Smoking: Can this global health scourge be socially responsible?

With all the recent anti-smoking laws banning tobacco in public places, restaurants, bars, whole towns even, it's easy to think that tobacco is a thing of the past. And combined with taxation, awareness of the health hazards, and growing mores against it, the habit is on the decline in the US. But as is often the case, the decline in one market sparks a search for new markets. And tobacco is no different.

Developing regions are now the principle target markets for Big Tobacco -including Eastern Europe, Asia, Latin America and Africa. They are also the least able to withstand the forces of marketing and the public health toll of smoking. Women and youth are the "must get" demographic. A new report by the American Cancer Society, along with other recent research reminds us that the global toll of tobacco use continues to be staggering:

* 1.3 billion people currently smoke worldwide.

* 14,500 people die from smoking each day.

* 20% of women will smoke by 2025, according to the WHO, up from 12% who currently smoke.

* The World Bank estimates that halving smoking rates by 2020 would save more than 180 million lives by 2050.

* 50% of healthcare providers smoke in some countries, in the US the rate of smoking among nursing students is double that of the general population.

While lung cancer is the main risk that comes to mind when we think of smoking, rates of all cancers increase from the habit, often dramatically. Heart disease and diabetes also increase, as well as virtually every other condition you'd prefer to avoid from asthma to wrinkles.

The WHO has responded with the FCTC: Framework Convention on Tobacco Control, an attempt to internationalize the fight against smoking. Higher taxes, anti-smoking media campaigns, decreased tobacco promotion, and increased efforts at smoking cessation all help, with the combination being most effective.

While many products and practices carry risks, tobacco is the only widely available product that when used according to manufacturers recommendations is guaranteed to diminish your health and dramatically increase your likelihood of death. And, contrary to the statements of top tobacco execs, it is highly addictive.

This is a forum about health, but also corporate social responsibility, which leads me to ask: Can a tobacco company ever be considered socially responsible? What about tobacco farming? The tobacco giant RJ Reynolds claims they are "committed to Corporate Social Responsibility", including the following "planks:" Harm reduction and product integrity, Responsible customer and consumer engagement, Youth tobacco prevention, Community and civic engagement, Environmental sustainability." Among the ironies: The only way to reduce the harm of smoking is to stop, certainly bad business for RJR. When you're killing off your customer base at a rate of 14,500 users a day, you have to target youth to replenish. And the idea of engaging with the community whose public health you are undermining is just strange. RJR is talking the socially responsible plank, now lets see them walk it.