As people in the developing world stop dying of diseases of the poor, such as diarrhea, influenza, malaria, and measles, they have started dying of diseases of the rich instead. Obesity is climbing the rankings as a killer, but it has some way to catch up to global public-health enemy No. 1: tobacco. The only consumer product that kills if used as directed is a leading risk factor for every major noncommunicable disease: cancer, diabetes, respiratory illnesses, and cardiovascular conditions. And while smoking has declined in the U.S. and Europe, it’s on the rise in the developing world. Roughly a third of the world’s adult population smokes, and every year more than five million people die from it—more than from AIDS, tuberculosis, and malaria combined. Which is why it may surprise you that international trade deals are adding to the global tobacco death toll, with the full knowledge and support of the U.S. government.
When was the last time you looked up from a U.S. highway to see a cartoon camel in sunglasses puffing away on a cigarette? If you’re having a hard time remembering, there’s a reason: It has been 15 years since RJR Reynolds’ cigarette mascot was retired, after the Federal Trade Commission sought an order barring anthropomorphic-dromedary-based tobacco advertising. Tough regulations on cigarette marketing, along with rising cigarette taxes and public health campaigns, cut adult smoking rates in the U.S. by more than 50 percent from 1965 to 2008.
In developing countries, however, cartoon characters (and the Marlboro Man) still promote cigarettes. And that’s just the start. Tobacco companies sponsored concerts in Indonesia by Alicia Keys, Maroon 5, and Kelly Clarkson before an international outcry and squirming worthy of Mick Jagger got the performers out of the deals; in the Alicia Keys case, the sponsor was an affiliate of Philip Morris. The promotions themselves were perfectly legal, and recent U.S. trade deals have positively encouraged them by putting barriers in the way of legislation designed to curb smoking.
Over the past 30 years, American trade negotiators have played an important role in prying open foreign markets for U.S. tobacco companies, which have used the same marketing tactics to addict a whole new generation of global smokers that worked so well back home. In the 1990s, Congress and the Clinton administration tried to curb this form of cigarette pushing by U.S. government agencies. Even so, in the past decade, nearly every U.S. trade and investment agreement has reduced tobacco tariffs and facilitated the establishment of U.S.-owned cigarette factories overseas, according to Thomas Bollyky of the Council on Foreign Relations. This might qualify as “leveling the playing field” between domestic and imported nicotine. But given that 90 percent of the world lives in countries with low retail tax rates on cigarettes and limited or no marketing restrictions on tobacco, it’s no surprise that these trade reforms have led to rapidly climbing smoking rates.
Multinational tobacco companies have used international trade and investment agreements to block even modest new steps toward regulation. Philip Morris has used the terms of investment treaties to fight new cigarette packaging laws in Uruguay and Australia, while British American Tobacco has provided legal assistance to countries that are using World Trade Organization provisions to challenge anti-smoking laws. The W.T.O., it turns out, is a remarkably hospitable venue for tobacco interests: even the U.S. ban on flavored cigarettes was declared in breach of World Trade Organization agreements.
The Obama administration has a chance to put the U.S. back on the right side of the war against smoking. The issue is back on the front burner thanks to negotiations on the Trans-Pacific Partnership—a nine-country trade deal involving the U.S., Australia, and nations in South America and Asia. Philip Morris has asked U.S. trade officials to use the talks to eliminate tobacco tariffs and block large health warnings on cigarettes.
The office of U.S. Trade Representative Ron Kirk is yet to respond. It should take this opportunity to promote a considerably more health-conscious agenda. Not least, it needs to push for explicit language allowing countries to use both legislation and regulation to deter tobacco use on public-health grounds. The U.S. should also call for an end to agricultural subsidies for tobacco in partner countries and the establishment of common standards on labeling and marketing. Doing so would give Trans-Pacific Partnership countries the same tools for combating nicotine addiction as the U.S. has—creating, in effect, a more level international playing field in anti-smoking efforts. That would make for a healthier planet—and allow Americans to feel better about themselves, as well.