In response to my call for all parties interested in providing their views about the Framework Convention on Tobacco Control ( FCTC), WHO received over 500 written submissions which were immediately made accessible for public scrutiny on WHO’s website. Representatives of over 160 organisations are currently providing oral testimony in Geneva. They represent most major tobacco multinationals and state tobacco companies, as well as several tobacco farming groups along with a diverse range of public health agencies, women’s groups, community based organisations and academic institutions.

All groups with a commitment to public health expressed extreme concern about the impact of tobacco use on the current and future health of populations, especially in developing countries. They urge rapid and decisive action. In contrast, most tobacco companies concentrated on what they believe to be the boundaries of 'reasonable' and 'appropriate' actions. Some questioned the role of WHO and the FCTC process in promoting action and making progress to reduce the public health impact of tobacco. Further, several tobacco companies continued to deny that passive smoking constitutes a threat to health.

In general, the tobacco companies have indicated support for policies and measures that are known to have a very limited impact on youth and adult consumption of tobacco. They appear to be against the interventions that WHO, the World Bank and public health experts have identified as having a measurable and sustained impact on tobacco use.

These are a combination of

• increased excise taxes,
• bans on tobacco advertising, sponsorship and marketing,
• controls on smoking in public places,
• expanded access to effective means of quitting,
• tough counter-advertising and
• tight controls on smuggling.

I hope that Member States will focus on these interventions as they deliberate about the measures to be included both in the FCTC and in their national laws and policies.

In much of their testimony, companies that are part of the tobacco industry focus on political, financial and human rights issues. They re-state well known predictions that international action to reduce tobacco use will lead to sudden and massive job losses, people driven further into poverty and threats to the sovereignty of nations. As we heard from other groups, these predictions do lead to genuine concern among decision makers: however, careful research has also shown that in most cases the predictions have no evidence base. It thus seems likely that the companies are trying to confuse the negotiating process that will be taken forward by delegates from WHO’s 191 Member States. They seek to do this just before the FCTC Intergovernmental Negotiating Body which starts Monday the 16^th of October.

A diverse group of organisations from developing countries provided different views of the impact of tobacco on farmers in rural communities. Some groups described the fears of tobacco farmers about the certainty of their future livelihood. While these fears are understandable, there is no evidence to suggest that they are justified.

However there is a need for careful study of the way in which long-term reductions in tobacco demand impacts on the supply of tobacco products in the long term. This would help with the identification of communities and countries that may have legitimate concerns about their vulnerability. It would indicate the options that exist to minimise potential hardship over the next few decades. Such work is underway - and being carried out in collaboration between FAO, the World Bank, US Department of Agriculture, Canada’s IDRC, Sweden’s SIDA and WHO.

During the hearings several tobacco companies have indicated that they are shifting their marketing policies - towards a "middle ground". Some spoke of wanting a "reasonable dialogue", and desiring to work towards "practical and realistic solutions". WHO takes the view that Governments must be cautious about what this means in practice. There is one underlying reality which we must all keep in mind - tobacco remains the only legal consumer product that kills half of its regular users.

WHO supports comprehensive effective policy measures to tackle all four approaches. Action on the first three ways has already led to health gains in many countries. Product modification and efforts to develop what tobacco companies call "less harmful" products may take some time to have an impact, and - as is publicly acknowledged by major tobacco companies - there is still no safe cigarette.

Despite our concerns about these clear differences in position, we are committed to hearing how the tobacco companies do propose to reduce the harm that their products cause. Our Scientific Advisory Committee is charged with proposing appropriate national and international tobacco product regulatory frameworks. We have invited tobacco company scientists to provide their views on product modification to this Committee later today.