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India: advocates hitback at smokelessindustryTobacco control advocates in India whohave been active for more than twodecades, together with a few ageingcolleagues from the west, will rememberthe sweat and toil of trying to kick-start aself-sustaining and viable Indian tobaccocontrol movement in the 1980s. Theswitch-back ride from optimism to dis-appointment, the new dawns and falsestarts, the workshop sessions shoutedagainst noisy air conditioners, the sheerhard work, heat and dust of it all – inthose days it seemed an impossible dreamto reach the present situation. However,there is now a real will at federalgovernment level, led by one of theworld’s most outstanding health minis-ters, and many skilled, experienced andwell informed health advocates con-stantly monitoring developments andlobbying for progress. India is a verydifferent place now, a fact recognised byits successful bid to host the next worldconference on tobacco and health.

Among the more visible evidence ofchange recently was an incident on thefront line of the ongoing battle forcomprehensive tobacco control legisla-tion. Unlike most big tobacco consumingnations, India’s biggest health problemcomes from the much greater amounts oftobacco consumed orally, in severalforms, than is smoked in cigarettes. Inaddition, the ubiquitous bidis, the cheap,hand-rolled, traditional smoking pro-ducts, cause massive damage to thehealth of the poorest sections of this vastcountry. In the past, cigarette manufac-turers have not been averse to implying intheir marketing communications thatIndians who suck or chew tobacco, aswell as bid-smokers, should trade up tothe higher ‘‘quality’’ offered by cigarettes.In the old days, advertisements portrayedcigarette smokers typically as successful,better paid and more educated membersof the burgeoning new middle-class, themillions of consumers being swept along

in the country’s incoming tide of eco-nomic prosperity.

Thus, while other countries have tocontend mainly with resistance to publichealth progress from the big cigarettecompanies, India faces additional foes –the formidable smokeless tobacco andbidi industries, both, especially bidi man-ufacturers, armed with the political blud-geon of far higher employment numbersthan the ever more capital intensivecigarette manufacturers.

Predictably, therefore, the union (fed-eral) health ministry’s efforts to imple-ment new tobacco product labelling rulesare being constantly countered by a widerange of tobacco industry opposition. Thearguments may be exactly the same onesfamiliar the world over – that it will takeat least 6 months to import new printingcylinders and fit them to their machines,for example – but the numbers bandiedabout on the employment argument aremuch larger than in most countries.

So it was that in March, the bidiindustry stepped in with an aggressiveadvertising campaign demanding ‘‘jus-tice’’. In particular, it asked politiciansto drop the proposed requirement of askull and crossbones to be printed on alltobacco packaging, including bidi wrap-pers – in fact, a highly creative and neatsolution to the problem of conveying thetrue risk of tobacco to illiterate users. Italso demanded that tobacco control mea-sures be ‘‘practical’’ (for which read

ineffective) and protect employment inthe industry; and that the two-thirdsincrease in excise duty on bidis proposedin the federal budget for 2007–8 bewithdrawn. The ad played the employ-ment case to the full, highlighting thehuge numbers of tribal people employedgrowing the trees whose leaves are usedas wrappers for bidis, as well as the largenumber who hand-roll them, mostlywomen (but without mention of children– bidi production is often a family affair).

At this point, ACT-India, one of themembers of the Advocacy Forum onTobacco Control (AFTC), a loose networkof organisations working on tobaccocontrol for the past half decade, realisedit was time to fire back with a like for like

All articles written by David Simpsonunless otherwise attributed. Ideas anditems for News Analysis should be sentto: [email protected]

India: when the bidi industry ran newspaper advertisements trying to persuade politicians to diluteproposed tobacco control legislation (above), health advocates responded.

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ad of their own. In lightning time, theycame up with a counter advertisement inthe Hindustan Times, one of the leadingnewspapers in the capital, New Delhi, andin another well respected paper inMumbai. Their ad, like that of themanufacturers, made prominent use ofsome large numbers, but in this case, theymeasured the horrific figures for mortal-ity and morbidity caused by tobacco inIndia. Large bullet points told of 4.4million new cases annually of tobaccoinduced heart disease, 3.9 million fromlung disease, and 200 000 from cancer.Total tobacco-induced mortality was pro-minently announced in the stark head-line, ‘‘Sadly, they speak of justice whentobacco kills 10 lac (1 million) Indiansevery year’’.

By happy coincidence, or kind editorialplacement, the same page in the Delhipaper reported a speech by an interna-tional cancer expert, predicting that can-cer cases would double by 2030. Best ofall, there was also a picture of a skeletonholding a cigarette in its hand, somethingthe near-empty coffers of the healthadvocates could not have run to even ifthey had thought of it; but years of effortto educate journalists, among other opi-nion formers, may be paying off at last.The outcome of the government’s struggleis awaited, but in the meantime, it is clearthat when trying to do the right thing, itcan draw on the support of a wellcoordinated tobacco control movement

USA/World: morepowerful version ofLegacy TobaccoDocuments LibraryIn May, the University of California, SanFrancisco Library and Center for KnowledgeMangement released a completely rede-signed version of the Legacy TobaccoDocuments Library (LTDL) website. The

new website is based on an updatedtechnology that allows full text search-ing across all 7.6 million previouslysecret tobacco industry documents(40.6 million pages) in the collection.In addition, LTDL contains two otherunique collections: DATTA (depositions,testimony, and opening and closingstatements from tobacco-related trials)and Multimedia (links to over 460videos that can be viewed online atthe Internet Archive website).

In addition, all 72 fields of indexingdata (metadata) used by one or more ofthe tobacco companies are now directlysearchable and researchers can createBoolean queries of unlimited length. Thefull text search capability allows research-ers to find many more documents. Forexample, searching on ‘‘World Bank’’yields 1777 documents on the oldLegacy site and 32 813 on the new site;searching on ‘‘Enstrom’’ yields 1921documents on the old site and 3654 onthe new.

Other features include query termshighlighted in results, simplified pagenavigation, sorting by document date,page count, Bates number and date addedto industry site, and proximity wordsearching.

The popular ‘‘bookbag’’ function,which allows users to save a document’smetadata and email or download therecords, has been expanded to includethe capacity to annotate each entry in thebook bag.

Since the Legacy Tobacco DocumentsLibrary was launched in January 2002,the size of the collection has grown from24 million pages to its current 40.6million pages, and the DATTA andMultimedia collections have been added.During that time, users have accessedmore than 19.3 million pages.

There will be continual additions ofnew features over the next year andsearchers are encouraged to use theQuestions or Comments? link on each pageto send comments and suggestions.

The LTDL was created with the supportof the American Legacy Foundation andthe scanning of the documents to createthe full text searchable format wassupported by the National CancerInstitute.

The URL for the new site remainsthe same as the old one: , http://legacy.library.ucsf.edu ..

KIM KLAUSNERKAREN BUTTER

STANTON GLANTZLibrary & Center for Knowledge Management,

University of California, San Francisco, USA;[email protected]

Smokefree Partnershiplaunches Global VoicescampaignThe Global Voices for a Smokefree WorldCampaign is being conducted in the lead-up to the second session of theConference of the Parties (CoP-2) to theFramework Convention on TobaccoControl (FCTC). For this meeting, govern-ment representatives from around theworld will gather in Bangkok, the capitalof Thailand, from 30 June to 7 July 2007,to discuss the implementation of theFCTC. Among other topics to be discussedwill be guidelines for the implementationof Article 8 of the FCTC, which deals withprotection from exposure to tobaccosmoke.

Initiated by the Global SmokefreePartnership, a new multi-member initia-tive to promote effective smoke-free airpolicies worldwide, the Global VoicesCampaign seeks to gather support amongpolicy makers for the Article 8 guidelinesto be adopted at CoP-2. These guidelineswill be non-binding recommendations forthe implementation of Article 8 to theParties of the FCTC – countries that havesigned and ratified the treaty – andshould represent the best practices neces-sary to protect people from secondhandsmoke exposure.

The goals of the Global VoicesCampaign are to mobilise non-govern-mental organisations’ support for best-practice smoke-free air laws, to raiseawareness of smoke-free issues in themedia, and to build support amongpolicy-makers for strong and effectiveArticle 8 guidelines. The latter will alsosupport another goal, country-levelimplementation of comprehensivesmoke-free air laws in accordance withthe guidelines.

Colleagues from around the world,both individuals and organisations, willbe calling on their governments to sup-port and implement all the provisions ofthe draft Article 8 guidelines, to make ahealthier, smoke-free world. By signingonto the campaign, individuals and orga-nisations signal their support of eightcampaign principles, which mirror theprovisions of the draft guidelines. Theseprinciples state that secondhand smoke isa significant health hazard; that there isno safe level of exposure to secondhandsmoke, nor any safe alternative to 100%smoke-free public places and workplaces;and that ventilation, air filtration systemsand designated smoking areas or roomsdo not protect people from secondhandsmoke. They also state that everyoneshould be protected from secondhandsmoke, and that all workers have the

India: this man in his 30s has been chewing paanmasala since he was 11 years old. [photo:Gemma Vestal]

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right to work in smoke-free workplaces.They further state that legislation withoutexemptions is needed to protect peoplefrom the dangers of secondhand smoke;and that effective enforcement, imple-mentation and monitoring provisions arenecessary components of effective legisla-tion.

Signatures supporting these aims willbe presented to delegates at the COPmeeting in Bangkok. Those wishing tojoin the Global Voices campaign can signup at www.globalsmokefreepartnership.org/globalvoices to add their voice or toget more involved with the campaign.

ANNETTE BORNHAUSERCampaign Manager

CASSANDRA WELCHProject Director

Global Smokefree Partnership;[email protected];

[email protected]

Hong Kong, China: nosmoking in housingestatesFollowing the implementation of the newlegislation in banning smoking in almostall indoor workplaces and many outdoorareas that came into force in January (seeHong Kong, China: bad atmosphere forpublic health. Tobacco Control 2007;16:3–4), smoking has been banned in allcommon areas of public housing estates,except in a few small designated areas.Common areas include roads, pedestrianpaths and pleasure grounds such as openareas, rest gardens, play areas and sportsgrounds.

Lack of well-defined boundaries at firstmade enforcement seem difficult, but thegovernment’s housing estates authoritiesdecided to extend the restricted areasafter obtaining the support of mosttenants. A decision was taken to desig-nate no more than five smoking areas oneach estate, irrespective of its size.Bordered by yellow or white lines, eachis about 5 square metres enclosing theperiphery of a bench. Enforcement islikely to be effective, as tenants whobreak the regulations can be penalisedwith five points without warning under amarking scheme, which can lead toeviction if a tenant accumulates 16 pointswithin 2 years.

The new scheme is thought to beunprecedented in public housing, andmust go some way to countering earliercriticism of the government for appar-ently caving in to industry pressures toallow some entertainment venues to setup smoking areas.

USA: Camel for womenAmong the more serious and depressingdevelopments recently in the home coun-try of multinational companies claimingto now be socially responsible, has beenthe introduction of new designs, withmassive associated promotion, for Camelcigarettes. While public health workersstrongly criticised RJ Reynolds (RJR) forintroducing a new version of its brandthat was clearly aimed at young women,financial analysts were falling over them-selves to applaud the move for what theyconsidered its potential for commercialsuccess. The new brand, Camel No 9, waslaunched with a promotional campaignestimated to cost $25–50 million. The

name was described by RJR marketingexecutives as meant to evoke happiness –being ‘‘on cloud nine’’ - or the heights ofstyle and fashion – being ‘‘dressed to thenines’’. Others cited in media coverage ofthe launch thought it might also suggestluxury perfumes such as Chanel No 9, orromantic songs such as ‘‘Love Potion No9’’.

Advertisements for the brand—‘‘reach-ing out to women,’’ as media writersprefer to put it—included the use ofslogans such as, ‘‘light and luscious’’.Colours used to adorn and promote thenew brand were described by mediacommentators as ‘‘hot pink’’ and‘‘minty-green’’.

It seems that RJR may be doing inreverse what Philip Morris did decadesago when it changed the gender limita-tions of Marlboro, originally a women’sbrand, to make it as macho as the cowboyfrom which it later became inseparable.Conversely, Camel has been a male-focused cigarette for decades, withwomen only representing about 30 percent of its customers. But women com-prise up to a half of the customers forcompeting brands such as Marlboro andNewport. Almost half of US adult smo-kers are women, limiting Camel’s poten-tial without adding female appeal.

RJR is to sponsor promotional eventsfor the new brand in large marketsaround the country, and push the brandin a variety of other ways, such ashanding out packs at nightclubs, discountcoupons, and ads in women’s magazinesincluding Cosmopolitan, Glamour, Flaunt,Vogue and W. Health advocates say thefirst two in particular will reach largenumbers of young readers, and claim that

USA: attractive colours and design promoting thenew Camel brand targeted at women.

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RJR is looking for initiation by girls andyoung women.

Aiming tobacco ads at women is a wellestablished strategy. Documents from theinternal files of US tobacco companiesindicate they studied female smokinghabits through research projects withnames including, ‘‘Tomorrow’s Female,’’‘‘Cosmo’’ and ‘‘Virile Female.’’ One of themost infamous moments in US marketinghistory was when Edward L Bernays,widely considered the father of publicrelations, alerted newspapers in theSpring of 1929 that women would besmoking in public during the Easterparade on Fifth Avenue, New York City,to promote ‘‘equality of the sexes’’. Heforgot to mention that he was paid for his‘‘torches of freedom’’ effort by AmericanTobacco, the maker of Lucky Strike.

With the tragedy of incurable diseasescaused by smoking being diagnosedamong women every day in the USA,and the tens of thousands of futurepremature deaths of American womenwho already smoke, it is extraordinarythat a campaign like this can still takeplace in 2007. But despite much progressand leadership by some states, the federalgovernment has done little over the pasthalf century. Women will still be lured bymulti-million dollar campaigns to smoketheir own new Camel, relishing the ‘‘lightand luscious’’ associations and the pinkgirly colours; in the future, surgeons willjust have to do their best with once pinkorgans so needlessly destroyed by smok-ing – and by a most cynical example ofcorporate social irresponsibility.

Philippines: PM artawardsBad news from the Philippines: PhilipMorris (PM) is still running art awards,equating life-enhancing visual art and theaspirations of young artists with themanufacture and promotion of productsthat enhance only the wealth of PM andthose involved in the terminal care andfuneral industries. In the past, it spon-sored the ASEAN Art Awards, coveringthe whole South East Asian region, ahuge jamboree with events at bothcountry and international level. It thusachieved massive feel-good publicity, por-traying it as a social responsible companyand giving the illusion that its eye was onhigher things than the bottom line.Needless to add, the awards also boughthigh-octane schmoozing opportunitieswith government ministers and otherdecision makers.

Having been resoundingly seen offafter repeated and determined protestsby health advocates, latterly organised ona truly international basis (see Thailand:

protest at PM art awards. Tobacco Control2004;13:326), the ASEAN regionalawards were quietly dropped. It seemedreasonable to assume that PM wouldgrasp that the inappropriate associationof addictive, life-destructive productswith the creative arts was best forgotten.But PM does not think that way, espe-cially in a country whose government hasnever been among the more vigilantproponents of tobacco control.Furthermore, where a cigarette calledPhilip Morris is for sale, as in thePhilippines, any positive promotion ofthe company name also directly promotessales of the brand.

So it was that in March, PM launched alarger and more exciting 2007 PhilipMorris Philippine Art Awards (PAA)competition, complete with its own web-site (http://philippineartawards.org) anda limited edition coffee-table book called,in case anyone missed the point of theexercise, Philip Morris Philippine ArtAwards: A Decade of Inspired Creativity.

By good fortune, a local tobacco controladvocate was able to attend the big event,pick up PM’s press kit, including a CDversion of the book, and most impor-tantly, distribute some informationexplaining what it was really all aboutto the assembled audience before slippingaway without being challenged.

Fortunately, the event received littlepublicity, especially considering theamount of time and effort PM had clearlyput into it. But who knows what lobbyingvictories were scored, and how they maytranslate, no doubt along with other, lesspublic efforts, into less effective tobaccocontrol measures in the Philippines? Suchevents are certain to increase in number

and degree of sophistication as govern-ments go through the motions of imple-menting the Framework Convention onTobacco Control. It is in the monitoringand exposure of such activities, often ofseemingly innocent and worthy intent tothe uninitiated, that public health work-ers will have their work cut out untiltobacco companies are universally recog-nised as well and truly persona non grata.

Pakistan: BAT exploitsenvironmental concernsIn April, national newspapers in Pakistancarried advertisements highlighting onceagain the strong relationship between thetobacco industry and the government.The local subsidiary of British AmericanTobacco (BAT) was bragging about a newpark it was about to create in a jointventure with the government; and thatthe dignitary who had accepted itsinvitation to lay the foundation stonewas none other than the prime minister.

Ghourgushti Environmental Park, inAttock district in the north west of thecountry, a new monument to BAT’sprofessed social responsibility, followsother public relations ventures such asthe planting of millions of trees and—abit of an own goal, this one—mobileclinics for patients who have sufferedheart attacks and the like in remote areas(see Pakistan: weapons of mass decep-tion. Tobacco Control 2004;13:7).Meanwhile, despite the government’s

Philippines: a folder for the CD version of thePhilip Morris coffee-table book promoting its artsawards scheme.

Pakistan: BAT’s subsidiary Pakistan TobaccoCompany took this ad in national newspapers toannounce that the prime minister would beopening its joint venture creating a newenvironmental park.

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assurances that it is working hard tocontrol tobacco use, it clearly has littleunderstanding of how the tobacco indus-try works. Pakistan remains one of themost exciting adventure playgrounds foryoung tobacco advertisers anywhere inthe region.

As the prime minister was busy declar-ing the environmental project to be underway, tobacco control advocates were busyasking colleagues around to help. Eventhough local appeals have so far goneunheard, it is hope to educate decisionmakers in the government that acceptingmoney from the tobacco industry isincompatible with effective tobacco con-trol.

Chile: new healthwarningsAbove is an example of how the bold newhealth warnings look on the two mainfaces of cigarette packs. The uncompro-mising statement on the first side says‘‘These cigarettes are killing you,’’ whilethe message on the other side tells howthe unfortunate smoker pictured, DonMiguel, lost his larynx to cancer. Theministry of health has been reproducingthe images in advertisements on largebillboards.

Canada: youth actiontakes on missionimpossibleIn April, teenagers staged this demonstra-tion in Mississauga and Brampton, inOntario province, demanding that thetobacco industry stop enticing youngpeople to smoke. The protest was part ofan Integrity Campaign, which bringstogether Youth Action Alliances (YAAs)from across Ontario to educate the com-munity about the tobacco industry’smanipulation techniques, such as offer-ing flavoured tobacco and using youngcelebrities in marketing campaigns. YAAsare funded by the Ontario health minis-try.

UK: cigarettes as themeasure of destructionIn March, the government’s considera-tion of whether to replace the UK’s ageingTrident nuclear missiles sparked fiercepolitical and public debate. Among thoseurging it to follow a more peaceful pathwere members of the Society of Friends,or Quakers, the Christian group with along history of opposing war by peacefulmeans. The design of this campaigning

billboard using cigarettes as an acceptedsymbol of addictiveness and massdestruction to health, seen in theQuaker heartlands of Birmingham,allowed health advocates a moment ofpositive reflection on how far tobaccoeducation has come in recent years.

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