The role of research for international tobacco control
Tobacco Use - a Challenge to Sustainable Development
Von Enis Baris
Global expenditures on tobacco control research, the basis for sound tobacco control policy and programs, are modest in spite of the significant burden of tobacco-related disease. Furthermore, this research takes place predominantly in developed countries and is only partially relevant to developing countries and regions of the world. So it is high time to set new priorities.
Tobacco use continues to be the leading preventable cause of death and disability amongst adults in the world today. By the year 2020, tobacco use is expected to cause approximately 10 million deaths, 70% of these in developing countries. As tobacco consumption decreases in developed countries, the Trans-national Tobacco Companies (TTCs) are vigorously expanding their markets in the South. Aggressive marketing, combined with changing social norms, particularly among women, has resulted in increasing rates of tobacco consumption in developing countries. In 1974-76, 49% of world’s tobacco consumption was in developing countries; by 1984-86 this rose to 61%. By the year 2000, developing countries are expected to account for 71% of global tobacco consumption.
Tobacco use is more than a health hazard; it is truly a quintessential challenge to sustainable development with its multifaceted consequences on environment, trade, taxation, social policy, direct and indirect health care costs and power/gender/labor relations. All of these dimensions equally apply to both the production and consumption of tobacco and its products. At present, close to 70% of world’s tobacco is grown in the developing world, yet tobacco farmers receive only a small percentage of the profits that tobacco production generates. Tobacco depletes soil nutrients faster than most other crops and requires heavy use of fertilizers and pesticides. Curing tobacco consumes 7 million acres of forest annually; and, it is a major occupational hazard, especially for women and children who do the menial work for example on plantations.
Many governments in the South are hesitant to curtail tobacco production and lukewarm to tobacco control. They do collect sizeable amounts of revenues through excise taxes on cigarettes and exportation of un-manufactured tobacco. However, they are either uninformed or misinformed regarding the long-term consequences of their flawed policies. Sooner or later, they will be depleting foreign reserves because of increasing importation of cigarettes and smuggling as well as incurring health care expenditures resulting from tobacco–attributable disease burden.
Regional agendas for tobacco control research
Approximately US$ 665 Million is allocated annually to global tobacco control research. Of this amount, $ 500 Million is expended in the US alone although this country still spends more, to the tune of US$ 680 Million, on research to improve tobacco farming.
Recently, Research for International Tobacco Control (RITC) has initiated a bottom-up, proactive process to establish regional agendas with the expectation that the integration of these agendas will constitute a sound basis for a global tobacco control research agenda. Between August 1998 and January 1999, RITC convened three regional meetings for Latin America and the Caribbean, South and Southeast Asia and Eastern, Central and Southern Africa which involved experts who are knowledgeable about tobacco control issues at the country level. The general objective of each meeting was to draft a regional research agenda for tobacco control to serve as a knowledge base for effective public policies. While there have been other attempts made to outline priorities for tobacco control research in the developing world, this process was unique in the inclusion of broad-based, multidisciplinary participants from a wide range of developing countries within each region. Their participation served to ensure that the ensuing research agenda truly represented regional concerns and identified locally-acceptable ways and means for putting that agenda into action effectively.
The meetings focused on thematic research issues related to both the supply and the demand side of tobacco use. Emphasis was on the economics of tobacco supply and demand, namely taxation, subsidies, pricing and marketing arrangements. On the programming and policy side research issues including tobacco prevention programs, health education and behavioral models were discussed. Special attention was given to cross-cutting issues such as gender, capacity building for tobacco research, North-South and South-South collaboration, dissemination of research results, advocacy, and bridging the gap between research and policy making.
As tobacco control takes its rightful place on the global human development agenda, it is important that funding for tobacco control research be increased. Significant gaps in information have been identified at the regional meetings. They are urgently required to be filled for sound basis for the development of tobacco control policies and programs needed to curtail the devastation brought about by tobacco use. In this respect RITC is prepared and willing to join hands with others advocating for global tobacco control research.
*Dr Enis Baris is Executive Director of RITC (Research for International Tobacco Control). RITC, formerly the International Tobacco Initiative or ITI, was established in 1994 to promote research for the development of effective public policies for tobacco control to support sustainable and equitable development. For more information about RITC, visit the website (www.idrc.ca/tobacco) or send an e-mail to: firstname.lastname@example.org . The reports on the meetings can be obtained on request, and will soon be available on RITC’s website: http://www.idrc.ca/tobacco/