January 20, 2011; Source: Foreign Policy | Smoking-control efforts in developing countries are stalling in the face of fierce industry opposition, according to the journal Foreign Policy.

One of the signal accomplishments of the nonprofit sector working with state and federal authorities was the Tobacco Master Settlement. The first Master Settlement Agreement (MSA) was between the attorneys general of 46 states and four major tobacco companies (Philip Morris, R.J. Reynolds, Brown & Williamson, and Lorilllard), dropping the states' Medicaid lawsuits (for the recovery of tobacco-related health costs) and exempting the tobacco companies from tort liability in return for the companies' promises to cease certain marketing practices, fund the American Legacy Foundation for anti-smoking advocacy, and pay money in perpetuity for the states' costs of treating people with smoking-related illnesses (an estimated $206 billion during the first quarter century of the MSA).

Some nonprofits have since criticized the Tobacco MSA as having left the tobacco companies even more powerful than before, but there is no doubt that tobacco use in the U.S. is at all-time lows (only 19 percent of adults smoke, compared to over 40 percent in 1965). How is it then that nonprofit and governmental education and advocacy has gotten the tobacco companies to reduce their egregious behavior domestically, but the U.S. is turning a blind eye (if not tacitly supporting) the tobacco companies' promotion of increased smoking in developing nations?

The companies have accepted restrictions on their marketing and labeling, but have vigorously fought efforts (promoted by the World Health Organization) overseas. The U.S. so far has refused to sign the WHO Framework Convention on Tobacco Control aimed at reducing tobacco supply and demand worldwide and does not require the application of marketing labeling restrictions in the U.S. on cigarettes designated for sale overseas.

The companies have succeeded in increasing tobacco use in Asia and are now aiming at Africa, which has historically not been a place of heavy tobacco use. President Obama has said that global health issues cannot be ignored. Then why ignore the companies' doing to Asia and Africa what we have prohibited them from doing here in the U.S.?

Nonprofits such as the Campaign for Tobacco-Free Kids have taken their domestic U.S. message overseas, but the money that the companies are putting into marketing in developing countries dwarfs what the WHO and others devote to anti-tobacco efforts. In an era of globalization, protecting the health of adults and children shouldn't stop at the nation's borders.—Rick Cohen