Tobacco Corporations Step Up Invasion of Developing Countries

Facing greater restriction in the USA and other industrialized countries, transnational tobacco companies are increasingly marketing their products in developing countries, particularly among women and adolescents.

While smoking rates in some industrialized countries are decreasing at about 1% a year, those in developing countries are increasing at around 3% per year. It is estimated that, if current trends persist for the next 30 years, seven million people from developing countries will die every year from smoking-related diseases.

For the past several years, corporations such as Philip Morris,producer of Virginia Slims cigarettes, RJ Reynolds, creator of Camel cigarettes and British-American Tobacco, producer of Dunhill cigarettes have been expanding rapidly in Eastern Europe, Asia, Africa and Latin America.

Tobacco-provoked deaths can only add to the inequities in health of ethnic and minority populations. Jeanette Noltenius, an expert on tobacco and alcohol abuse issues, stated, “In the US, minorities such as Hispanics have been specifically targeted by the tobacco companies since the early 1960s, and have received a double dose of advertising (in Spanish and English).”

According to data from the Bureau of Census, US Department of Commerce, Latino smoking youth will triple in size in 2020 in the U.S., increasing from 9% of the national youth population to 19%.

Since the early 1980s, US trade officials, with help from the Office of the US Trade Representative (USTR), have led a sustained campaign to open markets in Japan, South Korea, Taiwan and Thailand among the Asian nations.

In Taiwan, US officials' efforts to force Taiwan to open its markets to US tobacco products have resulted in increased smoking, particularly among women and children. Talking about US government support for American tobacco companies, a corporation executive remarked, ‘We expect such support. That's why we vote them in.’

These actions have prompted the Asia-Pacific Association for the Control of Tobacco to protest strongly at what they consider an invasion of their countries by US companies targeting Asian women and children. The Association has complained about the strong-arm tactics used by US government officials in their countries. A report from the US General Accounting Office established that ‘US policy and programs for assisting the export of tobacco and tobacco products work at cross purposes to US health policy initiatives, both domestically and internationally’.

Several studies have shown that in the poorest households in developing countries 10 percent or more of the total household expenditure is on tobacco. As a result, there is less money to spend on some basic items such as food, education and health care needs, thus increasing malnutrition, illiteracy and premature death.

In China, tobacco companies have been moving steadily inland with intense promotional campaigns. It is estimated that of the world's 1.71 billion smokers, more than 350 million are in China, where lung cancer has been increasing at a rate of 4.75% a year.

The Chinese government is facing the dilemma of promoting tobacco cessation policies while it is heavily dependent on earnings from the state-run monopoly tobacco company. However, researchers with the School of Public Health at the University of California state that raising the tobacco tax fifteen cents per cigarette pack could save more than 13 million lives and generate $9.5 billion in revenue for the Chinese government.

Lured by financial gains from growing tobacco, millions of hectares in China are presently under cultivation. Gains from the sale of tobacco, however, may be just short-term, since the costs of treating lung cancer and other related diseases amply exceed the tobacco profits. According to experts, those excess costs are $200 billion annually on a global scale, one-third of which is incurred by developing countries.

While anti-smoking efforts gather momentum in the USA, those efforts are far less effective in developing countries. Such countries' policies will not be as effective unless transnational tobacco firms are made to limit their aggressive advertisements.

Countries in Asia and Latin America are conducting health-education campaigns and have passed legislation to control smoking. Up to now, several countries worldwide have enacted legislation to control tobacco consumption. Although in general this legislation has been passed at the national level, in the USA, Canada, and in several countries in Latin America and the Caribbean these laws are being enacted by state or local bodies.

Despite increasing condemnation by public health officials and the World Health Organization (WHO), international companies continue with their indiscriminate tobacco-promotional efforts in developing countries, at a high human cost. As things stand now, only a multidisciplinary strategy including education, taxation, legislation, and regulation of trade practices of transnational corporations will be able to control this pandemic.

MCCH Bd. reviews tobacco policy

A recommendation by the Murray-Calloway County Hospital administration to allow for the use of tobacco products by hospital patients, visitors and employees has been delegated to a committee for further study by the MCCH Board of Trustees.
The topic originally came up during a meeting of the personnel committee Tuesday afternoon. John Wilson, vice president of human resources, presented the committee a report comparing the hospital’s existing tobacco-free policy to standards set by the Joint Commission, a national hospital accreditation group.
According to Wilson, a portion of MCCH’s policy is not in line with the Joint Commission, something that may turn into a black mark when it comes time for the group to re-evaluate the hospital. The Joint Commission standard reads if a hospital restricts tobacco use but allows exceptions, a designated area must be included in the policy. While MCCH allows an exception for patients to smoke on outdoor hospital grounds, there is no designated area in hospital policy.
Wilson presented two options to the committee to get into compliance. First, he said the hospital could simply modify the existing policy to remove any exceptions. Second, they could designate a smoking area and build a small shelter. There was some discussion over cost, location and how to handle visitors and employees, who would not be permitted to use the shelter. Wilson said visitors especially would be hard to enforce.
Hospital employees are currently allowed to smoke off-campus during non-paid lunch time. Normal breaks are not included because they are considered paid time. However, committee members noted there seems to be little enforcement of the policy, including at the Spring Creek Health Care facility. It was noted how many employees will cross busy streets or stand close to traffic, creating potential hazards.
“I think, as an institution, we have been poor neighbors,” said board chair Dr. Sandra Parks.
Interim CEO Brad Bloemer explained the administration’s formal recommendation included visitors and employees. The location at MCCH would be in the graveled area next to the Emergency Room in the South Tower. At Spring Creek, patients would be allowed to smoke at Station 2 and employees would go to an alternative location yet to be determined.
Dr. Rob Williams, chief of staff and member of the board and personnel committee, questioned the timeline and rush to get something done. Williams said it needed to happen quickly because of the Joint Commission, which will begin review of MCCH at some point in the future. Parks moved to accept the recommendation and send it to the full board for discussion and Dr. Burton Young seconded. Parks, Young and Murray Mayor Bill Wells voted yes, Williams voted no and Calloway County Judge-Executive Larry Elkins abstained.
In Wednesday’s full board meeting, Wilson presented the recommendation for discussion. Elkins asked if the issue had come up because of a policy change by the Joint Commission, but Wilson said it had been that way from the beginning but had never been noticed. Williams questioned the design and cost of the shelter itself, saying his concern was in giving approval to something that hasn’t been properly researched.
“The only current issue is, in the Joint Commission, it hasn’t come up before,” Williams said. “We don’t want to be in a hurry.”
The enforcement of the policy was brought up again, given the high number of employees that can be seen on the street smoking.
“It’s upsetting to me to see our employees sitting on the street smoking. I don’t want them to think we are encouraging smoking but on the other hand it’s a good idea to confine it,” said board vice chair Steve Owens.
When discussion turned to specifics of the shelter itself, some movement was made toward attempting to pass a temporary measure to try and come into compliance quickly and return to the issue at a later date. No motion was made, and board member David Garrison asked if it would be better delegated to a committee for further review. Williams, Young and Hal Kemp volunteered to serve on the committee and the motion passed unanimously by the board. The committee will also include members of the administration team, yet to be determined. Young said they would plan to bring findings to next month’s board meeting.
The hospital posted a strong financial result for January, with nearly $1 million in operational income and a total of $779,000 in net income.
“We continue to do very well,” Bloemer said. “It was the best month in several years. We’ve come a long way in the last two months and are up in just about every area in the hospital.”
Bloemer cited salary expense as having a large impact, which were just over $250,000 below budget. He said the staff has been doing a very good job of monitoring productivity. Another factor in the good month is a high daily census averaging 94. Numerous days have seen the hospital at or near capacity. While January is what Bloemer calls the “heart of the business season,” he said results were still exceptional.
Lisa Ray, vice president of patient care services, told the board they have designated two ER rooms for bed holding when the hospital is at capacity and patients are waiting. She said they can begin treatment while rooms are emptied and cleaned and it has not interfered with ER traffic or caused patient complaints so far.
In other business, the board:
• heard a complimentary report on anesthesiology from Williams, saying the facility is operated smoothly and with more local employees and less that travel in,
• heard an update on the upcoming half marathon from Keith Travis, vice president of physician development. Travis said more than 350 people have registered for the April 16 event and he expects an estimated 350 more,
• heard no recommendations from the Board Office Nominating Committee. Parks said the committee was not prepared to make a nomination but may do so at the next meeting, and
• held an executive session for personnel matters.

31 tobacco distributors fined for price-fixing

The Fair Trade Commission (FTC) slapped fines totaling NT$21.9 million (US$741,995) on 31 tobacco distributors Thursday for conspiring to fix the prices of various tobacco products.The most known tobacco products are cigarettes, they can be of different brands: Vogue cigarettes, Virginia cigarettes or Rich cigarettes.

It marks the first time tobacco dealers in Taiwan have been punished since the FTC was established in 1992.

The results of an investigation by the FTC show that the distributors, affiliated to Japan Tobacco International, held three meetings last May in which they decided to raise the prices of 36 products from June, including Mild Seven cigarettes, the prices of which were increased from NT$660 per carton to NT$680.

Also in the meetings, the distributors agreed to set aside NT$10 to NT$15 from every carton of cigarettes sold and deposit the funds in accounts they held separately in a Taipei City bank, as a form of insurance to make sure they all stuck to the terms of their price-fixing agreement, the FTC said.

The distributors decided that the deposits could only be withdrawn after three months, and accountants were hired to supervise the distributors to make sure they deposited the money regularly into the accounts, the investigation revealed.

According to FTC spokeswoman Shih Hui-fen, the commission began a probe into the case last June after receiving tip-offs from informers.

The distributors were questioned in July as part of the investigation, prompting them to drop the prices of their products over the following months, Shih said. (By Hsieh Jiun-

Legislature debates new cigarette tax

Lincoln, NE – Raising cigarette taxes would improve people’s health and ease the state’s budget problems, advocates told a legislative hearing Friday.

The proposal by Grand Island Sen. Mike Gloor would add $1.35 to Nebraska’s current tax of 64 cents a pack for a total of $1.99. Supporters project that would raise more than $100 million a year, and more importantly they say, deter 11,000 adults and 20,000 children from smoking. The bill would use about one quarter of the extra revenue to cancel proposed cuts in Medicaid payments to doctors, hospitals, and others. Almost all the rest could be used for whatever the Legislature wants. Kim Russel, president of Bryan LGH hospital in Lincoln, supported the bill on behalf of the Nebraska Hospital Association.


Sen. Mike Gloor's proposal would increase taxes on cigarette purchases throughout Nebraska .

“It will save the state money in the short and the long run on the cost of health care,” he said. “And it will preserve urgently needed Medicaid funding to serve Medicaid patients in every hospital in the state. I really believe your vote is a two-fer because it’s a vote both for physical health and for fiscal health.”

Senator Deb Fischer of Valentine asked Lou Kleager, president of the Nebraska Medical Association, about his support of the bill.

“If it’s truly a health concern, why don’t we ban the sale of cigarettes?” she asked.

Kleager responded, “I think it would be a long term goal. And I think you’d have to arrive there incrementally over a period of time. And in the meantime, get some increased revenue as you work toward that.”

Senator Abbie Cornett, chairwoman of the Revenue Committee that heard the bill, commented that you’d have to use all of the revenue for law enforcement to enforce a ban. Opposing the bill for the Nebraska Petroleum Marketers and Convenience Stores, Mark Whitehead, predicted it would fail.

“The reality is, people will find their cigarettes whichever way they possibly can, and that is a reality at the detriment of the retail industry in the state of Nebraska. They will bootleg it in, they will do it under the counter, they will do it via email.”

At the end of the hearing, Gloor said lawmakers might scale back the $1.99 proposal to match Iowa’s tax of $1.36. Any proposed increase would probably have to get extra votes to overcome a likely veto by Governor Dave Heineman.