Towards a tobacco-free world

A tobacco-free world is most importantly one with fewer wasted lives. It’s a world without the end-of-life suffering experienced by smokers. It’s a world with fewer grieving families: their tears, their distress and, very often, their failure to comprehend.

It’s a world in which no one would need an oxygen tank to make the arduous journey to the corner store for a few groceries. It’s a world in which no one would need an electrolarynx to read their child a bedtime story. It’s a world in which doctors would no longer need to deliver so many bleak prognoses to their patients.

A world without tobacco means eradicating the leading cause of preventable death in the world. It’s one billion lives saved throughout the 21st century worldwide - 10% of the total world population. For the average smoker, that means adding 11 years to their life expectancy. Who could possibly see that as a negligible benefit? Certainly not anyone who has witnessed the ravages of tobacco first-hand or lost a loved one far too early…  

A world without tobacco is also 4.3 million hectares of the planet’s farmland made available for more meaningful purposes. It’s also 2-4% of global deforestation avoided every year. Not to mention cleaner air, of course.

The list goes on. These are just a few examples, but I think they are enough to get a general idea of what a tobacco-free world might look like.

3 essential levers for fighting tobacco

I am convinced of one thing: the world with tobacco we live in today is not the only possible world. And I’m not just saying that because I’m an optimist. But because my experience, as a tobacco treatment specialist, as a member of the scientific board of SOS Addictions and in my work with AXA, has showed me an important truth: little by little, mindsets are changing. 

But that is not enough. To continue to fight against tobacco, we need to keep taking action on several levers, which will produce tangible results in the immediate and foreseeable future, as well as more long-term benefits:

• Price: according to the WHO, a 10% increase in tobacco prices would cut tobacco use by 4% in high-income countries and up to 5% in low- and middle-income countries. For the World Bank, raising tobacco prices by 50% could lead to a 20% decline in tobacco use.
• Denormalizing tobacco use: fighting against tobacco also means denormalizing tobacco use. A total ban on all forms of tobacco advertising notably helps to reduce tobacco consumption by 7% on average. Some countries have even cut tobacco by up to 16%, according to the WHO. Not only does banning smoking from public areas make for cleaner environments, it also changes people’s attitudes towards smoking. And even though smokers have a rough time adapting to these bans, the vast majority later agree that it is a positive measure and say they would not want to go back! Finally, whether through media campaigns or efforts on the ground, raising awareness remains a powerful way to denormalize tobacco use, especially among young people. 
• Reducing risk: reducing risk is a fundamental component of the global fight against tobacco. It notably encompasses tobacco harm reduction programs and programs to limit or stop smoking. Of course, it also includes personalized health monitoring. Britain’s National Institute for Health & Care Excellence (NICE) offers several detailed guidelines aimed at health professionals. We can only hope that these efforts will catch on and become the standard in other countries…

Other countries like Sweden and Australia are also pointing the way forward by enacting proactive policies identical to those in place in Great Britain. Their efforts have achieved equally encouraging results, made possible by activating all three levers mentioned above. More countries should follow their lead.

It is time to accelerate the movement

In 1962, the Royal College of Physicians, a leading institution on this topic, recommended 10 key measures to fight against tobacco use:  

• More education of the public concerning the hazards of smoking
• Prohibit the sale of tobacco to minors
• Restrict tobacco advertising
• Tax tobacco sales
• Carry out scientific research on cigarette smoking
• Open anti-smoking clinics
• Develop nicotine substitutes (nicotine injections)
• Encourage smokers who cough to quit smoking
• Urge doctors to avoid smoking in front of patients 

It took 30 years – and the discovery of second-hand smoke, which kills nearly 900,000 people every year! – for most of these measures to be put in place. It takes time for policies to enact change… Often, too much time: especially when it comes to smoking.

But today, we can rest assured that we are now on the right path. We have identified and defined the proper levers. They are within our reach and have already yielded results. Now it is time to implement these levers everywhere, simultaneously and in the strongest possible way.