With daily reportage and media coverage chronicling the first chinks in the once seemingly impenetrable armor of Big Tobacco, the general public might get the very erroneous impression that Big Tobacco is going down for the count. Nothing could be further from the truth. To the average person the $300-$400 billion dollar "global" settlement that is currently being bandied about seems like an awful lot of money. To those of us in the tobacco control business, we know it is but a drop in the ocean to Big Tobacco, and a small price to pay to ensure that they will be able to continue business as usual in the rest of the world. The Tobacco Industry won't even flinch as they write the check.
Because, as controls and regulations tighten in the United States and Western Europe, Big Tobacco is simply increasing its targeting and sales to developing countries. In most developing countries if legislation against tobacco advertising and access to minors exists, it is rarely enforced. And in the rare instances where developing countries have tried to curtail the importation of tobacco products, the United States and England have actually lobbied and in some cases threatened trade sanctions in order to ensure "free trade".
A recent trip to Dakar, Senegal in West Africa revealed little to no enforcement of existing tobacco control legislation. Big Tobacco sponsors youth dances and sporting events. They give away tobacco products and promotional items. Youth have open access to tobacco products. The only thing that slowed the proliferation of children smoking was the economic depression created several years ago with the devaluation of the French West African Franc. Big Tobacco mass markets death and destruction to people of color throughout the world cloaked in seductive images of the "American Dream".
Unfortunately, Big Tobacco has "flatly refused to negotiate" on international tobacco control issues. As the U.S. State Attorney Generals negotiate a "Global Settlement" with the Tobacco Industry, they must remember that the United States of America accounts for only 4% of the world tobacco market. That means that 96% percent of cigarette sales are generated outside of the United States. This hardly puts the U.S. in the position to save ourselves at the expense of the children of other nations. These negotiations should be open and inclusive. California was the first state to pass taxation legislation on cigarette sales. With revenues generated from the tax, California funded public health and media campaigns to get people to stop using tobacco. A quick look at the history and implementation of California's historic grassroots passage of Proposition 99 reveals many lessons for the country and the world.
As California's mainstream population began to get the message that smoking kills, Big Tobacco stepped up its targeting of women, youth, and communities of color. This parallels their method of targeting developing countries. Big Tobacco increased political campaign contributions and conducted slick strategic lobbying campaigns to block and circumvent the spirit of Proposition 99. They also continued to pump money (which equals a deafening silence) into ethnic newspapers and magazines. Big Tobacco continued to "sponsor" ethnic events which attempt to buy credibility and standing within those communities: from Alvin Ailey's Dance Theater of Harlem, to lectures on the Civil Rights movement by Julian Bond, to African American art exhibitions at reputable museums.
As California's health advocates began implementing tobacco control programs, they came head to head with the fact that in light of high unemployment, lack of affordable housing, crime, violence, and racism, the issue of smoking and tobacco usage took a decidedly low priority on the communities of color's fix-it list. When a community sends their children off to school and holds their breath til they make it back at night, whether or not that child happens to pick up a cigarette along the way becomes inconsequential. The same holds true for developing countries, the vast majority of which are dealing with high unemployment, lack of adequate infrastructure, trade deficits, low GNP, high infant mortality, and the list goes on. Whether in inner city Bayview-Hunter's Point of San Francisco or Dakar, Senegal, the topic of tobacco control brings the same uninterested shrug that translates to -- "it doesn't matter if tobacco is the number one cause of preventable death -- I have more immediate survival issues to worry about." This makes both of these communities easy prey to Big Tobacco. The critical difference is that in Senegal the group of advocates who would spearhead the attack against the Tobacco Industry are busy on more immediate fronts.
Another interesting and unanticipated phenomenon in the implementation of Proposition 99 was the slugfest in the state legislature each year over the millions and millions of dollars generated by the tax on tobacco products (Slugfest). Even though the language and funding levels of Proposition 99 were explicitly clear, this did not prevent infighting for funding dollars. At one point the California Medical Association (representing California's Doctors) and Big Tobacco were actually on the same side in diverting funds from tobacco prevention and education programs. Eventually this led to a lawsuit by American's For Nonsmokers Rights and the American Lung Association. They sued the State of California (and prevailed) in order to force the state to comply with the mandated funding levels of Proposition 99.
It is extremely necessary and can be extremely difficult to justify making international tobacco prevention and education an absolute priority. Sounds easy, right? Any rational logical person knows an ounce of prevention is worth a pound of cure. But imagine yourself as the head of a local public health department. You must choose between funding a program to give primary health care to indigent people or funding an after school tobacco media advocacy program for teens. Take it another step further to Senegal, now you must decide between a clean drinking water system for a long neglected rural area or an after school tobacco media advocacy program. Even for those with their heart in the right place, health care funding and priorities are hard decisions to make, these issues are compounded when there simply isn't enough money to go around. Now throw in a few political contributions and the best lobbyists money can buy and...
The lesson here is that the distribution of funds generated from a settlement must have tight controls with mandated funding levels, mandated prevention and education priorities, and nongovernmental independent oversight. Because the biggest lesson, lest everyone forget is that Proposition 99 was a grassroots driven process. Governments cannot be counted on to respect or enforce these mandates.
Carol McGruder is the Project Director for the San Francisco African American Tobacco Free Project
She can be reached at Polaris Research & Development, Inc. Tel: (415)777-3229. E-mail: email@example.com
- 182 Health