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News Analysis Tobacco Control 2000;9:359–363 359 Tob Control: first published as 10.1136/tc.9.4.359c on 1 December 2000. Downloaded from NEWS ANALYSIS the consequences; and censorship of ble rise in the future. It is not only a All articles written by David Simp- the news media: these were among the question of the relative lack of power son unless otherwise attributed. old, “red” culture’s distinctive fea- compared to massive transnational Ideas and items for News Analysis tures. Ironically, if the actors have companies which have bought their should be sent to David Simpson at changed, the basic scenery and script country lock, stock and ashtray, but an the address given on the inside remain largely recognisable, and the absurd imbalance of resources. front cover. very infrastructure that barred the way True, the country passed a tobacco of the tobacco companies in the past is control law, but it was never turning out to be among the most implemented. Admittedly, when to- valuable things the new “brown elite” bacco control experts from the World Uzbekistan: who’s has acquired. Health Organization were due to in charge now? Uzbekistan provides a striking arrive in 1997, the health ministry The disintegration of the former example. It is a large nation, dwarfing reckoned it had better have a tobacco Soviet Union into separate nation several western European countries. It programmes coordinator, so it states was accompanied by an unruly is over three times the size of England, appointed one, a busy cardiologist. He stampede by the transnational to- but with only half the population; just did his best, which was better than the bacco companies, falling over them- the tragically ruined and polluted area nothing the ministry had done before, selves to buy up the formerly state of the Aral sea, which lies within it, is but in fairness, having no salary for owned tobacco factories. Was it just one and a half times the size of the extra job thrust upon him, and no the opportunity to take over going Denmark. To BAT, no doubt, budget to spend, it was clear from the concerns at knock down prices, or Uzbekistan is first and foremost a large, outset that there was little he could more the chance to get into markets ready made market. Of its 25 million achieve. When he stepped down from that had been denied them up to that inhabitants, many are already smokers, the role (though diligently continuing time? Or was the most attractive most having picked up their addiction his anti-tobacco eVorts in his clinical in Soviet times. But there is still scope work), a successor was appointed, but feature the already high smoking http://tobaccocontrol.bmj.com/ rates, resulting from years of for more to get hooked, and especially still without salary or budget. When negligible health education and the for women to catch up with the men. the monthly salary required to fill implicit promotion of tobacco as an Perhaps most salivating of all to a such a post is probably less than a essential part of human existence, tobacco salesman is the fact that over tobacco company pays to fill the fuel which along with alcohol was used as half the population is under 15 years of tank of just one of its promotional a regulator of cash in the economy? age. Health organisations are well vehicles—US$15–20 per month—is it All these were no doubt obvious aware of the burden of disease that really beyond the reach of the govern- attractions at the time, but there is already results from past smoking, of ment to spend such a sum on starting another which, at least to observers in course, but feel virtually powerless to to tackle the country’s tobacco the health professions, is only now do anything about stopping its inexora- problem? beginning to be fully understood. When companies such as British on October 2, 2021 by guest. Protected copyright. American Tobacco (BAT) moved into the countries euphemistically known as the new democracies of Europe, they were, in actual fact, moving into cultures little changed from the former Soviet times. They were buying not only the factories, the mar- kets and the labour, but passports to unfettered action as well. For while these nations’ economies were quickly transformed from the former “social- ist”, centrally planned economic systems into market economies, the culture that accompanied them remained—and continues to remain—remarkably intact. Power controlled by a small, mostly unelected elite, protected from criticism and lionised as economic saviours; an almost total freedom of action, with no real accountability for Cigarette advertising in Tashkent,Uzbekistan. www.tobaccocontrol.com 360 News analysis Tob Control: first published as 10.1136/tc.9.4.359c on 1 December 2000. Downloaded from Contrast this situation with what numerous cigarette brand window the WHO delegates found when they signs and promotional awnings over arrived at the capital, Tashkent. While shops, as well as a plethora of high they, accredited WHO representatives quality plastic bags bearing tobacco as they were, had to wait three hours ads. In a sort of tobacco advertiser’s in diVerent lines to be processed by fantasy fulfilment, these bags were not immigration and customs, they saw only being used as shopping bags by someone who was able to walk freely the general population, but as through the immigration area to iden- briefcases by medical students. As in tify the people he was meeting, whom neighbouring countries such as Kaza- he then simply invited to follow him khstan (see Tobacco Control VIP style through to the waiting 2000;9:269), BAT is busy with a transport. The nature of his pass for much flaunted but worthless youth being able to exercise such privileges? education programme, which prob- A sign with BAT’s name and tobacco ably enhances the adult allure of ciga- leaf logo. Another representative of rettes for the next batch of “starters”. the brown elite was waiting with a sign Is the tobacco industry’s exercise of bearing RJ Reynolds’s name. power limited to more or less The team from WHO noted that unfettered advertising and shady BAT had been attempting—and guarantees not to impede its sales by apparently succeeding—to buy good- health promotion? With the sort of will by giving money to health care culture described above, which institutions; for example, it paid for a includes some of the secrecy of the Brochure promoting BAT’s youth education modern clinic in Samarkand, site of its former regime, it is hard to be sure, programme in Uzbekistan. One of the main plant. Perhaps more remarkable, but all too easy to guess. For example, co-sponsors is the Ministry of Public Education. they found other health institutes under the new constitution, Uz- which had been oVered money by bekistan is supposedly free from the up to write pieces with headlines like: BAT, but whose desperate need for censorship that was routine in Soviet “BAT is ours!” (reminiscent of funds was matched only by the integ- days, yet in reality, the apparatus of patriotic utterances by the party hacks rity of their leaders. Such heroic acts censorship still trudges on and little of the past, the Russian version scans); usually go unsung. has changed except those being and advice that it is better not to The WHO delegates also heard talk protected by it. Only this year, senior smoke, but if you do, then at least of a contract between BAT and the editors of a newspaper that had smoke good quality (code for western) government, limiting the anti- accepted a hard hitting story about cigarettes. This time, however, Uzbek smoking measures the government the country’s tobacco problem felt it readers were spared this sort of could take—perhaps it fixed the maxi- wise not to publish it before lengthy nonsense, though some observers still mum to be spent at less than $15 per sessions with the censors, conceding fear delayed and perhaps hidden http://tobaccocontrol.bmj.com/ month? They saw a massive amount several cuts and changes along the retribution. of tobacco advertising—ubiquitous way. In Soviet times, state interference in billboards, whose mild health warn- A few years ago, a less overt attack the press would not only have been ings in small print at the bottom was on tobacco in the news media resulted perceived by the general population as impossible to read from any distance. in some responses in kind: the sort routine, but journalists whose work According to their report, there were where a few paid hacks were cranked was censored might even have seen it as a reassurance of integrity, the inevi- table result of criticising the corrupt elite, possibly presaging eventual adoption by INDEX on Censorship. In modern Uzbekistan, it remains to be seen whether the abuse of power to on October 2, 2021 by guest. Protected copyright. protect the all powerful brown elite will become accepted as equally routine and inevitable. Mathew Arnold’s classic narrative poem Sohrab and Rustum ends by following the course of the Oxus river, beside which Rustum has unwittingly killed his long lost son in a duel of champions from opposing armies. The poem ends as the river struggles through miles of obstructions, “till at last/ The long’d-for dash of waves is heard, and wide/ His luminous home of waters opens, bright/ And tranquil, from whose floor the new-bathed stars/ Emerge, and shine upon the Sénégal: a billboard forming part of the launch of Houston brand in the summer.
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