Philip Morris
Final Report Fourth World Conference on Smoking and Health Stockholm, Sweden 790618 - 790621
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- European Congress of Cardiology
- European Coordinating Comm Smoking Healt
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- 4th World Conference on Smoking + Health
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- Armstrong, B.
- Byrne, D.
- Califano, J.A., J.R.
- Daube, M.
- Godber, G.
- Gray, N.
- Heath, W.
- Higginson, J.
- Hohnen, R.
- Howells, G.
- Leederer, S.
- Lindahl, H.
- Mahler, H.
- Pippett, V.
- Reader, R.
- Ringrose, E.W.
- Shaw, J.
- Young, G.
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FINAL REPORT
FOURTH WORLD CONFERENCE ON SMOKING AND HEALTH
Stockholm, Sweden
June 18-21, 1979
Prepared by
the ICOSI Task Force
August 22, 1979
This Final Report on the Fourth World Conference on
Smoking and Health is an appraisal of the implications for
~ the tobacco industry from what transpired at Stockholm. It
describes what is likely to happen as a result of agreement
by leading anti-smoking forces to undertake a joint, world-
wide campaign against smoking.
In addition, an attempt is made to analyze the con-
sequences of these important developments for the organiza-
tion of ICOSI and the scope of its activities, for con-
sideration by the member companies
INTRODUCTION
The Fourth WorLd Conference on Smoking and Health has
made three points unmistakably clear :
1. Major anti-tobacco forces are organizingg
and joining in a world-wide war against smoking.
. More governments and government-sponsored organiza-
tions (national, regional, internationaL) wilL
become involved in anti-smoking activities. Activi-
ties of those now involved'will increase.
3. The goal is the eventual elimination of smoking,
especially of cigarettes.
Participants in the Stockholm Conference moved quickly
to create the machinery needed to reach that goal, which was
stated'frequently throughout the meeting. Representatives from
the five international health organizations that co-sponsored
the Conference agreed to meet soon to establish officiaLly a
coordinating committee in Geneva and to begin planning,for a
Fifth World Conference on Smoking and Health.
Further, delegates from anti-smoking groups in eight of
the nine countries in the European Economic Community formed
a "European Coordinating Committee on Smoking and Health."
Thus, there should be no doubt that people are at work
now to consolidate, strengthen and expand the overall anti-
smoking effort.
It mattered little that the Conference was poorly run,
the participants generally less than enthusiastic, press atten-
tion minimal, and the science offerings weak. The Conference
served to provide an "official" setting for the health groups.
an&their leaders to establish and give impetus to an inter-
national commitment against smoking.
As a result of the developments in Stockholm, it can be
expected that the maj'or anti-smoking initiatives that pre-
viously originated in the i7.S., for the most part, will
be augmented before long by those originating elsewhere. Con
sequently, there will be a two-way pattern, a spillover to and
from the U.S. (An example : Sir George Young, Britain's Under-
Secretary for Health and a featured speaker at Stockholm, said
a few weeks after the Conference ended that his government was
determined to work toward elimination of cigarette smoking.
In the coming months, his government would be "considering all
the options with regard to policy on smoking and heaLth," he
was quoted:. Since then two MP's have introduced a private
members' bill, which effectively may ban all cigarette adver-
tising in the U.K.); even though it is likely that these fanatic
anti-smokers would have done so anyway.
GENERAL STRATEGY
The anti-tobacco forces will seek to help and work more
effectively with each other and with any group of similar
purpose.
They will do so by : seeking,to enlist the support of
politicians, government officials and the cooperation and parti-
cipation of influential groups that are now indirectly or not
at all involved'~in the smoking and health controversy. Further,
they will exchange ideas, information and materials across
national borders; they will exchange expertise when and~where
needed and they will sponsor meetings and make funds available
for anti-smoking activities.
The anti-tobacco groups will use a1L conceivable means
to promote the international campaign in four general areas :
- political
- legislative
- educational
- socio-economic.
The impetus for a world-wide campaign did not originate
at the Conference. Various groups and individuals had urged it
for years. It was obvious that the concept hadibeen agreed to
and settled in advance of the Stockholm meeting,. The Conference
provided a logical setting and a seal of approval by deLegates
from a reported 68 nations who attended.
Some delegates may have been paying lip service to a
global anti-smoking campaign, thinking it perhaps infeasible in
terms of their individual countries. However, from the speeches
and discussions at the Conference, there is no doubt of the
serious intent and capability of certain powerful and persua-
sive persons to organize the cooperative effort. They have
demonstrated their skills in the past.
Some of these persons are self-proclaime&fanatics im
regard to smoking. Others are dedicated and sincere in the be-
lief they are working for the good of humanity. Others seem to
be involved for whatever feelings of power and self-gratifi-
cation their participation provides. Still others have made
careers - and livelihoods - in the anti-smoking field.
And last, but certainly not least, there are those bureau-
crates and~politicians who, slowly but inevitably add another
dimension to the management of anti-smoking drives. Because they
have this function assigned to carry out policy, they coul~d turn
out to be one of the most effective elements of the campaign. A
number of high-level politicians (Mr. Califano, Sir George Young,
etc.) and lesser-ranked functionaries from around the worLd were
present in Stockholm.
Regardless of motivation, the objective is there : the
elimination of smoking as a societal custom.
Most leaders and supporters of the anti-smoking movement
realize that the elimination of smoking is an idealistic con-
cept. However, they believe their efforts over the long term
will lead to a gradual reduction in cigarette consumption that
would seriously damage the tobacco industry. They are inspired
by what they have accomplished in recent years.
They are determine&to step up their activities an&to
attack the tobacco industry at every opportunity and by every
means. Part of the propaganda they will use will depict the
industry as "merchants of death" and "the seven ugly multi-
national sisters."
MAJOR TARGET AREAS
Events at the Stockholm Conference, when viewed in the
context of recent history, cLarify what will be the major targets
or action fields of the international program. Only the third
is relatively new.
1. Socio-economic aspects:
a) Social unacceptability
b) "Passive" smoking
c) Education and cessation programs
dY Economic costs
2. Advertising and promotion
3. Third world countries
4. Other action areas.
It should be emphasized that health charges will remain
a basic and powerful weapon in the arsenal of the anti-tobacco
forces. Their theme is familiar: "There can be no serious debate
over the adverse health effects of smoking. Medical and:scien-
tific research~ has proven that smoking causes various major
diseases (lung,cancer, heart disease, chronic pulmonary ailments,
etc.). No further research is really necessary."
However, research will continue - indeed, some of it will
be sponsored by certain of the anti-smoking organizations - and
when findings support their positiony they will be widely
publicized.
- 7 -
1. Socio-economic Aspects
a) Social unacceptability
There will be increased emphasis on this area in the in-
dustrialized nations. The arguments and~fear-tactics will be
familiar and constant : Smoking is a dirty, unhealthy, unnatural
and annoying!habit that is offensive to nonsmokers, who comprise
the majority of the population., Further legislative restrictions
or outright bans will be sought against smoking in public places,
on public transport and in work places. The goal is to make
L- smokers objects of social disapproval : In essence, nonsmokers
are normal, smokers abnormal.
b) "Passive" Smoking
There will be an increased push in many industrialized
countries for further legislative action related to "passive",
or public, smoking. Some of the more extreme opponents of smoking
can be expected to resort to fear-mongering by charging,that
public smoking can cause disease or illness in nonsmokers. Those
less extreme will seek legislation even though they have little
supporting evidence. They will generaLly ignore or try to de-
nigrate the recent findings that smoking has no adverse effects
on the health of healthy nonsmokers.
When the anti-smokers find the health argument ineffective,
they will claim that smoking is annoying, offensive or physically
irritating to nonsmokers who have the right to breathe clean air.
There will also be an expanded~effort to have business
enterprises of all kinds restrict or ban smoking by employees
on their premises.
c) Education and:Cessation Programs
Education : There will be expanded efforts to enlist
more schools and teachers in educational programs aimed at dis-
suading youngsters, including those in lower school grades, from
starting to smoke, There also will be more programs designed for
adults. Emphasis wi'L1 be in the industrialized countries, but
some developing nations, especially those with sizeable profes-
sional classes, will be included. The health allegations wiL1 be
stressed. Research will continue in an attempt to find more
effective ways to reach young people.
Cessation : The Stockholm Conference, as have other meet-
ings in recent years, demonstrated lack of agreement among
"experts" onihow best to help smokers give up the custom. Regard-
Less, there will be an increase in the number of "stop smoking"
or cessation programs and clinics, both non-profit and commercial,
in the industrialized nations. More and more community health
groups, voluntary health agencies and related organizations wiLl
establish programs or expand existing ones. Such programs are
more successful in an anti-smoking climate.
(An International Conference on Smoking Cessation was held
in New York in June 1978 under the sponsorship of the American
Cancer Society, the International Union Against Cancer and WHO.
The meeting disclosed that a number of cessatiomprograms were
under way in most parts of Europe, Scandinavia and North America,
and in certain other countries such as South Africa, Australia
and:New Zealand. The nations reported to be most active in this
area were Sweden, Norway, England, West Germany, Canada, and the
U.S.)
d) Economic Costs
Increased emphasis can be expected, especialLy in the de-
veloped countries, on charges that smoking results in a serious
economic burden to society because of its effects omhealth.
Smoking is blamed for premature deaths, illness and disability,
and claims are made that, as a result, society will have in-
creased!costs for insurance, family welfare, hospitalization,,
absenteeism from work, an&Lost economic productivity.
Swedish Health Minister Hedda Lindahl opened the Stock-
holm Conference with a speech in which she caILed tobacco "a
great economic burden" to the world. Michael Daube, former head
of Britain"s ASH (Action on Smoking and Health), closed the
Conference with a speech in which he said that promotion of
smoking "will lead to thousands and possibly miLlions of pre-
mature deaths in the third world." In between there were similar
comments, including one by btheni) U.S. Secretary of Health,.
Education and~Welfare, Joseph Califano, Jr., who said smoking
is involved in 324,000 deaths annually in his country.
A lesser theme in this area, that of fires caused by care-
less smokers, may be promoted in certain countries..
2. Advertising and Promotion
A strong effort can be expected world-wide to persuade
governments to ban all cigarette advertising and promotion. Bans
reportedly are now in effect in 13 countries. Many opponents of
smoking claim that advertising persuades people, especially young
people, to take up smoking:.
Pressures will be exerted on politicians as well as doctors
and scientists to support demands for bans. The news media's co-
operation also will be sought to help build public pressure.
In many places, the drive for advertising bans probably
will be originated by "citi~zen-type", anti-smoking groups or vo-
luntary (private) health agencies and community health groups.
