ble effect of contributing to an increase in overall tobacco consumption, especially among those under age 20. The trade goal was appropriate given Japan's discriminatory trade practices and lack of antismoking health campaigns, but U.S. action, including active advertising and promotion by the U.S. firms that gained entry through U.S. government efforts, also led to increased consumption, most tellingly among youths.

Adverse health impacts militate against invoking Section 301 to facilitate export of tobacco products. Even when the purpose is solely to open unfair markets in countries that have not undertaken significant measures for tobacco control, such as Japan, the health impact should be taken into account before invoking Section 301. In cases in which national governments are actively attempting to rein in tobacco use, U.S. action to facilitate the entry of U.S. tobacco products is clearly in conflict with the public health policies of the foreign governments and is even less justified.

Most countries with unfair tobacco trade practices also protect other industries whose products do not have the adverse health effects of tobacco products. The U.S. Trade Representative should focus first on those products that confer trade benefits without the dire health consequences of tobacco products. A provision new to the 1998 appropriations act for the U.S. Department of Commerce directs the U.S. Trade Representative to use Section 301 for tobacco products only in very limited circumstances.78 The current administration has signaled that any tobacco-related dealings of the U.S. Trade Representative will include consultations with the Department of Health and Human Services. U.S. actions that conflict with credible tobacco control efforts in other countries are clearly inappropriate.

The United States can study and learn from effective foreign tobacco control policies.

The United States has the potential to influence international policy significantly. A handful of countries have been in the forefront of tobacco control for decades and are well in advance of the United States. Familiarity with their successes and failures can help predict the efficacy of proposed U.S. tobacco control measures. International data consistently indicate, for example, that in many diverse countries, price increases and bans on advertising and promotion and on smoking in public places reduce consumption.79 The international expert panel on nicotine maintenance without tobacco, cited above, is another example of how international groups can enhance tobacco control efforts.

The Koop-Kessler Report notes that U.S. leadership in tobacco control is not only a domestic issue but is also a foreign policy issue.80 U.S. tobacco policy will be an important international benchmark, and it should therefore be a high one. As the home of large, multinational tobacco companies, the United States can set standards for tobacco production and marketing and can "ensure that the conduct of U.S. corporations abroad is consistent with our domestic policies and national values.81 The Koop-Kessler report recommends several principles for addressing international issues, including promoting the international adoption of U.S. standards, emphasizing public health over trade interests, funding international tobacco control activities, and preventing U.S. tobacco companies from undermining these efforts.82 It also warns that "a weak scheme of U.S. tobacco con-



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