Tobacco Control 2002;11:171–175 Tob Control: first published as 10.1136/tc.11.3.171 on 1 September 2002. Downloaded from Newsanalysis................................................................................ Hong Kong: than pocket sized mini-billboards. circumstances—occupation (teacher), Apart from the health warning, each genetic background, living con- Marlboro tries it on large face was largely covered in ditions—the panel concluded that the images of that universal symbol of disease was at least 80% attributable (the pack) independence who shores up the to smoking. Whenever a government announces morale of PM’s nicotine captives. Building on the traditional approach tobacco control measures which to- Reports from Hong Kong suggest to toxic torts, the panel tried to find bacco companies suspect will be effec- this was a classic trial run. Will they the fingerprint of carcinogens of tive, the companies’ first reaction, at get away with it? They did that time, it tobacco smoke. According to the best least in private, is to work out ways of seems. Will they be back? And if they forensic evidence, these can now be getting round them. Under self regula- can get away with it in Hong Kong, found in the genes of the victim, tion, they implement whatever will they try it elsewhere? Make sure contained in the victim’s cells collected and preserved at the time of hospital schemes they think will most com- your legislation is tightly drafted, then administration. More specifically, re- pletely negate the measures they have sit back and watch this space. just agreed to, and continue for as long cent scientific literature suggests that as they can get away with it. It costs there are different genetic mutations nothing to make a grovelling apology, Italy: court’s expert of p53 and K-ras genes in smokers, after all; and in extreme cases, it can be panel condemns vis-à-vis non-smokers. This might delivered with an air of bewilderment have interesting implications in the that the breach—an isolated lapse tobacco field of mass torts, tobacco as well as non-tobacco related. whose local perpetrator has been se- Stalteri vs. Monopoli di Stato is the verely reprimanded—could ever have The most frequent mutation affect- first tobacco product liability case filed ing smokers or former smokers con- been allowed to happen in the first in Italy (in 1994) and the second one cerns codons 12 and 13 of K-ras, with place. in Europe. On 13 March 2002 a panel the first nucleotides of codon 12 Under legislation too, something ad hoc appointed by the Civil Court of mostly affected (65%) in smokers who similar is seen; they simply try it on, Appeal in Rome released its expert develop adenocarcinoma to the lung. starting with a small tester, working witness opinion on specific causation, That mutation was found in the case of up through repeated violations, until concerning the case of the late Mario the late Mario Stalteri. The three finally the breaches of the letter or the Stalteri, a pack-a-day smoker who quit person expert panel concluded there- spirit of the law become so outrageous smoking in 1987, four years before the fore that “a serious and reasonable cri- that they risk hitting the buffers of manufacturer issued the current terion of probabilistic evidence con- http://tobaccocontrol.bmj.com/ enforcement—legal sanctions that ac- version of warnings. Given the firms that smoking has been a tually hurt. The ideal is to cruise along just this side of enforcement, which in many countries is all too easy to do, either because of the effort required to go to court with a prosecution, or because of the equally tiresome effort of tightening up the legislation. In Hong Kong, China, with a near total ban on tobacco promotion, Philip Morris must have noticed that the on October 1, 2021 by guest. Protected copyright. detailed regulations specifying what has to appear on a cigarette pack had omitted to specify all the things that the government must have intended should not appear. All those positive images linking Hong Kong’s biggest preventable cause of premature death with macho cowboys, for example, whose banishment was the whole point of the ad ban. So it was perhaps no surprise that early this year, a range of Marlboro packs hit the streets of Hong Kong that were nothing less All articles written by David Simpson unless otherwise attributed. Ideas and items for News Analysis should be sent to David Simp- son at the address given on the inside front cover. Images on packs of Marlboro sold in Hong Kong: “pocket sized mini-billboards”. www.tobaccocontrol.com 172 News analysis Tob Control: first published as 10.1136/tc.11.3.171 on 1 September 2002. Downloaded from sufficient and adequate causation of as follows: ‘Yes,we agree that smoking The Rodin letter continued: “For the the specific cancer”. cigarettes, including our brands, time being, we are creating a database The next procedural step will be the causes lung cancer and other serious on all national and international pre- decree by which the Court of Appeal diseases in smokers.’” vention projects, more specifically pri- will accept or reject the evidence This seems to be yet another layer of mary prevention and especially to- submitted by the panel. In the Italian the onion that has been removed from bacco prevention among youngsters. legal system the latter event is rare. the game that British American Tobac- The purpose of this scientific research co’s Australian chairman in 1997 once is to give scientific support to other MARCELLO STALTERI described as “a charade”. So what does organisations and federate [sic] initia- Università di Firenze, 50100 Firenze, Italy it mean? Philip Morris and all tobacco tives that fall within the scope of its CARLO LA VECCHIA companies continue to dispute each objectives and raise awareness among Istituto di Statistica Medica e Biometria, and every litigant’s claim on just that: politicians.” Slight overuse of the word Università degli Studi di Milano, 20133 that smoking their company’s brands “scientific” there, one might think, Milano, Italy caused lung cancer or other serious presumably dictated by the urgent diseases in a particular smoker. Yes, need to win the confidence of the SILVIO GARATTINI they agree smoking their brands can letter’s recipients that their replies Istituto di Ricerche Farmacologiche “Mario would be handled in a way that was at Negri”, 20157 Milano, Italy cause cancer in smokers . .it’s just that they’ve never found a single instance once responsible and beneficial to where they agreed that this ever mankind. No prizes for predicting that PM: “We agree that occurred! Plus ça change, plus c’est la the science would be carried out même chose. according to the tobacco industry’s our brands cause standards, and that the principal ac- lung cancer in SIMON CHAPMAN tivities may closely resemble the well Editor, Tobacco Control known and totally inefficient youth smokers” prevention campaigns favoured by the Following an article I published in an Europe: Rodin’s big tobacco pushers. Australian newspaper in April, I re- ceived a letter from Philip Morris Aus- non-thinker South Asia: the tralia’s spin king Thomas Dubois, Just like CASIN (see “The Circumlocu- scolding me for not drawing readers’ tion Hall of Fame” below), the Belgian party goes on attentions to the company’s latest Rodin Foundation, whose strapline is As we know, international tobacco website position on disease causation “Analysing and taking action”, has companies are hard at work to rein- and smoking. I replied: “Many of my been contacting health agencies active vent their images, particularly in the colleagues understand the message on in tobacco control as if it had no west where people increasingly disap- your website to mean that Philip Mor- connections with the tobacco industry. prove of their activities. At the same ris agrees with the fact that there is Its unctuous approaches even included time, as we also know, their behaviour http://tobaccocontrol.bmj.com/ overwhelming consensus in the medi- a disarming if coy plea for us to make in the new markets of the developing cal and scientific community that allowances for the institutional equiv- world has not changed one iota, except cigarette smoking causes lung cancer alent of the innocence of youth. In a perhaps to intensify with each passing and other diseases. However, we be- letter sent to several organisations in month. lieve that this is no different to (for Europe, the following explanation was Pakistan has already been suffering example) the backpacker serial killer provided. “We are a very young organ- a sustained onslaught of tobacco pro- Ivan Milat saying, with hand on his isation and our activities have just motion clearly aimed at youth for heart, that he agrees that there exists started. We are based in Brussels and many years (see Tobacco Control an overwhelming consensus of evi- are funded by public and private 2001;10:93–4 and Tobacco Control dence that he killed seven young funds.” In fact the Rodin Foundation 2000;9:361, for examples). Have the people. This of course does not pre- has a contract with the tobacco manu- international tobacco companies on October 1, 2021 by guest. Protected copyright. clude him continuing to say, ‘I am facturers in the Belgian market and toned down their marketing recently, innocent of murder’. All he’s doing is will receive 1.85 million Euros in line with the new sense of corporate acknowledging that this consensus (US$1.75 million) annually over five responsibility they claim? Did they, as exists, just as PM is acknowledging the years.