The 20th century saw the spread of the most deadly form of tobacco use: cigarette smoking. Economic development further led to massive increases in male cigarette smoking in developing countries. Until the 1970s, no government took serious action to protect its citizens. Without drastic action to get current smokers to stop, the annual rate of tobacco-related deaths will grow from 5 million in 2006 to 10 million in 2025.
The obvious strategy is to make it illegal to manufacture or sell tobacco products, with harsh sanctions for those who break the law. However, with tobacco use endemic in society and such powerful commercial interests at stake, there is no political will to adopt this kind of measure. Therefore, rather than banning tobacco altogether, an effective tobacco-control strategy has to be developed to reduce tobacco-related harm. Some aspects of such a strategy are discussed here.
Limiting the tobacco industry’s activities
Limiting the tobacco industry’s efforts to win more smokers and not to stop could involve prohibiting marketing activities and monitoring unfounded claims about reduced health risks from products such as ‘low tar’ cigarettes.
Reduction of harmful use
There is scope for reducing tobacco-related harm by introducing regulations to reduce the number of harmful ingredients in tobacco products such as nicotine content.
Stigmatization
Historically, the most effective form of tobacco control has involved the existence of a strong taboo against women smoking. Even now, most of the world’s women face strong social pressures not to smoke, and smoking prevalence is much lower than in men. More subtle social coercion can play a vital role in the decline in smoking in men too.
Education and Persuasion
Education and persuasion have played a major role in decreasing smoking in some Western countries. Educating smokers about the harm caused by smoking and specific campaigns to shape social norms surrounding smoking were probably responsible for the downturn in smoking in the UK and USA. Warning labels on packaging and promotional material is another approach that is commonplace.
Tax Increases
Raising the cost of tobacco use has proved quite an effective tobacco control strategy. A major issue that arises in relation to tax increases is that of smuggling. Any fiscal policy needs to be accompanied by strong law enforcement to combat this problem.
Smoking restrictions
Comprehensive bans on smoking in workplaces and indoor public areas also appear to have had an effect. The main reason for introducing such bans is to protect the health and comfort of non-smokers, but bans can clearly motivate smokers to try to stop.
Thus, there are various steps that can be taken to reduce the prevalence of smoking without making tobacco illegal completely. All it needs is a collective political and social will.
