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Presentation at International Conference on Prevention of Tobacco Induced Diseases in Hong Kong by Hemant Goswami, Chairperson, Burning Brain Society

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  1. 1. Future Possibilities in policy and legislative measures to phase out tobacco Hemant Goswami hemant @ burning brain. org Welcome to
  2. 2. Important Question Before We Start <ul><li>Does anyone have any doubts that tobacco and its smoke kills people? Is science ambiguous on it? </li></ul><ul><li>What has changed in the last 40 years of tobacco control. Has the growth of tobacco reduced? </li></ul><ul><li>Any consumer product which cause even a single death anywhere in the world, wouldn't it be banned overnight in today’s developed world. </li></ul><ul><li>Why is then tobacco still surviving? Why no one is even thinking to ban tobacco despite a strong tobacco control lobby? Why? </li></ul>
  3. 3. Brief Facts <ul><li>In last 40 years of tobacco control & legislation there is no de-growth in tobacco consumption. On the contrary tobacco consumption has grown from 2160 billion tobacco sticks in 1960 to 5557 billion sticks in 2000 . In next two year (2000 to 2002) additional 104 billion sticks were consumed. By 2025, it’s expected to nearly double. </li></ul><ul><li>Among the four largest producers of tobacco, India & China consume most of it within the country; causing great damage to their own economy in the long run. </li></ul>
  4. 4. Startling Facts <ul><li>China produced 2410 thousand metric tonne of tobacco and earned only 231 million US$ (Ranked 8 th ) in export earning. Rest all tobacco consumed internally. </li></ul><ul><li>India produced 598 thousand metric tonne and earned 172 million US$ in export earning. Rest all tobacco consumed internally. </li></ul><ul><li>USA produced just 399 thousand metric tonne but earned 1040 million US$ in export earning. </li></ul><ul><li>Zimbabwe produced just 80 thousand metric tonne but earned 465 million US$ (3 rd Largest) in export earnings. </li></ul>2004 Figures :- Source: The Tobacco Atlas 2006
  5. 5. Burden <ul><li>In China adult male smoking prevalence is 67%, in India it is 47% (+Oral tobacco) </li></ul><ul><li>China now has high prevalence of lung cancer (42 + per 100 thousand) among males. </li></ul><ul><li>It is likely to increase, just like USA, which has a lung cancer rate of 62 per 100 thousand. </li></ul><ul><li>This will invariably affect all the neighboring areas and other parts of the world too. Tobacco has a detrimental cascading effect on economics . In a barrier-less globalized economic scenario, no one can escape.. </li></ul><ul><li>Who will pay for this ???? </li></ul>
  6. 6. FCTC – A New Era <ul><li>FCTC is a good initiative but is tilted more towards the demand side. In a way it’s a knee-jerk reaction to the tobacco corporate marketing tactics and the health consequences. </li></ul><ul><li>The biggest limitation is that FCTC is silent on supply side and commits very little on limiting tobacco cultivation. </li></ul><ul><li>No plan to compensate countries who have large stake in tobacco cultivation. It requires a global pool. </li></ul><ul><li>… . Its quite discouraging that….. </li></ul><ul><li>FCTC is silent on the end-game of tobacco. Among it’s objectives, FCTC does not speak about eradicating tobacco over a period of time. However long it might be. </li></ul>
  7. 7. FCTC – Scope <ul><li>Article 3: Saving policies from commercial & tobacco industry interests </li></ul><ul><li>Article 4: Parties shall cooperate for implementation of the convention </li></ul><ul><li>Article 17: Parties to cooperate to promote viable alternative for people engaged in tobacco cultivation and trade </li></ul><ul><li>Article 18: Parties to protect environment with respect to tobacco cultivation </li></ul>
  8. 8. Missing <ul><li>But where is any thought on reduction of tobacco cultivation or any other (real) supply side issue? </li></ul><ul><li>It’s Missing! Why? </li></ul><ul><li>How can tobacco control be achieved without effective supply side measures? Controlling tobacco at the supply side is half the pie. </li></ul>
  9. 9. Success of policies – Long term <ul><li>Article 6 talks about tax as a measure to reduce tobacco consumption </li></ul><ul><li>I t’s established that price increase reduces consumption </li></ul><ul><li>What about the scenario in developing world where the disposable income is increasing . The purchasing power of every consumer has increased. </li></ul><ul><li>The corollary is that increased purchasing power will increase tobacco consumption (even though tobacco price increases) in developing countries. This is already happening. </li></ul>
  10. 10. Independent thinking is absent <ul><li>We are thinking within a small perimeter and it’s reflecting in FCTC. </li></ul><ul><li>We are not thinking beyond economic theories, which are all about growth and revenue. </li></ul><ul><li>Since economics only deal with maximization of profit so there is no existing economic theory of de-growth . This does not mean that systematic de-growth of a product is not possible. </li></ul>Thinking within the existing theories is only proving to be a limitation to our thoughts, actions and in achieving the real solution
  11. 11. Questions and loud thinking <ul><li>Would we be happy if instead of five million global deaths only 4.95 million are caused annually? </li></ul><ul><li>Even if the proportion of youths taking to smoking halves, we would be able to save no more than 20 million people in the next 40-50 years. </li></ul><ul><li>Despite all the efforts and assuming success of current tobacco control initiatives, there still will be an estimated 500 million deaths ; instead of 520 million deaths otherwise. </li></ul>
  12. 12. Questions and loud thinking <ul><li>Why even most of the tobacco control organizations are deeply convinced that eradicating tobacco is not possible; who is promoting such ideas? </li></ul><ul><li>Is tobacco a life saving drug which needs to be sold in the interest of the mankind? Is it an indispensable nutritious concoction which is essential for the humanity? </li></ul><ul><li>Do a score of people have the right to kill millions every year by forwarding syllogistically false association of “Freedom of choice” with “tobacco consumption” and in the process earn billions of dollars? Who gave them this right? </li></ul>
  13. 13. Permanent Solution: Ending tobacco <ul><li>A timeframe for complete eradication, and not just control , should be the target. Tobacco must be treated as an illegal product (like any other addictive drug) in a timeframe of another 20 years. This should be the primary objective of our efforts. </li></ul>
  14. 14. Is this possible? How? <ul><li>Yes! Yes! Yes! Yes! Yes! Yes! Yes! Yes! </li></ul><ul><li>This is possible </li></ul><ul><li>However, this will remain impossible if tobacco remains freely available and under the control of the present tobacco industry </li></ul>
  15. 15. What must be done? <ul><li>License all form of tobacco trade </li></ul><ul><li>Nationalise/take-over the tobacco industry with proper legislative support </li></ul>Two actions which will make the biggest difference ever in tobacco control
  16. 16. Licensing Tobacco Trade- Why? <ul><li>License tobacco manufacturing, trading, sale and all other processes </li></ul><ul><li>Anyone who wishes to trade in tobacco must obtain a license to do so. </li></ul><ul><li>This way we can </li></ul><ul><li>control the random growth of tobacco vendors. </li></ul><ul><li>Stop the sale of tobacco by and to minors . </li></ul><ul><li>Restrain every second retail outlet from selling tobacco. </li></ul><ul><li>Restrain the promotion of tobacco products over the counter as the number of counters shall be reduced . </li></ul><ul><li>Control PoP advertisements , etc. </li></ul>
  17. 17. Benefits of LICENCING tobacco <ul><li>Number of tobacco outlets will shrink to less than one third of the present outlets. </li></ul><ul><li>Will ease enforcement of the legislations. </li></ul><ul><li>It will provide additional revenue which can be used by the State to promote activities under the Tobacco Free Initiative and cross-subsidize tobacco induced diseases and damages. </li></ul><ul><li>The budget of anti-tobacco campaigns which at present is close to nothing will come at par with that of tobacco companies. </li></ul><ul><li>The influence of tobacco companies over the policy makers will reduce because the revenue will start flowing from other quarters. </li></ul>
  18. 18. a posteriori deduction <ul><li>Tobacco Industry is incorrigible , it is not going to follow the spirit of the law. Greed for money will always overweigh on the deaths it causes </li></ul><ul><li>BUT </li></ul><ul><li>In a civilized world no one has a right; and no one should be allowed to make money out of someone’s death . It is more than merely being barbaric. It’s cold blooded murder. </li></ul><ul><li>Those who watch it silently are accomplices. </li></ul>
  19. 19. A possible Plan <ul><li>Chalk out a 20 years plan to finish tobacco and </li></ul><ul><li>Nationalise/ </li></ul><ul><li>take-over the tobacco industry across the world </li></ul><ul><li>(Governments all over the world should take the tobacco industry under their control or buy it out to turn it into a fully controlled corporation ) </li></ul>
  20. 20. Nationalizing/Take-Over <ul><li>A committed legislative measure to buy out the tobacco industry and all its processes with a 20 years phase-out plan eying a targeted, and planned 5 to 10 percent de-growth for the tobacco industry every year. </li></ul><ul><li>Many nations take-over and control certain selected industries and resources in public/national interest. Taking-over an industry is not a new thing. It has been done in the past too. </li></ul>
  21. 21. Who loose by tobacco take-over <ul><li>Public; No. All sections of the society stand to gain out of it. </li></ul><ul><li>Tobacco users; No; tobacco would be still available as it is on date; there is no proposal to ban it immediately. </li></ul><ul><li>Farmers; No; rather they stand to gain by the additional revenue and by better wages if the government takes over the industry. </li></ul><ul><li>Government; No; there shall be greater revenue now available. Besides by phasing out tobacco, the health care cost will also start coming down. </li></ul><ul><li>Share holders; No; system to pay them back the share value over a period of time can be worked out and no economic loss would be caused. </li></ul><ul><li>it’s only a win-win situation barring some minor losses to around 10-20 people around the world who illegally siphon most of the tobacco money. </li></ul>
  22. 22. <ul><li>It is in the interest of the highly exploited tobacco farmers as the earning from tobacco during the intervening period can go to these marginalised farmers and thereby enable a scientifically phased swapping of the tobacco crop with other cash rich crops. Currently all the earnings generated by exploiting tobacco farmers and by tobacco sales are siphoned by a handful of rich tobacco manufacturers and individuals. </li></ul>Beneficiaries Tobacco farmer gets just 1 cent from every dollar spent on tobacco
  23. 23. Possible Counter-Argument <ul><li>Counter Argument: Tobacco industry is run by the government itself in some countries but it has not resulted in reduction of tobacco consumption </li></ul><ul><li>Answer: Correct, this is because the governments in these cases had taken over the tobacco industry not in public-interest but with an intention to maximize profit. They run the tobacco industry just like any other business. No government having control over the tobacco industry has ever tried reducing production, clubbed with measures like price increase, advertisement bans, import control, etc. Even cross-subsidizing the agriculture and health care has not been thought of. The policy to control tobacco has to be well defined and properly legislated. </li></ul>
  24. 24. Opportunity <ul><li>Public health activists and organizations working in countries where the tobacco industry is already in control of the government have great opportunity to turn the tide and set examples. </li></ul><ul><li>It’s a huge opportunity . </li></ul>
  25. 25. Resistance from within: Most tobacco control workers consider such an idea as non-practical and are not even ready to think about it. The first challenge remains to convince and educate them . Inclusion in FCTC: Inclusion of such a proposal in FCTC is another big challenge. Those who initiate it should be ready to be labeled as extremists and radicals. Challenges: Possible Opposition and Slippery Slopes?
  26. 26. Convincing the governments: Next challenge is making it a public issue and convincing the governments that the idea has great public interest involved and has vote-conversion value . Ensuring a leak-proof legislation: If the initiative is not supported by a proper legislation which targets a 5-10% annual de-growth of tobacco at the supply side too, then even government control cannot help. The legislative measures must be irreversible. Without mentioning: overcoming tobacco industry influence remains a continuous challenge Challenges: Possible Opposition and Slippery Slopes?
  27. 27. Why consider these options? <ul><li>It’s an historical mistake that “Tobacco” became a legal product . The mistake needs to be rectified. </li></ul><ul><li>No reason to allow a few people to profit by killing someone. Right to life is guaranteed in a civilized world. </li></ul><ul><li>When we know that tobacco is a product which surely kill then why wait more to take corrective actions? Remedial measures can be taken only after having complete control over the industry. </li></ul>
  28. 28. Stop profiting by killing <ul><li>In a civilised society “ Why should any individual be allowed to profit from someone else’s miseries and death ? When for a relatively minor violation affecting human health like selling adulterated food articles, etc. one is put behind bars (for years) then how can we turn a nelsons’ eye to a deadly product like tobacco? </li></ul>
  29. 29. We are responsible <ul><li>If knowing well that Tobacco Kills, we still just scratch the surface and only talk about harm reduction, controlling tobacco’s growth, etc. and fail to even attempt ending tobacco as a consumer product then we are also guilty of the crime . </li></ul><ul><li>As public health workers and activists, we must accept the burden of the possible billion deaths this century. Remember these deaths shall be caused due to our lack of firm action. If we are serious then we have to do all what we can, to end tobacco as a consumer product. </li></ul><ul><li>There are no soft or mid-way solutions </li></ul>
  30. 30. Let's Work for a Tobacco Free World Hemant Goswami hemant @ burning brain. org