Clearing the air: Latin American governments are waking up to the cost of their citizens' smoking habit.

Back in the days when I lived, and choked in, Latin America's megacities, I never dared to hope its ever-puffing citizens would take on the global tobacco industry. But today that's just what is happening.

Brazil, the region's economic powerhouse, prohibits tobacco advertising and is one of only two countries (Canada is the other) that posts graphic photos of tobacco victims on cigarette packs. Cuba, where a renowned cigar industry is a source of cultural pride, banned smoking last year in offices, stores, theaters, public transport, schools and sports facilities. In March, Puerto Rico and Uruguay passed the toughest anti-tobacco prohibitions in Latin America. Uruguayans, whose president is a practicing oncologist, can now light up only at home or on the street. In 2007, Puerto Ricans will be barred from smoking in private cars if a child under the age of 13 is present.

Today, every country in Latin America and the Caribbean except Colombia and the Dominican Republic have signed the World Health Organization's Framework Convention on Tobacco Control, the first global health treaty aimed at stopping tobacco addiction, and the first to single out a particular industry for regulation at an international level. Ratified by 15 countries in the region at press time, it bans all tobacco advertising--adios, Marlboro Man--as well as tobacco-company sponsorship of concerts and sports events. The treaty also increases cigarette taxes, requires health warnings on cigarette packs, and prohibits smoking at the workplace and indoor public places.

The accord, which the United States has yet to ratify, is a major development for public health in Latin America and should be ratified by all governments. A million people die annually from tobacco-related illnesses in the Western Hemisphere, according to the Pan American Health Organization. A study by Corporate Accountability International, a U.S. non-governmental organization, shows that health costs associated with smoking represent between 6% and 15% of the region's public spending.

That's not counting losses from work absenteeism, premature deaths and treatment for related disabilities--all of them huge public and private enterprise costs. Chile, where 42.5% of people between the ages of 12 to 64 smoke, has one of the highest smoking rates in Latin America. Chileans spend US$1.40 billion annually on smoking-related illnesses, according to the country's narcotics control board. Another way to look at it: The equivalent of $0.45 out of every dollar Chile's state-run copper industry gives to the government is blown up in cigarette smoke.

The war on smoking comes at a time when health experts say tobacco addiction is on the rise in the Third World--a direct result of anti-smoking efforts in the developed world and of hundreds of millions of dollars worth of lawsuits from U.S. state and federal governments and private health insurers over the health cost of lifelong tobacco use. "While tobacco sales have plateaued in the United States and Europe, the tobacco industry has very aggressively gone after developing nations to expand their market," Bryan Hirsch, a spokesman for Corporate Accountability International, told me.

Limiting smoking is still a novel idea for many Latin Americans, who view any restrictions as an affront to their personal freedom and consider secondhand smoke a non-issue. A Pan American Health Organization study of more than 10,000 pages of internal documents from Latin America's leading tobacco venders, British American Tobacco and Philip Morris, found that Big Tobacco is doing all it can to derail the anti-smoking drive, lobbying lawmakers to allow "light" and mild" labels on cigarette packages, hiring scientists to counter evidence of the effects of secondhand smoking, and pressuring, even bribing, elected officials not to vote for the treaty.

In the long run, governments should begin phasing out tobacco by offering farmers cheap credit to grow alternative crops. Until then, regional leaders should respond to Big Tobacco's counterattack by launching programs to educate their citizens about the effects of smoking and support efforts to establish smoke-free enclosed areas. A 2004 study by the Johns Hopkins Bloomberg School of Public Health found carcinogenic secondhand smoke in 94% of public places in Argentina, Brazil, Chile, Costa Rica, Paraguay, Peru and Uruguay. Nicotine was found in 95% of hospitals studied.

Most important, existing bans must be enforced. Press reports say Cuba's new law is not being seriously enforced.

The anti-smoking treaty will eventually become law across Latin America despite last-ditch efforts by the tobacco giants to squelch it. And when it does, it will save millions of lives and ease the burden on public health systems.

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