I was shocked recently by a BMJ article by Tony Dalamothe entitled: “Deaths from smoking: the avoidable holocaust’. (http://www.bmj.com/content/344/bmj.e2029). He will no doubt cover the topic better than me so I am in debt to him for explaining the subject. In the article he presents a bleak view of the attitude to smoking. “About 100 million people died from smoking in the 20th century- twice as many as Stalin, Hitler, and Pol Pot were together responsible for.” He attribute the lack of response to the smoking related diseases pandemic to libertarian views that people have the right to spoil the own health and to the profit-motivated dealings of tobacco companies. He quotes the word of a World Health organisation committee in 2001: “Infectious diseases do not employ multinational public relations firms. There are no front groups to promote the spread of cholera. Mosquitoes have no lobbyists.”
I’ll expand on what Tony Dalamothe says slightly. Whilst the smoking rate in the UK (shown here as a percentage) has been steadily falling since 1960, step by step due to one piece of legislation then another, the future of smoking is unclear. If the observed trend continues (line A on the graph) the UK will be smoker free by 2040. Line B is the scenario where the smoking rates reduces to just a small number of die-hard smokers who refuse to quit despite all legislation. Line C shows the ideal situation; smoking rates decline until smoking itself becomes considered socially unacceptable and smoking rates plummet because it become easier to legislate against without political opposition. Whatever happens smoking in the UK looks to be going down.
The situation in the developing world is shockingly different however where smoking rates are increasing by about 3.4% per year. For every three cigerettes smoked world wide at least one is in China.(http://news.bbc.co.uk/1/hi/3758707.stm#china0). Tobacco companies have looked to the developing world for a market with enough wealth to afford a luxury (albeit a deadly on) like smoking under government which lack the tough control needed to enforce smoking legislation and cannot afford to ignore the tax benefits smoking provides. In this environment tobacco companies can make millions at the expense of the health of the people. As two of the biggest tobacco companies, British American Tobacco and Imperial Tobacco, are British this effectively means the UK is a net exporter of smoking-related diseases.
How we respond to the spread of tobacco in the developing world is a difficult issue. It would be hard to instruct and help developing countries to legislate on tobacco without fitting the much-hated stereotype of the prosperous westerners reliving the glorious days of the British Empire when a white man was needed to solve the big problems for the blacks. Given that our own companies are doing the damage any move of this sort would be obviously hypocritical. Tony Dalamothe takes the view that the only thing we can do is chuck these companies out of the country because they shame us all the time they are here. Is the only ethical way to deal with the problem would be to try to ignore the death and suffering from tobacco until developing countries have the confidence to legislate against the problem themselves?
(I recommend visiting the website of British American Tobacco and Imperial Tobacco for an entertaining PR masterpiece in excuses and apologies: http://www.bat.com/group/sites/uk__3mnfen.nsf/vwPagesWebLive/DO52AMD7?opendocument&SKN=1
The company’s overall message about delivering a high quality product, value for shareholders and responsibly farmed goods tries to hide the spread of smoking-related death and irresponsible selling that goes on. Worse still the companies are trying to jump on the anti-smoking bandwagon by campaigning against black-market tobacco that is more easily accessed by children (and no doubt harming their profit margins).)
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