Global citizen, that retroism from sunnier days is back. Calls for the US to be a better model for the rest of the world peppered the presidential campaign. Reforming global tobacco policy will be a critical first step in walking the global citizen talk.
The World Health Organization predicts that a billion people will die from smoking before 2100, 10 times the number during the 20th century. And 80 percent of smokers live in the developing world. That dark forecast reflects globalizing trade, Big Tobacco's marketing muscle, and US official help opening foreign cigarette markets, as Allan Brandt writes in "The Cigarette Century."
For years, health authorities in weakly regulated developing countries tried to get better control over tobacco use by restricting access to their markets. They worried that if Big Tobacco's marketing and pricing power made cigarettes cheaper, more people would smoke. They tried to shield themselves behind tariffs or import bans, often making Faustian deals with domestic growers.
Working with the tobacco lobby, Washington beat back those barriers. The key victory was a 1991 Global Agreement on Tariffs and Trade ruling against Thailand that enshrined tobacco as an ordinary product, like, say, a cookie, subject to ordinary trade rules. Although new cigarette markets were slowly opening, the decision was a universal entry ticket.
By 1994, tobacco giant R.J. Reynolds claimed access to 90 percent of the world's markets, compared with only 40 percent a decade earlier. And 100,000 people – mostly kids – become smokers daily. For millions, "better global citizenship" could mean the difference between life or death.
Part of being a good citizen is telling the truth. So our first step is to expose the fiction that tobacco is an ordinary product. In fact, tobacco is the only consumer "good" that, used properly, produces death in 50 percent of habitual users, a characteristic that seems not so much ordinary as uniquely lethal.
The notion that "ordinary trade rules" are appropriate is equally perverse. Because there is no safe way to use it, tobacco trade produces social costs, not benefits. Because tax revenues and profits are dwarfed by massive public costs, tobacco trade produces net economic losses not gains. Trade in tobacco makes more people worse off.
To end the tobacco bias in our trade agreements, the Obama administration and Congress should exclude tobacco from GATT and all future US bilateral and regional trade agreements. And when the White House asks Congress to renew its "fast-track" trade authority, if no exemption is included, Congress should make it a condition for new negotiating authority.
At the World Trade Organization, a US initiative should put tobacco beyond the reach of GATT rules and enforcement powers. And if the "Doha Round" of world trade talks revives in 2009, we should take similar action there.
But trade reform without parallel action on global health won't stem the spread of tobacco-related disease. Nor, welcome as it is will the largess of charities. They are up against an industry with $160 billion in revenues. We need to stop blocking efforts to control global tobacco and become their champion.
The centerpiece of the global effort is the Framework Convention on Tobacco Control (FCTC), the world's first global public health treaty. While it was negotiated, the US joined tobacco exporters to weaken its terms; but when it was completed, President Bush never submitted it for ratification [Editor's note: The original version misstated the president’s response. It is not the president’s job to ratify treaties, the Senate does that.]. Obama should send the FCTC to Congress and the Senate should swiftly ratify it.
The US could seek a protocol giving precedence to FCTC obligations in the event of conflict with duties under other treaties, like GATT. We could push more robust language on demand reduction in the treaty, particularly on cigarette taxation, advertising, disclosure of ingredients, and other strategies used successfully.
President Reagan's surgeon general, C. Everett Koop, charged the US with "the height of hypocrisy" for aiding tobacco exporters while hectoring other governments to stop cocaine exports. We still do. Unless we reverse policy on tobacco exports, that indictment will stand.