The International Traffic in Tobacco

ThirdWorld Quarterly, Vol 18, No 2, pp 303± 319, 1997

Theinternational traf® cintobacco

R SCOTT FREY

¼tobaccoexports should be expanded aggressively, because Americans are smokingless. DanQuayle, former USVicePresident

I’lltell you what I likeabout the business. First, there are no surprises. There is nothingmore to be said or discovered about the cigarette business or the industry¼Second, no new company wants to getinto the tobacco business. That’ s great. Third,we havethe best partners in the world: the governments. DavidER Dangoor,Excutive Vice President of Philip Morris International

Peoplein developing countries don’ t havea longenough life expectance (sic) to worry aboutsmoking-related problems. Cigaretteindustry spokesperson

Theless developedcountries ( LDCs) are heavilydependent on transnational corporations( TNCs) basedin the developed countries ( DCs) forcapital, technol- ogyand expertise. 1 Suchpatterns of dependency reduce the number of choices availableto LDCsandplace them in weak bargaining positions with TNCs. Many TNCstakeadvantage of this situation by exporting hazardous production pro- cesses, productsand wastes to LDCsthatare bannedor heavily regulated, obsolete,or of declining market value in the DCs.2 Since few LDCs have the abilityto adequately assess andmanage the risks ofhazardous exports, the exportpractices of TNCscontributeto the health, safety and environmental risks of the LDCs. Theexport of risk to the LDCsis examinedin terms oftobacco traf® cking in the LDCsofAfrica, Asia and Latin America by DC-based TNCs. Thediscussion proceedsin four steps. The nature of the international tobacco trade is ®rst examined.Political± economic forces characterisingrelations within and between DCs and LDCsthathave increased the traf® cking of tobacco in the LDCs are discussed.The extent to whichthis trade has negativehealth, environmental and socialconsequences for the LDCsisoutlined.Policies that have been proposed as solutionsto the problem are criticallyreviewed.

RScottFrey is atthe Department of Sociology, Anthropology and Social Work, Kansas State University, 204Waters Hall, Manhattan, KS 66506-4003,USA.

0143-6597/97/020303-17$7.00 Ó 1997Third World Quarterly 303 R SCOTT FREY

TABLE 1 Annual percentchange in growth of total andper capita tobacco consumption and the adultpopulation for the world, LDCs and DCs, 1974±76 to 1984± 86

World LDCs DCs

Totalconsumption 2.4 4.8 2 0.4 Per capita consumption 0.1 1.9 2 1.5 Adultpopulation 2.3 2.8 1.1

Source: Foodand Agriculture Organization, Tobacco: Supply,Demand and Trade Projections, 1995± 2000 , Rome: FAO,1990, p. 4.

Natureof the worldtobacco trade Tobaccoconsumption has growndramatically since the beginning of this century.4 Worldwideconsumption (based on an estimated one billion smokers) has morethan doubled in the last 20 years, 5 andit will continue to grow over the next 20.6 Butnot all countries are experiencinga growthin cigarette consumption:data in Tables 1 and2 indicatethat per capita cigarette consump- tionhas declinedsteadily in the DCsinthe past several decades, whereas per capitaconsumption has grownsteadily in the LDCs.7 Thistrend is expectedto continueand LDCsare expectedto become the major consumer of the world’ s tobaccosometime early in the next century. 8 Theinternational production, manufacture and distribution of tobacco(outside countrieslike China, Austria and France where the state has amonopolyon tobacco)is dominatedby seven TNCs.9 Theseare identi®ed in Table 3 as the British±American Tobacco Company ( BAT),RothmansInternational, Imperial Tobacco(all UK companies),Philip Morris, RJR Nabisco,American Brands (all UScompanies)and Japan Tobacco International. These seven TNCs produce about50% of the nearly six trillion cigarettes consumed worldwide each year

TABLE 2 Percapita cigarette consumption among adults bygeographic region, 1971, 1981 and 1991

WHO Region 19711981 1991

Europe 23002500 2340 Western Paci® c 11001610 2010 Northand South America 25802510 1900 SoutheastAsia 8501140 1230 Eastern Mediterranean 700 940 930 Africa 460 570 590

Source: Adaptedfrom AP McGinn,` Preventingchronic disease indeveloping countries’ , inLester RBrown et al, (eds), Stateof theWorld, 1997 ,Washington,DC: Worldwatch Institute,1997, p. 72. 304 THE INTERNATIONAL TRAFFIC INTOBACCO

TABLE 3 Majortransnational tobacco companies

Mother Company countryMajor brands

BAT Industries(British± UK Viceroy,Barclay, LuckStrike American TobaccoCompany Players555, Kent, Kool, Ltd PallMall, Capri

RothmansInternational UK Rothmans,Cartier, Peter Stuyuvesant, Dunhill

Imperial Tobacco(Hanson Plc) UK Embassy,Superkings, Lambert andButler PhilipMorris USA Marlboro,Virginia Slims

RJR Nabisco USA Camel, Winston,Salem, More American Brands USA Carlton (GallagherLtd subsidiary) UK Silk Cut JapanTobacco International Japan Mild Seven

Source: JMacKay, `Tobacco:the third world war’ , Thorax,No46, 1991, p 154. and80% of thetobacco leaf sold on theworld market. 10 Thetop three companies operatein most countries of the world: British± American Tobacco operates in 180countries; Philip Morris operates in 170 countries and sells 175brands of cigarettesthrough manufacturing and marketing af® liates,licensees and regional export-salesorganisations; and RJR Nabiscooperates in 160 countries. 11 TNCs havedirected their manufacturing and marketing efforts to the LDCsforseveral decades: LatinAmerica was amajortarget in the 1960s; the newly industrialis- ingnations of Asia were the primary target in the 1980s; and China, Eastern Europeand Africa have become important targets in the 1990s. 12 Marketingpractices of the tobacco TNCsare basedon a doublestandard: one standardfor the DCsandanother less restrictiveone for the LDCs.13 TNCs operatingin the LDCsoftensell cigarettes without health warnings, advertise on televisionand sell cigarettes with higher levels of tar, nicotine and other chemicalsthan those marketed in the DCs.14 Theyalso engage actively in promotionalactivities that target children and women, including the distribution offree cigarettes;the use ofimages and messages inadvertisements that promotesmoking as sexy,romantic, slimming, etc; thesponsorship of sporting, music,fashion and other events; and the use ofWestern rock stars, actorsand athletes.15 TNCsare ableto engage in such activities because there are few restrictionson marketing and promotional practices in the LDCs.16 (Table 4 containsinformation on smoking restrictions for 70 different DCs and LDCs in 1986and little has changedsince. 17) TNCsuse avarietyof other tactics to enhance their market share inthe LDCs. Theyprovide bribes and kickbacks to state of® cials and they apply political and commercialpressure in LDCsattemptingto regulate or restricttobacco marketing 305 R SCOTT FREY

TABLE 4 Restrictionson tobacco for various developed and less developed countries, circa 1986

Smoking Advertising Health Packagein publicSmoking in Country restrictions warnings info placesworkplace

Argentina Strongpartial ban Required Bolivia Strongpartial ban Required Moderate Brazil Required Moderate Canada Totalban (pending] Voluntary Nic/Tar Moderate Chile Moderateban Costa Rica Required Colombia Moderateban Required Ecuador Moderateban Required Guatemala Required Mexico Moderateban Required Panama Moderateban Required Paraguay Moderateban Peru Moderateban Required USA Moderateban Rotating ModerateLegislation Uruguay Moderateban Required Moderate Venezuela Moderateban Required Moderate Algeria Total ban Required Moderate Gambia Strongpartial ban Ivory Coast Moderate Kenya Required Moderate Mozambique Total ban Moderate Nigeria Moderate Senegal Strongpartial ban Required Nic/Tar Moderate Cyprus Strongpartial ban Required Moderate Egypt Strongpartial ban Required Nic/Tar Moderate Jordan Total ban Required Nic/Tar Stringent Kuwait Required Nic/Tar Lebanon Moderateban Required Moderate Pakistan Required SaudiArabia Moderate Sudan Total ban Required Moderate Hong Kong Moderateban Required Nic/Tar Moderate India Required Macao Moderateban Required Moderate Sri Lanka Moderateban Required Moderate Thailand Moderateban Required Moderate Austria Moderateban Nic/Tar ModerateLegislation Belgium Strongpartial ban Required Nic/Tar StringentLegislation Bulgaria Total ban Required Stringent CzechoslovakiaTotal ban Required Moderate Denmark Strongpartial ban Required Nic/Tar Moderate Finland Total ban Rotating Nic/Tar Stringent France Strongpartial ban Required Nic/Tar StringentLegislation DR Total ban Moderate FRC Strongpartial ban Voluntary Nic/Tar Legislation Greece Moderate Hungary Total ban Required Stringent Iceland Total ban Required ModerateLegislation Ireland Strongpartial ban Voluntary/ rotating 306 THE INTERNATIONAL TRAFFIC INTOBACCO

TABLE 4Ð continued Smoking Advertising Health Packagein publicSmoking in Country restrictions warnings info placesworkplace

Israel Moderate Italy Total ban Stringent Malta Moderateban Netherlands Moderateban Required Nic/Tar Legislation Norway Total ban Rotating Nic/Tar Poland Total ban StringentLegislation Portugal Total ban Required Nic/Tar Stringent Romania Total ban Stringent Spain Total ban Required Nic/Tar ModerateLegislation Sweden Strongpartial ban Rotating Nic/Tar ModerateLegislation Switzerland Moderateban Required Nic/Tar Turkey Moderate USSR Total ban Required StringentLegislation UK Strongpartial ban Voluntary/ rotatingTar Yugoslavia Total ban Moderate Australia Strongpartial ban Required FrenchPolynesia Total ban Required Japan Moderate Malaysia Moderateban Required Moderate New Zealand Strongpartial ban Voluntary Moderate Singapore Total ban Required Moderate

Source: Councilon Scienti®c Affairs, `Theworldwidesmoking epidemic: tobacco trade, use, and control’ , Journal oftheAmerican Medical Association ,No263, 1990, p 3317. andpromotional activities. 18 TNCshavealso shown remarkable ingenuity in gettingaround existing restrictions. They use techniquessuch as thesponsorship oftelevised events and cigarette placement in movies and television. One noted criticreports on ` brand-stretching’: InMalaysia, which forbids cigarette advertising, tobacco companies attach their brandnames to everything from watchesto safari out® ts, and advertise them instead.One brand, Salem, has achieved success in reaching teenagers through a highlyunusual route. One of KualaLumpur’ s leadingrecord stores, which has two outlets,is called the Salem Power Station,and its motifÐ on signs, ashtrays, and plasticshopping bagsÐ includes the Salem logo that appears on the cigarette packs inMalaysia. Salem cigarettes also use a greenpine tree as an identifying symbol, andwhen I walkedinto a SalemPower Stationa clerkchecked my briefcase and handedme a greenplastic pine tree with a numberon it. 19

Theinvolvement of TNCsincigarette smuggling (which accounts for 10% to 35% oftheworld’ s cigarettes 20)isunknown. 21 Cigarettesmuggling is especiallyserious wherelarge price differentials exist at border areas suchas Chinaand Hong Kong andacross severalcountries in the Middle East, Africa and Eastern Europe. 22 Tobaccois oneof the most widely grown non-food cash cropsin the world; estimatesare that0.3% of the world’ s arableland is devotedto tobacco cultivation, 23 (see Table5). Roughly 72% of the world’ s landunder tobacco consumptionis locatedin the LDCsanda majorityof the tobacco sold in the 307 R SCOTT FREY

TABLE 5 Worldtobacco leaf production, 1994

Metric tons producedPercent ofworld Country (000s) production

China 2263 35.0 USA 723 11.1 Brazil 536 8.2 India 528 8.1 Turkey 220 3.4 Zimbabwe 182 2.8 Italy 135 2.1 Greece 130 2.0 Argentina 100 1.5 Malawi 99 1.5 South Korea 88 1.3 Indonesia 85 1.3 Japan 74 1.1 Azerbaijan 68 1.0 North Korea 65 0.9 Kyrgyzstan 58 0.9 Myanmar 52 0.8 Thailand 52 0.8 Philippines 50 0.8 Other 1024 15.7 Total 6532 100.0

Source: Adaptedfrom Food and Agriculture Organiza- tion, FAOYearbookof AnnualProduction , Rome: FAO, 1995,Table 82. worldis producedby LDC smallfarmers. 24 Despitethis, however, most tobacco producedin the LDCsis controlledby TNCs.25 TNCscontracttobacco production outto small farmers: theyarrange loans for farmers, theyprovide farmers with tobaccoseed andnecessary inputslike fertiliser and pesticides, they see that farmers receiveproper instructions on planting and tending the crop, and they buythe tobacco that farmers produce. 26 Mostof this tobacco is producedfor localconsumption and not export.

Thepolitical economyof tobacco consumption and production

Politicaland economic forces characterisingrelations within and between DCs and LDCshavecontributed to increased LDC tobaccoconsumption and production.27 Thecontradictory demands of capitalaccumulation and the increased regulationof tobacco use inthe DCshaveled tobacco TNCstoincrease the marketingand production of tobacco in the LDCs. Statepolicies of many LDCs havealso encouraged tobacco use andproduction. And the policies of several international® nancialand development organisations have contributed to increased tobaccoproduction in the LDCs. 308 THE INTERNATIONAL TRAFFIC INTOBACCO

5000 Increased marketing of Fairness Broadcast ads Federal excise filter cigarettes begins doctrine for cigarettes tax on cigarettes

r introduced end doubled

a Korean War

e Postwar y

4000

r demobilization e p

First Surgeon t l

u General’s

d report a Early reports 3000 r linking published e Rotating p smoking and warnings

s Nonsmokers’ cancer e Great placed on t rights movement t

e 2000 depression initiated cigarette r

a packages g i

C World War II 1000 0 19251930 1935 1940 1945 1950 1955 1960 1965 1970 1975 1980 1985 1990

Source:T MacKenzie et al,`Thehuman costs oftobacco use’ , New EnglandJournal of Medicine , Vol 330, 1994, p 976. FIGURE 1 Percentadult consumption of cigarettes in the USA, 1925±1990

Crisis inthe core: adecliningmarket

Cigaretteconsumption has declinedin the DCsdueto state efforts to discourage use,including restrictions on advertising,excise taxes, laws restricting smoking, healthwarnings, increased litigation and US stateand federal efforts to make tobaccocompanies liable for smoking-related diseases andthe attendant health costs.28 (Figure1 plotsUS adultper capita cigarette consumption since 1925 in relationto state regulatory activities and Table 6 presentsdata on thepercentage ofadults who smoked cigarettes at various points in time in selected DCs.) Tobacco TNCshaveresponded by denying the health risks associatedwith smokingand actively seeking a marketamong minorities, women and the young in the DCs.29 But these TNCshaveincreasingly targeted LDCswherecigarette

TABLE 6 Percentageof adults smoking cigarettes in selected developed countriesby gender and time period

Men Women

1974±76 1983 1986± 87 1974± 76 1983 1986± 87

USA 43.435.5 31.7 31.429.4 26.8 UK 52.038.0 35.0 41.034.0 31.0 Australia 43.338.9 32.9 31.931.4 30.6 Canada 45.635.7 32.3 32.029.3 26.6 Norway 49.644.6 41.3 32.132.3 33.3 Sweden 36.026.0 24.0 34.028.0 27.0

Source: JPierce, `Internationalcomparisons of trends in cigarette smokingprevalence’ , AmericanJournal of Public Health ,No79, 1989. 309 R SCOTT FREY demandremains (and the growth potential is high),there are fewrestrictions on marketingand promotional activities and the health risks associatedwith smokingare notwidely known. 30 The LDCshavebecome an increasingly importantmarket: the USA exported56 billion cigarettes (8% of total production)in 1984, but by 1991 it was exporting194 billion cigarettes or 25%of totalproduction. 31 Thestate has playedan important role in themarketing of UScigarettesin the LDCs.32 Underthe Food for Peace programme(the Agricultural Trade, Develop- mentand Food Assistance Act), for instance, the US governmentroutinely shippedUS tobaccoworth hundreds of millions of dollars to LDCs at highly subsidisedrates until1980. 33 Morerecently, the US government(concerned with reducingtrade de® cits) helped tobacco TNCs(PhilipMorris and RJR Nabisco)by usingthe 1984 amendments of Section 301 of the 1974 Trade Act 34 to threaten tradesanctions against several Asian countries (including Japan, Taiwan, South Korea,China and Thailand) where trade agreements and high tariffs were allegedto limit the marketing of US cigarettes. 35 Promotionalactivities of tobacco TNCsare alsounderwritten by the state: cigaretteadvertising costs are taxdeductible. Tobacco TNCshavebeen able to reduce the uncertainties associated with a decliningmarket by reducing costs throughcontrol of tobacco cultivation in the LDCs. Mosttobacco grown in the LDCsisproducedunder contract to subsidaries ofmajortobacco TNCslikePhilip Morris, RJR Nabiscoand BAT.36 Tobaccois far cheaper for TNCstoproduce in the LDCs than in the DCs. Themarketing and production tactics of TNCshaveproven to be quite successful.Consider the case ofPhilip Morris: `In1992, Philip Morris was the seventhlargest industrial corporation in the United States, with $50 billion in sales. PhilipMorris made more money in 1992Ð $4.9 billionÐ than any other companyin the United States, re¯ ecting the large pro® t marginof cigarette sales.’ 37

Conditionswithin the periphery

Economicincentives provided by tobacco TNCs(inthe form of bribes and kickbacksto state authorities) encourage LDC statesupport of TNC cigarette promotionand use. The prospect of substantialrevenues from taxes on cigarette consumptionalso facilitates LDC statesupport of domesticconsumption, for such taxesoften represent one of thelargest single sources ofstaterevenue (as much as 45%of the total tax revenue and 15% of the total state revenues in some LDCs).38 Theseforces representstrong incentives for countries that are experienc- ingserious economic problems. 39 SinceWorld War II many LDC states havealso pursued agricultural policies thatpromote cash cropping.This model of developmentis viewedby proponents (in both the LDCs and DCs) as aneffective means ofincreasing agricultural productivityand generating needed jobs and income for reducing hunger, increasinginternational competitiveness and improving their balance of trade, fosteringdebt repayment to the DCsandinitiating an economic takeoff. Tobacco cultivationis aparticularlypro® table form of cash croppingbecause it ` isnot 310 THE INTERNATIONAL TRAFFIC INTOBACCO subjectto the ¯ uctuationsof world commodity markets’ , 40 and` thereturns per hectareare muchhigher than for food crops, and unlike fruits and vegetables, whichare highlyperishable, tobacco is easy tostore and to transport with minimalloss’ . 41 Pro®ts ontobaccoare ®vetimes higher than those for maize and threeto four times those of peanuts and cotton. 42 LDC statesupport of tobacco cultivationhas takenvarious forms, including special loans, tax incentives, agriculturalextension programmes and technical assistance. 43

Therole of bankingand development organisations Activitiesof several international banking and development organisations have alsoencouraged tobacco cultivation in the LDCs. Sincethe mid-1970s the World Bankhas loanedhundreds of millions of dollars to the LDCsfortobacco cultivation.The Food and Agricultural Organization ( FAO)andthe UN Develop- mentProgramme ( UNDP)havealso actively promoted tobacco as acash cropby providingtechnical information and assistance toa numberof LDCs. Various DC stateaid agencies have also contributed to tobacco cultivation by providingloans andexpertise to LDCs.44

Health,environmental and social costs Thereis anumberof adverse human health, environmental and social conse- quencesassociated with tobacco consumption and production in the LDCs.45

Humanhealth costs Tobaccois anaddictive drug that is hazardousto human health. 46 It contains hundredsof toxic and carcinogenic substances, including formaldehyde, nicotine,benzene, carbon monoxide, vinyl chloride, radioisotope polonium 210 (an alphaemitter), and a hostof other hazardous agents. 47 Onenoted critic has brandedtobacco ` theforemost human poison of the twentieth century’ . 48 Cigarettesmoking is amajorcontributor to preventable morbidity and prematuremortality worldwide. 49 (USmortalitydata reported in Table 7 illus- tratethe nature and scope of the problem: over 400 000 deaths or 19% of all deathsare estimatedto be linked to tobacco use in1980. 49,50)Smokingcauses lungcancer and a numberof other cancers, including cancers ofthe mouth, pharynx,ureter and bladder. Smoking is alsoknown to be a majorcause of pulmonaryillness and death: pneumonia, in¯ uenza, bronchitis, emphysema and chronicairway obstruction. It increases therisk of cardiovasculardisease: stroke, suddendeath, heart attack, peripheral vascular disease andaortic aneurysm. And maternalsmoking contributes to infant mortality (resulting from low birth weight,spontaneous abortions and other congenital disabilities) and ® re-related deaths.51 Tobaccouse is estimatedto cause atleast three million deaths world-wide eachyear (over half a millionin women) and the toll for the period from 1900 tothe late 1980s is estimatedto have been around 50 million deaths. 52 Current estimatesare thatthe mortality rate will continue to rise,resulting in 100million 311 R SCOTT FREY

TABLE 7 Estimateddeaths linkedto cigarette smoking in the USA, 1980

Causeof death Numberof deaths

Cancers 147 000 Diseases ofcirculatory system 240 000 Coronaryheart disease 170 000 Othervascular diseases 70 000 Diseases ofrespiratory system otherthan cancer 61 000 Emphysema 13 000 Chronicbronchitis and other respiratory diseases 48 000 Diseases ofthe digestive system 14 000 Diseases ofñsophagus,stomach andduodenum 2 000 Cirrhosisand other diseases ofdigestivesystem 12 000 InfantMortality (caused bymaternal smoking,low birthweightand other congenital disabilities) 4 000 Externalcauses ofdeath 4 000 Injuriescaused by® re and¯ ames 2 500 Otheraccidental injuries 1 500 Miscellaneousand ill-de® ned disease 15 000 Total 485 000

Source: Adaptedfrom RT Ravenholt,` Tobacco’sglobal death march’ , Population andDevelopment Review ,Vol16, 1990, p 235. deathsfor the 20th century. 53 By2025 tobacco will kill 10 million people each year.54 Sixtypercent or more of the current tobacco-related deaths occur in the DCs, butthis pattern will change as smokingdeclines in the DCsandincreases inthe LDCs.55 Severalstudies indicate a substantialdecline in lung cancer (some estimatesindicate a 25%decrease) andother tobacco-related diseases inthe DCs inthe next couple of decades and a dramaticincrease in the LDCs.56 Tobacco- relateddeaths are alreadythe single largest cause ofpreventable death in the LDCsaftermalnutrition and infectious disease, 57 butthe worst is yetto come accordingto one noted critic who uses thephrase ` Tomorrow’s Epidemic’to describethe problem. 58 Several LDCshavebeen identi® ed as likelycandidates for anepidemic of tobacco-related disease anddeath; these include countries containinga largeproportion of the world’ s population:Brazil, China and India.59 Andseveral experts predict that smoking will become the leading cause ofdeath in the LDCsinthe next decade. 60 By2025 seven million of the 10 millionannual deaths will occur in the LDCs.61

Environmentalcosts Tobaccocultivation requires extensive pesticide use. Pesticide use notonly poses acuteand chronic health risks tohumans, but leads to the destruction of soiland ¯ oraand fauna. 62 Pesticideuse causes suchproblems for a simple reason: alargeproportion of the pesticides applied move directly into ecosys- tems tocontaminate water, soil, air and food. Plant and animal species, as well ashumans,are affecteddirectly and indirectly by such ` pesticidedrift’ . Natural 312 THE INTERNATIONAL TRAFFIC INTOBACCO parasiticand predator species are reduced,resulting in outbreaks of pests that werepreviously not a problem.` Pesticidescreate pests’ in other ways; they contributeto thedevelopment of hundreds of pesticide-resistantspecies thatcan nolonger be controlled. Development of such pest-resistant breeds of mos- quitoesand other arthropods has resultedin an increasein malaria, yellow fever andother parasitic diseases. 63 Tobaccocuring is aprocess inwhich green tobacco leaf is keptat tempera- turesof 160 degrees Fahrenheit for six or seven days. This process requires substantial® rewood.It is estimatedthat it takes ` oneacre offorest to cure one acre oftobacco’ and that ` onetree is cutdown to cure every 300 cigarettes’ . 64 Themajority of the wood used in the curing process comes fromopen forest, woodlandand savannah, but protected forest is likelyto come under increasing pressure as existingstocks are depleted. 65 Calculationsvary, but Goodland et al. (1984; 57)estimate that each year ` worldwidethe equivalent of some 1.2million hectaresof open forest is strippedof woodfor tobacco curing’ , 66 andthe World HealthOrganization estimates that 12% of the trees cutannually around the worldare usedfor tobacco curing. Deforestation, in turn, leads to the loss of biodiversityand causes soilerosion and siltation of rivers and lakes, as wellas contributingto climate change, deserti® cation and increased incidence of infec- tiousdiseases. 67

Socialcosts Thenegative consequences of tobacco production (cultivation and curing) and consumptionare notequitably distributed within the LDCs. Deforestationcon- tributesto the shortage of fuelwood and the poor depend heavily on it for cookingand heating. The poor are atagreaterrisk of exposureto thepesticides usedin tobacco cultivation. As productionshifts from food to tobacco there is areductionin food supplies (and increased food imports) and hunger increases amongthe poor. Tobacco consumption among the LDC poor,though still limited, contributesto malnutrition because scarce resources are divertedfrom food purchases.Further, large numbers of small farmers havelimited autonomy and are athigh risk of being displaced as tobaccocultivation becomes increasingly mechanised. 68

Acost±bene® t assessment

Theeconomic costs oftobacco use inthe LDCsinthe form of health care expendituresand lost productivity are simplyunknown, 69 butestimates for the USAexceeded$100 billion in the early 1990s. 70 Theactual economic costs of tobaccoproduction are evenless certain.Despite substantial costs, however, tobaccoproduction and sales contributedirect economic bene® ts: incomeand employmentfor farmers andother workers, a substantialsource of revenue for governments,and large pro® ts forthe tobacco TNCs.71 Infact, tobacco production andmarketing provide jobs for anywhere from 15 millionto 140 million people inmany of the LDCsofAfrica, Asia and Latin America. 72 Severalstudies have concludedthat the long-term direct and indirect costs far outweighthe short-term 313 R SCOTT FREY bene®ts oftobacco production and sales inthe LDCs.73 Thereis littledoubt that tobaccorepresents a substantialthreat to the sustainable and equitable development of the LDCs.74

Whatshould be done? TheWorld Health Organization has recommendedthat cigarette exports to the LDCsbeoutlawed; 75 othershave argued that LDCsshouldsimply stop growing tobacco.76 Severalanalysts have taken a less extremestance, suggesting that the mosteffective means ofreducing the human and environmental costs ofthe internationaltraf® c intobacco is toinstitute stringent regulations on the marketing,promotion and use oftobacco in the LDCs.77 Recommendationshave includedchanges in DC state and TNC tradepractices and policies, increases in cigarettetaxes, restrictions on cigarette advertising and promotional activities, andthe elimination of subsidies for tobacco production. 78

DC state and TNC tradepractices and policies

DC stateefforts to encourage LDCstorelax their restrictions on cigarette marketingand consumption should be stopped. They should not subsidise (throughtax incentives and the like) tobacco TNCs’ effortsto marketand promote cigarettesin the LDCs. TNCsshouldalso adhere to standards regarding the marketing,promotion and sales in LDCsthatare requiredin the DCs. And TNCs shouldrefrain from lobbying and political pressure toprevent LDCs from engagingin anti-tobacco activities. 79

Increase cigarettetaxes

Research conductedin anumberof DCsindicatesthat increasing excise taxes on cigarettesreduces consumption, especially among the young and poor who are sensitiveto price changes. 80 (Severalof these studies indicate that a 10% increasein taxes results in an average 4% reduction in consumption. 81) Limited research undertakenin LDCssuggestsan even stronger link between excise tax increases anddeclining cigarette consumption. 82 Givensuch ® ndings,excise taxesshould be increased on all cigarettes marketed in LDCsandhigh tar cigarettesshould be taxedat a higherrate than low tar cigarettes. Such a policy wouldnot only reduce cigarette consumption and the attendant human and environmentalcosts, but the revenue generated could be used to fundhealth care costs andanti-smoking campaigns.

Restrictadvertising and promotional activities

Most LDCshavefew restrictions on the advertising and promotion of cigarettes (see Table4). Advertising and promotional activities should be banned or, at a minimum,heavily restricted. Easily understood health warnings should be con- tainedin alladvertisements and should appear on allpackaging. Other measures couldinclude bans on promotional activities such as thedistribution of free cigarettesand the sponsorship of sport and other events by tobacco TNCs. 314 THE INTERNATIONAL TRAFFIC INTOBACCO

Eliminatesubsidies for tobaccoproduction

Sincethere are manyincentives for LDC farmers toproduce tobacco, existing subsidiesshould be eliminated. These include subsidies provided by inter- nationalactors such as theWorld Bank and the FAO,as wellas subsidiesfrom LDC stateagricultural agencies and DC-basedaid agencies and TNCs.

Canthe smoke ring be broken? Implementingsuch policies would reduce smoking and the attendant human and environmentalcosts associatedwith tobacco in the LDCs. Itis unlikely,however, thatthese policies will be enacted in the near future because there are powerful economicand political interests (described by one noted critic as the` Smoke Ring’ 83)thatpro® t fromtobacco traf® cking. 84 Theseinclude a hostof actors hookedon tobacco production and sales: farmers, tobacco TNCs, governments thatcollect tobacco-generated taxes and foreign exchange from tobacco sales, andthe media that bene® t fromcigarette advertisements. As longas this` Smoke Ring’(which is embeddedin an international strati® cation system basedon the asymmetricalexchange of value) remains intact, the human and environmental costs ofthe tobacco trade in the LDCswillnot only persist but will take on epidemicproportions in the near future.

Notes 1 RichardJ Barnett& JohnCavanagh, GlobalDreams: ImperialCorporations and the New WorldOrder , New York:Touchstone, 1995; Richard J Barnett& RonaldE Muller, GlobalReach: The Power of the MultinationalCorporations ,New York:Simon and Schuster, 1974; and Christopher Chase-Dunn, Global Formation:Structures of the World-Economy ,Cambridge,MA: Basil Blackwell, 1989. 2 Tom Barry, TheChallenge of Cross-Border Environmentalism: The US± Mexico Case ,Albuerque,NM: Resource Center Press, 1994;William Bogard, TheBhopal Tragedy: Language, Logic and Politics in the Productionof a Hazard ,Boulder,CO: Westview Press, 1989;Barry I Castleman &VincentNavarro, `Internationalmobility of hazardous products, industries, and wastes’ , AnnualReview ofPublicHealth , Vol 8,1987, pp 1± 19; Daniel Faber, EnvironmentUnder Fire: Imperialismand the Ecological Crisis inCentral America,New York:Monthly Review Press, 1993;R ScottFrey, ` Thehazardous waste ¯owin the world-system’, in PaulCiccantell & StephenG Bunker(eds) Spaceand Transport in the World-System , Westport,CT: GreenwoodPress, forthcoming;R ScottFrey, ` Theexport of hazardous industries to the peripheralzones of the world-system’ , Journalof Developing Societies ,forthcoming;R ScottFrey, ` The internationaltraf® cinpesticides’ , TechnologicalForecasting and Social Change ,Vol50, 1995, pp 151± 169; Jane HIves (ed), TheExport of Hazard: Transnational Corporations and Environmental Control Issues , Boston,MA: Routledgeand Kegan Paul, 1985; Douglas L Murray, CultivatingCrisis: TheHuman Cost of Pesticides inLatin America ,Austin:University of Texas Press, 1994;Roberto A. Sanchez,` Health and environmentalrisks of the maquiladora in Mexicali’ , NaturalResources Journal ,Vol30, 1990, pp 163±186; andLeslie Sklair,` Globalsystem, localproblems: environmental impacts oftransnationalcorporations along Mexico’s northernborder’ , inHamish Main& WynWilliams (eds), Environmentand Housing in Third WorldCities ,Chichester:Wiley, 1994, pp 85± 105. 3 VincentT Covello& RScottFrey, ` Technology-basedenvironmental health risks in developing nations’ , TechnologicalForecasting and Social Change ,Vol37, 1990, pp 159± 179; and L Tomatis,` Socioeconomic factors andhuman cancer’ , InternationalJournal of Cancer ,Vol52, 1995, pp 121± 125. 4 William UChandler, BanishingTobacco ,Washington,DC: WorldwatchInstitute, 1986; Food & Agricul- turalOrganization, Tobacco:Supply, Demand and Trade Projections, 1995± 2000 , Rome: FAO, 1990; and RTRavenholt,` Tobacco’s globaldeath march’ , Populationand Development Review ,Vol16, 1990, pp 213±240. 315 R SCOTT FREY

5 Councilon Scienti® c Affairs, `Theworldwide smoking epidemic: tobacco trade, use, and control’ , Journal ofthe American Medical Association ,No263, 1990, pp 3312± 3318; and Hal Kane, `Cigarette production upslightly’ , inLester RBrown,Nicholas Lenseen &Hal Kane (eds), VitalSigns 1995 ,Washington,DC: WorldwatchInstitute, 1995, pp 96± 97. 6 FAO, Tobacco:Supply, Demand and Trade Projections 1995± 2000 ;andDan Stevens,` Worldtobacco consumptionto increase through2000 AD’ , TobaccoReporter ,January1990, pp. 40± 42. 7 See Chandler, BanishingTobacco ;JohnCrofton, ` Tobaccoand the Third World’ , Thorax,Vol45, 1990, pp 164±169; Sharon Kingman, ` Tobaccosales soar indeveloping countries’ , BritishMedical Journal , 18 November` 995,p 1321;Judith MacKay &JohnCrofton, ` Tobaccoand the developing world’ , British MedicalBulletin ,Vol52, 1996, pp 206± 221; and J MichaelMcGinnis, Donald Shopland & Clarke Brown, `Tobaccoand health: trends in smoking and smokeless tobaccoconsumption in the United States’ , Annual Review ofPublic Health ,Vol8, 1987, pp 441± 467. 8 FAO,Tobacco:Supply, Demand andTrade Projections1995± 2000; and Stevens, ` Worldtobacco consumptionto increase’ . 9 Barnett& Cavanagh, GlobalDreams ;GregoryN Connolly,` Worldwideexpansion of transnationaltobacco industry’ , Journalof the National Cancer Institute Monographs ,Vol12, 1992, pp 29± 35; Judith MacKay, `Tobacco:the third world war’ , Thorax,Vol46, 1991, pp 153± 156; Philip L Shepherd,` Transnational corporationsand the international cigarette industry’, inShepherd, Pro®ts, Progress and Poverty: Case Studiesof International Industries in Latin America ,NotreDame, in:University of NotreDame Press, 1985, pp63± 112; and Peter Taylor, TheSmoke Ring: Tobacco, Money and Multinational Politics , New York: Mentor,1985.0 10 MicheleBarry, ` Thein¯ uence ofthe US tobaccoindustry on the health, economy, and environment of developingcountries’ , TheNew EnglandJournal of Medicine ,Vol324, 1991, pp 917± 920. 11 ErikEckholm, CuttingTobacco’ s Toll ,Washington,DC: WorldwatchInstitute, 1978, p 22;and Kenyon RainierStebbins, ` Transnationaltobacco companies and health in underdeveloped countries: recommenda- tionsfor avoiding a smokingepidemic’ , SocialScience andMedicine ,Vol30, 1990, pp 227± 229. 12 Connolly,` Worldwideexpansion of transnational tobacco industry’ ; Kane, `Cigarette productionup slightly’; Kingman,` Tobaccosales soar indeveloping countries’ ; StanSesser, Òpiumwar redux’, New Yorker,13September1993, pp 78±89; and Philip Shenon, ` Asia’ shavingone huge nicotine ® t’, New York Times,15May 1994, pp E1, E16. The export of cigarettes tothe LDCsis notnew. The early daysof expansioninto the LDCsare describedin colourful terms bya former Presidentof British± American Tobacco:ª Theysay thatthe American MrJB Duke,when they brought him a machine thatwould make as manycigarettes ina minuteas aman hadhitherto made inan hour, said ` bringme theatlas.’ Whenthey broughtit, he turned over the leaves, lookingnot at themaps butat thesigni® cant ®guresat thebottom, untilhe came tothe legend. ` Population:430 000 000. That’ , hesaid, ` is where we are goingto sell cigarettes’ .Whenthey told him that the Chinese don’ t smokecigarettes, hesaid he supposed they could learn.In the best season Ican remember, ourcompany sold six thousand ® vehundredmillion cigarettes in Chinain a month.º(Cited in Mike Muller, Tobaccoand the Third World: Tomorrow’ s Epidemic? , London: War onWant, 1978, p 23. 13 Tomatis,` Socioeconomicfactors andhuman cancer’ . 14 Muller, Tobaccoand the Third World ;andStan A. Taylor,` Tobaccoand economic growth in developing nations’ , Businessin the Contemporary World ,Winter,1989, pp 58±59; but see RRHamadeh, KMcPherson &RDoll,` Tobaccoconsumption and chemical analysisof cigarettes inBahrain’ , InternationalJournal of Addiction,Vol29, 1994, pp 325± 337. 15 Amanda Amos,` Womenand smoking’ , BritishMedical Bulletin ,No52, 1996, pp 74± 89; Gregory N Connolly,` Western cigarettes andcelebrities inAsia’ , Prioritiesfor Long Life and Good Health , Spring 1992,pp 17± 20; Judith Mackay, ` UStobaccoexport to the Third World: third world war’ , Journalof the NationalCancer Institute Monographs ,Vol12, 1992, pp 25± 28; and Shenon, ` Asia’ shavingone huge nicotine® t’. 16 Councilon Scienti® c Affairs, `Theworldwide smoking epidemic’ . 17 Butsee James Brooke,` Brazil comes downhard on cigarette ads’ , New YorkTimes ,January15 1995,p 6; andR Roemer, LegislativeAction to Combat the World Tobacco Epidemic ,Geneva: WorldHealth Organization,1993. 18 See Barry,` Thein¯ uence ofthe US tobaccoindustry’ ; Connolly,` Worldwideexpansion of transnational tobaccoindustry’ ; MacKay, ÙStobaccoexport to the Third World’ ; Ravenholt,` Tobacco’s globaldeath march’ ;Sesser, Òpiumwar redux’ ;KenyonRainier Stebbins, ` Tobaccoor health in the Third World: a politicaleconomy perspective with emphasis onMexico’, InternationalJournal of HealthServices , Vol 17, 1987,pp 528± 529; Stebbins, ` Makinga killingsouth of the border: transnational cigarette companiesin MexicoGuatemala’ , SocialScience andMedicine ,Vol38, 1994, pp 105± 115; and Taylor, ` Tobaccoand economicgrowth in developing nations’ . 19 Sesser, Òpiumwar redux’, p82. 20 Mackay& Crofton,` Tobaccoand the developing world’ , p217. 21 GlennFrankel, ` Smugglinga burningissue forChina’ , WashingtonPost ,20November 1996, p A23. 316 THE INTERNATIONAL TRAFFIC INTOBACCO

22 Ibid 23 JohnMadeley, ` Tobacco:a ruinouscrop’ , TheEcologist ,Vol16, No 2/ 3,1986, p 127. 24 Barnett& Cavanagh, GlobalDreams ,p.206; and Stebbins, ` Transnationaltobacco companies and health inunderdeveloped countries’ . 25 Stebbins,` Transnationaltobacco companies and health in underdeveloped countries’ . 26 See Barnett& Cavanagh, GlobalDreams ,pp184± 207; Miller. Tobaccoand the Third World , pp 17±20; Stebbins,` Transnationaltobacco companies and health in underdeveloped countries’ ; andTaylor, The Smoke Ring.Contractfarming is becomingan increasingly important form of industrialised agriculture in many LDCs.See MichaelJ Watts,` Livingunder contract: the social impacts ofcontract farming in West Africa’ , TheEcologist ,Vol24, July/ August1994, pp 130± 134; and Michael Watts &Peter DLittle(eds), Living UnderContract ,Madison:University of Wisconsin Press, 1994. 27 See, forexample, Barnett& Cavanagh, GlobalDreams ,pp184±207; Nath, Smoking:The Third World Alert , Oxford:Oxford University Press, 1986;Shepherd, ` Transnationalcorporations and the international cigarette industry’; Stebbins,` Tobaccoor healthin the Third World’ ; Stebbins,` Transnationaltobacco companies and healthin underdeveloped countries’ ; Stebbins,` Tobacco,politics and economics: implications for global health’ , SocialScience andMedicine ,Vol33, 199, pp 1317± 1326; Stubbins, ` Makinga killingsouth of the border’; andTaylor, TheSmoke Ring . 28 PhilipJ Hilts, SmokeScreen: TheTruth Behind the Tobacco Cover-Up ,Reading,MA: Addison-Wesley, 1996;Thomas D MacKenzie, Carl EBartecchi &RobertW Schrier,` Thehuman costs oftobaccouse’ , New EnglandJournal of Medicine ,No330, 1994, pp 975± 980; McGinnis et al,`Tobaccoand health’ ; Richard McKerrow, `Merchantsof death target the Third World’ , ThirdWorld Resurgence ,Vol26, 1992, pp 8± 9; KennethE. Warner,` Effects ofthe anti-smoking campaign: an update’ , AmericanJournal of PublicHealth , Vol79, 1989, pp 144± 151; and Larry C White, Merchantsof Death:The American Tobacco Industry , New York:Beech Tree Books,1988, pp 72± 115. Over 50%of theUS adultpopulation smoked in 1964, but by 1991the ® gurewas 26%.Connolly, ` Worldwideexpansion of transnational tobacco industry’ . 29 See StantonA. Glantz,John Slade, Lisa ABero,Peter Hanauer &DeborahE Barnes, TheCigarette Papers , Berkeley:University of California Press, 1996;Hilts, SmokeScreen ; and White, Merchantsof Death . 30 Stebbins,` Tobaccoor health in the Third World’ ; Stebbins,` Transnationaltobacco companies and health inunderdeveloped countries’ ; Stebbins,` Tobacco,politics and economics’ ;andStebbins, ` Makinga killing southof the border’ . 31 McKenzie et al,`Thehuman costs oftobacco use’ ,p977. 32 AndrewSkolnick, ` USgovernmentcriticized forhelping to export a deadlyepidemic oftobaccoaddiction’ , Journalof the American Medical Association ,No267, 1992, pp 3256± 2357; and Taylor, TheSmoke Ring , p 287 ff. 33 Barnet &Cavanagh, GlobalDreams , p 200. 34 These permitthe US governmentto take actionagainst nations engaged in ` unfair’or `discriminatory’trade practices. Inother words, the act givesthe president the authority to retaliate againstother countries by implementingtariffs ongoods. 35 TedT LChen& AlvinE Winder,` Theopium wars revisitedas USforces tobaccoexports in Asia’ , AmericanJournal of PublicHealth ,Vol80, 1990, pp 659± 662; and Skolnick, ` USgovernmentcriticized’ . Several critics havecompared these actionswith the English efforts in the 19th century to foist Indian opium onthe Chinese in an attempt todeal witha serioustrade de®cit withChina. Barnett & Cavanagh, Global Dreams;Chen& Winder,` Theopium wars revisited’; AlexanderCockburn, ` Beat thedevil’ , Nation, 30 October1989, pp 9± 10; and Sesser, `Opiumwar redux’. There havebeen numerous attempts since theturn ofthis century to crack theChinese tobacco market. JudithMacKay, `The® ghtagainst tobacco in developingcountries’ , Tuberculosisand Lung Disease ,Vol74, 1994, pp 8± 24. See IBrian, TheOpiumWar , London:Hodder and Stoughton, 1976 for a gooddiscussion of theOpium War inChina;Sherman Cochran, BigBusiness in China; Sino-Foreign Rivalry in the Cigarette Industry, 1890± 1930 ,Cambridge,MA: HarvardUniversity Press, 1980and Y CWang,` Free enterprisein China: the case ofacigarette concern, 1950±1953’ , Paci®c HistoricalReview ,Vol29, 1960, pp 395± 414 for a historyof the tobacco wars in China;and Franhel, ` Smugglinga burningissue forChina’ , Franhel& StevenMulson, ` Vast Chinamarket keyto smoking disputes’ , WashingtonPost ,20November 1996, pp A1,A22 and Sesser, `Opiumwar redux’ fora discussionof the current tobacco war inChina and other parts of Asia. 36 Madeley,` Tobacco:a ruinouscrop’ ; andMuller, Tobaccoand the Third World . 37 Mackenzie et al,`Thehuman costs oftobacco use’ ,p975. 38 Nath, Smoking,p207ff; Stebbins, ` Tobaccoor health in the Third World’ , p528;and Stebbins, `Transnationaltobacco companies and health in underdeveloped countries’ , p231. 39 Nath, Smoking,p200ff; Shepherd, ` Transnationalcorporations and the international cigarette industry’; Stebbins,` Tobaccoor health in the Third World’ , p527ff; and Stebbins, ` Transnationaltobacco companies andhealth in underdeveloped countries’ . 40 Taylor, TheSmoke Ring , p 267. 41 Barnett& Cavanagh, GlobalDreams , p 207. 317 R SCOTT FREY

42 SherifOmar, `Smokingin the Third World’ , WorldHealth ,No48, 1995, pp 28± 29. 43 Nath, Smoking;andTaylor, TheSmoke Ring . 44 Eckholm, CuttingTobacco’ s Toll ,p21;and Taylor, TheSmoke Ring . 45 See, forexample, Carl E.Bartecchi, ThomasD MacKenzie &RobertW Schrier,` Thehuman costs of tobaccouses’ , TheNew EnglandJournal of Medicine ,No330, 1994, pp 907± 912; Council on Scienti® c Affairs. `Theworldwide smoking epidemic’ ;RobertJ AGoodland,Catharine Watson & GeorgeLedec, EnvironmentalManagement in Tropical Agriculture ,Boulder,CO: Westview Press, 1984;MacKay, `The ®ghtagainst tobacco in developing countries’ ; MacKenzie et al,`Thehuman costs oftobacco use’ ;John Madeley,` Theenvironmental impact oftobacco production in developing countries’ , New YorkState Journalof Medicine ,Vol83, 1983, pp 1310± 1311; Madeley, ` Tobacco:a ruinouscrop’ ; Muller, Tobacco andthe Third World ;Muller,` Preventingtomorrow’ s epidemic:the control of smoking and tobacco productionin developing countries’ , New YorkState Journal of Medicine ,Vol83, 1983, pp 1304± 1309; Ravenholt,` Tobacco’sglobal death march’ ;Taylor,` Tobaccoand economic growth in developing nations’ ; WorldHealth Organization, WHOProgrammeon Tobacco and Health: Report by the Director-General , Geneva: WHO,1985; and Derek Yach, `Theimpact ofsmoking in developing countries with special reference toAfrica’ , InternationalJournal of Health Services ,Vol16, 1986, pp 279± 292. 46 Bartecchi et al,`Thehuman costs oftobacco use’ . 47 Ravenholt,` Tobacco’s globaldeath march’ ,pp228± 229. 48 Ibid, p 229. 49 Bartecchi et al,`Thehuman costs oftobacco use’ . 50 JMichaelMcGinnis & William HFoege,` Actual causes ofdeath in the United States’ , Journalof the AmericanMedical Association ,No270, 1993, pp 2207± 2212. 51 Bartecchi et al,`Thehuman costs oftobacco use’ . 52 Amos,` Womenand smoking’ ; Councilon Scienti® c Affairs, `Theworldwide smoking epidemic’ ;and Ravenholt,` Tobacco’s globaldeath march’ ,p238. 53 Ravenholt,` Tobacco’s globaldeath march’ ,pp237± 238. 54 RichardPeto, Mortalityfrom Smoking in Developing Countries: An Analysis from Developed Countries , Oxford:Oxford University Press, 1994. 55 RichardPeto, Alan D Lopez,Jillian Boreham, Michael Thun & ClarkHeath, Jr,` Mortalityfrom tobacco indeveloped countries: indirect estimation from national vital statistics’ , Lancet,No339, 23 May1992, pp 1268±1278. 56 DMParkin,P Pisani,A DLopez& EMasuyer,` At least onein seven cases ofcancer is caused by smoking:global estimates for1985’ , InternationalJournal of Cancer ,Vol59, 1994, pp 494± 504; Peto et al,`Mortalityfrom tobacco in developing countries’ ; JohnP Pierce, LeighThurmond & BradleyRosbrook, `Projectinginternational lung cancer mortalityrates: ®rst approximationswith tobacco-consumption data’ , Journalof the National Cancer Institute Monograph ,Vol12, 1992, pp 45± 49; MacKay &Crofton,` Tobacco andthe developing world’ ; andIan Magrath & JorgeLitvak, ` Cancer indeveloping countries: opportunity andchallenges’ , Journalof the National Cancer Institute Monograph ,Vol85, 1993, pp 862± 874. 57 NigelGray, ` Evidenceand overview of global tobacco problem’ , Journalof the National Cancer Institute Monographs,Vol12, 1992, p 16. 58 Muller, Tobaccoand the Third World . 59 Gray,` Evidenceand overview of global tobacco problem’ ; andSally Wagner & Rose MaryRomano, `Tobaccoand the developing world: an old threat poses even bigger problems’ , Journalof the National CancerInstitute ,Vol86, 1994, p 1752. 60 PrakashC Gupta& KeithBall, ` India:tobacco tragedy’ , Lancet,No335, 10 March 1990, pp 594± 595; ThomasE Novtny& RichardPeto, ` Estimates offutureadverse healtheffects ofsmoking in China’ , Public HealthReports ,No103, 1988, pp 552± 553; Parkin et al,`At least onein seven cases ofcancer’ ;Richard Peto,` Tobacco-relateddeaths in China’ , Lancet,25July 1987, p 211;Peto et al,`Mortalityfrom tobacco indeveloped countries’ ; andPeto, Mortalityfrom Smoking in Developed Countries . 61 Pets, Mortalityfrom Smoking in Developed Countries . 62 Frey,` Theinternational traf® cinpesticides’ . 63 Ibid, Goodland et al, EnvironmentalManagement in Tropical Agriculture ;andMurray, CultivatingCrisis . 64 Muller, Tobaccoand the Third World ,p61;and Taylor, ` Tobaccoand economic growth in developing nations’, p63. 65 Madeley,` Tobacco:a ruinouscrop’ , p126. 66 Goodland et al, EnvironmentalManagement in Tropical Agriculture , p 57. 67 See, forexample, Piers Blaikie& HaroldBrook® eld, LandDegradation and Society ,London:Methuen, 1987;Goodland et al, EnvironmentalManagement ;Madeley,` Theenvironmental impact oftobacco production’; Madeley,` Tobacco:a ruinouscrop’ ; andAnne E. Platt,` Confrontinginfectious diseases’ ,in Lester RBrown et al (eds), Stateof the World 1996 ,New York:W WNorton,1996, pp 114± 132. 68 Goodland et al, EnvironmentalManagement ;Madeley,` Tobacco:a ruinouscrop’ ; Muller, Tobaccoand the Third World;Muller,` Preventingtomorrow’ s epidemic’ ;Nath, Smoking,p216ff; Taylor, TheSmoke Ring ; Watts,` Livingunder contract’ ; andYach, `Theimpact ofsmoking in developing countries’ . 318 THE INTERNATIONAL TRAFFIC INTOBACCO

69 HBarnum` Theeconomic burden of the global trade intobacco’ , TobaccoControl ,Vol3, 1994, pp 358±361; and Taylor, ` Tobaccoand economic growth in developing nations’ . pp61± 62. 70 MacKenzie et al,`Thehuman costs oftobacco use’ ,p.975. 71 FAO,`Tobacco:Supply, demand and trade projections,1995± 2000’ ; Taylor, TheSmoke Ring , p 267 ff; Taylor,` Tobaccoand economic growth in developing nations’ , pp64± 65. 72 AnnePhillips, Don de Savigny & MaureenM Law, Às Canadiansbutt out, the developing world lights up’ , CanadianMedical Association Journal ,No153, 1995, p 1112. 73 See ibid,pp1112± 1113; Taylor, ` Tobaccoand economic growth in developing nations’ , p65;and Wagner &Romano,` Tobaccoand the developing world’ for a review ofthis research. McGinnnotes: ª Pro®ts and taxes tothe Chinese government totalled $8.6 billion in 1995. Yet justtwo years earlier, theannual direct healthcosts andindirect productivity losses fromsmoking were estimated at $11.3billion by China’ s Academy ofPreventive Medicine.º Anne Platt McGinn, ` Preventingchronic disease indeveloping countries’, inLester RBrown et al (eds) Stateof the World, 1997 ,Washington,DC: WorldwatchInstitute, 1997, p 73. 74 Phillips et al,Às Canadiansbutt out’ , p1109. 75 WHO, WHO Programmeon Tobacco and Health . 76 Madeley,` Tobacco:a ruinouscrop’ . 77 Several groupshave acted tocurb tobacco consumption in the LDCs.They include government organisations suchas theWorld Health Organizationand non-government organisations such as theInternational Union AgainstCancer, InternationalUnion Against Tuberculosis and Lung Disease, InternationalOrganization of ConsumerUnions, and the International Society and Federation of Cardiology. C. Chollat-Traquet,` Tobacco or health: a WHO programme’ , EuropeanJournal of Cancer ,Vol28, 1992; pp 311± 315; Gray, ` Evidence andoverview of global tobacco problem’ , p16;and MacKay &Crofton,` Tobaccoand the developing world’, p216. 78 See, forexample, Chandler, BanishingTobacco ;Connolly,` Worldwideexpansion of transnationaltobacco industry’; Chollat-Traquet,` Tobaccoor health’ ; MacKay, `The® ghtagainst tobacco in developing countries’; MacKay, `Thetobacco problem: commercial pro®t versushealthÐ the con¯ ict ofinterests in developingcountries’ , Preventive Medicine ,Vol23, 1994, pp 535±538; MacKay, `Tobacco:the third world warÐadvice from General SunTzu’ , Thorax,Vol51, 1996, pp 562± 563; MacKay &Crofton,` Tobaccoand thedeveloping world’ , p211ff; Madeley, ` Tobacco:a ruinouscrop’ ; Muller, Tobaccoand the Third World , JohnPierce, `Progressand problems in international public health efforts to reduce tobaccousage’ , Annual Review ofPublic Health ,Vol12, 1991, pp 283± 400; Stebbins, ` Transnationaltobacco and companies and health’; Taylor, TheSmoke Ring ;Rebecca Voelker,` Youngpeople may face hugetobacco toll’ , Journal of theAmerican Medical Association ,No274, 5 July1995, p 203;Kenneth E Warner,` Tobaccotaxation as healthpolicy in theThird World’ , AmericanJournal of PublicHealth ,Vol80 1990,pp 529± 531; Elizabeth M Whelan, ASmokingGun: How the Tobacco Industry Gets Awaywith Murder ,Philadelphia,PA: George FStickley,1984, pp 174± 176; and Yach, `Theimpact ofsmoking in developing countries’ . 79 MacKay, ÙStobaccoexport to theThird World’ ; MacKay, `Thetobacco problem’ ; MacKenzie et al, `The humancosts oftobacco use’ . 80 Teh-wei Hue,Hai-Yen Sung& TheodoreE Keeler, `Reducingcigarette consumptionin California: tobacco taxes vsan anti-smoking media campaign’, AmericanJournal of Public Health ,Vol85, 1995, pp 1218±1222; Hal Kane, `Puttingout cigarettes’ , World Watch,Vol2, September/ October1992, pp 33± 34; Kane, `Cigarette taxes showups and downs’ , inBrain et al, VitalSigns 1995 ;McGinn,` Preventingchronic disease indeveloping countries’ , p74;and Pierce, `Progressand problems in international public health efforts’ . 81 Kane reportsthat: ` InNew Zealand,where theprice ofa packof cigarettes nearlydoubled between 1980 and1991, due to a taxincrease of$1.97, the number of cigarettes purchasedannually dropped from 4100 perperson to just over 1500. The United Kingdom achieved similar reductionsin smoking rates through cigarette taxhikes until the late 1980s,when it reversed itself andbrought taxes down.When the country cutcigarette taxes 15percentbetween 1987and 1990, smoking rates rose more than2 percent overalland by25 percent among people under 18 years ofage. The jump in rates occurreddespite an anti-smoking campaigndirected at adolescentsthrough the mass media’ .Kane, `Puttingout cigarettes’ ,p9. 82 SChapman& JRichardson,` Tobaccoexcise anddeclining tobacco consumption: the case ofPapau New Guinea’ , AmericanJournal of PublicHealth ,Vol80, 1990, pp 537±540; and Warner, ` Tobaccotaxation as healthpolicy’ . 83 Taylor, TheSmoke Ring . 84 Inother words, health, environmental and social needsare subordinatedto the needs of capital.

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