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WHO calls for tobacco tax increase and warns against industry tactics
POLICY AND PEOPLE
WHO calls for tobacco tax increase and warns against industry tactics igher taxes leading to a 10% increase in cigarette prices would motivate about 42 million people—especially the poor and the young—to stop smoking, according to a joint WHO–World Bank study. The 512-page report, presented to the 11th Conference on Tobacco or Health (Chicago, USA; Aug 6–11) calculated that this measure could prevent 10 million tobacco-related deaths. If current consumption rates continue, one billion smokers will die this century from smoking-related causes, it predicted. The report noted that taxation was probably the most effective weapon. This should be backed by a clampdown on smuggling, advertising bans, prominent warning labels, clean air restrictions, and easier access to nicotine replacement therapies. Tobacco Control in Developing Countries tried to dispel fears about the economic impact of a reduction in smoking. With the exception of a few African tobacco exporters, the report stated that the impact on jobs
H
set up by WHO director-general, Gro would be minimal because money Harlem Brundtland, last year to spent on cigarettes would be diverted study documents to other goods and released during US services. Rights were not lawsuits against WHO is likely to tobacco companies draw on the report granted to include this and to assess during October’s image in electronic whether these compublic hearings on media. Please refer to panies had interits planned internathe printed journal. fered with the WHO tional framework campaign. Its findconvention on ings, complete with tobacco. “It is likely the names of that tobacco compa- Will tobacco farmers lose out? tobacco company nies will attempt to agents, were damning. defeat the proposed “Tobacco companies fought convention . . . or to transform the WHO’s tobacco control agenda by proposal into a vehicle for weakening staging events to divert attention national tobacco control initiatives”, away from the public health issues warned another WHO report, raised by tobacco use, attempting to released on Aug 3. reduce budgets for the scientific and Thomas Zeltner, Director of policy activities carried out by Switzerland’s health ministry and WHO . . . seeking to convince develChairman of the Committee of oping countries that WHO’s tobacco Experts on Tobacco Industry control programme was a ‘first world’ Documents said WHO should be agenda”, said the committee. prepared for a “sophisticated and sustained” campaign from the tobacco lobby. The Committee was Clare Kapp
Canadian court tells government to relax marijuana law for patients he Canadian government has been given a year to amend its law prohibiting the possession of marijuana for medicinal uses, or Ontario’s highest court says it will legalise the drug for everyone, including recreational smokers. The marijuana provision of the Controlled Drugs and Substances Act violates the rights of sick people by forcing them to choose between “health and imprisonment”, a threemember Ontario Court of Appeal panel headed by Justice Marc Rosenberg ruled on Aug 30. But the panel suspended its declara-
T
tion of invalidity for a year to allow Ottawa to clarify the provisions of the drug act, which currently allows people to apply for marijuana exemptions for medicinal purposes, but is so vague in its definition of eligibility criteria that only about 50 such exemptions have been granted. Exemptions “dependent upon the unfettered and unstructured discretion of the minister of health is not consistent with the principle of fundamental justice”, Rosenberg wrote in his ruling. For example, Terrance Parker from Toronto has twice been charged with cultivating marijuana,
which he was growing to smoke —providing relief from the 15 to 80 life-threatening epileptic seizures he had each week. “I have concluded that forcing Parker to choose between his health and imprisonment violates his right to liberty and security of the person”, said Rosenburg. Federal Justice minister, Anne McLellan, has yet to decide whether Ottawa will appeal the ruling to the Supreme Court of Canada or simply amend the Act to clarify the rules on medicinal use. Wayne Kondro
Australia approves national electronic patient records scheme
A
ustralian health ministers have approved a scheme, which will link personal health records from the cradle to the grave. The HealthConnect scheme is based on unique identifiers and a smartcard to electronically collate, link, and store key aspects of patients’ personal health information backed by a system of databases. Public pronouncements indicate that the scheme will be voluntary with strict privacy protection. However the federal government’s
THE LANCET • Vol 356 • August 12, 2000
new privacy law, currently before parliament, is described even by the government as a “light touch” relying on industry codes and without independent monitoring. The government has said that the scheme will be viable with even 5% participation. As ill health is strongly correlated with disadvantage, it is likely that the scheme will target disadvantaged people. Pilot schemes are already in place for some Aboriginal Australians. The Minister for Health has said
that one of the advantages of HealthConnect is that immunisation reminders can be sent out. In Australia, failure to have your child immunised is linked to the suspension of the child’s endowment payments. However, some years ago Australians fought hard against the introduction of an “Australia Card”. It seem this may now be being introduced through the back door. Meredith Carter, Bebe Loff
575
For personal use only. Not to be reproduced without permission of The Lancet.
WHO calls for tobacco tax increase and warns against industry tactics igher taxes leading to a 10% increase in cigarette prices would motivate about 42 million people—especially the poor and the young—to stop smoking, according to a joint WHO–World Bank study. The 512-page report, presented to the 11th Conference on Tobacco or Health (Chicago, USA; Aug 6–11) calculated that this measure could prevent 10 million tobacco-related deaths. If current consumption rates continue, one billion smokers will die this century from smoking-related causes, it predicted. The report noted that taxation was probably the most effective weapon. This should be backed by a clampdown on smuggling, advertising bans, prominent warning labels, clean air restrictions, and easier access to nicotine replacement therapies. Tobacco Control in Developing Countries tried to dispel fears about the economic impact of a reduction in smoking. With the exception of a few African tobacco exporters, the report stated that the impact on jobs
H
set up by WHO director-general, Gro would be minimal because money Harlem Brundtland, last year to spent on cigarettes would be diverted study documents to other goods and released during US services. Rights were not lawsuits against WHO is likely to tobacco companies draw on the report granted to include this and to assess during October’s image in electronic whether these compublic hearings on media. Please refer to panies had interits planned internathe printed journal. fered with the WHO tional framework campaign. Its findconvention on ings, complete with tobacco. “It is likely the names of that tobacco compa- Will tobacco farmers lose out? tobacco company nies will attempt to agents, were damning. defeat the proposed “Tobacco companies fought convention . . . or to transform the WHO’s tobacco control agenda by proposal into a vehicle for weakening staging events to divert attention national tobacco control initiatives”, away from the public health issues warned another WHO report, raised by tobacco use, attempting to released on Aug 3. reduce budgets for the scientific and Thomas Zeltner, Director of policy activities carried out by Switzerland’s health ministry and WHO . . . seeking to convince develChairman of the Committee of oping countries that WHO’s tobacco Experts on Tobacco Industry control programme was a ‘first world’ Documents said WHO should be agenda”, said the committee. prepared for a “sophisticated and sustained” campaign from the tobacco lobby. The Committee was Clare Kapp
Canadian court tells government to relax marijuana law for patients he Canadian government has been given a year to amend its law prohibiting the possession of marijuana for medicinal uses, or Ontario’s highest court says it will legalise the drug for everyone, including recreational smokers. The marijuana provision of the Controlled Drugs and Substances Act violates the rights of sick people by forcing them to choose between “health and imprisonment”, a threemember Ontario Court of Appeal panel headed by Justice Marc Rosenberg ruled on Aug 30. But the panel suspended its declara-
T
tion of invalidity for a year to allow Ottawa to clarify the provisions of the drug act, which currently allows people to apply for marijuana exemptions for medicinal purposes, but is so vague in its definition of eligibility criteria that only about 50 such exemptions have been granted. Exemptions “dependent upon the unfettered and unstructured discretion of the minister of health is not consistent with the principle of fundamental justice”, Rosenberg wrote in his ruling. For example, Terrance Parker from Toronto has twice been charged with cultivating marijuana,
which he was growing to smoke —providing relief from the 15 to 80 life-threatening epileptic seizures he had each week. “I have concluded that forcing Parker to choose between his health and imprisonment violates his right to liberty and security of the person”, said Rosenburg. Federal Justice minister, Anne McLellan, has yet to decide whether Ottawa will appeal the ruling to the Supreme Court of Canada or simply amend the Act to clarify the rules on medicinal use. Wayne Kondro
Australia approves national electronic patient records scheme
A
ustralian health ministers have approved a scheme, which will link personal health records from the cradle to the grave. The HealthConnect scheme is based on unique identifiers and a smartcard to electronically collate, link, and store key aspects of patients’ personal health information backed by a system of databases. Public pronouncements indicate that the scheme will be voluntary with strict privacy protection. However the federal government’s
THE LANCET • Vol 356 • August 12, 2000
new privacy law, currently before parliament, is described even by the government as a “light touch” relying on industry codes and without independent monitoring. The government has said that the scheme will be viable with even 5% participation. As ill health is strongly correlated with disadvantage, it is likely that the scheme will target disadvantaged people. Pilot schemes are already in place for some Aboriginal Australians. The Minister for Health has said
that one of the advantages of HealthConnect is that immunisation reminders can be sent out. In Australia, failure to have your child immunised is linked to the suspension of the child’s endowment payments. However, some years ago Australians fought hard against the introduction of an “Australia Card”. It seem this may now be being introduced through the back door. Meredith Carter, Bebe Loff
575
For personal use only. Not to be reproduced without permission of The Lancet.