<Home> <Health News> <Smoking> <Proceedings of INGCAT's Int'l NGO MObilisation Meeting in Geneva> <Tobacco Control Now and in Future>

Proceedings INGCAT International NGO MObilisation Meeting Geneva, 15-16 May, 1999.

Why are we here? Introduction to the meeting
Kjell Bjartveit, MD, MPH
President of the Governing Council, INGCAT

Tobacco Control. We need ull mobilisation of NGOs allover the world. With this meeting, new partnerships will be formed. We need to ret ink our strategy about mobilising action, broaden our targets, develop new control measures, lobby governmen s, support the WHO, and more effectively fight our enemy.

On behalf of INGCAT, the International Non Governmental Coalition Against Tobacco, I have the honour to welcome you all to this meeting. We are very impressed to see attendance from so many non- governmental organisations.

Why are we here?

I shall try to give seven reasons.

We are here because we are facing the greatest epidemic, the greatest medical disaster, of the century. Right now, 4 million people a year are killed by tobacco. But this is only the tip of the iceberg. By the year 2030 this figure will have increased to 10 million; one Titanic disaster every 78 minutes.

In 1979, the dynamics of the tobacco epidemic were outlined by a WHO Expert ommittee, and in 1994 illustrated by Lopez, Collishaw and Piha.   Smoking started among men --young, well-educated, well-off men in urbanised areas in industrialised countries. Then it spread to other male segments of the population. After 50 years a peak was reached, and smoking decreased, first among high status men. The epidemic leaves the arena in the same order as it arrives. Among poor men in rich countries, and among rich men in poor countries, the peak has not yet been reached.

Some fifteen years after the men, women start to smoke -and again, young, high status groups are the first to takig up the habit. In some rich countries, the peak has already been reached, and fortunately at a lower level than among men. In some poor countries smoking has just started among women.

Some fiftedn years after starting smoking, the smokers begin to pay the toll of their deadly habit. In some rich countries the peak percentage of all male deaths caused by moking in a country has been reached, at a level of a lOUt one third of all deaths, and a decline appears --first in high status groups. Among women in rich countries, mortality has not reached its peak.

In poor countries. it will be a long time before the male turning point is reached. and among women, there are few tobacco-related deaths --as of yet.

This model tells us what we can expect in the future.

Why are we here?

We are here because we need full mobilisation of NGOs all over ther world that can support the WHO Director General in her endeavour, so that immediate and strong action can be taken by the governments.

We are here because the tobacco disaster cannot be expressed only in traditional health-related causes economic havoc to low income countries, it increases the need for food imports, it attacks vulnerable populations, it destroys poor families' household accounts, it causes deforestation and impedes true sustainable development.

Indeed, tobacco problems are not the exclusive domain of cancer, heart and lung societies.

Why are we here?

We are here because we are up against a mighty enemy --one who has almost unlimited resources at its disposal. An enemy that does everything it can to spread the epidemic. An enemy that knew its products caused disease. death and addiction, and knew this before the health community as a whole. An enemy that has. however. consistently denied this knowledge --even under oath.

Why are we here?

We are here because of the poor response from governments to this tragic situation.

Prevention is government's business. When a community faces a serious epidemic. government nvolvement is an urgent necessity. The whole community is now under threat, and common action by its governing bodies is imperative.

Faced with this enormous health problem, one would have expected a gigantic. aggressive, co-ordinated action against this man-made epidemic and against the powerful industry that has caused it.

And what has happened? With few exceptions, astonishingly little, really.    In general, the politicians have watching from the sidelines, and their involvement has been limited to rhetoric and expressions of deep concern. They have not taken adequate action on the warnings from the health community --on the contrary, they have listened to the arguments of the enemy, whose lobbying activity is tremendous. In the United States the industry hired one lobbyist for every two members of Congress, and spent over $30 million in lobbying fees last year, according to former Surgeon General C. Everett Koop.

Why are we here?

We are here because we see the dawn of a new day. Last summer, the new WHO Director General declared that the tobacco problem would be at the top of her priority list. Already, we see new activities being developed, the Tobacco Free Initiative. WHO is now being joined by other UN agencies, which have given full support to an international treaty on tobacco control, the Framework Convention on Tobacco Control.

For decades, many of us had been hoping for this.  Now it is becoming a reality.

Why are we here?

We are here because we need full mobilisation of NGOs allover the world that can support the WHO Director General in her endeavour, so that immediate and strong action can be taken by the governments.

National NGOs have been pioneers in tobacco control, through health education and influencing public opinion, through advocacy for legislative measures, and through a fearless fight against the enemy. In 1967, the American Cancer Society and other American NGOs took the initiative and organised the first World Conference on Smoking and Health; World Conference no.10 was held in Beijing in 1997, and in August 2000 no.11 will take place in Chicago, USA.

For many years now, some international NGOs have also been in the forefront. The International Union Against Cancer --the UICC --was the first to launch a tobacco control programme. Already in 1969, the UICC published a national report, Influencing Smoking Behaviour, which outlined a comprehensive smoking control programme. In 1976 a new report followed, Lung Cancer Prevention, which served as a manual for a long series of seminars that the UICC conducted all around the world. Since then, other international organisations have followed. A recent publication of interest is the IUATLD's manual Tobacco control and prevention - a guide for low income countries.

After the 9th World Conference in Paris in 1994, an important step was taken. Three major international NGOs, UICC, IUATLD and World Heart, founded the International Non Governmental Coalition Against Tobacco, INGCAT. The aim was to mobilise large numbers of people through national affiliates.

During recent years it has become apparent, however, that a much broader spectrum of NGOs is needed than the traditional health-oriented ones. We need new allies who can include tobacco control in their mandated goals.

Another group of allies has recently appeared in the arena, the pharmaceutical companies, which are willing to invest in tobacco control efforts. Hence, greater financial support for tobacco control is now available, which creates a completely new situation. The pharmaceutical industry is sponsoring this meeting, and we are very grateful for that.

One main objective of this meeting is to establish new partners, and if this is achieved, it will be a milestone in INGCAT's activities.

Why are we here?

We are here to re-think our strategy in the light of these new developments, and this will be done in the working groups. We need input from new associates in order to know how to

- mobilise new advocates into joining our ranks. How can we develop strategies that will appeal to them? By attaching more importance to issues like sustainable development, human rights, equity for women, consumer protection, elimination of exploitation and the fight against poverty? Also the traditional NGOs involved in tobacco control need to be re-awakened; we know, for example, that many national cancer, lung and heart societies do not take an active role in tobacco control.

- define a broader scope of target groups for our activities. Children are indeed a prime target; how can we prevent them from being influenced by the self-destructive behaviour of the adult world, how can we protect them from being seduced by the tobacco industry, and from being exposed to invol- untary smoking? Women are another target; how can we mobilise their resistance to tobacco industry maketing tactics, so that a further increase in smoking rates can be avoided? In addition, do we have other groups that need attention, for example the cou tless number of smokers who desperately want to quit, and to whom we can now offer new and pro using cessation methods?

- dev lop new control measures. We already have a wid range of measures that have proved to be effective. Used in combination --as an anti-tobacco coctail --each measure may have a synergistic effect upon the others, and bring about a clear fall in consumption. But do we have new methods that hav not been tried out before? How can we enable edu ation about tobacco --in a broader context?

.lobby governments and politicians more effectively. Many politicians are still sitting on the fence. How can we provoke the ignorant and reward the progressive? One day the children of today will have reached the age when they themselves are suffering from tobacco-related diseases. Who will they then put on trial for having caused an enormous amo mt of human suffering? The tobacco industry will, of course, be the main offender. But it will have an accomplice, namely today's politicians who knew, but didn't act.

- Promote the WHO Tobacco Free Initiative.  How can NGOs all over the world work together with WHO for the common cause?  How can we inspire each other?   United we are strong.  And Finally, we need input in order to know how to

- fight the enemy. We would be truly naive if we did not grasp the fundamental fact that the root of the problem is the conflict between health interests and economic interests. The health community wishes to main ain and improve health, and therefore, for them, smoking must be reduced and in the long run eliminated. The industry wants to maintain and improve sales, and therefore, for them, smoking must increase. There is no way of harmonising these conflicting interests.

During this meeting, we shall be confronted with data on present and future mortality. Mortality today tells of risk in the past. Risk today tells of mortality in the future. The past is past and nothing can be done about it. But the future is in our hands! The pessimistic predictions do not need to become reality. We dohave the possibility to influence today's risk and alter the future.

A fundamental question remains then: In whose hands does the future lie? In the hands of the tobacco industry? Or in the hands of decision-makers within all governments and all relevant members of the UN family? Their hands should be raised in a vote that commits them to a radical programme that will bring this epidemic to a halt.

Our task -as voluntary organisations -should be to assist them in achieving this goal. And that's why we are here.

Welcome to the meeting.