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Washington, D.C., World Bank, Population, Health and Nutrition Dept., 1987 Jun. 114,  p. (PHN Techical Note 87-15)The issue of appropriate tobacco policies for less developed countries (LDCs), based essentially on the experiences of the more developed countries, is addressed. Following an overview of current trends in tobacco consumption and production and discussion of the health consequences of tobacco use, attention is directed to the rationale for government policy within the context of neoclassical welfare economics. Issues surrounding policy instruments intended to reduce the demand for cigarettes are examined as are production related policies. Finally, focus is on the question of the propriety of the World Bank's lending for tobacco projects. Available evidence from several European nations suggests that simply the discussion of smoking and health policies can have a noticeable effect on smoking. Leu (1986) reports that smoking declined in Switzerland following the health disclosures, but it declined more substantially following a public referendum (1979) on a complete advertising ban despite the fact that the ban was defeated at the polls. The evidence for information dissemination programs is impressive, yet such approaches have been criticized as inadequate on the basis that the reductions in smoking have not been large enough and that people continue to be inadequately informed about all the risks of smoking. Information based policies to control tobacco use have several advantages, including: they are noncoercive and reinforce an individual's prerogative to control his/her own life; they improve market functions; and they have an important impact on tobacco use and tobacco induced illnesses. Specific recommendations are outlined. Setting aside health considerations, from both a longterm and global perspective, the case for promoting tobacco production on economic grounds is shaky. Tobacco now typically is a profitable crop, yet much of its advantage stems from the various subsidies, tariffs, and supply restrictions that support its high price and provide economic rents for its producers. Health considerations aside, from both a longterm and global perspective, the case for promoting tobacco production on economic grounds is weak. Tobacco typically is a profitable crop at this time, yet much of its advantage stems from the various subsidies, tariffs, and supply restrictions that support its high price and provide economic rents for its producers.
DEVELOPMENT COMMUNICATION REPORT. 1980 Jul; (31):3-4.The success in social marketing of the PROFAM brand of subsidized contraceptives, by a nonprofit private institution that supports the Mexican government program, is related here. PROFAM began in 1978, when half of contraceptives were purchased commercially from drugstores: they were neither economical, consistently distributed, nor advertised. Comprehensive market research revealed that a great demand existed. It generated information for choice of items to market, package design, and instructions. In 1979, pills, condoms, foam, cream and vaginal suppositories, all locally produced were distributed. A serious problem initially was the impropriety of using the word "contraceptive" in the media. The first phase of advertising targeted newspapers. After 3 months, 40% of Mexico's drugstores carried PROFAM. The second phase of advertising, in radio, magazines and newspapers, approached consumers with information tailored to the specific socioeconomic group involved. The third phase, geared to rural areas and general stores, concentrates on advantages of each method. Other aggressive aspects of the campaign include house to house sampling and a mail-in question and answer service. Evidence of success in broadcasting the PROFAM message is the frequent reference to PROFAM in jokes in the media and even in graffiti. The government's goal is to reduce the growth rate form 2.9 percent annually to 1 percent by 2000.