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The Transnational Tobacco Companies (TTCs) are targeting less developed countries. "Tobacco Control in the Third World" looks at the problem in a global way. This helps compare countries which is important in measuring progress. The Book's other progressive aspect is that its sponsor, the American Cancer Society has reached beyond the US and the Health Establishment to cooperate with the International Consumer Movement. It may be the beginning of a team effort.
Information came from questionnaires sent to health workers all over the world, the US Dept of Agriculture, the UN and the Tobacco Industry itself.
By the year 2000 80% of the world's population will live in less-developed countries (LDCs). These countries already consume more tobacco than the developed countries.
Women as Targets
Women's smoking is often low in the 3rd world so there is great potential for TTCs to increase tobacco consumption.
Information on 3rd World Health problems of all types is poor, with tobacco it is even worse. But health problems are only a minor part of the tobacco story. The UICC (International Union Against Cancer) has pointed out that tobacco is a major issue in LDCs mainly from an economic perspective.
3 Major Tobacco-Caused Problems are:-
1. Money used for tobacco purchase
causes malnutrition in poor families.
2. Tobacco cultivation and using wood to flue-cure causes deforestation.
3. Most developing countries have huge
trade deficits in tobacco products
which drain their economies.
Activists must have economic facts if they are to argue against tobacco.
The book discourages generalisation and looks at situations country by country. It claims to be realistic but not dispassionate. While it concedes that countries like Zimbabwe and Malawi have gained trade benefits from tobacco it points out that the average person in Malawi has gained little- it is still one of the worlds poorest countries.
Some Health Facts
Health aspects of tobacco are generally regarded as unimportant in the poorest countries where life expectancy is more than twenty five years less than Western values. The major effect is that tobacco competes with food for purchasing power.
Smoking only 5 cigarettes a day in Bangladesh translates into a monthly deficit of 8,000 calories, nearly a quarter of the diet of a 12kg child. Low birthweight is a major problem in the 3rd world, yet babies born to smokers are on average 200gm lighter than non-smokers' babies in the same ethnic group and socioeconomic class. In India the stillbirth rate amongst women who chewed tobacco was 50 per 1000 live births, in non-chewers only 17 per 1000.
Wealth and Poverty
The general level of wealth is seen by the tobacco industry as the major factor determining the level of tobacco consumption. Consumption rises greatly with income up to a per capita annual income of about US$5000. After this the effect is less. The question is whether or not this is the result of tobacco control policies in these richer countries.
But the poorest countries are not the most targeted by TTC's, as they cannot buy! Countries specially targeted are those with large recent rises in income.
Cultivation of Tobacco
In 1985 4.1 million hectares of land were under tobacco cultivation - 73% of this in developing countries. This is 0.3% of the world's arable land, compared with 0.7% for coffee, 2.3% for cotton and 16.3% for wheat. Malaysia has the most at 4.6%, Zimbabwe next at 3%.
The reason poor farmers grow tobacco in countries short of food is that the return per hectare may be 5 times that of maize and 3.4 times that of coffee or groundnuts. TTC's tend to pay growers cash. Other commodity buyers cannot offer the same support. But at times alternative crops are cost effective and why they are not tried may be political rather than economic. The World Bank invested US$1.6 billion in 19 countries' tobacco projects between 1974 and 1988.
Tobacco depletes soil faster than other crops so if fertiliser cannot be afforded, deforestation is needed to get fertile soil for tobacco. Pesticides and herbicides are ingested and washed into rivers.
"The drought and uncertainty over food supplies created a reluctance among customers ... to spend their limited cash on cigarettes. Under these conditions volume sales did well to achieve modest growth..".
- A Tobacco industry comment on the 1984 famine in Kenya.
TTCs boast of their economic benefits but of 65 LDCs exporting tobacco only 16 (25%) got over 1% of their total export earnings from it. 92 LDCs together earned US$1.9 billion for tobacco and bought $1.2 billion worth- a gain of $700 million for 92 countries. But 79% of this benefited only 8 countries (Malawi, Zimbabwe, Turkey, India, South Korea, Thailand, Brazil and Cuba). 58 countries (63%) spent more than they gained, Egypt lost $US178 million in 1984.
Countries with soft currencies lose out. They have to pay hard currency to import tobacco. e.g. Senegal had a 1988 balance of payments deficit of US$248 million, and a total deficit of US$3,000m Its tobacco trade deficit was US$27m.
Countries with low tobacco consumption and low income can either control tobacco use now or develop a domestic tobacco industry. We must try to persuade these Governments to take the former course.
Monopolies v. Transnationals
Tobacco monopolies often see their role as overseeing tobacco production for a market, and are willing to cooperate with health authorities in their nation. TTC's are an altogether different proposition. They quickly outmarket the monopolies, buy influence in the Govts, swamp health considerations and export capital. Tobacco taxes to Governments are merely transfer payments within the economy. They do not make countries richer.
The major 3rd world problem is the environment. Wood for tobacco curing is a major cause of damage. Brazil, India, the Philippines and most of Africa (except Zimbabwe) use wood. A wood shortage is looming in Malawi and Tanzania with deforestation in tobacco growing regions.
In Kenya BAT requires each farmer to plant 3000 trees. This needs at least 1.5 hectares, more than the average plot! Chapman says the BAT 'requirement' is just public relations. The Earthscan Report 1984 commented "If tobacco farmers had to pay for their fuel or ..planting trees .. they would no longer be competitive in international markets".
Though BAT had a monopoly in Kenya, mobile cinema units (MCUs) travelled the country showing films and cigarette ads and giving out free cigarettes. The same happens in Indonesia. Youth marketing is blatant and uses Western themes.
Education in LDCs is poor and cannot compete with tobacco promotion through retailer outlets. Only Schools, religious groups, and the medical system offer any hope of health education.
A number of case studies illustrate how the Tobacco Industry works. e.g.
- BAT Kenya exerted pressure to stop farmers setting up a co-operative so they could bargain with them.
- Malawi enjoys a $US162m surplus in tobacco trade, 60% of all exported commodities but has the 6th lowest per capita income in the world.
The striking factor of most LDCs is the trade deficit in tobacco. In India approximately 630,000 people die annually from tobacco caused diseases. Reverse chutta smoking is common (i.e. having the lighted end in the mouth). Only a minority of smoking is cigarettes. India is the 3rd largest tobacco producer after China and the United States.
In the Philippines a small group of lawyers have taken a class action to stop tobacco companies having different tar standards from the US. This has major ramifications for 3rd world countries. As well as the defence that it is subsidiaries (not them) selling cigarettes the companies have cross-sued the lawyers, who will be bankrupt if they lose.
Taiwan had its tobacco trade forced open by US pressure in January 1987. It now has unprecedented tobacco advertising. Youth is targeted using cigarette packets to get into discos. The amount of US cigarettes sold increased 24 times in the first year of deregulation. The private John Tung Foundation opposes this.
The Thailand Tobacco Monopoly (TTM) ceased all advertising in 1985. Foreign cigarettes which cannot be legally imported still advertise! The US is trying to open the market, and has taken the matter to GATT, (the General Agreement on Tariffs and Trade).
Brazil exports 58% of tobacco produced and is the 2nd largest exporter of tobacco after the USA. Tobacco is an important cause of deforestation.
Brazil also has probably the highest level of tobacco advertising per capita in the world. When advertising stopped for a year, cigarette sales fell 4.8% in nine months.
US 'TRADE FOR LIFE' - A GLOBAL PLAN
The American Cancer Society (ACS) has launched "Trade for Life", a "Global Plan to resist aggression by TTCs".
There are 3 Objectives for the Plan:
1. To act in exporting countries to reduce trade in tobacco and curb the marketing aggression of TTCs (Transnational Tobacco Companies).
2. To place tobacco control at the top of the agenda of Government and non Government health and development organisations.
3. To increase resistance to TTCs especially in targeted and potentially targeted countries.
U.S. As The Problem
The US is particularly guilty as it is suing Thailand in the GATT (General Agreement and Tariffs and Trade) court to force it to open its markets to US tobacco. US-based TTCs are also very hypocritical in their overseas marketing, selling with tar levels and promotions that would not be allowed in the US. The US is the world's largest tobacco exporter (217,000 tonnes in 1986).
The campaign involves getting the US to drop its GATT case and have its companies bound by the same standards overseas as they are in the U.S.
Another important agenda item is to get the attitudes to tobacco changed amongst UN agencies. This involves getting the World Health Organisation (WHO) to put more energy into the tobacco issue and stopping the Food and Agricultural Organisation (FAO), UN Development Programme and UN Environment Programme from helping tobacco projects.
The attempt to raise the priority of tobacco within WHO is a battle. WHO has allocated an extra US$600,000 for the tobacco and health project but this still represents less than 1% of its budget. It sees itself as implementing consensus policies. Unless this view is changed the problem comes back to the US and a few other countries blocking stronger action.
The flow of information on how to counter the TTCs is to be helped by the development of the ACS GLOBALink computer network- to be co-ordinated through the Advocacy Institute in Washington. This information will be immediately available.
HOPE FOR ACTION
ACS has realised that co-operation is important and intends to involve groups outside the US in the struggle, including International Non-Govt Organisations (NGOs) and IOCU (International Organisation of Consumer Unions).
Comprehensive Tobacco Control Acts allow years of accumulated knowledge to really have an effect. e.g.New Zealand and Singapore. Techniques developed in the West, the model legislation on Globalink, and the availability of facts will help. Other important functions are to translate research both into other languages and into more simple and action oriented forms.
Profit from 1st World sales still provides the capital that funds the 3rd World marketing. Sales volumes are high in 3rd world, but profit margins are small. So 1st World campaigns are very important.
Another item is to identify countries especially vulnerable to TTC attack. TTCs target countries that have had rapid rises in their per capita incomes. Consumers have unaccustomed disposable cash and TTCs try to turn that into a tobacco addiction. Simple economics will tell which countries these are.
The ACS acknowledges that this plan will work only if it has general support. There must be recruitment beyond just health workers. Environmental groups, International Aid group and community groups must be encouraged to help for a better world.
About the Authors of 'Tobacco in the 3rd World - A Resource Atlas'
Dr Simon Chapman lectures in Public Health. He has been an important link between the activists and academia.
Wong Wai Leng, a Malaysian Chinese has worked with the IOCU group in Penang.
'Tobacco in the 3rd World - A Resource Atlas' is available for $US15 from IOCU, PO Box 1045, Penang Malaysia
A good poster 'Smoking Can Cost the Earth' - ACOSH, PO Box 98 W.Perth 6005 (09) 322-6474 $2 single, 50c each extra.
GLOBALink - Advocacy Institute, 1730 M St., NW, Suite 600, Washington DC 20036-4505 USA. Ph (202) 659-8475
For copies of this article - Contact the Non-Smokers Movement of Australia,
Box K860, Haymarket NSW 1240.
TOBACCO AS PART OF GLOBAL ECOLOGY
The American Cancer Society's 'Trade for Life' programme is to be welcomed. The idea that trade should not promote death is clearly an important one. The ACS should also be congratulated for reaching beyond US borders for support and even for advice.
But if the US has traditionally been an inward looking nation, it is perhaps not a bad thing, if 'Trade for Life' retains this focus. The US is home to many of the biggest tobacco companies, Philip Morris and RJ Reynolds in particular. US pro-health campaigners are winning at the grass roots. They have persuaded middle American citizens that tobacco is not good and sales are falling despite record advertising levels. They are getting local ordinances passed frequently and state ordinances often. But at the higher Federal level where dollars and lobbyists speak, less progress has been made. When the Administration and Congress talk of foreign policy progress is even less. US financial interests win.
The US record in its votes on baby food regulations, tobacco and production of ozone depleting chemicals has been poor. The US forcing of Japan, Korea and Taiwan to open their markets to tobacco and its current bullying of Thailand is more reminiscent of the European bullying of China to force it to accept opium than of a nation fighting for world morality.
The naked use of trade power to force tobacco on other nations damages US credibility. When the US criticises the EEC or Japan for protectionism or demands action on whaling or drift net fishing what credibility does it have? US pro-tobacco foreign policy is a major obstruction to fairer world trade and co-operation for a better environment.
Good US activists battling 'money power' have a tough job. Former US Surgeon-General C. Everett Koop says "It makes me embarrassed to be an American". But the fact that the American Cancer Society is trying to put pressure where it matters and is willing to recognise the value of teamwork is a major step forward.