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World No Tobacco Day reminds us of the desolating effects of smoking on health

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In 2004 at Columbia University in New York, I worked with colleagues assessing the economic effects of heart disease in developing economies. I was invited to Washington, DC to address young economists from the International Monetary Fund (IMF) about tobacco as a contributor to vascular disease in sub-Saharan Africa and South America.

In DC, I was not among friends. Six young men in suits armed with data generated by mathematical models of intimidating complexity told me that tobacco was good for the [economic] health of evolving economies. It was easily grown; there was always a market; and governments loved it as a stable source of tax. Health consequences did not feature in their models — and so our meeting, though courteous, was brief.

Fast forward to Melbourne, August 2010, and the 63rd United Nations-auspiced international conference of non-government organisations (NGOs) working in developing economies on health and welfare. The theme was “Advance global health: achieve the millennium development goals”.

Despite the theme being like a slogan from the Chinese cultural revolution, the discussions were lively, open and constructive. Development was discussed from social, financial and political angles; but when tobacco was mentioned, quietness descended. Most representatives of the NGOs would say nothing bad about tobacco, because they had come to depend on tobacco companies’ largesse as governments,…