Lighting a fire for change

December 07, 2010
Andrew Draper
IDRC’s Research for International Tobacco Control (RITC) program is helping researchers in developing countries counter the influence and immense financial resources of transnational tobacco companies.

Tobacco control policies and programs have altered behaviour so dramatically in Canada and other developed countries, it’s easy to forget that a few decades ago smoking was the social norm. We smoked at work, at home, and in restaurants and bars, and tobacco companies relentlessly advertised their products on television, radio, and in magazines and newspapers.
 

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In the past two decades, the smoking rate for Canadians aged 15 years or older has been cut in half — from 35% in 1985 to 18% in 2006. Yet, as smoking rates have been declining in Canada and other Western countries, they have been rising in the developing world. By the year 2030, tobacco will cause an estimated 10 million deaths annually — 70% in developing countries. 

Unfortunately, the negative impact of tobacco in poor countries goes far beyond increased morbidity and mortality. Growing tobacco requires heavy use of pesticides and fertilizers and rapidly depletes soil nutrients, and 70% of the world’s tobacco is grown in developing countries. Land used for growing tobacco is not available to grow food. Every year, an estimated 2000 km2 of woodland are cut down to fuel smokehouses that cure tobacco. And tobacco workers, many of whom are women or children, typically work in poor conditions for very low pay.

An Understanding of What Works

 
The good news is that the tobacco control measures now prevalent in Western countries — including bans on advertising and sponsorship, increased taxes, smoke-free public places, anti-smuggling measures, product regulation, and education and quit-smoking programs — also work in the South, if they are backed by political will and sound research.
 
In the past two decades, the smoking rate for Canadians aged 15 years or older has been cut in half — from 35% in 1985 to 18% in 2006. 

Few people are in a better position to understand this than Linda Waverley of IDRC’s RITC, a program within the Social and Economic Policy program area. Created in 1994, RITC funds research in developing countries on a wide range of issues, including how to make the transition from growing tobacco to growing food; the health, economic and environmental impacts of tobacco cultivation; the health care costs of tobacco use; and effective policy approaches to reducing tobacco use. RITC addresses tobacco as a major development issue, exploring how globalization affects tobacco cultivation and use and how tobacco use affects poverty at both the household and national levels.

 
Linda Waverley began her career in tobacco control in the late 1980s in Victoria, British Columbia, where she helped implement Canada’s second smoke-free municipal bylaw (Vancouver had the first). “That process opened my eyes to many of the complexities of tobacco control,” she says.
 
It also led to her being hired by the Ministry of Health to manage British Columbia’s tobacco control strategy. “That job taught me the need for a broad-based, comprehensive tobacco control strategy that includes programming, policy, research, community-based intervention, and mass media campaigns,” she says. “I saw that it takes many sectors working together — researchers, policy- and decision-makers, practitioners, NGOs, and other advocates.”

The position also gave Waverley an opportunity to work on tobacco control at the national level, first as the BC representative on a national steering committee for reducing tobacco consumption, then as the committee’s chair. Her work experience, combined with a master's degree in investigative medicine and a PhD in the social science and public administration aspects of tobacco control policy, landed her the job of RITC senior program officer in 1998. Two years later, she became RITC program leader.

Major Successes, Major Challenges
 
During Waverley’s years at RITC, the program helped create an international community of tobacco control researchers who are building a locally focused knowledge base capable of countering the influence of transnational tobacco companies. RITC-supported researchers have scored some highly visible successes.
 
Created in 1994, RITC funds research in developing countries on a wide range of issues, including how to make the transition from growing tobacco to growing food; the health, economic and environmental impacts of tobacco cultivation; the health care costs of tobacco use; and effective policy approaches to reducing tobacco use.
 
RITC’s support of Vietnam in the hard struggle against tobacco has been very important. Through this research, consumers have gained greater awareness about tobacco, while we know more about the actual perceptions and behaviours of consumers. As a result, we have made recommendations and suggestions to officials responsible for tobacco control.”
— Dr. Do Gia Phan, Vietnam Standard and Consumer Association

In South Africa, for example, local RITC-supported research convinced the government to implement some of the strictest tobacco control measures ever adopted by a developing country. The consequences of that legislation were truly win-win: when the excise tax was increased from 34% to 50% of the retail price of cigarettes between 1994 and 1998, tobacco consumption dropped 15% while government revenues from tobacco taxes climbed 75%.

 
Success in South Africa inspired similar RITC-supported research in Jamaica, which helped the Jamaican government rebut the tobacco industry’s argument that higher taxes would have a devastating impact on the country’s already precarious economy. A RITC-funded researcher from South Africa worked with his Jamaican colleagues to provide the evidence required to convince finance ministry officials.
 
However, despite these and many other successes, RITC-supported researchers continue to face major challenges. “Tobacco control is a battle that has to be fought country by country,” says Linda Waverley. “The tobacco industry generates huge amounts of money and when it threatens to remove its operations from a country, often politicians listen. Tobacco control only works when there’s the political will to base decisions not on threats, but on the facts.”
 
Tobacco Control in Canada

Few countries have reduced tobacco consumption as quickly or as widely as Canada. A key part of this success has been Canadian leadership in integrated tobacco control policies and programs.

The first wave of tobacco control in Canada was spurred by the 1962 release of the United Kingdom's Royal College of Physicians' report on smoking and health, which unambiguously linked smoking to disease and premature death. Two years later, when the United States Surgeon General directly linked tobacco use to lung cancer, public calls for governments to introduce anti-smoking policies and programs grew louder, not only in Canada but worldwide.

Until the mid-1980s, Canada’s approach to tobacco control was piecemeal. This changed in 1986, when the federal government introduced multi-year, comprehensive, integrated strategies. The current Federal Tobacco Control Strategy has five objectives for 2001 to 2011: 

  • Reduce the number of Canadians who smoke from 25% to 20% of the population
  • Decrease the number of cigarettes sold by 30%
  • Increase retailer compliance with laws on tobacco sales to youth from 69% to 80%
  • Reduce the number of people involuntarily exposed to secondhand tobacco smoke in enclosed public spaces
  • Explore ways to mandate changes to tobacco products to reduce health hazards
Implementing the strategy requires the collaboration of many partners, including federal, provincial, and territorial governments, tobacco control advocates, and health care organizations and associations. It has four mutually reinforcing components: 
  • Protection: Creating an environment (physical, legal, and regulatory) that helps make non-smoking the social norm in Canada
  • Prevention: Discouraging Canadians, especially youth, from starting to smoke
  • Cessation: Helping Canadians quit smoking
  • Harm reduction: Reducing, as much as possible, the health hazards of tobacco products