The truth about big tobacco in its own words

Understanding the vector in order to plan effective tobacco control policies: an analysis of contemporary tobacco industry materials

This paper builds on tobacco document research by analysing contemporary materials to explore how the global tobacco market has changed, how transnational tobacco companies (TTCs) are responding and the implications for tobacco control. The methods involved analysis of a variety of materials, including tobacco company annual reports, investor relations materials, financial analyst reports, market research reports and data. Once China, where TTCs have little market share, is excluded, global cigarette volumes are already declining. Nevertheless, industry profits continue to increase. This pattern is explained by the pricing power of TTCs-their ability to increase prices faster than volumes fall, a consequence of market failure. Pricing power is now fundamental to the long term future of TTCs. Consequently, and in light of growing regulations, the business model of the TTCs is changing. Product innovation is now a key marketing technique used to drive consumers to buy more expensive (ie, profitable) premium cigarettes. Contrary to established wisdom, high tobacco excise rates, particularly where increases in excise are gradual, can benefit TTCs by enabling price (profit) increases to be disguised. Large intermittent tax increases likely have a greater public health benefit. TTC investments in smokeless tobacco appear designed to eliminate competition between smokeless tobacco and cigarettes, thereby increasing the pricing power of TTCs while enabling them to harness the rhetoric of harm reduction. Monitoring TTCs can inform effective policy development. The value maximising approach of TTCs suggests that a ban on product innovation and more informed tobacco excise policies are needed.

Open doorway to truth: legacy of the Minnesota tobacco trial

More than a decade has passed since the conclusion of the Minnesota tobacco trial and the signing of the Master Settlement Agreement (MSA) by 46 US State Attorneys General and the US tobacco industry. The Minnesota settlement exposed the tobacco industry's long history of deceptive marketing, advertising, and research and ultimately forced the industry to change its business practices. The provisions for public document disclosure that were included in the Minnesota settlement and the MSA have resulted in the release of approximately 70 million pages of documents and nearly 20,000 other media materials. No comparable dynamic, voluminous, and contemporaneous document archive exists. Only a few single events in the history of public health have had as dramatic an effect on tobacco control as the public release of the tobacco industry's previously secret internal documents. This review highlights the genesis of the release of these documents, the history of the document depositories created by the Minnesota settlement, the scientific and policy output based on the documents, and the use of the documents in furthering global public health strategies.

The Philip Morris Nordic journalist program: strategies, implementation and outcomes

OBJECTIVES

To describe media strategies for the Nordic countries outlined in internal Philip Morris documents and to evaluate their implementation and outcomes.

METHODS

Systematic search of internal tobacco industry documents from the databases available on the Internet and retrieval of newspaper and magazine articles from Sweden and Finland.

RESULTS

The Philip Morris Nordic journalist program contained a broad range of strategies to communicate company views and to counteract negative publicity, including trips for journalists, media briefings and special events. While several of these strategies were implemented, the efforts were largely unsuccessful in that the media in Sweden and Finland carried few tobacco industry friendly articles. Articles defending the tobacco industry appeared mainly in business papers. However, support of smokers' rights' groups and sponsoring of cultural events generated positive publicity for Philip Morris.

CONCLUSIONS

Despite minor transient victories The Philip Morris Nordic journalist program was largely unsuccessful in providing the anticipated media coverage to question the health hazards of environmental tobacco smoke (ETS) and in preventing ETS regulation in the Nordic countries. The study further supports the notion that the internal corporate documents may expose the intents of the industry, but do not include enough information to evaluate implementation of industry's strategies or their outcomes.

Litigation in Argentina: challenging the tobacco industry

OBJECTIVE

To evaluate the processes and outcomes of tobacco litigation in Argentina and to analyse the strategies of the tobacco industry to oppose litigation using tobacco industry documents.

METHODS

A systematic search of tobacco industry documents on the internet dating from 1978 to 2002. Law library searches using Argentinean official and unofficial reports systems were combined with computerised online searches.

RESULTS

There have been at least 15 failed litigation cases in Argentina and the tobacco industry presented a concerted defence in every claim regardless of cost. We categorised 11 cases as product liability and nicotine addiction, two as health care reimbursement, and two as criminal law and secondhand smoke. Industry strategies included hiring legal consultants from prestigious international and Argentinean law firms and developing litigation prevention programmes. Industry monitored legal academic meetings, controlled the development of new product liability legislation, obtained favourable opinions from experts, and closely observed the development of litigation in Argentina.

CONCLUSION

The strategies used by the industry have been successful in preventing recovery for tobacco injuries through litigation. Argentinean health advocates and lawyers need to be aware of the roles and strategies of the tobacco industry in order to develop effective litigation in Argentina.

The "ultimate prize" for big tobacco: opening the Chinese cigarette market by cigarette smuggling

Novotny discusses a new study in PLoS Medicine that documents how British American Tobacco has exploited China's large cigarette smuggling problem.

The dirty dozen: 12 myths that undermine tobacco control

Cigarette smoking is the leading cause of preventable death in the United States. The health risks of smoking are well documented, as is the effectiveness of clinical and public health interventions to prevent and reduce smoking. However, many myths about smoking either encourage people to begin or continue smoking or deter them from quitting. Some myths stem from a misapplied understanding of what might seem to be common sense; others are deliberately promulgated by the tobacco industry to induce people--especially children--to start smoking and to keep them smoking as adults. These myths undermine tobacco control. However, comprehensive tobacco control programs that include anti-smoking public education campaigns can effectively counter these myths and prevent illness and premature death.

Competing with kreteks: transnational tobacco companies, globalisation, and Indonesia

OBJECTIVE

To examine the strategies employed by transnational tobacco companies (TTCs) to compete more effectively compete with the dominant kretek manufacturers in Indonesia, and to consider implications of their failure.

METHODS

Systematic analysis of corporate documents obtained from British American Tobacco's (BAT's) Guildford depository and from industry and tobacco control websites document collections.

RESULTS

The limited progress of the TTCs in Indonesia is best explained by the distinctive political economy of its tobacco industry. Though effective when collaborating on regulatory issues of mutual interest, TTCs have been less able than kretek manufacturers to exercise political influence where their interests conflict. Global strategies of TTCs have undergone significant local adaptation in attempting to compete in this distinctive environment. While maintaining uniformity in core brand attributes, TTCs have sought to reconcile international imagery with local norms, particularly to appeal to women. BAT unsuccessfully attempted to develop clove based products that imitated the appeal of kreteks, withdrawn following concerns about exposing the company to charges of operating double standards.

CONCLUSIONS

The documents presented highlight the complexity of the global tobacco industry. Tobacco control efforts need to address more effectively the ongoing impact of kreteks while recognising the distinctive threats posed by TTCs.

The "global settlement" with the tobacco industry: 6 years later

On June 20, 1997 a group of attorneys and health advocates proposed a "global settlement" of all public and private litigation against the tobacco industry. This agreement was controversial, and the subsequent implementing legislation was defeated. We sought to determine whether the global settlement represented a "missed opportunity" or a dead end. We compared the global settlement with subsequent laws, regulations, settlements, and judgments against the tobacco industry and found that other than Food and Drug Administration regulation of tobacco, tobacco control advocates have achieved many of the policies included in the global settlement and several beyond it. The policies that have been developed since 1997 have advanced tobacco control substantially, often beyond the provisions of the global settlement.

Development of a model of the tobacco industry's interference with tobacco control programmes

OBJECTIVE

To construct a conceptual model of tobacco industry tactics to undermine tobacco control programmes for the purposes of: (1) developing measures to evaluate industry tactics, (2) improving tobacco control planning, and (3) supplementing current or future frameworks used to classify and analyse tobacco industry documents.

DESIGN

Web based concept mapping was conducted, including expert brainstorming, sorting, and rating of statements describing industry tactics. Statistical analyses used multidimensional scaling and cluster analysis. Interpretation of the resulting maps was accomplished by an expert panel during a face-to-face meeting.

SUBJECTS

34 experts, selected because of their previous encounters with industry resistance or because of their research into industry tactics, took part in some or all phases of the project.

RESULTS

Maps with eight non-overlapping clusters in two dimensional space were developed, with importance ratings of the statements and clusters. Cluster and quadrant labels were agreed upon by the experts.

CONCLUSIONS

The conceptual maps summarise the tactics used by the industry and their relationships to each other, and suggest a possible hierarchy for measures that can be used in statistical modelling of industry tactics and for review of industry documents. Finally, the maps enable hypothesis of a likely progression of industry reactions as public health programmes become more successful, and therefore more threatening to industry profits.

Tobacco industry strategies for influencing European Community tobacco advertising legislation

Restrictions on tobacco company advertising and sponsorship are effective parts of tobacco control programmes worldwide. Through Council Directive 98/43/EC, the European Community (EC) sought to end all tobacco advertising and sponsorship in EC member states by 2006. Initially proposed in 1989, the directive was adopted in 1998, and was annulled by the European Court of Justice in 2000 following a protracted lobbying campaign against the directive by a number of interested organisations including European tobacco companies. A new advertising directive was proposed in May, 2001. We reviewed online collections of tobacco industry documents from US tobacco companies made public under the US Master Settlement Agreement of 1998. Documents reviewed dated from 1978 to 1994 and came from Philip Morris, R J Reynolds, and Brown and Williamson (British American Tobacco) collections. We also obtained approximately 15,000 pages of paper records related to British American Tobacco from its documents' depository in Guildford, UK. This information was supplemented with information in the published literature and consultations with European tobacco control experts. The tobacco industry lobbied against Directive 98/43/EC at the level of EC member state governments as well as on a pan-European level. The industry sought to prevent passage of the directive within the EC legislature, to substitute industry-authored proposals in place of the original directive, and if necessary to use litigation to prevent implementation of the directive after its passage. The tobacco industry sought to delay, and eventually defeat, the EC directive on tobacco advertising and sponsorship by seeking to enlist the aid of figures at the highest levels of European politics while at times attempting to conceal the industry's role. An understanding of these proposed strategies can help European health advocates to pass and implement effective future tobacco control legislation.

Constructing "sound science" and "good epidemiology": tobacco, lawyers, and public relations firms

The tobacco industry has attacked "junk science" to discredit the evidence that secondhand smoke-among other environmental toxins-causes disease. Philip Morris used public relations firms and lawyers to develop a "sound science" program in the United States and Europe that involved recruiting other industries and issues to obscure the tobacco industry's role. The European "sound science" plans included a version of "good epidemiological practices" that would make it impossible to conclude that secondhand smoke-and thus other environmental toxins-caused diseases. Public health professionals need to be aware that the "sound science" movement is not an indigenous effort from within the profession to improve the quality of scientific discourse, but reflects sophisticated public relations campaigns controlled by industry executives and lawyers whose aim is to manipulate the standards of scientific proof to serve the corporate interests of their clients.

Public reaction to the portrayal of the tobacco industry in the film The Insider

OBJECTIVES

To assess public perceptions of the tobacco industry and behavioural intentions for tobacco use in response to watching the film The Insider.

DESIGN

Self administered pre-film survey conducted immediately before viewing and post-film telephone survey conducted within 1-5 weeks of viewing.

SETTING

Two commercial cinemas in Melbourne, Australia.

SUBJECTS

323 cinema patrons were recruited before screening of target films. 182 watched The Insider, 141 watched Erin Brockovich.

INTERVENTIONS

Subjects watched one of two films: The Insider which featured information about unethical conduct by the tobacco industry and negative information about the health effects of smoking, or the "control" film Erin Brockovich which had an analogous plot without anti-tobacco content.

MAIN OUTCOME MEASURES

Pre-film questionnaire: assessed movie viewing habits, demographic characteristics, smoking status, attitudes towards the tobacco industry, intentions for smoking. Post-film questionnaire: assessed same attitudes and intentions plus questions on the film viewed and perceptions of smoking prevalence.

RESULTS

266 (82%) subjects completed the post-film survey. Attitudes toward the tobacco industry were unfavourable at baseline. Those who saw The Insider held more negative views of business conduct by the tobacco industry than those who saw Erin Brockovich, once pre-existing attitudes to the industry were controlled for. The Insider also appears to have promoted a short term reduction in intentions to smoke.

CONCLUSIONS

Results of this study suggest that if people were recurrently exposed to anti-tobacco content in movies there is potential for a more substantial and lasting impact on attitudes toward the tobacco industry and smoking.