Vanguard Neurologist

From New York Times

Tobacco could kill up to a billion people during the 21st century, as cigarette sales soar in poor and middle-income countries even as they drop in wealthier ones, says a report issued Thursday by the World Health Organization.

The report, financed by Mayor Michael R. Bloombergs foundation, suggests a six-point program for fighting the tobacco industrys influence.

The W.H.O. is described by the tobacco industry as its biggest enemy, Dr. Margaret Chan, the organizations director general, said at a news conference introducing the report. Today we intend to enhance that reputation.

Nicknamed Mpower and based on a partly successful program for fighting drug-resistant tuberculosis, the report suggests raising cigarette taxes, banning smoking in public places, enforcing laws against giving or advertising tobacco to children, monitoring tobacco use, warning people about the dangers and offering free or inexpensive help to smokers trying to quit.

The report, to which Bloomberg Philanthropies contributed $2 million, is the first to compile global data on how many smokers or tobacco chewers each country has, how much they pay in tobacco taxes, and how antismoking efforts are faring.

Among its conclusions: poor and middle-income countries collect 5,000 times as much in tax revenue from tobacco as they spend in fighting its use. Only 5 percent of the world has no-smoking laws like those in New York City. Uruguay does more than any other country to reduce smoking.

Mayor Bloomberg, who is well known for his antipathy to smoking, said in presenting the report that it would be re-issued annually and would grade countries. The United States would get a C or D, he said, New York, an A or a B.

His statement puts him at odds with W.H.O. The agency has traditionally been cautious about offending members, and in interviews, officials from its Tobacco Free Initiative specifically said countries would not be graded.

Perhaps the oddest aspect was that the report itself was presented as if it were a campaign for menthol cigarettes, full of pictures of happy children and mottos like fresh and alive. It even came with what appeared to be a pack of Mpower-brand cigarettes, with a cheerful blue bubbles logo and a mock warning on the box

which actually contained a pad and pens.

That also seemed to fly in the face of the sort of harsh ads that Mayor Bloomberg endorsed, like those showing dying smokers croaking through tracheotomy tubes.

After the presentation, officials hastened to explain that the cigarette pack was not meant for the public, but to catch the eyes of health and finance ministers in poor countries.

Were co-opting the tobacco industrys branding strategies to capture the attention of government officials, said Sandra Mullin, a spokeswoman for the World Lung Foundation, which contributed to the report. We want to show that they dont own those mottos

freshness and fun and health.