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In November 2000, Turkey’s first tobacco litigation, a personal injury case in the district court in Edirne, in the north-west of Turkey near the borders with Greece and Bulgaria, was filed against Tekel, the Turkish tobacco monopoly. The plaintiff was Yurdagül Tufan, 44, a smoker since she was 17, who was responsible for the support of her blind husband and their young daughter.
After diagnosis and first line therapies, an improvement in her health was achieved. Knowing that as much as possible was being done for her physical health, albeit for a terminal disease, her doctor gave more thought to what else could be done for her overall well-being. The woman was desperately concerned for the welfare of her husband and baby, for whom she would soon be unable to care and then would leave behind for ever when she died. Although nothing could be done to save her life, at least she might be helped to understand that she was not the only one responsible for her situation, and could use her case to warn others not to smoke.
From what the doctor had learned from international news media and the internet, he conceived the idea of suing the tobacco company whose cigarettes she had smoked. Despite finding little support for the idea among colleagues, and although a lawsuit seemed an absurdly ambitious concept, he found a lawyer, Rifat Çulha, who was persuaded to run the case without payment. So Tekel was duly sued for compensatory and punitive damages of 1.1 trillion Turkish Lira (about US$1.6 million).
It was an utterly new phenomenon in Turkey, and a cause of general astonishment, reflected by widespread interest from the mass media. A quick search on the internet, by headlines and sub-headlines, found almost 80 news items about it. The story was also shown on the main news programmes of national television channels. The disease process, the trial day, the death of the patient and the amount of compensation claimed—all, in turn, were the basis of substantial news stories.
The suit was eventually rejected by the local court, after two and a half years, and details of the judgement suggested significant confusion. In essence, the court said it was a matter of free choice whether or not a person smoked; it was not proven that smoking caused cancer by itself; and the causes of cancer were not entirely clear. The patient could have become ill from other carcinogenic agents, including those found in many foods that were widely sold and consumed. In addition, the defendant, the tobacco company, was providing a legal product, and did not have a legal obligation to look after people’s health. The court also noted that there was a health warning on cigarette packs saying, “Cigarettes harm your health”, and in any case, the harm done by cigarettes was known by everybody, even without a health warning. This fact did not alter just because the product was advertised; it was the duty of every person to protect his or her health.
After this judgement, the lawyer appealed to the supreme court. However, after a process of two years it just became too burdensome, and he withdrew the case. He also decided not to appeal to the European Court of Human Rights, as previously intended. Although the case had been on the national agenda in a big way, no non-governmental organisation, or scientific or legal association, had come forward to support it.
Even though the final result was negative, this first attempt at tobacco litigation had many important effects. Firstly, it raised the level of discussion in Turkey about the harm caused by cigarettes, and made them clearer in the public mind. The whole country watched the death of a mother and wife, and the effects of her lung cancer, step by step. Tekel and other tobacco firms changed some of their unhealthy practices of their own accord. Tekel, due to be privatised, was clearly attractive to the large international tobacco firms. However, the privatisation programme fell behind schedule and it seems reasonable to speculate that at least one factor may have been the litigation.
In contrast to some of the US cases, Turkish citizens are still being killed by tobacco without costs being imposed on the companies. Much more vigorous tobacco control could be possible in Turkey if such suits began to be won. As the World Health Organization has recommended, the tobacco industry has to be held responsible at both the national and international levels, by legislation, law suits and other methods. Enlightened tobacco control leaders in the industrialised world must not overlook the harm being wrought on those living in countries with fewer resources, in terms of both finance and information about tobacco, by the same companies which they have been able, at least partially, to control in their own countries.