Millions added to fight smoking

Bill Gates and New York Mayor Michael Bloomberg announced Wednesday that they will spend $500 million to stop people around the world from smoking.

The World Health Organization estimates that tobacco will kill up to a billion people in the 21st century, most of them in poor and middle-income countries. Bloomberg's foundation plans to commit $250 million over four years on top of $125 million he announced two years ago. The Bill and Melinda Gates Foundation is allocating $125 million over five years.

That far outstrips current spending of about $20 million a year on anti-smoking campaigns in poor and middle-income countries, according to a recent WHO report.

The $500 million would be spent on a multipronged campaign – nicknamed Mpower – that Bloomberg and Dr. Margaret Chan, director of the health organization, outlined in February. It coordinates efforts by the Bloomberg Initiative to Reduce Tobacco Use, the health organization, the World Lung Foundation, the Johns Hopkins Bloomberg School of Public Health, the Centers for Disease Control and Prevention Foundation, and the Campaign for Tobacco-Free Kids.

The campaign will urge governments to sharply raise tobacco taxes, outlaw smoking in public places, outlaw advertising to children and free giveaways of cigarettes, start anti-smoking advertising campaigns and offer their citizens nicotine patches or other help in quitting. Third World health officials, consumer groups, journalists, tax officers and others will be brought to the U.S. for workshops on topics like lobbying, public service advertising, catching cigarette smugglers and running telephone hot lines for smokers wanting to quit. A list of grants is at

The campaign will concentrate on five countries where most of the world's smokers live: China, India, Indonesia, Russia and Bangladesh.

Dr. Richard Peto, an Oxford epidemiologist who leads studies on the effects of smoking in the developing world, called the announcement “excellent news.”

Catherine Armstrong, a spokeswoman for British American Tobacco – one of the Western tobacco companies that focuses on sales to the Third World – would not comment directly on the new initiative.

But she said, “We have no problem with government organizations educating people on the risks of tobacco.”

Cigarettes are not only highly addictive and supported by huge advertising campaigns, they are also an important source of income for many foreign governments. In some countries, tobacco is a state-owned monopoly, and low- and middle-income countries collect $66 billion a year in tobacco taxes.

About 5 percent of countries in the world have any anti-smoking measures like those the campaign envisions.

But Peto said anti-smoking campaigns were having effects in some countries. He surveyed thousands of smokers in China in the 1990s – “before the government was taking it seriously,” he said – and found 4 percent who identified themselves as former smokers. In his more recent surveys, he said, there were 20 percent.

In India, where people have long chewed tobacco but widespread smoking is more recent, Peto said he found almost no one who had quit.