Tobacco is a deadly threat to global development

Dr Margaret Chan, Director-General of WHO

Commentary 

30 May 2017

When I reflect on my tenure as Director-General of the World Health Organization, there are many areas where the agency played its unique role as the guardian of health for all people.

But I am especially proud of our work to fight tobacco use, something that I have personally championed since 2007.

Tobacco is a deadly product that kills more than 7 million people every year, and costs the global economy more than US$ 1.4 trillion annually in healthcare expenditure and lost productivity.

Tobacco control will play a major part in meeting the Sustainable Development Goal target of reducing premature deaths from noncommunicable diseases by one-third by 2030.

But tobacco control is about more than preventing deadly cancers, heart diseases and respiratory diseases. In addition to posing a serious threat to health, tobacco use also threatens development in every country on every level and across many sectors — economic growth, health, education, poverty and the environment — with women and children bearing the brunt of the consequences.

The theme for this year’s World No Tobacco Day, on 31 May, is "Tobacco – a threat to development". This year, WHO will launch a new report that highlights the great harm to the environment inflicted by tobacco growing, manufacturing, trade and consumption. For example, growing and producing tobacco uses 4.3 million hectares of land resulting in deforestation of 2-4%, and the pesticides and fertilizers used in tobacco growing can be toxic and pollute water supplies. Tobacco manufacturing produces over 2 million tonnes of solid waste each year. Up to 10 billion cigarettes are disposed in the environment every day. Cigarette butts account for 30-40% of all litter collected in coastal and urban clean-ups.

Tobacco farming also stops children from attending school and exposes them to hazardous chemicals. Children in tobacco-growing families often miss class because they are needed to work in the tobacco fields. Women are also disproportionately at risk of chemical exposure, as they make up 60-70% of the tobacco farming workforce.

Tobacco use hits the poorest people the hardest and exacerbates poverty. Spending on tobacco products often represents more than 10% of total household income – meaning less money for food, education and health care. Some 80% of the premature deaths attributable to tobacco use occur in low- or middle-income countries. These countries bear almost 40% of the global US$ 1.4 trillion cost of smoking from health expenditures and lost productivity.

Fortunately, we have powerful tools to fight the tobacco epidemic. The WHO Framework Convention on Tobacco Control (WHO FCTC), the first international treaty negotiated under the auspices of WHO, provides governments with clear, legally binding measures that they can introduce to reduce the harm caused by tobacco use. These include banning advertising, promotion and sponsorship of tobacco, effectively warning about the harmful effects of tobacco use, implementing tax or price policies and protecting people from exposure to second-hand tobacco smoke.

In line with WHO’s FCTC, WHO’s MPOWER measures support countries to reduce demand for tobacco, using methods that are practical, low-cost and high-impact. Tobacco taxation is a powerful tool for saving lives. Taxes reduce smoking rates and help government raise revenues to improve health and promote development. Increasing tobacco taxes and prices is one of the most effective, yet least utilized control measures globally. By increasing cigarette taxes worldwide by US$1, an extra US$ 190 billion could be raised for development.

We need to make sure that countries know that this tool exists and how to use it. Ministers of health are convinced by the evidence, and I ask them to be vocal in persuading ministers of finance, trade, foreign affairs and others not to be swayed by the unsubstantiated arguments of the tobacco industry.

Many countries have already shown tremendous progress in reducing tobacco use. Our challenge now is to help more countries follow suit, and to fight the efforts of the tobacco companies to hinder or counter progress that has been made by countries implementing strong measures.

Everyone can help play a role in stamping out tobacco and promoting development at the same time. People can commit to never take up tobacco products or to seek help to quit the habit. Governments can strengthen implementation of the WHO FCTC.

The tobacco industry is a vector of one of the greatest threats our society faces. It takes courage to antagonize powerful economic operators. If we fail to accept this responsibility, we will never make sufficient progress in health and development.

WHO stands ready to help governments introduce innovative approaches to tackle tobacco use. We have taken off our gloves and entered the ring on the side of the countries working to advance tobacco control, and we are going to fight tobacco tooth and nail.

If we rise to the challenge of beating tobacco by adopting measures that reduce demand for this deadly product, we can promote a healthier, more sustainable world.