Global Perspective/tobacco road
Many thousands, perhaps millions, of hard working, well-intentioned people work as tobacco farmers, tobacco industry workers, and in advertising, transportation, and retail sales for the tobacco industry. The end result of their hard work to harvest and process the back-breaking leaf is the promotion of an addictive carcinogen that directly kills half of its users, as well as nonsmoking bystanders.
How does so much well-intentioned labor result in such wide-spread misery? Could adopting a global perspective have reduced the suffering? Perhaps a narrow focus, lack of concern for human-well being, and a failure to adopt a global perspective have allowed this problem to persist for decades after the dangers became well known.
Here we will examine the history of tobacco use to see where a narrow perspective has caused problems that a global perspective might have avoided.
The tobacco industry is profitable for tobacco farmers, the tobacco industry, advertisers, retailers, as well as the stop-smoking and health care services industries. Tobacco sales have also generated substantial tax revenue for many governments.
In 1611, John Rolfe, an early Jamestown settler, became the first to commercially cultivate Nicotiana tabacum tobacco plants in North America. Beginning in 1612 export of this tobacco, lighter in color and flavor than its Spanish and Portuguese competitors, helped turn the Virginia Colony into a profitable venture. After naming his Virginia-grown strain of tobacco "Orinoco" he, along with his new wife Pocahontas and their baby son, returned to England to promote their new brand and introduce Europeans to the allure of its nicotine. By 1627 English imports of American tobacco had reached 500,000 pounds per year, and by 1670 half of the adult male population in England smoked tobacco daily.
When tobacco farmer Robert “King” Carter died on August 4, 1732 he was the richest man in Virginia, leaving behind 300,000 acres of land, 1,000 slaves, and 10,000 British pounds cash.
Today Philip Morris International is a typical large international tobacco company, with products sold in over 160 countries. In 2007, it held a 15.6% share of the international cigarette market outside of the USA and reported revenues (net of excise taxes) of $22.8 billion and operating income of $8.9 billion.
The cumulative revenue from US tobacco taxation has exceeded $15 trillion, creating a major source of income for government.
Yet tobacco use also has substantial human and financial costs. The risks associated with tobacco use include diseases affecting the heart and lungs, with smoking being a major risk factor for:
- heart attacks,
- chronic obstructive pulmonary disease (COPD),
- emphysema, and
- cancer (particularly lung and cancers of the larynx and mouth).
These cause terrible human suffering. In addition, the cost of health care for those suffering from tobacco-related diseases is huge. Financial accounting systems are largely successful in isolating and decoupling those profiting from tobacco use from those bearing its costs. In addition, health care costs are often borne by insurance agencies funded by employers or governments, insulating tobacco companies and their customers from these costs. A narrow focus on financial gain for many special interests, separated from the great human and financial cost to users, has sustained tobacco use. The ability of corporations to shed externalities contributes to this problem.
Tobacco is an addictive carcinogen that directly kills half of its users, as well as nonsmoking bystanders. There is no safe form of tobacco and no safe level of exposure to secondhand smoke. However, quitting greatly reduces health risks and produces immediate and long-term health benefits. Tobacco’s terrible health consequences are entirely preventable. 
The magnitude of the financial costs of tobacco use can be estimated by considering the Tobacco Master Settlement Agreement, an agreement entered into in November 1998, originally between the four largest US tobacco companies and the attorneys general of 46 states. It provided for payments totaling $206 billion in damages.
Much of the disease burden and premature mortality attributable to tobacco use disproportionately affects the poor, and of the 1.22 billion smokers, 1 billion of them live in developing or transitional economies.
In Indonesia, tobacco accounts for 15% of the money spent by the lowest income households. In Egypt, more than 10% of households' expenditure in low-income homes is on tobacco. The poorest 20% of households in Mexico spend 11% of their income on tobacco.
Yet the dangers of smoking are distant, abstract, and ambiguous to a young person who begins to smoke. The benefits, including social acceptance, status, and indulging an addiction are immediate, tangible, and vivid. A natural tendency toward a short-term perspective favors the benefits and diminishes the perception of the dangers. Once the addiction begins, rational thinking becomes moot.
Those profiting from tobacco use limit their scope of concern to their narrow business interests and deliberately exclude a broader, human-based perspective. In addition, their businesses require on-going growth to remain competitive. This requires them to continue to expand the markets for their products by enticing new users faster than present users die off.
As of 2000, smoking is practiced by some 1.22 billion people, poor more likely than rich, and people in developing countries or transitional economies are more likely than people in developed countries. As of 2004, the World Health Organization (WHO) reports that of the 58.8 million deaths that occur globally, 5.4 million are tobacco-attributed.
The World Health Organization estimates that tobacco caused 100 million deaths over the course of the 20th century. Similarly, the United States Centers for Disease Control and Prevention describes tobacco use as "the single most important preventable risk to human health in developed countries and an important cause of premature death worldwide."
The cultivation of tobacco can be economically detrimental to developing countries. When resources are put into tobacco production, they are taken away from food production. Large amounts of firewood that could be used domestically for fuel and heating are instead used for the curing of tobacco.
The problems have been shifted to the distant "others" while the profits stay close to home, even as the industry continues to receive substantial government subsidies. What might have happened if we adopted a global perspective on tobacco use?
If we begin by choosing humanity, preserving dignity, and ensuring we do no harm, then the dangers of tobacco smoking become paramount. Could tobacco farmers choose to grow food rather than addictive drugs? Could advertisers shun tobacco products and focus their business on safer products? Could tobacco company executives practice their business skills in some other industry? Could tobacco companies treat their customers as human beings deserving respect rather than as marks in a con game? Could regulatory agencies put humanity ahead of economic growth and establish more effective regulations?
The dangers of tobacco use become important and the fleeting pleasures become trivial if we take a long-term perspective. Perhaps we could have made better choices.
A financial analysis encompassing a global perspective is very different from a narrow analysis restricted to the scope of a farm or a tobacco company. Such an all-inclusive analysis would include the health care costs, lost wages, compensation for suffering, the cost to taxpayers' of government subsidies, and other costs. Subtracting these costs from the income substantially reduce the profitability of any tobacco-based business.
Substantial evidence of the dangers of tobacco use was emerging throughout the 20th century, yet it was not until January 11, 1964 that the landmark study Smoking and Health: Report of the Advisory Committee to the Surgeon General of the United States was published by the Surgeon General's Advisory Committee on Smoking and Health, chaired by then-Surgeon General of the United States Luther Terry regarding the negative health effects of smoking. It eventually led to policy and public opinion changes such as warning labels and restrictions on advertising, large scale anti-smoking campaigns, and questioning from the tobacco industry. None the less, it was hard for typical Americans to believe that such a widely used and heavily promoted product could be fatal. If the available evidence was assessed more objectively and urgently many years and many lives could have been saved.
In 1966 the Cigarette Labeling and Advertising Act came into effect and cigarette smokers were warned: “Cigarette smoking may be hazardous to your health.” Unfortunately this warning provided more protection to the tobacco companies than it did to smokers. It was now clear that smokers were to blame if they became ill after ignoring the health warnings and continued to use tobacco products. Cigarette sales continued to rise throughout the US.
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