Billboard attempting to counter tobacco advertising throughout the globe.

The popularity of cigarette smoking, a habit that Westerners recognize as deadly, is on the rise across the developing world. The World Bank estimates that given current smoking patterns, tobacco-attributable deaths by the year 2025 will increase to ten million annually, exceeding deaths from HIV, tuberculosis and complications from childbirth combined. More than 70 percent those deaths will occur in developing countries that are least prepared to deal with the resulting medical and economic burdens. These countries also are least prepared to counter American tobacco companies and American marketing genius, which bear direct responsibility for the sharply increased smoking statistics among women and children worldwide.

WHO estimates that 500 million people alive today will die prematurely from smoking, most of them in the developing world where smoking rates are rising. Some 60,000 teenagers worldwide start smoking every day compared to 3,000 in America. U.S. tobacco companies sell far more cigarettes overseas than in the US, targeting nonsmoking children and women in less developed countries, and earning more than half their profits in overseas sales. However, unlike for other public health emergencies, for international tobacco control the U.S. provides no significant programs, support or leadership. It is this important gap that has been CECHE's priority in tobacco control.

The decline in Western tobacco use is no accident-it is the result of massive accessible information and public education programs which in turn have led to action by governments and individuals. CECHE’s programs are designed to counter the growth of tobacco use through mass media and information technology for positive social impact, especially among women and youth.

A young Mexican gets an unfortunate early start at smoking

CECHE has been undertaking tobacco control activities since its origin in 1990, and tobacco control is an integral part of all its projects. Examples include smoking prevention and cessation in our heart disease prevention program in the Czech Republic, several series of Public Service Announcements broadcast throughout the CEE-NIS, a full 30-minute segment in our TV series A Family Year, and another in our ten-part TV series Elixir of Life, which premiered on Czech TV in November 1998.

A scene from CECHE's "A Family Year". Hungarian teens light up and risk a host of chronic diseases and death.

CECHE’s efforts include securing support of international anti-tobacco leaders for a letter to President Clinton and selected members of Congress, urging them to embrace the international tobacco-or-health struggle and support CECHE's proposals for a global tobacco-control program. Working in partnership with the American Cancer Society, American Heart Association, Campaign for Tobacco-Free Kids, Essential Action, Global Action Network, and others in the US public health community, CECHE efforts have emerged as the focal point for global strategy and action by these key American public health groups. Since 1997, CECHE has played a central role in proposing multifaceted legislation directed to international tobacco control.

CECHE’s US-based tobacco control activities have targeted raising the profile of international tobacco control issues among members of Congress and the US media, and promoting US legislation to support international tobacco control.

The proposed international provisions are directed to:

  1. Bar U.S. government funds from being used to promote U.S. tobacco interests overseas.
  2. Support the establishment of an American NGO that would assist public health organizations in other countries through public education programs, technical assistance to health professionals, mass media campaigns, grants and other general assistance.
  3. Create a special funding mechanism to support the NGO, governmental tobacco control efforts overseas, and multilateral institutions such as WHO and UNICEF.
  4. Establish a code of conduct for U.S. tobacco companies, their subsidiaries, affiliates and licensees overseas; and,
  5. Impose strong anti-smuggling provisions.

In support of these provisions, in July 1998, CECHE convened experts on international tobacco control on the Capitol to discuss the issue of women, girls and the threat of tobacco. Led by Dr. Judith Mackay, the Director of the Asian Consultancy on Tobacco Control in Hong Kong, and joined by Congressman Lloyd Doggett (D-TX) and Congresswoman Nancy Pelosi (D-CA), the news briefing was designed to gain support for preventing U.S. tobacco companies from marketing to women and girls around the globe, especially in developing countries. CECHE Chairwoman Dr. Sushma Palmer moderated the event. The event Women, Girls and the Threat of Tobacco: An Appeal for Global Action was cosponsored by American Cancer Society, American Heart Association, American Lung Association, American Medical Women’s Association, Center for Communications, Health, and the Environment, Essential Action, and the National Center for Tobacco-Free Kids and endorsed by over forty public health groups.

CECHE Chairman, Dr. Sushma Palmer, and Vice Chairman, Ambassador Mark Palmer are active participants in World Conferences on Tobacco or Health (WCTOH). They also served as a resource for and participated in Sen. Richard Durbin’s international policy conference on children and tobacco in 1999. Both served as members of the planning committee several key subcommittees for the 11th WCTOH in Chicago in August 2000, and each hosted a workshop: one on mass media as a communications toll and the other a symposium on Internet-Based Tobacco Control—a part of the CECHE-initiated,
World Bank/InfoDev-supported tobacco control program in the Czech Republic (see Internet-Based Tobacco Control Program in the Czech Republic). The session focused on the following:

  • How to use the Internet as a communication tool for creating a network of health professionals for tobacco control
  • How to use the network to engage media entities, the public and policy-makers in the tobacco control movement and launch a nongovernmental organization (NGO) whose central mission is tobacco control
  • How to apply the lessons from this model to expand the movement to other Central and Eastern European countries and additional parts of the world

Participants in the symposium were: CECHE partner Dr. Rudolf Poledne of the Institute of Clinical and Experimental Medicine (IKEM) - Prague; Dr. Hana Sovinova of the National Institute of Public Health (NIPH) - Prague; senior members of the Czech Ministry of Health or the Czech parliament; Ruben Israel of GLOBALink/UICC - Geneva; and Czech celebrities from the broadcast or print media.

Tobacco-Related Publications

Several CECHE publications routinely cover tobacco issues.  For key topics, see America’s Shame, A Child is a Child is a child, Global Health and Environment Monitor (Fall/winter 1995; Spring 1998, Spring 1999, Fall 1999, Summer 2000).

Other International Tobacco Control Sites


In Focus, CECHE's new online publication, brings into focus lifestyle-related chronic diseases and environmental issues worldwide. It reaches health professionals and policy-makers in over 50 countries

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