A call for world action last week sounded as familiar as, say, that against global warming. But while a UN report did warn of a "catastrophe" in the 21st century, the topic wasn't the usual greenhouse gases. It was tobacco smoking.
In terms of global priorities to save lives, the math alone argues for as much attention to be paid to tobacco addiction as to climate change – maybe even more.
In the 20th century, more people died prematurely from smoking (100 million) than those who perished under the ruthless regimes of Hitler, Stalin, and Mao. Today, tobacco is seen as responsible for more deaths than from AIDS, tuberculosis, and malaria combined, according to the World Health Organization in its 300-plus-page report, "Global Tobacco Epidemic, 2008."
And with escalating numbers of people taking up the habit in poorer countries, WHO predicts another 1 billion people will die prematurely in the 21st century – unless more governments and people act to prevent smoking.
At its root, of course, smoking is more than a public health problem.
Like choosing to operate cars or appliances that cause carbon dioxide emissions, it is an individual moral choice that creates a harmful dependency but which can be reversed by an appeal to a person's higher nature and concern for the future. Fear of dying in a horrible way may compel many smokers to quit – 1 in 10 deaths is reportedly related to tobacco – but many ex-addicts say it is their love of life that saved them.
In fact, the theme of WHO's new antitobacco campaign is "fresh and alive." Its report is the first of yearly ones to come that will track each nation to see if it is following the UN agency's six recommendations, which are to:
•Monitor tobacco use and prevention policies.
•Protect people from tobacco smoke.
•Offer help to quit tobacco use.
•Warn about tobacco's dangers.
•Enforce bans on tobacco ads, promotion, and sponsorship.
•Raise taxes on tobacco.
As with global warming, only a few places have set the pace, such as Uruguay, California, and New Zealand. More than 150 countries have ratified the 2005 Framework Convention on Tobacco Control, which requires nations to take antismoking steps – although few have. Only 5 percent of the world's population lives in countries with smoke-free public spaces, prominent warning labels on cigarette packs, cessation support, and a ban on tobacco marketing.
Hiking tobacco taxes has helped reduce tobacco usage, but another way would be for filmmakers to avoid smoking scenes in movies. Walt Disney Co. plans to do so and the Motion Picture Association of America started last year to consider smoking in its film ratings, along with sex, violence, and language.
Another sign of change: Nigeria is the first developing country to sue international tobacco firms. It alleges that three firms have targeted children in their marketing.
Too many governments rely on tobacco taxes for use as general revenues – about $200 billion globally. Less than 1 percent is spent on tobacco control. All that tax money should be invested – yes, invested – to end smoking.
Ever since King James I in 1604 called it a "vile and stinking" custom, tobacco use has been destined for the ashtray of history.