Good news at the end of November from the ‘fourth session of the Conference of Parties signed up to the UN WHO Framework Convention on Tobacco Control, otherwise known as COP4 WHO FCTC’ (who names these meetings?): world governments have pledged to commit to smoking cessation education programmes, for which there is dire need. Every year, more people are killed by smoking-related illnesses than by HIV/AIDS, illegal drug use, alcohol use, motor vehicle injuries, suicides and murders combined1.The jargon from this convention in Paraguay shrouds something of a landmark change in efforts to combat one of the planet’s biggest health problems.
The most popular method employed to curb smoking rates has been legislation – in recent years, national governments have banned tobacco advertising and smoking in public places, and raised the legal age at which one may buy cigarettes, and smoke them. In Europe, the trend is particularly marked: health authorities in the UK have floated plain packaging as a solution; 2 and the Finnish parliament would like to outlaw all forms of tobacco consumption in an effort to drive down smoking rates.3
It’s easy to see why legislation is a favoured answer to a public health scourge such as smoking. Most obviously, legislation is cheaper than educational programmes and this sits well in ‘an age of austerity’. Furthermore, the short-termism of politics encourages policies with an immediate impact, which reflect positively on politicians in the media and public eye.
But prohibition has a long history of very public and embarrassing failures. There is no reason to suppose that a ban on cigarettes would be any more successful in cutting smoking rates than alcohol prohibition was in the US, or indeed, the UK’s ‘war on illegal drugs’ is today.4 Besides, the tobacco lobbying industry is so powerful that legislation is nearly always contested at great lengths and expense through the courts. In the long run, it appears that education programmes aimed at smoking cessation and prevention are more effective at reducing smoking rates.5 It is easier to nudge a sea-change with educational policies rather than legislation – it just requires more time and investment.
And the lessons for education-based public healthcare programmes can be seen in other fields. In time for World AIDS Day this month, the UNAIDS programme published the heartening news that the HIV/AIDS epidemic has been halted.6 The same could happen in the battle to push back tobacco use around the world – this agreement at the WHO Convention on Tobacco Control in Paraguay is a first step towards achieving this goal.
1 http://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/effects_cig_smoking/
2 http://www.guardian.co.uk/society/2010/nov/20/cigarettes-plain-brown-packs
3 http://news.bbc.co.uk/1/hi/8459947.stm
4 http://www.guardian.co.uk/society/2010/nov/01/alcohol-more-harmful-than-heroin-crack
5 http://online.wsj.com/article/SB10001424052748703957804575602822217085074.html?mod=rss_Health
6 http://www.bbc.co.uk/news/health-11819901
Thursday, 9 December 2010
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