Stop smoking: it’s common sense

During the 1990s just when the rumblings about the effects of smoking on health were finally being heard in developing countries, a world tobacco conglomerate sponsored a forum for journalists. It was held at a swanky hotel on a Caribbean island and in addition to the amenities afforded them, each attending journalist was offered cigarettes and the wherewithal to light up at any time. When one of the sponsor’s representatives was asked about the obvious inducement, he made the point that no one had asked about the bottled water or juices placed at the table during sessions and stated that the cigarettes were just as much a choice as anything else that was available at the conference.

Was he right? No, because there is nothing addictive about water or juice. Taking or leaving either one is much easier done than quitting smoking once the user is addicted. Tobacco companies manufacture cigarettes with enough nicotine, which is what makes them addictive, to hook and keep smokers smoking.

So as not to leave the story unfinished, it should be noted that only those journalists who were already smokers took the cigarettes—about 70% of those gathered—there were no converts. There was umbrage at the manoeuvre and the idea that big tobacco actually thought it could use its cigarettes to sway journalists’ thinking, but not enough that the corporation suffered any negative effects at the time. But no company, large or small, would survive any such gamble today, not with the instantaneousness of the media.

Smoking is one of the behavioural risk factors associated with chronic non-communicable diseases such as diabetes, hypertension, cardiovascular disease and some cancers. Second-hand smoke also places non-smokers at risk and ongoing research is showing that third-hand smoke can be just as bad, particularly for babies and small children.

It is for these reasons that governments in developed countries began to take firm steps to control tobacco use, but not as quickly as they could have. In the UK, for example, this began with the Consumer Protection Act of 1987, which while not wide-reaching, addressed tobacco packaging and labelling. The UK continued to pass several other pieces of legislation over the years that addressed the sale of tobacco products to children as well as advertising and promotion of such products.

In the US, after the first Surgeon General’s report linking smoking to disease was published in 1964, federal laws regarding labelling and advertising were enacted in 1965. Between then and 2016, the US has passed several other laws, amended some and added regulations to others as part of its tobacco control strategy. Other first world countries followed suit with some laws dating back even before 1965.

When these moves started to affect the bottom line of the big tobacco companies, they began extreme marketing in developing countries where there were no laws, or what was there was shaky at best. They were free to target women, children, sponsor sporting activities and sell products which had sexy packaging as opposed to those that were plain or had warning labels that were beginning to take effect in developed countries. Nicotine infusers disguised with glamour and touted as slim, low-tar, no-tar, lite and menthol, which were already losing their foothold in their countries of origin, flooded the markets of developing nations. They were an easy sell – many of the western film stars already doted on by the masses in these countries could be seen puffing on cigarettes and blowing smoke rings in their blockbuster movies.

It was the noted link between cigarette smoking and chronic non-communicable diseases, which was having a negative effect on labour productivity that saw developed countries move on tobacco control. But a curious anomaly existed. According to Section 4 the US Federal Cigarette Labeling and Advertising Act, Public Law 89-92 of 1965, “It shall be unlawful for any person to manufacture, import, or package for sale or distribution within the United States any cigarettes the package of which fails to bear the following statement: ‘Caution: Cigarette Smoking May Be Hazardous to Your Health.’ Such statement shall be located in a conspicuous place on every cigarette package and shall appear in conspicuous and legible type in contrast by typography, layout, or color with other printed matter on the package.” However according to Section 8 of the same Act: “Packages of cigarettes manufactured, imported, or packaged (1) for export from the United States or (2) for delivery to a vessel or aircraft, as supplies for consumption beyond the jurisdiction of the internal revenue laws of the United States shall be exempt from the requirements of this Act, but such exemptions shall not apply to cigarettes manufactured, imported, or packaged for sale or distribution to members or units of the Armed Forces of the United States located outside of the United States.” Carte blanche, it seemed, for cigarette manufacturers to poison the rest of the world as long as they continued to toe the line in the US. Of course, this eventually backfired because immigration over the years meant that the US labour force came from all over.

Today, tobacco control is almost universal. With the assistance of the World Health Organisation and other global bodies, even the poorest of nations are enacting laws that deal with not just packaging and labelling but smoking in public buildings and advertising.

But even given all of this, the battle to curb the use of addictive nicotine is still a hard fought one. Smokers will still tell you they have the right to choose. They are not wrong, they just lack common sense.