Letters
Tobacco control in tobacco-producing countries
Editor Adamson Muula accurately points out the difficulties inherent in the control of tobacco use in a major tobacco leaf-producing country like Malawi (1). However, several statements need clarification. First of all, his title "The challenges facing Third World countries in banning tobacco" implies that the goal of tobacco control is to ban tobacco use. It is not. The World Health Organization (WHO) and the World Bank do not recommend a total ban on smoking, let alone a ban on the production of tobacco leaf. Rather, they advocate strong evidence-based demand-side measures such as increases in taxes, comprehensive bans on tobacco advertising and promotion, smoke-free indoor air restrictions, and health information campaigns.
Press-clippings originating from major tobacco-producing countries seem to indicate that the tobacco industry is once again deliberately misleading the public in pretending that the main objective of the Framework Convention on Tobacco Control (FCTC), currently being negotiated under the auspices of WHO, is to ban tobacco farming. The following quotes illustrate such misrepresentation. "African countries are in a dilemma whether to approve WHO's proposal calling for a ban on tobacco farming" (2). "Malawi has vowed to fight tooth and nail to protect its economic lifeline tobacco which is currently threatened by a mounting global anti-smoking lobby seeking to force cessation of production by 2003" (3).
It is also incorrect to state that countries benefit from the production of tobacco. The so-called financial or economic benefits are illusory in most countries: the loss of productivity and health care costs of premature morbidity and mortality due to tobacco use far outweigh the economic contribution tobacco may provide (4). Further, it should be reiterated that the negative impact of tobacco control on employment has been greatly overstated. In fact, statements that tobacco control will mean massive job losses are usually based on studies funded by the tobacco industry (5).
That is not to say that, in a few countries like Malawi and Zimbabwe, tobacco does not play an important economic role. However, it is important to note that reduction in the demand for tobacco products will be gradual and decades will go by without any dramatic changes taking place. As the absolute number of smokers increases because the global population increases the continuity of a big enough market to keep the current generation of tobacco farmers in business is ensured. Any slowing down of demand will happen so gradually that it will allow for an equally slow process of adjustment for those most directly affected. Moreover, as smokers quit, the expenditure saved must be spent on other goods or services. This, in turn, will generate new employment in existing markets.
It is with all these points in mind that WHO's Tobacco Free Initiative is working closely with other UN agencies, through its chairmanship of the Ad Hoc Inter-Agency Task Force on Tobacco Control which was established in 1999. New interagency partnerships focusing on the economics of tobacco control and issues of supply and production have been initiated. For example, the Food and Agriculture Organization, in collaboration with WHO and the World Bank, is currently conducting a study that aims to explore various strategic policy options arising from a reduction in demand for tobacco leaves while taking into account certain countries' dependence on tobacco production. The results will be of value to various national and international organizations concerned with the health implications of tobacco consumption, as well as to the countries involved in tobacco production and trade. In addition, WHO and its UN partners have scheduled an international consultation on economic transition in tobacco manufacturing and agriculture to take place in December 2001 at the WHO Kobe Centre in Japan.
In the words of Dr Gro Harlem Brundtland, Director-General of WHO, the biggest cost of tobacco lies in its health impact. Currently, four million people die every year because of tobacco use. This figure is expected to rise to 10 million by 2030, with most of the deaths occurring in developing countries. As the rich increasingly abandon smoking, the health burdens are highest on the poor. Health, and not economics, is the reason for controlling tobacco. 
Emmanuel Guindon
Economist, Tobacco Free Initiative
Douglas Bettcher
Coordinator, Framework Convention on Tobacco Control
World Health Organization
1211 Geneva 27
Switzerland
1. Muula AS. The challenges facing Third World countries in banning tobacco. Bulletin of the World Health Organization, 2001, 79: 480.
2. Africans worried by new WHO tobacco initiative. Africa News Service, 2 October 2000.
3. Tenthani R. Malawi to fight for tobacco. Panafrican News Agency, 13 March 2000.
4. World Bank. Curbing the epidemic: governments and the economics of tobacco control. Washington DC, World Bank, 1999 (Development in Practice Series, http://www1.worldbank.org/tobacco/reports.htm).
5. World Bank. Curbing the epidemic: governments and the economics of tobacco control. Washington DC, World Bank, 1999 (Development in Practice Series: chapter 6, http://www1.worldbank.org/tobacco/book/html/chapter6.htm).
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