It is a great pleasure and a privilege for me to address you on this World No-Tobacco Day. First of all I want to pay homage to our hosts. Not only for their gracious welcome in this beautiful province of B.C., but also for Canada the pioneering and role in health promotion and disease prevention. Over the last twenty years, Canada has taken many ground-breaking initiatives, which have been emulated by other countries and have resulted in clear improvement in the health status of the people. Canada's comprehensive approach to tobacco control is an outstanding example of a well thought out public health operation. And therefore WHO has decided and asked Canada to celebrate World No-Tobacco Day 1995.
According to estimates there are more than one billion smokers in the world today. About 200 million men in developed countries, and 700 million in developing countries are smokers. Among women, there are about 100 million smokers in developed countries and approximately an equal number in developing countries. Globally, 48% of men and 12% of women are smokers. In developed countries, 41% of men and 21% of women smoke. While in developing countries, about 50% of men smoke compared with 8% of women. In the course of a year, world-wide, tobacco kills about three million people. Two million of whom live in developed countries, and one million in developing countries. If current smoking patterns persist, in three to four decades, the annual toll will rise from three to ten million deaths.
Currently in developed countries, smoking is a cause of about 36% of men's deaths and 13% of women's deaths before the age of seventy. On average, smokers who die before the age of seventy lose twenty-two years of life expectancy. Of great concern to us, the rapid growth of tobacco use in many developing countries will dramatically rise in this global picture. Thus, it can be expected, that developing countries share in the overall mortality burden. It will increase seven-fold, from one million at present, to seven million deaths a year by the year 2020, or 2030. This mortality rate has been estimated by WHO, in close collaboration and co-operation with epidemiologists from Oxford University in United Kingdom, and the American Council Society. In the case of HIV/AIDS, there is about ten years between the infection, and the explosion of AIDS. But in tobacco, the evolution is much more insidious. It has been estimated that the peak in mortality will follow the peak in smoking preference by thirty years. In theUnited Kingdom since 1950, there has been a very rapid increase of cigarette consumption. But appearance of lung cancer was about thirty years after the initial peak of the cigarette consumption. Contrary in Japan, Japanese men are very heavy smokers, I'm not, and you see after the WWII, due to economic difficulties, tobacco consumption dropped, and even in the 1950's, or 1945 to the early 50's, under the occupation and economic difficulties, tobacco consumption was not as such.
With economic growth, tobacco consumption is increasing as is shown in this slide. The number of lung cancers is increasing steadily. But again, about thirty years after the tobacco epidemics. Tobacco epidemics and lung cancer has a lapse time of thirty years. This is why often, tobacco companies and tobacco promoters say that Japanese are heavy smokers and there is no lung cancer. But lets wait until thirty years from now and there will be lung cancer in Japan. And this is the exact same picture in other countries and many developing countries. We must look thirty years after. Therefore the full irreversible impact of the tobacco epidemic becomes apparent world-wide not only nation-wide. The consequences, in terms of mortality and morbidity are enormous. A comparative study has estimated huge deaths among the thousand one hundred year old people who smoke cigarettes regularly and continue to do so throughout their lives. In the United Kingdom, out of one thousand young people before the age of seventy, one will be murdered, six will be killed in traffic accidents and 250 will be killed by smoking. In the United States, homicide will cause 8.8 deaths. Sixteen deaths will be caused by traffic accidents, and smoking will kill an estimated 250 people. In Canada, homicide will cause one death, traffic accidents will cause nine deaths, and smoking will cause 250 deaths. In Japan, there will be less than one death due to homicide, nine due to traffic accidents, and 200 deaths due to smoking. That means that among the major causes of adult deaths, the working population deaths, cigarette smoking kills many more people, comparing with homicide due to violence and traffic accidents.
The economic losses incurred by all countries because of smoking are also huge. Profits made by tobacco companies, are facilitated by a combination of financial incentives, expenditures of public money and resources. This is also true in many cases for those costs that are associated with the treatment of illness caused by direct or indirect exposure to tobacco smoke. There is lower productivity due to illness, property damage, fire damage and even the cost of enforcement measures. A World Bank official has estimated that tobacco use is responsible for a global loss of US dollars, approximately 200 billion per year. For Canada alone, health and property damage due to smoking has been responsible for the loss of and estimated 9.6 billion Canadian dollars. Faced with such alarming figures and prospects, WHO is determined to do everything possible to help countries contain the spread and the impact of tobacco use. This determination will be reflected in the tobacco or health plan of action for 1996-2000, currently in preparation.
A comprehensive strategy has two main objectives: first to prevent people, mostly children and adolescents from starting to smoke. Particularly for the women. Second, to help people quit smoking. In order to achieve these two objectives, we must combine a number of educational, legislative and fiscal measures. Health education must be used to create a healthy and tobacco-free environment within the family, in public places, transport and the work-place. We must help reduce peer pressure among children and adolescents so that they are not social forced into acquiring the habit. We must also emphasize the importance of a non-smoking family environment to protect children from such a social pressure and also from the health damage caused by direct and indirect exposure to smoking. Legislation should be passed and enforced to eliminate tobacco advertisement. As well, legislation should be passed to require strong warnings on packages and ideally, to have neutral packaging. This should be decisive in helping us to reduce the social acceptability of smoking.
I would like to commend the efforts of the Minister of Health, Honourable Mrs. Marleau, and her initiative to put this issue into legislative merger. We must be aware that the tobacco industry relies more on brand loyalty than on price competition and uses aggressive advertisement and Canada's Health Minister commended print campaigns to promote tobacco consumption in general and it's social acceptability in particular. Legislation must also come in to place to restrict access to tobacco products including vending machines and to ban smoking in public places. WHO has been vigorously promoting the enforcement of a tobacco-free environment in all UN agencies and conferences, including UN full-site conferences. We also applaud the resolution of the International Civic Aviation Organization, to propose to ban smoking on all international flights. Which in fact meets the demand of a vast majority of airline passengers. In addition, we all know that any decision making on any public policy is heavily influenced by the issue of cost. Within our comprehensive tobacco control strategies, we must be ready and able to use cost both as an argument and as a weapon for requiring, as well as for enforcing action.
Tobacco companies are among the most profitable in the world. Tobacco is cheap to produce and process. Cigarettes are cheap to stock and ship. Even when taxes are taken into account, the potential for profit is immense. The economic consequences of tobacco use are being documented in a growing number of countries, demonstrating that overall costs for the communities, many times exceeds the short time economic benefits which are produced and derived from tobacco sales. The economic losses incurred have been reported in many developed countries and new studies are emerging in such countries as the People's Republic of China, Egypt, Malaysia, South Africa and Venezuela. These studies show that in most developing countries, tobacco use is also causing large economic losses. It has been estimated that in a developing country, with a per capita gross domestic product of 1000 US dollars, effective smoking prevention would cost only 20 US dollars per capita, with a 40 per year life gain for the individuals concerned. On the other hand lung cancer treatment will cost, even in developing countries, 18 thousand US dollars per year of life. World-wide experience has shown that effective measures are viable and can be enforced to reduce tobacco consumption. Economic measures such has increased taxes on tobacco have given us some of our most impressive victories in public health campaign to date. To be fully effective however, they must be coupled curbing advertising which has a major influence on tobacco consumption. In addition, tobacco taxation should not be perceived as just another source of revenue for the states. Unless legislation is passed to ban or restrict tobacco advertisement, supportive measures must also be taken to help the media, art and sports institutions overcome due economic loss thus incurred. For example, we should also use the media more activity with our health promotion campaign. Here again, revenue collected from tobacco taxation can be put to good use.
Through taxation, government finance departments can help to reduce tobacco consumption or at the very least slow down it's rate of growth. Tobacco taxes are relatively easy to administer in most countries. The supply of tobacco products is controlled by only a few companies. Taxes can easily be collected at the point where tobacco products are released by these companies. In countries where imported tobacco dominates the market, some of the money that would otherwise leave the country as appropriated profit can and should be used to benefit local citizens. Tobacco tax policies will provide much needed revenue to help countries, particularly developing countries to finance their social and economic development and the well-being of their people a generation later. These benefits will become further apparent and increased as fewer lives are lost prematurely because of tobacco use. The human and economic potential is enhanced and the tobacco related burden on health dealt by the system is lessened. By reducing tobacco consumption, tobacco taxation will result in reduction in productivity losses. A reduction in the health care burden and finally a reduction in the human misery associated with unnecessary deaths and illness. The tobacco industry remains entrenched in its opposition through the promotion of improved public health through strengthening tobacco control measures. But this opposition should not deter us from advocating more effective use of tobacco taxation as one key element in what must be compared to tobacco control strategies. Health oriented tobacco control policies which act simultaneously on tobacco taxation and advertisement, will help us reduce use and achieve our goal of a tobacco-free world. When the finance ministry, bodies of research, health professionals particularly, teachers and parents work closely together in developing and in preventing effective strategies, then progress can be achieved in controlling tobacco. Then more of today's children will be able to live happy, healthy and smoke-free lives as tomorrow's adults.