Tobacco manufacturers set sights on developing world

WHO's Framework Convention on Tobacco Control, due to be in place by May 2003, is an international attempt to regulate tobacco use. Negotiations are just beginning on the convention, which will set standards that countries can adopt to control advertising, prevent tobacco smuggling and promote smoking-cessation programs. "Like the convention to ban land mines, the tobacco convention also seeks to stop a killer," said Dr. Gro Harlem Brundtland, WHO's director general.

But what the convention will include and how it will work are the daunting questions facing WHO's 191 member states. A draft of the framework will be presented at the second session of negotiations this April.

WHO estimates that 4 million people will die of tobacco-related illness this year, and in 20 years that figure will leap to 10 million, with 70% of these deaths occurring in developing countries. "The framework is a global complement to national action," Geneva-based Douglas Bettcher, WHO's coordinator for the Framework, told CMAJ. "You don't do one without the other."

Since 1995, new cigarette factories have been springing up in countries such as Tanzania, Poland and Cambodia; the companies' Madison Avenue marketing campaigns have followed. Many ads target women, who are traditionally nonsmokers in most developing countries.

"We need a global effort to control tobacco," says Linda Waverley Brigden, executive director of Research for International Tobacco Control, who warns that "a piecemeal approach opens gaps for the tobacco industry."

WHO's current emphasis is on reducing demand, says Bettcher.