Amazing progress in Latin American and Caribbean; industry fighting back hard

The reason that I have been so quiet for the past three weeks is that I was on vacation in Costa Rica (a great smokefree place) for two weeks, then attending the Fourth Latin American and Caribbean Conference on Tobacco or Health in San Jose Costa Rica.
 
The conference, organized by the Costa Rica Ministry of Health and Interamerican Heart Foundation with support of a range of agencies, brouught together about 400 energized and committed public health professionals for serious discussions about progress to date and how to deal with the tobacco companies' increasing aggressive opposition.
 
There was way too much going on to provide a detailed report, but in many ways the Latin American and Caribbean (LAC) countries are well ahead of the USA.  Here are some examples:
 

• Widespread adpotion and enforcement of smokefree laws
• Widespread strong graphic warning labels, including warnings about smoking and breast cancer
• Big national tax increases
• Bans on all or most additives (including menthol), something the industry is litigating against
• Almost complete bans of advertising and promotion
• Severe restrictions on point of sale advertising, including a ban in Panama

 
Of course the tobacco companies are fightlng back in the courts, using trade agreements, front groups (inlcuding the US Chamber of Commerce and the UK government) and have slowed things down, but the progress is remarkable,  The fact that fights over advertising are mostly about sneaky efforts of get around poing-of-sale restrictions shows how far things have come.
 
Another thing that struck me was the sprit of cooperation between different countries, NGOs and support from outside the region from agencies such as Tobacco Free Kids and academic leaders like Jim Thrasher.
 
After a long battle (documented in our paper [en Espaniol] and report on Costa Rica), the country has aggressively implemented its comprehensive smokefree environment law (which includes casinos and bars).  No smoking signs are everywhere and we did not see a single cigarette smoked indoors anywhere.
 
The agencies, including funding agencies, that have supported this work in Latin America and the Caribbean have a lot to be proud about.   With continued support, the people there are rapidly moving to implement former Surgeon General C Everett Koop's vision of a smokefree society.