Editor’s comment

Cough like a cowboy

The tobacco industry has long held a susceptible group of the public in its sway. As a child I remember the Marlborough cigarette adverts – the rolling plains of North America and an impossibly rugged, handsome man riding into the sunset on his beautiful horse – cigarette in hand. I heard that the man in the advert died of lung cancer. I have no idea whether or not this was true, but statistically we have known for a very long time now that cigarette smoking is the single most important risk factor for at least two types of lung cancer. We also now know that cigarette smoking is the single largest risk factor for a host of otherwise preventable causes of premature death and that it has a directly additive effect on many others.

 

In the light of this, the landmark decision by the Australian High Court to dismiss the challenge by several leading tobacco companies against plain cigarette packaging is particularly encouraging. The tobacco industry is one of the giants of the commercial world and has long had the power to intimidate. This decision in Australia bodes well for other countries, including South Africa, who are considering plain packaging, to follow suit – but no doubt the industry will continue its challenges.

 

The number of smokers in the developed world does seem to be dropping, although there are worrying trends among young women. However, in the developing world, although the full figures are not known, the tobacco industry still seems to be managing to potentially destroy the lives of far too many people. The Lancet recently published the results of the Global Adult Tobacco Survey (GATS), which took place between 1 October 2008 and 15 March 2010. The survey covered 14 low- or middle-income countries: Bangladesh, Brazil, China, Egypt, India, Mexico, Philippines, Poland, Russia, Thailand, Turkey, Ukraine, Uruguay and Vietnam. Householders over the age of 15 were surveyed. GATS compared tobacco use within and between these 14 countries and surveys in the UK and USA.

 

The results of GATS are sobering. In participating countries, an average of 48% of men and 11% of women used tobacco, and manufactured cigarettes were favoured (82%) overall. Levels of tobacco use in men ranged from 21% in Brazil to 60% in Russia. In women, the range was from 0.5% in Egypt to 24% in Poland. Numbers of people who stopped smoking were less than 20% in China, India, Russia, Egypt and Bangladesh. These figures show that public health measures to prevent people from starting to smoke and to encourage smokers to quit are ineffective in the countries surveyed. More to the point, they show how effective the marketing messages from the tobacco companies are.

 

When my parents (and all their friends) smoked – which is incidentally why I never have – the dangers of tobacco use were not known. In fact, in the Rhodesias, where I grew up, tobacco use was patriotic because of the contribution of tobacco to the economy. That excuse is no longer there. We know that tobacco kills. The commercial interests of big tobacco and government’s dependence on revenue from tobacco taxes should not override the damaging effects on health. The sooner we introduce plain packaging the better.

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Bridget Farham

ugqirha@iafrica.com