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Doing the unthinkable (and saving millions of lives)
  1. Richard A Daynard
  1. Dr R A Daynard, Public Health Advocacy Institute, Northeastern University School of Law, 102 The Fenway, Boston, MA 02116, USA; r.daynard{at}neu.edu

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In the 17 years since the journal Tobacco Control began, control of tobacco has made tremendous progress. Smoke-free laws are sweeping the globe. Voters in several US states went to the polls to raise cigarette taxes, funding tobacco control programmes and reducing smoking rates. A 1998 settlement of state lawsuits against the tobacco industry in the United States raised cigarette prices, eliminated most outdoor advertising, funded counter-advertising, greatly reduced youth smoking rates and put millions of documents evidencing industry misbehaviour around the world on the internet. More than 80% of the world’s population now live in countries that have ratified the Framework Convention on Tobacco Control (FCTC), thereby committing themselves to greatly limit cigarette advertising, ban misleading package labelling and require strong package warnings, protect non-smokers, control smuggling and take other steps to discourage smoking. And major foundations have committed over $500 million (£340 million; €390 million) to supporting tobacco control efforts worldwide. Aren’t we in (or at least fast approaching) the best of all possible worlds?

Well, actually, no. There are currently over 40 million cigarette smokers in the US, and around 1.3 billion smokers worldwide. In the US half of all lifetime cigarette smokers will die from cigarette-caused diseases. Each year about 1% of US cigarette smokers die from these …

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