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For Costa Rica, smoking laws have proven elusive

From the print edition

Costa Rica has led the region in emphasizing and promoting cleaner ways of living. And yet a large portion of Latin America has surpassed Costa Rica in passing anti-tobacco legislation. 

The country seemed ready at last to pass comprehensive smoking reform that would prohibit smoking in public spaces such as bars, restaurants, public buildings, bus stops and taxi stands, increase taxes an extra ₡20 ($0.04 cents) per cigarette, and require cigarette packs to display text and photo warnings on at least 50 percent of the box (TT, March 2). 

Lawmakers passed the bill in second debate last week. But a legal challenge and a constitutional review by the Constitutional Chamber of the Supreme Court (Sala IV) could delay the bill again. Why has Costa Rica struggled for so long to reform its anti-smoking laws?

The Tico Times takes a look at the history of tobacco smoke in the country by examining a research paper titled “Tobacco Industry Success in Costa Rica,” which cites the University of California at San Francisco’s Legacy Tobacco Documents Library, a vault of 80 million pages of formerly secret tobacco industry documents.

Where does Costa Rica rank in terms of anti-tobacco legislation?

In Latin America, Costa Rica has fallen behind in the region due to the influence of tobacco companies British American Tobacco and Philip Morris International, and meddling by Health Ministry officials and restaurant representatives in anti-tobacco bills. These measures have prevented the ratification of the Framework Convention on Tobacco Control that sets standards ascribed to by the World Health Organization (WHO).

Uruguay leads the way in banning tobacco, having enacted nationwide reforms in 2006. Ten countries have approved WHO guidelines, including Panama, Guatemala and Honduras in Central America. Brazil became the largest country in the world to approve a 100 percent smoke-free law in late 2011.

Has Costa Rica always lagged with implementing anti-tobacco reforms?

Costa Rica was one of the most progressive countries in terms of public health in the mid-1980s. When the dangers of secondhand smoke became a major health concern, then-Health Minister Edgar Villa began a campaign to snuff out cigarette smoking’s prevalence in the country. In the ’80s, Costa Rica banned smoking in workplaces except in designated areas, and on buses, one of the first countries in Latin American to do so.

How did Costa Rica fall behind?

The tobacco companies, of course. By the end of the ’80s, Costa Rican lawmakers drafted a bill to prohibit smoking in all public places except restaurants and bars and to ban all tobacco advertising. Threatened by the legislation, the tobacco giants not only managed to stop its advancement but also turned Costa Rica into a test site for future smoking policies. 

British American Tobacco and Philip Morris recruited local organizations such as the Costa Rican Chamber of Restaurants and the Costa Rican Chamber of Hotels to lobby against the all-encompassing bill in the early ’90s. The industry repeated that certain aspects of the legislation could encounter “constitutional problems” if passed. Furthermore, tobacco leaders covertly recruited scientists from the United States to downplay secondhand smoke’s harmful effects. 

The strategy worked, and a watered-down version of the bill passed in 1995.

How did tobacco companies turn Costa Rica into a policy pilot site?

Two policies in particular were effective. One, still promoted heavily today by the Chamber of Restaurants, is known as the “Courtesy of Choice.” The “courtesy” accepts that giving patrons designated smoking areas is effective for protecting public health. However, studies have shown that enforcing these rules – and the fancy ventilation systems that sometimes come with them – are costlier for restaurants and bars and less efficient for customer health. The “Courtesy of Choice” program had spread to Argentina, Brazil, Chile, Colombia, the Dominican Republic and Guatemala by 1999.

The other policy involved self-regulation. Instead of allowing the legislators and courts to deal with sticky constitutional issues, tobacco companies would police its own advertising policies, claiming that they would ban ads targeting minors and step up enforcing policies against selling cigarettes to underage customers. The advertisements focused on “peer pressure and parental behavior and away from the fact that its advertising and marketing promotes smoking to youth.”

A report by the British American Tobacco company lauded the effectiveness of the tobacco companies’ “implementing voluntary initiations to preempt” WHO’s guidelines.

What caused Costa Rica to want to ramp up anti-tobacco efforts again?

A weakened law, like the one put into place in 1995, is still a law and can delay the creation of more effective policy for decades. In 2007, health leaders formed the National Anti-Tobacco Network (RENATA), the group that finally led the charge to upgrade the 1995 law.

Citizen Action Party Legislator Orlando Hernández drafted a new bill calling for 100 percent smoke-free environments, elimination of tobacco advertising and an increase in cigarette taxes in May 2009. Meanwhile, RENATA conducted research showing that 10 Costa Ricans die per day from tobacco-related causes, and the country annually spends $273,000 on fighting those illnesses. Polls showed that 93 percent of the country supported toughening the laws.

And yet almost three years later Costa Rica still has not enacted a 100 percent smoke-free law. Why?

Never underestimate the power of the tobacco companies.

RENATA took years to convince lawmakers to come to the anti-tobacco side. It appeared the law could have passed in early 2010, but former Health Minister María Luisa Ávila sparked a controversy by holding a meeting with tobacco companies to hear their complaints with the legislation. She later stated to national media that the meeting would not hamper the potency of the bill. However, lawmaker Hernández said changes were made to hurt the bill’s effectiveness. 

Soon after the clamor, Hernández and other lawmakers who supported the legislation reached the end of their term limits. The bill had not yet been voted on, and RENATA had to restart the process of lobbying lawmakers as to why the country needed to improve its anti-smoking laws.

On Feb. 27, Costa Rican lawmakers passed a 100 percent smoke-free environment bill. But 10 opposition legislators sent the bill to the Sala IV for review before President Laura Chinchilla could sign it into law.

If the court rules aspects of the bill unconstitutional, its implementation could be delayed for months, if not years

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