On Tobacco, Obama Must Quit to Lead

With the country facing an economic disaster and crises throughout the world, it may not seem very important that President Obama smokes cigarettes. The public response to his struggle to quit seems to be: Give the guy a break.

But tobacco smoke kills 440,000 people a year in the United States and 5.4 million each year worldwide. That number will reach 8 million by 2030, with 80 percent of those deaths in developing countries. Tobacco will kill 1 billion people this century. It’s the most preventable cause of death in rich and poor countries alike.

President Obama can save millions of these lives by joining the fight against this global epidemic. But unless he can quit smoking and stay quit, he might actually hurt the cause.

The international tobacco industry spends tens of billions of dollars each year pushing its message that smoking is normal and desirable. A charismatic world leader who is an inspiration to young and old — and who smokes — would be a godsend for the industry. But if the same world leader publicly quits, and supports changes that help others to quit and children never to start, he could turn the tide on this epidemic.

Smoking in the United States has declined in recent decades, leveling off at about 20 percent of the adult population. Meanwhile, the global reality is much worse. Countries with low or moderate per capita incomes are particularly at risk because of low tobacco prices, lack of awareness, and aggressive tobacco marketing.

Indonesia is a tragic example. Over 60 percent of adult males smoke. So do a quarter of teenage boys under 16. The rate among young girls is rising fast. Tobacco advertising is rampant and, like most developing countries, Indonesia has few of the controls that can reverse the tobacco epidemic.

It’s also a country where President Obama is very popular, having spent some of his childhood living there. By speaking out as an honored world leader who has quit smoking, he could help countries like Indonesia overcome tobacco industry muscle and enact desperately needed anti-tobacco measures.

Africa is another region with a growing tobacco epidemic where President Obama could help. While tobacco prevalence in Africa is still relatively low, it’s a vast new marketplace for the tobacco industry because of lax controls and a young populace.

Reversing the global tobacco epidemic is not complex. It doesn’t require breakthrough cures or heroic medical treatment, just policy changes that already have been tested, plus enforcement. A recent World Health Organization report laid out the path countries must take by using the acronym MPOWER:

• Monitor tobacco use and prevention policies;
• Protect people from tobacco smoke;
• Offer help to quit smoking;
• Warn about the dangers of tobacco;
• Enforce bans on advertising, promotion and sponsorship; and
• Raise taxes on tobacco.

These are well-researched and proven methods. If adopted by all countries, these policies would save hundreds of millions of lives.

The tobacco industry vigorously opposes the MPOWER measures. And many countries have yet to develop the political prowess to resist the industry’s powerful influence and sophisticated tactics. President Obama can help by supporting global adoption of these policy changes. He could begin by getting the United States to ratify the World Health Organization’s Framework Convention on Tobacco Control. This treaty is a blueprint for reducing the worldwide supply of and demand for tobacco. While 161 nations are parties to the treaty, the United States isn’t one of them.

President Obama will battle unemployment, the real-estate collapse, worldwide recession, climate change, a broken healthcare system, the Israeli-Palestinian conflict and crises still beyond the horizon. But he should not ignore the planet’s greatest preventable health threat. Because he’s admired throughout the world and because he himself struggles with addiction to cigarettes, President Obama could be instrumental in reversing the global tobacco epidemic.

Jim Gogek is a blogger and writer in La Mesa, California. Ed Gogek, M.D., is a psychiatrist in Prescott, Arizona.