New Zealand health experts are at the forefront
of a new international effort to make the world tobacco-free by
University of Auckland professors Robert
Beaglehole and Ruth Bonita, with the backing of health and
addiction experts from around the world, are calling on the United
Nations to lead a "turbo-charged" effort against the tobacco
It's timed to coincide with the next World
Conference on Tobacco or Health, which will be held in Abu Dhabi
In perhaps a nod to the difficulties of wiping
out use of one of the world's most popular addictive substances,
the experts are defining tobacco-free as being used by under 5
percent of all adults - and they're not calling for
Writing in the latest issue of medical
journal The Lancet, the Kiwi pair - along with
Derek Yach of the Vitality Institute of New York, Judith Mackay of
the World Lung Foundation in Hong Kong, and K Srinath Reddy of the
Public Health Foundation of India - present a four-step approach
they believe could tobacco could be "out of sight, out of mind, and
out of fashion - yet not prohibited".
"The justification for the endgame is the
uniquely hazardous and highly addictive nature of tobacco products
and the need for more radical solutions to address the failure to
achieve rapid and substantial reductions in the prevalence of
tobacco use," they claim.
Firstly, and most urgently, the researchers
want "the inclusion of an ambitious tobacco target in the post-2015
sustainable development health goal"; secondly an "accelerated
implementation of the WHO Framework Convention on Tobacco Control
(FCTC) policies in all countries, with full engagement from all
sectors including the private sector - from workplaces to
pharmacies - and with increased national and global investment";
thirdly, "an amendment of the FCTC to include an ambitious global
tobacco reduction goal"; and lastly, a "UN high-level meeting on
tobacco use to galvanise global action towards the 2040
tobacco-free world goal on the basis of new strategies, new
resources, and new players".
"Decisive and strategic action on this bold
vision will prevent hundreds of millions of unnecessary deaths
during the remainder of this century and safeguard future
generations from the ravages of tobacco use," they write.
In 1980, it was estimated 41 percent of adult
men and 11 percent of adult women smoked. In 2012, that had fallen
to 31 percent and 6 percent respectively.
But the tobacco industry hasn't seen a
corresponding fall in income, because population growth pushed the
number of smokers up from 720 million to almost 1 billion.
The Lancet estimates only 10
percent of the world's population live in countries with adequate
control measures - for example, hefty taxes on cigarettes - and
only 15 percent have access to smoking cessation programmes.
The 2040 goal lags 15 years behind the New
Zealand Government's aim of making the country smokefree by
Prof Richard Edwards, co-head of the University
of Otago's Department of Public Health, says both are ambitious
targets that won't be achieved without making drastic changes.
"Business as usual using current interventions
is unlikely to be sufficient to achieve Smokefree 2025,
particularly among Maori communities.
"There are no major new tobacco control
interventions in the pipeline (although standardised packaging and
refreshed pack health warnings are hopefully still on track). More
fundamentally, the lack of any comprehensive Government plan as to
how Smokefree 2025 will be achieved suggests a lack of rigorous
planning and of political will and momentum."
Assoc Prof Nick Wilson of the University of
Otago agrees the target is ambitious, but the world's managed
similar feats before, eradicating diseases like smallpox and
dramatically reducing the impact of polio and HIV.
"We need to plan for ongoing tobacco tax
increases after the current series ends in January 2016. We need
[plain] packaging passed into law. We also need new laws on
expanded smoke-free areas to protect children from secondhand smoke
in cars and playgrounds.
"But more importantly we really need one or
more major new strategies to ensure success with the tobacco
endgame. These might include phasing down of retail outlets or
possibly phasing down nicotine levels in smoked tobacco."
A potential roadblock for the WHO could be
international trade treaties, which give tobacco companies the
right to sue countries that threaten their revenue. The
Lancet article focuses on Finland, which has a stated
objective to eliminate tobacco use by 2040 - going so far as
"The major danger to Finland's strong stance
could ironically come from their membership of the European Union
and its Tobacco Products Directive, which could interfere with
individual governments' right to enact stricter legislation," the
Australia has been challenged in court over its
plain packaging ban, and the UK seems to be heading for a similar
Former Maori Party co-leader Tariana Turia, who
spearheaded much of the Government's recent efforts to curb
smoking, will be honoured at next week's conference for or her