In response to the mounting cost of medicalcare for smoking-related illnesses in CostaRica, the Social Security System (Caja) is analyzingthe possibility of suing the tobacco companiesthat operate here.“Everyone who causes harm to other people isobligated to make reparations. The (tobacco)companies must answer for the damages theirproducts cause,” said Rodrigo Cordero, head oflegal corporate affairs for the Caja.However, he added, nothing concrete has beendecided.According to the Caja, this year alone it will spend¢25.6 billion ($60 million) on health-care costs forthose who suffer from smoking-related diseases – anincrease of ¢2.5 billion ($5.8 million) over the previousyear.THOSE numbers do not imply the amount theCaja would seek in a court case, Cordero said. It is stillundecided which companies – if any – will be sued,and if so, for how much.What is clear is that people’s tobacco use is affectingthe country’s health-care system.“The harm is obvious,” Cordero said. “There is no doubt that smoking cigarettes is linked to a large number of diseases.”He pointed to a study by the U.S.Center for Disease Control and Prevention,based in Atlanta, Georgia, which concludedthat smoking, both active and passive, isassociated with 116 diseases.The habit is responsible for roughly67% of all deaths caused by tumors, 15.8%of deaths caused by cardiovascular disease,and 10% of prenatal deaths, according tothe study.IN Costa Rica, two prominent tobaccocompanies have cornered the market: Philip Morris (now also under the monikerAltria Group that includes Kraft foods),which distributes Marlboro and Derby cigarettes,and British American Tobacco,whose brands in Costa Rica include Delta,Viceroy, Belmont, Kent, Kool, LuckyStrike, Rex, Capri and Ticos.Both companies told The Tico Timesthey are open to suggestions for regulatingtheir products, and both insist they havealready taken measures beyond those mandatedby law to restrict access to their cigarettes.Douglas Chaves, director of corporateaffairs for Philip Morris in Costa Rica, suggestsalternatives to suing the tobaccocompanies.“I don’t believe that through lawsuits(the Caja) can resolve this issue. Healthauthorities want less people to smoke, sothey should restrict advertising and educatepeople through informational campaigns,”he said.Philip Morris regulates its own advertisingtactics, Chaves said. It does notadvertise in any electronic media, whichkeeps its propaganda off the radio wavesand television screens where minors couldbe exposed to them.Also, he said, the company does notadvertise at concerts or other gatheringsopen to the general public.Chaves said the problem with the proposedlawsuits is a question of fairness.“IF foreign companies come here andcomply with all of the government’srequirements, it can’t sue them, especiallyafter 60 years of lawful business,” hesaid.Lorena Barzuna, manager of corporateaffairs for British American Tobacco,agrees with the regulation of cigarettesand listed some of the ways that her companyattempts to dissuade minors fromsmoking. She refrained, however, fromspecifically mentioning a possible courtcase.“The company has always been willingto work with government institutions andNGO’s [non-governmental organizations]in the search for sensible solutions to regulatetobacco in a reasonable way, respectingthe rights of smokers and non-smokers,”she said.SHE said British American Tobaccohas paid for television advertisements todiscourage children from smoking, andposts printed material to that effect inplaces where its products are sold.Like Philip Morris, it does not advertiseon television, Barzuna said, “as long astechnology that allows for the media to discriminateaccording to the age of the consumeris unavailable.”Besides the obvious image problemsand expense of a court battle, Chaves mentionedand Cordero conceded that the legalprocess in Costa Rica could be slow.“The court case could take years,”Chaves said, “and we’re going to defendour interests.”Cordero said the Caja’s aim would notbe the economic boon of a successful suit,rather, that a win in the courts might discouragetobacco companies from sellingand advertising as extensively here as theydo now.THE point, he said, is to lower thenumber of smokers in Costa Rica.“The Caja is the lifeguard of the healthof Costa Ricans. That is its first responsibility,”Cordero said.Cordero said the Caja’s contemplationof a lawsuit against tobacco companieshere is not directly related to successful government legal action against tobaccocompanies in the United States.The U.S. Master Settlement Agreementwas struck in 1998 between the AttorneyGenerals of most of the U.S. states and territoriesand the country’s major tobaccocompanies. It prohibited the companiesfrom targeting youth in their advertising,imposed restrictions and bans on cartoons,transit advertising, product placement inmedia, branded merchandise, free productsamples and most sponsorships.Cordero said the Caja had been lookingat all possible options to diminish tobaccouse in Costa Rica for years – even beforethe success of the U.S. tobacco companysettlements.THE Caja has taken some steps toraise awareness about the health problemsassociated with smoking. Each of the hospitalsdevelops activities to help peoplereplace their smoking habits with exerciseand nutritious diets.Dr. Eliseo Vargas, who stepped down aspresident of the Caja last week (TT, April23), said the Legislative Assembly hasrecently approved a loan from the Inter-American Development Bank for nearly $2million to promote healthier lifestyles inCosta Rica and curb the incidence of cancerand cardiovascular disease.Those two diseases caused the deathsof nearly half of all Costa Ricans in 2003,the Caja reported.SMOKING is a prolific killer.The Costa Rican Institute of Alcoholismand Drug Dependence (IAFA)reports that it is the cause of one in fivedeaths worldwide, and that it is to blamefor one in three cases of cancer, one in fourheart attacks, nine in ten lung tumors andeight in ten cases of emphysema and bronchitis.In 2002, according to IAFA, 1,683Costa Ricans died of diseases related totheir tobacco use.Smoking is associated with breast cancerand osteoporosis in women and, contraryto the images of virile, young, good lookingpeople of Derby advertisementfame, is linked to erectile dysfunction inmen.The World Health Organization(WHO) estimates that one-third of theadult population of the world smokes,about 1.1 billion people.Of those, about 800,000 are CostaRicans – roughly 20% percent of the country’stotal population, according to theWHO.IN general, men smoke much morethan women, although statistics for womenare drastically different depending on theircountries’ level of development.According to the WHO, 47% of theworld’s men smoke, a number that isslightly lower in developed countries, and7% of women smoke in developing countrieswhile 24% of women smoke in developedcountries.Global health authorities predict thattobacco will become the leading cause ofdeath by 2020, surpassing deaths byAIDS, tuberculosis, deaths during childbirth,car accidents, suicide and homicidecombined.THE percentage of smokers in CostaRica decreased slightly between 1995 and2000, the last year that IAFA conducted acomparative study among Costa Ricansages 12 to 60.In 1995, 17.5% of those surveyed weresmokers, a number that decreased to 15.8%in 2000.One of the government’s most recentefforts to help smokers quit is sponsorshipof the Quit and Win 2004 internationalcompetition. Smokers who enter and don’ttouch tobacco for the entire month of Maywill be eligible for national and internationalprizes (TT, April 2).For info about quitting, seek advicefrom a health-care professional or callIAFA at 224-6122.