PRESS CONFERENCE ON WORLD NO TOBACCO DAY

Press Briefing

PRESS CONFERENCE ON WORLD NO TOBACCO DAY

World No Tobacco Day was the only global event dedicated to calling worldwide attention to the tobacco epidemic, Dr. David Kessler, Dean, Yale University School of Medicine and former Commissioner of the United States Food and Drug Administration, told correspondents this morning at a Headquarters press conference given by the Coalition for World No Tobacco Day.

The Coalition represented an opportunity to join together to disseminate information to educate the public about the dangers of tobacco use and to motivate individuals not to use tobacco through positive health messages, he said. Joining Dr. Kessler was Dr. David Brandling-Bennett, Deputy Director of the Pan American Health Organization, and Tim McCarver, New York Yankees commentator, and former Major League baseball player.

Dr. Brandling-Bennett said that experts around the world had recognized tobacco use as one of the foremost public health concerns. By the year 2020, approximately 10 million persons each year will die from tobacco-related disease. It was that reality that had galvanized the World Health Organization (WHO) to call for a concerted global effort to prevent deaths from tobacco. In 1988, sparked by the health and economic toll of tobacco, the WHO declared 31 May, World No Tobacco Day and invited individuals and groups around the world to support that annual event.

The Pan American Health Organization was one of the founding members of the Coalition for World No Tobacco Day, he continued. It was the duty of every health organization to make an effort to fight the tobacco epidemic. The Coalition would serve as an instrument to focus attention on the importance of World No Tobacco Day. Every year the WHO ignited the Day with a theme and this year's was "leave the pack behind".

He added that the organizations that had joined the Coalition included the American Cancer Society, the American Heart Association, the National Association of African Americans for Positive Imagery, SmithKline Beecham Consumer Healthcare and the Campaign for Tobacco-Free Kids. They had recognized how necessary it was to motivate tobacco users to quit and to stop the nation's youth from starting tobacco to begin with.

In the past 10 years the participation of countries around the world had increased significantly, he said. It was through the Coalition and the activities planned, including a public service announcement with Major League ballplayers, that the Day would become a marquee event in the United States. The Coalition could make a significant impact on the public health of the United States. The two Co-Chairmen of the Coalition were Dr. Kessler and John Seffrin, Chief Executive Officer of the American Cancer Society.

Dr. Kessler remarked that the physical damage inflicted by tobacco use was well known. Hundreds of thousands of Americans had lost their lives prematurely due to tobacco addiction. Moreover, the financial burden had been extreme. It was estimated that healthcare costs associated with smoking-related illnesses in the United States were over $90 billion. The worldwide net loss of tobacco-related disease was over $200 billion.

Nevertheless, not all the news was bad, he said. Fortunately, in the United States, great strides had been made in reducing the number of people using tobacco. Thanks to the efforts of many of the organizations that comprised the Coalition, there were many more Americans trying to quit and quitting successfully. The public was also more informed about the dangers of tobacco.

He said that for too long the tobacco industry had manipulated users, particularly cigarette smokers, by luring them into the habit at an early age and fostering their addiction. But now, the public was beginning to understand the addictive nature of tobacco. That knowledge had empowered them to take a stand, in Congress and in the courts, against those companies promoting tobacco use.

However, to break free of the deadly addictive effects of tobacco, users must remember that quitting was a process, he continued. The effort was much, much harder than simply breaking free of a habit. In fact, it usually took several tries. Today, there was access to more proven tools than ever before that could help interested quitters get the help they needed to stop their deadly addiction. Smoking was the most preventable cause of disease in the United States.

It began as a paediatric disease, he said. Even as a paediatrician, he did not realize that the average smoker began at 11, 12 and 13 years of age and then became addicted at 16, 17 and 18 years of age. If a young person could get to the age of 19, 20, or 21 without starting smoking, they were more likely never to begin. One of the most important ways of keeping a young person from getting addicted was not to smoke yourself, especially if you were a parent. The Coalition could help to remind adults of their impact as role models for children. Children were entitled to a lifetime of free choices, not a lifelong addiction. For many Coalition members, the focus remained on preventing young people from ever starting smoking.

To further combat the global tobacco epidemic, influential organizations, such as the WHO, had now taken a more aggressive stance against tobacco by advocating measures that called for a worldwide ban on tobacco advertising, regular tax increases on cigarettes and better access to tools that help tobacco users quit, he said. However, despite the progress made, the work was far from complete. Initiatives, like World No Tobacco Day, remained vital because they encompassed all forms of tobacco use. Although cigarette smoking existed as the most widespread health threat, there were

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also other grave dangers associated with pipe smoking, cigar smoking and chewing tobacco.

He said that the Coalition would work to focus on prevention and treatment to ensure that the public understood that tobacco use, in any form, posed a serious health risk and that there were tools available to help users quit. It could also help wage a successful battle against tobacco use beyond the United States. The United States tobacco industry was responsible for perpetuating the so-called glamorous appeal of tobacco use, as evidenced by the now global notoriety of images, such as the "Marlboro Man". It was up to United States health leaders and organizations, such as the Coalition, to tear down a century of brand and image building.

Tim McCarver said that during his time in the baseball community, he had seen many players and coaches affected by tobacco use. Baseball had lost far too many of its members to tobacco. That was why he was lending his support to World No Tobacco Day. His years in baseball had shown him what a tremendous influence players had on their fans, especially on children. Those in baseball had a responsibility to those fans and the public service campaign, being unveiled today, was a positive step towards that end.

He commended the players -- Nomar Garciaparra of the Boston Red Sox, Paul O'Neill of the New York Yankees, Eric Karros of the Los Angeles Dodgers, Robin Ventura of the New York Mets and Travis Lee of the Arizona Diamondbacks -- who took the time to be part of World No Tobacco Day and demonstrated a commitment to raising awareness about the event.

The Day offered an opportunity for those using tobacco to quit for at least a day, he said. Although he was fond of cigars, he decided to give them up for a day in commemoration of the Day. While he could not promise to be tobacco-free for the rest of his life, the initiative was helping him realize and consider the health risks of tobacco use.

Following the video presentation of the premiere of the World No Tobacco Day public service campaign, he said that he hoped the media would do what they could to ensure that it received ample air time. Those players could do much to reach the nation's youth and convince them of the dangers of tobacco use.

He said that over Memorial Day Weekend, and possibly throughout the baseball season, the ballparks would be showing the public service announcement on their jumbotrons during the ballgames. In addition, as of today, there was a new web site -- worldnotobaccoday.com or wntd.com -- that would offer information about initiatives taking place during the year and allow users to download the public service campaign. There was also a media-protected section, which he urged journalists to register for, to get the most up-to-date information about World No Tobacco Day.

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In response to a question on what exactly was going to take place worldwide on 31 May, Dr. Brandling-Bennett said that there were many different activities that would take place. Countries would be undertaking activities, through their ministries of health, along with the country and regional offices of the WHO. Among other things, activities might consist of events in schools, poster and essay competitions, and efforts to involve athletes. Sometimes there were scientific events, although it was meant to be a public occasion. They included a wide variety of things, developed specifically for the country, depending on the interest and the approach the particular country wanted to take.

It was interesting that up until this year, while there had been individual groups in the United States that had focused on World No Tobacco Day, in general the Day had been known much better outside the United States, Dr. Kessler added.

One correspondent noted that the Coalition was holding their press conference at the United Nations, a building where people smoked wherever they wanted to, although there had been improvements. He asked what the idea was in holding a World No Tobacco Day if the global organization, that represented the world, did not ban smoking everywhere in its Headquarters?

To that, Dr. Brandling-Bennett replied that he had worked with the Secretary-General and the staff to try to advance the interest of making the United Nations a smoke-free environment for a number of years. Gradually, some progress had been made. While the WHO and all its offices around the world were smoke-free, he was still pushing for the United Nations Headquarters and other United Nations facilities to become smoke-free worldwide. It was a gradual effort, but progress was being made.

Dr. Kessler added that it was about leadership. It was often underestimated just how difficult quitting was. Those in the United States had a responsibility, as public health leaders, to demonstrate by example. There was a lot of work to be done.

Speaking of leadership, the correspondent noted that the Secretary-General smoked cigars. Dr. Kessler said that it was very important to understand that there had been decades of image building around smoking. Also, the addictive nature of smoking made it very hard to quit. The public service announcement was one of a whole host of efforts to begin to change that tide. The tobacco industry had been brilliant over the last half century. There was imagery, created over a century, that had resulted in generation after generation of young people becoming addicted. It was going to require almost an equal amount of time to get a generation tobacco-free. It was harder than anyone thought.

Dr. Brandling-Bennett added that the level of awareness of the dangers of tobacco were much less in other countries. Many of the people working in

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the United Nations came from countries where there had been less information and from generations that had not been aware of the dangers of tobacco. There was a need to push on those people, so they could become aware and then set an example for those who would follow.

Asked about measures being taken outside the United States, particularly in China, Dr. Brandling-Bennett said that the Chinese Government had recognized the serious impact that tobacco was already having and would have because of the high levels of smoking, particularly among males. In China some 70 to 80 per cent of males smoked, and rates were increasing among women as well.

The World Bank had recently issued a report showing that even countries that had an apparent significant economic return from production of tobacco or sale of tobacco products had a net negative economic impact. That was because of the costs of tobacco-related disease. The Bank had urged all countries to consider significantly increasing taxes on tobacco, which would make up for lost revenues related to the decrease in smoking, and indeed cause a decrease in smoking. China was actively pursuing that now.

He hoped that that message would be understood by more and more countries, both the tobacco producing countries and those that were going to be affected by the efforts of the tobacco industry to sell its products in the developing world, he said. It was in the developing world that the major increase in tobacco use and the number of tobacco-related diseases was going to be seen, if something was not done. It was going to be a slow, continuous process.

The world in which the tobacco companies operated had changed dramatically over the last several years in the United States, Dr. Kessler added. The concern was what was happening globally. Tobacco marketing was still looked upon by the rest of the world as something exported by the United States. In 20 or 30 years, when the epidemic of tobacco mushroomed astronomically, it would not portend very well for the United States. That was why the country had an obligation for leadership.

Elaborating on what he meant by mushrooming, he said that the smoking rates had increased exponentially around the world. If one looked at the graph on women in the United States, women had started smoking in the 1920s, 30s and 40s. If one also looked at the age-adjusted curves of mortality among women, deaths due to lung cancer started to increase in the 1950s, had increased exponentially and had still not yet peaked. Lung cancer was the leading cause of death among women, even surpassing breast cancer. While the curves for breast cancer were relatively stable, the curves for lung cancer were exponential. That exponential curve was what was going to be seen worldwide.

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In response to a question on whether there was any recognition in the medical profession of a special need on the part of schizophrenics to smoke, Dr. Kessler said that the tobacco companies had for decades tried to argue for the benefits of smoking. They had tried to argue that nicotine had benefits in certain diseases. There was no known evidence that there was a positive effect and there was no medicinal use for cigarettes.

Asked if the networks could do more to get the message out about smoking, Mr. McCarver said that the networks were very sensitive to tobacco and alcohol use. However, they could do more as far as tobacco was concerned and they were trying to do more.

Regarding tobacco use in the clubhouse, he said that he had seen much less use by today's players than in past years. That was probably the biggest decrease that he had seen.

In response to a question on whether Cleveland would destroy the Yankee bullpen in the playoffs, he said that the Yankees were not playing very well right now and Cleveland would be coming to New York next week on Memorial Day. That series could indicate how things would end up in the post-season. There was no question that the Yankees were struggling right now.

In conclusion, Dr. Brandling-Bennett said that the United States was often criticized around the world as exploiting its culture and having a bad image about what it exported. What had been accomplished in the United States against the use of tobacco had been one of the most positive things that had happened in that country. That should be built upon and exported.

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