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Legislators in tough economic times are using tobacco settlement money to desperately plug budget holes. Massachusetts state lawmakers in at least the last two years have used the funds to help cover general fund expenses as the deficit widened into the billions of dollars. In November, a $100 million economic stimulus bill passed that relied on more than $33 million in tobacco money. Two local law firms that helped the state win its $8.3 billion tobacco settlement are suing the commonwealth for $1.2 billion they say they’re owed in legal fees.
But ostensibly, the money is supposed to be spent to help educate young people to stop smoking and for other health-related programs.
That happened the first year the money came in. In 2000, a $326 million tobacco payment came in and 70 percent was saved or invested. The rest went to the Tobacco Settlement Fund for education programs, all according to statute. In 2001, $242 million came in, again at the 70/30 percent ratio.
But in 2002, $305 million came in, and 50 percent went to the general fund. The rest went to the Health Care Security Trust. In 2003, $303 million came in and all of it went to cover general fund expenses, a trend expected again this fiscal year.
Massachusetts established the Health Care Security Trust in 2000 to administer and invest the money as it came in. It’s a one-man office, run by 49-year-old Paul Todisco, who was transferred from the state pension fund to manage the money as it came in. Todisco recently talked to Boston Business Journal reporter Mark Hollmer about the tobacco money, where it’s been spent so far and how much of it has actually been spent on health care.

Q Tell me about the Health Care Security Trust office.

A It was created through the Legislature … and basically, we’re charged with managing and investing all the money generated by claims or actions undertaken by the attorney general’s office over the tobacco settlement.

Q How did the funding formula initially work?

A Initially the Legislature set up the formula in the statute that said 30 percent of annual receipts in this settlement would be used … for tobacco cessation (antismoking initiatives) and 70 percent … would be saved or invested for some future use for health care purposes.

Q How much money has come in to Massachusetts to date?

A About $1.2 billion.

Q How much has been saved or invested to date?

A In our most recent quarter we had a net asset value of $494 million.

Q Why didn’t you get any new money to invest this year?

A The state is in a budget crisis … and like many states around the country, we’ve taken receipts from the tobacco settlement and used it for general purposes as opposed to targeting health care. This is not anything that’s basically earthshattering, given the fact that practically all 50 states have had fiscal bumps on the road, (but) it’s the state’s prerogative.

Q Has Massachusetts used the money as the Legislature intended?

A Massachusetts has really been a model for other states around the country, as far as health care and using this money for tobacco cessation programs. It will be a leader once again once the state gets back on its footing.

Q What has happened to the tobacco settlement fund?

A In this last budget, the tobacco settlement fund was eliminated and folded into the general fund of the commonwealth.

We are considered a reserve fund. It is in the commonwealth’s prerogative to use the assets as they see fit for whatever purposes they feel are necessary.

BULLET POINTS on Todisco * Is executive director and sole employee of the Health Care Security Trust that administers and invests the state’s tobacco settlement money

* Oversees assets that are expected to reach more than $8.3 billion over 25 years

* On who holds the tobacco settlement purse strings: “We’re just kind of the bank. The state is the entity who decides how it gets spent.”

Planners should represent the interests of the communities they serve by working with others involved in housing and regeneration, Yvette Cooper tells Chris Griffin
On the eve of some crucial announcements for the future of planning, the junior minister with responsibility for housing, planning and regeneration nails her colours to the mast. Planning, says Yvette Cooper, “should be considered from the point of view of the local community”. The implication is that she is less concerned about the processes themselves.
She has already picked up extensive experience during her four years in government-first as public health minister, then during a brief stint in the Lord Chancellor’s department and, since last summer, at the ODPM. Married to Ed Balls, economic adviser to chancellor of the exchequer Gordon Brown, she was tipped by the US embassy earlier this year to become the UK’s second woman prime minister.
Cooper became interested in politics through her father, a trade union official: “We always had politics in the family.” Her first job was as economic researcher to the late John Smith during his time as shadow chancellor. “John had a passion about social justice and a strong moral sense about politics changing people’s lives, which I found inspiring,” she recalls. “That encouraged me to develop my interest in social exclusion and regeneration and their relationships to economics,”
She likes the way her integrated brief at the ODPM allows her to consider planning from the point of view of communities. “Most people have no concept of what planning is about,” she accepts. “Often their first contact is when they learn of an application or development near their home that they don’t like and don’t think should have gone ahead.”

Cooper explains that her Yorkshire constituency of Pontefract and Castleford includes two largish towns with two ex-collieries between them. “These communities have many views about the ways they think the land and the towns should be used,” she explains. “These are real planning issues, yet few people know about development plans or have been involved in the debate overthem.”

She elaborates: “People don’t feel that planning links in with the discussions and attitudes they have about what should be done in their area, particularly if it needs regenerating. They consider that it is experts, not members of the community, who make the decisions. We need to make the system faster and more transparent and link the development of local planning issues with community debate.”

The dual emphasis in the sustainable communities plan on market renewal pathfinders in the north and Midlands and growth areas in the south is correct, she insists. While Cooper is convinced that the emphasis on the southern growth areas is sustainable, she tactfully adds that “links between the housing market and the economy must tackle regional economic disparities and get more economic growth into the poorer regions”.

“Housing has to respond to the demands of the local economy, and a good planning system is one way to underpin the process,” she maintains. “One of the greatest mistakes has been the separation of housing policies from those affecting the local economy. In the housing renewal areas, these policies are linked. We need to know whether low demand is because the population has declined or because people want a different type of housing.

“We must recognise what the local workforce wants, assess the population projections and use appropriate processes to deliver accordingly. We need to generate growth in the regions themselves. If you look at the gap between London and our other regional cities compared to other countries, it is much wider. This suggests considerable potential for those cities to be the drivers of regional economic growth.”

Cooper points to latest figures showing that returns on property investment in many northern towns and cities are considerably higher than previously anticipated. “Getting entrepreneurs and investors to recognise the economic potential for the growth of jobs and opportunities and investment from property is now even more important,” she contends.

She also emphasises the need for good design of buildings, the spaces between them and the whole environment, revealing a particular interest in increasing green space provision in towns. “Environmental factors are important in attracting businesses and people to the north. Businesses won’t invest in places where their workforce doesn’t want to live,” she warns.

But in the drive to attract people and businesses, she does not accept that the minimum density of 30 homes per hectare in PPG3 should be relaxed. “Other countries manage to build attractively at greater densities and it means you don’t have to worry so much about using greenfield land. It’s also about bringing life back to town and city centres,” she stresses.

A regional focus is important in the high-demand areas of the south, Cooper believes. “You can’t only look at planning from the point of view of one village or estate,” she argues. “The introduction of a strong regional dimension into the planning process is critical in getting the right balance. While using a local democratic element, you require a decision that benefits the whole region and country.”

Will the rekindled notion of planning tariffs (Planning, 7 November, p2) help to deliver more affordable housing than the current system? “We are aware of the conflicting views and perspectives, but we are determined that any change will not weaken the delivery of affordable housing,” she says. “Everybody has grumbled about the way that the system works, from many perspectives.”

She was reluctant to speak ahead of next week’s preliminary announcements on the Egan review of built environment skills and training. But she accepts the need for closer collaboration between the planning, housing and regeneration professions. “I speak at housing, planning or employment conferences but rarely at integrated events,” she notes.

The new mechanisms outlined in the Planning and Compulsory Purchase Bill, especially regional spatial strategies, offer greatly improved opportunities to link planning, housing and regeneration issues, she insists: “We must bring all the disciplines into the same debate.” She also hopes that the interim report of the Barker review of housing delivery, also due next week, “will closely link housing and planning with the economic agenda”.

Gus Alexander wonders whether too much Health and Safety is bad for you

The trouble with working for the Health and Safety Executive (HSE) is that once everything has been made safe, you’re out of a job. For this reason the boundaries of what is not acceptable are being constantly extended.

Building construction represents 10 per cent of GDP and is the biggest industry in Great Britain. This is where the ramifications of Health and Safety have the widest impact. Nobody expects trades’ people to have to work on dangerous building sites, and nobody wants their own children out clubbing in fire traps, but there comes a point where enough is enough. In the building industry we reached this point in April 1995 with the implementation of the Construction (Design and Management) Regulations.

What this legislation said was that issues of health and safety had to be considered at the very outset of every (non-domestic) construction project, and a new role, that of ‘Planning Supervisor’, was created to monitor the whole process. Building a new airport? Right. Appoint a Planning Supervisor and instigate a Safety Audit immediately. Secondary consultants such as architects and engineers can come later.

Good designers have always considered the manner in which their creations are put together, if for no better reason than danger begets difficulty; difficulty begets expense; and things which are expensive tend not to get built in the way that they were designed. Half-decent commissioning clients don’t want their buildings to be made too dangerous or difficult to maintain, for the same reason. However, as building becomes more and more speculative, and the relationship between the initial developers and the end-users ever more remote, the idea of common sense among consenting adults can no longer be relied upon. Instead, a Health and Safety hare has been set loose and a huge paper trail is developing in its wake. This is not a ‘make everything safer’ trail, so much as a ‘cover my ass’ trail.

For a tiny fraction of the cost, and to massively greater effect, HSE could increase the number of building inspectors twentyfold and give the existing ones greater powers to shut down construction sites where they find operatives working near unprotected lift shafts or standing knee-deep in water and attacking 40 gigawatt live mains feeder-cables with De Walt power-saws. Instead the CDM Regulations have ensured that responsibility for safety is now buried in a file located miles away. As long as somewhere buried in this file there is a method statement which prescribes how operatives are going to ensure that the supporting agent (finger) will not become sited between the percussive compression plant (hammer) and the ferrous fixing agent (nail), HSE is satisfied. For as long as building clients are obliged to have such files filled, consultants will be more than happy to charge imaginatively for filling them.

But to what end? The drop in the number of construction-site deaths has been negligible since the introduction of the CDM Regulations in 1995. Indeed, the figures for 2002 show a slight increase. The regulations don’t apply to private residential work where half-a-dozen wholly uninsured labourers may be trying to construct an additional floor five storeys up in a howling gale.

Safety in the building business is full of anomalies. Far more onerous regulations are enforced for a balustrade on a fixed staircase in a building which people use everyday, under perfectly controlled conditions, than those applied to a cross-Channel ferry where the environment is not only a strange one for the majority of the users, but is also pitching and lurching 40 feet above a surging sea. On London’s Routemaster buses, folk of all ages are expected to navigate a staircase (a miracle of circulation design) where the treads rise almost vertically and are only inches wide at their narrowest point. Not only is the stair-well highly constricted; the whole operation is lurching forwards at 40mph, with passengers making their way down as you are going up.

All domestic electrical installations have to be fitted with earth leakage circuit-breakers. The ELCB is a serious-looking switch the size of your thumb sited next to the meter. The slightest leak and the entire supply is tripped out. Very admirable in its way – it stops you getting fried by the lawnmower or welded to the toaster. However, it does mean that if you happen to be walking downstairs at night, carrying a tray full of boiling hot drinks, you’ll be plunged into total darkness should your rogue mobile-phone charger misbehave for an instant. A safety measure in one field can become a health hazard in another.

We recently fitted out an inner-city 19th-century board school as a temporary shelter for 50 rough sleepers. The residents found themselves upgraded from diesel-soaked Toshiba box one night to full-specification Health and Safety accommodation the next. For reasons to do with funding we were obliged to have the hostel up and running before the local authority were in a position to test the fire alarms. My clients have a lot of experience of keeping derelicts dry, and employ an in-house safety consultant to certify installations in just such circumstances. Nevertheless, two weeks after the scheme had been tenanted, the local authority insisted on sending in its own inspectors. Notwithstanding the fact that this is an institution which is fully staffed day and night, the council insisted that the alarm system was activated, and tested in every single location.

One hundred decibels is what you hear when a Boeing 757 takes off 150 metres away across open country, so a 110 decibel alarm is a violently intrusive acoustic manifestation. Once activated, the target audience gets the general idea in about a fifth of a second. Noise at this level is capable of generating physical pain. Imagine being scaled into a K2 telephone kiosk with a police screech siren. ‘Just to be on the safe side,’ said the council officers, cocooned in their sound-attenuating ear-muffs, as they spent nearly 30 minutes walking along every corridor, and taking a meter-reading at the head of every single bed.

By the end of this exercise at least half the residents – fragile people at best -were running around the playground in circles, clutching their heads and screaming with pain. Of course, one or two managed to remain fast asleep in front of Bargain Hunt, blissfully unaware of the acoustic intrusion. What does it matter if some of the residents suffer from tinnitus for the rest of their lives? At least they’d be okay in a fire.

Once the HSE has dragged everything up to comply with its current safety standards, what next? Full illumination in cinemas so the exits are always visible? Permanent 100mm diameter holes in all external walls where there is a gas appliance evident? Self-closing, half-hour fire doors in two-storey houses? Fire-alarm testing on the hour? As long as the words ‘Health and Safety’ retain the power to invoke terror and anxiety in our legislators, there will be no limit.

Dr. Morton Rapoport leaves a legacy of integrity at the University of Maryland Medical System.
There’s just something about Dr. Morton Rapoport. He’s like a wise man with vision, standing atop some distant mountain telling all of us what he sees. But Dr. Rapoport, who just retired as president and CEO of the University of Maryland Medical System, is the kind of wise man who often looks down from the mountain. And if he sees one person hurting, one person in need, he’ll come down from the mountain, and won’t go back up till that person has been helped.

It’s almost as if while he’s descending, his soul is actually ascending.

Dr. Rapoport, 68, would probably scoff at such grandiose descriptions of himself. The man who literally restructured the landscape of health care in this region has a severe case of modesty. He doesn’t see himself as a visionary. He sees himself as a simple guy who likes to play tennis and watch Orioles games with his beloved wife, Rosalie.

But in fact, Dr. Rapoport’s accomplishments are astonishing. The only president and CEO of the University of Maryland Medical System (UMMS) since it was privatized in 1984, he took over an ailing University of Maryland Hospital and turned it into a regional powerhouse. The six-hospital system includes facilities such as Kernan, Mt. Washington Pediatric, University Specialty, North Arundel and Maryland General. World-class treatment centers such as the Greenebaum Cancer Center, the Gudelsky Clinical Tower, the Shock Trauma Center and the Weinberg Building all operate under its auspices.

UMMS now trains more than half the state’s physicians and is one of the state’s top five employers. Patient revenues have gone from $174 million in 1984 to $1.2 billion. Admissions over that time have tripled to 65,000 a year.

So just how does a modest physician trained in the study of infectious diseases, a doctor who once studied anthrax, turn to the business of medicine? On a quiet, pretty Sunday afternoon, when most of the area’s attention was focused on the Ravens, Dr. Rapoport sat with Rosalie in their Brooklandville home and pondered his professional journey.

Perhaps it began in a place called Rapoport’s Market near Memorial Stadium. There, young Morton Rapoport worked stocking shelves, bagging groceries and doing anything his parents, Aaron and Bessie, needed. The family lived on top of the store until he turned 12, when they relocated to Forest Park.

“I learned how to run an enterprise, and how to treat customers while working in the store,” he said.

Dr. Rapoport attended City College as well as Har Zion Hebrew School on North Avenue, Baltimore Talmud Torah and even the Hebrew College, where he learned from the late Dr. Louis Kaplan. He earned his medical degree from the University of Maryland School of Medicine,

Dr. Rapoport and Rosalie, a psychotherapist, actually knew one another in elementary school at School No. 50. Mrs. Rapoport also grew up near Memorial Stadium and Eastern High School. She went on to Towson University and the University of Maryland School of Social Work.

After the Rapoports left for Forest Park, the two didn’t come back into contact until Rosalie went on a blind date with Mort’s roommate. The Roommate never stopped talking about Mort.

And Rosalie hasn’t stopped since, either. Married for more than 45 years, the electricity and love between them is still apparent.

The couple became active members at Beth Israel Congregation, and count the late Rabbi Seymour Essrog and Toby Essrog as best friends and influences on their lives. Their first trip to Israel was with Rabbi Essrog in 1973.

“We were a Conservative family,” said Dr. Rapoport. “Our kids, though, became more frum [observant].” Daughter Esther (Marcus) lived in Israel for 11 years. Their other daughter Robyn (Spero) attended the Pardes Institute in Israel, while son Dr. Aaron Rapoport is a Baltimore physician, one of 20 in the extended family. The Rapoports also have 15 grandchildren.

Dr. Aaron Rapoport, 43, a hematologist and oncologist, said his father inspired him to become a doctor.

“He’s achieved a great deal, and he’s reached real heights in terms of his professional accomplishments,” he explained. “There are two words I’d use to describe him: integrity and humility. He’s very reachable and very approachable. I see that in the way the employees of the hospital look at him, the orderlies, the greeters, not the high and mighty but the workers. They think the world of him and feel a connection to him. He’s noticed them, he’s valued them, and he’s communicated that feeling of making them feel important and valued. He never lost touch with the capability of connecting with people at all levels.”

The younger Dr. Rapoport loved the walks he and his father would take together to synagogue on Shabbat, and how his parents embraced their children’s growing observance of Judaism.

“We feel very blessed,” said Mrs. Rapoport. “I can’t say it was something we forced. It was something they came to. But by observing our children, we became more observant.”

The couple is now affiliated with Congregation Shomrei Emunah. But they are looked upon as affiliated with everyone.

“Mort Rapoport is the Jew who makes all Jews look good,” said Rabbi Mitchell Wohlberg of Beth Tfiloh, where Dr. Rapoport is a trustee on the board of the Community Day School. “The way he carries himself and conducts himself. There’s a dignity, a mentschlikeit, a humanity and an intellect that make for a perfect combination. He’s more than a doctor, more than an executive. He’s a role model and an inspiration.”

Rabbi Wohlberg cited Dr. Rapoport’s habit of visiting Beth Tfiloh congregants in the hospital, whether he knows them or not, and regardless of their status or financial situation. He doesn’t do it, the rabbi explained, to curry favor: “He does it because he knows it’s the right thing to do.”

Associated: Jewish Community Federation of Baltimore former president Morton Plant describes Dr. Rapoport as quietly forceful.

“Look, he took that place [University of Maryland Hospital]. It was a downtrodden hospital, and he built it into a powerhouse. It’s comparable to Hopkins, and it’s continually vying for recognition because of Mort. He makes things happen.”

Dr. Nelson Sabatini, the state’s secretary of health and mental hygiene, worked for Dr. Rapoport for eight years. “He’s one of the best friends I ever had,” said Dr. Sabatini. “Most people will say that he’s a visionary and a leader, a physician and an astute businessman. He is just a very special human being. He’s got a sense of dedication and a sense of family I’ve only seen in few people. He’s a nice, good human being. I feel blessed to have him as my friend.

“He can be a very difficult, demanding boss,” continued Dr. Sabatini. “But you don’t mind, because he is just as difficult and demanding on himself. That’s Mort. That’s who he is.”

The positive impressions of Dr. Rapoport have made it all the way up to Gov. Robert L. Ehrlich Jr.’s office.

“Committed, bright, connected, important, friend, these are five words I think of when I think of Mort,” Gov. Ehrlich told the BALTIMORE JEWISH TIMES. “He not only made us the model for around the country and the world, but he also should get some credit for development of the west side of Baltimore City…. He is low-key. He is subtle. He’s never been about bringing attention to himself. It’s not his way. I know he says he’s retiring, but I told him real retirement is not an option. He’s too valuable. We’ll keep him busy.”

Fifteen years before becoming CEO, he was incrementally becoming more management-oriented in the business end of health care.

In 1984, the state legislature enacted a bill establishing the University of Maryland Medical System as a private, not-for-profit corporation. This freed the state from regulations that kept it from being competitive in the hospital marketplace. With the legislation in place, Dr. Rapoport and the system could reinvest cash, borrow money and raise money from philanthropic sources. Dr. Rapoport’s first major new project was the $44 million Shock Trauma Center in 1989, followed by the Homer Gudelsky Building in 1994, which houses cutting-edge facilities for cancer care, cardiology, neurocare and transplantation. During Dr. Rapoport’s 20-year tenure, the system raised more than $100 million in private gifts. And all of this from a doctor who specialized in medical research on metabolic changes in infectious diseases. Or to look at it another way, all of this from a man who grew up in his parents’ grocery store.

Dr. Rapoport’s name even turns up in conversations with people who might not have a University of Maryland Medical Systems connection. Yaakov Goldstein, the executive vice president of the Torah Institute of Baltimore, for example, went to Dr. Rapoport for advice on how to help his school become fiscally sound.

“When I think of Dr. Rapoport, I think of a person of deep compassion, gifted with great wisdom, who I have the privilege to know and learn from,” he says reverently.

Or as Jewish community leader Howard Friedman says, “I think of someone who is a dynamic, successful person who has been successful in his career but at the same time has a deep Jewish neshamah [soul]. He feels a responsibility to work for the Jewish community. He hobnobs with the best of them, be it [Orioles owner] Peter Angelos to the governor. He’s Doctor Baltimore or Doctor Maryland. Even when he was ultra busy, no one would be too small for him. He is just a real mentsch.”

“A credit to Jewish community and the overall community,” said the Weinberg Foundation’s president Bernie Siegel. “What he’s done for UMMS is absolutely amazing.”

Rosalie Rapoport fights back tears when she looks at her husband across the living room. She calls him a kiddush HaShem (a blessing to God). “In so many ways, he has touched the lives of people who have come to the hospital.”

Mrs. Rapoport explains that her husband, the person who expanded the hospital into prominence, is the same guy who will secure kosher food for a patient in need, even one he doesn’t know personally.

“Life with Mort has been an adventure,” said Mrs. Rapoport. “He always has a view of another mountain to climb.”

His daughter Esther Marcus, 41, says she smiles when she thinks of him.

“I always thought he was the greatest,” she said. “I don’t just look at him on a pedestal. I know him. He’s inspiring. He’s a good guy. He’s always trying to improve himself or others around him. And to me, he’s always been religious. He sees himself in a modest way as a servant of God.”

Daughter Robyn Spero, 38, added, “I think my dad is great. He used to say to us as kids when all else fails, think. I see my dad as a thinker.”

Even though he’s retired, Dr. Rapoport doesn’t like to talk about what he calls the “r” word. Instead, he prefers to call it the “t” word, for transition. He said he’s not clear yet what he’s going to do next. In a testimonial speech at Dr. Rapoport’s retirement dinner, Mr. Angelos jokingly offered the chairmanship of the Orioles to Dr. Rapoport, a rabid fan. “I politely declined.”

So, looking back, was there anything he didn’t get done? Were there frustrations along the way?

“What frustrated me is that I just wanted to go faster,” he said. “I have a certain impatience. Over the years I’ve had a burning desire to achieve. I come from a work ethic, and sometimes I am impatient and less tolerant of people who don’t have that same work ethic.”

And what about a relationship to God? He calls this a “hard question,” one that he needs time to answer.

“I look at my children and I know that they are more observant,” he finally began. “One of my daughters describes us as on a ladder or path. I’m still on that path, and I’ve been on that path for a long time. I’m a stronger believer than I was 30 years ago, and probably stronger than 10 years ago. Rosalie and I have been influenced by our family, by our parents and our children. They’ve been spiritual forces for us. God and family are synonymous for us.”

Ask him about heroes, and he talks of his late father’s faith in God and the work ethic he lived by.

The baton has clearly been passed. Dr. Aaron Rapoport lovingly tells a single, simple story that he says sums up the essence of his father.

A woman in the Jewish community needed to come down to the hospital for some important appointments. She didn’t have a way to get there, so she asked Dr. Morton Rapoport if he could help her arrange transportation. He said he’d take care of it.

And so, every morning, UMMS President and CEO Morton Rapoport came to the woman’s house to pick her up and deliver her to the hospital on time. The wise man on the mountain, remember, listens out for those in need and does whatever it takes to help them.

A global regime for tobacco control could start in Vietnam by the first quarter of 2004, bringing with it many restrictions on the promotion and sale of cigarettes.
The Framework Convention on Tobacco Control (FCTC) has been approved by the government and the presidential nod is expected early in 2004, according to Ly Ngoc Kinh, head of the Treatment Department of the Ministry of Health.
The FCTC seeks to limit tobacco use through controls on promotion, advertising, tax and price.
Cigarette packs would be required to have at least 30 to 50 per cent of their surface covered by warnings on health damages, Kinh said.
“The FCTC also stipulates a complete ban on advertisement and promotion of cigarettes five years after coming into effect,” he said.
The Ministries of Trade, Planning and Investment, Industry, Finance, Agriculture and Rural Development, and Foreign Affairs were all asked for suggestions but they all expressed support for the FCTC regulations.

Vice minister for Trade, Le Danh Vinh, said: “In Vietnam, the number of cigarette smokers is relatively high. Fifty per cent of men and 3.4 per cent of women smoke,” he said.
“The damage caused by cigarettes to Vietnamese smokers is cause for alarm.”
Bold measures are needed to reduce the rate of smokers to 20 per cent by 2010 as targeted by the government, he said.
Nguyen Tuan Lam, programme assistant of the World Health Organisation (WHO), said: “Vietnam has completely prohibited advertising of cigarettes through various laws but regulations relating to promotion and warnings printed on the cover need to be strengthened.”
Deputy minister Vinh said: “Policies regarding packaging and trademarks will be amended soon. A minimum of 30 per cent of cigarette pack surfaces will then be covered by warnings on the hazards of smoking.
“The amended trade law will include a complete prohibition on cigarette promotion,” he said, adding that tobacco promotions are currently only prohibited from targeting children below 16 and from holding contests.
“Furthermore, other policies like prohibition on smoking in offices and public places like cinemas and railway stations are proposed,” he said.
Lam said the value-added tax of 10 per cent on cigarettes, to kick in early 2004, could reduce their consumption.
“However, the total taxes levied on cigarettes is just 45 per cent, lower than that in developed countries,” he said.
According to the Ministry of Trade, average consumption in Vietnam is around 600 cigarettes per person per year. WHO estimates around eight million people, or 10 per cent of the country’s population, will die early due to serious smoking-related ailments.