Remember Thank You for Smoking? The 2005 film where Big Tobacco?s chief spokesman, Nick Naylor almost convinced you to take up smoking. If it were not for the counter debate towards the end of the movie, one could argue that it was an advocacy for the billion-plus smokers in the world.

The movie would have been as relevant a decade ago as it is now, when the third edition of The Tobacco Atlas has released. Tobacco is still the only consumer product that harms every person exposed to it and kills half of its regular users. Really, little seems to have changed. And that?s where this publication counts. The evidence-based Atlas is rich with data and offers ample food for thought to the tobacco control community to bring a change.

It encompasses a wide array of issues ? right from tobacco?s effect on health, politics, economics, big business, corporate behaviour, globalisation, smuggling, tax, religion, allocation of resources, poverty, gender issues, human rights, children, human development and the future.

But yes, a few countries have definitely passed legislation to increase tobacco taxes, ban tobacco promotion, issue health warnings and create a smoke-free public environment. US, for instance, brought into effect the largest-ever single increase in US federal taxes on cigarettes, almost tripling the tax on a packet to more than $1. Elsewhere, the British Medical Association is also calling for smoking to be banned from all hospital grounds in Wales.

Playing it up

Still, one billion men (about 35% in high-resource countries and 50% in developing countries smoke) and 250 million women in the world (22% in high-resource countries and 9% of women in low-and-middle resource countries) smoke. A befitting return to the $13 billion the companies are spending per year to influence non-smokers to start and encourage existing smokers to try new brands. Add to that the lobbying expenditure on influencing public policy. And now tobacco companies are shifting their focus from traditional advertising to point-of-sale promotions, with 87% of their marketing dollars used to subsidise the price of cigarettes to encourage more consumption.

The marketing strategy too deserves credit. On one hand smoking is ?marketed as a masculine habit? to lure men and on the other, women are enticed by using ?false images of vitality, slimness, emancipation, sophistication and sexual allure.? Interestingly, even the healthcare professionals easily fall prey to tobacco. ?In the early stages of the typical tobacco epidemic, smoking rates increase earlier among higher-status individuals and social trendsetters, such as health professionals, than among the general population,? the Atlas notes.

Tobacconomics

The mass consumption in turn fuels the $378 bn dollar industry even as it exerts a profound burden on the global healthcare system. By 2012, the global tobacco market will touch $464.4 bn ? up by 23%. Another issue that the Atlas brings to the fore is of illegal cigarettes. In 2006, contraband cigarettes accounted for 11% of global cigarette sales, or about 600 bn cigarettes. Canada?s two largest tobacco companies, last year, paid a whopping $1.12 bn in penalties for smuggling cigarettes!

Fortunately, the Atlas records that despite the tobacco industry?s long history of successfully buying favourable public policies and scientific research, the weight of scientific evidence and the tide of public policy continue to mount against Big Tobacco.

Research has also documented that the fear of smoking bans affecting business adversely are largely unfounded. But among nonsmoking adults living in countries with extensive smoke-free law coverage, 12.5% were exposed to second-hand smoke, compared with 35.1% with limited coverage, and 45.9% with no law, and only 5% of the world?s population is covered by comprehensive smoke-free laws.

The health burden

Underneath the debate lies the fact that the burden of tobacco initiated diseases is huge ? it is an addictive carcinogen that directly kills half of its users, as well as nonsmoking bystanders. 650 million smokers, representing 10% of the world?s population will eventually succumb to tobacco-related diseases. Research suggests the risk of dying from lung cancer is more than 23 times higher among men who smoke cigarettes, and about 13 times higher among women smokers, when compared with nonsmokers.

Passive smoking is as fatal. Nonsmokers exposed to secondhand smoke at home or at work increase their heart disease risk by 25-30% and lung cancer risk by at least 20-30%. Moreover, there is no risk-free level of exposure to secondhand smoke. Breathing even a little secondhand smoke can be harmful to health.

Economically, or socially ? there?s too much at stake to be lost in a smoke.

• By 2010, about 6.3 trillion cigarettes will be produced ? more than 900 cigarettes for every man, woman, child on the planet.

• Tobacco?s estimated $500 billion drain on the world economy is so large, that it easily exceeds the total annual expenditure on health in all low- and middle-resource countries.

• Today?s 18-year-olds have grown up during a period in which over $100 billion has been spent to market cigarettes in US alone.

•If Big Tobacco were a country, it would have the 23rd largest GDP in the world, surpassing the GDP of countries like Norway and Saudi Arabia.

• China, Brazil, India, USA produce two-thirds (67%) of the world?s tobacco. Its global production has almost doubled since the 1960s, increasing 300% in low and middle-resource countries.

If smoking were banned in all workplaces, the industry?s average consumption would decline… and the quitting rate would increase…. Clearly, it is most important for (Philip Morris) to continue to support accomodation for smokers in the workplace.?

?Philip Morris, 1992