Tobacco and Public Health - TCSC Indonesia

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PREFACE
Concluding comments
I have a vision for public health that is optimistic and realistic. In my lifetime, I have
seen the rise and fall of epidemics, and I have come to believe that well-intentioned
men and women, motivated by a will to serve and guided by science, can control disease
and eradicate plagues. Unlike other epidemics, the disease of tobacco addiction
and its many life-threatening accompaniments has an important ally in Big Tobacco.
But no form of institutionalized evil can perpetuate itself for long when the truth
about its intentions and methods becomes known. Therefore, it is realistic to believe
that we will turn the tide on this epidemic. We will isolate and contain Big Tobacco,
and we will see the decline of tobacco-caused disease and disability. We have the foundation
to make tobacco-caused disease history, and the dawn of the next century
a time that, once again, will see lung cancer a relative rarity.
There is not unanimity among those in the profession of public health concerning
how Big Tobacco should be brought to its knees. Some public-health advocates believe
it is possible to have a dialog with Big Tobacco; this implies that it is possible to negotiate
morality with Big Tobacco, even though the industry has deliberately spurned such
opportunities for many decades, while using their deceitful data to serve the ends of
greed rather than health. These folks in public health, in general, are kind, compassionate,
and truly believe that the tobacco industry will eventually come around. It is my belief
that nothing is further from the truth. I firmly believe that the aforementioned tactic
will never work, but with due diligence, the second tactic might work under carefully
orchestrated circumstances.
There is another segment of the public-health profession that has quite a different
attitude toward Big Tobacco and thinks that the only way it can be brought to its knees
is to destroy it as it presently exists. In days of yore, when military combatants protected
themselves with suits of armor, combat was at close quarters, and frequently
hand-to-hand. You destroyed your enemy by finding the chink in his armor and
through it you thrust your spear, shot your arrow, or guided your blade.
Isn’t it time that public-health people, united, studied the armor of Big Tobacco carefully,
found the chinks therein, and acted accordingly? The tobacco enemy is big,
powerful, extraordinarily wealthy, and has learned to practice its deceitful ways over
half a century, but the one thing it does not have on its side is righteousness. I do believe
that, in the long run, Big Tobacco can be brought to its knees with the combined righteous
outrage of the citizens of the world.
Of course, none of this will be easy, and we do not have all the answers to the questions
before us. Never has so deadly an epidemic been so well protected by intertwined
commercial and political interests. But never has so deadly a commercial empire faced
so many assaults on so many fronts. I do believe in the ultimate triumph of right over
wrong. The tobacco industry has been blatantly and reprehensibly wrong for much of
the twentieth century, and is attempting to extend that record into the twenty-first, but