In the War Against Smoking, America Is on the Wrong Side

As people in the developing world stop dying of diseases of the poor, such as diarrhea, influenza, malaria, and measles, they have started dying of diseases of the rich instead. Obesity is climbing the rankings as a killer, but it has some way to catch up to global public-health enemy No. 1: tobacco. The only consumer product that kills if used as directed is a leading risk factor for every major noncommunicable disease: cancer, diabetes, respiratory illnesses, and cardiovascular conditions. And while smoking has declined in the U.S. and Europe, it’s on the rise in the developing world. Roughly a third of the world’s adult population smokes, and every year more than five million people die from it—more than from AIDS, tuberculosis, and malaria combined. Which is why it may surprise you that international trade deals are adding to the global tobacco death toll, with the full knowledge and support of the U.S. government.

When was the last time you looked up from a U.S. highway to see a cartoon camel in sunglasses puffing away on a cigarette? If you’re having a hard time remembering, there’s a reason: It has been 15 years since RJR Reynolds’ cigarette mascot was retired, after the Federal Trade Commission sought an order barring anthropomorphic-dromedary-based tobacco advertising. Tough regulations on cigarette marketing, along with rising cigarette taxes and public health campaigns, cut adult smoking rates in the U.S. by more than 50 percent from 1965 to 2008.