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The manufacture, use, and marketing of tobacco present a serious threat to children's right to health. This makes the Convention on the Rights of the Child a potentially powerful tobacco-control tool and the United Nations Children's Fund (UNICEF), which oversees the convention's implementation, a potential leader in tobacco control. UNICEF actively supported tobacco control initiatives in the late 1990s, but since the early 2000s UNICEF's role in tobacco control has been minimal. Using the Truth Tobacco Industry Documents library, an online collection of previously secret tobacco industry documents, we sought to uncover information on the tobacco industry's ties with UNICEF. We found that from 1997 to 2000, when UNICEF was actively promoting tobacco control to support children's rights, the tobacco industry saw children's rights and UNICEF as potentially powerful threats to business that needed to be closely monitored and neutralized. The industry then positioned itself as a partner with UNICEF on youth smoking prevention initiatives as a way to avoid meaningful tobacco control measures that could save children's lives. After UNICEF's corporate engagement guidelines were loosened in 2003, tobacco companies successfully engaged with UNICEF directly and via front groups, including the Eliminating Child Labour in Tobacco Growing Foundation. This was part of an overall tobacco industry strategy to improve its corporate image, infiltrate the United Nations, and weaken global tobacco-control efforts. As part of its mission to protect children's rights, UNICEF should end all partnerships with the tobacco industry and its front groups.Keywords:
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The publication of a special communication by Ronald Davis in this issue (see page 211) 1 about a report on the effect of tobacco advertising bans (“the Boddewyn report”) that was in fact ghost-written by British American Tobacco caused one of us to experience a memory flashback to the mid-1980s. At that time, MW was working as a research officer in a state health department in Adelaide, South Australia. I (MW) distinctly remember being given the Boddewyn report to provide comment on to my health minister’s office. Even though I was then an inexperienced researcher, I could see that the report was seriously flawed. Because it was apparently the work of such a prestigious-sounding individual and organisation, I became deeply concerned that it could actually influence government policy. I prepared several pages of critique pointing out the problems with the report, added a concise summary, and sent it back up to the minister’s office. I received no further requests about the report, but it was the first time I was shocked by the extent of misinformation from sources allied with the tobacco industry. That situation was one of several that drew me more closely into a career in tobacco …
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The manufacture, use, and marketing of tobacco present a serious threat to children's right to health. This makes the Convention on the Rights of the Child a potentially powerful tobacco-control tool and the United Nations Children's Fund (UNICEF), which oversees the convention's implementation, a potential leader in tobacco control. UNICEF actively supported tobacco control initiatives in the late 1990s, but since the early 2000s UNICEF's role in tobacco control has been minimal. Using the Truth Tobacco Industry Documents library, an online collection of previously secret tobacco industry documents, we sought to uncover information on the tobacco industry's ties with UNICEF. We found that from 1997 to 2000, when UNICEF was actively promoting tobacco control to support children's rights, the tobacco industry saw children's rights and UNICEF as potentially powerful threats to business that needed to be closely monitored and neutralized. The industry then positioned itself as a partner with UNICEF on youth smoking prevention initiatives as a way to avoid meaningful tobacco control measures that could save children's lives. After UNICEF's corporate engagement guidelines were loosened in 2003, tobacco companies successfully engaged with UNICEF directly and via front groups, including the Eliminating Child Labour in Tobacco Growing Foundation. This was part of an overall tobacco industry strategy to improve its corporate image, infiltrate the United Nations, and weaken global tobacco-control efforts. As part of its mission to protect children's rights, UNICEF should end all partnerships with the tobacco industry and its front groups.
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This paper reviews progress in tobacco litigation since Tobacco Control ’s founding 30 years ago, with a focus on cases which are ongoing or recently decided. Litigation in tobacco control falls into several classes: legal challenges brought by the tobacco industry to block implementation of tobacco control measures, public interest litigation brought by civil society to push for higher standards of implementation of tobacco control measures and liability litigation by governments and individuals to hold the tobacco industry accountable for the harm it causes. In each class of cases, there are a number of major case studies which show the importance of international frameworks, including most significantly the WHO Framework Convention on Tobacco Control, to tobacco litigation.
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To examine some recent examples of tobacco control policies used elsewhere that seek to directly erode tobacco industry power, and to consider the relevance of these to New Zealand.A literature search was supplemented with six key informant interviews, with World Health Organization (WHO) officials, and Canadian officials and advocates.The Provincial Government of British Columbia (BC) from 1997 to 2001 had an explicit objective of 'denormalising' the tobacco industry. Legal action was started against the industry to recover healthcare costs. The Canadian Government has been involved in defending its comprehensive tobacco control legislation in court against the industry since 1988. The policies to directly erode industry power, of both Canada overall and at the province level (BC), have been temporally associated with significant declines in smoking prevalence. Since 1998, WHO has conducted a series of inquiries into tobacco industry influence within WHO, and at regional and national levels. Its research and publishing focus on the industry has supported the creation of the Framework Convention on Tobacco Control, which has sections with the potential to assist national governments in strengthening strategies to erode tobacco industry power. The limitations of such strategies, and the uncertainties with using these approaches in the New Zealand context, suggests the need for careful planning and ongoing evaluation.Recent experience (in several jurisdictions and organisations) suggests that policies to directly erode tobacco industry power may contribute to the effectiveness of comprehensive tobacco control programmes. Some of these lessons could be incorporated into New Zealand's tobacco-control strategy.
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Tobacco is one of the greatest threats to human health. Doctors and their professional associations have a vital role in reducing illness and death from tobacco. But tobacco control is not just an issue for doctors. Meaningful regulation of the tobacco industry is needed. The WHO Framework Convention on Tobacco Control aims to protect the public against the global spread of tobacco. This review sets out the main provisions of the Framework Convention, and its implications for governments and for the medical profession.
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Background Few studies have investigated tobacco industry interference in the tobacco control policies of Arab nations. This paper explores the tactics used by the industry to subvert tobacco control policies in Oman and offers lessons on how to prevent such interference in the future. Methods We searched the Truth Tobacco Industry Documents Archive using the word ‘Oman’, names of government institutions, policymakers and local tobacco distributors. Extracted data were noted chronologically by key elements of tobacco control measures. Gulf Cooperation Council (GCC) Health Ministers’ Council resolutions on tobacco control were also reviewed. Results Out of 1020 tobacco documents located, 327 were closely related to policy interference. Documents revealed that the industry met key government officials, offered in-kind services, used local diplomatic missions to influence Omani policymakers, opposed smoking bans, delayed regulations to lower tar and nicotine content of cigarettes, and to require effective health warnings, circumvented a tobacco advertising, promotion and sponsorship ban and provided voluntary codes as an alternative to effective regulations. Additionally, industry representatives lobbied individual countries in the GCC to veto tax increments and defeat consensus on agreed resolutions of the Health Ministers’ Council. Conclusion The tobacco industry interfered in all key public health policies aimed to reduce tobacco use in Oman. There is an urgent need for the Omani government to enforce the Civil Code of Conduct and develop guidelines for all policymakers through implementing Article 5.3 of the WHO Framework Convention on Tobacco Control to curb the tobacco epidemic.
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Tobacco use is the leading preventable cause of death in South Carolina. Smoking-related medical costs amount to $1.1 billion each year, including $393 million for Medicaid. Tobacco growing in South Carolina declined by over 50 percent from 1997 to 2008. Tobacco accounted for less than 10% of the state's cash receipts from all crops in 2007. Despite the low levels of actual tobacco growing and the small role tobacco played in the state's economy in 2008, the cultural construct of being a “tobacco growing state†continued to have a disproportionately large impact on tobacco control policy making. Between 1997 and 2008, the tobacco industry lost its alliances with the Farm Bureau Federation and Commissioners of Agriculture, former staunch industry allies, because of negotiations over the Master Settlement Agreement, the buyout of the Tobacco Price Support system, and increasing purchase of foreign tobacco. Tobacco control Policy Score rankings of 2007/2008 legislators by knowledgeable tobacco control advocates revealed that legislators from the Pee Dee region, historically the stronghold of tobacco agriculture, were similar to the rest of the state's legislators in their attitudes towards tobacco control. Tobacco area legislators were formerly strong allies of the tobacco industry and historically worked with industry lobbyists to ensure defeat or manipulation of tobacco control bills. The 2007/2008 Policy Scores indicated that this was no longer the case. Tobacco control advocates should take advantage of the growing distance between tobacco companies and its former tobacco-growing allies and the decline in the actual importance of tobacco agriculture to challenge the rhetoric and resistance to tobacco control policies in the state. The tobacco industry built significant political influence in South Carolina through lobbyists, alliances with prominent trade associations, campaign contributions and other political expenditures. From 1996 to 2006, tobacco companies, trade associations and producers contributed a total of $680,541 to candidates for state office and to political parties. There is a measurable relationship between tobacco industry contributions and legislative behavior. As rated on a Policy Score scale from 0 to 10, with 10 being extremely receptive to tobacco control and 0 being extremely pro-tobacco industry, for every $1,000 received from the tobacco industry during the 2006 election cycle, a legislator's Policy Score decreased by 1.5 points. Democrats were on average 3.6 points more favorable towards tobacco control than Republicans, after controlling for campaign contributions. South Carolina was selected by the NCI in 1990 to participate in the 17-state ASSIST program. ASSIST funded tobacco control programming within the Department of Health and Environmental Control and established the state's first formal tobacco control coalition, the Alliance for a Smoke-Free South Carolina. The Alliance disbanded in 1997, leaving tobacco control advocacy disorganized and ineffective through 2003. ASSIST ended in 1999 and was replaced by a minimally-funded DHEC Tobacco Division supported primarily by about $1 million annually from the US Centers for Disease Control and Prevention. In 1998, the state signed the Master Settlement Agreement, securing approximately $70 million per year from the major cigarette companies. In 2000, the state securitized its settlement revenue, receiving a lump sum of $900 million up front in lieu of its annual payments through 2019. Refinancing in 2008 moved this date back to 2012. The 2000 General Appropriations bill set up 4 trust funds from the securitized MSA funds, with 73% ($574 million for healthcare), including tobacco control. Only $3.34 million of the MSA revenue was spent on tobacco control between 2000 and 2008. The state allocated an additional $6 million from the General Fund to the DHEC Tobacco Division between 2002 and 2008, with no state funding for the program between 2003 and 2006 and again in 2008. The Tobacco Division developed small-scale but innovative tobacco control programming, particularly community programs to promote policy change and the Rage Against the Haze youth movement. The DHEC leadership did not prioritize tobacco control between 2000 and 2008, although its support increased gradually due to efforts by the Tobacco Division, DHEC regional staff and the voluntary health groups. Funding requests remained at $2 million, significantly below the CDC recommended $62.2 million per year. Limitations by DHEC leadership on the role that DHEC staff play in local community-wide policy change efforts changed in 2007 to allow direct participation, but remained limited in scope. The voluntary health groups failed to prioritize increased funding for the DHEC Tobacco Division relative to their other lobbying focuses and continued in 2008 to act hesitantly in their lobbying of DHEC leadership to support tobacco control funding and policy change. In 2001, tobacco control advocates formed the South Carolina Tobacco Collaborative. It received 83% of its funding from the state health department, limiting its advocacy capacity. Increased funding from voluntary health groups and national partners between 2005 and 2008 allowed the Collaborative and the other prominent tobacco control advocacy groups, the South Carolina African-American Tobacco Control Network and the Smoke-Free Action Network, to increase advocacy between 2005 and 2008. These developments led to notable successes in clean indoor air policies and attempts to increase the state's tobacco tax. The cigarette tax in South Carolina remained the lowest in the nation in 2008, at 7 cents per pack. The last cigarette tax increase was in 1977, with nearly annual attempts to increase the tax defeated by coordinated efforts from the tobacco industry. Tobacco control advocates began to push for a cigarette tax increase in 2000, without success. Between 2006 and 2008, the Collaborative developed a well-funded and well-coordinated public education and lobbying campaign to support a cigarette tax increase. In 2008, the General Assembly passed a 50-cent increase, with $5 million of the annual revenue directed to the DHEC Tobacco Division, over active opposition from the tobacco industry and its allies. Governor Mark Sanford vetoed the bill for its lack of revenue neutrality, and Speaker of the House Bobby Harrell successfully prevented a veto override in the House. The 2006-2008 cigarette tax increase campaign showed that well-funded tobacco control advocacy could be successful over tobacco industry opposition in the legislature. The defeat of the increase bill demonstrated the need for stronger grasstops lobbying and relationship building with legislative leadership. Between 1977 and 1989, local policymakers passed 19 limited clean indoor air ordinances, building momentum for consideration of a state-level clean indoor air bill. In 1990, tobacco control advocates compromised with tobacco industry lobbyists to allow the passage of a weak statewide Clean Indoor Air Act, halting significant progress on clean indoor air through 2005. In 1996, the tobacco industry succeeded in using the Synar Amendment to integrate preemption into a youth access to tobacco amendment. The tobacco industry and tobacco control advocates assumed the provision also preempted local clean indoor air activity. Beginning in 1999, local policymakers in Charleston began to support local clean indoor air ordinance attempts despite assumed preemption. While Charleston did not pass an ordinance until 2006, news coverage of the city's efforts began a wave of consideration of local ordinances, eventually supported by state and local tobacco control advocates and the Municipal Association. Between May 2006 and December 2008, 21 local clean indoor air ordinances passed, 12 of which passed before the state Supreme Court rejected the argument that preemption applied to clean indoor air ordinances. Two localities were sued over their ordinances on preemption grounds, but won both cases in the Supreme Court. During the 2007/2008 legislative session, tobacco control advocates joined together to successfully defeat multiple attempts to institute express preemption through weak clean indoor air legislation supported by the tobacco industry. Given the success of local clean indoor air efforts, the strategy of tobacco control advocates developed during 2008 should be maintained: continue to promote comprehensive local smoke-free ordinances, while avoiding any action on clean indoor air in the General Assembly.
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Author(s): Lee, Chung-Yol, MD, MPH; Glantz, Stanton A., Ph.D. | Abstract: Cigarette consumption among people 15 years or older peaked in Switzerland in the early 1970’s with 3,700 cigarettes per capita and per year, followed by a decline to 2,800 cigarettes per capita and per year in 1994. After a decline of the proportion of smokers from 37% in 1980 to 31% in 1992, this proportion has increased again to 33% in 1997. Women, particularly the young, and children and adolescents, have shown a continued increase in smoking prevalence, despite the focus of tobacco prevention efforts on children and adolescents.Every year, over 10,000 people die from tobacco use in Switzerland, about a sixth of all annual deaths in Switzerland, making smoking the leading preventable cause of death in Switzerland. This number is more than 20 times higher than the number of deaths caused by illegal drugs.The tobacco excise tax in Switzerland is the lowest in Western Europe. The laws governing tobacco products, their marketing and sales, are weak and have little practical effect on the tobacco industry.There is no meaningful protection of nonsmokers from the toxic chemicals in secondhand tobacco smoke, in public places or work places.A ten-country survey on people’s experiences and attitudes concerning tobacco and smoking in 1989, commissioned by Philip Morris International, showed that Swiss people were aware of secondhand smoke’s adverse effects on health, but only a minority favored government regulations for smoking in restaurants and workplaces.A first comprehensive 5-year tobacco prevention program, 1996 to 1999, issued by the Swiss Federal Office of Public Health lacked adequate financial resources, focus on specific interventions, cooperation between partners for tobacco prevention, and program coordination and management. It ignored the role of the tobacco industry.As a result of recent events in the US and WHO’s active engagement of the tobacco industry, the draft five-year plan for tobacco prevention in Switzerland for 2001 to 2005 identifies the tobacco industry as a major obstacle to tobacco prevention.Until the recent merger of British American Tobacco (BAT) with Burrus-Rothmans in 1999, the single most important tobacco company in Switzerland was Philip Morris (PM), with a market share of close to 50% (and close to 25% for Marlboro alone). Since the merger, the tobacco market is dominated by PM and BAT, each with a market share of cigarette sales between 45% and 50%.As was the case in the US, in the early 1960’s, the scientists in Swiss tobacco industry research laboratories (in this case, FTR (Fabriques de Tabac Reunies) / Philip Morris) accepted and discussed the dangerous effects of smoking on health in internal company communications. At that time, these scientists earnestly tried to find ways to reduce the carcinogenic effects of cigarettes through elimination of carcinogenic components.Contrary to privately expressed views, tobacco industry’s public position in Switzerland was that there was ongoing controversy in the issue whether smoking caused diseases or not.The “controversy” was nurtured through regular media briefings and scientific meetings with carefully chosen scientists who would publicly support the industry’s position, but without declaring their liaisons with the tobacco industry. Relationships with these industry “consultants” or “witnesses” were maintained through direct payments and indirectly through funding of their research.By late 1980’s the tobacco industry had identified the decline of social acceptability of smoking in Europe as a major threat to its viability. This recognition led to the development of a comprehensive strategy to fight the secondhand smoke issue. “Courtesy and tolerance” and economic arguments were used to divert the public’s and policy makers’ attention from the health issue. The resulting strategies were often devised in consultation with executives of other Philip Morris subsidiaries and Philip Morris International headquarters in New York. Well aware of its low credibility with the public, journalists were given interviews and told not to mention the tobacco company’s name in the newspaper article.Official publications, such as “Smoking and Mortality in Switzerland” by the Federal Office of Public Health, the report on the respiratory effects of secondhand smoke by the US Environmental Protection Agency, as well as original scientific publications, such as an article in the American Journal of Respiratory and Critical Care Medicine, dealing with secondhand smoke and respiratory symptoms in Switzerland (SAPALDIA study) written by a group of Swiss scientists, were massively attacked by the tobacco industry. The tobacco industry employed “consultants” and politicians with industry ties, who used standard industry arguments.One of the most active industry consultants in Switzerland was Peter Atteslander, a Swiss citizen and professor at the University of Augsburg in Germany. He wrote white papers for the tobacco industry and reported from meetings worldwide. Atteslander appeared to be the essence only member of the Switzerland-based “Arbeitsgruppe fur Gesundheitsforschung (AGEF) (“Working Group on Health Research”), which published his work without disclosing the ties to the tobacco industry.To fight smoking restrictions in restaurants and hotels, the tobacco industry developed a strong ally in the hospitality association, the International HoReCa. The secretary general of International HoReCa at the time was Dr. Xavier Frei, also president of the SCRA (most likely the Swiss Cafe and Restaurant Association). The hospitality association made extensive use of tobacco industry resources and repeatedly printed tobacco industry positions in hospitality industry newsletters, without the members of International HoReCa or SCRA being informed about the close ties between their organization and the tobacco industry.The “accommodation program,” a well-known tobacco industry strategy to preempt regulatory measures against smoking in restaurants and workplaces first developed in the United States, was used in Switzerland. The fact that even the logo was the same as the one used in the US is another illustration of tobacco industry’s recycling of strategies and tactics worldwide.The shift of focus from the problem of secondhand smoke to one of indoor air quality in general was (and remains) a major strategy used by the tobacco industry worldwide to dilute the problem of secondhand smoke with other indoor air pollutants and ventilation of buildings. To this end, an indoor air quality control company with close ties to the tobacco industry, ACVA Atlantic Inc., USA, later renamed Healthy Buildings International, HBI, collected data which was used extensively by the tobacco industry to further their goal of downplaying the role of secondhand smoke as a major component of indoor air pollutant. Employees of HBI were sent to Switzerland to collect data on Swiss office buildings, and the data were used in the newsletters of HoReCa to support the accommodation program and against non-smoking regulations. HBI has been discredited in the US.The tobacco industry tried to influence smoking policy in airplanes through partial funding of IFAA’s (International Flight Attendants Association) world congresses. This influence was established through close relationship with the president of the association, a common industry strategy in influencing organizations. When, in the wake of smoke-free flights in the US and other countries, Swissair finally introduced smoke-free flights, it was heavily criticized in newspaper articles by the Swiss “Smokers Club,” and later the Swiss “Club of Tobacco Friends,” whose president and founder is a former public relations official for the tobacco industry.The Swiss Cigarette Manufacturers Association successfully influenced smoking policy in railway trains through letters to the publishers of newspapers and direct lobbying toward cantonal authorities and the head of the national railways.Two referendums on tobacco and alcohol advertising bans in 1979 and 1993 were rejected by Swiss voters despite pre-referendum polls favoring advertising bans through a strong and lasting alliance of the tobacco industry with the advertising agencies and the print media. The tobacco industry successfully kept itself behind the scenes in order to avoid negative publicity while financing the anti-advertising ban campaigns and supplying the alliance against advertising bans with well-crafted arguments by tobacco industry public relations and law firms through the International Tobacco Information Center, INFOTAB. The tobacco industry and its allies used economic and political arguments, such as purported effects on employment, state tax revenues, and individual and corporate freedom to fight the advertising bans.Close relationships with officials and politicians were emphasized and maintained through regular meetings with the head of the political parties and briefings of the “tobacco caucus” in the parliament. This caucus gave the tobacco industry the means to stay well informed about the political agenda and to easily influence the political process in their favor.While Switzerland has some of the most progressive and innovative public health promotion programs, most public health advocates underestimate the power of, and driving forces behind, a tobacco industry, and only few of them have confronted the industry directly.
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