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16 Yale J. Health Pol'y L. & Ethics 327 (2016)
A Breakthrough with the TPP: The Tobacco Carve-out

handle is hein.journals/yjhple16 and id is 339 raw text is: COMMENTARY A Breakthrough with the TPP: The Tobacco Carve-Out Sergio Puig* and Gregory Shaffert The United States has made great progress in reducing tobacco consumption at home while spending taxpayer money to promote its consumption abroad.' While U.S. tobacco consumption rates haven fallen dramatically since the 1960s, they are soaring in the developing world.2 Today, about twenty percent of adults in the world smoke, and more than eighty percent of them live in low- and middle-income countries.3 As a result, tobacco could kill one billion people this century, and largely in these lower-income countries.4 Tobacco's global success is partly the result of free-trade agreements that * Associate Professor of Law and Director of the International Economic Law and Policy Program at James E. Rogers College of Law, University of Arizona. T Chancellor's Professor of Law and Director of the Center of Globalization, Law, and Society at University of California, Irvine School of Law. 1 Since the first Surgeon General's Report on tobacco use was published in 1964, adult smoking rates in the United States have decreased by more than half, from 42.4% in 1965 to 16.8% in 2014. See OFFICE OF THE SURGEON GEN., U.S. DEP'T OF HEALTH & HUMAN SERVS., THE HEALTH CONSEQUENCES OF SMOKING-50 YEARS OF PROGRESS: A REPORT OF THE SURGEON GENERAL 720 (2014); Ahmed Jamal et al., Current Cigarette Smoking Among Adults-United States, 2005-2014, 64 MORBIDITY & MORTALITY WKLY. REP. 1233, 1233 (2015). 2 See Tobacco and the Developing World, ACTION ON SMOKING & HEALTH 1 (2015), http://ash.org.uk/files/documents/ASH_126.pdf; WORLD HEALTH ORG., WHO REPORT ON THE GLOBAL TOBACCO EPIDEMIC, 2015: RAISING TAXES ON TOBACCO 11 (2015), http://apps.who.int/iris/bitstreaml1O665/178574/1/9789240694606_eng.pdf (reporting that over 80% of premature deaths from noncommunicable diseases occur in the developing world, and that tobacco represents the largest preventable risk factor for these diseases). But see Carl E. Bartecchi et al., The Human Costs of Tobacco Use, 330 NEW ENG. J. MED. 975, 975 (1994) (reporting former Surgeon General C. Everett Koop's statement that cigarette smoking is the leading cause of preventable premature death in our society and the most important public health issue of our time). 3 See WORLD HEALTH ORG., supra note 1, at 15. According to the World Health Organization, member states are grouped into four income groups (low, lower-middle, upper- middle, and high) based on the World Bank's list of analytical income classification of economies. See Health Statistics and Information Systems: Definition of Region Groupings, WORLD HEALTH ORG. (2016), http://www.who.int/healtltnfo/global burden disease/definition regions/en. 4 See WORLD HEALTH ORG., supra note 1, app.VII (reporting an age-standardized tobacco smoking rate of 2l.1% in 2013 among persons aged at least fifteen years); Tobacco Could Kill a Billion People This Century, UN Health Official Warns, UN NEWS CTR. (Apr. 29, 2011), http://www.un.org/apps/news/story.asp?NewslD=38240#.Vu7l3xlrKV4. 327

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