NEW YORK — Facing greater restriction in the United States and other industrialized countries, multinational tobacco companies are increasingly marketing their products in developing countries, particularly among women and adolescents.
While smoking rates in some industrialized countries are decreasing at about 1 percent a year, those in developing countries are increasing at around 3 percent.
It is estimated that, if current trends persist for the next 30 years, up to 7 million people from developing countries will die every year from diseases related to smoking.
For the past several years, corporations such as Philip Morris, RJ Reynolds, and British-American Tobacco have been expanding rapidly in Eastern Europe, Asia, Africa and Latin America.
Tobacco-provoked deaths can only add to the inequities in health of ethnic and minority populations.
Jeanette Noltenius, an expert on tobacco and alcohol abuse issues, stated recently, “In the U.S., minorities such as Hispanics have been specifically targeted by the tobacco companies since the early 1960s, and have received a double dose of advertising (in Spanish and English).”
According to data from the Bureau of Census, U.S. Department of Commerce, the number of young Latino smokers is expected to triple by 2020, accounting for 19 percent of young American smokers, up from 9 at present.
Since the early 1980s, American trade officials, with help from the Office of the U.S. Trade Representative, have led a sustained campaign to open markets in Japan, South Korea, Taiwan and Thailand among the Asian nations.
In Taiwan, U.S. officials’ efforts to force Taiwan to open its markets to U.S. tobacco products have resulted in increased smoking, particularly among women and children. Talking about U.S. government support for American tobacco companies, a corporation executive remarked: “We expect such support. That’s why we vote them in.”
These actions have prompted the Asia-Pacific Association for the Control of Tobacco to protest strongly against what they consider an invasion of their countries by U.S. companies targeting Asian women and children.
The association has complained about strong-arm tactics used by U.S. government officials in their countries. A report from the U.S. General Accounting Office established that “U.S. policy and programs for assisting the export of tobacco and tobacco products work at cross purposes to U.S. health policy initiatives, both domestically and internationally.”
Several studies show that in the poorest households in developing countries, 10 percent or more of the total household expenditure is on tobacco. As a result, there is less money for basic items like food, education and health care needs, thus leading to increased malnutrition, illiteracy and premature death.
In China, tobacco companies have been moving steadily inland with intense promotional campaigns. It is estimated that of the world’s 1.71 billion smokers, more than 350 million are in China, where lung cancer has been increasing 4.75 percent a year.
The Chinese government is facing the dilemma of promoting tobacco cessation policies while it heavily depends on earnings from the state-run monopoly tobacco company.
Researchers with the School of Public Health at the University of California state that raising the tobacco tax by the equivalent of 15 cents per cigarette pack could save more than 13 million lives and generate $9.5 billion in revenue for the Chinese government.
Lured by financial gains from growing tobacco, millions of hectares in China are presently under cultivation. Gains from the sale of tobacco, however, may be just short term, since the costs of treating lung cancer and other related diseases amply exceed the tobacco profits. According to experts, those excess health care costs amount to $200 billion annually on a global scale, one-third of which is incurred by developing countries.
While anti-smoking efforts gather momentum in the U.S., those efforts are far less effective in developing countries. Such countries’ policies will not be as effective unless transnational tobacco firms are made to limit their aggressive advertising.
Countries in Asia and Latin America are conducting health education campaigns and have passed legislation to control smoking. Up to now, several countries worldwide have enacted legislation to control tobacco consumption. Although, in general, this legislation has been passed at the national level, in the U.S., Canada, and in several Latin American and Caribbean countries, these laws are being enacted by state or local bodies.
Despite increasing condemnation by public health officials and the World Health Organization, international companies continue with their indiscriminate tobacco-promotional efforts in developing countries, exacting a high human toll.
As things stand now, only a multidisciplinary strategy including education, taxation, legislation and regulation of trade practices of transnational corporations will be able to control this pandemic.
Cesar Chelala, M.D., is an international public health consultant.