Tobacco industry interference in controlling tobacco consumption

A nineteenth-century, tin box of
 Kyriazi Frères brand, Egyptian cigarettes
Dr. Essam Elmoghazy, Egypt 
The tobacco epidemic is one of the biggest public health threats the world has ever faced, killing nearly six million people a year. More than five million of these deaths are the result of direct tobacco use while more than 600 000 are the result of non-smokers being exposed to second-hand smoke. Approximately one person dies every six seconds due to tobacco, accounting for one in 10 adult deaths.

Up to half of the current users of tobacco will eventually die of a tobacco-related disease. Globally there are around 1 billion smokers today, 80% of whom live in low and middle income countries. 15 countries are home to approximately 2/3 of these smokers: China, India, Indonesia, Russia, Bangladesh,    Brazil, Mexico, Turkey, Pakistan, Egypt, Ukraine, Philippines, Thailand, Vietnam, and Poland (in order by number of smokers).

There is a fundamental and irreconcilable conflict between the tobacco industry’s interests and public health policy interests. Tobacco control efforts are systematically opposed by the tobacco industry. In its efforts to derail or weaken strong tobacco control policies, tobacco industry interference takes many forms.

Dr Ehsaan Latif , Director Tobacco Control at the International Union Against Tuberculosis and Lung Disease (The Union) rightly avers that, “The ‘charitable donations’ by the tobacco industry only serve to open doors for the industry to expand their businesses, provide legitimacy to their actions and to block effective tobacco control policies.”

Hence countries, when dealing with the tobacco industry or those working to further its interests, should be accountable and transparent. They should require the tobacco industry and those working to further its interests to operate and act in a manner that is accountable and transparent. As their products are lethal, the tobacco industry should not be granted incentives to establish or run their businesses.

Daouda Adam, Technical Advisor at the Union, Tobacco Control in Africa, informed that, “The main obstacle to protecting millions of people in Africa from the devastating Impacts of tobacco use is the interference of tobacco industry in Health policy.”

Tobacco Industry in Egypt

Tobacco cultivation is not legal in Egypt, therefore companies who produce tobacco products rely entirely on imported raw tobacco largely imported from India and China, as well as from Brazil, Italy, Syrian Arab Republic, and the United States of America. Egypt's tobacco industry is dominated by the Eastern Tobacco Company (ETC), the largest cigarette manufacturer in the Middle East. A small but ever increasing amount of Egyptian cigarettes are exported to neighboring countries, mostly to serve Egyptians working abroad. The Egyptian cigarette industry, during the period between the 1880s and the end of the First World War, was a major export industry that influenced global fashion.

The development of a major cigarette industry in Egypt in the late nineteenth century was unexpected, given that (i) Egypt generally exported raw materials and imported manufactured goods, (ii) Egyptian-grown tobacco was always of poor quality, and (iii) cultivation of tobacco in Egypt was banned in 1890 (a measure intended to facilitate the collection of taxes on tobacco).

The use of tobacco products in Egypt is widespread and smoking is almost integrated in the Egyptian culture, especially amongst men. It is estimated that approximately twenty percent of the population uses tobacco products daily. Cigarettes are the most common form of tobacco consumption, with an estimated twenty billion cigarettes smoked annually in the country. Smoking is far more common among men than in women. However, the number of women smokers is on the rise. After cigarettes, shisha (water-pipes) are the most common form of tobacco consumption. Many Egyptians are not fully aware of the health risks of using a water-pipe and believe it to be less harmful than cigarettes.

In 2007, Egypt passed a smoking ban, which applied mainly to government-owned public places, hospitals, schools and universities, as well as public transport. Apart from a short-lived test run in Alexandria, the law has remained largely unimplemented. Although a lot of awareness campaigns about the effects of smoking were implemented with clear warnings on cigarette packs--Smoking is harmful and causes cancer-- the number of smokers and sales of cigarettes continues to rise.

Recently, in an ongoing effort by Big Tobacco to preempt and undermine countries’ efforts to combat illicit trade, Philip Morris Egypt announced a partnership with the Egyptian Customs Authority to track down counterfeit cigarettes, which compete against brands like Marlboro. Philip Morris International and other tobacco corporations are increasingly trying to position themselves as part of the solution to combating illicit trade in tobacco around the world. Illicit trade floods markets with cheap, unregulated tobacco products, making them more widely available to youth and the poor. The rush to tout self-regulation is spurred by last year’s unanimous adoption (despite aggressive interference by Big Tobacco in the negotiations) of a World Health Organization Protocol on Illicit Trade in Tobacco, which strictly prohibits agreements or partnerships with the tobacco industry, due to its long history of complicity in the illicit trade of its own products in order to open new markets and skirt regulations. As more and more countries sign and ratify the WHO FCTC, Big Tobacco will continue to work to undermine its life-saving potential by tying governments’ hands with unscrupulous agreements and partnerships.

Dr. Essam Elmoghazy, Egypt 
Citizen News Service - CNS
September 2013

(The author is the Chairman of the Association against Smoking , Tuberculosis and Lung diseases - Cairo)