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Pratap Ravindran

THE World Health Organisation (WHO) is blowing smoke when it says, as it did on October 14 in Geneva during talks on a global tobacco control treaty, that developing countries must increase taxes on tobacco products because "cheaper tobacco products will only fuel the tobacco epidemic further — leading to more consumption, disease, and death in the future".

`Epidemic' is about right because, according to WHO estimates, there are 1.1 billion smokers in the world today, and this number is expected to rise to 1.64 billion by 2025. About four million people die each year from tobacco use, and, if current trends continue, will escalate to 10 million by the early 2030s, with 70 per cent of those deaths occurring in developing countries. Based on current smoking trends, tobacco will soon become the leading cause of death worldwide, causing more deaths than HIV, maternal mortality, automobile accidents, homicides, and suicides, combined.

The WHO is getting worked up because tobacco products in the developing world now cost less than they did 10 years ago though there is overwhelming evidence that higher prices reduce consumption, especially among the young and the poor. The evidence that the WHO is referring to, presumably, includes a World Bank study, which estimates that a 10 per cent global increase in the real price of cigarettes (over and above inflation) will induce approximately 42 million smokers to quit the weed, and deter millions of others from taking up smoking. Somebody, somewhere must be listening to the World Bank because, as a WHO study of 80 countries establishes, cigarette prices in the developed countries have generally increased, while the prices have decreased in many poor countries over the decade ending 2000.

The WHO, for its part, is of the view that governments must tax tobacco products in a manner that ensures an annual price increase of at least 5 per cent ahead of inflation, if a deterrent effect is to kick in. The governments, it says, must then deploy a part of the tax proceeds to finance tobacco control programmes.

Let us take a look at the realities in India. The Government of India can tax tobacco products till it is blue in the face but will not record any deterrent effect for the simple reason that the makers of these products will (a) understate their sales, and (b) sell their products at a price free of tax. This will suit everybody — the government because it is doing the politically correct thing; the politicians and bureaucrats because they can extort more bribes from the manufacturers of tobacco products; the manufacturers themselves because they get to pay more bribes to the politicians, and the bureaucrats, using money that should have gone into the exchequer but did not, thereby giving them more clout; and users of tobacco who continue to get their product.

That is as far as India goes. At a different level, the problem is, of course, that Big Tobacco is far too powerful to be taken on by some well-meaning health freaks. Big Tobacco is about money, and does not care about people's health. And the WHO knows this. Its July 2000 report, "Tobacco Company Strategies to Undermine Tobacco Control Activities at the World Health Organisation", states unequivocally that "tobacco is a case unto itself", and that "reversing its burden on global health will be not only about understanding addiction and curing disease, but just as importantly, about overcoming a determined and powerful industry". An industry which, incidentally, has the firm support of the US government. How on earth can a Third World government be expected to introduce measures which will, in real life, limit the sale of tobacco products?

There's dark humour in the fact that the average man on the street in developing countries is not aware how important he is to tobacco transnationals such as Philip Morris, British American Tobacco, and R.J. Reynolds.

He does not know, for instance, that international trade is central to the world's largest tobacco companies, and he embodies their future. The US-based Philip Morris earns more than half of its cigarette profits overseas, gets about two-thirds of its tobacco revenues from foreign markets, and sells more than three-quarters of its cigarettes outside the US. The company has established its current position of dominance in the global marketplace after two decades of massive overseas spending to advertise its products, buying newly privatised cigarette companies, setting up joint ventures, and building distribution networks. Tobacco companies hate spending money unless they are certain that the expenditure will result in significant profits. In this case, they figured out that their future markets lie in developing countries, where the people are far too poor, and ignorant, to worry about their health. As for the backing that they have from the Governments of the US, Germany and Japan, one has to look no farther than the fifth round of negotiations that just took place now (October 14-25) on the proposed tobacco control treaty called "Framework Convention on Tobacco Control".

The US government is working with great enthusiasm to weaken the treaty deadlined by the WHO for completion by May 2003. It is doing so, primarily, by insisting that tobacco products be retained under trade law.

The implications of Washington's stance in this regard become clear only when viewed in light of the fact that anti-tobacco activists have long been pointing out that the treaty should ideally commit nations to enact effective tobacco-control measures, and, equally significantly, protect their right to enact these measures by shielding them from being challenged as violations of trade agreements.

This issue is critical as the tobacco industry has a long history of using trade law as a tool to thwart tobacco-control policies, usually with the active support of the US Government.

For example, Philip Morris has threatened to challenge Canada's proposed ban on misleading terms such as `light', and `mild' as a violation of the North American Free Trade Agreement (NAFTA), and an international agreement on patents and trademarks.

The US Government has gone along with Philip Morris in spite of the fact that a November 2001 report by the US National Cancer Institute has tagged these terms as `deceptive', misleading people into believing that cigarettes so categorised are less harmful.

Furthermore, the US has supported FCTC provisions that would subordinate the public health provisions of the Treaty to trade considerations even though a majority of the countries, including many American allies and trading partners, have supported provisions explicitly stating that public health measures enacted in accordance with the treaty should take priority when they conflict with trade rules.

Obviously, nothing much is going to come out of the tobacco control treaty until tobacco is excluded as a trade item in bilateral and multilateral agreements. After all, similar exclusions are already there in various existing international conventions — for instance, the Basel Convention on the Control of Trans-boundary Movements of Hazardous Wastes and Their Disposal (1989), and the Montreal Protocol on Substances that Deplete the Ozone Layer (1987) — that govern the traffic of environmentally harmful materials, including toxic and hazardous waste, pesticides, and biologically-altered organisms.

Can the relentless invasion of Third World markets by Big Tobacco be stopped or, at least, slowed down. Yes, it can. But not by the governments of poor countries, which have agendas of their own, and, not necessarily congruent with the interests of the people.

The best way of bringing down a big and powerful industry is by shooting it in the hip pocket. John and Jane Doe in the US have already tangled with tobacco companies in the court... and won.

Right now, Big Tobacco is distinctly edgy because of a recent case which resulted in the largest verdict for a single plaintiff in the US history — a $28 billion punitive award against Philip Morris in Los Angeles. The case, which is being called a forerunner of judgments to come by the plaintiff's attorney, involves a plaintiff 64-year-old Ms Betty Bullock, who was diagnosed with lung cancer in early 2001.

The cancer subsequently metastasised to her liver, and she is not expected to live much longer. According to Ms Bullock's counsel, Mr Michael J. Piuze, she sued Philip Morris for fraudulently concealing the danger of its products.

Mr Piuze followed the strategy established in his previous win against Philip Morris, using documents from the industry to assert that tobacco company personnel disputed scientific studies linking tobacco use to cancer, despite knowledge of the dangers of smoking, in order to preserve the market.

To cut an extended, and highly convoluted, courtroom story short, Mr Piuze successfully introduced in court an internal Philip Morris memo written three weeks after the 1964 release of the surgeon-general's report linking smoking to lung cancer. In a segment of the memo on the company's prospective public relations response to the report, the author advises that "we must in the near future provide some answers which will give smokers a psychological crutch and a self-rationale to continue smoking."

Mr Piuze also used the March 1998 testimony of Mr Geoffrey Bible, then chairman and CEO of Philip Morris. Mr Bible had been asked, Mr Piuze told the jury, "Do you know how many people have died as a result of smoking?" Mr Bible had answered, "I don't know if anybody has died." To another question, Mr Bible had asserted, "I do not believe that cigarette smoking causes cancer." This was evidence enough, Mr Piuze told the jury, of an ongoing effort to commit fraud.

On September 26, the Los Angeles jury awarded Ms Bullock $650,000 in compensatory damages, then added $28 billion in punitives on October 4. Philip Morris says it will be filing motions to set aside or reduce the verdict.

What then? The sad truth is that there is no easy way out. Poor people just do not have the resources to take on big companies in court. In such circumstances, the best we can hope for is that non-governmental organisations will do something to make people understand that they are being manipulated into getting addicted to cigarettes, and other tobacco products. If a sufficient number of people start boycotting tobacco products, there is very little that corporations, with all their resources, can do.

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