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Latvia: window of opportunity
  1. David Simpson

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    For once, it seems that one of the new democracies of the former Soviet Union may be able to avoid the worst of the enslavement to western tobacco companies that has happened to so many other countries in the same situation. Latvia, in fact, is actually quite an old democracy, having tasted independence and freedom in the early part of the 20th century, developing to have one of the highest standards of living anywhere in Europe in the 1930s. From 1940, it was occupied with extreme brutality first by the Soviet Union, then by Nazi Germany, and then again by the Soviets, whose pretence of allowing independence turned into forcible membership of the USSR. But eventually, in 1991, this small nation finally regained its independence. Nowadays it has around two and a half million people, including a sizeable Russian minority.

    Sandwiched between Estonia and Lithuania, Latvians recently followed their Baltic neighbours by voting to join the European Union (EU). Membership of the EU, together with the Framework Convention on Tobacco Control (FCTC), whose ratification is among the legislative priorities of the present government over the next year, may turn out to be key factors in saving Latvia from the worst of the trends so needlessly repeated in the other former Soviet states. Some 51% of men smoke daily, but only around 19% of women.

    While the relatively low female smoking prevalence is to be welcomed, health officials know it offers an irresistible opportunity for foreign tobacco companies unless the current partial advertising ban is made total as a matter of urgency. Apart from a committed health minister, herself a gynaecologist, the infrastructure of tobacco control in Latvia also enjoys several other bonuses. The health ministry and related government agencies contain officials well versed in tobacco control theory, and with quite enough knowledge of tobacco industry tactics to spot bogus, industry friendly policy should it show up on the radar. There are some knowledgeable and well trained officials in the right places, and the beginnings of an anti-tobacco coalition. There is a well functioning inter-ministerial commission against tobacco, though members from the health sector cannot wait for its promised reform, to remove the entirely inappropriate and counterproductive presence of tobacco industry representatives.

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    A lavishly produced promotional item by the makers of Marlboro, designated for tobacconists in Latvia—obviously not a market yet forsaken by the tobacco industry.

    In its parliament, Latvia has another bonus: the composition of its members makes it unusually well prepared to pass legislation to improve health. The largest single professional grouping in parliament is not lawyers, as in so many other countries; nor is it business people, or local mayors and other party hacks of a former regime—it is doctors. Asked why, local people reply as if it is obvious: doctors are well known in their communities, and people believe what they say; and with some whiffs of corruption still lingering from the past, that makes them obvious candidates for parliament.

    If the FCTC and Latvia’s progress as an EU accession country have come at the right time to guide tobacco control policy on the path to health, one area requiring urgent attention is the widespread belief in government circles that tobacco tax rises will reduce total government revenue. It seems almost certain that tobacco interests were originally responsible for the sowing of this dangerous seed of false concern, but whatever the origins, it is accepted as genuine by key officials in the finance ministry, and by others in the wider world of government policy making. It has already resulted in Latvia opting for the maximum allowable time to harmonise tax levels to EU standards.

    Another major task ahead concerns smoking in public places, which is subject only to laws that are almost totally ignored. Yet good quality data shows a high level of knowledge of the dangers of passive smoking, and widespread demand for protection, especially at the workplace.

    It is always unwise to be anything but pessimistic when forecasting tobacco control developments in any country; but for Latvia, the time might just be right for looking ahead with hope.