Tobacco Documents Online

MFlY 25 '93; 05:27PM 914 3359974 T8a ACT=vYNT KoMM P,2:14 The following is a broad overview of the well developed network set up by the anti-tobacao proponents to advance their issues with opinion makers in government and in the media. The paper, degcrilbes the major international. organizations and the leading'regional groups. It also bighlights the roles played by certain individuals within the network who, behind the saenes, set the agenda and coordinate the attack. The leadership of the activist movement is disproportionately composed of people drawn from the Nordic and Anglo-Saxon countries. Within this group, the Australians play a prominent role. i. ,j11teHat~l Ytat orr There are a nuwaber of organizations involved in managing the anti-tobacco agenda from a global perspective. The bodies exercising considerablee influence and which provide tha framework for the international anti-tobacco network ares. . 0 World Health Organization, Geneva-based International Union Against Canaer, Geneva-based with regional offiCes in Copenhagen, Washington, Manila, Dakar, Alexandria and Brazzaville o The Advocaoy Ynstitute, Washington-based o International organization of Consumers Unions, based in the Hague, with regional offices fn Montevideo$ Penang, Nairobi There are also specialized international groups dealing with specifia issuas on tobacco control, such as the International Network of Women Against Tobacco (InwAT - based in Washington) and regionally focused groups guch as the lU Asia-Pacific Association for the Control of Tobacco (APACT). N O Crt . ~A GD ~ M~+ N ~.+

Yn order to oommun ioate more effeotively on advocacy issues in 1992, the anti-tobacco movement initiated its own quarterly journal. Tobacco Control consolidates the 'best lesgons' on smoking control for activists, advises an current issues and alerts its readers to alleged tobacco induetry ma~ipra~otices. The journal operatee a two-tier editorial board. Tho lnternational editorial board congists of leading activists, such as David Simpson (U.K.), Simon Chapman (Australia), Judith MacKay (Hong Kong), Greq Connolly (U.S.A.), Michael Kunze (AusCria), Michael Daubo (Australia) and - claire Chollat-Traquet (Switzerland). The second level- editorial board is made up of 'national contributing editord', inoluding individuals such as Michael Pertochuk (U.B.A. ), -Mark Flannagan (U.K.) and Prakash Gupta (India). The journal is sponsored by the British Medical Assooiation as part of its on-going csommitment to pubi.ioations on the tobacco debate. The journal oarries little or no advertising although attempts to encourage advertising from the pharmaceutical companies which market smokinq cesgation products are being made. 1. Y$or~d~ b organl~ra~ on ~]J$,(~. The WHO is a multilateral UN agency mandated to deal with health and sanitation problems around the world. Its role id essentially that of aooordinating body, ensuring that national health authorities of its Member Countries are aware of and implement a variety of health programs. One small element of the WHO Healthy Lifestyles Program is the Tobacco Or Health (ToH) Prog ram. A relatively poorly fwvded unit, it focuses on publicizing its anti-tobacco mandate and qlobal efforts. Essentially a"publio relations" function relying on un-paid edia, it has been very successful in qenerating widespread attention to its "cause". Conseguently, it is re arded as by far one of the more effeotive programs the Wfl0 has ~nitiated. Headed by Dr. Roberto Manchaoa (Cuba), the unit is supported by an Epi.deniologist, Dr. Alan Lopez ,' a Hedia Program Coordi.hator, Dr.. Claire Chollat-Traquet (Saritzerland), and a Program Coordinator, Neil Collishaw (ex Canadian Health Depaactment). 7Che work of the WHO. had been supported by other ~j organi.aations such as the UYCC (see 1.1) and the national ~ cancer. t~harities. A core group of national governments, IV including the U.S.A., U.R., Norway, Saeden, Finland, Australia, C/1 New Zealand and Canada, themselves all outspoken advocates of 'A tobacco control, are also strong proponents of the WHO Toll ~Q Program. N

In l ight of its poor funding arrangements, the WHO cannot be looked upon aa the owerhouse for smoking control around the worid. The monie~t ~t does have available ars" badically Iseedcorn', to provide the framework and climate through the media for the growth of smoking control strategied in the Member states. ' The WHO operates the ToH prograR through ite Geneva headquartern'and its regional offices. There are desi4nated 'foN Focal points in eachh of' the regiong, which take responsibility for the implementation of tobacco control ptrate giee within the Member states. The antis have been careful in the use they have made of the WfO. They do not perceive it as taking an activist lead in tobaovo oontrol, but rather use the organization to endoree and legitimize the anti-tobaoco agenda. As a multilateral health agencsy, the WHO presents a credible platform which the antis may not achieve through their own pressure groups. . 1. a. Yntern~~tio al Un on AgAinat Caac r,. 1QICL) The UICC ham declared its intention to aobiliae all of irs member organizations (mainly national cancer charities and cancer research rsenters) in the f ight against tobacco. To fulfill this aim,.in 1976 it established The Tobacco and Cancer Program, which operates through a regional network of tobacco control aativists. Prior to the appointment of current Chairman, Dr. Michael Wood (U.R. ), the Program Chairman for the UICC Tobacco Project was Michael Daube, who is currently CIDO of the princess Margaret Hoepital for Chixdrent perth, Western Australia. Daube still retains the status of Specialist Adviser to the UICC on tobacco control. The next President of the UXCC will be Dr. Rigel aray of the Anti-Cancer Council of Victoria,. Australia. Dr. eray has been on the Executive Committee of the t1ICC for approximately 15 years and was himself a regional coordinator for the Tobacco and Cancer Program in the South/Western Pacif ia Region. Gray will retain the status of &peoialist Adviser to the UiCC Tobacco Program during his tenure as UICC President. With its headquarters in Geneva, the UICC is well placed to provide effective lobbying on tobacco issues at the WHO. In fact the 1+IHO has aocorded official NGO status upon the UICC, giving the organization effective open access to WHO officials and meetings. It is im ortant to note that the UICC Tobacco Project Regional Coordinators are almost all Members of the WHO Expert Advisory Group to the ToH Program. Thi.s no doubt ansures that the views of the UICC tobacco activists are well represented within the ToH program objectives.

The UICC actively encyourages its national members to lobby on the behalf of tobacco control aotivists. The antis valve this accessibility, as its helps in their coalition building , ~ and-lobbying effort. The Ulce has also agreed to act as the internatioral voordinating body for access to the GIABAL3nk interactive advocacy and information database of the activist movement. ovex 90 activist groups around the world eubscriba to the ai,omink database. The database has established a true network through which the antis can exchange data and information on the types of programs and legislation that are the most effective. 1.3 l!l1X.ttQAltY YnatJtRt_! .(Ali. The AI is truly embedded in the global anti-smokinq movement. x'he majority of its funding for smoking control initiatives is drawn from cancer charities in the U.S. and U.K „ The group - har produced a number of tobacco control guides on behalf of the UICC and the American Cancer Society and has given 'expert advice' in the lanning of anti-~tobacco initiatives ~.n a number of countrr~Qs around the world, including NQw Zealand, the U.K., Canada and Australia. Michael Psrtschuk (one of its co-direvtors and former Director of the U.S. Federal Trade Commission) is regarded as a 'leading. light' in thA activist movement. He acts as a the WHO Expert Advisor and a member of vhat has been described as "The Golden Circle" of the novement. Se serves on the exclusive international Liaison Group on Tobacco or Health, which oversees the organization of the now bi-annual World Conference on Tobacco or Health (WGTH). The Secretariat for the ILGTH is provided by the UIGC. The last WC'1'N took place in Buenoa Aires in April 1992. 1.4 The It3CU is a coordination body for consumer activist groups around the world. As with the WHO and the UICC, the organization operates through regional groups. National consumers groups have been quided in their activism against tobacco through the IOCU coordinating body AGHAST (Action Groups To Halt Advertising and sponsorship By Tobacco), which is based in Penang, Malaysia. AGHAST has been quite weak in recent years, with the activist lead being taken by groups such as the UICC, the Al and regional anti-tobacco groups.

2,1 Latin Apgerica Yn Latin America, the ma jority of omoking control activities are organized by the Latin American Coordinating , Coramittee for 8noking Control (CLACCTA). Argentina cutrently holds the presidency of this group. CLACCTA is funded direotly by the tIyCC~ the American Cancer Sooisty (ACS) and to a limited extent the VHO/Pan American Health organization Office in washington. cLACCmA hos also received significant technical a.nd logistical support from the U.S. Surgeon General's Office and the U:B. Office of Smoking #nd Health. The U.S. Surgeon General was a principal speaker at.the 1992 WCTN in Buenos Aires and this yoarfs U.S. Surgeon General Report was entitled "Smoking in the AmerioAS". CLACCTA was cultivated by representatives of the ACS as early as 198d and has proved to be an important focus for smoking control initiatives. The ACS' initially deve].o ed the group after reoeiving requests for assistance fror the then embryonic smoking control groups in Latin America. CLACCTA nov has a permanent representative in every Latin 1Uoericstn country. It has demonstrated its effectiveness in promoting restriotive legislation against tobacco in countries euoh as Argentina where a comprehensive anti-tobatsoo bill was passed by Congress and blocked only by Presidential veto on October 13, 1993. The development of activists in the Spanish speaking community had also helped to strengthen linkS between activists in Europe (Spain) and, avre Importantly, in the Spanishh speaking voypmunities of the U.S.. ..cLA+CCTA has adopted the common WHO practice of 'tvinninq 11 its member countries with its more health conscious Latin counterparts in Europe, particularly in Spain, Italy and Portugal. The a,im is to help less developed nations devslap a more forward looking approach to smoking control. In effeeti, it is an opportunity to advance the oase against tobacco through •shared experienaa and strate+giee.

it should, however, be noted that AatihST will continue to be an important communication tarus for anti-tobacco activiste, particularly since YOCV_i* i;esp4ngible for the production of the Tobacco Control Atlas, under the editorial guidance of leading Australian anti-smoking activist Simon Chapman. IOCU members are particularlyy staunch defendard of consumers' rights and can be encouraged to take 'a gtand' 3n defcnae of the 'rights of ndn-smokers', as has been demonstrated in the Tobacco Institute of Australia and Australian Federation of Consumer Organizations (AFCO) case, which is now in appeal. XOCU also operates the Consumer Protection Legal Advisory Service (CPLAS), which is a support organisation of class action lawyers in 40 countries. Thty have been very active in tobacco litigation, encouraged by the successes of AFCO and the Tobacco Products Liability Projeot, headed by Richard Da~nard from Bogton. The CPAS publishes a regular newsletter entitled "The Consumer Proteator". 1.5 Internationt Network oX ~ IfoAa,.,N Against Tobaooo IXM), INWAT was formed in 1990, at the 7th WCTH in Perth, Western Australia. The group aims to give better representation to 'gender sensiti.ve isgueo' 'in the tobaooo control arena. The group in developing worldwide with almost 120 registered activists listed in its latest direotory. YNWAT will become more ,(mportant as it moves to bring all women's groups into the tobacco deba-te and may focus on targeting in advextioing and children's exposure to $T8. Z• alS1p.ASl SixSt1Ims The three strongest regional blocks in the ahti-amoking movement have eme,rged in Latin America, Asia/Paoifiv and Europe. As yet the Indian sub-continent, Middle Bast and Afriaa have no strony regional, effoxts, however the VICC and the WHO regional offioes are developing such groups in their respective regions. whf.le there is currently no formal group for the North America and Caribbean Region, at the 8th WCTH in Buenos. Aires, Dave Sweanor (Canadian Non smdkexs' Rights Agsoaiation) and Michael Pertschuk (AXj announced that a regional group would be created in 1992/1993.

2.2. Asie,/paaific In Asia/Pacifio, one group exerts significant 'influonce over all national tobacao control organizations. The Asia Pacific Association for control of Tobacco (APACT), founded in Taipei (Taiwan) in 1989, brings to ether all national interests in an umbrella group, designed ~nitia.lly to address market access and trade issueg. National activist groups such as the Nong Kony Council on 8moking and Health, the Korean ,Rssodiation on Smoking and Health, the Thai National Tobacco Control Projeot, the Tung Foundation (TsiWan), the Indonesian Consumer Aseopfation and other groups from the Philippines, Halaysia, Singapoxa, Australia and New Zealand have all linked together in a concerted effort to limit the market penetiration of U.S. cigarette manufacturers into the region. operating with funds from the Saaakawa Foundation (Japan), the Tung Foundation and the national cancer charities .in tho region (all UICC members), the group has developed an effective lobby program against U.S. exporters' aspirations in the liberalized Asia/Pacific markets, The group has coordinated a pool of $experts' who have b®en called upon to give testimony to the GAO (now undertaking its second inqu iry into the activities of U.S. cigarette exportors in Asia) and at U.e. Congressional hearings. They have also initiated letter writing and advertising campaigns as well as direct lobbyinq of the U.S. Congress and GATT. *For example, during recent bilateral trade talks between the U.B, and Taiwan, APACT placed advertisements in several major U.s. newspapers denouncing U.S. cigarette exports to Taiwan. With the assistance of individuals sucb as Judith MacKay of the Asian Consultancy for Tobacco Control (ACTC~, Hong Kong, the group has proved to be a formidable force aga nst industry interests in the region. APACT-is by far the best •funded, coordinated and managed of the regional groups. Its guiding montors include Dr. Ted Chen •(U.S.A.), David Yen Foundation), Dr. T. Han (WHO Western Pacific Regional oflice,r Manila) and Gregory Connolly (Department of Public Health, Masgaohugetts). Connolly's ra].ationship with outgoing Congresgman Chester Atkins stimulated the GAO investigationg as well as some Congressional hearings. Connolly alao uses shareholder proxy resolutions to U.S. tobacco companies to seek changes in their business practices.

The role of Judith MacKay in the region is worthy of special attention. As uICC Regional Director for tha Tobacco and Cancer Program, Member of the WHO Bxpert Advisory Group and a member of the Ynternational Liaison Group on Tobacco or Health, MacKay is best placed to adviee on the broad etrategy objectives of APACT and the national activist groups. Ae aa charitable agency in itg own right, the ACTC has the power to advance the tobacco program priorities of its main funding organizations, namely the v:ECC, ACS and the British Medical Association. A respeoted medical doctor,, MacKay has high credibility both within the ' anti-tvbarsoo fraternity and within government health departments in the region. With hsr experience in drafting legislation, she has been ueeo by the PRC government to frame legislation on advertising bans and publiv nnoking restrictions, and is a member of the board of the recently formed Chinese Assooiation on Smoking and Health. More recently MacKay assisted the Vietnamese government in drafting propogaXd for public smoking restriotions and provided technical exp~c ertise to the Malaysian government in drafting the proposed law banning advertising. She was used extensively by the Thai authorities, most recently in drafting the proposals on ingredient disclosure and pack labe].linq MacKay is largely responsible for inviting Dr. Neil Collishav, (ex-Canadian Minister of Health and *urrent WHO Toli Program Coordinator) to Thailand to guide the Health Ministry in its effort to force brand specsific ingredients dievlosure, Canada is the gbU country which requires this type of disalosure making Collishav a valuable advisor. He knows the arguments used by the industry an well as the best rebuttals. 2.3 $g,Xope ISCjHpTgjSfigtftrn ltur_opaf $urope has the largest number and broadest xanga of anti-saoking activists anywhere in the world. • At the international agency level, the presence of the WHO in Geneva and 'Copenhagen (and its. soientifio arm in Lyon, the International Agenoy for Research on Cancer - IARC), ensures health issues remain high on the political agenda of all European nations.

At the international non-governmentiAl organization (NGO) level, groups suoh as YOCU (The Hague), Xnternational Union of Health Educators (zUHB - Geneva), UICC (Geneva), and the Xnternational Union for Tuberculosis and Lung Disease (IU'rLD - Deneva), provide the regional and national anti-smoking grou s with the broad based health platforms and routes (through their memberships) to effect lobbying of national governments, and the WH0, xt is important to note that all of these NGOs have attained their acrreditation with the WHO, other UN agencies, and the UN itself. 'In addition to the international iVGQs opeFrating through either regional offiaes or their Geneva based headquarterr, there are also specific anti-tobacco groups which operate on a . regional basis in Europe, for example: European Bureau for Action on Smoking Prevention (BASP - Brussels) is a wholly funded European Commission Consultancy. It provides an advisory and publications service on tobacco iggttes to the European Community, In particular to EC Commissioneare and Members of the European Parliament. The current director is Luk Joossene . (Belgium). BASP plays a particularly important role in tba dissemination of argumentation against tobacco to national and regional anti-tobacco groups. In effect, eASP gives the groupe.the ammunition to argue igsuer -on•a common basis across the Member States of the EC. Jooegens is a key figure in the European anti-smoking movement. He is regarded by his peerr as their Fbest expert' on the eoonomic impact and advertising issue and he is regularly used to develop strategic initiatives on behalf of the movement, particularly in Eastern Europe. At the 8t.h WCTB Joossens announced that BASP would be ftwinning• with activists in Jap an In an attempt. to improve management of the advertis.ing issue. As a Speoial Advisor to UxCC, Joossens encouraged the Tobacoo- Program Direotor to appoint a permanent Tobacco Program Liaison officer for Burope, In order to improve the eoordination between the disparate regional anti-tobacco ipterests. Andrew Ha nees (who was recruited frcim the~ WHO 'Health for A~.l• P;o~ect 2000 iinitiative in the U.K.), now links closely with the Europe Against Cancer Program, the WHO offices in Geneva and Copenhagen, the UICC Regional Tobacco Directors and the Ageoa3.ation of European Cancer Leagues (an important funding body for national anti-tobacco activity).

The Europe Against Cancer Program (gAC - Arussels, with national offices In the Member States of the BC) ir an BC funded 10 point plan to reduce the incidence of cancer !n its Member States. Coordinating with health agencies at all levels In the FC, the program drawe its strategy from national cancer charities and leagues (UICC Members), represented by a'Comuaittee of Cancer sxperts#. Al.aost all the experts are, or have been, on the Council of the UzCC and are active in the smoking control movement In their own countries. The'Suropean Union of Non-Bmokers (Et1N - Strasbourg) was established in 1987, to represent the "expression of•over 75,000 non-smokers and tobacco ndn-coneumersM . SUN's goal is to harmonize European laws and regulations "designed to In non-smokex$s and impose 'clean air# regulations in the workplace, schools, universitied, health care incilitieg, public transport, restaurants and hotels. Membership is drawn from national non-smokers rights associations in ten B'~irdpean countries (Belgiuw, Luxembourg, Denmark, Franoe, Netherlands, Norvay, Sweden, switterland, West Germany and U.X.). The current prorident is Jean Tostain (France). The European Medical kasociation on Smoking Or Health (EMASH) was established in 1990 to stimulate the debate on smoking within the aQdioal profegaion as an impetus to stimulating national smoking contral policy and European policy again'st tobacco. Members invlude Michael Kunze (UICC, Austria), Sir John Crofton (IUThII, CI.K.), Professor Albert Hirsch (CNTC - Comite National Contre Ie Tabagisme, France), Jean Tostain (KUN, France), Michael Wood (UICC, U. K. ) and Witold fatonski (WHO upert Advissor, poland) . The WHO Regional offioe for Kurope (WHO EURO, Copenhagen) is the only WHO regional office to have staff dealing exclusively with tobacco control issues. or. W. PihA (on long-term funding from the Finnish government) and Dr. John Roberts (previously with the 'TobacCO Free projevt" in ManchestQr, U.K.) are In the process of developing a' second acti:on plan on tobacco, which will require the WHO EURO to facilitate the development of smoking control measures In Eastern Europe, alongside those proposed within the framework of the BC, The W]IO EURO, with assi.gtanae from UICC, has initiated a number of smoking control workshops In Eastern Europe, and helped sensitize national health ministries to the fpqtential benefits? of N tobacco control measures. ~ ~ +Gi . ~