• 2/7/2008
  • web-based article
  • Henry Goldman and Bill Varner
  • Bloomberg (www.bloomberg.com)

Tobacco use will kill 1 billion people in this century, a 10-fold increase over the past 100 years, unless governments in poor nations raise taxes on consumption and mandate health warnings, the World Health Organization said.

No country fully implements these most important tobacco- control measures, according to a 330-page report released today by New York Mayor Michael Bloomberg and the Geneva-based UN agency. Bloomberg, who helped fund the study, joined WHO Director-General Margaret Chan at a news conference in New York to discuss the findings.

“This is a unique point in public health history as the forces of political will, policies and funding are aligned to create the momentum needed to dramatically reduce tobacco use and save millions of lives by the middle of this century,” Chan said in a foreword to the report.

The WHO said the tobacco “epidemic” causes the deaths of 5.4 million people a year due to lung cancer, heart disease and other illnesses. That figure might rise to 8 million per year by 2030, including 80 percent in “countries whose rapidly growing economies offer their citizens the hope of a better life,” the report said.

American States
The U.S. Centers for Disease Control and Prevention, in its Morbidity and Mortality Weekly Report, said states are falling short on U.S. recommendations to boost insurance coverage of proven anti-smoking treatments that fight nicotine addiction.

The Atlanta-based U.S. government agency said eight states’ Medicaid programs, which serve the poor, fail to reimburse for any tobacco-dependence programs, and only Oregon covered them all. About 35 percent of Medicaid patients are smokers, it said.

Tobacco is the “single most preventable cause of death” in the world, the WHO said. Yet governments in low-and middle- income countries that collect $66.5 billion in taxes from the sale of tobacco products spend only $14 million on anti-smoking measures, and 95 percent of the world’s population is unprotected by the type of anti-smoking laws Bloomberg has pushed in New York.

Commitment Sought
“Now for the first time ever we have reliable data, a system of analysis and clear standards to promote accountability,” Bloomberg said of the report, which examines tobacco use in 179 countries. “What we are still missing is a strong commitment from government leaders, but we believe this report will empower more leaders to act.”

Bloomberg, 65, the billionaire founder and majority owner of Bloomberg News parent Bloomberg LP, announced in 2006 he intended to donate $125 million to worldwide smoking-cessation efforts.

Bloomberg’s Health Department has made fighting tobacco use its top priority, enforcing age limits on smoking, distributing free nicotine patches and chewing gum though the city’s 311 telephone information number and producing television ads featuring a former smoker who lost his voice to throat cancer at age 39.

The Health Department reported in January that teenage cigarette use has been cut by half — to one in six teenagers — since Bloomberg became New York City’s mayor in 2002. That year, he persuaded the state legislature to ban smoking in indoor workplaces including bars and restaurants. He also fought for and won a cigarette tax increase of $1.50 that lifted the average price to about $7 per pack.

Role of Taxes
The WHO said raising taxes was the most effective way to reduce tobacco use, noting that a 70 percent increase would prevent a quarter of all tobacco-related deaths.

The report cites a 2001 study titled “Critical Issues in Global Health,” by epidemiologists Richard Peto and A. D. Lopez, edited by former U.S. Surgeon General C. Everett Koop, as support for the assertion that population and smoking trends during the next several decades might lead to as many as 1 billion lives lost to smoking.

China, the world’s largest producer and consumer of tobacco, was highlighted by the UN agency. Almost 60 percent of men smoke cigarettes in China, compared with 21 percent in the U.S. At the same time, the report cited a survey that said most urban residents of China support a ban on tobacco advertising, higher tobacco taxes and smoke-free public places.

David Howard, a spokesman for R.J. Reynolds Tobacco Co., which reported $8.5 billion in U.S. sales of brands such as Camel, Kool and Pall Mall cigarettes, said his company has expressed “the very clear opinion that smoking causes serious diseases.”

The company, owned by Winston-Salem, North Carolina-based Reynolds American Inc., continues its sales efforts, Howard said, because “there are about 45 million adults who are aware of the risks and have made the conscious decision to use tobacco products, and it’s a legal product.”