Abstracts

Introduction

The human health impacts of tobacco use are well-documented. The World Health Organization (WHO) estimates that there will be more than 8 million tobacco-related deaths a year by 2030, amounting to 10% of annual deaths worldwide.¹1. Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 2006 Nov;3(11):e442. http://dx.doi.org/10.1371/journal.pmed.0030442PMID:17132052
http://dx.doi.org/10.1371/journal.pmed.0...

The impact that tobacco has on the environment is less well recognized. The WHO Framework Convention on Tobacco Control (FCTC) addresses the environmental concerns regarding tobacco in Article 18, which states that:

In response, a series of policy options and recommendations were agreed at the sixth Conference of the Parties to the FCTC in 2014.²2. Report of the sixth session of the Conference of the Parties to the WHO Framework Convention on Tobacco Control. Sixth session; 2014 Oct 13-18; Moscow, Russian Federation. Geneva: World Health Organization; 2014. Available from: Available from: http://www.who.int/fctc/cop/sessions/COP6_report_FINAL_04122014.pdf [cited 2015 Oct 1].
http://www.who.int/fctc/cop/sessions/COP... The meeting identified key sources of environmental concern and recommended environmental impact studies on tobacco growing.²2. Report of the sixth session of the Conference of the Parties to the WHO Framework Convention on Tobacco Control. Sixth session; 2014 Oct 13-18; Moscow, Russian Federation. Geneva: World Health Organization; 2014. Available from: Available from: http://www.who.int/fctc/cop/sessions/COP6_report_FINAL_04122014.pdf [cited 2015 Oct 1].
http://www.who.int/fctc/cop/sessions/COP... Given the environmental and occupational health concerns associated with tobacco growing, the FCTC also addresses the need for alternative livelihoods for tobacco growers in Article 17.

The environmental lifecycle of tobacco can be roughly divided into four stages: (i) tobacco growing and curing; (ii) product manufacturing and distribution; (iii) product consumption; and (iv) post-consumption waste. Here, we describe the environmental and health concerns at each of these stages and propose recommendations for policy-makers.

Tobacco growing and curing

In 2011, around 4 200 000 hectares of land were devoted to tobacco growing, representing less than 1% of total arable land globally; however, in several low- and middle-income countries, the percentage of arable land devoted to tobacco growing has recently increased.¹1. Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 2006 Nov;3(11):e442. http://dx.doi.org/10.1371/journal.pmed.0030442PMID:17132052
http://dx.doi.org/10.1371/journal.pmed.0... For example, it has almost doubled in China, Malawi and the United Republic of Tanzania since the 1960s. Deforestation for tobacco growing has many serious environmental consequences - including loss of biodiversity, soil erosion and degradation, water pollution and increases in atmospheric carbon dioxide.

Tobacco growing usually involves substantial use of chemicals - including pesticides, fertilizers and growth regulators.³3. Lecours N, Almeida GEG, Abdallah JM, Novotny TE. Environmental health impacts of tobacco farming: a review of the literature. Tob Control. 2012 Mar;21(2):191-6. http://dx.doi.org/10.1136/tobaccocontrol-2011-050318PMID:22345244
http://dx.doi.org/10.1136/tobaccocontrol... These chemicals may affect drinking water sources as a result of run-off from tobacco growing areas. Research has also shown that tobacco crops deplete soil nutrients by taking up more nitrogen, phosphorus and potassium than other major crops. This depletion is compounded by topping and de-suckering plants, which increase the nicotine content and leaf yields of tobacco plants.³3. Lecours N, Almeida GEG, Abdallah JM, Novotny TE. Environmental health impacts of tobacco farming: a review of the literature. Tob Control. 2012 Mar;21(2):191-6. http://dx.doi.org/10.1136/tobaccocontrol-2011-050318PMID:22345244
http://dx.doi.org/10.1136/tobaccocontrol...

Land used for subsistence farming in low- and middle-income countries may be diverted to tobacco as a cash crop. Intensive lobbying and investments by multinational tobacco companies (e.g. Philip Morris International, British American Tobacco and Japan Tobacco International) and leaf buyers (e.g. Universal Corporation and Alliance One International) along with market liberalization measures have encouraged the expansion of tobacco agriculture in low- and middle-income countries. Many of these countries have limited legislative and economic capacities to resist multinational tobacco companies' influence and investments. As a consequence of expanded tobacco agriculture, there are short-term economic benefits for some farmers, but there will be long-term social, economic, health and environmental detriments for many others.⁴4. Lecours N. The harsh realities of tobacco farming: a review of socioeconomic, health and environmental impacts. In: Leppan W, Lecours N, Buckles D, editors. Tobacco control and tobacco farming: separating myth from reality. New York, USA: Anthem Press and the International Development Research Centre; 2014.

Due to widespread concerns about unfair labour practices in tobacco agriculture, tobacco control advocates have recently been working with tobacco farmers and farm workers to ensure the right to collective bargaining and to receive living wages and fair leaf prices.⁵5. Otañez M, Glantz SA. Social responsibility in tobacco production? Tobacco companies' use of green supply chains to obscure the real costs of tobacco farming. Tob Control . 2011 Nov;20(6):403-11. http://dx.doi.org/10.1136/tc.2010.039537PMID:21504915
http://dx.doi.org/10.1136/tc.2010.039537... Given the agricultural labour practices in both low- and middle-income countries and more developed countries, attention is also needed to ensure the safety of children involved in tobacco farming. Farm workers, especially child labourers, minorities and migrant workers are at risk of nicotine toxicity (green tobacco illness), caused by handling tobacco leaves without protection during harvest and processing.⁶6. Riquinho DL, Hennington EA. Health, environment and working conditions in tobacco cultivation: a review of the literature. Cien Saude Colet. 2012 Jun;17(6):1587-600. PMID:22699649

Manufacturing and distribution

In 1995, it was estimated that global tobacco manufacturing produced over 2 000 000 tonnes of solid waste, 300 000 tonnes of non-recyclable nicotine-containing waste and 200 000 tonnes of chemical waste.⁷7. Novotny TE, Zhao F. Consumption and production waste: another externality of tobacco use. Tob Control . 1999 Spring;8(1):75-80. http://dx.doi.org/10.1136/tc.8.1.75PMID:10465821
http://dx.doi.org/10.1136/tc.8.1.75... If annual cigarette production had remained constant for the past 20 years (output has actually increased from 5 to 6.3 trillion cigarettes annually), tobacco factories would have deposited a total of 45 000 000 tonnes of solid wastes, 6 000 000 tonnes of nicotine waste and almost 4 000 000 tonnes of chemical wastes during this time. Other toxic by-products of tobacco manufacturing or chemicals used in manufacturing include ammonia, hydrochloric acid, toluene and methyl ethyl ketone.

Product consumption

The health impacts of environmental tobacco smoke exposure include lung cancer, cardiovascular disease and pulmonary disease.⁸8. The health consequences of involuntary exposure to tobacco smoke: a report of the surgeon general. Rockville: US Department of Health and Human Services; 2006. Exposure to residual chemicals in environments where smoking has taken place may also have human health impacts, though these impacts have not yet been quantified.⁹9. Matt GE, Quintana PJE, Destaillats H, Gundel LA, Sleiman M, Singer BC, et al. Thirdhand tobacco smoke: emerging evidence and arguments for a multidisciplinary research agenda. Environ Health Perspect. 2011 Sep;119(9):1218-26. http://dx.doi.org/10.1289/ehp.1103500PMID:21628107
http://dx.doi.org/10.1289/ehp.1103500... Most cigarettes are lit using matches or gas-filled lighters. If, for example, one wooden match is used to light two cigarettes, the six trillion cigarettes smoked globally each year would require the destruction of about nine million trees to produce three trillion matches.¹⁰10. Peattie DC. A natural history of western trees. Boston: Houghton Mifflin Harcourt; 1991. p. 40. There are also environmental impacts of manufacturing and disposing of the plastic, metal and butane used in making cigarette lighters.

Cigarettes remain an important cause of accidental fires and resulting deaths. In the United Kingdom of Great Britain and Northern Ireland, cigarettes caused 7% of fires in 2013-2014, making them the single most important cause of deaths related to fires (34 deaths/1000 fires).¹¹11. Fire statistics Great Britain 2013 to 2014. London: UK Department for Communities and Local Government; 2014. Available from: Available from: https://www.gov.uk/government/statistics/fire-statistics-great-britain-2013-to-2014 [cited 2015 Oct 1].
https://www.gov.uk/government/statistics... In the United States of America, cigarettes have been responsible for 8-10% of all fires over the past 10 years (on average 90 000 fires per year); they also remain the single most important cause of deaths related to fires (540 of 2855 total deaths in 2011).¹²12. Hall JR. The smoking material fire problem. Quincy: National Fire Protection Association; 2013. Available from: Available from: http://www.nfpa.org/research/reports-and-statistics/fire-causes/smoking-materials [cited 2015 Oct 16].
http://www.nfpa.org/research/reports-and... These fires were responsible for 621 million United States dollars in direct property damage and 1640 civilian injuries. Regulations requiring cigarettes to self-extinguish in Canada and the USA were associated with a 30% decline in fire-related deaths from 2003 to 2011.¹³13. About fire safe cigarettes. Quincy: National Fire Protection Association ; 2015. Available from: Available from: http://www.nfpa.org/safety-information/for-consumers/causes/smoking/coalition-for-fire-safe-cigarettes/about-fire-safe-cigarettes [cited 2015 Oct 19].
http://www.nfpa.org/safety-information/f...

Post-consumption waste

Cigarette butts are the most commonly discarded piece of waste globally and are the most frequent item of litter picked up on beaches and water edges worldwide.¹⁴14. Novotny TE, Slaughter E. Tobacco product waste: an environmental approach to reduce tobacco consumption. Curr Environ Health Rep. 2014;1(3):208-16. http://dx.doi.org/10.1007/s40572-014-0016-xPMID:25152862
http://dx.doi.org/10.1007/s40572-014-001... The non-biodegradable cellulose acetate filter attached to most manufactured cigarettes is the main component of cigarette butt waste and trillions of filter-tipped butts are discarded annually. Assuming that each filter weighs 170 milligrams, the weight of all tobacco-attributable non-biodegradable (filter) waste discarded annually is about 175 200 tonnes.

Hazardous substances have been identified in cigarette butts - including arsenic, lead, nicotine and ethyl phenol. These substances are leached from discarded butts into aquatic environments and soil. Although the environmental impact of this waste has not yet been quantified, the large quantity of discarded butts may allow leachates to affect the quality of drinking water. Other post-consumption wastes, such as medicines, pesticides and plastic microbeads from cosmetics, have been found in drinking water sources.¹⁵15. Eriksen M, Mason S, Wilson S, Box C, Zellers A, Edwards W, et al. Microplastic pollution in the surface waters of the Laurentian Great Lakes. Mar Pollut Bull. 2013 Dec 15;77(1-2):177-82. http://dx.doi.org/10.1016/j.marpolbul.2013.10.007PMID:24449922
http://dx.doi.org/10.1016/j.marpolbul.20...

16. Glaser A. Threatened waters: turning the tide on pesticide contamination. Washington: Beyond Pesticides; 2006. Available from: Available from: http://www.beyondpesticides.org/assets/media/documents/documents/water.pdf [cited 2015 Oct 16].
http://www.beyondpesticides.org/assets/m... ^-1717. Doheny K. Drugs in our drinking water? Atlanta: WebMD; 2008. Available from: Available from: http://www.webmd.com/a-to-z-guides/features/drugs-in-our-drinking-water [cited 2015 Oct 1].
http://www.webmd.com/a-to-z-guides/featu... It is possible that tobacco product waste may also prove to be a significant environmental contaminant and potential human health hazard through bioaccumulation in the food-chain.

With 6 trillion cigarettes manufactured annually, about 300 billion packages (assuming 20 cigarettes per pack) are made for tobacco products. Assuming each empty pack weighs about six grams, this amounts to about 1 800 000 tonnes of packaging waste, composed of paper, ink, cellophane, foil and glue. The waste from cartons and boxes used for distribution and packing brings the total annual solid post-consumption waste to at least 2 000 000 tonnes. This compares with an estimated 1 830 000 tonnes annually of plastic waste from mineral water bottles (estimation method available from the corresponding author).

Electronic cigarettes may contain batteries that require special disposal as well as chemicals, packaging and other non-biodegradable materials. The US Federal Emergency Management Agency (FEMA) has expressed concerns about the flammability and lack of product regulation of electronic cigarettes and their components.¹⁸18. Electronic cigarette fires and explosions. Emmitsburg: US Fire Administration; 2014. Available from: Available from: https://www.usfa.fema.gov/downloads/pdf/publications/electronic_cigarettes.pdf [cited 2015 Oct 16].
https://www.usfa.fema.gov/downloads/pdf/...

Carbon dioxide emissions

Tobacco smoking leads directly to the emission of 2 600 000 tonnes of carbon dioxide and about 5 200 000 tonnes of methane.¹⁹19. Tobacco and the environment [Fact Sheet]. London: Action on Smoking and Health; 2015. Available from: Available from: http://www.ash.org.uk/files/documents/ASH_127.pdf [cited 2015 Oct 1].
http://www.ash.org.uk/files/documents/AS... Data from 66 low- and middle-income countries showed that tobacco growing and curing caused significant deforestation between 1990 and 1995, amounting to approximately 2000 hectares - on average, 5% of each country's estimated deforestation during that five-year period.²⁰20. Geist HJ. Global assessment of deforestation related to tobacco farming. Tob Control . 1999 Spring;8(1):18-28. http://dx.doi.org/10.1136/tc.8.1.18PMID:10465812
http://dx.doi.org/10.1136/tc.8.1.18... Worldwide, approximately 13 000 000 hectares of forest are lost due to agriculture or natural causes each year,²¹21. Global forests resource assessment 2010: key findings. Rome: Food and Agriculture Organization of the United Nations; 2010. Available from:Available from: http://foris.fao.org/static/data/fra2010/KeyFindings-en.pdf [cited 2015 Oct 13].
http://foris.fao.org/static/data/fra2010... and of this, at least 200 000 hectares are for tobacco agriculture and curing.¹1. Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 2006 Nov;3(11):e442. http://dx.doi.org/10.1371/journal.pmed.0030442PMID:17132052
http://dx.doi.org/10.1371/journal.pmed.0... Deforestation is the second largest anthropogenic source of carbon dioxide to the atmosphere (approximately 20%), after fossil fuel combustion.²²22. United Nations collaborative programme on reducing emissions from deforestation and forest degradation in developing countries. Geneva: UN REDD programme; 2015. Available from: Available from: http://www.un-redd.org/AboutREDD/tabid/102614/Default.aspx [cited 2015 Oct 13].
http://www.un-redd.org/AboutREDD/tabid/1... One estimate of the impact of deforestation in tobacco agriculture and curing is that it causes almost 5% of global greenhouse gas production.²³23. Farrell B. Tobacco stains: the global footprint of a deadly crop. In These Times. October 1, 2007. Available from: Available from: http://inthesetimes.com/article/3324/tobacco_stains [cited 2015 Oct 1].
http://inthesetimes.com/article/3324/tob...

Despite their now well-known efforts to sow doubt among the public and policy-makers about anthropogenic climate change,²⁴24. Monbiot G. Heat: How to stop the planet burning. London: Penguin Books; 2006. tobacco companies have advertised their efforts to reduce carbon emissions. British American Tobacco estimated in 2006 that production of one million cigarettes produces 0.79 tonnes of carbon dioxide. According to this estimate, 4 740 000 tonnes of carbon dioxide would be emitted annually by global cigarette manufacturing. Other analyses assert that this is a gross underestimate of the greenhouse gas burden due to tobacco growing, manufacturing and transport.²³23. Farrell B. Tobacco stains: the global footprint of a deadly crop. In These Times. October 1, 2007. Available from: Available from: http://inthesetimes.com/article/3324/tobacco_stains [cited 2015 Oct 1].
http://inthesetimes.com/article/3324/tob... No estimates are as yet available on the extent of carbon dioxide emissions due to tobacco product transport.

Proposed next steps

The FCTC recommendations encompass all aspects of the livelihoods of tobacco growers and workers - including health, economic, social, environmental and food security concerns.²⁵25. WHO Framework Convention on Tobacco Control: an overview. Geneva: World Health Organization ; 2015. Available from: Available from: http://www.who.int/fctc/about/WHO_FCTC_summary_January2015.pdf?ua=1 [cited 2015 Oct 13].
http://www.who.int/fctc/about/WHO_FCTC_s... The recommendations re-emphasized the need to confront the vested interests of tobacco companies. These companies have promoted policies that avoid all environmental responsibility of the producer, and they attempt to divert public attention away from their environmental responsibilities through corporate social responsibility programmes.²⁶26. Smith EA, Novotny TE. Whose butt is it? tobacco industry research about smokers and cigarette butt waste. Tob Control . 2011 May;20 Suppl 1:i2-9.http://dx.doi.org/10.1136/tc.2010.040105PMID:21504919
http://dx.doi.org/10.1136/tc.2010.040105... Protecting the public against the tobacco industry's environmental impact is aligned with FCTC Article 5.3 and its guidelines, which remind Parties that:

The FCTC recommendations also propose conducting an analysis of the main barriers and existing opportunities for Article 18 implementation.²2. Report of the sixth session of the Conference of the Parties to the WHO Framework Convention on Tobacco Control. Sixth session; 2014 Oct 13-18; Moscow, Russian Federation. Geneva: World Health Organization; 2014. Available from: Available from: http://www.who.int/fctc/cop/sessions/COP6_report_FINAL_04122014.pdf [cited 2015 Oct 1].
http://www.who.int/fctc/cop/sessions/COP...

A community of concern needs to be established among multiple sectors - including health, agriculture, trade and environment - to address the environmental impacts of tobacco production and use. The FCTC Parties may consider such a broad approach as a new way to include academia, nongovernmental organizations and non-party countries. It is clear that tobacco control intersects with other pressing global issues such as sustainable development, environmental policy, climate change, trade agreements and human rights. By taking broad-based but effective action against the environmental hazards created by the tobacco industry, the demand for tobacco products will be further reduced. With strengthened environmental policies, there will be increased costs for tobacco products, decreased social acceptance of tobacco use and changes in the most commonly used tobacco products.

Policy options and recommendations on alternatives to tobacco growing involve comprehensive, environmentally-oriented tobacco control interventions for both tobacco growing and non-growing countries. We propose seven recommendations for Parties to the FCTC to consider. First, identify, prevent, treat and monitor health effects related to tobacco growing among farmers and workers. Second, develop strategies to free tobacco farmers and especially their children from unfair and unsafe agricultural and labour-related practices. Third, strengthen regulation of tobacco agriculture to prevent deforestation and land degradation. Fourth, implement extended producer responsibility regulations on the tobacco industry to reduce, mitigate and prevent manufacturing and post-consumption tobacco product waste. Fifth, extend tobacco product sales regulation to eliminate single-use filters - including any biodegradable varieties - to reduce post-consumption waste. Sixth, engage litigation and economic interventions to recover the costs of industry misconduct and environmental damages. Seventh, innovate, improve and enforce new and existing environmental regulations and agreements that may apply to tobacco manufacturing, transport and management of post consumption waste.

References

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History