Twenty years from now, tobacco-related diseases will be implicated in 9% of deaths worldwide, with the majority occurring in lower-income countries. Already two-thirds of smokers live in 15 low- and middle-income nations.
Addressing the World Conference on Lung Health in Cape Town last week, Judith Mackay of the World Lung Foundation said communicable diseases — those that spread from person to person — receive attention, money and support lacking in the case of non-communicable diseases such as those caused by smoking.
According to the International Union Against Tuberculosis and Lung Disease (The Union), about 13 500 people die daily as a result of tobacco-related diseases, but these lost consumers are replaced by the 100 000 young people who start smoking every day. Globally 2,5% of deaths are related to tobacco.
It is estimated that 1,3-billion people in the world smoke, of whom one billion are men, mainly living in Asian countries. In sub-Saharan Africa, about 29% of men and 8% of women smoke.
In 2006 enough cigarettes were consumed to provide 2,4 for every man, woman and child on the planet every day. Tobacco consumption is linked to a wide range of diseases, including cancers and, more recently, tuberculosis. Smoking also damages parts of the immune system that play a key role in fighting HIV infection.
South Africa played a significant role in an international campaign against tobacco, which resulted in the World Health Organisation’s Framework Convention on Tobacco Control (FCTC). This has been ratified by 151 countries. Key components of the convention are to increase taxes on tobacco, ban advertising and create and enforce smoke-free environments.
Tobacco industry opposition to these measures suggests that they are effective in reducing smoking. Mackay described the FCTC as an ‘international, unstoppable and a necessary public health measureâ€.
She said that because the FCTC was an international treaty it had ‘kicked [tobacco] upstairs†into the highest levels of government, rather than leaving the issue in the hands of traditionally less powerful ministries of health. The creation of an international plan to curb tobacco use has hampered industry attempts to lobby countries individually — ‘picking them off one by one†was her evocative phrase.
South Africa is due to report on its measures in relation to the FCTC in November 2008, but graphs of consumption and taxes on cigarettes in South Africa show a neatly inverse relationship between the two.
Kelly Henning of Bloomberg said about $13-billion is spent on advertising and marketing in the United States alone.