Turning the Tide in the War on Tobacco: Bill Savedoff

Most people understand the personal risks associated with smoking, but surprisingly few understand its impact globally. Every year, more people die from tobacco related illnesses than from HIV/Aids, TB and malaria combined. Nevertheless, governments and international aid agencies have yet to pay serious attention to what some believe to be one of the most needless disease burdens in human history.Here to breathe some fresh air into the fight to curb smoking is senior fellow Bill Savedoff, who joins me this week to discuss his latest blog post, Death by Tobacco: A Big Problem Needs Bigger Action. Upon returning from a meeting on tobacco control in New York City last month, Bill set out to raise the alarm about something he found to be shockingly little-known: the shockingly low cost of highly effective tobacco controls.“What is strange to me is that more than 5 million people a year are dying from tobacco… and it’s needless,” says Bill. “The interventions we have are really low cost and very effective. Just small amounts of additional effort would make a huge difference.”I asked Bill to walk me through his list of ten ideas for the international community to turn the tide in the war on smoking. Going after big tobacco with gusto is the first and foremost challenge facing those fighting the epidemic, he says. Never before have global health policymakers and practitioners fought a more determined and devious opponent.“Malarial parasites are not out there meeting to figure out how to infect more human beings,” says Bill. “There are very few health crises out there where you have someone conspiring to increase the disease burden.”Reforming international trade laws, raising tobacco taxes, and restricting advertising rights are all low cost or even profitable measures that can help curb the influence of tobacco companies and reduce smoking. But while large and rich states can undertake these measures on their own, he says, smaller and poorer countries need the help of international financial institutions to match the clout of big multinational tobacco companies.“This struggle is going on in a lot of countries around the world right now,” says Bill “That’s why we need to enlist the World Bank at its highest level to include recommendations for higher tobacco taxes as part of their lending policy dialogue and to offer technical expertise for any country that seeks assistance with implementation.”In ending, Bill shares some sobering news from China, the latest front line in the war on tobacco. With incomes rising, smoking rates and smoking related diseases are increasing rapidly. Moreover, the Chinese state-owned tobacco company is gearing up to export low-priced cigarettes to surrounding countries.“If they drop the cigarette price down to 10% of what it is now, you’ve offset a huge amount of the gains that have been made by the rest of the world,” says Bill “With so many potential new customers in the region, this is a huge threat.”If you have iTunes, you can subscribe to get new episodes delivered straight to your computer every week. My thanks to Will McKitterick for his production assistance on the Wonkcast recording and for assistance in drafting this blog post.