78 News analysis....................................................................................... Tob Control: first published as on 24 March 2006. Downloaded from essence, the court said it was a matter Turkey: first tobacco of free choice whether or not a person smoked; it was not proven that smoking litigation caused cancer by itself; and the causes In November 2000, Turkey’s first of cancer were not entirely clear. The tobacco litigation, a personal injury case patient could have become ill from other in the district court in Edirne, in the carcinogenic agents, including those north-west of Turkey near the borders found in many foods that were widely with Greece and Bulgaria, was filed sold and consumed. In addition, the against Tekel, the Turkish tobacco defendant, the tobacco company, was monopoly. The plaintiff was Yurdagu¨l providing a legal product, and did not Tufan, 44, a smoker since she was 17, have a legal obligation to look after who was responsible for the support of people’s health. The court also noted her blind husband and their young that there was a health warning on The woman at the centre of Turkey’s first daughter. cigarette packs saying, ‘‘Cigarettes harm tobacco litigation case, Yurdagu¨l Tufan, with After diagnosis and first line thera- your health’’, and in any case, the harm her blind husband and their daughter. pies, an improvement in her health was done by cigarettes was known by every- achieved. Knowing that as much as body, even without a health warning. the companies. Much more vigorous possible was being done for her physical This fact did not alter just because the tobacco control could be possible in health, albeit for a terminal disease, her product was advertised; it was the duty Turkey if such suits began to be won. doctor gave more thought to what else of every person to protect his or her As the World Health Organization has could be done for her overall well-being. health. recommended, the tobacco industry has The woman was desperately concerned After this judgement, the lawyer to be held responsible at both the for the welfare of her husband and appealed to the supreme court. national and international levels, by baby, for whom she would soon be However, after a process of two years it legislation, law suits and other methods. http://tobaccocontrol.bmj.com/ unable to care and then would leave just became too burdensome, and he Enlightened tobacco control leaders in behind for ever when she died. withdrew the case. He also decided not the industrialised world must not over- Although nothing could be done to save to appeal to the European Court of look the harm being wrought on those her life, at least she might be helped to Human Rights, as previously intended. living in countries with fewer resources, understand that she was not the only Although the case had been on the in terms of both finance and informa- one responsible for her situation, and national agenda in a big way, no non- tion about tobacco, by the same compa- could use her case to warn others not to governmental organisation, or scientific nies which they have been able, at least smoke. or legal association, had come forward partially, to control in their own coun- From what the doctor had learned to support it. tries. from international news media and the Even though the final result was internet, he conceived the idea of suing negative, this first attempt at tobacco CELAL KARLIKAYA the tobacco company whose cigarettes litigation had many important effects. Trakya University Medical School, Edirne, on September 28, 2021 by guest. Protected copyright. she had smoked. Despite finding little Firstly, it raised the level of discussion in Turkey; [email protected] support for the idea among colleagues, Turkey about the harm caused by and although a lawsuit seemed an cigarettes, and made them clearer in absurdly ambitious concept, he found a the public mind. The whole country USA: Pacific island lawyer, Rifat C¸ulha, who was persuaded watched the death of a mother and wife, to run the case without payment. So clears the air and the effects of her lung cancer, step Tekel was duly sued for compensatory The 9th December last year was a by step. Tekel and other tobacco firms and punitive damages of 1.1 trillion historic day on the Pacific island of changed some of their unhealthy prac- Turkish Lira (about US$1.6 million). Guam, an unincorporated territory of tices of their own accord. Tekel, due to It was an utterly new phenomenon in the United States. Governor Felix be privatised, was clearly attractive to Camacho signed into law a bill making Turkey, and a cause of general aston- the large international tobacco firms. ishment, reflected by widespread inter- restaurants and most enclosed public However, the privatisation programme places smoke-free. Bill 16 was written est from the mass media. A quick search fell behind schedule and it seems on the internet, by headlines and sub- by Democratic senator Lou Leon reasonable to speculate that at least Guerrero, who, in 2003, raised tobacco headlines, found almost 80 news items one factor may have been the litigation. about it. The story was also shown on taxes on Guam. While the bill that was In contrast to some of the US cases, the main news programmes of national passed was not as strong as the original Turkish citizens are still being killed by television channels. The disease process, version, it represents a step towards a tobacco without costs being imposed on the trial day, the death of the patient healthier future for the island’s 170 000 and the amount of compensation people, who have the highest adult claimed—all, in turn, were the basis of smoking prevalence of all US States substantial news stories. All articles written by David Simpson and Territories. The suit was eventually rejected by unless otherwise attributed. Ideas and It took a lot of manoeuvring and the local court, after two and a half items for News Analysis should be sent shrewd political strategy to get the bill years, and details of the judgement to: [email protected] passed, because of efforts to block and/ suggested significant confusion. In or dilute it by parties aligned with www.tobaccocontrol.com News analysis 79 On 22 November, the finance com- and is an important trendsetter for the mittee finally released a compromise northern Pacific. The Federated States version for the legislature’s considera- of Micronesia (a US affiliated tion. The revised bill stipulated that Micronesian country) is already looking Tob Control: first published as on 24 March 2006. Downloaded from restaurants and bars prohibit smoking to emulate the Guam law. until 9 pm, after which it would be allowed. The majority of senators ANNETTE DAVID rejected the compromise version, using Guam Department of Mental Health and arguments from the technical informa- Substance Abuse; [email protected] tion previously disseminated by various pro-health groups. On 30 November, 12 of the 14 Senators present voted to pass Spain: going smoke South Africa: fire on Table Mountain One of Guam’s first comprehensive smoke-free free the hazards of smoking which tends to receive public places law. The final version bans From 1 January 2006 the Spanish less attention than it merits was all too starkly smoking completely in enclosed public government introduced a new law illustrated by this fire on Table Mountain, places, workplaces and restaurants, but against smoking (Ley 28/2005). This outside Cape Town in January. It was started by allows smoking in bars. a British tourist throwing a cigarette butt out the law is not only a ban on smoking but window of his car. The man was spotted by an The combined efforts of community a compendium of public health mea- alert game guide, who radioed the police. The advocates, prevention workers, several sures against smoking and regulations man was later arrested and there were calls for senators committed to public health on the sale, supply, consumption, and him to be given the maximum sentence and policies, and the global tobacco control publicity of tobacco products. The law’s fine. community ensured that a sound ver- main objectives are to protect non- sion of the original bill prevailed. While smokers (especially at the workplace) not as comprehensive as the original tobacco-related interests. Introduced by from secondhand smoke—currently, version, the current law represents a 69% of the Spanish adult population, the health committee, the bill was major step forward towards creating a unexpectedly taken over by the finance both sexes combined, declare they are healthier, tobacco-free future for Guam. non-smokers—to prevent initiation committee, supposedly because of con- In addition, Guam serves as opinion cerns about adverse effects on business among young people, and to promote leader and setter of precedents for the smoking cessation. revenues. However, local community other US-affiliated Micronesian islands, advocates and political observers noted The law creates smoke-free environ- that the senator heading the finance ments in all enclosed public and private http://tobaccocontrol.bmj.com/ committee belonged to a powerful workplaces and smoking is now banned family that oversees the distributorship in all indoor public places, public trans- of tobacco and alcohol products on portation including closed stations, hos- Guam. In addition, the Guam Hotel pitals and other health care facilities, and Restaurant Association opposed schools and universities, as well as retail stores and shopping centres. There are the bill early on, purportedly because important (and worrying) exemptions of concerns that it would reduce hospi- regarding bars and restaurants: while tality revenues, particularly from hospitality venues of more than 100 Guam’s Japanese and South Korean square metres are smoke-free, the law tourists.