WHO World Health Organization

World No-Tobacco Day

“No Tobacco in Sports. The Game Must Be Clean” is the motto of the 2002 world soccer championship. The Federation of International Football Associations (FIFA) was awarded a prize of the World Health Organization (WHO) for the contribution to the stop-smoking campaign, i.e. announcing the 2002 soccer championship as tobacco-free. The world has got down to fighting smoking in earnest. Smokers are allotted smoking areas located far from public places and protecting people from passive smoking. Radio and TV stations broadcast programmes reminding the audience of the no-tobacco policy.

A press-conference held on May 31, 2002 at the premises of “RIA-Novosti” News Agency on the occasion of the World No-Tobacco Day, was attended by Mr Gennady Onishchenko, First Vice-Minister of Health, the Chief Sanitary Doctor of the Russian Federation, Mr Vladimir Nelyubin, State Secretary of the Russian Sports Committee, and Dr Mikko Vienonen, Special Representative of WHO Director General in the Russian Federation.* According to Mr Onishchenko, the recent federal law on smoking has not effectively impacted on current situation while the international common paradigm: “expensive cigarettes mean less smokers” is hardly practicable in Russia. As reported by WHO, over 270,000 deaths result every year in Russia from smoking, which is more than from AIDS, road accidents, drug abuse, murders and suicides altogether. Respective annual loss totals USD200 bln globally.

“Russia will not be able to change significantly the smoking status in the near future. This, however, does not mean that we will not make effort to fight this dependency,” said Prof. Raphael Oganov, Director of the State Scientific Research Preventive Medicine Centre (SSRPMC), Ministry of Health of the Russian Federation.

The eve of the World No-Tobacco Day in Moscow summarized the “Quit & Win” Anti-Smoking Action organized jointly by the WHO and SSRPMC. Of the 42,000 smoke-droppers in 28 cities and regions of Russia tempted by a big purse, only 174 reached the finale of the competition. Now, Edward Stotsky from Biysk represents Russia at the world and the European contests in Cyprus, offering USD 10,000 and USD 2,500 in prizes, respectively. Dr Tatyana Kamardina, Senior Researcher of SSRPMC, WHO Coordinator of No Smoking programme said that the critical role in organizing the above action in Russia was played by the regional centres, implementing international integral non-communicable diseases programme (CINDI). Giving up smoking is never late, because the destructive processes fostered by tobacco are by and large reversible.

Address on Behalf of WHO World No-Tobacco Day

Moscow, 31 May 2002

Today we are to mark the World No-Tobacco Day in the Russian Federation. We can say based on scientific sound knowledge that tobacco and alcohol are by far the biggest causes of premature mortality and morbidity of our time. They are the main causes of cardiovascular diseases and cancer.

WHO exists in order to provide:

In the recent meeting of the WHO World Health Assembly, which ended in the mid-May in Geneva, our Director General Dr Gro Harlem Brundtland underlined the world wide smoking problem. She told about the meeting she had had with the International Olympic Committee, International Automobile Federation and others to launch the campaign for Tobacco Free Sports. The message is straightforward: TOBACCO AND SPORT DO NOT MIX. Sports must not be used to spread messages that are associated with disease and death. We need to break the dependence of sport on tobacco and tobacco sponsorship. At the same time, support must be provided for a world-wide increase in people’s involvement in sport and physical activity.

A year ago the World Health Assembly adopted a resolution calling all Member States for greater transparency in tobacco control. WHO was asked to keep governments informed of activities of tobacco companies’ dangerous, unfortunately effective, and often secret ways of undermining people’s health. Negotiations towards the signing a Framework Convention on Tobacco Control next year is well on its way. Russian Federation together with its partners in the Commonwealth of Independent States has played an important and positive role in this work. Last year in September and this year in June WHO organized working meetings on the topic.

Specifically in the Russian Federation WHO has noted with satisfaction the new law against tobacco, which came to force early this year. Restriction of smoking in public places was limited, advertisement of tobacco was tightened, and sales to minors was clearly prohibited.

The direction is correct, but unfortunately from the public health point of view and evidence collected by WHO they are not sufficient. We know that if advertisement of tobacco is not totally banned, a partial ban does not help. Advertisements only shift to another place as everybody can see: the streets of Moscow are full of tobacco advertisements, which give totally misleading information as if cigarettes were a health product.

Furthermore, legislation alone does not help, if it is not implemented and enforced. For those who violate the tobacco law, fines are very small or non-existent. I would be interested to know how big and how many fines since the adoption of the law have been given to those who violate the law.

We should not grow complacent, as a lot should still be done, and as smoking in Russia is today more prevalent than probably anywhere else in Europe. The WHO statistics tell that 63% of all men and 10% of all women smoke. The annual Russian Longitudinal Monitoring Survey tells about even higher figures from last year. What is even more alarming is that smoking among young women has risen to about 30%. About 40% of boys smoke. Recent Russian studies have even revealed that a high proportion of 12–15 year old children are already regular smokers! This is particularly alarming because smoking habit seldom starts at an age over 25. But those who have started in their youth cannot quit even if they wanted to do so. Nicotine is a strongly addictive substance.

Tobacco business knows that they must every year recruit new victims to replace those who have died prematurely of their habit. And they ruthlessly and in most clever ways target the children and the young, who due to their age are vulnerable to resist the group pressure.

Russian tobacco industry has had its golden years lately. Since 1995 to 2000 only legal production of cigarettes grew from 141 billion to 341 billion. The share of transnational production had risen to 65%. It means that for every Russian citizen including babies and old people 117 packs of cigarettes were produced and apparently consumed every year. It also means that on average every citizen could count for 6 cigarettes every day. As babies and many others still do not smoke in Russia, except passively, which nobody can avoid, those who do smoke usually have at least twenty or more on their daily plate.

We who are responsible for the health of our people, must constantly bear in mind that growing figure of smoking is not a natural force which we should accept and only try to live with. Many European countries have been able to reverse the trend followed by lower numbers of cardiovascular and cancer morbidity and mortality.

We should also remember that smoking, in spite of the fact that it brings tax revenues to the state coffers, becomes much more expensive. Comprehensive economic calculations have shown that the net bill of smoking to the state is negative. This in spite of the fact that one big tobacco company had tried to convince –secretly of course – that promoting smoking is good business to the state, as citizens would die before their retirement age! To me such conclusions reveal the real nature of tobacco industry: they are the merchants of death.

At this point it would be worth to remember that putting a higher price to tobacco products through taxes is indeed a good way to reduce tobacco consumption and to improve the health of people. This is still largely an untapped source in Russia.

In the year 2000 the state only collected some 5 billion rubles in tobacco tax, which is only about 4 rubles per package. According to WHO’s advise, at least 80% of the price of tobacco should be tax, which could double or triple the state revenues.

I am sure that the government could find good use for another 5–10 billion rubles. If I may, I could suggest improving sports facilities for young people, paying for sports instructors and promoting healthy lifestyles. Presently the money mainly benefits the multinational tobacco producers and their shareholders.

The recipe to bring smoking down is not very complicated at all: you ban all advertisement, you ban smoking in all public places so that nobody is exposed to tobacco smoke against their own will, you raise the level of taxation to about 80% of the production price of tobacco, you ban the sales to minors under 18, and you enforce that all this is implemented by putting a realistic fine – say 1000 Rubles- to those who break the law. For every repeated violation you could multiply the fine by 10.

When I have presented this recipe, my Russian colleagues have said that it is not possible. And yet many countries have done it. The results have always been successful, except for the tobacco industry.

The question is not about skill, it has more to do with will and courage. As far as I have learned, Russians have plenty of both so let`s do it!

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