World Medical Association, Statement on the Health Hazards of Tobacco Products (1997)

Adopted by the 40th World Medical Assembly
Vienna, Austria, September 1988
and
amended by the 49th WMA General Assembly
Hamburg, Germany, November 1997



PREAMBLE
1. Three million deaths occur worldwide each year due to tobacco use. Unless the current smoking trends are reversed the number of deaths due to the use of tobacco is expected to rise to 10 million by the 2020's or early 2030's, and 70 per cent of these will occur in developing countries. The global public health community, through the World Health Organization, has expressed increasing concern about this alarming trend. Furthermore, irritating and harmful substances from smoking tobacco may impose a health burden on non-smokers who are in proximity to smokers
2. The tobacco industry claims that it is committed to determining the scientific truth about the health effects of tobacco, both by conducting internal research and by funding external research through jointly funded industry programmes. However, the industry has consistently withheld and denied information concerning the deleterious effects of tobacco smoking. For many years the industry has claimed that there is no conclusive proof that smoking tobacco causes diseases such as cancer and heart disease. It also claims that nicotine is not addictive. These claims have been repeatedly challenged by the global medical profession, which because of this is also resolutely opposed to the massive advertising campaigns mounted by the industry and believes strongly that the medical associations themselves must give a firm lead in the campaign against tobacco.
3. The tobacco industry and its subsidiaries have for many years supported research and the preparation of reports. By being involved in such activities, individual researchers and/or their organizations give the tobacco industry an appearance of credibility even in cases where the industry is not able to use the results directly in its marketing. Such involvement also raises major conflicts of interest with the goals of health promotion.

RECOMMENDATIONS
4. If they have not taken appropriate action already, the WMA urges the National Medical Associations and all physicians to take the following actions to help reduce the health hazards related to smoking and to other use of tobacco products:
i) Adopt a policy position opposing smoking and the use of tobacco products, and publicize the policy so adopted.
ii) Prohibit smoking at all business, social, and ceremonial meetings of the National Medical Association, in line with the decision of the World Medical Association to impose a similar ban at all its own such meetings.
iii) Develop, support and participate in programs to educate the profession and the public as to the health hazards of tobacco products. Educational programs directed specifically at children and young adults to avoid the use of tobacco products are particularly important. Programs for non-smokers and non-users of smokeless tobacco products aimed at avoidance are as necessary as education aimed at convincing smokers to cease the use of tobacco products.
iv) Encourage individual physicians to be role models (by not using tobacco products) and spokesmen for the campaign to educate the public about the deleterious effects on health resulting from the use of tobacco products. Ask all hospitals and health facilities to prohibit smoking on their premises.
v) Refrain from accepting any funding from the tobacco industry, and to urge medical schools, research institutions and individual researchers to do the same, in order to avoid giving any credibility to that industry.
vi) Advocate the enactment and enforcement of laws that:
a) require warning about health hazards to be printed on all packages in which tobacco products are sold and in all advertising and promotional materials for tobacco products.
b) limit smoking in public buildings, commercial airlines, schools, hospitals, clinics and other health facilities.
c) impose limitations on advertising and sales promotion of tobacco products.
d) ban all advertising and sales promotion of tobacco products, except at the point of sale.
e) prohibit the sales of cigarettes and other tobacco products to children and adolescents.
f) prohibit smoking on all commercial airline flights within national borders and on all international commercial airline flights, and prohibit the sale of tax free tobacco products at airports.
g) prohibit all governments subsidies for tobacco and tobacco products.
h) provide for research into the prevalence of use of tobacco products and the effect of tobacco products on the health status of the population, and develop educational programs for the public about the health hazards of tobacco use.
i) prohibit the promotion, distribution and sale of any new forms of tobacco products that are not currently available.
j) increase taxation of tobacco products, using the increase revenues for health care measures.