- Open Access
Tobacco Control in Industrialized Nations: The Limits of Public Health Achievement
Public Health Reviewsvolume 33, pages553–568 (2011)
In 1999 Gro Harlem Brundtland, Director General of the World Health Organization, painted a stark picture of the global toll in morbidity and mortality that could be expected from tobacco consumption. “Tobacco-related diseases are spreading like an epidemic and are likely to be killing ten million people a year around 2020.”1 The warning was coterminous with the drafting by the WHO of the Framework Convention on Tobacco Control, a treaty designed to interrupt and reverse the “epidemic’s” course. In the next decades attention to the impact of tobacco will shift to the less developed and rapidly modernizing nation. At this juncture it would be useful to review the almost half-century long public health campaign to confront tobacco in the industrialized nations, where extraordinary achievements in the reduction of tobacco consumption reflect the impacts of persistent public health efforts in the face of powerful commercial resistance.
The five countries we have focused on here France, Germany, Japan, the United Kingdom and the United States share a broad commitment to liberal political values yet they differ in important ways. Two are common law and two are civil law states. Japan is a “mixed” system; The US and Germany are federal systems. France, the United Kingdom and Japan are unitary. Yet despite these differences and those that characterized their first encounters with tobacco they now reflect a broad convergence on the most effective public policy responses to smoking related morbidity and mortality. The experiences and differences of these nations is important to note even though to some careful observers of the global politics of tobacco none would have been classed as pioneers in tobacco control.
This analysis is drawn from a broader examination of the global picture of tobacco control at the end of the first decade of the 21st century.2
Brundtland GH. Why investing in global health is good politics, speech. Council on Foreign Relations. New York, NY; 6 December, 1999. Available from URL: http://www.who.int/director-general/speeches/1999/english/19991206_new_york.html (Accessed 13 December, 2011).
Feldman EA, Bayer R. The triumph and tragedy of tobacco control: A tale of nine nations. Ann Rev Law Sci. 2011;7:79–100.
Honjo K, Kawachi I. Effects of market liberalization on smoking in Japan. Tob Control. 2009;9:193–200.
Fukuda Y, Nakamura K, Takano T. Socioeconomic pattern of smoking in Japan: income inequality and gender and age differences. Ann Epidemiol. 2005;15:365–72.
Board Trustees Am. Med. Assoc. Media advertising for tobacco products. JAMA. 1986;255:1033.
Hodgson TA. Cigarette smoking and lifetime medical expenditures. Milbank Q. 1992;70:81–125.
Takeshi H. Non-smoking wives of heavy smokers have a higher risk of lung cancer: a study from Japan. BMJ. 1981. 282:183–85.
BBC News. EU adopts tobacco ad ban. BBC News World Ed. 22 December, 2002. Available from URL: http://news.bbc.co.uk/2/hi/europe/2535071.stm (Accessed 13 December, 2011).
Associated Press. EU uncertain if all nations will comply with upcoming law banning some tobacco sponsorship. AP Worldstream. 27 July, 2005.
Newman M, Bodoni S. EU-wide tobacco ad ban upheld by European Union’s highest court. Bloomberg News. 12 December, 2006. Available from URL: http://www.bloomberg.com/apps/news?pid=newsarchive&sid=a3U5tTDARAPI (Accessed 13 December, 2011).
Lorillard Tobacco Company, et al. v. Thomas F. Reilly, Attorney General of Massachusetts, et al.; Altadis U.S.A. Inc., etc., et al. v. Thomas F. Reilly, Attorney General of Massachusetts, et al. Supreme Court of the United States. Decision 28 June, 2001. 533 U.S. 525 (2001).
Family Smoking Prevention and Tobacco Control Act. United States. H.R. 1256. Public Law No: 111–31. Enacted 11 June 2009. Available from URL: http://thomas.loc.gov/cgi-bin/bdquery/z?d111:H.R.1256: (Accessed 13 December, 2011).
American Civil Liberties Union. ACLU to U.S. Senate, June 1, Re: ACLU Calls for Narrowing Advertising Restrictions in S. 982, The Family Smoking Prevention and Tobacco Control Act. ACLU. Washington, DC; 1 June, 2009. Available from URL: http://www.aclu.org/files/images/asset_upload_file503_39723.pdf (Accessed 13 December, 2011).
Feldman EA. The culture of legal change: a case study of tobacco control in 21st century Japan. Mich J Int Law. 2006;27:743–822.
Chaloupka FJ, Straif K, Leon ME. Effectiveness of tax and price policies in tobacco control. Tob Control. 2010;20:235–8.
Reed H. The effects of increasing tobacco taxation: a cost benefit and public finances analysis. ASH Rep., Action on Smoking and Health. Washington, DC; 2010. Available from URL: http://www.ash.org.uk/tax/analysis (Accessed 13 December, 2011).
World Health Organization Regional Office for Europe. The European Tobacco Control Report 2007. WHO. Copenhagen, Denmark; 2007. Available from URL: http://www.euro.who.int/en/what-we-publish/abstracts/european-tobacco-control-report-2007 (Accessed 13 December, 2011).
Joossens L, Raw M. 2007. Progress in tobacco control in 30 European countries, 2005 to 2007. Presented at the 4th European Conference Tobacco or Health. Basel, Switzerland; October 2007. Available from URL: http://www.cancer.dk/NR/rdonlyres/7976C5B7-0608-429D-9E94-B0E93274E22E/0/Sammenligningafrygeforebyggelsei30europ%C3%A6iskelande.pdf (Accessed 13 December, 2011).
Frankenberg G. Between paternalism and voluntarism: tobacco consumption and tobacco control in Germany. In: Unfiltered: conflicts over tobacco policy and public health. Feldman E, Bayer R, editors. Harvard University Press: Cambridge, MA; 2004. pp. 161–90.
Hanewinkel R, Isensee B. Five in a row—reactions of smokers to tobacco tax increases: population-based cross-sectional studies in Germany 2001–2006. Tob Control. 2007;16:34–37.
American Lung Association. State of Tobacco Control 2010. Am. Lung Assoc. Washington, DC; 2010. Available from URL: http://www.stateoftobaccocontrol.org (Accessed 13 December, 2011).
Rabin RL. Tobacco control strategies: past efficacy and future promise. Loyola Los Angeles Law Rev. 2008;41:1721–68.
Sanchanta M. Japan considers higher tobacco taxes. Wall Street Journal. 2 November, 2009. Available from URL: http://online.wsj.com/article/SB125716473476722663.html (Accessed 13 December, 2011).
McCurry J. Japanese yen for smoking tested by 33% cigarette price rise. Guardian. 6 October, 2010. Available from URL: http://www.guardian.co.uk/world/2010/oct/06/japan-cigarette-tax-increase (Accessed 13 December, 2011).
World Health Organization Regional Office for Europe. The European report on tobacco control policy: review implementation of the third action plan for a tobacco-free Europe 1997–2001. WHO. Copenhagen, Denmark; 2002. Available from URL: http://www.euro.who.int/en/what-we-do/health-topics/disease-prevention/tobacco/publications/2002/european-report-on-tobacco-control-policy (Accessed 13 December, 2011).
Spinney L. Public smoking bans show signs of success in Europe. Lancet. 2007;369:1507–8.
European Public Health Alliance. European smoking bans—evolution of the legislation. EPHA. Brussels, Belgium. Available from URL: http://epha.org/a/1941 (Accessed 13 December, 2011).
Phillips L. Commission preparing pan-european smoking ban. EUobserver. Brussels, Belgium; 2010. Available from URL: http://euobserver.com/9/31021 (Accessed 13 December, 2011).
American Nonsmokers’ Rights Foundation. Summary of 100% smokefree state laws and population protected by 100% U.S. smokefree laws. ANRF. Berkeley, CA; 7 October, 2011c. Available from URL: http://www.no-smoke.org/pdf/SummaryUSPopList.pdf (Accessed 13 December, 2011).
Schroeder SA, Warner KE. Don’t forget tobacco. N Engl J Med. 2010;363:201–4.
American Nonsmokers’ Rights Foundation. 2011a. Municipalities with smokefree park laws enacted as of April 1, 2011. ANRF. Berkeley, CA; 7 October, 2011a. Available from URL: http://www.no-smoke.org/pdf/SmokefreeParks.pdf (Accessed 13 December, 2011).
Japan Today. Kanagawa adopts anti-smoking ordinance; 1st among 47 prefectures. Japan Today: 25 March, 2009.
Brandt, AM. Blow some my way: passive smoking, risk and American culture. In: Ashes to ashes: the history of smoking and health. Lock S, Reynolds L, Tansey EM, editors. Amsterdam: Atlanta, GA; 1998. pp. 164–91.
Abt Associates Inc., Hamilton WL, Norton G, Weintraub J. Changing social norms. In: Independent evaluation of the massachusetts tobacco control program, seventh annual report, January 1994 to June 2000. The Massachusettes Department of Public Health. Boston, MA; 2000. pp. 79–94. Available from URL: http://www.mass.gov/eohhs/docs/dph/tobacco-control/abt-7th-report.pdf (Accessed 13 December, 2011).
Bauer UE, Johnson TM, Hopkins RS, Brooks RG. Changes in youth cigarette use and intentions following implementation of a tobacco control program: findings from the Florida youth tobacco survey. JAMA. 2000;284:723–8.
California Department of Health Services, Tobacco Control Section. 1998. A model for change: the California experience in tobacco control. Calif. Dep. Health Serv. Sacramento, CA; October 1998. Available from URL: http://www.cdph.ca.gov/programs/tobacco/Documents/CTCPmodelforchange1998.pdf (Accessed 13 December, 2011).
Gilpin E, Lee L, Pierce J. Changes in population attitudes about where smoking should not be allowed: California versus the rest of the USA. Tob Control. 2004;13:38–44.
European Commission Health and Consumer Protection Directorate-General. 2007. Towards a Europe free from tobacco smoke: policy options at the EU level. Green Paper COM2007 27 Final. European Communities. Brussels, Belgium; 2007. Available from URL: http://ec.europa.eu/health/archive/ph_determinants/life_style/tobacco/documents/gp_smoke_en.pdf (Accessed 13 December, 2011).
Chapman S, Freeman B. Markers of the denormalisation of smoking and the tobacco industry. Tob Control. 2008;17:25–31.
Feldman EA, Bayer R. Conclusion: lessons from the comparative study of tobacco control. In: Unfiltered: conflicts over tobacco policy and public health. E Feldman E, Bayer R, editors. Harvard University Press: Cambridge, MA; 2004. pp. 292–307.
Phelan J, Link B. Controlling disease and creating disparities: a fundamental cause perspective. J Gerontol B. 2005;60B:27–33.