The World Conference on Tobacco or Health is a triennial event, last held in Beijing in 1997, which has attracted 4,000 delegates to Chicago this week. Delegates have come from all spheres involved in tobacco control, including legislators, public health specialists, economists, government representatives, lawyers and those involved in therapeutics and smoking cessation.
The Republic is well represented: the Irish Cancer Society and the Irish Heart Foundation are presenting papers at the conference. Mr Peter McDonnell, a solicitor prominent in fighting tobacco claims, is attending, as is respiratory consultant and veteran anti-smoking campaigner Dr Luke Clancy. Department of Health and Children officials and GPs are also present.
Dr Fenton Howell, public health specialist with the NorthEastern Health Board and chairman of ASH, described the conference as an opportunity for anti-smoking activists to compare notes and to learn from one another's successes and failures.
He said: "This unique conference will really help to show how badly behaved the tobacco industry has been in its response to court actions and public health campaigns. For example, the Oireachtas Joint Committee on Health & Children was treated with less than complete candour by the industry recently."
The tobacco industry's role in promoting smoking as a social phenomenon has been well and truly laid bare. Research published at the weekend provides even more damning evidence of an industry determined to protect its commercial interests at the expense of worldwide public health.
In 1997 seven of the world's major tobacco companies formally conspired to mount a programme of "smoker reassurance" to counter the increasing social unacceptability of smoking. The conspiracy, according to Dr Jonathan Klein, of the University of Rochester's School of Medicine, led to the formation of the International Tobacco Information Centre to undermine tobacco control measures throughout the world.
British tobacco companies are actively encouraging smoking in young people and not just seeking to extend brand share, as they frequently claim. They aim to enhance the appeal of what they call "rites of passage" behaviour through pack design and sponsorship deals.
Documents circulated at the conference contain information which has shocked even hardened anti-tobacco activists.
Smoking is a "paediatric disease": 89 per cent of all people who ever try a cigarette try one at the age of 18. Very few start smoking during adulthood. Some 90 per cent of new smokers are children and teenagers. These new smokers "replace" the smoker who quits or dies prematurely from smoking-related disease. Young people are encouraged to start smoking by friends and family who smoke, by tobacco advertising and promotion, and by the easy availability of tobacco.
Adolescent smoking prevalence declined in the late 1970s and early 1980s, but has levelled off since then. The latest research, published in a special edition of the British Medical Journal to mark the tobacco conference, is more promising. Passive smoking exposure among those between the ages of 11 and 15 has halved in the last 10 years, according to British researchers. There is evidence linking childhood exposure to environmental tobacco smoke with subsequent active teenage smoking, which makes the latest findings especially relevant.
The World Health Organisation predicts a global annual death rate from smoking of 10 million by 2030. Currently, in Europe alone, there are 1.2 million tobacco-related deaths annually. Some 38 per cent of these are attributable to cancers, with lung cancer the most common type; 34 per cent of deaths are associated with disease of the heart and circulation; and 28 per cent are due to respiratory disease.
In the United States, the direct and indirect medical costs of smoking amount to approximately $100 billion each year. Last month a Florida court ordered the tobacco industry in the US to pay more than $140 billion in punitive damages to sick smokers. In April the jury in this first smokers' class-action lawsuit had already ordered the industry to pay $12.7 million in compensatory damages to three smokers representing the class.
The tobacco giants went to great lengths to scupper the first evidence linking passive smoking with lung cancer. We now know that a non-smoker who is married to a smoker has a 30 per cent greater risk of developing lung cancer than the spouse of a non-smoker.