Changing The Fatal Impact Of A Legacy From Days of Whaling

As early as the 17th century Manila galleons brought bundles of tobacco to Micronesia well before the days of the US Surgeon-General reports on "Smoking and Health." Across the Pacific, whalers, explorers and early missionaries generally valued tobacco as a commodity for exchange and personal use.

But the Pacific scene with tobacco seems set to change as a result of two recent moves.

The first was a decision by 11 Pacific countries to conclude the Pacific Islands Countries Trade Agreement (PICTA) in Nauru in 2001. Now in its third year of operation, the agreement heralds new trade opportunities in the Pacific.

Tobacco and alcohol were initially exempted from the agreement. Now, the issue is back on the agenda for PICTA countries as well as trading blocks in other parts of the world.

If tariffs on tobacco are lowered, price generally falls and with consumption increases that detrimental effect on public health.
A decision seems likely early 2005, with impact on the four manufacturing plants in the Pacific, all owned by one of the largest multinational tobacco companies.

Another significant move was a decision in 1999 by the World Health Organisation (WHO) to push for an international treaty on tobacco and particularly encourage national and trans-national approaches that countries face as a result of globalisation of trade, promotion and the use of tobacco.

More than 170 countries participated in the development of this first global health treaty known as the Framework Convention on Tobacco Control (FCTC).

The FCTC was finally agreed early in 2003, and following its adoption in May 2003 at the World Health Assembly was opened for signature and ratification at the United Nations in New York.

Since then, more than 100 countries have signed the treaty including a number of Pacific Islands. Fiji and Palau have now ratified the treaty with the approval of their respective governments. Further support from the Pacific islands is likely in the next few months.
The reasons for the treaty are compelling with five million deaths a year globally caused by tobacco. The FCTC enables countries to tackle the problems together. Some key issues include trans-national advertising and sponsorship, smuggling of tobacco across international borders and appropriate consumer information including health warnings concerning the harm from tobacco use. The FCTC is intended as a minimum or "floor" for countries to adopt and implement in order to reduce tobacco disease and deaths.
The use of tobacco results in many diseases and reduced life expectancy in all Pacific countries. Nauru and Tonga have a male smoking prevalence of around 60 percent, and the French territories of New Caledonia and French Polynesia, have both high male and female use, with around 40% of the population as smokers.

Guam has the highest prevalence of use of any U.S. State or territory at just over 40% of the population. The Cook Islands, Fiji, Papua New Guinea, the Solomon Islands and Vanuatu have slightly lower rates of smoking.

Even more disturbing is the uptake of smoking by young people and the use of young people to buy cigarettes for use by parents or others in villages. This process of familiarisation with tobacco is part of what sustains the cycle of addiction. Many households spend significant segments of their income to sustain their addiction.

Politicians and leaders often ask: "What are the benefits of the treaty to my country?" The Framework Convention on Tobacco Control aims to deal with key aspects of national and international policy that can improve health outcomes through the implementation of effective tobacco control measures.

This treaty aims to:
€ Ban all advertising and sponsorship including cross-border advertising such as "Formula I' and the removal of deceptive words such as "light", "mild" or "low-tar";
€ Provide protection from passive smoke in indoor workplaces, public transport and indoor public places;
€ Ban the sale of tobacco to and by minors;
€ Require at least 30%, preferably more of pack to have clear and direct health warnings;
€ Calls upon countries to consider the benefits of higher tobacco tax as a means to reducing consumption; and
€ Advocate for and allocate funding support to education and treatment programmes for tobacco use.
Countries have until June 29, 2004 to sign the FCTC and be party to what is truly a historic treaty. Signature is like a notice of intention, indicating the will of the party to ratify the convention, or receive official government approval to sign the treaty.
Public health personnel in the Pacific will also be watching with interest the decisions made both in relation to PICTA and the FCTC, as a lowering of tariff or excise duty on tobacco is likely to lead to greater consumption.
If this were to occur, additional consumption taxes following import could maintain the price to consumers and ensure no loss of revenue to governments, a decision that in most countries is generally supported by both public health and treasury officials alike.
When Ireland recently banned smoking in pubs, Mr Bertie Ahern, the Irish Prime Minister, said: "I am confident that this measure will provide a healthy legacy, not just for current but also, for future generations who thankfully, will never know what it was like to work in an enclosed smoke-filled environment."

It is hoped that future generations in the Pacific will be able to reflect on similar leadership.