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The tobacco industry knows that motion pictures are one of humanity’s most common entertainment experiences. In a world with two billion urban dwellers (12), cinemas sold eight billion movie tickets in 2006, an all-time high. Of these, 20% were sold in the United States and Canada; however, 80% of admissions and 63% of box office revenues were in other countries (13). Based on figures from exhibitors, distributors and market analysts, the world spends an estimated US$ 100 billion a year on cinema tickets and on legitimate or pirated video copies of films. Roughly 30% is spent on single viewings in theatres, while 70% is spent on videos that can be viewed multiple times. Motion pictures are increasingly viewed outside movie theatres and distributed through other channels. The movie medium is extended by the Internet, TV, DVDs and other video access, reaching widely across cultures and economies. Thus, exposure to film content is vastly underestimated by movie theatre attendance data . . .
In an analysis of more than 1200 US-produced live action films – nearly the entire body of feature films released to theatres both by major studios and by independent producers in 1999- 2006 – tobacco imagery permeated both youth- rated (G/PG/PG-13) and adult-rated (R) movies, with more than three quarters of US-made movies featuring tobacco imagery (14). More specifically, close to 90% of all R-rated movies included smoking, while smoking appeared in three quarters of movies rated PG-13 and was found in more than a third of movies rated G or PG. Altogether, live action movies of all ratings produced in the United States between 1999 and 2006 contained approximately 8400 tobacco incidents.iii
Of these incidents, 68% were in movies rated R; 29% in movies rated PG-13; and 3% in movies rated G or PG. (See Box 1 for an explanation of the rating system.) There was no significant trend in tobacco incidents per film, either up or down, over the period 1999–2006. . . .
Movies, especially those made in the United States, are a major source of viewer identification with celebrities. They can encapsulate dreams, craft hopes and help viewers escape the tedium of everyday life. For the tobacco industry, films can provide an opportunity to convert a deadly consumer product into a cool, glamorous and desirable lifestyle necessity. The Marlboro Man is a powerful salesman, but even he lacks the draw of popular historical and contemporary movie stars from Hollywood, Bollywood and other film production centres. In contrast to traditional advertising, film stars provide indirect but nonetheless powerful information about the “benefits” of smoking.
Experimental and observational studies (27,31) show that cigarette smoking in films can influence young peoples’ beliefs about social norms for smoking, beliefs about the function and consequences of smoking and their personal intention to smoke. The presentation of smoking in films does not reflect reality. In reality, smoking tends to be highest among lower socioeconomic groups. In films, the prevalence of smoking depicted by characters, in particular among the higher-socioeconomic characters frequently portrayed by lead actors, is higher than the prevalence of smoking by comparable people in the general population (40). The real health consequences of smoking are rarely shown (40). Young people, especially, look to those celebrities for reassurance about their choices in fashion and behaviour. As they formulate their lifestyles, the film medium may provide a particularly attractive resource to promote these choices. . . .
When developing policy, both national and global perspectives should be considered. Well designed, evidence-based public health policy will improve population health both nationally and globally. The primary objective of actions to reduce smoking imagery in the movies is:
To substantially and permanently reduce children’s and adolescents’ exposure to tobacco imagery in movies.
Only options that meet this objective would then be evaluated for political feasibility, legality, sustainability and cost. The principles that guide such evaluation include:
• Principle 1: Seek “upstream” solutions
Policy should motivate change in the film industry’s behaviour so as to reduce harmful content at the source (“upstream”) instead of burdening the adolescents in the audience and their parents with taking some sort of protective measures (“downstream”). Films with smoking imagery are causally associated with smoking initiation, and therefore industries that profit from marketing these health risks should be responsible for making them safe. . . .
In May 2007, the Motion Picture Association of America (MPAA) proposed adding descriptors such as “pervasive smoking” or “glamorized smoking” to some ratings, absent a “mitigating context” (69).xiv Such content descriptors fail to convey the harmful effect of the film’s smoking imagery. It is the cumulative exposure to smoking in films – not the amount of smoking in a particular film – that best predicts the effect on adolescents. The recommended approach is to precede any film with tobacco imagery, in any distribution channel, with an effective anti-tobacco spot message. . . .
The Indian experience demonstrates the importance of exposing and neutralizing counter- strategies from the tobacco industry or its surrogates and allies. Successful implementation requires not only judicial intervention but also raising public awareness of the serious harm resulting from onscreen promotion of tobacco. The analytic studies in 2003 and 2004– 5 clearly established that, like the US films dominating screens in other countries, Indian films were depicting more tobacco imagery following implementation of the TCA and thus influencing young people to smoke. National interventions in India, as in the United States, can thus have global impacts in preventing smoking initiation. . . .
Experience shows that whenever tobacco advertising and promotion is restricted in one medium, it migrates to another. Tobacco appearances in films accelerated in the United States while tobacco advertising in other media was being restricted, and in India a similar process occurred after tobacco advertising in other media was prohibited. Because smoking on screen is uniquely vivid and because young people see so many films so often, its promotional effect on smoking initiation is striking. Any country seeking to ban or restrict tobacco advertising and promotion must address the issue of smoking on screen or risk having its public health efforts being severely compromised. The most vulnerable age group (adolescents) must not continue to be exposed to the most powerful promotional channel for smoking imagery available in today’s globalized economy. A comprehensive approach to combating smoking imagery in film is therefore required. . . .
There are a number of levels of intervention whereby smoking in the movies can be restricted. The overall evidence suggests that voluntary and self-regulatory measures have not been successful. Advocacy approaches to obtain stronger labelling requirements (adult ratings) for movies showing smoking imagery as well as anti-smoking messages and assurances that no payoffs are received from the tobacco industry have received wide support recently in both the United States and India. It is clear that restrictions of smoking imagery in movies with wide global distribution will serve a larger, multinational public good. Thus national approaches, and even local approaches, can have wide-ranging positive global effects. Multinational cooperation will also be critical in restricting the global reach of movie-based tobacco imagery.
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Backed by evidence that smoking in movies causes youths to want to light up, the World Health Organization is calling upon countries to enact enforceable policies that would severely restrict such depictions.
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The report recommends that all future movies with scenes of smoking should be given an adult rating, with the possible exception of movies that reflect the dangers of tobacco use or that depict smoking by a historical figure who smoked.
Studies show that smoking continues to permeate movies, including those rated as suitable for youth. The policies recommended would help ensure that movies that are marketed to youth do not include tobacco imagery.
"Voluntary agreements to limit smoking in movies have not and cannot work," the report says. It continues, "Logic and science now support enforceable policies to severely restrict smoking imagery in all film media."
"The WHO recommendations are evidence-based and very much needed," said WHO Assistant Director-General Dr Ala Alwan.
Half measures are not enough. We urge the government of Pakistan to impose a complete ban on tobacco advertising; to withdraw the Statutory Regulatory Order allowing creation of Designated Smoking Areas as a prelude to creation of 100 percent smoke-free environments and to raise tobacco taxation.
The acting representative of the World Health Organisation (WHO), Ahmad Shadoul, expressed these views while addressing participants of a 'Youth Hike for Tobacco Control' that started from Trail 3 and ended at Gokina on the Margallas here on Sunday.
The hike, which was organised by the Tobacco Control Cell of the Ministry of Health, in collaboration with the National Volunteer Movement of the Ministry of Youth Affairs and WHO, was aimed at sensitising young people about the fact that they are the primary target of the tobacco industry in Pakistan.
The hike also served to awaken the country's policy-makers from their deep slumber.
Tobacco epidemic carried away 100 million human lives in the 20th century and today smoking causes the premature death of 5.4 million people.
Unless decisive measures are taken, the figure will go up to 8 million in 2030, says a report on the global tobacco epidemic that was published here Thursday.
Experts of the World Health Organization say more than two thirds of smokers live in ten countries – China, India, Indonesia, Russia, the U.S., Japan, Brazil, Bangladesh, Germany, and Turkey.
Russia is ahead of the U.S. in what concerns the number of smokers although it has a much smaller population.
Michael Bloomberg and Bill Gates today announced joint efforts to combat the global tobacco epidemic. A combined investment of $500 million will help governments in developing countries implement proven policies and increase funding for tobacco control. Unless urgent action is taken, as many as one billion people this century Ð more than two-thirds in the developing world Ð could die from tobacco-caused illnesses. Paula Johns, executive director of Brazil's Alliance for the Control of Tobacco Use, and broadcast journalist Charlie Rose joined Bloomberg and Gates for the announcement.
Bloomberg's Initiative to Reduce Tobacco Use, which was established in 2005 and includes a $125 million commitment, will be extended with a new $250 million, four-year commitment.
This brings Bloomberg's total commitment to date to more than $375 million.
The Bill & Melinda Gates Foundation announced that it will invest $125 million over five years to fight the tobacco epidemic, including a $24 million grant to the Bloomberg Initiative. In addition to the grant to Bloomberg, the Gates Foundation will support complementary efforts to reduce high rates of tobacco use in countries such as China and India, as well as to help prevent the tobacco epidemic from taking root in Africa. . . .
"When I announced this initiative, I said that I hoped others would step forward," said Bloomberg. "I'm delighted Bill and Melinda Gates are supporting one of the most important public health efforts of our time. Our commitments will help governments confront the tobacco epidemic by implementing the proven MPOWER package . . .
¥ The Bloomberg Initiative to Reduce Tobacco Use is implemented though five partner organizations: the Campaign for Tobacco Free Kids, the Centers for Disease Control and Prevention Foundation, the Johns Hopkins Bloomberg School of Public Health, the World Health Organization and the World Lung Foundation.
The World Health Organisation warned Monday the global financial crisis may spark a rise in mental illness and health problems as people turn to alcohol, tobacco and drugs to get through the downturn.
"This has happened in the past," said the UN agency's Director-General Margaret Chan at the launch of a conference on the financial crisis' effects on health.
"In times of economic crisis, people tend to forego private care and make more use of publicly financed services," she said, adding that many country's public health systems are already "overstretched and underfunded."
Cancer will overtake heart disease as the world's top killer by 2010, health experts warned today.
Rising tobacco use in developing countries is believed to be the main reason for the shift, particularly in China and India, where 40 per cent of the world's smokers now live.
According to the new report by the World Health Organisation (WHO), cancer diagnoses around the world have been rising steadily and are expected to hit 12million this year.
Rising tobacco use in developing countries will see cancer overtake heart disease as the world's biggest killer, the World Health Organisation report
Yet, despite the exposés, the lawsuits, and the settlements, the massive trade in contraband tobacco continues unabated. Indeed, with profits rivaling those of narcotics, and relatively light penalties, the business is fast reinventing itself. Once dominated by Western multinational companies, cigarette smuggling has expanded with new players, new routes, and new techniques. Today, this underground industry ranges from Chinese counterfeiters that mimic Marlboro holograms to perfection, to Russian-owned factories that mass produce brands made exclusively to be smuggled into Western Europe. In Canada, the involvement of an array of criminal gangs and Indian tribes pushed seizures of contraband tobacco up 16-fold between 2001 and 2006. "The big companies know that to some extent the golden period of smuggling is gone," observes Belgium-based sociologist Luk Joossens, a World Health Organization expert on tobacco smuggling and co-author of the 1995 study that first alerted the world that billions of exported cigarettes had gotten lost in transit. "You have still the normal small-scale smuggling, but you also have counterfeit production, illicit manufacturing. . . and a lot of small companies that are involved. So the whole area of illicit trade has become much more complex." Joossens also said that while Big Tobacco's participation in cigarette smuggling in Western Europe and North America has largely been curtailed, the situation remains murky in Africa and other developing areas of the world.
This week smuggling experts, customs officials, and diplomats from nearly 160 countries are gathering in Geneva, Switzerland, to push for what has eluded governments for decades: a global crackdown on the black market in tobacco.
The United Nations World Health Organization (WHO) said today that, contrary to claims by advertisers, the electronic cigarette - a battery-powered product usually made of stainless steel and resembling a real cigarette - has not been proven a safe or legitimate nicotine replacement therapy for smokers trying to quit.
Marketers have claimed that the product helps smokers break their addictions to tobacco, with some even going so far as to imply that WHO views it as a legitimate nicotine replacement therapy like nicotine gum, lozenges and patches.
"The electronic cigarette is not a proven nicotine replacement therapy," said Dr. Ala Alwan, Assistant Director-General of WHO's Non-communicable Diseases and Mental Health Cluster.
"WHO has no scientific evidence to confirm the product's safety and efficacy. Its marketers should immediately remove from their web sites and other informational materials any suggestion that WHO considers it to be a safe and effective smoking cessation aid."
The Coalition of Tobacco Control in Pakistan (CTC-Pak) has taken strict notice of the tobacco industry’s growing audacity in terms of violation of tobacco control laws on the one hand, and engagement with the media on the other.
In a letter written to the Ministry of Health and World Health Organisation, CTC-Pak has drawn attention to how the tobacco industry continues to violate tobacco control laws by finding loopholes in the existing tobacco control ordinance and taking advantage of lack of proper implementation. “The industry keeps on challenging the government’s drive for effective tobacco control in the country by occupying more space in media and resorting to other tactics,” CTC-Pak points out in a press release issued here on Thursday.
CTC has urged the implementation cell of the Ministry of Health to take appropriate measures to check the violations of the law by the tobacco industry.
In an interesting development that took place this week in a nice and cozy hotel located in the famous tourist resort of Nathiagali, a leading tobacco industry spent hundreds of thousands of rupees to organise a one-day workshop on 'Responsible Journalism.'
Around 20 journalists were taken to Nathiagali on the expenses of the tobacco industry to learn the A, B, C of 'responsible' journalism and the impact that irresponsible reporting can have on people reading or watching their scripts.
Taking note of the development, Khurram Hashmi, coordinator of the Society for Alternate Media and Research (Samar) as well as Coalition for Tobacco Control, told 'The News' that his organisation will register its regret to the Ministry of Health and the World Health Organisation (WHO) against the tobacco industry openly engaging with mediapersons. . . .
The tobacco industry also distributed attractively designed booklets about how hard it is trying to save the crippling economy of the country by contributing millions and millions of dollars as taxes. Interestingly, none of the booklets contains any mention of the millions and millions of dollars the government requires to provide treatment to patients suffering from diseases induced by tobacco use.
This new move by the ever-intelligent managers of the tobacco industry has come almost a month after the Ministry of Health and WHO facilitated the establishment of the Journalists' Health Forum . . .
'The News' has learnt that some of the tobacco industries operating in NWFP and parts of Kashmir have openly started violating the anti-tobacco law by issuing banned advertisements to various media outfits.
the city's municipal government is also making efforts to ensure a healthy Games by prohibiting smoking in public areas.
The regulation was enacted to meet requirements from the World Health Organization (WHO).
In a 2004 meeting with Premier Wen Jiabao in Beijing, former WHO Director-General Dr. Lee Jong-wook said it was his hope that all athletes and spectators coming to the Beijing Games have a smoke-free environment at the competition venues.
Premier Wen agreed, noting that a smoking-free Olympic Games is in line with the Olympic spirit, and would further enhance tobacco control in Beijing.
Health authorities in Beijing banned smoking in public areas beginning on May 1. . . .
To meet the regulation, a total of 6,700 no smoking signs were place at all Olympic sports venues.
To create a smoke-free dining environment, the Beijing Health Bureau and other organizations issued a regulation requiring no-smoking areas in the city's 40,000 restaurants in February 2007. . . .
Another no-smoking campaign requires medical organizations to take the lead to turn hospitals into a no-smoking environment, then promote the initiative to all of society.
The Beijing Health Bureau has formulated six standards for smoke-free hospitals. . . .
From April to June in 2008, a total of 165 reports on smoking control appeared in the news media.
Posters to promote tobacco control were placed in many communities in Beijing. . . .
The Beijing Health Bureau has also strengthened cooperation with WHO and other international organizations to enhance the tobacco control task in the city.
Smoking bans are an effective way of preventing heart disease, getting cigarette users to quit and protecting children from second-hand smoke, a World Health Organization (WHO) report issued on Monday said.
The report by scientists at the WHO's International Agency for Cancer Research urged more countries to adopt smoking bans in public and at the workplace, saying there was enough evidence to prove they work, without hurting businesses such as restaurants and bars.
"Implementation of such policies can have a broader population effect of increasing smoke-free environments," the researchers wrote in the Lancet Oncology special report.
"In more and more countries, the chief causes of deaths are noncommunicable diseases such as heart disease and stroke," Ties Boerma, director of the WHO department of health statistics and informatics, said in a statement.
The annual report, World Health Statistics 2008, is based on data collected from the WHO's 193 member states.
It documents levels of mortality in children and adults, patterns of disease, and the prevalence of risk factors such as smoking and alcohol consumption.
"As populations age in middle- and low-income countries over the next 25 years, the proportion of deaths due to noncommunicable diseases will rise significantly," it said.
By 2030, deaths due to cancer, cardiovascular diseases and traffic accidents will together account for about 30 percent of all deaths, it said.
WHO Director-General Margaret Chan, in a speech to the WHO's annual assembly on Monday, voiced concern at the growing toll of chronic noncommunicable diseases.
Geneva, home to the United Nations' European headquarters and scores of banks catering to the very rich, will ban smoking in public places following a referendum on Sunday, the Swiss news agency ATS said.
Some 79 percent of voters in Switzerland's second-largest city supported the prohibition, which the local government said it would quickly put in place, ATS said. . . .
Geneva will be the sixth of the Alpine country's 26 cantons to institute a ban on smoking in public places.