The world tobacco epidemic

Health Minister Dr Louis Deguara last weekend addressed the Euromed consultation meeting on the economic control of tobacco. Following are extracts from his speech - in which he emphasises the need to face up to the grim reality of tobacco smoking

The world is faced with an epidemic, the tobacco epidemic. Without sounding alarmist the truth is that a billion people around the world are currently smokers, people who are addicted to an engineered drug-delivery device of nicotine, a substance claimed to be more addictive then heroin.

One billion smokers actually translates into 16.67% of the world’s population which according to the US Census Bureau stands at around six billion. Let us not forget that the rest of the world’s population, a good five billion, are at risk from the hazards posed by passive smoking.

Cigarette smoking is undisputedly damaging human health on a global scale. 1 in 10 adult deaths worldwide is a result of smoking-related diseases. By 2030, if not sooner, the ratio will be 1 in 6 ie. 10 million deaths a year with the result that smoking is the largest single preventable cause of death. This devastating epidemic has shifted from the populations of rich countries to the developing world as the tobacco industry flexes its muscles with heavy marketing and advertising to hook new addicts.

We must face up to this grim reality. Tobacco use is damaging our people and our societies. We might feel it is inconvenient to talk about it and that it makes us feel uncomfortable.

We might not fully appreciate the disabling and fatal diseases that tobacco causes. However we might choose to see the tobacco issue and from which ever angle we debate it: be it public health, economy or social impact, the bottom line is that human life and health are too precious to be neglected.

If global economy is to thrive, and thrive well sustainably, it is imperative that health is safeguarded within that process so that human development is encouraged. On the darker side, when health is side-tracked to safeguard the economy, the results on human well-being are disastrous. Such a disregard for human values is wrong and inappropriate.

I am sure that many of you here, only last month, read in the international media a study recently commissioned by one of the tobacco giants in an attempt to convince governments that tobacco consumption saves us money in pensions, housing and health care as a result of premature deaths. Such an inhumane analysis leaves me wondering as to how anyone could consider a cost-benefit analysis of human lives. Thanks to the uproar of the pro-health activists, the tobacco transnational which paid for the report apologised and admitted that it was wrong in the first place. I am sure you all wonder if this U-turn in thinking was well-intended.

If one had to ever consider the erroneous assumptions made in this report then it would be correct to state that governments of tobacco-burdened countries are enjoying surplus in their finances and we could all wake up tomorrow to a tax-free world. All of us gathered round this room know that this is far from the truth. All of us here are well aware that where this merchandise of death is left to flourish and thrive it is at the expense of human potential and human life.

Any government who believes that smokers save us money due to their untimely deaths, is entirely off-track. The real calculations and cost analysis reveal that the high cost burden posed by tobacco consumption makes it nothing less than a liability.

Furthermore economic and epidemiologic studies assess that trade liberalization in tobacco products has a significant negative impact on public health in low and middle-income nations

Well established economic theory indicates that free trade generally leads to lower prices, greater competition, more vigorous marketing and greater economic efficiency. All these factors will lead to increased production and consumption of the traded good.

This is the ultimate goal of free trade and the justification for free trade policies if the product in question is a good in a literal sense. The problem with tobacco is of course that it is not a beneficial product, definitely not one that can be classified as good.

Each unit of tobacco consumption causes additional death and suffering, as well as a net economic loss to the economy of the nation in which it is consumed and to the global economy. When applying the free trade concept to tobacco it backfires onto the economy. It is therefore logical to state that if the use of a product is harmful all measures should be taken to decrease the trade of the said product.

We therefore have no reason to treat tobacco like any other consumer product. I would like to remind you at this point that when used as intended tobacco kills well over half of its long-term users. The current global death toll has already reached 4 million lives per year. This depressing figure is forecasted to double in developing countries alone within the next two decades.

Let us also not forget that each year approximately 400 billion cigarettes end up illegally smuggled across international borders. Cigarettes are the world’s most widely smuggled legal consumer product. This poses evasion of duty fees and taxes whilst having a direct influence to increase the number of smokers by providing a less-expensive cigarette thereby adding further insult to injury.

From what I have described so far, I am sure that you can already figure that tobacco and its merchants are a liability to societies everywhere. Dragging our feet and going slow on tobacco control policy is also resulting in increased teen smokers specifically in females. In my country alone results from a health behaviour survey carried out amongst school-aged youths just last year, alarmingly reveals that 16.38% of girls aged 14 years and younger, smoke when compared to 14.8% boys within the same age category. This is nothing less than tragic but a reflection that the increase in female smoking is a global concern. Young tobacco recruits are hardly conscious of the future costs of smoking. Little do they realize the difficulty in reversing a decision made in their youth partly due to the nicotine addiction.

With all these facts at hand it is time for us to show solid leadership and to refrain from abdicating our responsibilities toward this issue. In a tobacco-free world we will spend our money on other goods, we would be genuinely saving on health care, improving human productivity and enjoying less suffering, less pain and less grief of relatives.

I cannot emphasize enough the benefits to our cause in reducing the burden caused by tobacco, when the health and financial sectors work hand-in-hand. Our goals are the same. The two sectors thrive on sustainable development. Development that results from the right investments. Let us ensure that we choose well, that the investments we make safeguard a symbiotic partnership between economic sustainability and healthy nations. Economic investment that thrives on the poisoning of human health is a parasitic situation which we need to avoid at all costs. It is therefore imperative that the denormalisation of tobacco is not only in the hands of leaders in public health.

I am sure that this technical consultation meeting will not only clarify as to why a solid partnership is vital between the health sector and finance one but it will also provide ideas as to how this can be achieved. I sincerely hope that following this consultation meeting in Malta we will all have a better understanding of the mutual benefits arising from working together as we focus on the common goals of tobacco control. We need to shape tobacco control policies together so that we really and truly reduce tobacco consumption. I believe our collective support as nations, towards the framework convention on tobacco control, is a must for all those of us who have at heart the future prosperity of their country. It is the only way of curtailing the manoeuvres of the tobacco cartel and thereby reducing the global toll of tobacco-related death and disease.

May I close by wishing you all a pleasant stay on our island which I hope will provide you with the right setting for your discussions over the next few days.