Tobacco Free Initiative (TFI)

Bellagio Statement

A group of 22 international organizations and individuals met at the Rockefeller Foundation`s Bellagio Study and Conference Centre in Italy, June 26th - 30th, 1995, to examine the implications of current global trends in tobacco production and consumption, especially in developing countries, for sustainable development. In the course of presentations and discussions on tobacco use and control, and situation analyses from Africa, Asia, and Latin America, the following were noted:

  • world-wide, there are only two major underlying causes of premature death that are increasing substantially - HIV and tobacco;
  • each year, three million of the 30 million adult deaths in the world are attributable to tobacco. On current smoking patterns, by about 2025, this annual number will rise to 10 million deaths, of which seven million will then be in developing countries;
  • of today's children and teenagers, about 200 million will, on current smoking patterns, eventually be killed by tobacco use. The addiction usually starts before adult life;
  • each additional 1 000 tonnes of tobacco production will eventually result in about 1 000 deaths;
  • the net economic costs of tobacco are profoundly negative - costs of treatment, mortality and disability exceed estimates of the economic benefits to producers and consumers by at least 200 billion US dollars annually, with one third of this loss being incurred by developing countries;
  • there are about 800 million smokers presently in developing countries, and the number is still increasing. It is estimated that half of the men and almost 10 percent of the women in developing countries smoke;
  • smoking during pregnancy substantially reduced birth weight, and low birth weight is strongly associated with infant mortality and illness;
  • parental smoking increases the incidence of acute respiratory infections and asthma in children; and
  • women and youth in developing countries are being targeted as a growth market for tobacco.

Participants concluded that tobacco is a major threat to sustainable and equitable development.


In the developing world, tobacco poses a major challenge, not just to health, but also to social and economic development and to environmental sustainability.

Tobacco control needs to be more widely recognized as a development priority, but it is not on the agenda of most development agencies. Resources available from the donor community to assist in researching and responding to this pandemic are inadequate in view of the growing global burden of tobacco-attributable disease.

The initiative started at Bellagio will continue, and others will be invited to join an informal partnership, which includes those United National and bilateral agencies, individual experts, research institutions, media, private sector groups, national agencies, foundations, and non-governmental organizations with particular interests in developing countries in order to:

  • facilitate interaction and information exchange on tobacco;
  • stimulate appropriate research into the causes and consequences of tobacco use;
  • inform and motivate appropriate development agencies to place tobacco control on their agendas;
  • accelerate action on tobacco control within agencies and governments;
  • build capacity for tobacco control; particularly in developing countries;
  • support ongoing actions and programs within agencies, such as WHO and the United Nations Focal Point on Tobacco or Health; and
  • mobilize new and additional resources for responding to the development implications of tobacco.

To this end, participants invited the International Development Research Centre (IDRC), Canada, to lead a round-table process of consulting with other agencies, countries and experts in the preparation of a broad-based funding strategy and global partnership that responds to tobacco as a major threat to equitable and sustainable development. 


June 1995



Asian Consultancy on Tobacco Control, Hong Kong

Australian Agency for International Development

Canadian International Development Agency (CIDA)

Development Bank of Southern Africa

Food and Agriculture Organization of the United Nations (FAO)

International Development Research Centre (IDRC)

National Cancer Institute/Health Ministry, Rio de Janeiro

Swedish International Development Agency (SIDA)

Swiss Development Cooperation

Tata Institute of Fundamental Research

Tobacco Control Commission for Africa


United Nations Focal Point on Tobacco or Health (UNCTAD)

United States Agency for International Development (USAID)

United States Centres for Disease Control and Prevention

University of Oxford

The World Bank

World Health Organization (WHO)