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=**The Global Tabacco Threat**=



Three years ago, an international treaty took effect that was designed to help developing countries resist aggressive marketing by big tobacco companies. The idea was that if a large number of countries committed themselves to the same tobacco control policies — including bans on all advertising and promotion — they would be better able to resist pressure from multinational tobacco companies and their own domestic tobacco sellers. Unfortunately, the governments of low- and middle-income countries have not followed through. With tobacco use declining in wealthier countries, tobacco companies are spending tens of billions of dollars a year on advertising, marketing and sponsorship, much of it to increase sales in these developing countries. A new report issued by the World Health Organization, with financial help from Mayor Michael Bloomberg’s foundation, offers the first comprehensive analysis of tobacco use and control efforts in 179 countries. It notes that tobacco will kill more people this year than tuberculosis, AIDS and malaria combined. It warns that unless governments do more to slow the epidemic, tobacco could kill a billion people by the end of the century, the vast majority in poor and middle-income countries. There is no great mystery about what needs to be done. The W.H.O. recommends several proven strategies: very high taxes on tobacco products; a total ban on all advertising and promotion; a ban on smoking in all public places and workplaces; large, scary warning pictures on packs; and strong programs to help people quit. Yet few countries are doing any of these things with notable vigor. Not a single country fully implements all of the measures, and not one of the recommended steps covers more than about five percent of the global population. The tobacco companies’ vigor to sell is unflagging. As part of a strategy to ramp up its sales in the developing world, Philip Morris International is being spun off from the Altria Group so that it can escape the threat of litigation and government regulation in the United States. The international company is also planning a slew of new products aimed at particular countries, including sweet-smelling cigarettes that have more tar and nicotine. It is hard — no, impossible — to believe claims by many companies that they are not trying to addict new smokers but are only trying to convert adults who are using inferior local brands. The W.H.O. survey contends that the industry is targeting teenagers and women in developing countries. One problem is that many low- and middle-income countries have become addicted to revenues from tobacco taxes, which may lessen their zeal to curb tobacco sales. Such governments need to realize that unless they move now to curb the epidemic, tobacco will cause horrendous health and economic damage. The Bush administration, which reluctantly signed the international treaty, has not submitted it to the Senate for ratification. That means that the United States officials will not have a seat at negotiations, begun last week, over a supplementary treaty to combat smuggling, counterfeiting and other illicit trade in tobacco products — a source of funds for criminal gangs and terrorist groups that could threaten this country’s security. The White House needs to stop dithering and present the treaty for ratification.