Smoking and health: a new generation of campaigners.

Abstract

Last month more than 1000 delegates from 79 countries converged on Winnipeg for the fifth world conference on smoking and health. It was a meeting with a difference. At previous conferences campaigners saw smoking as a largely medical problem to be resolved by curing smokers of their disease. This time participants were forced to recognise that the smoking and health campaign is a war that must be fought in the political arena?against the tobacco industry and not the smoker. The agents of the opposition were there in larger numbers than had ever attended before?keeping a low and anonymous profile and recording every statement that might prove useful for future ammunition. They inadvertently acted as a barometer of the key issues in smoking control: the more industry representatives that attended any one session, the more important it was likely to be for smoking control policy. Some of the conference rhetoric was not new but sadly needed restating. Despite more than 20 years of antismoking campaigns, smoking remains the single, largest preventable cause of ill health and premature death in the industrialised world and is being exported rapidly to the Third World. There can be no excuse for government inaction. There is a clear and proved policy for smoking control recommended by the World Health Organisation1 and the International Union Against Cancer and endorsed by the British Medical Association and many other national medical and health organisations. It comprises legis? lative and political action, including a total ban on all cigarette promotion backed up with adequately funded education, infor? mation, and cessation programmes. Yet most governments? with notable exceptions such as Norway and Finland?still acquiesce, preferring to settle for ineffective voluntary agree? ments that protect government revenue and tobacco interests. In 1979 the fourth world conference summarised information on the major smoking and health issues and pointed to some of the areas where action was lacking?such as in the Third World and with women. Mike Daube, senior lecturer in health education, University of Edinburgh, summing up at that conference, said: Perhaps the smoking and health campaign needs to change itself while it seeks to change others.2 There was evidence of this change at Winnipeg. Some of the old expertise gave way to new issues led by new campaigners. The emphasis this year was on three topics : tobacco and the Third World, women, and children. For the first time in its history the conference recognised the importance of inviting many Third World and women speakers. A pity, therefore, that it was reluctant to incorporate many of their suggestions into major conference recommendations. Tobacco and the Third World