Accelerate antismoking measures

The World Health Organization in early February released a report stating that the global tobacco epidemic is one of the greatest public health threats of modern times. It said that in the 20th century the tobacco epidemic killed 100 million people worldwide.

WHO also predicted that, unless governments take urgent action, tobacco could kill more than 1 billion people by the end of this century. In Japan, smokers will soon need age-verification electronic ID cards to buy tobacco from vending machines. Still, Japan is the slowest in pushing antismoking measures among developed countries.

WHO Director General Ms. Margaret Chan said: “The cure for this devastating epidemic depends not on medicine or vaccines but on the concerted actions of government and civil society.” The government should take the report and her statement seriously and embark on new effective measures to curb smoking and protect nonsmokers.

The WHO Framework Convention on Tobacco Control, which was ratified by more than 150 countries and went into effect in February 2005, has accelerated global moves to prevent and curb smoking. The WHO Report on the Global Tobacco Epidemic 2008, which deals with tobacco use and control in 179 countries, is the first comprehensive report under the convention. It says that nearly two-thirds of the world’s smokers, estimated to number at least 1.25 billion, live in 10 countries — China, India, Indonesia, Russia, the United States, Japan, Brazil, Bangladesh, Germany and Turkey.

There are an estimated 5.4 million tobacco-related deaths annually worldwide. Such deaths are believed to top 110,000 a year in Japan. Unless effective actions are taken, such deaths globally will rise to more than 8 million a year by 2030. Noting that the tobacco epidemic is shifting toward developing countries, the report says that 80 percent of the projected more than 8 million deaths are expected to occur in such countries. The report points to a strategy of tobacco industry to target both young people and adults in the developing world.

Ms. Chan says the rise of tobacco use among girls and young women in low-income countries is “among the most ominous trends.” These are points that tobacco companies should seriously consider even if they support provisions incorporated in the antismoking framework convention.

The WHO report calls on government and civil society to adopt a set of six key strategies to significantly reduce tobacco use. The acronym identifying the strategy package — MPOWER — uses the first letters of the sentences describing the strategies: Monitoring of tobacco use and prevention policies; protection of people from tobacco smoke; offers of help to quit tobacco; warnings about the danger of tobacco; enforcement of bans on tobacco advertising, promotion and sponsorship; and raising of taxes on tobacco. WHO found that only 5 percent of the world’s population live in countries that have fully implemented any one of these measures.

An important point about the six strategies is that they work if implemented in earnest. In New York, the smoking rate was about 22 percent in 2002. But TV campaigns, the Smoke-Free Air Act banning smoking at workplaces, bars and restaurants, and a steep tax rise on tobacco contributed to lowering the smoking rate to 17 percent by 2006. Ms. Chan says, “These six strategies are within the reach of every country, rich or poor and, when combined as a package, offer us the best chance of reversing this growing epidemic.”

The government should ponder the WHO finding that raising the price of tobacco through higher taxes is the single most effective strategy to induce smokers to quit. Clearly Japan’s tobacco prices are low compared with those of other developed countries. In Europe, a pack of cigarettes costs more than ¥1,000; in Japan, it is about ¥300. Raising tobacco tax for revenues to protect people from the harm of tobacco is a realistic option.

This year marks the 30th anniversary of the start of a civic movement against smoking in Japan. On Feb. 18, 1978, a civic group called “Kenen-ken kakuritsuo wo mezasu hitobito-no kai” (literally the Association of People Seeking to Establish the Right to Shun Tobacco Smoke), whose English name is “Action for Nonsmokers’ Rights,” was launched in Tokyo.

In 30 years the smoking rate among Japanese men has dropped from 75 percent to about 40 percent. Smoking bans have been introduced in many public places and in many taxis. But only 1 percent of restaurants impose a total ban on smoking. Meanwhile, the Tobacco Industry Law promotes “healthy development” of the tobacco industry, and the government is the major stockholder in Japan Tobacco Inc. The first thing the government must do is to set a numerical target for reducing the smoking rate.