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M. Lyndon Haviland, DrPH, Chair, Editorial Board

This issue of the Journal highlights the challenges of health promotion and disease prevention in a world increasingly defined by global brands, porous borders, instant messaging, and economic interdependencies. Turning these new technologies and economic realities into opportunities for bold action and science-based interventions is the work at hand. Worldwide, there are an estimated 1.3 billion smokers, and by 2030 tobacco will have become the leading cause of preventable death and disability, responsible for an estimated 10 million deaths annually. To halt this epidemic, we must find the political will, international leadership, and funding to put tobacco prevention, care, and treatment within the reach of all people. Tobacco control must become a global priority.

Nicotine addiction and tobacco-related disease are carried like parasites on the wave of globalization. Indeed, tobacco use is on the decline in many developed countries, yet economic development and emerging markets provide new targets for the tobacco industry. Today, rapid economic development in China and India offers multinational tobacco companies new pools of potential smokers. Philip Morris has responded by expanding in China and Indonesia, planning to produce Marlboros through a joint venture with Longyan Cigarettes in China, and attempting to enter the kretek (clove cigarette) market in Indonesia with Sampoerna. China already has an estimated 300 million smokers—how many more will reach for a Marlboro in 2005? To combat the tobacco industry’s expansion, we must position tobacco control as central to the social and economic infrastructure of developing countries.

The first steps in the globalization of tobacco control include the development of the World Health Organization’s Framework Convention on Tobacco Control (FCTC) and the international research projects discussed in this issue by Stillman, Warner, and Lando. The FCTC is a historic development in public health. It is the first WHO global public health treaty and offers a regulatory framework for tobacco control globally. As Warner and Lando remind us, the FCTC negotiations relied on research, advocacy, diplomacy, and science; however, they also showcased the challenges faced by science and public policy when confronting economic realities and the tobacco industry.

International and multilateral models of health promotion and disease prevention exist, and the Global Fund to Fight AIDS, Tuberculosis and Malaria offers an example of what is possible when international leaders embrace a sense of urgency and unite to address a disease or threat. Through the Global Fund, more than $3 billion has been committed to support country-specific plans to prevent the spread of these diseases and bring medical treatment to those most in need. The immensity of the tobacco epidemic demands the same—we need to arouse public interest, engender a sense of urgency, and engage policymakers in the fight against tobacco. Unfortunately, the economic and social realities of the tobacco industry worldwide complicate the funding and implementation of effective tobacco control research, policies, and services. Indeed, where prevention and treatment is most needed—in developing nations—tobacco control funding is least available.

The challenge we face is to make tobacco control a priority for all nations and to prohibit companies from making a profit by selling death and disability. Together we can create a world where young people are not seduced by the tobacco industry and all smokers can get the help they need to quit. Let’s get to work.

This Article Extract Full Text (PDF) Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Haviland, M. L. Search for Related Content PubMed Articles by Haviland, M. L. Related Collections Global Health Tobacco Control