• news analysis

Turkey, strategically placed between Europe and Asia, is understandably seen by tobacco companies as a key market. The struggle to obtain comprehensive tobacco control legislation has been long and strewn with setbacks, as frequently reported in these pages (see

). As with any legislation passed without a strong, cabinet-wide commitment to effective action on tobacco, there are limited resources, and more than a hint of limited enthusiasm, for monitoring and enforcing the law. Blatant tobacco industry lobbying and promotional efforts aimed at establishing Formula 1 (F1) motor racing, in a country with no popular interest in motor sport, have now gone underground. However, there are frequent signs that tobacco interests are still actively pushing for the establishment of motor racing as a handy means of mass cigarette promotion in the region, and it seems inevitable that a tobacco friendly F1 or equivalent race will come to Turkey within a few years.

Meanwhile, the government has continued to dither over the sale of Tekel, the tobacco monopoly. Government and parliamentary sources have indicated desperate lobbying by British American Tobacco (BAT) and others, some of it apparently involving conditions for a takeover that would effectively break the tobacco law. No wonder, then, that doctors, always at the forefront of the campaign in Turkey, have been trying to expand their activities, taking tobacco control to the regions and stepping up pressure to promote tobacco control to a fully recognised national health priority.

Earlier this year, more than two dozen doctors took part in a week long training course in Ankara. Many were clinicians in charge of smoking cessation clinics in their hospitals and health centres. At least, they were when they arrived; but many left the course already planning to take on other tobacco issues in their regions. Evidence of their new activities soon began to accumulate. In Ankara itself, meetings were arranged with parliamentarians and national medical organisations, to press the government over the Tekel sale. In Mersin, on the Mediterranean coast, a one hour live television programme was arranged; a training workshop was held for local doctors; and a stand was taken in the centre of the city with a “death clock”, to begin the long task of educating the public. In Trabzon, on the Black sea coast, doctors went public with a major campaign, including a smoking cessation booth at a local health fair.

In Turkey, overt tobacco promotion is still very evident, as illustrated by this Gitanes ad above a street sign to a bar.

Some tobacco promotion in Turkey is complex, even unintended, as in this child’s jigsaw featuring the Marlboro logo, but with a small change to the name.

Meanwhile, the newly inspired medical activists have been monitoring tobacco promotion, all of which is now supposed to be illegal. Even before the end of the Ankara course, students spotted a nearby Gitanes ad on a street sign to a bar, and arrangements were made to pursue this with the authorities. In Bursa, in the west of the country, several child friendly items were located which were more difficult to deal with, as they had not necessarily come from tobacco companies themselves. Instead, they were classic examples of the goodwill of individual cigarette brands being so great, and the social acceptability of smoking being so widespread, that manufacturers of other goods imitate cigarette brand characteristics to glamorise their products. Thus, an inexpensive jigsaw was just one letter away from advertising Marlboro. And in the playground of a large shopping mall that attracts tens of thousands of customers every day, “dodgem” cars were painted in imitations of Winfield and Benson & Hedges F1 colours. The carefully painted village scene on the back wall of the dodgems circuit included something so far entirely alien to any Turkish village or city, a motor racing circuit complete with a West F1 car.

The “death clock”, used to educate the Turkish public about the dangers of smoking.

Turkish health advocates are deeply concerned about the likelihood of continuing attacks on the Tobacco Act. For all Turkey’s progress in recent years, leading to a possible application for European Union membership, some aspects of its governmental and business life, including corruption, still render it vulnerable to abuse by unscrupulous companies. The international tobacco control movement played a major role in helping Turkish colleagues to get their law. It may soon be called upon again to help them to preserve it.