Getting the Word Out

By Lisa Seachrist Chiu

Getting the Word Out

Countries are personalizing their anti-smoking messages

By Lisa Seachrist Chiu

The world over, no other consumer product kills as many people as tobacco. That message seems simple to convey. But the 140 countries that recently ratified the World Health Organization’s Framework on Tobacco Control are taking very different tacks to meet the treaty’s requirements to reduce tobacco use.

In India, a creative campaign headed by the nonprofit Cancer Patients’ Aid Association (CPAA) is seeking a legislative ban on smoking in television programs and film, says Y. K. Sapru, the organization’s founding chairman and chief executive officer. The country prohibited all tobacco advertising, smoking in public places, and tobacco sales to minors in 2003, but advertising sneaks into television shows and films when characters smoke or chew tobacco. The prevalence of tobacco use is high and rising: 53 percent of college students in Mumbai smoke, and more sixth-graders use tobacco than eighth-graders.

Several famous actors from India’s Bollywood film industry have joined CPAA’s entertainment-oriented efforts by asking directors and producers to reduce or eliminate smoking scenes. Actor Vivek Oberoi denied the tobacco company Godfrey Phillips India positive publicity by returning an award for his work with tsunami victims. And, according to Sapru, three-minute films featuring Bollywood stars who gave up smoking “are among our most successful anti-smoking campaigns.”

CPAA-sponsored lectures presented in schools, colleges, corporations and poor neighborhoods include celebrities, who tell audiences that they don’t use tobacco or make friends with people who do. Says Sapru, “They make the point that attractive men and women don’t select partners who use tobacco.”

Coupled with help from Bollywood are a series of print advertisements produced by CPAA that have won international acclaim. One particularly striking ad features the Marlboro Man standing next to his fallen horse with the caption “Secondhand smoke kills.” Sapru admits, however, that these ads have been more effective in foreign countries. “We’ve had better success in India using models, actresses and actors,” he says.

Brazil, the world’s third largest producer of tobacco, has employed a combination of graphic advertising, education and treatment to spur a remarkable decline in tobacco use. Over the past 15 years, the country has seen its smoking rate plummet from approximately 32 percent to roughly 25 percent, according to Paula Johns, a coordinator of the São Paulo–based Alliance for Tobacco Control (ACT), a coalition of nongovernmental, medical and scientific organizations.

“It’s been huge progress,” says Johns. “Unlike other countries, in Brazil the anti-smoking movement was initiated by very committed people in the government.”

Building on a similar Canadian effort, Brazilian cigarette packages include shocking images. Since 2002, the packs have featured amputees suffering from smoking-related circulatory problems, a premature baby stuck full of tubes, and a cigarette that dangles limp ash with the message that smoking causes sexual impotence. The images have had an effect: Smokers who saw them said they were more likely to try to stop smoking as a result, says Johns. A 2002 survey of smoking adults indicated that 70 percent thought the images would prevent people from starting to smoke and 67 percent said the images made them want to quit.

“Our children have a lot of information about smoking,” adds Silvia Cury Ismael, a psychologist and coordinator of an anti-smoking campaign for the Brazilian Cardiology Society, which provides educational information about the consequences of smoking. “They are learning very early what cigarette smoking can do.” Cury also notes that Brazil’s national health plan will pay for smoking cessation programs, though the funds aren’t adequate to treat all smokers.

There’s probably no country more associated with an after-dinner smoke than France. Still, this past October, France joined the ranks of Ireland, Italy, Sweden and the U.K. when French Prime Minister Dominique de Villepin issued a decree banning smoking in public spaces. Starting in February, smoking will be prohibited in all offices and shops. Cafes, restaurants and bars become smoke-free next January. The new ban bolsters a groundbreaking, but largely ignored, 1991 law that provided for separate smoking areas in restaurants and bars.

“Smoking is the greatest preventable cause of premature death and ill health in France,” says anti-smoking advocate Yves Bur, a member of the French parliament. “The government has a well-developed tobacco-control program in place. But everyone in government and the tobacco-control community agree the only solution was to extend smoke-free environments.”
Despite France’s identification with smoky cafes, several surveys—the most recent in February 2006—have shown that roughly 80 percent of the population approves of a public-smoking ban. Even so, Bur notes that before any restrictions can be introduced, the French government will implement campaigns to raise awareness further about the health risks of secondhand smoke.

Establishments will be allowed to provide smoking areas that have self-contained ventilation systems, but that doesn’t mean these areas will be pleasant, says Bur. Only customers may enter the rooms: Waiters, busboys and housekeeping staff will not work in smoking areas.

A similar plan worked in Italy, Bur says. “Only 2 percent of the bars and restaurants chose to convert sections to smoking areas. It seems that most of the French professionals are not very interested in it either.”

“I know that many Americans and other visitors were waiting for a nonsmoking France,” Bur adds. “I hope that very soon we will welcome them back in smoke-free cafes, bars and restaurants to enjoy our new way of life.”