Extend food and drug regulations to tobacco industry

by Chakravarthi Raghavan

Geneva, 27 Apr -- The head of the World Health Organization, Mrs. Gro Harlem Brundtland has called for extending food and drug regulatory rules governing sales and promotion of nicotine delivery services to cigarette and tobacco industry products.

Speaking at a conference in Berlin of international drug regulatory authorities, Mrs. Brundtland said: "A cigarette is an euphemism for a cleverly crafted product that delivers just the right amount of nicotine to keep its user addicted for life before killing the person... the product should be judged for what it is, not what it is made out to be by the tobacco industry."

Mrs. Brundtland's call for extending the reach of food and drug regulations and regulatory authorities to cigarettes and other tobacco products, comes even as WHO executive board is asking the World Health Assembly, at its meeting in Geneva in May, to decide on a negotiating process to negotiate a framework convention on tobacco control (FTCC), and perhaps some related protocols.

The Assembly is being asked to decide to set up an intergovernmental body, open to all Member states, to draft and negotiate the proposed FTCC and possible related protocols.

In her speech at Berlin before an international conference of Drug Regulatory Authorities, Mrs. Brundtland cited from a 1972 internal tobacco company document, "uncovered recently", and written by a senior scientist of a company where he said: "The cigarette should not be construed as a product but a package. The product is nicotine. Think of the cigarette pack as a storage container for a day's supply of nicotine. Think of the cigarette as a dispenser for a dose unit of nicotine. Think of a puff of smoke as the vehicle of nicotine."

And if drug regulatory authorities can and do control and regulate the sales and promotion of nicotine delivery devices, so should they now deal with cigarette and other tobacco products in the same way, as nicotine delivery devices, Mrs. Brundtland said.

WHO secretariat documents put out to promote an FTCC spoke of national and "transnational" tobacco control and cooperation measures, with the framework convention agreeing on "guiding principles", and with protocols dealing with specific obligations.

The use of terms in the document -- such as 'transnational', which really means acting beyond national borders, instead of 'multilateral' meaning intergovernmental actions through a multilateral forum -- create some confusion as to what the WHO secretariat and those running the program mean or aim at.

The FTCC initiative also seems to avoid the hard core trade issues - addressing instead issues about prices, smuggling, tax- free tobacco products, advertising and sponsorships, Internet advertising/trade, testing methods, package design/labelling, information sharing and agricultural diversification.

The attempt to avoid the "trade" issue is perhaps understandable. An earlier initiative at the WHO, supported by the US health authorities, for using the WHA's ability to write binding rules through a resolution, was squelched by US State department officials who used arguments about international trade free of restrictions.

But the climate in the United States has changed with federal and state authorities suing tobacco companies, and the administration trying to use its executive power to regulate tobacco and nicotine use (an issue now in the courts, with the US Supreme Court recently agreeing to review a lower court ruling against executive actions).

However, parallel to these has been the success of tobacco industry lobby to prevent laws being written against their activities abroad.

In her speech, Mrs. Brundtland spoke of tobacco promotion being linked to smoking initiation, with initiation among the young often leading to addiction. "This is not freedom of choice," she said. Addiction results in prolonged use and causing avoidable premature deaths decades later. Focus on tobacco promotion now would determine who would be killed by tobacco in 2025 by when (if present trends continue) some 10 million a year, triple of level now, would be killed by tobacco.

Smoking, she noted, was growing rapidly in the developing world and nearly all the consumption growth, and seven million extra deaths, were expected in the developing world.

Part of the failure of tobacco control, she said, was due to the "incongruous way" tobacco products have been regulated.

Selling price was controlled through taxes, and the cigarette box marginally controlled in many countries through mandated health warnings, while tobacco advertising is controlled only in some countries.

But the root problem is not the cigarette package or the price or the advertising, but the product itself, she said, adding, "Cigarettes are inherently dangerous products. The tobacco companies, despite knowing this for many years,, have steadfastly chosen not to remedy this and to press forward their sales.

"It is this failure of the market place to solve the problem that is our invitation to step in and make a differences."

Though this was not easy, too often the challenges have been over-stated and too often countries have chosen to tinker at the edges.

One of the largest transnational tobacco companies opposed tobacco content regulations, though the same company is not unfamiliar with such regulation in its activities in its food products division.

The proposed FTCC would be the world's first public health treaty, but will work only when it works in conjunction with domestic policies. (SUNS4424)

* Chakravarthi Raghavan is the Chief Editor of the South-North Development Monitor (SUNS) in which the above article first appeared.

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