Perceptions of industry responsibility and tobacco control policy by US tobacco company executives in trial testimony

Big tobacco focuses on the facts to hide the truth: an algorithmic exploration of courtroom tropes and taboos

OBJECTIVE

To use methods from computational linguistics to identify differences in the rhetorical strategies deployed by defence versus plaintiffs' lawyers in cigarette litigation.

METHODS

From 318 closing arguments in 159 Engle progeny trials (2008-2016) archived in the Truth Tobacco Industry Documents, we calculated frequency scores and Mann-Whitney Rho scores of plaintiffs versus defence corpora to discover 'tropes' (terms used disproportionately by one side) and 'taboos' (terms scrupulously avoided by one side or the other).

RESULTS

Defence attorneys seek to place the smoker on trial, using his or her friends and family members to demonstrate that he or she must have been fully aware of the harms caused by smoking. We show that 'free choice,' 'common knowledge' and 'personal responsibility' remain key strategies in cigarette litigation, but algorithmic analysis allows us to understand how such strategies can be deployed without actually using these expressions. Industry attorneys rarely mention personal responsibility, for example, but invoke that concept indirectly, by talking about 'decisions' made by the individual smoker and 'risks' they assumed.

CONCLUSIONS

Quantitative analysis can reveal heretofore hidden patterns in courtroom rhetoric, including the weaponisation of pronouns and the systematic avoidance of certain terms, such as 'profits' or 'customer.' While cigarette makers use words that focus on the individual smoker, attorneys for the plaintiffs refocus agency onto the industry. We show how even seemingly trivial parts of speech-like pronouns-along with references to family members or words like 'truth' and 'facts' have been weaponised for use in litigation.

How Tobacco Companies are Perceived Within the United Kingdom: An Online Panel

INTRODUCTION

Little is known about how consumers perceive tobacco companies in the United Kingdom.

METHODS

An online cross-sectional survey with those aged 16 years and over (N = 2253) explored perceptions of, and attitudes towards, tobacco companies. This included awareness of tobacco companies, views on tobacco companies' practices (targeting the most vulnerable, encouraging smoking to replace those who quit or die, making cigarettes more addictive) and values (honesty, ethics, interest in harm reduction), perceptions of regulation of tobacco companies (whether tobacco companies have the same marketing rights as other companies, should be allowed to promote cigarettes, be required to sell cigarettes in plain packs, and pay for associated health costs), and locus of responsibility for health problems caused by tobacco use.

RESULTS

Prompted awareness of tobacco companies was high (68%). Almost a third of the sample had a negative perception of tobacco companies' practices, for example, they thought they made cigarettes more addictive. In terms of tobacco companies' values, less than a fifth considered tobacco companies honest, ethical, and interested in reducing the harm caused by cigarettes. Indeed, tobacco company executives were rated lower than the seven other professions asked about, except car salesman, in terms of ethics and honesty. More than half the sample supported greater regulation, for example, requiring tobacco companies to pay for health costs due to tobacco use. Most attributed responsibility for smoking-related health problems to smokers (88%) and tobacco companies (55%).

CONCLUSIONS

The findings suggest that consumers are not fully informed about tobacco company practices.

IMPLICATIONS

Few studies outside of North America have explored perceptions of tobacco companies' practices, values and regulation and responsibility for smoking-related illness. Adults surveyed within the United Kingdom considered tobacco companies dishonest, unethical and untrustworthy, but only a third of the sample thought that they encourage new smokers or have made cigarettes more addictive, and just over a half attributed most of the responsibility for smoking-related health problems to tobacco companies. As consumers do not appear fully informed about the role of tobacco companies in initiating and perpetuating the tobacco epidemic, tobacco industry denormalization campaigns may be of potential value.

Whole-of-government approaches to NCDs: the case of the Philippines Interagency Committee-Tobacco

To address the rise in non-communicable diseases (NCDs), governments are now being urged to 'put forward a multisectoral approach for health at all government levels, to address NCD risk factors and underlying determinants of health comprehensively and decisively' [UN, 2011. Political Declaration of the High-Level Meeting of the General Assembly on the Prevention and Control of Non-Communicable Diseases (No. A/66/L.1). New York, NY: United Nations]. There is a global consensus that whole-of-government approaches (WG) can be particularly effective in regulating products such as tobacco, pre-packaged foods and alcohol, which are or can be major risk factors for NCDs. Despite the overwhelming push towards interagency arrangements for health policymaking and implementation, including in contemporary efforts to prevent and control NCDs, there has been minimal investigation into how countries have pursued WG and which types of institutional designs and arrangements offer particular utility to achieve health objectives. This article examines these issues through a case study concerning the interagency mechanism that the Philippine government currently utilizes to govern tobacco control, the Interagency Committee-Tobacco (IAC-T). We conducted key informant interviews (n = 33) with government officials, and representatives from civil society organizations, health professional associations and intergovernmental organizations. We targeted informants who have been involved in the work of the IAC-T and/or tobacco control policy more broadly. We also analysed public documents to contribute to our analysis of the structure, functioning and legal status of the IAC-T. Our findings highlight two salient challenges that arose in the Philippines case: (1) the inclusion of industry representation on the IAC-T and (2) the attempt to consolidate the responsibilities of the different departments through a policy of 'balance' between health and commercial interests. We analyse how health proponents navigated this challenging institutional arrangement and the various barriers they faced in achieving the intended health objectives. We draw from this case to discuss the lessons that can inform broad calls for WG to NCDs.

Success counteracting tobacco company interference in Thailand: an example of FCTC implementation for low- and middle-income countries

Transnational tobacco companies (TTCs) interfere regularly in policymaking in low- and middle-income countries (LMICs). The WHO Framework Convention for Tobacco Control provides mechanisms and guidance for dealing with TTC interference, but many countries still face ‘how to’ challenges of implementation. For more than two decades, Thailand’s public health community has been developing a system for identifying and counteracting strategies TTCs use to derail, delay and undermine tobacco control policymaking. Consequently, Thailand has already implemented most of the FCTC guidelines for counteracting TTC interference. In this study, our aims are to describe strategies TTCs have used in Thailand to interfere in policymaking, and to examine how the public health community in Thailand has counteracted TTC interference. We analyzed information reported by three groups with a stake in tobacco control policies: Thai tobacco control advocates, TTCs, and international tobacco control experts. To identify TTC viewpoints and strategies, we also extracted information from internal tobacco industry documents. We synthesized these data and identified six core strategies TTCs use to interfere in tobacco control policymaking: (1) doing business with ‘two faces’, (2) seeking to influence people in high places, (3) ‘buying’ advocates in grassroots organizations, (4) putting up a deceptive front, (5) intimidation, and (6) undermining controls on tobacco advertising, promotion and sponsorship. We present three case examples showing where TTCs have employed multiple interference strategies simultaneously, and showing how Thai tobacco control advocates have successfully counteracted those strategies by: (1) conducting vigilant surveillance, (2) excluding tobacco companies from policymaking, (3) restricting tobacco company sales, (4) sustaining pressure, and (5) dedicating resources to the effective enforcement of regulations. Policy implications from this study are that tobacco control advocates in LMICs may be able to develop countermeasures similar to those we identified in Thailand based on FCTC guidelines to limit TTC interference.

Social responsibility in tobacco production? Tobacco companies' use of green supply chains to obscure the real costs of tobacco farming

BACKGROUND

Tobacco companies have come under increased criticism because of environmental and labour practices related to growing tobacco in developing countries.

METHODS

Analysis of tobacco industry documents, industry websites and interviews with tobacco farmers in Tanzania and tobacco farm workers, farm authorities, trade unionists, government officials and corporate executives from global tobacco leaf companies in Malawi.

RESULTS

British American Tobacco and Philip Morris created supply chains in the 1990 s to improve production efficiency, control, access to markets and profits. In the 2000s, the companies used their supply chains in an attempt to legitimise their portrayals of tobacco farming as socially and environmentally friendly, rather than take meaningful steps to eliminate child labour and reduce deforestation in developing countries. The tobacco companies used nominal self-evaluation (not truly independent evaluators) and public relations to create the impression of social responsibility. The companies benefit from $1.2 billion in unpaid labour costs because of child labour and more than $64 million annually in costs that would have been made to avoid tobacco-related deforestation in the top 12 tobacco growing developing countries, far exceeding the money they spend nominally working to change these practices.

CONCLUSIONS

The tobacco industry uses green supply chains to make tobacco farming in developing countries appear sustainable while continuing to purchase leaf produced with child labour and high rates of deforestation. Strategies to counter green supply chain schemes include securing implementing protocols for the WHO Framework Convention on Tobacco Control to regulate the companies' practices at the farm level.

Do we believe the tobacco industry lied to us? Association with smoking behavior in a military population

Despite the dangers of smoking, tobacco companies continue to impede tobacco control efforts through deceptive marketing practices. Media campaigns that expose these practices have been effective in advancing anti-industry attitudes and reducing smoking initiation among young people, yet the association between knowledge of industry practices and smoking cessation and relapse has not been studied. In a large military sample entering Air Force Basic Military Training (BMT), where tobacco use is prohibited, we investigated (i) the prevalence of agreement with a statement that tobacco companies have misled the public about the health consequences of smoking and (ii) the association of this acknowledgement with smoking status upon entry into BMT (N = 36 013). At baseline, 56.6% agreed that tobacco companies have been deceptive, and agreement was a strong predictor of smoking status [smokers less likely to agree, odds ratio (OR) = 0.39, P < 0.01]. At 12-month follow-up, we examined the association between industry perception at baseline and current smoking status (N = 20 672). Recruits who had been smoking upon entry into BMT and who had acknowledged industry deception were less likely to report current smoking (OR = 0.84, P = 0.01). These findings suggest that anti-industry attitudes may affect smoking relapse following cessation.

Stakeholders' opinions about a tobacco policy in Lao PDR

The global epidemic of tobacco smoking is expected to impact hardest in low- and middle- income countries (LMIC). There is a lack of understanding regarding the policy environments within which tobacco control policies are being introduced particularly in LMIC. This study aims at exploring key stakeholders' beliefs about a tobacco policy in Lao PDR.

This is a qualitative case study with a standardised open-ended questionnaire answered by eleven stakeholders in leading positions within different ministries and the media, donors and NGOs. Themes included the perception of tobacco among professionals, awareness of tobacco as a public health issue, importance of inter-sectoral cooperation, and obstacles faced in implementing policies. The research team included both outsiders and an insider. Analysis was done using the case and cross-case analysis.

Among the respondents there was consensus regarding the positive impact of a national tobacco policy with the exception of the representative from the Ministry of Agriculture. Stakeholders identified education, awareness creation through media and law enforcement as important interventions, followed by taxation. Education should be diversified in the way it should be delivered. It was emphasized that people in rural areas and minority groups need tailored made approaches. A major limiting factor in moving tobacco control forward in LMIC was stated to be the lack of funding. The refusal by tobacco industry to participate in the study is noteworthy. It is essential to draft a national tobacco policy that can help the government to increase taxes, and create adequate provisions for the enforcement of tobacco laws and regulations.