The tobacco industry

“More people smoke today than at any other time in human history. One person dies every ten seconds due to smoking-related diseases. Research evidence in the past five years shows a bleaker picture of the health danger of smoking than previously realised. Tobacco is the biggest killer, much bigger in dimension than all other forms of pollution.
Children are the most vulnerable. Habits start in youth. The tobacco industry knows it and acts accordingly. This is a medical challenge, but also a cultural challenge. Let us all speak out: tobacco is a killer. It should not be advertised, subsidised or glamourised. Adolescents should not be allowed to mortgage their lives to the seductive advertisements of the industry.
Girls and women are being targeted all over the world by expensive and seductive tobacco advertising images of freedom, emancipation, slimness, glamour and wealth.
Tobacco companies should be accountable for the harm caused by tobacco use. The day I took office I launched the Tobacco Free Initiative (TFI) to spearhead the struggle to reverse the worsening trends in health caused by tobacco and to add momentum to a critical public health struggle.
The initiative aims at heightening global awareness of the need to address tobacco consumption. It also seeks to build new partnerships and strengthen existing partnerships for action against tobacco; to commission policy research to fill gaps; and, to accelerate national and global policy to implement strategies. The way it works illustrates the way we wish WHO to work in the future making the most of our own resources and knowledge and drawing heavily on the knowledge and experience of others.
Our goals are to:
• build “a vibrant alliance” between WHO, UNICEF, the World Bank, and “partnerships with a purpose” with non governmental organisations, the private sector, academic/research institutions and donors.
• try to get more people to work on and support tobacco control activities and ensure that more resources are committed to tobacco research, policy and control.
• develop the Framework Convention on Tobacco Control (FCTC), the world's first public health treaty. The treaty will only be effective if it works in conjunction with, and builds upon, sound domestic interventions. The good news is that the epidemic does not have to continue this way. There is a political solution to tobacco – a solution routed through ministries of finance and agriculture as well as health and education. We know that tobacco control measures can lead to a reduction in smoking as witnessed among some member states. WHO, the World Bank and public health experts have identified a combination of the following as having a measurable and sustained impact on tobacco use:
• increased excise taxes;
• bans on tobacco advertising, sponsorship and marketing;
• controls on smoking in public places and workplaces;
• expanded access to effective means of quitting;
• tough counteradvertising;
• tight controls on smuggling. These must all be implemented if the predicted expansion of the epidemic as outlined in this atlas is to be prevented. The picture is far from bleak. Globally, we have seen a sea change over the past few years. A groundswell of local, national and global actions is moving the public health agenda ahead.

A message from
Dr Gro Harlem Brundtland
Director-General
World Health Organization

Tobacco use - cause of illness

Tobacco use is the leading preventable cause of death and illness in the United States, causing more than 443 000 deaths each year. The consequences of tobacco use include harms to the health of the fetus, such as low birth weight and sudden infant death; harms to children from tobacco use and secondhand tobacco-smoke (SHS) exposure, including respiratory illness, infection, and decreased lung function; the uptake and establishment of tobacco use and nicotine addiction by the next generation; fires attributable to smoking; the economic costs of purchasing tobacco and tobacco-use materials; litter and debris from tobacco products; additional cleaning and maintenance of facilities in which tobacco is used; the health care and emotional costs of diseases associated with tobacco use and SHS exposure; and the costs to families and society because of poor health and lost productivity.

Most tobacco users (
80%) started using tobacco products before 18 years of age.Initiation of tobacco use is often instigated by exposure to tobacco use by parents or peers, depiction in movies and other media, advertising targeting children and adolescents, and other environmental and cultural factors. The connection between children and tobacco use is so strong that the commissioner of the US Food and Drug Administration declared tobacco use a “pediatric disease” in 1995.

Tobacco use is a pediatric disease because of the extent of harms to children caused by tobacco use and SHS exposure, the relationship of pediatric tobacco use and exposure to adult tobacco use, the existence of effective interventions to reduce tobacco use, and the documented underuse of those interventions. This statement provides guidance for providers of pediatric services, including the American Academy of Pediatrics (AAP) and its members, and summarizes other AAP policies that have addressed tobacco use and control. Because tobacco use has significant effects on children and families, its management has been reviewed in many AAP policies and official documents.

The information and recommendations described in this statement are consistent with recommendations in the other AAP publications cited as well as with tobacco policies from other clinical professional membership organizations, including the Academic Pediatric Association, the American Academy of Allergy Asthma & Immunology, the American Academy of Family Practice, 21 the American Academy of Pediatric Dentistry, and the American Medical Association. The policy is accompanied by 2 technical reports: “Secondhand and Prenatal Tobacco Smoke Exposure” and “Tobacco as a Substance of Abuse.”The AAP recognizes the dangers of tobacco use and SHS exposure to children’s health. Tobacco control was named a strategic priority by the AAP in 2005, and the Julius B. Richmond Center of Excellence (www.aap.org/ richmondcenter), dedicated to the elimination of children’s exposure to tobacco and SHS, was established in 2007 to foster tobacco-control initiatives at the AAP.