Girding for new fronts in the battle against Big Tobacco

The 17th World Conference on Tobacco or Health, meeting from tomorrow till Friday, will review the latest research on e-cigarettes, debate which policies best blunt tobacco sales, and take stock of worrying trends across the developing world.
The name of the conference, “Tobacco OR Health”, leaves no room for doubt: you can’t have both.
“The cigarette is the single most deadly consumer product ever made,” says Ruth Malone, a professor at the University of California’s San Francisco School of Nursing and editor-in-chief of the Tobacco Control journal.
Tobacco claims nearly seven million lives yearly from cancer and other lung diseases, and accounts for about one-in-10 deaths worldwide, a million in China alone, according to the World Health Organisation.
Even as the percentage of adults who smoke has dropped in rich nations and flat-lined in some emerging ones, the total number of smokers keeps climbing, driven by an expanding global population and more people in poor countries lighting up.
The industry sells 5.5 trillion cigarettes last year to nearly a billion smokers, generating some $700 billion (Bt22 trillion) in sales. 
“The fact remains that one out of every four men still smoke, as do one out every 20 women,” notes Emmanuela Gakidou, a researcher at the University of Washington’s Institute for Health Metrics and Evaluation.
What the WHO calls a “tobacco epidemic” eats up one trillion dollars in healthcare expenses and lost productivity every year.
But the United Nations, governments, NGOs and activists have not stood by idly.
The 180-nation Framework Convention on Tobacco Control, the only treaty negotiated under the WHO, lays out actions for curbing supply and demand.
Measures include higher prices and taxes, laws to curb smoking in public places, graphic labelling on the dangers of tobacco, banning advertising, and programmes to help people quit.
“The single most effective measure to reduce tobacco use is to increase the price of tobacco products, through taxation or pricing,” explains Kelley Lee, a policy expert at Simpson Fraser University in British Columbia.
Australia, Canada, France, Britain and other European countries have also pushed through laws requiring logo-free, plain packaging dominated by graphic images such as rotted teeth and throats wasted by cancer.
Cities around the world have banned smoking in public places, including Shanghai last year. 
Health advocates say these efforts have saved 35 million lives over the last decade. 
    
Asian giants
At the same time, however, they have barely dented industry profits.
British American Tobacco – the largest publicly-traded tobacco company in the world after the takeover last year of Reynolds American – raked in 5.2 billion pounds (Bt226 billion) in profits in 2016.
The shares of all major listed tobacco companies soared in 2017.
“The tobacco industry has learned to wield extensive political influence to survive, and even thrive, despite producing and marketing a product that kills half of its regular customers,” says Lee.
“There is no easy way to challenge such a powerful industry given its deep pockets.”
Indeed, experts express concern about several developments in the last few years. 
One is the aggressive expansion of state-run tobacco monopolies in East Asia.
“The global market share of the new emerging – especially Asian – tobacco companies is growing rapidly,” says Professor Jappe Eckhardt, at the University of York in England. Japan Tobacco International, he says, morphed in less than a decade from a domestically oriented company to a major multinational. “Our research shows that Korea is going to follow suit,” with Taiwan and Indonesia not far behind. 
    
Jury still out on e-cigarettes
“And China’s national company” – the largest in the world, with a 42 per cent market share of cigarettes sold – “is poised to dwarf all existing companies in the foreseeable future.”
Another hot topic at the conference will be e-cigarettes, which has caused a “sharp division” in the public health community, said Lee.
“Given how relatively new these products are, we just don’t have the data on their long-term health impacts,” Lee says.
The jury is still out, she said, on whether vaping is a “gateway” to combustible smoking, and may be dangerous in itself.
Big Tobacco has invested heavily in electronic cigarettes.
In the meantime, industry has opened up a legal front in the war over tobacco, launching dozens of lawsuits against governments on every continent trying to enact anti-smoking laws.