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1 Premature mortality due to tobacco: Counting the dead and saving lives Neil Collishaw Research Director Physicians for a Smoke-Free Canada Ottawa, Ontario.

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Presentation on theme: "1 Premature mortality due to tobacco: Counting the dead and saving lives Neil Collishaw Research Director Physicians for a Smoke-Free Canada Ottawa, Ontario."— Presentation transcript:

1 1 Premature mortality due to tobacco: Counting the dead and saving lives Neil Collishaw Research Director Physicians for a Smoke-Free Canada Ottawa, Ontario June 1, 2007

2 2 “30,000 die while feds sit on hands”

3 3 Smokers and non- smokers life tables: R. Pearl 1938

4 4 Survivorship curves, smokers & non-smokers R. Pearl 1938

5 5 Shifting the burden of tobacco-caused death

6 6 Estimated adult smoking prevalence by WHO region, early 1990s WHO regionMen (%)Women (%) Africa 294 Americas 3522 Eastern Mediterranean 354 European 4626 South-East Asia 444 Western Pacific 608 All developed countries 4224 All developing countries 487 World 4712

7 7 The slow-moving tobacco epidemic

8 8 Achievements  Comprehensive tobacco control implemented in several countries (e.g. Slovenia, Poland, Slovakia, Estonia)  Good progress, but tobacco control still short of comprehensive in several countries (e.g. Lithuania, Romania, Czech Republic, Bulgaria, Turkey)  Committed, trained, active tobacco control workers in all 27 countries of the region  National committees and other institutions for tobacco control in several countries

9 9 Lessons learned  A systematic approach to global tobacco control is feasible  Multiplier strategies and experiential learning are important and effective strategies  Creating long-term institutional capacity is a key to long-term success

10 10 FCTC history: 1994: WCTOH calls for convention 1995: WHO asks for feasibility study 1996:WHA accepts framework convention approach 1999–2000: Working groups 2000-02: Negotiation sessions 2003:Treaty text agreed to 2004: 40 countries ratify (including Canada) 2005: Came into force on Feb. 27 2006: 1 st Conference of Parties in Feb., 2006 2007:2 nd CoP in July, 2007: 147 parties

11 11 Ten key obligations are in Articles…  5: general obligations  6: prices and taxes  8: protection from second-hand smoke  11: health warnings on packages  12: health promotion and education  13: tobacco advertising  14: smoking cessation  15: smuggling  20: surveillance and research  22: international cooperation

12 12 In the future the FCTC could:  Protect non-smokers  End tobacco advertising  Control cigarette smuggling  Protect from unfair trade challenges  Help developing countries put measures in place  Hold tobacco companies accountable  Monitor global tobacco use  Improve warnings on packages  Increase research

13 13 Cooperate… cooperation …cooperate… coopera tion …cooperation…cooperate…cooperative… cooperation…cooperation…cooperate…cooper ation…cooperate…cooperation…cooperate…c ooperation…cooperate…cooperation…coopera te…cooperation…cooperate…cooperation…co operate…cooperation…cooperate…cooperatio n…cooperate…cooperation…cooperate…coop eration…cooperate…cooperation…cooperate… cooperation…cooperate…cooperation…cooper ate…

14 14 We have a plan…  Organize regional training seminars to train trainers  Send trained workers to help in selected developing countries  Fund local personnel and projects  Ongoing monitoring and encouragement, including follow-up visits to target countries  Attract additional partners  With participation of additional partners, expand project beyond original target countries, eventually to all countries

15 15 1969: External Statements Brief to Commons Health Committee (Isabelle Committee), 1969. ITL head Paul Pare presents for industry

16 16 1969: internal research  du Maurier  Players  Matinee Minutes of BAT Research & Development Meeting, July 1969. R.S. Wade from Imperial Tobacco Canada participated.

17 17 Dr. S.J. “Jim” Green Senior Scientist, BAT UK, 1976

18 18 The dissembly continues in 1987… “It is not the position of the industry that tobacco causes any disease … The role, if any, that tobacco or smoking plays in the initiation and development of any these diseases is still very uncertain.” Jean-Louis Mercier President, Imperial Tobacco House of Commons Parliamentary Committee on Bill C- 204 and C-51. November 24, 1987

19 19 Before TPCA After TA

20 20 Are tobacco companies evil? Are they pscyhopaths?

21 21 Imperative to maximize profits  which restricts corporations from acting in ways that protect public health if the result is a reduction in short and long term profits.  122. (1) Every director and officer of a corporation in exercising their powers and discharging their duties shall (a) act honestly and in good faith with a view to the best interests of the corporation;

22 22 "The cigarette company is to the lung cancer epidemic what the mosquito is to malaria. It is the vector of disease."

23 23 The anatomy of a mosquito

24 24 Limited liability Mobility Access to capital Ability to own other corporations Separation of ownership and management The anatomy of a tobacco corporation Corporate immortality Corporate law & duty to shareholdersLimited accountability Invisible hand of the marketplace

25 25 What if we had been successful from the start

26 26 At this rate ….

27 27

28 28

29 29

30 30

31 31 Long-term solution: Tobacco can be supplied by public- interest enterprises

32 32

33 33 New potential  Tap the secret knowledge of tobacco experts  Tobacco marketers become tobacco demarketers  R&D department stops designing cigarettes that will sell more, and starts designing cigarettes that will sell less  Increase innovation  Meet the needs of smokers  End the war between Big Tobacco and public health  Resolve the ambiguity of government’s intentions  Create a more cohesive society

34 34 Revolution? Evolution?

35 35 Bolder goal-setting and tobacco control actions by governments

36 36 Tobacco retailing in Canada  60,000 retailers get $80 million per year in promotional allowances from Big Tobacco.  Advertising banned; power walls being banned.  Sale to minors prohibited and enforced.  Smoker buys cigarettes once a day but only visits his doctor once a year.

37 37 Power walls Blank walls

38 38 Transformed walls

39 39 Transforming tobacco retailers from Big Tobacco lackeys to public health agents and community centres.  Create incentives for transformation.  Train clerks in brief counselling and smoking cessation referral, and other health promotion techniques.  Transform stores into meeting places, neighbourhhood watch and community information centres.

40 40 Obliging tobacco companies to meet public health goals Billions of cigarettes and cigars  200734.5  201714.5  201813.5  2031 0.5 Billions of grams of all other tobacco products  20072.25  20170.75  20180.70  20310.05

41 41  Lesson # 1: We can change the world  Lesson # 2: Tobacco companies adapt to overcome public health measures  Lesson #3: Tobacco corporations are compelled to maximize profits.

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