Tobacco Documents Online

APPENDIX A Critique of WHO Report EB77/22 Add 1 Entitled "The Adverse Health Effects of Tobacco Use" l C 1. The document is a radical departure from traditional WHO concern for objective science and a realistic approach to world health problems. There is a clear indication that the WHO has succumbed to pressures from anti-smoking activists and the report reflects thei'r views without question or comment. 2. The language of the report is emotional and abusive. Phrases describing the health question as a "pandemic", tobacco manufacture an "unscrupulous commercial enterprise" and parental smoking as a form of "child abuse" stem from anti-smoking activists. The list of references is drawn entirely from anti-smoking sources. 3. Examples of irregularities and inconsistencies in the report are as numerous as are the distortions. To begin with the report claims that the connection between smoking and health "is clearly proven" and hence further basic research is "unnecessary", subsequently the report suggeststhat more basic research into the"question of smoking and health is needed. 4. In an effort to interject fear on the subject, the report claims that both rates of cardiovascular disease and lung cancer are rising in all countries and that smoking is implicated as a causal factor in these rising rates. Yet the report conveniently ignores-recent, important studies (well known in the international scientific community) which have shown that smoking has little, if any, effect on cardiovascular disease and rates of lung cancer. More importantly, the report again contradicts itself when it states at a later point that some "trends in ... tobacco-related diseases have actually been reversed". 5. The report states that smoking is undoubtly a major cause of disease and accuses the tobacco industry of maintaining that the "causal connection" has not been scientifically established and that the evidence is "only statistical", but while the report claims that the causal evidence is "over-whelming" it endeavours to support this conclusion by evidence which is itself over-whelmingly epidemiological (statistical). 6. One glaring example of the misuse of scientific terms appears in the report under the discussion of cigarette smoking as a claimed "addiction". At one point, the report even states that cigarette smoking may be more addictive than the use of heroin. Yet at other places in the report, smoking is referred to as a "habituation" and a "dependence" - terms which fall far short of classifying tobacco as an "addiction". 7. The claim by the report that tobacco is addictive is misleading, incorrect and in direct contradiction of the manner in which tobacco is classified by the WHJ itself. W, t /7....

-2- The WHO's International Classification of Disease 9th Ed 4 , ., classifies many products as addictive - but not tobacco. (The authors of the report have also completely ignored other WHO publications on what constitutes "addiction"). Furthermore, the report later states that 9 million smokers in the United Kingdom and 33 million smokers in the United States have "quit on their own" - hardly an expected result if tobacco were truly addictive. 8. The report characterizes tobacco smoke as "the largest source of indoor-pollution" and it claims that exposure to environmental tobacco smoke may injure the non- smoker. This claim is not only not supported by the evidence on in-door air pollution and environmental tobacco smoke, it simply ignores a great deal of the scientific evidence available on the subject. This other evidence includes three recent authoritative pronouncements on the question of environmental tobacco smoke exposure and the health of the non-smoker. 9. In 1983, the Royal College of Physicians admitted "The extent to which passive smoke exposure can damage the health of otherwise healthy individuals is by no means clear." In the same year,'a symposium at the University of Geneva reached the conclusion that an increased risk of lung cancer to non-smokers from tobacco smoke exposure "has not been established." in 1984, a seminar of scientists and physicians in Vienna, determined that "no link has so far been scientifically established between passive smoking and lung cancer." 10. Recently, Dr Gio Gori, a former researcher at the U.S. National Cancer Institute and long time critic of smoking, wrote "uncertainty about the health effects of passive smoking still prevails ... this clearly is not for want of trying, as many people have strong interests in the results of such research." He added, "What needs to be stated is that, despite numerous and extensive trials, available evidence has not been found that a massive public health problem attributable to passive smoking exists." 11. So much for the medical evidence. The report also claims that the very economic lifeblood of nations around the world is somehow threatened by tobacco. The clear focus of the report is that the "evils" of tobacco are the sole responsibility of the large, private tobacco companies around the world. The report describes them as the "profit taking" and "ruthless transnational corporations" and identifies them as responsible for all claimed tobacco-related health problems. Having clearly asserted that the "transnational tobacco companies" are responsible, the report then proceeds to admit that government owned or controlled companies and not the "transnational companies" are responsible for well over half of all tobacco manufacturing and sales. This figure does not include what the report itself acknowledges to be "a very large cotage industry", where thousands of families around the world earn their •livelihood directly from the manufacture of tobacco products in the home or small factories. N CJi 0 ~ ~ 10 0 co C /3....

. ,. ~ -3- Y7 ` 12. Continuing its attack upon the private companies, the report claims that tobacco usage is a result of "intense and ruthless promotional campaigns on the part of the transnational tobacco companies." The report offers no evidence to support this statement but merely presumes a connection between advertising and consumption. If this were true, the continued extensive use of tobacco products in countries where advertising has been banned for a number of years is impossible to explain. 13. The report states that cigarette "tar" and nicotine yields in developing countries are higher than those found in cigarettes used in developed countries. This general and unsupported statement is directly contrary to a scientific report issued by the WHO itself in 1984 which stated that cigarette yields are comparable in developing and developed countries. Furthermore, the report again contradicts itself when it later admits that the WHO is currently carrying out a research project to determine whether or not "tar" and nicotine yields in developing countries are in fact "high". 14. As an indication of the degree of selection employed in the report, reference is made to the Economist Intelligence Unit declaring that "80$ of timber generated fuel is wasted" in tobacco curing. No reference is made to the findings of the Economist Intelligence Unit that tobacco production makes a significant;.and beneficial contribution to the agricultural development of Third World countries. The publications of the Economist Intelligence Unit, which are definitive on the subject, are not listed in the list of references. . 15. Reference is, however, made to an "unpublished" FAO paper (ESC: MISC 82/1)* on the economic significance of tobacco. Regretably, use of this paper is again entirely selective and its conclusions which are favourable to tobacco production, are either not fully reproduced, disputed or ignored. * The paper has actually been published. 16. Thus, where as the report maintains "on a long term basis.. tobacco production entails definite economic and environmental losses to the producing countries, especially the developing ones," and later "The negative effects of tobacco production on:the environment and rv economy of the developing countries are many and far- U' 0 reaching....", the FAO paper finds as follows: ~ 4~- "32. In conclusion, the cultivation and manufacture of `0 tobacco result in a number of immediate and tangible o social and economic benefits, particularly in the poorer ~ producing countries. Tobacco growing generates large scale rural employment in over-populated areas and provides a ready source of cash for small holders who would other- wise be dependent on less remunerative crops or on subsistence farming. In nearly every producing country, tobacco is one of the most valuable crops grown, and its contribution to total agricultural income is almost invariably significant, reaching 25 percent in t:ie case of Zimbabwe. Tobacco is also one of the most remunerative cash crops, yielding net returns per unit - P....

-4- of land which may.be several times higher than those obtained from industrial crops or staple food-stuffs. In addition, tobacco leaf is an important source of foreign exchange for exporting countries. The value of world exports in 1979-81 averaged US$4 000 million, of which about US$1 600 million accrued to developing countries, and tobacco makes a substantial contribution to the agricultural export earnings of many individual countries, especially in Africa and Asia." 17. The FAO paper continues: "33. Tobacco maufacturing creates extensive employment opportunities, particularly in developing countries where manual methods of production are still the rule, so that the labour force may run into hundreds of thousands. The wages and salaries paid by tobacco factories compare favourably-with those paid by other industries employing workers with similar skills; the value added by processing contributes some 3 to 5 percent to net industrial output in most developing countries, and about 1 percent in the developed countries." So much for the machinations of the transnationals. 18. Another example of distortion and inaccuracy in the report can be found in its attempt to portray tobacco production as a misuse of land which could be more advantageously put to food production. Thus the report maintains "Adverse effects of tobacco cultivation on the availability of food are well documented, although little known" ... (No references are given) and continues "When land or labour is scarce, any.used for tobacco cultivation reduces that available for food production." 19.~ The FAO paper however, states: "Tobacco is probably the most widely grown among the non-food crops, being produced in about 120 countries and territories, yet it occupies a mere 0.3 percent of the world's arable land, compared with 0.7 percent for coffee and more than 2 percent for cotton. The proportions of total arable land devoted to these three crops, and to four of the principal food crops, show that the tobacco area is less than half as large as the area under coffee, and occupies only one-eighth of the area under cotton, one-thirteenth of the area under maize, and less than one-fifty-fifth of the area under wheat. Moreover, tobacco is frequently grown in rotation with crops such as wheat, maize, rice, groundnuts, or other oilseeds, as well as with grass and clover, not only in developed but also in many developing countries, including India. Where tobacco is grown on the same land year after year, as it is in Greece, Turkey, Malawi and Zimbabwe, the soil is generally unsuitable for most other crops." 20. To conclude, the general impression gained from the report is that, under pressure from the militant element at the 5th World Conference on Smoking and Health, held in Winnipeg in 1983, the WHO has adopted the attitude that the case against tobacco requires no further investigation and all out offensive against the industry 'is imperative. As a result the report is not required to be objective but merely a polemic against the tobacco C / 5 . . 0 0