictions on public smoking_
Cases now \~ry frcrn smokers
and non-smokers filing for
d.m.ge to health: public interest
lew suits seeking to force the
industry or go\,cmluent to
comply with leg.l or

86

.>

BAT
faced

lawsuits
in the USA alone
at the end of 2001
eonsutuuonat requirements;
governments .suing (or tobaccoattributable health care costs or
for lost taxation due to
smuggling; to cases brought by
the tobacco industry ag.tinst

Individuals, orgolnisations or even

governments.
The judge in an Australian
Ii)\\'$uit against B.AT. in 2002
found "'that gh-en the filet that not
a Single document was in fa.ct

discovered in thaI calegory

(pharm=loglal
dTects of
nicotine) the Implication se:c:rru
overwhelming that disco"cry has
been fund..nenully thwarted
under this Cllcgory by '1tinue or
the 1998 destruction prognmme.

29 Price Policy
~t.
Nm and tobactO Jrt CJ:)ftWnC)Cjttics
which OIft nowhtft nec:tSSariel of lift, whid'l
art btexlme objtcts: of almost u.~
ttlmumkw\. Jnd .hld! art dlettfort
c.atmMly proper subjttIs of taxation.
Adam Smltt. Nt IfVlviry kI:o 1M Uotll'l'e OfJd
o,l/Sdo(fltto IVtclflidUotiom 1776

5''''

The price of tobacco is the single

largest t~Clor inl1ucncing shorr
turn consumption pattern!, More
importantly. price plays a major
role in determining

CA.~D&

UHITED
STAfES
OF AYE.leA

bow mOl"Y

young people wlll start snloking,

and thus profoundly tnrlucnoes
longltfffl ccnsuurpucn trends.
There is a dear Inverse
relationship between tobacco
taxes and tobacco consumption.
For C\'cry 10 percent Incre .a.se
in cigarcHc taxes, there is on
ave ..,.,&c .t four per(""Cl1t reduction
in consumpuon, Youth, mincritlcs,
..lIU) IO"'-inCOI11C smokers are l\VO
to three t1111e$ more likely to quit
or smoke le.s than other smokers
in rCJpOnl'C to
price increases.
Tobacco laXC5 are an hnpol1anl
source
revenue (or countrles.
but the pCrCCl1lJgc or total
government revenues accounted
for hy tobacco taxes is relatively

or

.(..9...

( !

", ,,,,
l

- ~-~ ! l:
0

"

Tax down - but prices up

Declining cigarrtte 13)(in the USA
as a p(fccntagc of retail price:
Smolen Ofttfl QSWmt shot CIgOrr:rtes
so u.ptflj.h~ bouk
offftcottOldtC,ft1'" ft.'" Utt USA.
whIlt tilt' prittof C'f9off'rtts has rt'IO'tOSf'd.
flit proponlon go;,., fO to. IS ht)tf of whof
~"CSjn 1965.
haV't bOmt

"".....

EB

small. leu than 10 percent in ;)11

countries, and less than 2 percent
In most coumrf .".S. Higher
tobacco lJX\'S arc also c.uy to
implement,
and nCOIrly alwaj s provide mere
g0\,crnlucnt revenue, despite Ute
riJCl th31 people- arc: l'moking less.

,~oo

in the UK 1971-95
tJlptndlturr on d~'f't1t\

'" mlllion~ of pound\ ~lt,nng

p,itt of
20cigaftHM

84

2 ., . ,

Smoking goes down

as prices go up Re.al
cigarette prim
and dgatetlt consumption

1I' ' ' '.!'''iJ 1 ' '

1971
t974

'977

'980

'983

'986
'IllS

...

'1192

Land devoted to growing tobacco

""'"'

Art-a In

MM

neetares

ovtr 100.000

10.000 - 99,999

1.000 - ".999

under 1.000

5.000 - 9,999

(obattO

RUSS'~N
fEOe .... 110H

00

tobocco grown

is 9ro\\I" on mort'

thin one pcrC'tnt of

.gricullurallalld

.J
~

."....

_ -.

.')

1''''1

-Luding produccn of tobacco !elves

Thousindi 01 mctnC ton1
;01)1

- -- ,.7

132

ChIna

India

Bra11l

us...

Turkey ZImbabwe IlIdon.. ,.

Italy

130

Or....

103

101

120

Malawi Pallo,.n Argen1ina

47

The Tobacco

Atlas

"When one has. thorough knowledge or both tbe enemy and

oneself. victory Is assured. When one has thorough knowledge
of both beeven and ear th. victory will be complete."
- General Sun Tee
The An ~1I&r: A Trearis< on Chinu< MiUra'}' Sd<ntt
c. 500 B.C.

IIII_III.IIIII~IIIII'I.
J77W-RXB-WYDZ

"

FOREWORD
A message from
Dr Cro Harlem Brundtl3nd

Dlreeeor-Gcneral
World Health

Organization

"More people: !mokc tod3.),than at

.lny other

rime in human history. One perl'On dies every len

seconds due to ~1nokJng.related diseases.
Research evidence. in the past flve years shows a
bleaker picture of 'he health danger of smoking
than previously realised. Tobacco ts the biggest
killer, much bigger in dimension than all other
forms of pollution.
Children arc the most vulnerable, I"loiliiustart In
youth. The tobacco industry knO"'\tS it and .lets
accordingly. This iii .l medical ch0111cnge.but clso a
cultural challenge. Let us all speak au" tobacco l<.
killer. It should no' be advertised. subsidised or
glemouetsed.
Adolescents should not be allowed to mortgage::
their lives 10 the seductive advertisements
the
industry. GirJs and women arc being urgeted 111
over the world hy expensive and sodecrive rehacco
ad\'ertising imJgcs of freedom. ern ..ncipation,
slimness, glanlour and wealth, Tobacco companies
should he aeeoun rablc (or the hum caused by
t01>3(""<:0 usc.
The (I:.)' I took office I launched the Tobecee
free Initiative (fFI) to spearhead the struggle to
reverse the ,,'orJcning trends in health caused by
tOb3CCOand to add momentum to a erlticOlIpublic
health $trugglc. The initial-h'c aim, ;at hC:lghtenlng
global aw ..reness of the need to a<ldress tobacco
ronsumption, It aiM) seeks to huild new
partnerships a.ntl $tI'cnglhcn existing P..rtnershipJ
for action agil,;"!t tobacco: to ccmmtseton policy
research to fill g"pSj and, to accelerate nation.ll and
glohill policy to Implement nr-.ltcgicJ,
The \vay It ' vorks illustntes the "'ilY "'C wtsh
WI~O 10 work in thr future making ,he "lOSI of
our nwn resources and kno,vlcdgc and dra\ving
he.,,'lIy On the IuUJ\\flctlgc and expertence or othen.

or

Our gMI! are to:

build ", vibrant .lIimcc" between WHO.
UNICEF. the World &nk, and "parmershtps with
purpose- with non go\'crnment;ll orgmiAlions, the
private sector, academtc/researeh institutions snd
donors,
try to gel morc people to work on and
support tobacco control ~hities and ensure lb.t
more resources are committed to tobacco
research, policy and control.
develop the Framc\\--ork Convenucn on
Tobacco Control (FCTC), the world's rom public
health treaty. The ''''''y \\ill only be effecth .. i( i,
works In conjunction whh, and builds upon. sound
domestic Interventlons.
The good ne" .. is Uul the epidemic (Ioes nOI have
to continue this "'a)'. There is I political solution to
tobacco - a solution routed through ministries of
nn.nce and .gricultu"" .. well as he.11I> and
education.
\-\le knO\, tNt tobacco control matures can
lead to 3 reduction in _moking as wlmessed .tnlong
some member 't.)(('.I. WHO, the '''orld &nit and
public health expertJ bave identified a c::ombim1ion
of the rollo"'ing U N'ing a measurable and
rurulned hnpact en tolc:co use:
increased excise taxes;
l)4n, on tobacco ad"crtislng. sponsorship and

PROMOTION

"Smoking a cigarette for the bcginner is a symbolic act, I am no

longel' my mother's child, l'm tough, I am an adventurer,
Toni

Osdcnc,

oI\Vby ODt smokcst.

quoted in l.tow Db}"U S~I1l)tc:}).
C.mpoign forTooocco Free KidJ.
Washington DC. 200 I

I'm not square. Whatever the individual talcm, the act of

smoking remains a symbolic declaration of personal identity ...
As the force from the psychological symbolism subsides, the
pharmacological effect lakes o,oer LO sustain the habit."

6 a

57

31
The lob3CCO industry

Projections by Industry

predicts a

global expansion of the tobacco

epidcmtc in the next few years.
The Increases in ccnsumpticn

lie

principally in the developing

nations, while consumption in the
industrialised

countries

will be

static or in decline.

In all die countries surveyed,

the higgest gro\\'lh between 1998
and 2008 is expected to he in
Zlmbcbwe, followed by Cote
d'Ivolrc, Brazil, Morocco,
venezuela. Pakistan, United

UNtfED

SJAr(s

Dr AUERICA

Republic OfrJn7 ..ania and

8.1ngl.ldcsh.
11,C grc.at(..~l cleclint! t~expected
to New Zeal.locl, followed hy the

UK. South Arne>. Hong Kong.

Au:u:ralia, Singn.porc and Finland.
In Africa, only UU!South AfriC.lf1
marke; is expected to decrease,
In the

AlllCr!C,'A$,

gro\\rth In

Lattn A'l1crlc4 is cxpcctcd ro

compensate for declines in t-he

USA and Canad a, will, Il,C

greatest

Increases in Brazil,

venezuela, Mexico. Peru, Chile

and Urugu'y.
In Europe. the forecast is
mixed, wtth Increases in some
markels and decreases in others.

The biggest Increase L~expected

in Nor-way, and the greatest
decline in the UK.
In the Michl": 1!a5t region, the

high .. , gro",h is expected for

Morocco, followed hy Pakistan
and Tunjsta. N(, couolry in this
rcglvn IIIcxpecrcd to experience a
decline In consumption.
In South East A.lIiil, Oang)<ltlel,h
will sec the higllc~t gro\\th.

followed hy Thailand, while

cousumpuon

remslns static In

lndl a,
In 1111\:V: CSh'rn pjl(:inc,
VICln,ull

88

tops the gro\\>'th charts. while New

Zealand. I-Jong Kong. Austr~li~
and Singapore shew L11C greatest
decline.

This transfer of the epidemic

from rich to poor countries,

with

it$ hc~hh and economic

consequences,

L", one that

dC\'cloping countrtes can ill

.Oord. As long ago

'5

1986. the

World Health Organiution

pre(licted that the differential

in

wealth between rkh ;tnfl puor

eouutrtes would wtden further a~
.1 resuh of t()l~coo, leading to
ccrnpromlse

in sustainable

development.
These projections are nOt
h\e\'it3ble;

tOb3CCOcontrol

iluer\'Cn1ion can make

difference.

:I.

Pt-rttr.ugtof
tob.Jcco

1l-lSvealoOCS

1oI\<!"i9

1001

Of

lo'ot """ lob",

"0"0/10'.

ft9l()(lO/ OI't'ifytlaZD

JIRIt and tMr

2~ - 29'lO
10'" - 1900>
under lQQb

vlnablt:JCllb

nodal

'to ".,"
0'

AIII',(A

.....

--

.._
..... _

6()qb

GIRL
S
29

$~(LERS

Google,

INTERNET CIGARETTE SEARCH

WgRUDWID

Rtsults

Search term

I disrount

I chtop

2002

found

cigortHt

9,070

cigortHt Itox

5.510

frtt cigortttt

I mall

1.540

ordu cigortttt

--

-,

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--/- I
User ccmment posted on
discount cigarette site, 2002

/'

INTERNET

CtGARETTE

VENDORS,

USA 1000

.I

intunet
situ

cigartttt

with Surgeon-Gene

vendor sites
.. I'! warning

silts stlling

bidi!

sitts wilh special promotions

situ

with age waning

typtS of ogt vtfificotiDn

euste e er self-reporting

they are over 18

driving license information

US teenager,s

with internt!

24:J!!
8%
33%
8 7%

Icquilcd:

typing in a birth date

entering

188

accus

I ~99b

115%

19%

lover
Ba:al

50%

n'J3fl

I
61
1

II

RlRE5T:

Frtedom Organisotion fo, Ih. R~hl

10 Enjoy Smoking Tob.=

RlRCES: Fighl Ordm.nco:s I!Ro:stri<tions

10 ContrOl a Binlinal( Smoking

Smoker. oro not 0

constituency that CADbe
easily

~-,
U",...

EI,'lherla

-rirat ve aUIt. work horder

at qettlnq aeokera to help
t,he induatry. It we A,rO
to have any luCC81S at
changing tho climato ot
opinion, we have to qet the
anokers moee on our side,
or at leaat enou9h of thea

'We try to keep Philip Korrl$

out ot Dedi. 1 u.I like
taxation, 1:.oUng ~,n.
ond marketln9 restriction
Inltd, ve t,ry to provide
the media with Itote~nt.
in support of our positlon.
from third party loure
, which carry DOre
credibility than our

rallied.

They

anger or ren~nt. There

t. no lign ..on9 thea of any
significont doterainatlon
to
assert their rights a.
...okoto."
RJ Reynold.,

1918

cocpany and bave no

apparent v.lt,ed intereat."

PhilIp Horr! ., 1993

to start to .. te a
difforonce.-

Philip Horrie, 1985

-In Au.teal1. ~,
thrOu9h POREST,
we have awakened
the public In the tax
area, vith carofully
orch.atrated
C'UlpA19n

Philip

_.. ._ .....

HOrri.,

u.

defen,ivo, often selfdeprecat1n9, .cmewhat. IharMd.

Hay .eo them lvee engaged
in
4 habit thoy wish they could
qu,it. They ore a passive
q-roup. Expr ing very lit.tl.

1985

; "I!I

..

II

Cigarette exports
million of cigattltts 2000

Cigarette imports

100,000

cwtl

10,000 - 99,999

1,000 - 4,999

betew 100

Top '0

100 - 999

no data

2O(J() numbtts of

cigan::tt~importing countritS
cigartnes

5,000 - 9,999

25.1bn

-IftAlll

....

."

'--'

,.,

fr.~,

Cigarettes
mttric

tons 2000

IOlallmporttd: , 5,27'

~-

total c)(po(1td: 14S,533

us Import.

_\~

V"\~

....".

'"

US exports

53

Smoking prt'Vlllence for men

~mOl;"9 Amono MIIII~<:.gl"a

It.:a,vJ

tlvtf

lor .. r OYDilobl. dora

6O'!b and above

30'!'0- 3~

SOOb - S9'lb

10,"-19ClO

no

dati

b<low 201!>
Top ~n

high~[ overall $mOkingrates

of men .nd ""'omen comblntd

.... .

-,...
,

...,
....

-"""

... .....

AUSTRALIA

._.-.

--!r
Physldans who smoke
Smo\ing pr<VaICtlCCa"lOng physicians
1000 Cllolest",'Oiloble doro
.sdect~ countries

pc:tttntagcs

women

.!!
:0

men

it

'.!
"!

_~

I~
o
_

i!
u

...
,;t

~
r.':l

ti l
1

II

<:

!i

~
0

2~

:S

1!

;;

- e

...

e .

1>

.E
0.

.>!

it

'"

"

'"

s:

'"

.,~

;3

25

27
Education

is essential

Health Education

--

for

sustained progrc$!I in tobacco

control.

Many legultlt:i\'c or tax

Interventions

\\;11 not he

effective if there is no public

understanding. support and
demand for such changes_ People
support tux tnereases whcu they
understand that the rationale is to
reduce youth .5Illoking: an ,,\'{'rage
of 87 percent of respondents in

local

Argentina, India, Japan. Nig('ri~t

and the Russian Federation were
in favour of international efforts
to create a set or rules and
regulaljon!l to curb tobacco use.

Schools can provide an ideal

venue not only to leach about the

harmful effects of smoking. hut

.dso to teach students refusal skills
and an understan<ling or Ute
behaviour of the tobacco
industry. This includes .1oJ.lysing
the mantpuladon ()f young I)(:()ple
by Inarkcting which equates
,srlloking with gro\\'ing up.
freedom ~J1dbeing cool.
The first step with school
prObTr.lmmc.!l is: to increase

knowledge about the harm caused

hy SlnokJng and 10 Ch.lIlgC beliefs.
anitudes llnd Intention .". Thls
alone is not sufllcicnt to change
behaviour.
control

A school tobacco

progr:unnu::

must

:.10

Incorporate prohibiting 10b.<.OO

usc: at afl scbccl facilitirs and
events, helping student.! and st3ff

programs support
lourl objoctive of
discouraging unlair
end counterproductive
fedoral, state And

C"ffADA

to quit smoking. and Ide.lI),

In.ldng the course part of a
eoordlnated school health
programrne, relnforced b~
communtty-wtdc

efforts.

To improve its public imilge.

the tobacco industry has recently
become active in .moking
prevention programmes for
young people. '111t:seprogr;unmes
panfil)' .sllloklng as an adult
decision,

and that young people

should wait until they are gro"'n

up to decide to .smoke. Stnce
young people .upirt' 10 be young
adchs, Ihis Iype of Inc:~s;age
mJlY
itclually make smoking more
appealing 10 youth.

restrictions on
S

c
i

advertisin9_US Tobacco
Institute,
1
9
9
1

.......

World No Tobacco DIY: 31St May

1988

1989

1990

1991

annual themes
1992

Tol>&o<o Women GrowIng up Tobacco in teeaeee

without
and
Public
II lhe
Tobacco lob.ern Places aria WortptaCt
Choo"

or Htalth'
Htalth

on Public

rrlnsport

1993

1994

Hullh

The Media
.g-llnst

XNKt'S.

including

Hullh
PCl'$onncl.
'gainH

teeeeee

80

Tobam

1995

1996

1997

199B

The
Spo",..6 The U.II<1I Gro...-ing up
Ec:onomlcs The Arts Nations and
VWllOO>Jt
o(lobo
Wlthoul
SpcC.,liztdIl>tloo
teeseee

Agt"CI~

Against
Tobacco

"United fOl

ToOoo-

hot W.. ld-

--

PART

.2
THE COSTS OF TOBACCO

"I'll tell you why I like the cigarette business. It costs

a penny to make. SeIJ it For a dollar. It's addictive.
And there's Fantastic brand loyalty."

39
6 a

The Demographics

Table A

pc":rt'COugt;,
to!.d

3.496

4O.5'l!I
19.8'lb

2.035
2.913

Liberia
Libyan Arab Jamahiriya

5.290
3.698

luxembourg
Maetdonla. Forn'ltr Yugos. Rtp. of

437
2.034
15.910
11,308
22.218

Malawi
M<llaysia
Maldlvts
Mall

291
11.351
390

Malia
Mauritania
Mauritius

2.665
1.161

Multo
Mic:ronC1ia, Federattd States of
Rtpublic

46.O'1!1
38.5'l!I

3S.O'lb
1.0'1b

J3.5'l!I

51,OC1b

16.0'1b

33.0'1b

39,OC1b

'6.O'1b

40.0'1II

27.0'1b
32.O'1b

14.5'l!1

9.ll'1b

26.''''
26.0'1b

49.2'110

3.5'lb

37.ll'1b

l!i.O'1b

23.9'11>

33.1'"

14.611>

23.9'"

".II'"

of

98.8n
123

34.8'lb

.,295

32.0'1b

Monaro
M..,goll.
M()(OCl'O
Mozambique

33
2.533
29.878
18.292

Mvanmar

47.749
1.757

Namibia
Nauru
Nepal

12
23,()43

Nelhttlands
New Zeal.nd

15.8&4
3.778

Nltaragua

10.~2
113.862

Nigeria
Niue
Norway

.....

P"""""'P

r......

,
16.M1

16.O'1b

16.O'1b

51.2 ...

21.7'Ib

21.9'!b

r~.

2.9'Ib
18.4'Ib
18.0'1b

46.7'Ib
18.1'M>

67.11...

25.5'l!I
1.611>

32.9'Ib

43.5'M>

5O.0'1b
54.0CI>

65.0'111

22.3'M>
36.O'1b

34.S'"

47.0'1b

38.5'l!I

61.0'lb
48.0'111

3J.0CI>
25.0'1b

37.0'lb
25.0'111

29.ll'1b
26.O'1b

29.ll'1b

7.8'lb

12.O'1b

6..O'Ij

..'\. ~

Oman
PoIklstan
Polau

~
l!i.4'Ib

1.7'Ib

58.0'111
31.0<10

17.ll'1b

'.469

37.5'l!I
31.5'l!I

8.6'Ib

2.538
141.256

8.6'Ib
22.5'M>

l!i.5'lb
36.0<10

1.5'l!1
9.ll'1b

22.3'1io

7.9'!b

19

15. I'M>

Panama

2.856

38.0'lb

PoPU' New Guinea

4,809

37.0'lb

5.496

14.B'1io

"",.gu.y

I'tnI

25.662

Philippines

29.6'Ib

75653

32.''M>

Poland

38.605

Pon"gal
Oalar

10.016
585

34.5'l!1
18.7'M>

Romania

22.438
145.491

R""'an r.dmtion
Rwanda
S4Hlrt'bl

'ow

5.071

Niger

98

(vaalc

51-

MDIshalllslands

Mold ....

~Io

4.0'1b

Uthuania

Madagascar

Youth tobacco use

Adult tomo1cing

tbOWMIW
lebanon
Lesotho

Popubtion

Countr-ies

of Tobacco

7.609
JC'~ 1M....

124

56.0'lb
46.O'1b
2'.1'"
41.5'l!I
53.8'1io

18. I'M>

22.O'1b

58.S41o

S6.O'1b

16.ll'1b

32.O'1b

~j.:

20.ll'lb

-~

28.ll'1b
5.5'l!1
15.7'Ib
11.0'111

44J)'Iio

2S.ll'Ib

18.8'lb

JO.2'M>
37.o'1io

7.1'"
O.5'l!l

43.5'"

62.0'111

25.0'lb

36.5'l!1
S.5'lb

63.2'M>
7.0'lb

9.7'Ib
4,OC1b

I lu IIOfrM: rowlU~ diu ll't ~

19.5~

22.O'1b

23.3'M>

31.2'1io

1~.~
17.2'1io

24.o111lt

29.ll'1b

2O..o:Ma>i-

3S.1'M>

4().lI'Ib

"'"
oo,om. ~nY'lln

~R

m.a.u '*-'..: ~

MIdIre oo( 1I00I''''''1 noptaomUth~ cIthe mcm CWlIb)'.

Tobacco manufacturing workers

Number of worttrs

)DWallarm OViJ1IDh~aOfD

.......

ave. 200,000

10,000 - 100.000

5,000 - 9.999

1.000 - 4.999
1 - 999
no data

India:
6 million children,
ages 41014.

work: full time in

the bldl ,"dustty

filTER

Less tobacco per cigarette

tstlmau;d Ibs of leaf used
pet '.000 clgarctttS
In tho USA

tlG4RE

ADDITIVES
S,I.<1cd addi,l ... and offm,
thingn pH Ind m.v

'961H999
Flavouring,

InOclst nicotine .bsorphon

(,,"anet tas-Ie

Eugcnol .nd

make mOlt pilat~bft

numb IhrQ.a1 and

Monthol

fatil1tatt Inh.lallon

Othen

dIlate ilfWilVi
rna~t sm(1I 'I'd Invisibility

SweelC'ntn

Coe<>.

of stdcstltam smokt
o1hcr Itddlrrves: ammon'l ... mmQn~lJm
nydrO)l;idc. beta-eeeteee, gentian rOOI
l".XHKt. Itvuflnlc aCID, patchouli oil, urn,

melhy1cyc:lopt'ntenolcne,

$Nl:troot otl

49

28

Quitting

"&try nicotiM patch told MUll)

200 cig.rrtta not soN. .. Oiw IIta.
ASH UK, 2002
~ the' UK. ~Rr e
nalJItIk ttl all c:itiztm
U!"dcr tht

The nuin d.lOgers or smoking

decrease wben smolccn quit. n'cn
in those who have smoked for 30

1UliOoaI1I .. ltlo _
Mdkm~
"tr Y
oft

-..
.
oth er

or more ye.lrs.
Smokers move through .uges In
reution to quilting: or precontemplation. contemplation,
resdte ... then >dion, fcllcwed by
maintenance or relapse. ~'1iU'1y
move through thi< cycle >e,'er>!
tim es before they fin.lIy quit,
while others report they round It
easier 10 quh than the), expected.
The se stages are influenced by
tncreased CQSl5 from lax increases
or reduction of sn,uggling. illnes.
in the smoker, farnlly or friends
dying from robscco, the media,
he ..hh profCl5lon. hans on
promotion, ereauon of smokefrce areas anti, whllc lUO~t
smokers sull quit on their 0\\'11,
a\'ailahilit)' of support anel
treatment,
There are now technique. to
lLul.!1t these who want 10 'lull
smoking, .Ithough th ese are not

.".iI,bl. in _II paru or the world:

.od~l"upJl'ol1. dlniCl, quilHnca,
Intemet .lte.; .leJII. t.. lnln&:
ntcoune replacement thenpy
(NI\T) and other l'lohanll.1.CCullcal
IfC4.uncnu.

r~

1 ct.y Iltll:'

*'

or

of slo9Ping ImOIdng
Hearl. blood ",<$W't. and the blood
show WI! pf'OVtlMft IS

1yea, lalt'

Ex<m ruJt of ......... 'Y hurt

d.staSt

tt

h.lf U,JI of I conlIn", IIf

smoW
Sto 15Y''''
lilt'

lOY''''
1.1,c.,

RI'" of

st"*, " ,_

Effects of starting .nd quitting smoking on d~.ths

to Wt

of ntYtflo~t"

Rill of lung CIMlttl "mfU(td

to

'6' tN" half that of ""'t'""'ng

>mO''''': ruJtlof ",."., ot....

Total.CX\Imula1cd tobacco .... tIK

1000, 1025 ond 2'OSO fJI'Oi<c,ed
million>

~,,_,_lit
pi""'"

15 yca"

w11..'..,......
".,.. ..

IIlAZll

If hucr\'cndons only focus on

prevention
initiation, and do
not addrt':" CCJs<1tion. lhtn
160 million ""dldon.l.mo.o ...
"III dl. bef ore 2050 (see below).

Quitting Caiendar
The: ""n<fits

., Nttt C*4M de ;

w......

laltr

82

ancttS

drfl~

Rls.k of torot\lry heart dlit.Sf ,~

slmll.. to that of ntV<">mOt,rs,

and the OYfrali ,Ilk of deJth
.tmost tnt same. t~lllly.t tht

l~(,f qu,t~ btrOf'r llinm dtvt'lo,"

5lOn1

50000

PART

1
PREVALENCE AND HEALTH

"". tobacco is the only legally available consumer product

which kills people when it is entirely used as intended."

21

32 The Future
"'he vse of tobacco. whi('h h~s made Its

way thanks to the sptrit of imitation. as

wen as to Its PC:C1J.1II' effts. has

.lnqyiVitd

humanity .nd will CQntin..,c: to

,elgn untilltle end or tht world."

LouiJ l.ewin, nw"tIlHiro:
om!
Stimulorjng Drugs.rIc1924

","CO

tobatto

Number of smokeD
assuming ('onstont
pre'JDltn~ and medium 't'Oriont
projttd populoDon

"Thcfe will be' , billion de.ths from

In the 21st ntury unleU strong

and s"mined mion is uttn now,"

. ::=
,fI--J=---=:-~
_
-:--==:-=f=--=t~-=
~:..

Number of smokers

nature speculative but some

billions

Ridtlrd Ptto 'nd Ala" I..opf.z, 2002

Future prcdlcttons are by their

thjngs arc certain: the tobacco
epidemic, with its attendant
health and economic burden, is
both inCrC.1..iing and also shifting
from developed 10 <Icveloping
nations nations; and more women

mloldng.
The industry is consolidating.
and also shifting from the west to
(Ie,'eloping regions, where there
may he less go\'cmmcnt control
and puhlic debate abom the role
of transnational tobacco
companies.
The future looks bleak: the
globallohacco epidemiC is
worse

O$$uming rtdtJCXd
/N<volenc.o(
-7.OCIbp.a .. medlum

1.4
.,

voriant prajtcted
population

1.3

1>oIiciciI, politics ancl ;1ctions

laken lo<by.

1.4

billions

Health

aTC

today tJ\olll it was 50 years ago.

And it wtll be even worse in
another SO YCOlr.sunless An
extT.lordinary effort is made now.
Several countries have Ollrcady
shown that snloking rates can be
reduced. These successes can be
reproduced hy any rcspcnslble
nation, hut only through
Immediate, determined, and
sustained gO\'emmenlll and
comrnunity action. The future
epidemic depends on
undcn;t-;tncling of the blue. and

1.6

Eeonomla

t*o-

Tobacco's s!\itt of global dt:ath

and disability Is]qh

IndMMk 9C"cdc:ally prone '0

ttltttlS distasts un be idc"t~

100 miflion c:tIlIClrtn Vlpostd '0

paulY( vnotlng i1 1'101'1'1(..

CiIlttl'S, (!UlTtfttly ulItrt;,hlblt.

trtate4.

82_ of smours fivt in d('vttoping

C'Ot.lntTio.

Htw
trtMoio9Y
(01
diI9~.lId
tttatlfleftl wfll be: ~"siY(.nd
hIIvt IItt1C'
Ifflpa(1 on glob;,1 momUry $tatl.stks.

Global annual rcooorn1C' rests

toOactO:
USSSOO billion a yr.lr by 2010.

0'

at birth.

ooukl be

iUl"ltiSts nSot to top !'Itllth

uptnClitufc in malry countries.
My governmc:ftU condudc tilt e<.'OI\OfI'Ilc
toS~ of tobKto Q{"Itwdgh atly bcfIc:fit.
fObaCtO-ftbttCl

A SC'IttC t(OftI)rI'IiC' dqwt:s:siO.ft Ind/or Njoc

intc:m.t'CftaI ~rity 0'1s1s eI\I5t tbbacto
ls$I.ItS to U1"poqril,
dlmillll$h in Importal!l("t:.

Tob.o industry

to procIuct gt:ntoolty modified tobX't'O

'MUllowtl nicotint.
AUtmptl

Sotnc tobla-o C'Ompal"l!~buy phan'NIttlltK-a1

C'OfI'Ip.I"it's.

90

Tht indu\trv tritI to ttposition iu publlt image: "

a mponSible: COtpootion.
'lit indlntJy ~b

own tt.rms.

Action
Ukt.n

ttg\llltio"on its

framCWOtl CotIYtndOfl on
Controll'ltititd.

reeeeee

SoIT\lf oollntrits bin smoki~ InWHI'I'CS tOl

QIoIllting Incfudc
I'ftOnCtJry savi~ UII~OhrrOalCS and kMer Malth
Insurance: prmll'llms.
Doubts abollt ~'m
prodlJttS IntrtlStS.

Nlilr.,toUS"

In dCYdocl<d countries. theft Is.

Drld\.l,l Shih in the Ptlttpdon ot
$tnQklAg Ii It COtI'<$ to be: letn H
,ntlsodat.

Industry

tonsolic
b~ kads to 2
or lllugr:

C!
Of9om
mto
ICCDlI

"ting for
tbe buCk

WOtIdoldc.

.dvtttlsing
Inc! Vacant
procfvctd to switch oft
lIicotiM ttrtpton.

1.11... 1,.;,_ Vlobilllynu_

"",""'tk
ttlthlng on tobao.
will be: odI'~

et
,toNI
satts.

Slt'lOk~'r" ,raj

CondrlUC
'cJ pri'vitisa

Cig,ardle: Pltkti Will

be: pI.in bUdI.IId

tion
Jtt$

(tid

Gf sta1~"
tcbattO
C'CII'I'Ipi81
t\.

tlitk
mlfkrtl
ltill aiu
for
smaller
plIyerS

tot not'I.

~"'Oklll9btint the

norm.

white: .nd tonUln

ontvbrand n.amc Ind
expllt:ltht.lth Mm.

TobICUI dependent
.uistcd In
dl,.",,.,,~
Nkotlnt Rtpl~t
Thmpy sold
((:C)tIOI'NtI 1ft

OWf the

countc:r wortICtllYlck.

f...
19'",

ItIItffl.
UbmliiAt
iolli of
glob"
trJdt

(\lIes
wel<omtd
by the:
Il'Idl4tlY.

s.nllggltd

dg.ltttr
s
0Yffta\t
11:911sa
,"-

.
E
l

_
i
m

l
l
n

o
l
t
i
M

or tobltc:O

-.lNolld's worst
forest fire
caused by

cigarettts

300 lclllrd
madl: homeltsS

;.
l

Every year

PlliUppl ...
$ 6 0 0

mi

~~. : ; ' ' i- Bi on

- ---_'

every year
Annual cost of loss
S16.5 million from time off work
T(ltCOm Austrilia
C'mploytts
1994

Austl'iflin S
percentage of all fire deaths: 1()C)b
t.L'lIIclII,d by firts c.U$ed by .moling: 300.000
tctet (Ost of rues caused by smoJ:if'lg: USS,27 billion

$5.5 million

41

Table B

The

Business

of Tobacco
1

Cro,,ing1"ob.lcco

, (;CMLfttrb

Agricuhur.ll

Un.ft
re

d~"OI~

gro""nt

tobacco
1>0_

t~l1cJ de"01NI
10 icbacco

Tobacco Teade
Tob.t,('01XJ

1,n)(lullC!C1

(.J:rming

..0(."'
.".'j
0

aCudtt:!l
mell'"ic

:I:

lOlU

Gc.......

:C

T(.~c;(!o
I",r

Tob..n>u
1",(

""f""'S

mtU'ICCcw.

Silln1 Kitts and Ucvis

Salnlluda

20.

5.ln1 Vincent .and Gr~n.adin~

Samo ...
San 'Aarino

70

0.55'10

85

<I)

0.03%

135

30
3.250

25

150

20.000

622

500

366

1.647

100

sao

Sao T~(_'nd Principt

Saudi Alibi.

Senegal
5<)<",11 es

15

Sierra Leone:

<I)

1l11%

1.134

OA7'oI>

Singapore:

So"'!,lia
South Alri",
Spain
Sri Lanka
Sudan
Suriname
Swaziland

250

Trinidad'and Tobago
Tunisia
Tuitev
TURmrnistan
Tuvalu
Uganda
Ukraine
Unit~Arab Emiraln
Unit~ Kingdom or Gr. Dr. & N b.
Unittd S10IttS Amtrica

, YugOslavia
Zambia
21mbab we.

0'

M2'11>

14,100

O.ll9'o

133SO

0.09%

4,780

0.45'\11

194

Sweden
Switzerland
I Syr;.~ Arob Ropubllc
Tajikistan
, T,manl a, United Republk: of
TNiland
T!)go
Tongo

Uzbttistan
Vanuatu .
Venezuela
I Viet ~m
Yemen

200

0.30%

Slovakia
Sto'ltnia

UrugulY

20

0.()4'11>

58.745

13
49,350

50

900

1.870

I
I

100
29,700

7~

.926
,133

<IlO

I
I

32'
2.5.175
50

2.000
200

51,800
4,000

0.21'11>

74.200

1.500

0.1611b

2.000

1,000

2,000

sao

),400

290.000

0.17'01>

260.000

0.07 ....

2.000

1,500

0.11 ....

10.000

4.300

3.000

2.000

8,000

111.006

20,000

608
471.630

30

8.000
2
148.261

1.m

7
111789

7,372

31.486

2.315
7.000
21,350

2SO

25,025

10.177
3

15

7.500

0.23'"
0 .. 1....

11,288

250

50

21.200

0.26%

12,S81

2.000

2.000
150

l.250

101,500

0.26%

11,341

0.06'\0
2.56%

3,200
227.726

22.950

2.000

48.846

4,71-'

144

1.579

1MOO
236

60

7'

19.000

8.013
800

40

asoo

0.11*

2,900

129,28'

9.945
19o.538

O.()6llb

9,858

2.065
218

'5,018
15.064

830

go,769

3.825

1.500

10.500

24."00
5,209

2.37'

0.08'11>

6.000

SJ.B95

1,000

0.Q4%
3,100

0.1 so.tJ

6,.930

25.615

400
23.400

12.265

191,176

15,go5

70

1),500
26,670

0.07%

!1.500
20
130

5,67'

420

0.54%
l.oG011

50

750

20

5.200
<0,000

800

12.158

100

0.17%

1.182
26.112

2.266
1.775

25

651
16,726

0.25'1b

40

128.569

WJl62
8.954
5,.50

..

186
96

10,507

3.710
3,(;()O

2.700

163,933

6.723

16.000
8.502
1,100

108

~r<":_IU"< Il~

"

-Small shopke.pors were

enlisted to write
protests to member. of
p4rli4Den~, ~h. letter.
'Ione with d.liberato

cypogrophical errore to
create ~h.aura of
authenticity,' were
prepared by the
(tobacco) indu.try for
the shopkeepets.Philip

Horri8,

1990

~e

have got the union.

to aupport indultry

in

several countries.
Prcmlnent have been the
efforts they have made
on t,he t,ox isaues in
the OX where they vere
very involved in 4 letter
writing campaign to
Members of Parliament.Philip Morria,

1985

Phil1p Morris and the

industry are positivoly
~pactin9 the government
decisions of 8ehrain,
~uwAit, oman, Qatar, Saudi
Arabia and the UAE throu9h
the creative use of market
specific studiea, position
papers, well briefed
distributors who lobby,
media owners and
eonsult4nta_

Phi1ip

Morri.,

19.7

-TUrning nov to primary

ond passive IDOk1nq_To
get mor,. favorable
prOI.,

we are

conte~pl4tin9
organizing anothor
journalists'
con
terence similar
to
the one
put together in Madrid
tor Laein ~rican
journalist. in 19".-

w.

Philip

Korril.

1985

Buying favours

Top lObatto contnbutions

to federal clndidittS
lISA 1955-2000

The International
TObacco Grovers
AssociatIon could
'front for our ~hird
world lobby activitiea
at WHO, and 9.10 auppor't
from nation. hootil,.
to multinat1.onel
corporiltion'_
rNFOTAB.
(tobacco induatry
pressure qroup), 1988

63

23

Tobacco Control
Organisations

-robe 111ft of wk10ty eM .hot in warflre

see to it (h,t they rltSt h.IW rtrong
InOttI Ollto( and th.t the: '""Y t. wetl
6l,qpil.td.

r.lf.

q rnr "t,rorr~.

0er!~"'1St."
O!')

1htArr4lf~Vor.A

TrH_
c.SOO8C

-ToIo k I kiner. Wt ntr4 btoIod

allilMe Dgll!r\t tobattO, ttll"'" on wick
t.nge: 0' ~"flnt"100h.U the rtkntku
Inertll( '1'1 glo.bal tobtO ~"wmpUo,,"
1 Or 0'00 Harlem a'Vndl"'I'~.~~"i

O,'"tOor.OI'I""I,

Tlu:: lollJ-cc.J control

\"'.10.

~_u

l'

network iJ

ceenmfued .lilt.! far.re~ching.The

World H lth Org.nl7.>rlon 'J
Tobacco Frc~ Inlll>l"'o (TR);"
ceodceied fh'm ~<ldqu.arten In
Gene ..... eI I~'rtgIonol ond
mtion",1 Hmt(~~round the world,
There uno'" , WIIO Foc.al Poinl
on Tobscee or lIe.lth In.1I
ccurnries. and \)Il"'", i,
supported by. number of olher
inlcnladOnal.lg'nc.;c;j
sueh as
Unicef, the W"~<II1,nk, IARC
and

the UN

"u:

nllll

IHIII\d.Hlun.

g'" l'rI\"""IU,,1

org.niulian. (NlIO.) highlighted

on thi) molp arc lhp't' whOit
remi; II tOO ~J'(\'nt ,oI)"ltt"O
related. There are dO/\"I1" more
InlC'm.atlon.&1 NGO$ \\ I'kl,
~1cJrc:sJ tobAcro con,rol ~J PIn (if
their .cthill , r anging rrom the
WorM Medlc.1 , .. >Od,,'on 10

Inl{'_malion~J.
Ac.ldcmi,ll ..150 .II v ..Iuible
Coruumt.n

partner, .u many

unh'(':rJitiCli

cJrry out research end pron,ote

policy

Inltl;"ht~8 In lohl('c(.
control.
There O'.I"C ;tlw Inany n,nlonal
tobacco control org;aniloltionJ
whose ilnpilct b not restrtcted to

thlt oounlry but .1.., roh

world.,.;d., Tbese Include ASH In
the UK, Th.oiHuhh In Th.oll.nd.
.nd the Campaign ror T oI"em
free KI.b In Ih. USA, In .. Idillon,
Inlny

72

I",tional NCO. \\ nrk I"'rt

time on tobacco iuu~.

Numerous other ~rtncr. include
orgl\nlsaliof\~ itn'ul\'cf! )'lfl"
women, youth, f'11\lrl'lllnu."nt,
14\\'" economles, 1.wllla,1I righi"
religion and de. elopmenr.
~tOJIIObACtO control
organiPtioru
OU"C! acrioUJily undt:r
Nndcd gwen the fCOpc ohhe
lobxco <pi<lcmic. The better
On.nttd, sud> .. 11WHCilth, .,...

funded by pcrct'n .. gc of
100>aOCI>

LlJ(.

26
-Plain P.dta9;"9

Ii Important

~eI\ISC:

L
it

ctiminatu the poshlvrt Imagn'Y assodatfCI

with the bnnd and pottlttiJlly disrupts
dI~P~" of smoIcing
i"iti~tionwhtrt{)y
thUd

,mote" bontt twal'ld loyal."

Rob Cun"igham and
Ken Kyte. 1995

Health \vamings about tobacco

have been in existence

for four

hundred years, starting with King

James Iin England and Fang Yizhi
in China, both in the 17th cen,ury
(sec map I).
Clgarelle packs fi rs , carried
health \\'amings in the 1960's
follo\ving scientific reports on the
hazards of smoking in the USA
and the UK. These early \\tamings
were weak and inconspicuous.
Contemporary

Canadian

\\'arnings

are the most "hid in the world

Health
Warnings
I

and arc serving as the model for

other countries.

such as Rr.lzil,

While man)' countries

have some

t}1>e of health \\'aming on the

pack. these arc net universal and
many tlut do exist arc not as
unequivocal,

simple and stark as

is neccssary;

some arc not in the

loa.ll:angu.lgc

nor on all tobacco

products.
Reports

(rom Canada and

Awtralia suggC$t that plain

packaging may increase both
prominence and believability of
health \varnings. That is, no use
of colour, logo or graphic design.
but simply a generic pack of
dgarcne,s.

Health authorities
recommend

"

with the brand name.

now

that cigarette

packages should not contain tar

and nicotine

smokers to compensate to

levels as measured

get

by smoking machines ... these do

more nicotine

not reflect the actual inhalation

cig.1-f'C-tte) and arc thw

to include this Iefcrmatioe

misleading. Others suggest that a

range of values should be
presented that better resembles
bow smokers actually smoke, and

pad< of cigarettes

tar-and nicotine due to Cigarette

design (primarily ventilation

holes), and individual smoker

behaviour (3 tendency for

78

of

from each
on tbc

in section on

toxic constituents, ","hich also

includes levels of carcinogens and

carbon monoxide

exposure.

Sa a

de

hal< C P

Table A

The Demographics

Ccuntrtes

Saint Kitts and N.vis

Saint lucia
Salot Vincent and Grtn.dfnts
Samo;o
San Marino
Sao Tome: and Principe:
5audr.~rabla
Seneg.'
Seychel,es
Sitrrl leone:
.Singapote
Slovakia

SIOYtnl.
Solomon 1~land$

Somalia
Soulh Afric.
Spoln
Sri lanka
Sud
Suriname:
SwaliJand
Swtden
.5wilmland
Syrian Arab Republic
Ta]lk"tan
Tanzania, Uniu:d Rtpublic of

Th.il.nd
Togo
Tonoo
Trinidad and Tobago
Tunisi.
Tur1<ey

Population

...,und.

38
1<411
113
159
27
138

Adult 5mok_ing

Youth tobacco usc: I

total

Ukralnt

United Arab Emirates

Unlled Kingdom
Unlttd Stat es of America
Uruguay
Uzbtklstan
Vanuatu
Vtno.d.
Viet Nam

YtmCft
Yugoslavia
lImbla
Zimbabwe

I"""'""&'"
.... le

r~lc

15'!b
23.3'l1>

U.so.

26.~
33.!RI
28..016,

3.so.

11.so.
4.6Ilb
22.1J11b
18.5'ib
15.1J11b
42.6Ilb

55.1C1b

25.2'111

3OJl'Ib'

20.3'11>
23.1J11b

43.309
39.910

26.5'ib
33;4'111

42.0'lI>
42.1ii>

1I.0'lI>
24.7_

18,924
31,095
417
925
8.842
7.170
16,189
6,087
35.119
62,806
4.527

13.7%
12.9'111

25.7'*>
2.......

13.4'111
19.0'lI>
33.s..
30.3%

24.7CIb
19.0'lI>

1.988
7

4,137
10
23.300
49,568
2.608
59,415
283.230
3.337
24,881
197
24.170
78.137
18.349
10.552
10.421
12.627

..

22.011

1.1J11b

37.1J11b

6.9'lb

3.1.
30.lJllb

26.R>

'~

31.0'IlI
23.4'111
38.J1lb
25. 1'10
34.R1
'4.IJIIb

14.1J11b
41m,

1.7'l1>

1.4_

SO.6'I>

2.1"
19.0'lI>
28.0'lI>
9.911b

49.5'ib
44.I111t

12.4111>
2.6'1>

39.IJIIb

62.4
42.1'l1>
61.9'111

14.2IIIt
8.0'lI>
7.1'MI
20-24%

27.cw.
51.0'IlI
5UJIlb
51.1'"
18.3'Ib
27.0'10
2S.""
31.1'MI
49Dlb
49.0'lI>

1.IJIIb
31.0'lb
.. 17.()111o
19.4'10
<I.()IIIo
26.0'10
21.~
14.3'11>

27.1'lI>

".8'111
SO.7'*>

47.1)qb

S2.1)qb

39.2111t
3.5'10
29.1J11b
42.0'lI>

22.~
17.8~

35.1J11b

lo.o'Ib

34,,,*,

34.S'I!I

35.3'10

9m,

211.5'10
23.6'1>
23m,
29.oqo

27m,

4O.so.

6Q.IJIIb

-~

.1
_. _:.. .

9.1

.,..
-"'

8,n8

99
1.294
9.459
66.668

fem&le

.I'l1>

9.421
4.405
4,018
5.399

... 1.

12.7'l1>
17 JlIIIi.

20.346
80

,_m......

tow

T~r1<meni'tan
Tuvalv
ligand.

of Tobacco

24.3'l1>

~ 29.1)qb

-.".

9.!RI

-,

~
14.J1lb

2M ..
5.8'l1>

"

..

18.5411

":.-...

10.1111t

....
e,

14.2'Mo

1o.2'l11

_~
U~

34.6'1>

2.S.....
23.9CIb

9.IJIIb
SO'lb

1.2'10

14.8'111

18.3C1b

...

19.O'1l1

17.0'Ib

100

Sou~

"'"

I""'"~114

Ir

lot

ctIIIJMM. dIou.- b..W.Ift youtt. '";wVt)'t in

-'

rIOII

IW'ftMUIJy ~.uw:

m.p

dda or~.
crI the -we~.

Most popular cigarette brand by c:ountry

Jo~nPlaytl

Marlboro

!klmont

Prima

Statd"pros 555

Prin(e

Senson a Hedges

SpOfUman

II
~USSIAN
~EDft"'10N

Bristol

casino

Ddt>

Winston
ot~brin6s

-..

The M.,(boto Mvt

wa$ the lOp ad
teen of the

fHINA

j~silOtts!

20th

........

INDIA

[wlti, GoI' FI.G':

-etoMl

\II

~
~

... ..

century

accordlng to
AdvertisJng Age

11100

to: f $ I '"

~""
AUSlRAllA

"'JIk

""""
Changes in cigarette marketing
expenditure in the USA
197099
clgareite consumption per ptoon

amount spent US $miUion

4,095

3,858
3.400

59

Table B
Count';,..-

The Business

of Tobacco

I
CrO"'ing 'tobacco
l.3nd
d~'Ottd to

growing
tobacco

Agricuhunil
I.. nd devoted
to lob.acco

rllTn)ing
P"""'oog<
0( toul

heet .....

1
Tobacco Trade
TQb.lcoo

I""oouttd
Cig.lteu~

~f'0ru
nnlholU

mrtriet(W.

Austria
Aztr~ijan

Bahamas
Bahrain
Ba~gl.desh
Batb.dos

1,300
5,700

0.,88'10
0..0.3<11>

8.000
1,153

3,100

0.,11%

3,000

57,300
2,528

o.o.4'l!!

0.,18%

114,156

ISO

<00

4,000

1,600

1,_

111

1I.S03

1.681

931

10.,404

7.789

0..51%

17.2581

500

3,<00

11.870

o.'"'*'

2,<00

4,577

35,000

'380.

a.o.5'!b

1,<00
'1.300

2.000

o.a3'!b
0..07'10
0.0.5""
o.25'1b

72,51lO
319

'14.000

702

'8,200
155

160
975
3,600

0.4SllO

42,000

G.3211b

Faso

1,000
700

70,000

8,728

0.351lb

350
7,665

3,<00
25,000

Q.031lb
0.060;0

',700
71,000

'16,666

800
1,000

550
56
343,029

2.647

21,000

7,400

O1ad
Chile

Chinli
Colombia

OJ)41!b

600
145
3,508
1.441.147

18,250

890
618

.:00

1,IlS'
1,051
100
1,600

5
396

220

890
2,400

23,015

3,2.91

cape Ifttd,
CentlOll Arrl~n Rep.
350

'41.0104

8'
50

0.03'10

800
Q.041lb

530.

578,451

360
9,669

55
40
2,839

10.,347

500

900
300,989

892

20

4,000
20.

917
110.
1,060

2,<00
2,200

<00
55

B,lglum

canada

34

18,000

230.

0..0.1'10

Bl.llundl
cambodia
Camtroon

l,soo

',000

7,762

800

Bufgaria.
Burtina
590

""""" .....

0.Q1""
0,01'10

3,185

BClint.$

Bolivia
Bosnia and Hmegov.na
Bot)wana
B",rll
Srunel Oiruss.alam

~t(1ftIo

.. ..r

iml>ort,

6,80.3
2,537
14,355

31,161

Bdit.
Benin
Bhutan

i:r.,;:

C$JIO,l:t

T_

1,500

Afghanistan

Alb,nl,
Algeria
Ando<",
AngOla
Antigua and Barbuda
Arg,nrina
Armc-nia
Australia

Cig.amlt).

TONCC'O
I~r

40
140

500

<0,1""
0.16'!\>
1.1'4>
a,3'!\>

210
10.521
2.563,510
33.216

5,500

55
135
'7,740
13.260

0.19'!\>

100
3,600

30

230.
41,566

100
915
131.980

1.837
27,018

10.217

3.331

Cornaro!

Congo
Congo, Oem. RepCook 1,I.nd,
Costa Rica

COte d'lvolre
0 .. 11.
Cub.

Cyprus
Decl'! Repubhc
0.,,01311<

2SO
7,700

0.09'11>

108

0.200b

200

20.,000

0.28'10
D.5S'1b

10,000

0,85""
0.05'*'

30..562
374

6,100
45.185
76

o.a~

8,600

270

G80
960

890

500
IS

70
5.899

UOO

100
3,550
16.500

4,000

6.<00
147
761

6.000

2.000

400
5,S.5

isso

3.002
4.000

420
2Q242
16,0.50

102

Srn"r ... : .ff

~sC' III

-~1'f~fl.rll~

Smuggled cigamm
Eslirnall ,,"U99'1d9orrttt5 as pm,nla9' 01
dOm<Slic .. 115 1995

"'....

3~ortno,e

reeent or currenl

W>o- 29'0>

1QI!b - 1gq"
smug;1 ng rolJto
whmAnowtt
5'1'> - 9<Ib

RU$StAN

FfDER"

I'll> - 4~

liON

nod.a

(H I U"

.......

$1.8 billion

Global smuggling
Numbcl'5 of smuggled cigarc.ltu 1993
~o( VI'Orld cigarette SOI(S Dft smuggled
"...t:ranait._i&

eoeentially

the

illegal import ot
branda_upon which
no duty hoe been

98 billion

151muggled

AsiaP,c::ific
1989

!Mall bun"
$54.000

20

clgDrette.
sold

reit of the world

paid .

axr.

For ovary

85 billion

'Io2DQGOD

55

The Tobao Alias C World Hulth Orgmization 2002

AU rights reserved
Aut publlshed 2002
109876543
ISBN 92 +156 209 9
Produced for the world Health Orga.nintion by
Myri.d Editions Limited
&-7 Old Steinc, Brighton BNI IEJ, UK
http://www.MyriadEditions.com

Edued and coordin ed for M )'Tild Editions by

Paul jeremy and Clndid. '-'eey
Design and graphia by Paul jeremy
and Corinne Peulm..,
M.p' creaed by l..helle Lew"
Printed and bound in Hong Kong
Produced by Phoenix OfTsel Umit.ed
under the lupcrvidon of Rob Cu~ls.
The Hanway Press, London

11,;, book is sold ,ubjec.

'0

the condition that it shall not by

..vay of ,,,:ull: or otherwtee, he lent, ee-seld, hired out, or

otherwise cireulated without the publisheros prior consent

in any form of binding or cover other than that in ,\-hich it
i.< publlshcd and without I simi"" condition including this
condllion being imposed on the subsequent purdwer

8 Passive Smoking
..Art hour I day in i room with I smokt:t is
nt:#t1'( a hundttd limet. more: likely to
cause lu"9 ~.n"r il'l :I non-1moker th,n
20 )'ttlt5 ,ptel'lt in a building containing
Sir Ricb.inf 0011.1985

,*uos. ~

The first conclusive evidence on

the dJ.ngcr of passive silloking

carne from Takcshi f JiraYJlnJ's
Slu(l), in 198 I on lung cancer in
non .smoking Japanese women
married to men who smoked.
Although the tobacco industry
Imrncdiatcly

launched

.1

multi

nillion dollar Cln11)a.i!:,1T1l0

discrt~lit rhc evtdcnee, dozens or
further studies have t'()nfiml{!tl
the liuk. Rescarclt thcn broadened

into other areas and new scientific

evidence continues to accumulate.
t\ complex

mixture

of chemicals

Is genera' cd front the huming and

snln'dog of tobacco,

As a passive

smoker, the non-smoker breathes

"sldcstream" smoke from rho
burning tip of the cigdrClll! "ltd

"malustrcam" smoke uuu bas been

inhaled and then exhaled

by the

smoker,
The r-isk of lung cancer in non ..

smokers exposed to pils..'i\i\'~

s'l'Ioking is Increased hy between
20 a_ul 30 percent. and the CXC'CSS
rillk ofheart

sclKted tountries
XJOr Orltlltsr olOl/abftdpfO

dlseasc is 23IH'rC;:t~nl,

lr

Children aI"(' at j):trlicul:'ll" ruk

front adults' ~moking. Adverse
hCOllth circe....include pncumoni:t

p<rCtn~ts
r

&~*
:i!..* ~
~

and bronchuls, coughing ;lIul

\\,hcC'l.lng. \\'nrselling ur
asthma,

,~ ., , *
*. . .
.~.
r-;~e

.... ....

."

Iltltlcllt: car cll~41~c, alltll)()~slhly

ucuru-bchavlcural
31111

cardiovascular

."

,),,,, .p>

'l:.

lntpalrtneru
disease

ill

.2

adulthood.
A pregnant woman's cxpoulrc>
to ruher f)CUI,Il!'s snluklng C31t
harm her roetus, "(11L'(-'lTl'('ts

compounded when the dtllt!

~
c

.a

31\'

i~

~
~
C

...

'i'J

s: is

...e
C

!!

~
~ :;;

ft

.:11

is

:&

e
~

-t:

SiI~

exposed to 11A,,<isl,\'I'cHlolting after

.E

blrth.

34

'"

'"

:c

THE

"Lying

j"

TOBACCO TRADE

done \\ ith \\urd, and ,,1,0 with silence,"

A<i,k-nnc RlLh. 1'1"

45

ABOUT THE AUTHORS

Dr Judith Mackay is medical doctor
~nd Senter- Policy Advisor to the

World Health Org.niution.

She is

hued in Hong Kong" he", she is the

Director of the Afim Con..cultancy on
Tobacco Control. After an carly career
as a hospital physician, she became 3health advocate, She is Fellow of the
Royal Colleges of Physicians of Edinburgh and London and
the Hong Kong Academy of ~"edicine and author of Tbe
S,are of Heal,h A,lat an d The Pmgul. All", if Huma. s..ual
Ikhavior. Dr Mackay has received mmy internationll
awards including the \VHO Commemorative r-ledOll, the

Fries Prjze for ImpTO';ng Hea hh. the Luther Terry Awar
d for Outstanding ladlvidual Leadcrshlp, the International
Partnering for \\Todd Health A\\41rd. aad the FoWlding
International

Achievemeer Award from the Asia P.Jdf'ic

Association (or the Control ofToIcco.

Dr ~'fjchael Eriksen is former Director

of the U.S. Office on Smoking and

Health and is currcn~y
Distinguished Consult.lnl at the
Center. for Disease Control and
Prevention in ALimta. Since 2000,
Dr. Eriksen

ha.s served

.JS

an Advisor

10 the world Health Organiution

in
Geneva, I-Ic: is a recipient of the "'HO Ccmmemcrauve
Medal. He is a Past President and Distinguished FeU"w
of the Society for Public H.11th Education an d is thirtyyear member of the American Public Health A.$SOCi.ltlon.

a:

17

PREFACE
"when J was young, I kissed my first woman and smoked
my Or-SIcigarette on the same day. Believe me, never stoce
ha\'e Iwasted any more time on tob.lccn."

Arturo Tosanini (1867-1957)

T!ll5 book is intended for anyone concerned with

personal or politial health. g",'Crnancc, politics,
economics, big business, corporate behaviour; smuggling.
tax, religion,

Internet,

allocation

of resources,

humm

development and the future.

The ;tdas

nl:lpS

the his1,ary,

OJrTen\

Jitllation

and some

prediction. for the future of the tobacco epidemic up 1.0

the yo.r 2050.
It illustrates 110\\, tobacco is not just a simple health
Issue, but mvolves ecoaemtcs, hig business. politics, tnde
and ernnes sueh as snluggHng, litigation and deeen.
1tnuhjfacetcd
The atlas also shews the importance
approach to rwudng the epidemic - by \VHO. other UN
l.genciC5. NCO., the private sector and. in fact, the wbele
of civil society.
The publication of this atlas marks a criucal time in the
epidemic. \Ve sund at a crossroads, with the future in ourhands. \Ve can choose to stand aside; or (0 take. \\~k and
tneffecuve measures; or- to Implement robust anti enduring
measures to protect the he a lth inti weahh or nations.

or

JUDITH MACl(AY. Hong Koog

~11C1IAO. EAIl:.stN, Gc:nc,'a
June 2002

11

Europe
Americas

UK rtl'lit Report

of th' Brililh

USA 0:0. of
('igareae tompaNts

nkodne it not
1900

l,u,
lBOO

lnuodlJCC:S U~('

Camdbrand

ftporbOfl

0>09'" mis1lm.
\_f\c

1950

commctei;lIy

AmtriCis

tfI,e_ first WO!N'I ttl

'

smob:m~

and.. III

6crftl.ny(2)

1195

Sammutl Thomas

5mtnc:ring

YOI!

rtportS(11'1(ttS

mokers

Engl~nd rnst0'161
stucty of tfftt'tS
of tof)a,t'C'O Oohn
Hili); '!i,.uff ~
war1\Cd they ri1t

UK l'I>o5p""""
frittion nua:bcs

[L,-

blt'_."
co"ntr.cn:ial JOlt.
". ,ling smoI>ng
l'Jt.O'1~nIol'lW'l'lktil

_1

1710 Rust"

1700

lilt

hts COUf1;ct$

to
$Cd.t tobKro~
dtri: mfftt. \ctn.aspnI~EuroptJn

(Ommcrti:Jlly
15'31

Pttef

Qff-.I a'lC'Olingn

f.sII>onabIc "'"

"~SlIt'.ItlC'C'~

r~ttO t1~t9rown

a.","~ee

~e~bcarl'lf:

'limolil'lg (Oofl

of the lip in plpt:

1000 CJn.d.
rotlac('o I'lrsl grown

1700

Fnnt't Fmftric

USA Invtl'ltion of

cigarette machine

1612

fo.ndcd

m.jor0

UKFim

addlc:tM

,913USA 8lttt. of U,c

modffn" dgarc:tte:
II! R_'d,

Tob.aem
al"l1 Bntlsh
Arrrmca~ tobacco

Coa.pa ...,

end Hrotlh

CongrtSS U!a\ It Is

East
UK~.I

"tl

Ro(al Colle!< of
PIIy!lcbns of
London Smo4ing

tHtifv Mfa"

I~r oplnio.t\ UUt

and Middle

&.gland lOOO

Santo ~ll'lgo
Europe." ~ltJtB
IKgin tobat<'O
cultivation

Turtcy Ot.lh
pCMltyfot

''''''''''9
Engtand
(ing J.mtll

1 GOO

0'631

tobomI """" Of>'"

wrth
lim. sale of

0'6();1

FnItCtJ~
'linn stfIcb YllIff UI

'Arg1ri._

\OIo'tl1u

I~d

A eocmtelblo:src
IOrobom>

Clthtrifle-dt

to lfUl bc:r

mig'aiM

Evn>pc

I.,.,.""

pllnt btoug"h! 10
~Attc",p'ts
It adtMtlon

Africa

t>4JC1d!t EKt
1500<1_ ....
il'ltnac!UttO
.htn
Tlorts

tarty

t"

It:O [gr;n

2000

1700

blJ

1111 Africa-US Afritln

sJa-vcs Initblt, u$t-d
to work:'ft too .. eee
fide" .. not on
conon pl'I'Hatlohs

-1650S

IS60

South Africa
Etlropta" sertlers
9tOw tob.ceo and: I.IU
It ., form of
tunOftCY
Afrka PortugUtlt
.fld Spanl.rds slllp
tOblttO re EaSl
"ftic<l. where It
'tIft.d 10 Cffttflll.nd

Wt1lAf,ic.

11)0\

19

Cost or a pack or 20 Marlboro dgartttl'S

an t'quivalt":nt intc:mational brand
USS 'dtctcd counlrics z001 or /01<s1_ilobl<
01

'''r'n''>'''

dolO

$5 and above

RUSSIAN

ffOEflAIION

$4 .. S4.99
S3 .. $3.99

20 imported
cigartttes costs
mere than half

S2 .. S2.99

$1 .. SI.99

IIIfJ!

ICSSlhan $1

\iii

..... ragcd.ily

income:

no data

Smokers in
Minhang, China
spent an average

DONISIA

of their personal
income on
cigarettes

-~

.7

A pack of Marlboro or equivalent international brand will buy...

For tnt' price of

20 Marlboro

kilograms of
cucliMbus in

.... a_neggs

you could buy ...

Geo<gia ..,

in Panama ...

.Jour p;oin; of

a.tton sOcks in
O1ina ..

..a dottn
coc:onuU i"
Papua.New
Guinea ...

_onetilogtam

offish

in mnce,
Ghana or'

Moldova ..,

43

RUSSIAN

f-EOf IIAfIO~

(rr
Japan TobatcO
Intem~tiC)nil

"'IJI
~

R J Reynold.

I
.'.'

"

:
:
:

f f "

..

........

,
,. .....
...
.....

....~.
~
~

BAT
531.1 billion

_ ...

m
$21.6 billion

16.4'!b

leading tr~nst'lationa1tobacco

comparUts
1999

11<"""1>9< of globol
marlctt sha~

rt't'tI1U(

Philip Morris

BAT

Rc(ltlSta

Altadis

USSbiliioM

51

Tobacco

product

- Any product manufactured

wholly or partly from tobacco and intended for we by

!moking, inhalation, chc\\'ing, snifftng or sucking. with
the exception of medicinal preparations containing
nicotine.
Tobacco production
- Tobacco Ieaf production in
metric Ions refers to the actual tobacco leaves harvested

from the field, excluding

harYCSling

and threshing losses

Water pipe - A water pipe. or hookah. consists of a

receptacle for water which has an opening on the top 10
3 long wooden stem is fixed, the lower end being
below water level. AI the top of this stem, a sm'!l bowl
is attached for tobacco. The tobacco is drown through
the water and inhaled through. long rube fixed to an

which

outlet on the side of the receptacle. Cut, shredded

tobacco moistened with molasses or other sweeteners,
is kept in the bowl and burned with eh.reo.1.

and any part of the tobacco crop not harvested for any

reason.
Tobacco usc - The consumption of tobacco products

by

burning, chc\\ing.

inhalation. or other fonn. ..

or

ingcrtion.

112

al dcngan hal<cpa

GLOSSARY
Ad,tcrtising

OF TERMS USED IN THE TOBACCO

- Any commercial effort to promote,

including the usc of sponsorship

activities,

the use,

image or awareness of. tobacco product, its trade

mar"". hr3n<1 name or nl:u\ufaClurer.

001nn10n.

cigarette

consumption is calculated by dividing total

by the lobi population of mrue

who are 15 years and older. Smuggling may account for
Inaccuracies

In these estimates.

Excess mortality

- The amount by which dc.lth rates

for a gi.en population group (e.g. SlnOWS) exceed that

of another

population

group chosen as

jJ

reference

or

standard (e.g. non-smokers}.

- A mixture which typically consists of

areca nut, tobacco,

slaked lime lnd S\\'cctcning

or

na\'Ouring agenl~. ,,'r.tppcd in :a betel Ieaf Betel-quid is

chewed in .na.ny countries in Asia. such as India, Sri
Lanka, &ngl.dcsh, Cambodt a and M.laysi a.
Bidis - COnSiJl of J small amount of tobacco. handwrapped in dricd tcmburnl ICJ.fand tied ,vith string.
I)e.spitc their snlall size, their tar and carbon monoxide

deltvertcs can he higher than manufactured dgaretlt$

because of the need to puff harder 10 keep bidis lit.
IIIdls are used extensively in are as of Southeast Asia and
;;Ire .he

calculated by adding a country's cigarette produaion

and imports and subtncting 6ports. "Per adult"
dg:r.rcn,e consumption

Are<.'a nut -l1te fruit of the Areca Catechu tree.

Areca nut is oornrllonly combined with betel leaves,
sl ..kcd hme, and tobacco and chewed as betel-quid,
particularly in areas of Southeast A5iJ. In Northeast
India, U1C use of fermented areca nut [tamcl] is

Betel-quid

ATLAS

1I1",';t (;ulnlTlunly

!>Jlll)kcd tul acco produce In

Indi a.

Health

\varnings

- Vcrb.1.I, written

or \isuaJ

\varnings, required by gm'ernmenU on pad.eu

advcrttsemems or all tobacco products.
Hookah

or

- st< Water pipe

Ingredients
- Every component of the product that is
smoked or chewed, including ,U additives and
flavourings, contents such as~ paper, ink ~d flhers,
md rnatertals used in the: manufact.uring proces. (such
as adh es h" erc.) pr eseent in the finished product in
burnt
or unburned form, and whether the tobacco has been
gc.nctJaUy.noc.Hnetl.

Chilum - A night, conical pipe made of clay. Chilum

smoking i5 practiced mostly among males in the
northern
rural areas flf Inelia, 'rite pipe is held vertically,
and to prevent the tohacco Ieom entering the mouth, it
pchhle or stopper is inserted into the top of the chllum,
'rite entire pipe is U5U.lJly filled \\'ith tobacco and the
mouth-piece is \\rr.tpl)cd with " wet piece of cloth to
protC!ct the mouth from the heat and to serve as a filter,
Cigars - ~'adc of air-cured .nul fermented toh3CCOS
with a tobacco \\'T.lpllCr, they come in In;tny shapes and
Si1.('S, from dgarette.sj7.e~1 dgarillos, double coronas,
cheroots, stumpcn. chultu anti dhurnlis, In reverse
chuua and dhumt! lI"ll1oldng the ignite(1 end of the cigar

Kreteks - Clove-Ilavocred cigarclteJ, They (Onwn a

wide r.l.nge of exotic nl\'ourings and eugenol, ,\~ch has
an anacsthctilting effect, 1110\\",ng for g~:3(er and deeper
inhalation,
Manufactured
clgarertes - u,ruist or shredded or
reconstituted
tobacco, pl"OCC$S('dwith hundreds of
chemic. I., wrapped in paper, and cltcn with. flher and
manuranurcd by. machin e, They are d", prcdominont
form of tobacco used wcrldwtde.

Nicotine

- nicotinic alkaloids.

Niootine

repl~""ment

therapy CNRl) -" 1)1><: of

treatment used as an aid to Jmoking

ill pleccd in)idc the mouth.

phannaoologiQ]

Clove cigarettes

(.~..!s~tion, It includes devices such as transdermal

1)J.lchel, nicotine gum" nicotine nHal sprays and

- ~e Kretoks

Inhalers.

Consumption
-lel,al c..;gan:ue ('ons-ulnptinn i~ the
nunlhcr of ClgiU'CUc:f soltl nnnuilly In it countr)\
USU;lUy
In tllillions of :UIC'M. Total Ligill'eue OOI'bllrnptlon is

110

Pan maAla

- Pan tn~ala or betel (Iuhl ron.sinj of (our

Inaln Ingrcdicnt.s: lobiCCO, irea nuts oJnd ~Iikedlime

"'''.-pped in a bctclleaf. It can AIJO contain other

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2)1.)4; H.(llO)

c.. .."', ~

KIIukh.ti." C."'1I1
1.11"'1'(":tOI,

r,.,a ...

t""'""ylOlll
"'~'1U'00fI1(>~

"f,IIWdI OreU"Aotlull ~'"tI

,ht tllolro('<!"'lloA~ C""'"" .........,1.. ftOWoo

./1mI~~Iut,J_

'tw,I A..'.!I.-,11M ~.

,..,,"'. N"w G."'",.

Thl",[u) I~"..I ""1M ,""7 )001.

0I'Il!.-. ,,..-

l'OOI)

h".ru~r('_
.l~

ffl~.bSokMl.

c..,or,II.""",

19"'Uf'o".u_1 ~~

...

$won. UI'fJI'$w.d ...

"""! "..-"..,I

\\'''0,. ... ~"t,ItI!Ort.w

l't"'ldo:, Iuo ... I......

tko-IlWbfo:IIo
.I"'I.ltA

\\,,.0

c-.,.

..... ......,""_

k ...

\\".01""" .... , DC

K"",.khn .. "w in lito""""" \10'.",01, I" (1(IfO) 1~

... ill tlwri'1niN ......... !ft~...

'_'<1,lffIro,/ha:I-. )II},' ~-1O
Ki".,.II'1.,..''''-''''' ... 1OIoktk
,
_I ~w.I"'.I,..AIo_
~.M.' I)I....t ..- ( ,...w,.. ,,",",,,I"I..,."
KilIo\wIi I'o' .. ~
t.ot.I """"'"
f... 'ioI.no
.. or 1101111.A. n'J'l.orl(d ~ till: \\'''IlQ~t'
'~,Ieo.:000
"0' .... "'INbll'f (jrC
mt
rill\, Il. I\~!fllXJOto, TrtII'Ioof o.1f"'01W .. 1M"""
d ..",I.IItO ........."" _I cr
1,..,....._ ..... KaT. lido "u.1d C...........
" ~

_s....dIo, .......

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OK ,..,..."
1(",,,,

.11

.\I .. lt ..-, ..... , 1 (ChIf ...

r.. .t1

C',.'"

"~.ll,~O~) ,1011.

'II'H>;

.....

Coo''''ft_,

)olt..lo.......

!oI..,. ltIlll ...

"',,,,,1"11,, r""'n-.Io~IoUffOllr. Ttobl.,C_,.,1 tot.rd~ ...,.~ XIOl')

"1'C""." ~~
.. hbIll.d. ."-"""111 U. C.ud.l_ .. (I,." ~oIow
p iW("M i"'''), \\110. (1""1 ~-w \I' I,uhlo "1!1~'8I,'" "-qM..1.,t.

"'1() .........'"

, ,

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1~1 ... 1WO

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_

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to""""" .",.~

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1."_

A. "PO"'''''''

".w-. ..

0'1'"" .... ," "

!tor \1,'1"'0

".roy'"

114

c-......

'.

1'\)I."d

Oin,,'" " .... cc.. ' .. ~.

41001,

n... , ...
c.. .ld!.:""

r-..

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II"""''''

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..

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....tJ,
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......

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"~"""jl

....... "....."."

,-;"""""">

_,a.,to (1'1"1. 0[0) It..)....

til' ('_._ 1('0 MO\II ou;n
..' ..... ~ I _._.SunftI'-'" ~ ...~ ~t
100
d

1~1IlIt~" 0\ C....,..-wO('
I'IItt-rto kl(IIIC'wMI-I"'rlld
O"""!'(:.,.,.,. .....h- ....
Q~ II.-..d Mod.-'C"'''''' .... (un ...., I""" ... ~
..... I-..._..... "'"'~
""public
or lIh.lodfOO. C'w_ ,..........._ lloop \lot .... l&t,.)d,()o~'II..yIo_l
I.I .....IIIr.._..n'10011
c-...

_tl,... I"''''''_'

C)ff'H'.r..-ho ....... (mJI;

a.I ...,.

AcOo_., rWol", .1<"""-UO r,n 1!""'I'" 199' lOOI ("~'II

tebtM!(l1i ~_II>fto) ""'f) '/So~.
I~ ... ~t4 .. t;wt_ ~_
1fJf~

01

"'"""c;....,..,~-.tt...~I""I"'Io!n,.,.II.o.,
11OOO.J"",'t'; A.t.~,",,""'II'ILcioI
\--.
",1JI11';_""'I""'Not...-i'(~w--..
"'~I"""

.tw'\tI'd~I'toIl

'norl-.....,_

..".~I_

~_~ .... c"'''''' ......... -.ol.tf;,

""",-",,,,-"_1. " ........G-,

1"'~C--'~l

.....

,..._J""'_"'_

_1lo-"' ... oL.

1""....,*I,~'

~-...ulk.i,1ron.,.

(10Ul, ,"" 1... ".._ lI.,.....,.c(-'Ilrport

1~

.t

~...,..

..

"'I~

tlw''''"'

nh

Table

The Business

of To bacco

I
Cro'ringTob.3c(l_O'-::-7'
-r-

,.._

'Iobacco'Irade

71

r-'

u.ncl

1 Agrieuhunl
devoted to
land devoted
growieg
10 tobacco
tobacco
farming
P""""'i"

Tob.acco
produced

or ux&l

hwtares

Djibouti

80
30

Dominic.
Dominican

Republic

-East TImor
Ecuador

1,725

Egypl
EI Salvador

Equatori.1

1.28<1fo

13..250

Guinea

Eritrea

estonia
Ethiopia

, AJi
Finland
I France:

0.02%

lat
vi
a

3,461
2,4
00

60
0

104
s..tI"_:
~ Il.lgt'\
114

Gambia

46,9
00

4,50
0
18
0

1,1
75
23,1)
91
3,
09
9
4.5
00
4,5
00

9,25
4

Georgia
Gcrmany
Gkana
Greece
Grenada
Guatemala
Guinea

1,80
1
3.00
0
4,20
0
62,91
7

Guln,a-Bissou
Guyana
Halll

Honduris
Hunga'Y
Iceland
'ndia

8.37
4

24.3
00

44,0
00

2.00
0

Indonesia

lro.. 1st R,p.

Iraq

Jamaica
Jap.n
Jordan

. Kazakhstan
Kenya
Klriball
Korca. Republic of
Katel. Oem. ~pfe:'s Rep. of

Kuwait

K'I'1I'fZ$un
Lao I'toplc's O,m. Rep.

14,640

100
1,400
0.10'
lI>

883
O,Q7'I
b

246

55,040

500
1,100

0,04
Qb

Gabon

1"I.nd
Isracl
""IV

17.229

100

I
40
0

11,21
4
5,76
4

463,20
0
223,00
0
20.00
0

14,4
65

6.7
00

0.05'
1b
0.07'
1b
o.05'
1b

0.1I'
Ib

o.O

O.OSl
li>

046'
1>

3,000
150

12

25,534

193
23.300

0,44'
1

0.6'
1>
1.06'
1>
0.01'1
11
0.19<
1b

1,855
8,500
2,500

90.637

136.593

17.000

18,630
1,800

1.800

l'lb
o.O
G'Ib

1.
6
~
o.4
3~
o.13'
1b

1.62
'lb
2.10'
l1>
0,64'
1
0,87'
1

90
550

4,318

236

10.485

3.500

701,100

145.000

1,500
17,500

21.000
2.250
2.000

o.02'
1b
o.05'
1b
0.47
llb
o.14'
1b
023
Qb
o.72'
lb

200
132.200

193

1.800
6O,8OJ
2,667
9.000

40
13.961
300
12,600

7,000

550

68,198

6,712

63.000

34,613
33,400

8'

448

1.307

4
200
130
3,904

600

200
14
1.700

67.571

46,D23

70,528

100

116
1,500

793
2.000

33.604
35
11.000

41,430
255
100,889

600

9.043

189.669
56

19.554

30
20

70

20

soo

660

2,547
759

600
200
140

119.643

8,000

1,516

450

2,400

643

37.097

83
10

3.205
17,539
1.500
40,913
842
2.400
5,650
4,700

38,830

56.475

93M2

1,780

130

450

83.478
200

31

98.919

483

1,400

3.000
50

7,521

6.129

4,423

50

9.378

5,618

12,781

5.000

576

1.000
1.000

35.000

6
260

1.000

1.544

Part Five:
TAKING ACTION

Samet

J. Ilmunond

SK, ~

pbor:f

in 8cdON.

Spin Ul!romo c-nl1OO1. II: IJ.....M

B'~

NO LOSS OF flESTAURANT ."'ND lIAR SAW

.and "fur Snd('oflTt 1 .. Ant Qu..:1n- T...".... s.Ir.e ~

,\1AL'< M.A.!'
Comoll ...... tloI \\'kk

\\''''feh,

COC, 29 Marth.

2002

!'ttll('onlleon"'rM'Ileltioo wilh Grr.1d ):nI~h, ]8 ~t.y 100'

~h

RESEAKCII

~apmodit\ln'.

'''ltI<llh~./~lU

us

1997,199$.1"'.1(0),2001

~ttr:II-._.ca.J:O'
Jrw:-"/IIq99i.Mm
hnptll_.bot:.Q.p/nc. ....I. 'II~l.m
kttpd J- ....hor_.Q.U"/Dl"'"' .. /ptI"tTlllfOl.pdI'.

Rc;w..-rn

N_ktfUI t~ll\ltelo (I( lIo:"!th. XlOI.

for

"

C.lifQrnI.IlJo;an) clliqualit..doe>.

COMPARA11vE

iII,.we

Ran, Sule or c.Jito.-ab 1"1 1m. ~

Cdlornia Dqlt..
ailkdth: c.womY &.anJ ~~.
-.: ~
J. c,.,. ~
CoMJ'OI ~UM
Smol"ieI d~ I~
Ino:btry1.'_ 2ooo,"c<m:
l:J4, hup:JJ......,~nII'n
fto4U.UIt.

~Mt"

tob.o NOOk

ftI.~

bt.tp:lI .._. ,t~lI-troI,alm(~/hV:1rM/fuJJ/ll/l/lil

22 Research
en'S: ~

to

aflllltf'Ut

de

bUp:II .. .. .... ~LIIIII.lV"J4)Ir.~lUd~/r-unJi-t:RDeatchlt.tuo.htm.

"II.E COST OF \\'OR':,L\CE ~tOKINC
Grir",1w, J. CriM~ k, "~s-l"'l tlw 1I_"""'.u..t....,..t. ~
\\'110 Europun P#'Uln..... ~C'(.'lto)R~~
~

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oCAnrs
~tlnlDO AM. Slrlitl! SL. ~;

I .. dj~,ill.lry~

r.. lOOO. "' .... "'''', 1'1I.. J

1OO1:}

\'0'.9. No 11.Tallie 1. 9 OfAlt1lOO1. N"OOIW Cmter for

s,,,un:kJ ~.

1I",,,1tIt s..tirtln. C:!ntn-J f"r

o;",,,toI!

Ccont.ouland Ptr .... r.dll ..lI.

CUPBOARD

,,"trin-..; ~ptkIn

flf..SAJtCIU

" .... Ufll' " ....Mt"d. USN,tiorul

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&ri, rt .1. keteneh pliariDo

J. MUIM)rM'lliQlII.

Raotric:d,,,,,: b..u ."npL- MnIlliaC

Rall'\ No.: 101.w'''21110/4284,

hllp;II_ ...I~~/~_c.-.pN(;~;-2OlJ'142101
41'"', 1:1UIM1pur,b. us.o\, 12Odo:oba 1,.,2

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lOOO.
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An!"',"),

G.t.It.

QNMrw,: A

C_..J 9, 217_11.

~fI"""

25 Legislation: Ad,'crtising Bans

Nak.na)
~WSMAr

1'IuJ, \\'.ubi"'l'tlQ I>C. U~

Jb. I~ OWouru

rJ, ~~I

I. ~

_lIftlft.

OdoreS U.nlftnhy

_flUId,

Q.,1ord UaInIlY

1'nA.l'OOO12}1-1}Z

23 Tobacco Control Organisation.

r.f.FtCT OJ! AD MNS

ClJI'IM)t\RO
Ik.nlmmtl

C"UINIl U. Philip ,\\oorriJ,./u,n{tthl:

<k''''''r_fth

1II""'11/Sc!ot","",*

Jb.t P.. ~u

.tlftUlln, ~ndlto::.alth

in Au,lnlu. 1m

r<d,.--ry.lUlo ... MISC

twlfnl'JI M'~

,:,~.
~,

2000:114.1)1

10149711(117/10049.

<MIP:II"' ...-... ,.wbk~mn'ta.(.."..I,

...f.mtSe.tc:LK.,J<.....flltlbu-.

..bfl~

CUI"BOARDS
AcnONM_",N

til",,,\1O.anI1\\201l1lti-l&l-tj,j(0tn,ment::::\'ES#(I)i,,I.a)'Form
ej9~J

.. =-GII:&trmtill

1;'.u:

<NIP: J I"'V,w.I<Jl............"orj!./Ooc:UlIIlnuJ

71102 .. ta1t.l~Jllrll

Tdt.acoo

ess,

1'1lX1'

cu.

1If ... !dtJ w:1

OIK'C1t)r (karr..J

r......1.lw. \\bf\1

Sl'ecc:illfJ tk Sill \\'",Id

('.ene

11(..J1bA~U,.

flr.ahh Or~.
,)

"tt, ,"8

24 Legi.lation: Smoke-free Arc..,.

.\tArN MA I'
C(ltr.o

fIoV.. GmJo" CE. Sh..rm~ N, SlJUi:l)d~ OF (f4), T~

hoilttt, A","on

C_II"c-.II)

C.,.cTr Suclf'Y. Allarl". (;,\. USA. 2000

RI'I'IToI(!n R(.', 1I-,1IdntoI)I~ \"~~I"

tlMt \\'v,~,
,,,,Mk: SuP'llO)r1 - ",,.lrot\kJ R~",oJ\

..1_' "",,1"""'''

Colt'."'''''

,\\A. EffmJ

'"

Smol"'J

Rntrlttlfom '"

lIolJd, 1001, 1):J))-14.

GnAlp, -CMvflI_. fmftl r-...'."

Ctll~I""UI 1bb.n~l. C.IJ I!)r 'Juughl.f l~kMt-

JO Ortllf..,. 1001,

h1III:1I"f);-M.-irOlllicll.rllrl/_.IM.I,II, a~aIO~81
I'()LLUrtu

J~t

S.'.\Cf.s (lLARCLONA)

M, f'\d!t:tt "'. ttllj.tr.n X. Atlalt",

L. s-",).,

J. Fo!m",,--t,.,

f.. ~o

122

...

RI Rq'nOkJ" Tobacxo"'_
rr IS FEL.T...
MlDet L. I'rindp,", J

Su~f'I1o 10~"'_'
J ,bloW ~

I~

Aqui I'O'Q. fl.0 2Ul' fl.eMrirttd. Gnlql ftf!KUm

Centrc:.IIri.w. Amtr~

It". LkJ No. .)076()4S96

'" ,*,J. dnap.

Ii ~t

Co.l.td, )hy)t

19S6..JIt..Jm No.

lOl699)41.I02'99S00

Jh:. P. OlablJ'lla I,),

1,,"-, 2000;2l9
\\'.lc:f}d.j"",

ft

Jiiog

c-,.,

.1. Tht dr._'W'

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l)t..,.., c-n"",

pad .... I~

_."~

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U. ~

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f}.

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n,.. t'iTt'O cI ado,,"kin,

TEXT
O:Uord UIliO'ft'liI,
(rcn.

wNa.

l)d7l-i8O
Q1111ob.cx.

~pem.

IHJJJ>&-JoJOOO11,.1117-)1

26 Legislation: Health WMnings

MAIN.MAI'

CoITMi MA. C.1doa CD, Slli.nN N, SholtlMI OF (..dl) ...._

c-...r r-)
,.,;;14. t\mcr-k'al ~
Soot'!' AllaAU. CA, USA, 1'000.
Vobl'lrd I k-4hh c:n-,ultAlic.I, 'JOOacn ftf't InitWth~, LT.wM MCWoIta
..dol'cf'd by \\'110 )kmbtr A

"-'-:i.Itm s.c.~ 14 Mar xm. (~)

Table B

The Business of Tobacco

T_

.Coo._

CrmvingTob.acco

Uberia
libyan Arlb J.m,hl,lya
lithuania

Land

deeeted
tc
'390

lUllC'mbourg

Macedonia. Former't'ugos.
Madag .scar
Malawi
Mal~
Maldivo
Mali
Malta
l~non
Ma.wll bl.nds

Agricultural

6SO

Rep. of

0.03'111
Lmd oJ<,,,, ed

1._
0.11_
6.18C!O>
0.1....

25.000
2.110
113.823
12.500

Cl.ImII

230

9.700

2.02C!O>

Tobacco lhld e
Tobacco

1.~
'1,300
prod""'"
32.000
2.000
12Q.000
7.260
110
13.~

'1<.000

30
1Q.609

250

200
2.200
1.500
'8.200
500
1
90

lJ)37

SO
1.400

Mozambique
Myanma(

U,m,bfa

22.614

0.62_
0.0s...

<S,105

20

18.608

0.92'11>

22.401

5.300

400

440

3,500
gT01'ing
7.000
3Q.000

.......,..

H'UN

H,pol
Lo,uho
Hc1h<Ii.ndJ

<.283

0.03'"
r~natnc
0.08'"
Q.31_

lOl~

'":r::r

0.21)q1o

100

3,~
9.<10
.a.260

..- .....

3.109

New Ze,l,nd

Hialraguo
Niger
N1gerj,
Niue:

HolWay
Om.n
P1kfstl"
Palau
Ptnama
P2PU.:I New Guinta
Paraguay

Pt,.

""flippin
Poland

I'orwgII

1.395
1.000
22.000

o.ow.

2.000

0.03_

om ..

850

9.200

270
56,<00

0.18C!O>
0.22_

1.300

3,100

0&........ Cig>rm40..

:~r
.......
101.5SO
75

SO
101.700

1.100

0.1,_

1.800

7.000
13.500
40-169
14.OS7
2.132

0.2_
0._
o.sg.,.
0.1'-'

11.000
17.231
<9.<93

10,970
1.100
2.800

0.1..
<0.1_

1.,800

Q.2....

3,800

29.545

6.183

R",u~nr"tdtf1tjOft

Rwanda

I.GOO

800

800

9.900

40
93.000
21<

19,514

10

ns
20

10
60
7

400

8.623

21.811

2.652

Tobacco
Ia(

""J'O'1>

19.630
36

800
8.500

1.24.3
'13
110

1.000

364

2.500
3,IOS
7.716
3,800

'.000
100
5
2.500
10
2.101<
104
1.606

s.soo

900

.s.ooo
3D

89

.'00
10.509

51.

Oala,
Romania

- -'16,666

800

~uritania

Mauritius
Mexico
Micron,sli. FI'fllI St.tes Of
Moldov R,public of
Monaco
Mongolia
MOt....

3.100
2.915
'<1.01<
2.100
362
800
2

V6
152
.625
1"
11,639
4,955

3.505
838
470

8.021
Ia(
600

622
13,100
112.607
UlO

ns

100
1.500
6.4.10
321
110
2
140

s.soo

621
28.7tO
6Q.218

7.a<O
10
25.257
763."9
3D

106

St~lrff-* .....

f:'<i'r

I'.

...

Ie.

""'r'- .......

.
.

CtOIJ,lL S.\llICGU~G
'IICKkIlJ I.. , ..... !#-M

c-..<Io.lI!l till

-11''''1~''

4~

1OTI1 ctN'T\lrty

~ 1111(0.",."",t

lilt Sc:IIId \\'(JfW C:lnkfcn on

TI!NI'tIl G'tll".J,llf"f"W'Iluuon.u

MockTQ Cri",l:I ..ll".'nClg~ioo. Or),~ilf'll Crime 1d Ulln\;Ut

Rigbu.

1 ~Id'

CIUNA
.:oroLi T. T."

,,_

1001

"'"1,IU W 0Irt.

(PI~'IO..' ,,,,,,.

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Tobacco Industry Documents

0" May 12, 1954,." "",oUdtcd boJ;

0' wtl.llppeJmI' to be- tofliK(O ~
'o('l;IJM"'b.'" Ik4lwrc4 t. ,"fenor
St.,..lo" Gl,fltL-Thc CIoc:Y_.tlb, the: boo...
datfCI ftom the: carly 19501, to the: urt,
1980"'~ Thry COtIikttd pttm,rily Gf
cont'idcntj,a1Inlcmll mC:MOrI"d. ~latt1f
1.0Bnw
BAT. MarlY cf Ut, dOalmc"b
C'Oflt.inotd ink"",1 di.I(VuioM ef tilt
tobacco incI~rt:r(' plJbbc rtb1ion' .Ild
kgal n:ntqits om' tft' Y't'n. and tMy
wtrt otttfllabttk4
('OftfWt"d.1'" 01'
'prl'l'lltttd: TM frtVm teNt"" Oft me: bo
Mr IMU ....

."d

IU~ . " '. . ....-

So starts Tlte C'g"'dlt P"pc.r:1, the

Mi"l'IflOC':
Philip Mot",

Or'S' r('pon chronicling the release

or pre,;owly &<a"C'lobocro
Inclunry documcnt~. Pubhe
relca ..c or these doruments clearly

Brow. &

JIA'

Tht: TobKt'o 'flJ1rtutt

The Council for T otIiK'CO Ac.wltt'h

exposing tobacco h,t1u~lr)'

bc.h.lviour. arut they

l)rOroundl~'influc:nad public
opinion.
I=ollo\ving the rclc.l.e
,he
13,\or dOCUmCnL\ and .15 1\ result
of Illigation and leg.ll tlcttll.'nu'!nt

or

agrernlents in the USA.

.
_lcx'ufn~nitnstroc.lu(~tdhrou
gh

'0

l<gil dlscevery II.. ve lwl

h.
",adt publicly a,'all.ble hy the
telhlocO indu,try

revetled A total

- -._
.

million
pages

of onco sec rot

lnternat tobacco
Industry documents
are now in the
pubhc domain

in ph)'lli("~1

llcl~horie.t in Allnn('aptllb, USA

ancl Gutldford, UK,
As. result o r the 1998 M.. IOT
Sculclncnt

Agreenlc.n\

.'

=:r...

IIlus-tr.llt,:fl their pO\\'cr In

(!orpor-,uc

. .. . .. . .

1~\\CU'I

~6 r.\,,'CIi" and the lHh,,((.o

Iudunry, the dO('"UI1I('nt'l
the
lo.'lnllelW'ua DCI)C.'lIitory are to be
duplkared cettne \ i:. seaeehable
"Ch.dIH m.J.inulnc'Ct by ('X'h or

or

\ht OOlnplnif'$,

"Our
Senegal re.ulted
1.n
a nov adverti.inq
decree which

.
.
.
.
1

-Kork to develop. ly.teD

by which Philip HOrti.

CAn
.e ute trends on the i
u. of Smoking And I.l~,

Identify
(a1omic religious leader
who opPOIO interpretation.
of the
Our&n which would ban ~h.
u of tobacco and
encourage support for

.
1
f
)
.
~

_. -

-,.......

......

-A law prohib~tin9
~obaeco advertS.ing va.
paa.od 1n Ecuador bu~,
after a mobilization of
journoliltl froa
tbrOU9bout Lotin A%erico

0-

and nu..rolJs
lntarftat.l0na1
org4nlzoLion iL
YO.

Horri., 1981

66 - Phil

Philip Morrl.,

1986

ip

-- - Mo

rrlo

odvorti.in9

198

bon.~

these 1 dorl.
Philip

vetoed

by the Pre.id~n~.

CII~IU

Part Three:

RtfllC11.-':C '.1 J 'ITAAS .

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lao ~ Cileeh RcopahilC'.
rornmlukwwd h) PhIlp ...t.orrN.C:rrth RqM.bflf. 1001
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THE TOBACCO TRADE

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12 Growing
ANNUAL COSl' Of' tOSS OF ru.IF. OFF \\'OR~
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('I)oIh01 ~
1ft wllB,",
$l4'fo ntlnwto.lhdr q,jio.:!.}.-I dwir _pl..:- .. ifwI.. u..- C.wJ 199ft
':290--- JOO Cj\lll\ln:l ,.
Mill"

\fl~

t,,,,,*

C, Cl"Jlh F. SmokIf' ..nn'~

USA, SNI Sri_mol "'........., 19!'9;'11;}7!j-91

,.."."""" ........."'--....
_,
..W!p,.~c....,."-l&~$U,

lIT.,Of

J~

Motullt,. y

U...... 'oWn I"S

l'OOI. Sit ..., )O().._to,

",UtN 00.0.: .. tnlr:"'l' ofLlw-

JOOI:I~

UiIoH... Coouo.l -Sl'rn'f'tlrion"

Au,I'''''''''

SYMIOI-

c......NA. c.....
~

.'1

r-ood

,-'M,....., ..

"T.

-.I f.-* Cuno.

.IIJ.."....ll~"

J'IIRbhloll')'fI/

0, T","",.wI

0,....,.,-.

1>EFORf.ST4T1Ot..
cn.'t. <W...,_.. Jr.:(..

ft'Ltc,i _

~-= ..~.

s-......,

0. CIo.., dcrtW' \UU""" pn'*. AI.,,'r

M1d1lM..JT.a,.,..pt,...d.~COU
...fkt.r~
_, "Hh~ tin.... ho!","""",,,. Apr" 50.I~1

Oc~t ..

",tAJl

(fJ ....

tlln,

(~cwa

<iI'otll"@,~"'f',\tUJ,u.,>

=,c.....MA.C

l-,

"+J-.

~.

...~.

..t1"( .....

.&.d.bill,l' ul4~ .. rt

_s. -.....Df(

c-... _,. .......

~_...,

J...,.

lOOl.

...~.

-c-Jc....r

CA. 1&. ""'"

u--,.Ak-7'lt, ~~~.
.. ~.

~~C9-'I01)T"""IS4.

w;ww....t..: ... ..:rtillfl. -'T.a.1S7.

~
.......
~
co..alrln.IMG--ltH,USllA_"(~~lOOJ, hnp!
ll""w"'fT' IIIda J:i"1d.uJ""'~ .,.!t'=~("'0121

It...P MIIi ~,.b

rl ,.,.._ (.-HI.
U"h''-'''''r rm..1OO(), pp. 1110 JI7
GkWll..t..t, 1M,,,, ''''' ...
f'n.r Kld_, USA XlII

A IIA"n IMY'" .,..0 ...11

~ .....c.r.....S lhI .. i. '01(11It Tf'o:ftIJ_. .

...._.

PrilI.W'".~-sw.

WI'lIP' ,,,1fItod1lCtI.:.,Cropo

Priu

Ik. 1000.

v-n........_...

l'OOl.fAOsr.'T I~
Redtt. r.o\O..m.;u. ~
LUp11 J 'WI,
'InSOO/ ..~

11.'"",_ltrv

r'ns" .... ~. I_nt"-'

Plnlln'ohIp

A,"!Io'.1iI1..h._, ....I ,;"I.....~n c 'f,oJ.n. S.u ."." I"

.......

(............,,_,.

U.S1M~.

...... "*"~h.Wft_

...

fItOOUCEkSOfTOtJACCOLU\'ES

............. ""'"

C_
.

"w'll:._ UMU "

KO)

"-1.rll"f'f"" 1_"'I' ....KO/.,.

.,.,.-,J.,A",nl.wt

C(ln-w MA, ~Ii...tt. (.f. c..uinliln \~Shmll.l N .... ,(Idlll& tlw- .... Idmcf. ...
lot ~oI-'It"-"' f~~
,...,. .. riP" N"" IWN.
x))). 11
(7J .,..... no.- ...._
,. ... l.""t.:" .. u'~d'lpi(l_lOtI
.. """"",......~
......,..,.. IhrfU .. lb._
,_.,
1.19'H O.u'-Iwqroot_

0'

Df(_) ...... C-.lc_,

c.\.. us.\.

~."Iutk ... Tw..a:o Lt~'(t" No U..-tld

fA(b"'lAl' ~
MouIu. FAO .....4 .... , I'ftwd

c-.t'''''.'I' l'

dC"ellf' ,11n!I:
..",11 .. f(1f)1n 1,}It ' ' 1,1(Tc-.l\oCJlIllTldnt W.1ohh,MM ~
c..ufll
lOOJ:IIIIS
.... Il.Il.a r",,,\ FtOnoOl1Inllnlelllg.:11OI U.,h. ok",llIillfll nwd~ Ly
\""hllIl!"~1I O'CUlludf",.

\\lW," A. A ,.,-:1.

S. _
AtL.K&.

~.en,...........,~=su.,

tEADINC

ro, , 51j),1".. S, 'Mh

)(.01

1--.,.1OOl,

Us." AMlliI Srnc ....

U(f' ......

MAI~"l,"
Cuir ...","

-'1Irt)'.

111A1:c' nc-~~

(ilornun).

jl

Cou. to the Smoker

II

a..-

C[.

Aw..w. CMar

nvs ro~'TRI[S

M,-~\y. 111(A: rUllt.WlrllJloKt fA !motwg 00 ~II.

C ...

Alft

FAOnAT~~fAO-d....."'_"

em' el)llJ" tk

",,"1In1

"1f'1~11.","_I('.ItJ.-wJ'!I"..,."'

l--.

OrtIMlMJ( ~

~ (Iw.ur...).QI.

U M<Ulur.auring

YJII(

c.j

""_.,,...C_

{TIlNt

......

.... 0",",

1\...,.

lew lCtlll(W

Tobocx:o

w.M.,_ w..~

.WJ,II"""
~N\'

A PACK ()f "'IA'''' tIOMO OR fQUf\'.\LL''T ..

W~~ A A pov' 0( Md-=-o fi)I'-..
f'V~r
A" ..... T......l .. rutw(O Qmptip.

<.""hlt,@V

Pwv-.

1_,....,

Sv.r,...,. I" t..-.,tn, """ 1000.

C~II\aI

IoiI,\IfJ>

klll,'1 I

MINIIA.N(l. C1UNA

c..'e I,Y, ~'f"'11

ill

JI~ rl'." \v, Chtc" ClI,

OIi!u.J-WIItf''' ....

7.] ",

r,llul!. JR.

NlII.IJdvafAaNl"_'''S,

etc.,. lie 1II1(4_"~

'74 11"...4

""'.1

\;~.~"'"C1f'dlu.

Q.-.lo.~ "'-', ~

,990 10

o..dopNall

~R,,"hlo.. 2, IIIllw ~ip J,rvd. JI4

IM-./k/WI14
..hbllh

\\'lItalllll(!
'fOtlACC() DOlLAR COtS. I",
USl)'.I~_'N"""''
J.MI_

118

''OCT

0,

...._.,_ ................. "......""". '.....

......
1cod oIlS1CC...... U...., N...-. IIWIuNlioNJs.-t..N ~
(lL'''mO,. ~

..

-u...n ... 1001

...G_AI,","-l.

, . ..

. .. .

C.pdw.rtT

"_"'_'~~''''-'

m.r_"'~~

The Demographics

Table A
Counu-ics

Adult smoking

tMU$.t.nd,

pernt*ges
tot.d

,.

632

Dominjc~

71

Dominican RcPublic~

.~ oJ"

.,

1
Youth tcbecoc use

Population

Djfboutt _

of Tobacco

8,373',

m.u<

puttnugeo
(,"-m~l('

.31.1'"

S7.5'Ib

20.1 ...

24.3'1b

17.1~
17.~

101.1.1

m.ue

4.7'i>
19.3'"

23.8'Ib

(Ccm.a.)~

-=14.sqo

East Timor

ftuOdor
Egypt
EI salvador
Equatorial Guinc::a

France

."

~~~ ,

OabM.r
Gambia

!1"~'

Germany
Gha _ .' ,

38.1J'1b

I~

1,393

32.!11b

".!11b

20.!11b

62;9oa
814

15.8'Ib
20.5'"
23.5'10
34.S'"

82.017
19,306

Grcnada; .. ~;

.... -

25.!11b

1,303
5,262 "
"

Greece

GuineaBissau

35.!11b

'.2.30 ~

G.o!')i.

Guatemala
Guinea ~ ~
.~.

45.5'1b

18.3'"

1.8'Ib

457
3,659

Estonia
[Ethiopia <
F"nland'

31.S'Ib

67,884
6,278

Erit,.. ~
Fiji

g646

37.5'"
35.!11b

'sf.N>

Haiti

r;.:

~.

15.11o

19.3'10

Jo.3'Ib

9.7,,"

1.5'lIJ

39.!11b
28,4'10

15.!11b
31Dlb
3.sqo

4.7.Qi14)

29.O'!b

- ;.

14.4'M>.

37.8,<
59.5'"

16.8<11>

I~
17.!11b

15.3'10

21.6'Ib

20.7'o

21.!11b

23.SCJo
35.5'Ib

".0'Ib

24,O'!b
16.O'!b

25.1J'1b
29.4%

23Dlb
2.5'!b

variable

V3ri.Jblc:

212,092
70,330

31.4'1<0
15.J<!b

59.1J'1b
27.2'lb

22..O'1b

38.O'!b

lraq~-.

22,946

Ireland

3,803

22.SCJo
31.5'10

4O.IJ'1b
32.!11b
33_

5.!11b
31.O'!b
24.O'!b

52.S%
' .. 48.1J'1b

13.4'M>

~
9,968

Hungary
Ic:tli.d

India

1,008,937

Indonesia
trao, lsi, Rep,

1I;

279 .

6,040-

!2&Ylb

2,576
121,096

~F- ...

~""14.6IM)
33.1,*,

.Or.

4,913
16,172

~zakhStan
-:',

Kenya;
Kiribati

1>....

RepubliJ: of."

I(uw~tt,:.,).}~
Korl~a, Dern. Ptople's Rtp, of

Kyrgyzst.n

1.10Ptoplt'$ .Qtm~t""
latvia

96

SoUfC'n:

see p.ti~124

r,

46,140
22,268

33.5,,"

6O.0'lb

'49,4""
42.0CJ0

66JI'lb
56.5%

'35.0'Ib
15.8'Ib
37.S'lb
";38.QClb
31,0'Ib

65.1""
29.6'lb
6O.!11b
41_
49.!11b

I for ~

11_

4JA

8.8'Ib
l1Dlb
27.O'!b

....

17~

17.7'i>

10.7'"
36,!11b

Honduras

._

10.9'\':)

-.;,!

_
~r>~

2Q.O'Ib

34.!11b
6O.!11b :

17.8'1<0

27.8'Ib

.",;;ln11~\ _~

17.!11b

27.!11b
38.8'Ib

:"'_

16,!11b
38.!11b

10,610

24.!11b

11.1'l1>
20Dlb

variable

5.JC1b

3."""

lQ.OQb

"':~

19.3'1b

24.4'1<0

14.5'Ib

'20,6'lb

27.oC1b

luqr,

13.1J'1b

lfiO'!b.

7.0CJ0
31.9'!b

lQ.OQb

32.Jqo

4.8CJo
I.S'Io
1S.6'lb
1S.00b
13.0CJ0

OOUntfld. tbu

:-,lI

lore bbcd 0:11 ;<O'Ith.....,.cys 11'1 ~

dtlet.,. p-volllC'D.
.. :i <An: not f><:tt~",~-ry(tk')1lItk-,~tr).

22 Research
Basie scientific cpidemiologaC"oll
resear ch over W 1.. , 50
yeu.1us proved the Iunnrutnt'.u
or
tobacco.
Reducing toh~cco usc reqelres
kno\ving ,,,hilt works, ill1(1
applying thl. Infom'''lon

............._..'.*
...".....,~theW

scientific base ;$ :a prerequisite

for

_",III 01 the Sodtty

'0/1

OlI: ........

o.to.1

_.

'0

.,..
_.

dc\'cioping (,'uuntrfe",. InclutHng

Ihe laek or ".HllArdISt~1 ,I....
absence or .. network for
ccmmunkatton, bek ef robsceo

:<'

rescarch coIPit_'it)',l..nd the

need for human and nn.mdal

resources.
The seuree or Ihe (undlng i. of

1:t*

.IAIIL

"lu>I impon.""". lIutori.,.U)'.

tob.K:co coulp.micl

bave

rcx.arda.

prontising

cemplete indep endeece. only 10

hury unf.nour;ahle nnt,ling and
delete words sueh a'l "c..n.
ccr." lmprove rhelr publle
In'''gc.

"0

tohilCCO COIHI\tUlltJ ",rc once ag.aln

otTering ~ul'st ..ntI31 research

funding 10 Ilc.,delulc In ..thutlOI1J
worldwide I promlJing complete
Independence, Acoadc.mlc

Complrltivt rtStlrc:l1
upcnditurt Nationallnstitu'le:I of Htalth

r"",.rd,eTS """uld ron.hlor thl.

USS pet "Io,td duth 2001

opuen caullou,I)'. ghen

hbtOI')'

hy JnlcrmllONt

\\'hile i~ ..~(1 run.lingI'

exist, A recent
rellO"continue
highlighted
import;mt.
oorrierl
rc<',\lrring rcsl'ard, Ihenh~$for

sponsored

I I

u~.

development .geodes .nd

rotm<L.lion s. tob.to control
...... reb In the dc, doping world
is .bo beginning 10 Ilcweb.

wntrol

ir Io o a b

lit tI:*lIU

in'oesuncnts

..,.

h.<

fl$1 f r lr I.

Prob'l"css. In developed countries,

on tobacco 11s. e. Th an", In p>n
to

..

,.. _ .,..aa., . . . .. . ,
.
II

. . . , - ..

there !wi been no Shot.:agl or (1.1..1

SY"CIl1.'IC3Uy. Uulhling Il,C

-...,

or nll,uJ< of

.teIollifir fincJing.,

sptrwfing on rOC:Jrch fundlng for mJIor

dl~

SLOGO

70

StO.ooo

STt.ooo

$t, .ooo

S .ooo

S'AOO

12.000
_

.
/
/
/
/

INDEX
additives :1:2

on tobacco control 22
boys, tobacco usc 22

i.8.

direct mail

Burson-Marsteller,

6!!

outdoor 5.B.
newspaper 5.8
point of sale >8
publie transport 58
Je~ ullO promotion
Africa, history 12
Alladlli. clgareu(' manufacturer
Amertcas, history 1.8
areca nut

.ill

ASH UK 52
A$ia. history L8
brand 52
Australian AS50ci3tCtI Press 60
Austria Tabac, dg;,l.rctte
manufacturer iQ
Astra, cigarette

Camel, cigarette brand Cl

cancer
in passive smokers IS
in smokers 13
Cerpan, cigarette brand 59
C asa Sports, dguette b ra nd 59

5.9:

Casino, cig:a.rcne brand

dg.rct\c brands 59
d.ily male consumption 11
forest

fire

i.l

male smokers 25
Clive 52
Belmont. dgarcl1(: brand
Benson & f-Icdgc.s.
cigarcue brand S9

rl1"rkcl(n& expenditure In liS."

ll. UJ)
i2

British American Tobacco (llAT)

ad b.los 1Jj
Gulldforcl depository
litigation 8fi
Jilnugglillg
women's

ss

lInlokJng

50

61

nicotine 12

poll'lcs 63
Brundtlaud, Gro Harlem
Foreword 2.

126

S:I:::&5
tobacco content ~
cigmll..

Wl

Cleopatra.

dgarfltt brand 59

Commodore,

cigarette menufacturer

6.6.

brand >8

Diplomat, dg ar eue brand 59

Doll, Sir Riclurcl
on passive $molclng 11
Dunhill, cig.rclle brand 59

clgal"'Cltc

brand s.9

definition Ull
Cook, Cap .. in '.mes 18
costs
or workplace ~mok:ing 25

'0 the economy illd.I

10

the smoker 42-41

Cr ..ven oIA '.. clg<lrcttc

Cunnlnghanl,

Embus)" cigarelle
eugenol, in krc'cb
Europe, history Cl
exports

Rob 18

brand >8

ll. ill

5.3
8.3

brand

On:,iJ
Fog.rlY In,eroational Center 11

FORCES6S
FOREST6S

Or price

conscmpucn,

Oro"'n and \Villia,nson.

Minnc~JQl3 (Icpos:itor-y

59
lax as proportion

Columbus, Chrlstophcr 1.8

2.6

brand

ciga",,"e

59
Derby, dguell.
dhumtis U

2&::l1

costs to smoker 42-43

cigarette manufacturer

:Yi

F.ng Yizhi 18, 78

female smoking

cig>lT't'ttct:

manufacturer

Del .. ,

ex-smckers

duly worldwide 30

In India 11

Orblol, cigarcne

quilling and 52
deforestation

tobacco lear i2

Philip 1t1orris on 2i
cigarette consumption 30-31
o,ino1J

5.2

hldi.
description

pas' and future 16

cig.rcttes

RQtJuna.ns on H

betel qutd, 23. UJ)

(."('I1SUI11ptlulI

l6:IZ

Chtea

Ilaisha, dgarcl1c brand 52

1.1.\'' ' ,

deaths

future 2Q. 2.J

men and women 12

chemicals in tobacco smoke 12

cheroots U
cheWing tobacco 23
chilum ll. UJ)

u.o.

ll.,

public relations'

compon)' 6!

5.8

nlagazJne

D.ymrd, Ricb.rd 8fi

8uff." WJrrtn 12

in USA SJi
internet ~

62

Curie, .\bric
Cyprus 60

on female smoking 26

,ld"crtising 1 J Q
bans 76-Tl

5.B

f'Ortuna Ret:I. dgarette brand 52

FrlmC\\'Orx Con\tention on Tobacco
Con Il"OI J.!!
future,

the

90_91

Gallaher, cigareu. manufacturer 5.0

girl" tobacco use 2.9
Glanl1., S,an,on
on litigation 66 glo ..
.,,. 1 to-II? gO'f~rnment
income 8.5 growing ,
00.000 ~
derorootJ.don attTibuuble
land nea devoted '.0 :Yi
le.ding producers i1

co:4b

smokers' righl-ll organisations 65

Rockefeller Foundation (USA):zJ
Roper

Orgolnization

Rothmans,

dgJrcl"Ic

y_
brand 52

United Nations Foundaucn :zJ

",x

USA

and cigarette price 84-85

dccllnlng

on Chinese ~nloking2.i

USA S
by 5muggling 55

proportion in

revenue lest

Tckcl. cigarette brand sa

This. dgarct-tc brand ss
Three Rings, cigarette brand 59
Time. dgarcnc brand 5.2
Tobacco AdVisory Council 16
tobacco

school health programmes SO

SG, cigarcltc brand 59
shish. 22
smoke-free areas 74-75 Ul
smokers' righu organiSJtions

chc\\'ing 23

M-65
5ftloking

health risks

in pregnancy 12
male prevalence 2k2.5
male trends 24
t-ax and consumpuon 8.:l
workplace iL 7.. 1S.
worldwide projections 8.S
smuggling ~5.5
.nuIT !!, 23, U1
Soptanac, cigarette brand i2
Sportsman, dg.lrcttc brand 5.2
State Express 555, cigJrctle brand

~
state manuf ..cturing monopolies
Stella, cig.rette brand S!l
Streitfeld, David 60

"urnpen 22
Sun T7;U, General t, 12
Surgeon General's Report 1964
LB

SO

g,

13

tobacco indurtry promotion

ss.ss

tobacco leaf
cXllOrtcr!l 52
Importers 51
producers i1
tobacco trade Sl::S.3

dgarctte

cxpor15 S3
imports

53

tobacco lear trade 5.2

tobacco U$C, t)1'C' of 22-23
'loscanlnl, Arturo. U
trade route."
legal i2

S111Ugglillg 54-55
Trescr, cigorettc brand 59

128

Victor)', cig>rette brand 59

Washington. George 13
Ilds.hingron Post 60
water pipe 22

6!l
Will .. Gold FLtke
l2. Winston.
cig.rette brand 59 workers in
JTWlufacturing tobacco
dg;arcttc brand

tyJ>C"2b23
youth. users 29
tobacco companies
by country 5.biJ
by muket share 51
t,oh:.cco control organisations
2l=Zl. ill

dg.lr'Ctt,c

COstsof workplace smol:!ng i.l

1J.aSSi\'C: .smoking in 15
politics g, til
US Tobacco Institute SO

\Va\,(';Snct

content per cigarette 49

female prevalence 26:21

female trends 26

(US/I)

tar 78, ill

:IJ!d9
orkptaee smoking 2i
world conferences 72-73
World Health Organiution
prediction On \\wth and tobacx:o
Ill!
regional offi= 72-73
smuggling ij.
World No Tobacco Day Slb:8J
World T.bles 2l=1.Q2
youth 2.8::22
passive smoldng l!
Philip Morris 1lI
R.J. Reynold. 28.

tobacco users 29

1F.>;T

CUI'IK)AltU

s..,,''V

gtlllllOl,. kI"i.Jttm.

PLilip l\tri.

In~.I.

198;, ~

,,11m,,"

1.-kI

lOlJl6SJl949

\\'irtb,

Ad.llli SmIth. An '1Ii1d'l ~... lAwl\'Jffltf

J"" ~

Ctu-10ti1*" FI, r..IwNo (<<mill

III

1776

~tk:p.n, UUllfHd, O.o;rord UnhTOO)

XIOO, 1iII:4t 14) 1.)nIi T"tJ,. 11.~; 2"-}40.

f'~.

COII,W.JJIM Jliutr.

,,-,

l1\'

"11

191

11 ArrilOOl

Part Six:
WORLD TABLES
T.hle A The Demographics

JO Litigation

U"_""-.

1911

Loptt l\l), ptl"Mll'\ll rotot....uoOOn

nxr

ar..". n-

L. ,.,..,. .... oI! ,'lIim!dc..J Su.W.1'l1

InMhtni..,. PlI.'

of Tobacco

I. POPUUnoN

uncsno

MAI;'Ir.' ,\lAP $ 5;\lUGGLI."\G

Pr""'~

RkLnI O,,}"'.lrd.
t.-. N(Irtl!e ... tl:m U.lhtTI!. liSA. 1001

r'U~na1tUlUlfunlt"~

.,dtll rru(o_

(1/

t.u:II. ......... t.u.iDt/ .. br/.lOOl/rn.lillJ/cra/umaJlII6O I.bt..

2. ADULT 1.\tOKISG
Mlt fO~
f_ mar S: ,\lIin "'-'r
1. "OUTII S<\IOKIKC
~

IJAT I!ACI:o 4."19

",ncrt._ ToIwrn.
lOIn. us liltgl1km: J8

'tnll.ll

AnnUolKJt"Y_ mel SIlmIt'UJ f'in.r.nd.iI: ~I

WI'IIC),\RO

~\i""

Ed""nl~ I. Report from P,,jl!p l\\(Jn"lt eou,_11G !'IIltip Mu,ri. Coun..d

R"'t'"1ins
Of\ A,_,irtit .... () N' ..,.. .tw~ 19:16. Ilot ... N... :
101)1,)0;)46/)).67,

...."'-,',i>&trooiocull'mlIol .. C.'l:t.it ....dm~&dJ= 2S1S6aunp;IOIW=8

11111.: II"

UIJ:Yllrlmp:sm..h~:,.n
TIlXT

1)..,.,..'11"

tIliCIOo,,", "'UtIrd.. iI:~.an'toA ,lIde"I

fl.A. 6.lto C. fr.wttq' N. TuWo

"'IM".,/. 8 J.ln\l.l:t)

]ex,

)]Q;

\\..1.1.... Rn. Tht pro~

fut &lukll.dll&I~

Iiti.Ilion. \\'110'.

"i,il,,,.,"',,,p_ """rulJ"

6.QUml}l.G
u.o r

...." 21.!M"',).I."

Table B The Business of Tobacco

I. GItO\\'lNG TOIl.-\CCO
~jf:""n' 1 eo: !: see ~
b
I'OIu.mn J: _ ~
I'cw'\~

Org.lnlt..ltion (\\'110),

.. . . .

J-..,

'''i' ....,.., I.J.~

IS ~\&r(h 1002

roIwnn, I 1:.MlC' lI>OWCo for Map IS .)t.in

~u.mnJ ) ": -ee ~
r.. "tlp 1S.T~
). ~lA,'IIUf'.AcruRlNC
CQI_

1:

01,'1(

_l'"

~i.,

"~In

12l.ftdinc pmoJwu. JTMwntI..ut'f!ll

"'If'

u p .l llot ...w,

fvr

nIoIwnn l: uSO.\. ~

""'P 11:
IW~

"t .... ,\l4p

Scr.~. ~o.ac.w ~

Ilttp.II

',com

-t.-ro Id..t..f "'),,1 riI;-wo....,.?f~~I:

......_'.u-s ..

, '" 1: fft
wllllWlt] ..... '"

5. T....x

by Industry

IIOIIfn!'lI
tOIAft

1:

adllrM

n.c

t~'1 $"",,],, IKe c,""'P lIAr. lO

1)401 2.1

fOf M,.. II. M... M..p

fur ~t.p II. A 1"'" 0.,. 'f Smtolt:

f' o(JW'l," 10",. ~~.19. j,1I1no M1I

2: W't tnUI"f"eI I(.,. M.",19.C~
... TOIlAC(.'O lNUUSTkr OOCU.)l[%\.'TS

('uI1II'MI

f:RC. 1k lI",tJ ('-IPlft1f Iltnrht

(9-4102)'LMt

1001 .

.dor.itt: ~)In_"

alIllrMIt

~\"IN(0,\""

I",*,,"in."

TOBACCO

161. \\blte! CIc",,"1f' F'If:o:NMbI. Stk-ned Coufilrir.t" 19ro--t"i. USD.\

..bo.intl'qoml,ul)'1.1J,,9/nNl_loI\Wl_h':J1(;>I'1IMW'ID:

31 Projections

MAp Il:

1. TOa.\.CCO TRADe

111_11 J

1"1ftNlkwW C<m.fUC'ftrt31 Cllll~ 'I(,I"n c.;"lIoll .....1 '-It" 11110

1ro_.,~1 C..... ""'
~
... (f'fI"./. N_ DrIhI.lndA. 7
2000
8t.r.kv 01). ~olI '~.1fJ.
ub.t. COI'Iutl. \\'otld Ilt.lth

(01" tlYp .i: ,\1.Ipt

l'Q~

YOUTII EXPOSEO TO P.'SSI\'E SMOKING .-\T HOME

..,...Kt~
(Of"..up 11 Otildrrn ~
to ~
~
at t.:.r-.
s. OCAREITE CONSU.MmON
see toUrn:I rOf nwp 6: M-. )\Ip

see ~--o

intor!W' &or. T.ol.m

"I..,

r(ot M~ 11:M.I~

IT..XT

\\',,,,-III(.iI\ll OfgMlll.illo,.l. GtrlCu.l)rw

rcf,r.~. \VHQI1:lb,I.I'86

C. O\kNriU A. Ju-'''' M. (ir.,. M. 1lw fut_ 0( ~

proJat
""",!.t1On .-I1.iI:d~eIn li~ Impl~ ~ d'e r~1ne

s.w.

32 Future
11M[I.L"'E
M.I("i..y J, t_~.frnmtlw GrtIjtlClIiltl Tilt ,,"',., JS ,_"

l(kh \\' .. 11d CM,r~'t1lft

')Illi'AtMT(l (I' IInl1h .. Hcotj~. ChiN. J4-1~ "I'K"~1M

l'klWJ" TJo..rr. C_,J Nt; 111wH.111,..J ...... "t..

f'VtuIl' ~

(NtiV_oI

lit" \\\)rld

"u~

6-11
MUI"rlyCJI,

1000
1~'f""'AI).

c..r~
,Itt

ljll:tAJ).

Ilf'

lOO.orfJ or II~h.

C,1.>NI'IItM

O,~ i.Ytbt. II.,.-.n! ~

I-'Tto I~

Glossarj'

pd~

1"-.

ctl""fO

11 A,,1111001

c-t.I.~...,

mil~.

\\'01-1.:111(.""

ull~-.I .. I kJtJ,. \\~!.Ib.&nl. 1996!.S

('I)11)",,,"klllvll

~III
UniondIi"'rth~.I~c-M
'ffl.l: 1l.Wi5
Clml7. S. MIoU ...... 1'.JwM._ pJ- .....\'~ ': r"'_" ).1999
~11oJ~Iot'IwIuujL r-J. Ltoa:c.
C-"" O.bd Uaf .. :... ky
I-'rot, lOOO:~'

124

\\'C.1d I tNh.h Ort-t

...,..,.. r-Im_}

rNIOfJI., ..J _,..."...,

...,I....
tr,J-. \\'1I0.Ct:nro....lmtl]) us

r~".,

IWA;A

GW>.II$t ., AqoIo't. \''110. ~

...

1m