 |
 |
 |     |
 |
Question 2. As we move forward, what kinds of groups outside the government will we need to help us move the decision makers to create the laws and programs we want? |
 |
|
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
The organized professional and citizen groups vital to a country's tobacco control movement will probably differ from country to country, as we have seen. Yet all countries have certain groups in common whose help you will need to build a powerful and effective national movement. Some of these groups will bring public attention and the voice of authority to tobacco control efforts. Some will bring organized and influential constituencies. Others will contribute organizing skills, as well as human and financial resources. Yet others will bring passion to your advocacy work. Among these potentially important groups for a strong national tobacco control movement are:
Health Scientists and their Professional Societies Economists and their Professional Societies Lawyers Voluntary Health Associations Organized Groups of Tobacco Victims Youth Advocates Advocates for Young People Women's Advocacy Groups Consumer Advocacy Organizations Religious Groups and Leaders Groups That Work to Control Alcohol and Illicit Drugs Political Leaders and Parties Environment Advocates Labor Unions Groups Concerned about Globalization Human Rights Organizations Groups That Work for the Rights of Indigenous Peoples Business Leaders Pharmaceutical Companies that Sell Smoking Cessation Products Health Insurance and Life Insurance Companies Other Groups with Funding Potential This is a long list of potential allies. No tobacco control leaders in any country will have the time, energy, or resources to reach out to all of them. In your strategy-planning process, once you have identified your top policy objectives, you can go through this list and ask these questions:
After this analysis, you need to prioritize the importance to your strategy plan of each group you have chosen. This process can help you decide how much of your organizing group's time and resources to dedicate to building each partnership. Remember, your goal is not to build the longest possible list of supportive organizations. Rather, you want the active, effective support only of organizations that will help you achieve your policy objectives. And as your campaign gathers momentum, many groups may elect to join you. To help you decide where to concentrate your alliance-building efforts, we discuss the important roles each group has played in tobacco control advocacy campaigns. You can see, then, what each might contribute to yours. Doctors and Medical Societies
Most societies trust the authority of doctors on health matters. Around the world, concerned physicians have been among the earliest and most eloquent voices for action when the public's health is at risk Leaders of doctor's professional organizations or of medical institutions, such as hospitals and medical schools, speak with institutional authority. This is one reason their involvement in your movement is crucial. For example, a handful of members of the Royal College of Physicians in London were responsible for the groundbreaking report in 1962 that concluded smoking caused cancer. The same group of doctors later persuaded the Royal College to found and provide early financial support to the smoking-control advocacy group known as ASH (Action on Smoking and Health).
Health Scientists and Their Professional SocietiesScientists generally bring authority to scientific issues in their field of expertise. For example, an epidemiologist can provide data on tobacco's mortality toll. Health-policy research scientists can testify about the proven health benefits of such policies as cigarette-tax increases and advertising bans. Economists can cite economic science that challenges the economic myths constantly promoted by the tobacco industry's pseudo-scientists. In many societies, prize-winning scientists hold even higher status than do scientists in general. Their achievement often gives them ready access to the media, as well as to government leaders. In 1963, a group of twenty-five prominent Swedish scientists, including three Nobel Prize winners, successfully petitioned the Swedish government to institute one of the earliest national education programs on the hazards of smoking. Economists and Their Professional SocietiesThere is probably no scientific discipline that is more important to tobacco control than the field of economic science. In countries newly open to free markets, the tobacco industry hires economists to argue that tobacco control laws violate free-market principles. They convince key audiences—such as commerce and finance ministers—that such regulations are leftovers from discredited communist regimes. But these tobacco-industry economists lose their audience when respected liberal economists and economic institutions, such as the World Bank, officially report that tobacco control laws strengthen national economies and have a net benefit to almost every nation. If you are fortunate, you may find a scientist who is also a committed tobacco control advocate. One such individual is India's Prakash Gupta, a distinguished epidemiologist. Another is Kenneth Warner, an equally notable US health economist. Both scientists have become skilled in advocacy without compromising their scientific standards. Among their other priceless skills, both scientist-advocates present their findings in simple, powerful language nonscientists respond to. LawyersPhilip Karugaba, a public interest attorney with the Environmental Action Network in Uganda, has been working to pass public health legislation and to build a case against several tobacco companies, including British American Tobacco. He found help from the Environmental Law Worldwide Alliance in both of these efforts, and he speaks highly of his allies:
Lawyers and lawyers' groups can contribute in very different ways to your objectives:
Lawyers in some legal systems play a different supportive role: They bring lawsuits against tobacco companies. Even when these lawsuits do not succeed, they are powerful in generating media attention and greater public awareness of the corrupt activities of the tobacco companies. Drafting tobacco control laws requires special skill and more attention to detail than does writing most other health laws. Lawyers not expert in tobacco control law may not spot loopholes that the industry will exploit.
Voluntary Health AssociationsIn many wealther countries, voluntary associations that focus on cancer and on heart and lung disease have been among the earliest initiators and most consistent supporters of tobacco control. These groups can combine the voices of doctors with the voices of patients and their families, the victims of tobacco-related disease. They can often attract as volunteers people who are close to key government decision makers, including their spouses and family doctors. These associations also can organize and provide the skilled services of trained professional advocates, as well as volunteers. And they can raise funds to support tobacco control advocacy—and teach others to become successful fund-raisers. As voluntary health associations take root in developing countries, they are increasingly seen as pioneers of tobacco control advocacy. The American Cancer Society (ACS), through its International American Cancer Society University, and the ACS/UICC International Tobacco Control Leadership Fellows Program have trained cancer society leaders around the world. These leaders have the skills to develop financially strong societies and to encourage and implement tobacco control advocacy efforts. The ACS has also provided grants for the development of national tobacco control coalitions in India, Romania, Hungary, Honduras, and others.
Tobacco's VictimsIn Sri Lanka, the Health Promotion Foundation has organized an advocacy group restricted to the victims of tobacco-caused disease and their family members. This group successfully carries to communities the message of tobacco's harmful effects. It has also joined in the efforts of advocates who seek to strengthen tobacco control policy. Around the world, prominent citizens have become avid tobacco control advocates after a traumatic brush with tobacco-related disease. The organizations with which these individuals are connected often become powerful tobacco control advocacy groups. For example, the founder of the Bombay Salaam Foundation developed cancer through tobacco use. This foundation is now a strong member of the Indian Action Forum on Tobacco Control. It provides funding and skilled media-advocacy support for the ICTC's advocacy campaigns. Almost every country can take pride in individual citizens—some of whom are highly influential—whose personal confrontation with the ravages of tobacco has made them powerful tobacco control advocates. In the United States, probably the most well known and effective of these individuals was Victor Crawford. Crawford had been a corrupt tobacco industry lobbyist, he admitted—until he contracted fatal throat cancer. He spent the last three years of his life describing to the public the lies and deceptions he and other tobacco lobbyists had long practiced. His powerful testimony about his experiences with the tobacco industry was widely publicized. Searching for allies may lead you to unexpected places. The number of individuals who suffer from tobacco-related diseases is steadily rising, and you will find more and more groups that have formed to offer support to these victims and their families.
Youth Advocates
Around the world, youth advocates for tobacco control are eager to make themselves heard. Many youth coalitions are organized and funded by public health groups, such as the American Lung Association and Teens Against Tobacco Use (T.A.T.U.). The Campaign for Tobacco-Free Kids in the United States sponsors the Youth Advocates of the Year Award, a nationwide competition. The award honors the outstanding work of young advocates who have taken the lead in holding the tobacco industry accountable for its efforts to market tobacco to youth. Young activists in the United States are fighting to protect their peers, their communities, and the nation from tobacco addiction and tobacco-caused disease. They initiate public education efforts, student-to-student training, and outreach to policy makers. Many lobby their town councils and state legislatures for laws to limit kids' access to tobacco products. Others develop innovative programs to teach young children about the dangers of tobacco use, and work to protect youth from exposure to secondhand smoke. Medical student leaders in developing countries such as Slovenia and Romania have been among the early organizers for tobacco control advocacy. There is enormous potential to recruit young tobacco control activists. They recognize that they are targets of the tobacco industry. They know that tobacco-advertising tactics are manipulative. They understand the health risks of tobacco use. And they are often the best messengers to educate their peers and to advocate for local, regional, or even national policy change.
Advocates For Young PeoplePerhaps the single most effective US tobacco control advocacy group is dedicated to preventing tobacco use by children and youth: the Campaign for Tobacco-Free Kids (CTFK). Indifferent legislators and even legislators opposed to tobacco control measures are often moved by messages about the health and addiction risks to young people—especially when we force them to consider that nine- or ten-year-olds are smoking. CTFK advocates for the full range of tobacco control policies, but its appeals on behalf of children succeed with many lawmakers not persuaded by information about the negative effects of tobacco use on adults. CTFK fights tobacco use among youth in many ways. It provides support, information, and materials to organizations dedicated to keeping kids tobacco free. And it seeks to stop the tobacco industry from targeting and eventually addicting kids. The Campaign works to help expose the industry's deceptions and manipulation—and to help pass laws that protect kids and reduce the death and disease caused by tobacco. Children's advocacy groups and others concerned about the full range of children's issues, such as parent-teacher associations, can be powerful allies to tobacco control activists. They are often the most aware of the dangers children face—particularly factors that influence children too young to make mature decisions. For instance, they understand we must protect children from advertising that seduces them into using tobacco. And we must protect children against smoking allowed in public places, which directly harms them and makes smoking a symbol of adulthood.
Women's Advocacy GroupsIn countries where tobacco control is still in its developing stages—particularly in Asia— women's advocates confront twin outrages. First, the transnational tobacco companies saw an opportunity to build a new market when they realized that smoking rates among women were close to zero. They then targeted marketing campaigns at young women in countries such as Japan. These advertisements portrayed smoking by women as a way to imitate admired US girls—at the same time that smoking was declining among US women. Many countries have fought historic battles over the attitudes and engagement of women's advocacy groups in tobacco control. In Nigeria, for example, a national commission on the liberation of women listed the freedom of women to smoke as one of their goals of liberation. A dissenting member asked, "How can a form of enslavement be a symbol of freedom?" The transnational tobacco companies have exploited smoking as a form of female liberation in their advertising and marketing—and in their strategic philanthropy. For many years, Philip Morris has been a generous supporter of women's advocacy groups. But the idea that Philip Morris was a positive force for women began to change in the 1980s and 1990s. Death rates from tobacco reflected an increase in smoking among women—and tobacco control advocates made women's groups aware of the tobacco companies' history of marketing their products specifically to women. By the late 1990s, women's advocacy groups in the United States began to refuse any more funding from the tobacco companies, and joined tobacco control coalitions.
Consumer Advocacy OrganizationsThe tobacco business is an all-time consumer fraud. The industry has violated practically every basic consumer right—the right to a safe product, the right to information, the right to compensation when injured, and the right to clean air. Tobacco is the only industry that kills half its customers prematurely. So all consumer organizations must make tobacco control an important activity. Most countries have consumer organizations with the basic infrastructure, regular consumer activities, and campaign skills to include tobacco on their agendas. Their activities should include tracking the tobacco business, advocating with the media, lobbying government for stricter legislation, making surveys, and publishing reports. The Consumers Association of Penang in Malaysia (CAP) has been fighting tobacco for many years. The group campaigns at a local, national, and international level. Its activities include regularly monitoring the tobacco companies that operate in Malaysia and exposing their latest tactics—CAP issues statements and keeps the debate alive in the media. For example, CAP took on British American Tobacco (BAT). BAT's sponsorship of the telecast of the 2002 FIFA (Fédéracion Internationale de Football Association) World Cup to Malaysians violated FIFA's smoke-free policies. CAP's activity was intensified and had a much bigger impact when the international community—particularly ASH UK—tackled BAT in the United Kingdom. CAP used this opportunity to lobby the Malaysian authorities to ban indirect tobacco advertising and sponsorship once and for all. CAP also conducts public anti-tobacco exhibitions and training workshops in schools and villages. The group's monthly consumer magazine caters to the general public. It serves as an important lobbying and educational tool by carrying stories the regular press won't publish. Topics include tactics of the tobacco companies, progress in tobacco control elsewhere in the world, and representing the consumer voice. When consumer organizations unite at the international level, consumers grow stronger and tobacco companies worry. For example, 250 consumer organizations in 115 countries today belong to Consumers International (CI). (The group was formerly known as the International Organization of Consumers Unions.) In the past the fearful tobacco industry closely monitored CI's anti-tobacco campaign, as internal tobacco-company documents reveal.
Religious Groups and Leaders
Drawing religious groups and leaders into tobacco control advocacy is one of the more sensitive topics you must consider as you seek to build an all-inclusive alliance. Tobacco control leaders are sometimes uncomfortable about the participation and support of religious leaders and their groups. These advocates may be sensitive to the tobacco industry's persistent efforts to dismiss smoking-control-policy initiatives as the result of a repressive, temperance morality—rather than a desire based squarely on health science for judicious controls on tobacco-company promotion and public smoking. Yet religious groups and leaders have made significant contributions to tobacco control advocacy around the world. In the Sudan, powerful coalitions among Muslim religious leaders, political leaders, and physicians encouraged strong national legislation. Another example is the Seventh-Day Adventists, who place tobacco control among their highest public policy priorities. They have made major contributions of funds and human resources to support national tobacco control legislation—from South Africa to the Pacific Islands. And they are known for their commitment to smoking-control education in developing countries. The desirability of cultivating close associations with religious leaders varies greatly from country to country—even between neighboring countries. Supportive political leaders urged Sri Lankan advocates to reach out enthusiastically to religious groups and their leaders—this encouragement indicates the influence of religious groups in Sri Lanka. In neighboring India, advocates looked at their countries religious conflict and strong tradition of secularism in politics; they decided it would be risky to attempt to create alliances with religious groups.
Tobacco control advocates in countries with broad-based, established smoking-control movements usually need not fear joining forces with religious groups. New Zealand health groups have effectively cooperated with conservative church groups to support laws that restrict the sale of cigarettes to minors. In Hong Kong, tobacco control leaders were concerned that their efforts were mostly initiated by the government. They welcomed the collaboration of Seventh-Day Adventists to promote a national non-smoking day. Tobacco control leaders have often found that church leaders are careful to avoid looking like heavy-handed moralists. In Northern Ireland, a Presbyterian Church leader spread an aggressive smoking-control message through his churches; another church leader chose not to, for fear his parishioners would react negatively. Groups That Work to Control Alcohol and Illicit DrugsTobacco control advocates and groups that work to control alcohol and other addictive drugs face common problems. They share a concern over the physical and social costs of addiction. They also fight many of the same aggressive youth-oriented advertising and marketing strategies. But tobacco control advocates have often had uneasy relations with advocates of drug and alcohol control. Sometimes they have competed for public attention. Yet in some developing countries, such as Ukraine and Sri Lanka, NGOs dedicated to both tobacco and alcohol control have led tobacco control efforts. The social and political culture of your country will help determine whether you will find it useful and effective to build close or loose alliances between tobacco control advocacy and advocacy for the control of other drugs. But in every country, advocates for the control of any addictive drug need to collaborate and support each other, rather than compete negatively with one another.
Environmental AdvocatesEnvironmental groups may be valuable allies in your tobacco control efforts. In many countries, these groups have been leaders in public interest advocacy—they know how "system" works. Often they can offer tobacco control groups valuable media contacts. They can share intimate knowledge of the legislative process and point out ways to force your issue onto the official agenda. In the last few years, a number of environmental groups in Africa have taken up tobacco issues. Partly they are concerned about tobacco-related deforestation from curing. But they also recognize that large corporations—usually foreign owned—often determine the environmental health (or poverty) of their countries. If your country is a tobacco producer, you may also want to connect with groups that address farm-worker safety. Tobacco farmers are exposed to toxic chemicals; they are at greater risk of Green Tobacco Sickness, caused when their skin absorbs nicotine as they handle tobacco leaves.
Labor UnionsLabor unions have mixed attitudes about regulating workplace smoking. They are often torn between their smoking and non-smoking members. Unions also generally resist any controls over the behavior of workers. However, unions have joined tobacco control advocacy efforts to provide "equal protection" for workers under a particular set of circumstances: when laws protect some workers from secondhand smoke, such as transportation workers, but not other workers, such as restaurant and bar workers. Tobacco control advocates also need to be aware of union members' interests and concerns. In South Africa, the Food and Allied Workers Union represents workers employed in tobacco manufacturing. It joined two other unions affiliated to the Congress of South African Trade Unions (COSATU) to oppose tobacco legislation. The three unions threatened rolling mass action—including a march on Parliament and demonstrations throughout the country—if the government did not withdraw the tobacco bill. Health advocates met with COSATU and explained that mechanization and improved technology were a bigger threat to tobacco workers' jobs than tobacco control laws. The mass action did not materialize, and COSATU itself did not oppose the tobacco bill. In another example, advocates knew that many teachers in India's urban schools used Gutka, a form of pouch tobacco. They concluded that the teachers' union was not open to tobacco control advocacy.
Groups Concerned about GlobalizationTobacco control advocates and organizations recently have spent enormous time and energy working to end the domination of international trade regulation by transnational corporations. Marketing abuse by tobacco companies offers an extreme case of this power. Their example is useful for educating the public about the destructive health and economic effects of unrestrained global manufacturing and marketing practices. Tobacco control advocates with medical or health-science backgrounds have been somewhat slow to recognize their common ground with environmental, consumer, and other advocates for greater public control over globalization. However, social justice NGO advocacy groups, such as Public Citizen and INFACT, have become forceful advocates for tobacco control. The NGO Framework Convention Alliance (FCA) brought together a range of such advocates from around the world to work for a strong WHO Framework Convention on Tobacco Control (FCTC). Although the negotiation sessions for the FCTC have ended, the FCA continues to work to build broad alliances to support national tobacco control advocacy.
Human Rights Organizations
Groups Who Work for the Rights of Indigenous Peoples
An Indigenous Peoples network in tobacco control is developing that includes groups from New Zealand, Canada, Australia, and the United States. Business Leaders
Business leaders are often undecided about tobacco control efforts. Their first instinct is to support any business targeted by advocacy efforts that would subject it to government regulation. Tobacco companies have vast, interlocking relationships with other businesses: through common ownership, membership in business organizations, and as suppliers to and customers of other companies. Yet when advocates in developing countries reach out to business groups—especially local groups—surprising things happen. Several local Chambers of Commerce have actively supported tobacco control efforts. In Jaipur India, Rajasthan Cancer Foundation leader Rakesh Gupta successfully recruited the local automobile dealers' association to the local tobacco control coalition. Business associations that fight tobacco control regulation, such as restaurant owners who oppose smoke-free restaurants, may change their position when they are subject to incomplete l regulation. When New York State made only urban restaurants smoke-free, restaurant owners in New York City began to advocate for smoke-free-restaurant laws throughout the state. The restaurant owners became activists because they did not want to lose customers to unregulated restaurants in nearby areas. Even if you cannot persuade business groups to become active in tobacco control efforts, it is important to try to convince them not to support tobacco companies. Sri Lankan tobacco control advocates managed to convince local business leaders to remain neutral. Tobacco companies found this out when a prominent group of business leaders refused to support them in opposing a national ban on tobacco advertising. Pharmaceutical Companies That Sell Smoking Cessation ProductsNew Zealand's Maori Smokefree Coalition has found alliances with drug companies extremely useful. The organization's leader, Shane Bradbrook, said the group has worked with "GlaxoSmithKline and Pharmacia because we've got a lot of cessation services running." The group is "building that relationship up because . . . we need cheap access [to smoking-cessation products], because our indigenous community can't afford it." Pharmaceutical companies have provided important funding for broad tobacco control activities, including sponsoring conferences and workshops. They may have helpful influence with government policymakers, and educate health care providers and smokers on the health hazards of tobacco use. Advocates must keep in mind that the primary objective of these companies is to market their nicotine-replacement therapies. But towards that objective, they too want to increase public awareness of the hazards of tobacco use. They also support public policies that encourage smokers to cease using tobacco, such as smoke-free public places and workplaces. Tobacco control advocates have found that when these companies promote cessation products to medical professionals, they engage doctors in tobacco control. Some of these physicians have become active in tobacco control advocacy. Some tobacco control advocates are uncomfortable as allies of large transnational pharmaceutical corporations. They have concerns about these companies' role in corporate dominance, especially pricing policies for essential drugs in poor countries. Advocates also worry that these companies may distort the agenda of tobacco control conferences they sponsor, and shift the focus from policy advocacy to their cessation services. But some strong advocates accept pharmaceutical support as essential to building tobacco control movements in developing countries; these advocates still maintain independent control of their agenda. Of course, the companies want attention paid to their products. But they also recognize that the stronger a country's tobacco control movement, and the more comprehensive its regulation, the greater the potential market for their products.
Health Insurance and Life Insurance CompaniesYou might expect insurance companies to support tobacco control activities. Such efforts reduce the prevalence of tobacco use, thereby reducing health-care costs and extending the lives of policyholders. Some companies do offer lower insurance rates to non-smokers. But insurance companies have generally not been interested in funding or otherwise supporting tobacco control advocacy. They fear reprisal from tobacco companies and their allies, who are also customers for insurance business. A few health-care insurers cover preventative medicine—such as smoking-cessation aids. And a few are involved in tobacco control activities. For example, in the United States, the Integrated Healthcare Association is an executive member of the steering committee for Next Generation, a California Tobacco Control Alliance. Other Potential Sources of Funding for Tobacco Control
Funding for Government Health AgenciesHealth departments sometimes support nongovernmental tobacco control activities, especially in developing countries. The funds usually come from international funding from WHO and other aid programs, such as those from the European Union and the U.S. Centers for Disease Control and Prevention. Such funding can be vital to the very existence of NGO tobacco control activities in developing countries. But NGOs that rely on such funding can grow reluctant to challenge the government publicly—even when such challenges will advance their advocacy agenda. "Do not bite the hand that feeds you" is unfortunately a universal constraint. Nonetheless, some NGOs do succeed both in accepting government support, and in speaking out against government action or inaction when appropriate. Funding for Nongovernmental OrganizationsTobacco control NGOs need some independent funding to ensure their freedom to challenge the government. Some robust aid programs have directly funded NGO activity without constraints, such as those from Canada, Norway, and Sweden.
Funding from Philanthropic SourcesA few private philanthropies have funded vigorous NGO advocacy—most prominently the Open Society Institute for the countries of the former Soviet Union, and the Rockefeller Foundation in South Asia (though not currently).
Funding from the Tobacco IndustryWorldwide, the tobacco industry—and particularly Philip Morris—supports a public relations campaign to change its public image. The industry funds programs it claims are designed to prevent youth smoking. But, as the Campaign for Tobacco-free Kids declared: "The evidence is clear that, while Philip Morris and the other tobacco companies try to portray themselves as part of the solution to youth tobacco use, they remain the main cause of the problem." That is why, as tempting as the companies' offers of funding may seem, every experienced tobacco control organization in the world has learned to reject such funding. In its series of special reports, Behind the Smokescreen, the CTFK describes some tobacco-industry attempts to buy respectability and rebuild its corporate image through yet another deceptive marketing campaign: http://www.tobaccofreekids.org/reports/smokescreen/ |
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Copyright Information | Contact Us
