In 2000, while at a meeting of the WHO Framework Convention on Tobacco Control’s (WHO FCTC) Intergovernmental Negotiating Body, founding authors Michael Eriksen and Judith Mackay discussed the need for a global atlas on tobacco. Having recently authored two health atlases, Mackay thought it was an intriguing notion, but was concerned there might not be enough data for a true global atlas. After years of working in tobacco control at the US Centers for Disease Control and Prevention and the World Health Organization (WHO), Eriksen was confident that the data existed and that the real need was for the data to be assembled in one accessible place, presented in a colorful, graphic and readable format, and disseminated widely. In 2002, WHO published the first edition of The Tobacco Atlas.
In the subsequent 13 years, much has changed in global tobacco control, and yet much has remained the same. The WHO FCTC was unanimously approved by the World Health Assembly in 2003 and signed by 168 member states, covering 90% of the world’s population. WHO also developed MPOWER, providing evidence-based best practices. Countries have continued to adopt often paradigm-shifting policies such as prohibiting “light” cigarettes, implementing complete public smoking bans, and introducing plain/standardized tobacco product packaging. Philanthropists Michael Bloomberg and Bill and Melinda Gates have committed hundreds of millions of dollars to support global tobacco control, which among many efforts helped implement the Global Adult Tobacco Survey (GATS) in 2007 to serve as a complement to the existing Global Youth Tobacco Survey (GYTS). In the United States in 2006, the tobacco industry was found guilty of fraud and racketeering in one of the largest civil cases in history. In Europe, member countries have twice revised the wide-reaching Tobacco Products Directive.
What has remained the same is that the tobacco industry continues to thrive with revenues approaching USD 1,000,000,000,000 annually, with millions of deaths occurring each year among the one billion adult smokers who consume trillions of cigarettes annually. And today, after a century of harm, the tobacco industry is trying to re-invent itself by selling purportedly less harmful products, but in such a way as to maintain and expand nicotine addiction worldwide.
While progress is being made, the pace is too slow and too many lives continue to be lost. As we planned the fifth edition of The Tobacco Atlas, we were driven not only by our sense of urgency to continue to vigorously promote these proven tobacco control strategies, but also to broaden the base of tobacco control and expand the number of people who are willing to act.
We believe that by engaging a wide-ranging array of health, legal, economic, development, and environmental proponents and demonstrating how tobacco use affects their issues, we can amplify our impact. Documenting the impact of tobacco use and how it exacerbates mental health conditions, substance abuse, diabetes, tuberculosis, HIV, poverty, and environmental degradation can help enlist an increasing number of individuals and institutions, thereby expanding our collective spheres of influence.
Not only do we hope to enroll a larger and robust cadre of proponents concerned about tobacco control and urge them to action, we also hope to share best practices and lessons learned. Tobacco control lessons include the importance of strategies that affect populations—not just individuals—such as the powerful role of policies and litigation in disrupting the status quo. There may be strategies that work in development, climate change, environmental protection, or poverty reduction that could be extremely promising for tobacco control. How can we share approaches and best work together to collectively advance the human condition?
In the first edition of The Tobacco Atlas, we wrote:
“The publication of this atlas marks a critical time in the epidemic. We stand at a crossroads, with the future in our hands. We can choose to stand aside; or to take weak and ineffective measures; or to implement robust and enduring measures to protect the health and wealth of nations.”
Five editions later—with the wonderful earlier contributions of Omar Shafey (2nd and 3rd editions) and Hana Ross (3rd and 4th editions)—these words are as true today as they were then. The founding authors, together with new authors Neil Schluger, Farhad Islami, and Jeffrey Drope, the American Cancer Society and the World Lung Foundation are proud to present the fifth triennial edition of The Tobacco Atlas, along with the interactive www.tobaccoatlas.org website. We hope this endeavor will accelerate global efforts to reduce the harm caused by tobacco use and will engage new partners that will collectively advance global health.