Drugs giants take on tobacco barons

Last week’s Budget rise of 17.5p on a pack of 20 cigarettes is a modest victory by the anti-smoking lobby, in a long and dismal war against the tobacco barons.

Despite widespread knowledge that cigarettes can impair your longevity and even your sex life, more cigarettes than ever are sold worldwide. In Britain, the number of teenage girl smokers is rising and female smokers could soon outnumber male smokers, which has already happened in Denmark and Sweden. Smoking is also increasing in Austria, Greece, Italy, Luxembourg and Spain. In Moscow, half of male teenagers smoke. Across the world there are 1.1 billion smokers.

The latest reverse for the health lobby occurred last month, when the High Court ruled that 46 cancer sufferers had waited too long to bring their action against Imperial Tobacco and Gallaher. Such setbacks are familiar to the tobacco-control movement. At the same time, more than 2,000 of its members at a meeting in Las Palmas, Gran Canaria, heard how tobacco companies had snuffed out every move.

Speakers told the second European Conference on Tobacco or Health: “When the public began believing the cancer-tobacco link in the Seventies, the industry skillfully reinvented itself with a ‘clean’ image by producing low-tar cigarettes.”

Brands such as Benson & Hedges Ultra, Marlboro Lights, Matinee Extra Mild King Size were born. Filters were supposed to reduce cancer-causing tar, although the conference heard that these cigarettes achieve little, except a different cancer – ademo carcinoma – deeper in the lung. Research this week by the Health Education Authority, shows that smokers of mild cigarettes falsely believe they are not exposing themselves to danger.

Advertising bans turned out even better for tobacco companies. They rapidly showed that sponsoring Formula One motor racing was a better promotional tool. Luk Joosens, a tobacco-control consultant from Belgium, said manufacturers found funding youth festivals and distributing giveaways was far more effective than ads. Health warnings on packs were too small to be of use.

Research shows that one of the best ways of deterring young smokers, is through price rises. Few people start smoking once they reach 20. But according to Joosens, price hikes were being undermined by cross-border smuggling. “If we do not resolve the smuggling issue we will lose the major weapon of cost control,” he said. In Britain, the Treasury loses 1.5bn a year in duties from tobacco smuggling. Berating smokers – a policy now dropped – made the practice more appealing to rebellious teenagers.

The health lobby claims tobacco companies genetically manipulate their crops to increase the nicotine yield. Professor Gerard Dubois, from Amiens University in France, said that while food manufacturers were under fire for selling GM products, tobacco companies “did not ask, they just did it”.

Whatever the truth of the charge – denied by the industry – numerous surveys show two in three smokers want to give up. Most try and fail. This is where addiction specialists are finding a very useful ally. The pharmaceutical industry is one of the few sectors which rivals tobacco manufacturers in its reputation for marketing, litigation and tough-dealing with governments.

These skills are being made available to the anti-tobacco lobbyists. The reason is that drug companies have a safe, sellable product to offer. More than 40 studies show nicotine replacement therapy doubles the successful long-term quit rate, compared with placebo products. No study indicates significant safety worries, and some suggest the nicotine dose could be safely increased to boost effectiveness. Stick-on patches release a stream of nicotine, absorbed through the skin, designed to “unhook” the smoker over several weeks. The technology resembles that developed for hormone replacement therapy.

As every salesman knows, it is one thing to have a product and another to sell it. Here official help is at hand. Last December, the Government announced a 60m prevention drive over three years, as part of its tobacco White Paper “Smoking Kills”. Disadvantaged smokers will receive a week’s free supply of the patch. In addition, the World Health Organisation is launching a major publicity drive, as stop-smoking treatments win over-the-counter licences across Europe.

Three major international companies are competing for the UK market, which last year was worth about 40m and could rapidly double as the Government anti-smoking initiative gets underway.

SmithKline Beecham launched its NiQuitin CQ patch with a 12m marketing spend last year. It is sponsoring what is thought to be the biggest study yet into European smoking habits. The brand was the main commercial sponsor of the Las Palmas conference and is funding a US project to train pharmacists to counsel smokers to stop.

Swiss giant Novartis and multinational Pharmacia-Upjohn were very active at the conference. They are both sponsoring the WHO campaign, reportedly each contributing 250,000. GlaxoWellcome is also giving 250,000 in preparation for an assault on the UK market later this year.

The marriage between pharmaceutical companies and the anti-tobacco lobby may be based on mutual convenience. But it should ensure a more even contest against the tobacco industry.

Another thing to cheer delegates in Las Palmas was a pledge by European Union commissioner Padraig Flynn to enact a new anti-smoking Directive, although how this will be affected by this week’s events at the European Commission is unclear.

Any new action would limit tar and nicotine levels, require bigger health warnings and also the insertion “in or on packs” of advice on how to quit. Cigarettes, Flynn said, were killing 500,000 Europeans every year and threatened to cause the greatest epidemic of all time.

“Tobacco companies use ads and sponsorship to maintain the illusion that smoking is cool,” he said. This poses a “unique and persistent danger” to Europeans. He left no one in any doubt as to his will to enact tighter legislation after his “landmark” directive last year banned ads and laid the ground for a total promotional ban in the UK.

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