Smoke and Mirrors: The Canadian Tobacco War
CMAJ 1997;156:1199
Rob Cunningham. 361 pp. Illust. International Development Research Centre, Ottawa. 1996. $30.50. ISBN 1-088936-755-8
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| Overall rating: |
Excellent |
| Strengths: |
Tells an important story concisely and completely; well researched |
| Weaknesses: |
Lack of explanation of inaction of Canadian health community for almost 3 decades |
| Audience: |
Physicians, health educators, public health officials, politicians, officials and the public |
Rob Cunningham has written an important book that chronicles the history of the tobacco industry and its foes. It is an outstanding overview of the tobacco problem in Canada and would serve as an excellent starting point for anyone interested in this issue. And it is even more valuable as a summary of the issue for those who do not require the detail that only a literature search can provide. Published last year by the International Development Research Centre in Ottawa, the book is lavishly illustrated with tobacco advertisements and many editorial cartoons as well as numerous charts and graphs detailing tobacco production and consumption trends. It is extensively researched, with 650 references. It will appeal to anyone interested in public health, including physicians, health educators, public health officials, politicians and officials. Internationally, this book will appeal to those involved in tobacco control movements in other countries who wish to learn from the Canadian experience.
The book is divided into 7 parts. Part 1 consists of case histories of illnesses caused by tobacco, a summary of the health consequences of tobacco use and an outline of the major players in the Canadian tobacco industry. Part 2 looks at the early history of tobacco control. Part 3 contains a brief summary of the scientific evidence supporting a ban on advertising and sponsorship. There is detailed information on the campaign that resulted in the passage of the Tobacco Products Control Act and the legal battle that killed it. The tactics of the tobacco industry, including its marketing efforts directed at young people and women, are explored in Part 4. The history of tobacco growing in Canada is also outlined.
The efforts of the tobacco industry to export the epidemic to the rest of the world are examined in Part 5, along with the tragic consequences of this trend. The last 2 parts catalogue what actions should be taken, mainly by government, to reduce the incidence of diseases caused by tobacco. Cunningham's predictions are not always rosy, but they are usually realistic.
My only criticism of the book is that it lacks a more thorough discussion of the fact that it took almost 3 decades for the tobacco issue to be taken seriously. If we had started committing resources to eliminating tobacco in 1965, where would we be today? This is an unanswerable question, but it must be asked if we are to prevent similar public health catastrophes as we move into a new millennium.
Mark C. Taylor, MD
President
Physicians for a Smoke-Free Canada
Department of Surgery
University of Manitoba
Winnipeg, Man.
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