The World Health Organization will congregate today in Geneva and may vote to ratify the Tobacco Control Convention. Like U.N. environmental treaties, the convention would export stringent controls from the West to developing countries. It would not be a global treaty, however, as 34 poor countries have had their voting rights withdrawn for falling a few thousand dollars behind in their WHO contributions. Nevertheless, if the convention is approved, much money will be spent on anti-tobacco education. The poor African countries, which might have preferred help in combating infectious and water-borne diseases, have been disenfranchised by the WHO.
Part of the WHO's new fervor can be attributed to its director general, Gro Harlem Brundtland, who took over last July. Dr. Brundtland is a talented woman and a consummate politician who, as Norway's prime minister, pioneered global environmental politics. But now she has moved on to safeguarding the world's good health. In particular, she has two main focuses: saving innocent children from malaria and saving naughty grownups from tobacco. As regards malaria, it is about time; in Africa, a child dies every minute from this devastating disease. As for tobacco, we can see where this campaign is headed from the call Dr. Brundtland made last week for cigarettes to be available on prescription only, like nicotine patches.
Dr. Brundtland's evangelism reaches beyond Africa. She has persuaded the World Bank to join forces with the WHO in recommending a world-wide price increase of 10% a year on cigarettes over the next decade. The Bank's new report "Curbing the Epidemic: Governments and the Economics of Tobacco Control," to be issued this week, also demands a ban on tobacco advertising and suggests that funds raised from taxation should be spent on more research and anti-tobacco education programs.
At the World Bank, Dr. Brundtland has found an equally eager crusader. Since he took over as head of the bank in 1995, James Wolfensohn has tried to create a socially responsible image and is actively supporting the WHO's Tobacco Free Initiative. But "Curbing the Epidemic" ignores sense, science and economics. The report's key assumption is that many smokers are ill-informed of the dangers of tobacco; by the time they become aware, their addiction to nicotine precludes them from making a rational decision.
It is patently absurd to claim that lack of information about tobacco's harms is the main reason people begin smoking, since the dangers of smoking have been known for three decades in developed countries. On the other hand, if the World Bank expects 40 million people to quit world-wide on account of a 10% price increase, as the report suggests, its assumption of an irrational addiction is overplayed.
"Curbing the Epidemic" also makes other ludicrous claims. Premature death in middle age includes deaths occurring at up to 69 years of age. This definition is arrived at by using life expectancy in Japan as the standard. However, Japan has the greatest expected longevity in the world at 80. For most of Africa, life expectancy is between 45 and 60 years, and 10% of babies will die in their first year.
It gets worse. In one of the report's most confusing sections, the authors admit there's "a large body of econometric research that finds that advertising has little or no effect on aggregate cigarette consumption." Undeterred, the World Bank commissioned research that apparently finds that advertising does increase smoking, but doesn't significantly affect overall consumption. Because of this convoluted thinking, the report supports the World Health Organization move to ban tobacco advertising world-wide.
All in all, the World Bank is peddling nonsense. The smoker who is supposedly burdened with a personality-splitting addiction is about to be taxed further, and the money will go to health evangelists who will then lecture the addict. The approach should alarm those selling other so-called addictive products, such as alcohol, coffee and chocolate.
"Curbing the Epidemic" is a summary document. Because all the research has not yet been published, criticism might be premature. But, similarly, it would be unsafe to base any policy decisions on it until the underlying assumptions of all the economic models on tax, employment and, crucially, smuggling are analyzed by independent economists.
In its zeal, the World Bank has stooped to data manipulation, obfuscation and tenuous assumptions. One hopes that finance ministries around the globe will see beyond the rhetoric and tax tobacco at a level that does not lead to massive smuggling. If you thought the "war on drugs" was messy, wait until the war on tobacco truly begins. Prohibitions are not needed to make this a reality. Massive taxation increases will do just fine.
Lorraine Mooney is a medical demographer for European Science and Environment Forum, a scientific think tank in Cambridge, England, and co-editor of "Environmental Health, Third World Problems, First World Preoccupations" (Butterworth Heinemann).
Comments on this posting?
Click here to post a public comment on the Trash Talk Bulletin Board.
Click here to send a private comment to the Junkman.