This year’s World Day Against Smoking (May 31) found the international community in the midst of an unprecedented campaign to restrict smoking with what is a potentially powerful new weapon in the battle against this harmful habit. Professor Haralambos Roussos of Athens and McGill universities said a recent draft treaty drawn up by the World Health Organization was a «revolution in the attempt to stop the scourge of smoking.» Roussos, whose field is pulmonary disease and intensive care, proposes additional measures to restrict smoking, such as setting up a national bureau for the coordination of action against smoking and making cigarette packets uniform. «The draft treaty is a major step forward, since dealing with an epidemic cannot be limited to the boundaries of one state or group of states. In other words, we are talking about global cooperation against a global power – the tobacco industry,» said Roussos. This historic pact comes at the end of a long series of efforts that began centuries ago. «Inhaling smoke from the combustion of various material has its roots in the ancient world, from Egypt and Babylon up to the Greek-Roman world,» he explained. «But the spread of smoking in its current form began in the 15th century with the importation of the tobacco plant from America to Europe.» Roussos noted that initial reactions came from church circles but the strongest opposition came from Sultan Murat II, who in the early 17th century imposed the death penalty on anyone caught smoking. The total number of victims of his anti-smoking campaign are estimated at around 100,000. The battle proper began in the second half of the 20th century, when epidemiological studies linking smoking to lung cancer began to appear. The tobacco industry’s response was to sponsor shows and step up advertising, including the introduction of the famous Marlboro cowboy. In 1981, a study from Tokyo showed that passive smokers were also at risk of contracting lung cancer. A similar report submitted in 1986 by the US Surgeon General and Congress banned smoking on domestic flights of less than two hours. In 1988, the US Surgeon General reported the powerful addictive properties of nicotine. In 1995, the actor who represented the Marlboro cowboy, David McLean, died of lung cancer. Subsequently documents were leaked revealing the tobacco industry’s illegal means of encouraging smoking. As a result, the tobacco industry in the USA signed a collective agreement regarding restrictions and obligations, tantamount to admitting that smoking was seriously harmful to the health. It was then that efforts began in earnest to contain the smoking epidemic. «The real revolution, however,» said Roussos, «occurred a few days ago with the approval by 192 states to a world treaty on limiting smoking. The difference between this and other international meetings on the subject lies in the fact that these decisions are legally binding for all signatory states. The key points in the treaty include the enlargement of the warning label on cigarette packets to cover at least 30 percent of its surface, a ban on deceptive words such as ‘light,’ a complete ban on advertising and on the sale of tobacco to juveniles, as well as the promotion of therapeutic programs for people who want to kick the habit.» According to Roussos, there is still plenty of room for additional measures against smoking, such as the establishment of a National Coordination Bureau for Action Against Smoking, to act as a link between agencies involved in the anti-smoking campaigns and administer the resources allotted for the purpose. The bureau could collect information on the incidence, mortality and morbidity of smoking and set up a committee to oversee and process legislative acts. Another proposal is to make all cigarette packets uniform, apart from the name of the brand, the warning label and reference to the dangerous substances in the product. Roussos says this is important, as the packet is at the heart of marketing strategy and all advertising messages are directly linked to it. Moreover, uniform packets would send the message that the product is so dangerous that the State does not permit its sale with ordinary packaging. In addition, the plain packaging would not distract smokers’ attention from the warning on the packet. The professor also sees a need for clinics for people who want to quit smoking, provided with sufficient funding and granted reduced prices for nicotine substitutes, which he said should be prescribed through social security funds. «It is inconceivable that these preparations should be viewed as ‘lifestyle’ products and not as substances that save lives,» said Roussos. In the meantime, much can be achieved by raising doctors’ awareness. «Doctors should be helped to get the message through on a regular basis to their patients that smoking is harmful, and not just when a particular disease is linked with the habit,» he said. 215 million smokers in Europe According to World Health Organization figures for 2002, about 215 million Europeans smoke, 130 million of them men. Of these, approximately 1.2 million die every year from smoking-related diseases and about 700,000 in Eastern Europe and Russia. Worldwide, there are about 4 million deaths every year, expected to rise to 10 million by 2030. Smoking is widespread among young people and there are no clear indications that it is on the wane. Lower socioeconomic groups smoke considerably more than higher income groups, and the unemployed more than those with jobs.