Examination of witness (Questions 300
- 307)
THURSDAY 9 DECEMBER 1999
DR DEREK
YACH
Mr Gunnell
300. I would just like to ask you what you think
of the ISO standards, the International Standards Organisation
standards for measurement of cigarettes? Is that data of use to
consumers? Have you made any representations to ISO and what would
you like to see happen? Is WHO represented on the relevant technical
committee or is it still purely dominated by the tobacco companies?
(Dr Yach) When we started this initiative, which was
only 18 months ago, we recognised pretty soon that the whole area
of product design required us to understand the measurement methods
used by ISO in detail. We tried to gain official status in the
committees, in the particular committee in the Tobacco Control
126 Committee of ISO. Only very recently on 20 October in their
last Committee they agreed to give WHO Category B liaison which
allows us for the first time full access to all their documentation.
Our concerns are exactly what you are saying that, first of all,
it is interesting that the delegations coming from countries tend
to be dominated by the tobacco industries. In the case of the
UK it would include delegates from Imperial Tobacco, Philip Morris,
BAT, Gallaher's and so on. In many cases the government regulatory
person would not even be represented. Many of the governments
are solely represented by tobacco companies, this is the group
that finalises the measurement methods and I think there has been
outstanding work done by colleagues in this room and elsewhere
showing the shortcomings of the measurement methods which I am
sure they would go into in greater detail. The bottom line is
that as we move into the area of product modification we need
to know what we are really measuring and at this stage we have
very good reason, from the evidence coming out of the court cases,
to believe we are not measuring what is biologically the real
dose and impact of all the carcinogens and components of cigarettes.
301. So the consequences of you at least having
the status you have now gained in that is that you can expose
the measurements—
(Dr Yach) We certainly think that there will be a
useful purpose in entering into very serious dialogue through
our new status and how we are going to pursue that is still to
be finalised. If we are going to move to an international approach
to product modification it is essential that this be done pretty
quickly. ISO has official status with WHO. Obviously ISO has activities
across a wide range of public health measurements. They are a
non-governmental association in official relations and attended
the Framework Convention meeting, so that dialogue has literally
just begun.
302. The documents from Minnesota showed that
young people were being targeted in the west. To what extent is
this happening in the west still and to what extent is it happening
today in the east? That does not just apply to young people, it
applies to women as well, which is an area where you still have
many non-smokers.
(Dr Yach) First of all with regard to children, we
are concerned that smoking rates are rising among young people
in many developed and most developing countries. The problem has
not yet gone away. If the tobacco industry had the full will to
stop sales to children we believe it could. There are a range
of measures that it could truly introduce that would be highly
effective in combination with Government—and this cannot
be done without strong government action. We reviewed the evidence
on what works to reduce youth consumption in a meeting in Singapore
earlier this year and came to the conclusion that the best means
of stopping youth consumption continuing to rise is by applying
strong tax measures, total advertising and marketing bans on advertising
of products, providing youth with the means to quit. A higher
proportion of youth worldwide want to quit than we have ever suspected
and yet we are not providing the services for them to do so. Similarly,
we should use counter-advertising measures that are driven, directed
and worked on by youth themselves. Clearly one of the key issues
we fail to do is to think of what really appeals and what is going
to make a difference in youth groups and that is something which
we believe some of the campaigns like the Florida "Truth"
Campaign showed could make a difference. We would have to think
worldwide how we can do this more effectively. We hosted a meeting
two weeks ago in Kobe, Japan which included senior representatives
from the Commission on the Status of Women, the Convention on
the Elimination of Discrimination Against Women and the outcome
of that meeting was grave concern about the fact that on a worldwide
basis 12 per cent of women smoke as opposed to 47 per cent of
men and that is seen as a massive marketing opportunity for the
tobacco industry. From the women's organisations' perspective,
they believe this represents one of the greatest preventive potentials
for public health in the next century and if we could maintain
and reduce the rates of smoking among women by women providing
the leadership role in tobacco control, since clearly we men have
failed, I think we may very well find that the long-term public
health consequences of tobacco would be averted in the next century.
I can leave with you the outcome of the Kobe Declaration which
will be carried forward into the follow-up Beijing conference
on women and development.
303. I believe that it is a compliment to describe
WHO as a "super-nanny". Do you feel that in order to
get effective work in this area we have to abandon the idea of
voluntarily moving forward our no smoking policies and we must
introduce an element of compulsion into the activities which surround
passive smoking? We cannot make progress without some compulsion
from government and we should not be afraid of being described
as a "nanny state".
(Dr Yach) I think we would entirely agree. We have
seen that governments who have moved from voluntary agreements
to hard law have had greater success. At the international level
we have had these resolutions over the years and we are now moving
for the first time to a treaty. In 50 years history of WHO they
have never used their outlaw option of a Convention, the equivalent
approach we will be taking to the need in controlling biological
weapons or major environmental risks to the environment. We believe
that that is the level of seriousness that we need if we are really
going to make a difference for all countries.
Audrey Wise
304. I would like to pursue the question of
women. It is my observation that in this country in the past smoking
was regarded by some women as a sort of expression of emancipation,
i.e. you could be like men and do what men do. I was told by a
woman doctor in America last week that there had been an advertising
campaign there directed at women which says "Get a voice"
and this is expressly to do with smoking. Are there any equivalent
things happening, as far as you know, in the marketing ploys in
other parts of the world? There will have to be improvements made
to the status of women. Is the desire for women to advance being
manipulated in marketing in other places?
(Dr Yach) Yes. That is happening in virtually every
country undergoing development in the world and the tobacco industry
are very skilfully using the aspiration of women to seek greater
political involvement, to play a greater role in all aspects of
society as a means of increasing their sales and marketing. So
in Japan you will find advertisements aimed particularly at women
moving into the employment sector in greater numbers. You will
find that across the world. What was presented in Kobe as well
was the most extraordinary review in advertisements over the last
20, 30, 40 years of how the shift has been to focus more and more
on the issues of emancipation in advertising and marketing. You
just have to look at the women's magazines to start seeing how
this is occurring. They are playing on the themes of emancipation,
the themes of thinness and slimness and many of the other themes,
the desirability of achieving an American lifestyle when at exactly
the same time the rates in many parts of the US are declining
among women and people are recognising the dangers. We would urge
that the video tape of this material may be something you should
have a look at. It was produced by the Robert Wood-Johnson Foundation,
which was the primary founder of tobacco control at a foundation
level in the US and within ten minutes you immediately have a
pretty good insight into the way in which they are working. As
I said, I will leave with you the Kobe Declaration produced mainly
focusing upon women. Many of the people who came to the meeting
represent major international women's organisations who had never
ever been involved in tobacco and did not see this solely as an
issue to do with women in development. They left feeling this
is a major neglected area requiring global action. Again, many
of the major thinkers are based in the UK and need to be exported
to carry the message worldwide.
305. So we have got to get across to women that
there is no liberation in dying like a man.
(Dr Yach) Exactly.
Chairman
306. That is one way of putting it, Audrey.
Dr Yach, I would like to ask one final question before we finish.
We are meeting officials from the EC next week. Do you have any
specific thoughts on the role of the EC in respect of tobacco
policy and the areas that our Committee should be addressing when
we meet with officials in Brussels next week?
(Dr Yach) The EC has a unique position now in the
WHO Convention as a very special case of an inter-governmental
agency itself representing the will of EU members and they can
play a very strong leadership role in ensuring that the 15 Member
States speak as one and speak at the highest possible level of
tobacco control from a public health point of view. They are also
thinking very deeply about the area of product modification. I
think they need to be encouraged to continue their work in concert
with WHO, which is something we know is happening. As they start
thinking about the accession countries and the countries who are
likely to become members over the next decade I think we should
emphasise to them the fact that this is the time for them to bring
their tobacco control policies in line with that which applies
within the European Union. Many of those countries are focusing
at this stage on the financial requirements for joining, but they
need to recognise there will be many other Directives, the advertising
one being an important starting point. We would see the EC as
a vital partner alongside the Member States and at this stage
we would regard our relationship as extremely good. The other
issue is the issue that you raised, Ms Wise, and that is the need
to ensure you have a coherent approach to tobacco control across
all sectors and that does require decisive leadership and that
is the kind of leadership Dr Brundtland seems to have been able
to install in many national leaders. You cannot continue agricultural
subsidies simultaneous with trying to profess the need for strong
public health measures against tobacco.
307. Can I thank you for your very helpful evidence
and for your participation in this inquiry and for the documents
that you have been good enough to give us. We are most grateful
to you. Thank you very much.
Dr Yach) Thank you.
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