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Crosbie E, Tran B, Albuquerque de Figueiredo B, Severini L, Severini G, Sebrié EM. Tobacco industry strategies to influence the regulation of new and emerging tobacco and nicotine products in Latin America and the Caribbean. Rev Panam Salud Publica 2024; 48:e43. [PMID: 38859810 PMCID: PMC11164239 DOI: 10.26633/rpsp.2024.43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 01/02/2024] [Indexed: 06/12/2024] Open
Abstract
Objective To document tobacco industry strategies to influence regulation of new and emerging tobacco and nicotine products (NETNPs) in Latin America and the Caribbean. Methods We analyzed industry websites, advocacy reports, news media and government documents related to NETNPs, focusing on electronic cigarettes and heated tobacco products. We also conducted a survey of leading health advocates. We applied the policy dystopia model to analyze industry action and argument-based strategies on NETNP regulations. Results Industry actors engaged in four instrumental strategies to influence NETNP regulation - coalition management, information management, direct involvement in and access to the policy process, and litigation. Their actions included: lobbying key policy-makers, academics and vaping associations; providing grants to media groups to disseminate favorable NETNP information; participating in public consultations; presenting at public hearings; inserting industry-inspired language into draft NETNP legislation; and filing lawsuits to challenge NETNP bans. The industry disseminated its so-called harm reduction argument through large/influential countries (e.g., Argentina, Brazil, and Mexico). Industry discursive strategies claimed NETNPs were less harmful, provided safer alternatives, and should be regulated as so-called harm reduction products or have fewer restrictions on their sale and use than those currently in place. Conclusion Our analysis provides a better understanding of industry strategies to undermine tobacco and nicotine control. To help counter industry efforts, health advocates should proactively strengthen government capacities and alert policy-makers to industry attempts to create new regulatory categories (so-called reduced-risk products), provide misleading information of government authorizations of NETNPs, and co-opt so-called harm-reduction messages that serve the industry's agenda.
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Affiliation(s)
- Eric Crosbie
- School of Public HealthUniversity of Nevada RenoRenoNVUnited States of AmericaSchool of Public Health, University of Nevada Reno, Reno, NV, United States of America.
| | - Brian Tran
- School of Public HealthUniversity of Nevada RenoRenoNVUnited States of AmericaSchool of Public Health, University of Nevada Reno, Reno, NV, United States of America.
| | - Beatriz Albuquerque de Figueiredo
- Campaign for Tobacco-Free KidsWashington, D.C.United States of AmericaCampaign for Tobacco-Free Kids, Washington, D.C., United States of America.
| | - Luciana Severini
- Pan American Health OrganizationWashington, D.C.United States of AmericaPan American Health Organization, Washington, D.C., United States of America.
| | - Gianella Severini
- Campaign for Tobacco-Free KidsWashington, D.C.United States of AmericaCampaign for Tobacco-Free Kids, Washington, D.C., United States of America.
| | - Ernesto M. Sebrié
- Campaign for Tobacco-Free KidsWashington, D.C.United States of AmericaCampaign for Tobacco-Free Kids, Washington, D.C., United States of America.
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Spillane TE, Madar A, Cohen JE, Welding K, Clegg Smith K. Tobacco companies' creation of additional communication space: a content analysis of cigarette pack inserts and onserts. Tob Control 2023:tc-2023-057982. [PMID: 37380350 DOI: 10.1136/tc-2023-057982] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 06/08/2023] [Indexed: 06/30/2023]
Abstract
OBJECTIVES Pack inserts and onserts-removable items placed inside or on the outside of packs-are a communicative strategy used by tobacco companies that provide them with additional marketing space. A content analysis of these items was conducted across several years, countries and brands to assess how these items are used to communicate with consumers. METHODS Between 2013 and 2020, cigarette packs were systematically collected using the Tobacco Pack Surveillance System protocol. Packs with inserts or onserts (n=178) were identified from 11 low and middle-income countries. Packs were coded for tobacco company strategies, physical pack characteristics and imagery and lexical marketing appeals. RESULTS Of the 5903 packs, 3% (n=178) had an insert or onsert. 171 of these (96%) were inserts. While most (78%) pack exteriors were entirely in English, over half (51%) of the inserts/onserts were entirely in the local (non-English) language from where the pack was collected. The most common appeals on the inserts/onserts were product dependability (64%), luxury/aspirational (55%) and machinery/technology (37%). Product images were prevalent as well as images or words mentioning filters (22%). The most used appeals involved featuring aspects of a product (66%), addressing customers directly (52%) and informing customers about new aspects of a product (31%). CONCLUSIONS Cigarette pack inserts/onserts are unregulated in many countries and provide additional space for tobacco companies to extend and innovate their advertising. Tobacco advertising and packaging policies such as plain and standardised packaging should expand to address inserts/onserts to protect consumers more fully from industry promotion of deadly products.
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Affiliation(s)
- Torra E Spillane
- Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Alena Madar
- Department of Health, Behavior and Society, Institute for Global Tobacco Control, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Joanna E Cohen
- Department of Health, Behavior and Society, Institute for Global Tobacco Control, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Kevin Welding
- Department of Health, Behavior and Society, Institute for Global Tobacco Control, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Katherine Clegg Smith
- Department of Health, Behavior and Society, Institute for Global Tobacco Control, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
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Poole NL, van Straaten B, van den Brand FA, Gilmore AB, Willemsen MC, Nagelhout GE. Content analysis of Dutch newspaper coverage of three tobacco control policies, 2017-2019. BMJ Open 2023; 13:e057912. [PMID: 36764730 PMCID: PMC9923323 DOI: 10.1136/bmjopen-2021-057912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
Abstract
OBJECTIVES News media coverage can influence support for and implementation of tobacco control policies. This research aims to analyse and compare newspaper coverage of newly implemented policies: a substantial tobacco tax increase, point-of-sale display ban and plain packaging. DESIGN We conducted a content analysis of articles covering the three policies from ten national Dutch newspapers. Articles published between November 2017 and November 2019 were coded for type and tone. The policy dystopia model was used to code arguments opposing the policies. Tobacco industry appearances in news articles were also analysed for frequency and type. RESULTS A total of 134 news articles were analysed, of which the industry appeared in 28%. The majority of coverage was neutral in tone, although among articles that were coded as expressing a positive or negative tone, plain packaging and the point-of-sale ban were portrayed more negatively than positively. Negative coverage was predominantly accounted for by industry presence. Arguments opposing the policies focused on negative economic consequences, challenging the need for policy and adverse consequences for retailers for tax, plain packaging and the point-of-sale display ban, respectively. We identified six specific new arguments that fit within existing domains of the policy dystopia model. CONCLUSIONS The tobacco industry and its allies still appear in a substantial proportion of news articles in relation to tobacco policy. This study identifies contemporary industry arguments against tobacco control policies in Europe which, alongside the policy dystopia model, can be used to predict and counter the tobacco industry's future attempts to oppose policies.
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Affiliation(s)
- Nikita L Poole
- IVO, The Hague, the Netherlands
- Department of Health Promotion, Maastricht University Care and Public Health Research Institute, Maastricht, the Netherlands
| | | | - Floor A van den Brand
- Department of Family Medicine, Maastricht University Care and Public Health Research Institute, Maastricht, the Netherlands
| | | | - Marc C Willemsen
- Department of Health Promotion, Maastricht University Care and Public Health Research Institute, Maastricht, the Netherlands
- Drug Monitoring and Policy, Trimbos-instituut, Utrecht, the Netherlands
| | - Gera E Nagelhout
- IVO, The Hague, the Netherlands
- Department of Health Promotion, Maastricht University Care and Public Health Research Institute, Maastricht, the Netherlands
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Yang JS, Kotzias V, Crosbie E, Mackey TK. COVID-19 and a Window of Opportunity: Guiding Principles for a Health-Promoting Trade Agenda. Int J Health Policy Manag 2022; 11:1604-1607. [PMID: 33327688 PMCID: PMC9808361 DOI: 10.34172/ijhpm.2020.241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 11/25/2020] [Indexed: 01/12/2023] Open
Affiliation(s)
- Joshua S. Yang
- California State University, Fullerton, Fullerton, CA, USA
| | - Virginia Kotzias
- Norwegian University of Science and Technology, Trondheim, Norway
| | | | - Tim K. Mackey
- Department of Anesthesiology, Division of Infectious Disease and Global Public Health, School of Medicine, University of California, San Diego, San Diego, CA, USA
- Global Health Policy and Data Institute, San Diego, CA, USA
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5
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Yadav A, Glantz SA. Tobacco industry thwarts ad ban legislation in India in the 1990s: Lessons for meeting FCTC obligations under Articles 13 and 5.3. Addict Behav 2022; 130:107306. [PMID: 35305326 PMCID: PMC9942803 DOI: 10.1016/j.addbeh.2022.107306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/21/2022] [Accepted: 03/11/2022] [Indexed: 11/22/2022]
Abstract
Bans on tobacco advertising are important for reducing tobacco-caused disease. Previously secret internal tobacco industry documents and organizational and newspaper websites related to tobacco control efforts in India during 1990s were analyzed. The Ministry of Health and Family Welfare, World Health Organization, Indian Council of Medical Research, and civil society played important roles in pushing for tobacco control legislation beginning in the 1980s. Guided by transnational tobacco companies, especially British American Tobacco, Philip Morris International, and RJ Reynolds, Indian cigarette companies formed the Tobacco Institute of India (TII). Following the industry's global strategy, TII proposed voluntary advertising codes, used diplomatic channels and high level political and judicial lobbying, and allied with other industry, sports and trade groups to delay legislation for ten years. TII argued for the social and economic importance of tobacco and that laws were unnecessary, unconstitutional, and would hurt the economy. These early global strategies were continuing in 2022 to delay and evade legislative efforts to ban tobacco advertising. Understanding these strategies can inform public health efforts to counter industry efforts to thwart the WHO Framework Convention on Tobacco Control in 2022 not only in India, where the Ministry of Health and Family Welfare has proposed strengthening India's tobacco control law, but globally.
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Affiliation(s)
- Amit Yadav
- Center for Tobacco Control Research and Education (CTCRE), University of California, San Francisco, USA; The International Union Against Tuberculosis and Lung Disease (The Union), South East Asia Office, New Delhi, India
| | - Stanton A Glantz
- Center for Tobacco Control Research and Education, Cardiovascular Research Institute, Division of Cardiology, Department of Medicine, University of California, San Francisco, CA, USA.
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Crosbie E, Borges LC, Eckford R, Sebrié EM, Severini G, Bialous SA. Overcoming tobacco industry opposition to standardized packaging in the Americas. Rev Panam Salud Publica 2022; 46:e145. [PMID: 36211244 PMCID: PMC9534348 DOI: 10.26633/rpsp.2022.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 05/04/2022] [Indexed: 11/24/2022] Open
Abstract
Countries in the Region of the Americas have been slow to adopt standardized packaging of tobacco products. The objectives of this analysis are to report on the progress made in adopting such packaging in countries in the Region, review known tobacco industry strategies for opposing these policies and discuss the resources available to academics, advocates and policy-makers who might be interested in advancing the use of standardized packaging in the Region. Of the 23 countries worldwide that have fully adopted standardized packaging laws, only 2 are in the Region (Canada and Uruguay). Six other countries (Brazil, Chile, Costa Rica, Ecuador, Mexico and Panama) have tried to introduce standardized packaging through draft bills, all of which have been delayed or withdrawn. There are indications that the tobacco industry has used its playbook of arguments to oppose the policy in those countries, including allegations that standardized packaging breaches national laws and international treaties protecting intellectual property, alongside threats of litigation. It is possible that these threats and allegations may have had a greater effect in the Region because of the lengthy (6 years) and costly (legal fees of US$ 10 million) international investment arbitration brought by Philip Morris International against Uruguay's strong tobacco packaging laws. However, all of the industry's arguments have been debunked, and national courts and international legal forums have upheld standardized packaging as a lawful policy. Governments in the Region of the Americas should follow the examples of Canada and Uruguay and reject the industry's false arguments and litigation threats. This analysis discusses some of the financial and technical resources that can assist them.
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Affiliation(s)
- Eric Crosbie
- School of Public HealthUniversity of NevadaRenoUnited States of AmericaSchool of Public Health, University of Nevada, Reno, Reno, United States of America
| | - Luciana C. Borges
- School of Public HealthUniversity of NevadaRenoUnited States of AmericaSchool of Public Health, University of Nevada, Reno, Reno, United States of America
| | - Robert Eckford
- Campaign for Tobacco-Free KidsWashington, D.C.United States of AmericaCampaign for Tobacco-Free Kids, Washington, D.C., United States of America
| | - Ernesto M. Sebrié
- Campaign for Tobacco-Free KidsWashington, D.C.United States of AmericaCampaign for Tobacco-Free Kids, Washington, D.C., United States of America
| | - Gianella Severini
- Campaign for Tobacco-Free KidsWashington, D.C.United States of AmericaCampaign for Tobacco-Free Kids, Washington, D.C., United States of America
| | - Stella A. Bialous
- School of NursingUniversity of CaliforniaSan FranciscoCaliforniaUnited States of AmericaSchool of Nursing, University of California, San Francisco, California, United States of America
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Goel S, Kar SS, Verma M, Sivanantham P, Naik BN, Gupta D. Evidence on article 5.3 of FCTC (tobacco industry interference in tobacco control activities) in India- a qualitative scoping study. BMC Public Health 2021; 21:1855. [PMID: 34649546 PMCID: PMC8515702 DOI: 10.1186/s12889-021-11773-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 09/10/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The Tobacco Industry (henceforth TI) yearns to portray itself as being "socially responsible" and fights for the decision-making positions; that are it used to deter, delay or dilute tobacco control measures. There is little documented evidence of Tobacco Industry Interference (henceforth TII) from India, the scope of their interference and challenges faced by the experts for effective tobacco control. This research study seeks to cover this significant gap in the literature on the TI of India. METHODS A cross-sectional qualitative research design, based upon in-depth interviews (N = 26), was used to explore the key stakeholders' opinions regarding TII in India. The interviews used a set of questions to collect information about the participant's roles and responsibilities in tobacco control, the nature of TII faced by the participants, means of influence by TI, barriers and challenges to tobacco control efforts. RESULTS Most of the respondents were engaged in tobacco control, training, advocacy and awareness generation activities for 5-10 years or more. The respondents defined the TI and its scope as per their experience with the help of the power ranking methodology. Most of them perceived TI as 'manufacturers' while others consider them as 'advertisers', 'public relation companies', 'wholesalers', 'vendors', and 'Government firms with TI stocks. The research team identified six significant domains: influencing the policy and administrative decisions, Interference in the implementation of tobacco control laws and activities, false propaganda and hiding the truth, manipulating front action groups (FAG), rampant tobacco advertising and promotion activities and others under which TII activities were classified. Most respondents believed that TI players were interfering in the policy decisions, implementing the tobacco control laws and activities and manipulating the FAG. A detailed taxonomic classification of the TII strategies that emerged from our analysis was linked to article 5.3 of FCTC. CONCLUSIONS The study documented a significant level of TII in different domains, with stakeholders acting at various hierarchical levels. Thus providing insight into the tactics of the TI in order to enable stakeholders to anticipate and pre-empt the kinds of alliances the TI may attempt to build; stimulating academicians and researchers to undertake in-depth analysis into various strategies and therefore underscoring the need to ensuring transparency in official interaction with the TI and its representatives.
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Affiliation(s)
- Sonu Goel
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012 India
- Public Health Masters Program at School of Medicine, University of Limerick, Limerick, Ireland
- Faculty of Human and Health Sciences, Swansea University, Swansea, United Kingdom
| | - Sitanshu Sekhar Kar
- Department of Preventive & Social Medicine, Jawaharlal Institute of Postgraduate Institute of Medical Education & Research, Puducherry, India
| | - Madhur Verma
- Department of Community and Family Medicine, All India Institute of Medical Sciences Bathinda, Bathinda, Punjab India
| | - Parthibane Sivanantham
- Department of Preventive & Social Medicine, Jawaharlal Institute of Postgraduate Institute of Medical Education & Research, Puducherry, India
| | - Bijay Nanda Naik
- Community & Family Medicine, All India Institute of Medical Sciences Patna, Patna, India
| | - Deepti Gupta
- Department of English and Cultural Studies, Panjab University, Chandigarh, India
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8
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Expanding our understanding of industry opposition to help implement sugar-sweetened beverage taxation. Public Health Nutr 2021; 25:180-182. [PMID: 34218841 PMCID: PMC8825965 DOI: 10.1017/s1368980021002883] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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9
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Patanavanich R, Glantz SA. How to combat efforts to overturn bans on electronic nicotine delivery systems: lessons from tobacco industry efforts during the 1980s to open closed cigarette markets in Thailand. BMJ Glob Health 2021; 6:bmjgh-2020-004288. [PMID: 33500264 PMCID: PMC7843299 DOI: 10.1136/bmjgh-2020-004288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 12/23/2020] [Accepted: 01/06/2021] [Indexed: 11/21/2022] Open
Abstract
Until 1990, it was illegal for transnational tobacco companies (TTCs) to sell cigarettes in Thailand. We reviewed and analysed internal tobacco industry documents relevant to the Thai market during the 1980s. TTCs’ attempts to access the Thai cigarette market during the 1980s concentrated on political lobbying, advertising and promotion of the foreign brands that were illegal to sell in Thailand at the time. They sought to take advantage of the Thai Tobacco Monopoly’s (TTM) inefficiency to propose licencing agreements and joint ventures with TTM and took advantages of unclear regulations about cigarette marketing to promote their products through advertising and sponsorship activities. After their initial efforts failed, they successfully lobbied the US to impose trade sanctions to liberalise Thailand’s market. Similar to the situation for cigarettes in the 1980s, since 2017, Philip Morris International has worked in parallel with a pro-e-cigarette group to pressure Thailand’s government to allow sales of electronic nicotine delivery systems (ENDS; including e-cigarettes and heated tobacco products), knowing the products were illegal under Thai law. Health advocates and government authorities should be aware of past TTCs’ tactics for cigarettes and anticipate that TTCs will attempt to use international trade law to force markets open for ENDS if their domestic efforts fail.
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Affiliation(s)
- Roengrudee Patanavanich
- Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, California, USA .,Department of Community Medicine, Mahidol University Faculty of Medicine Ramathibodi Hospital, Bangkok, Thailand
| | - Stanton A Glantz
- Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, California, USA
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Bhatta DN, Crosbie E, Bialous SA, Glantz S. Defending Comprehensive Tobacco Control Policy Implementation in Nepal From Tobacco Industry Interference (2011-2018). Nicotine Tob Res 2021; 22:2203-2212. [PMID: 32309853 DOI: 10.1093/ntr/ntaa067] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 04/16/2020] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Nepal passed a comprehensive tobacco control law in 2011. Tobacco control advocates successfully countered tobacco industry (TI) interference to force implementation of law. AIMS AND METHODS Policy documents, news stories, and key informant interviews were triangulated and interpreted using the Policy Dystopia Model (PDM). RESULTS The TI tried to block and weaken the law after Parliament passed it. Tobacco control advocates used litigation to force implementation of the law while the TI used litigation in an effort to block implementation. The TI argued that tobacco was socially and economically important, and used front groups to weaken the law. Tobacco control advocates mobilized the media, launched public awareness campaigns, educated the legislature, utilized lawsuits, and monitored TI activities to successfully counter TI opposition. CONCLUSIONS Both tobacco control advocates and the industry used the discursive and instrumental strategies described in the PDM. The model was helpful for understanding TI activities in Nepal and could be applied to other low- and middle-income countries. Civil society, with the help of international health groups, should continue to track TI interference and learn the lessons from other countries to proactively to counter it. IMPLICATIONS The PDM provides an effective framework to understand battles over implementation of a strong tobacco control law in Nepal, a low- and middle-income country. The TI applied discursive and instrumental strategies in Nepal in its efforts to weaken and delay the implementation of the law at every stage of implementation. It is important to continuously monitor TI activities and learn lessons from other countries, as the industry often employ the same strategies globally. Tobacco control advocates utilized domestic litigation, media advocacy, and engaged with legislators, politicians, and other stakeholders to implement a strong tobacco control law. Other low- and middle-income countries can adapt these lessons from Nepal to achieve effective implementation of their laws.
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Affiliation(s)
- Dharma N Bhatta
- Center for Tobacco Control Research and Education, University of California, San Francisco, CA.,Global Cancer Program, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA
| | - Eric Crosbie
- School of Community Health Sciences, University of Nevada, Reno, NV
| | - Stella A Bialous
- Center for Tobacco Control Research and Education, University of California, San Francisco, CA.,Global Cancer Program, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA.,Social and Behavioral Sciences Department, School of Nursing, University of California, San Francisco, CA
| | - Stanton Glantz
- Center for Tobacco Control Research and Education, University of California, San Francisco, CA.,Global Cancer Program, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA.,Department of Medicine, Philip R Lee Institute for Health Policy Studies, University of California, San Francisco, CA
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Bhatta DN, Bialous S, Crosbie E, Glantz S. Exceeding WHO Framework Convention on Tobacco Control (FCTC) Obligations: Nepal Overcoming Tobacco Industry Interference to Enact a Comprehensive Tobacco Control Policy. Nicotine Tob Res 2020; 22:2213-2223. [PMID: 31535694 PMCID: PMC7733065 DOI: 10.1093/ntr/ntz177] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 09/11/2019] [Indexed: 11/14/2022]
Abstract
BACKGROUND The tobacco industry works to block, delay, and weaken national tobacco control legislation to implement the WHO Framework Convention on Tobacco Control (FCTC). This article reviews how Nepal overcame industry opposition and to a comprehensive tobacco control law implementing the FCTC. METHODS We triangulated newspaper articles and policy documents with key informant interviews. RESULTS With the support of international health groups, local tobacco control advocates worked with policymakers in Nepal to pass a comprehensive tobacco control law that exceeded FCTC obligations. The tobacco industry exploited a time of political transition to block consideration by Parliament, arranged and sponsored foreign tours for legislators, made death threats to tobacco control advocates and their families, and argued for the economic importance of tobacco farms. Despite strong interference from Health, and Law and Justice ministers, a 2009 Supreme Court ruling helped tobacco control advocates secure a comprehensive tobacco control law in 2011 that included rotating pictorial health warning labels covering 75% of both sides of cigarette packages, 100% smoke free public places and workplaces, private homes and vehicles, and a tobacco advertising, promotion, and sponsorship ban. CONCLUSIONS Advocates in developing countries should utilize Nepal's experience to reject tobacco industry offers of compromise and continue educating politicians and legislators to generate political support to pass a comprehensive tobacco control law. Technical and financial support from international agencies, and effective collaboration and coordination of civil societies, and utilization of domestic litigation are helpful in LMICs where governance is weak (the abstract in Nepali is available as a Supplementary Material). IMPLICATIONS The tobacco industry exploited a time of political transition in Nepal in its effort to block comprehensive tobacco control policy in Parliament by sponsoring foreign tours of legislatures, making death threats to tobacco control advocates and their families, and arguing for the economic importance of tobacco farms. Tobacco control advocates used litigation to raise awareness and educate legislators and promote strong legislation with the involvement of international health groups. Technical and financial support from international agencies, and effective collaboration and coordination of civil societies, and utilization of domestic litigation are helpful in LMICs where governance is weak.
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Affiliation(s)
- Dharma N Bhatta
- Center for Tobacco Control Research and Education, University of California, San Francisco, CA
- Global Cancer Program, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA
| | - Stella Bialous
- Center for Tobacco Control Research and Education, University of California, San Francisco, CA
- Global Cancer Program, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA
- Social and Behavioral Sciences Department, School of Nursing, University of California, San Francisco, CA
| | - Eric Crosbie
- School of Community Health Sciences, University of Nevada, Reno, NV
| | - Stanton Glantz
- Center for Tobacco Control Research and Education, University of California, San Francisco, CA
- Global Cancer Program, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA
- Department of Medicine, Philip R Lee Institute for Health Policy Studies, Cardiovascular Research Institute, University of California, San Francisco, CA
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Crosbie E, Schmidt L. Commentary on Hilton et al. (2020): Expanding social discourse analysis to gain traction on the broad commercial determinants of health. Addiction 2020; 115:2315-2316. [PMID: 32720419 DOI: 10.1111/add.15186] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 07/06/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Eric Crosbie
- School of Community Health Sciences, University of Nevada Reno, Reno, NV,, USA.,Ozmen Institute for Global Studies, University of Nevada Reno, Reno, NV, USA
| | - Laura Schmidt
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, USA.,Department of Anthropology, History and Social Medicine, University of California San Francisco, San Francisco, CA, USA
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Crosbie E, Hatefi A, Schmidt L. Emerging threats of global preemption to nutrition labelling. Health Policy Plan 2020; 34:401-402. [PMID: 31173105 DOI: 10.1093/heapol/czz045] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2019] [Indexed: 11/14/2022] Open
Affiliation(s)
- Eric Crosbie
- School of Community Health Sciences, University of Nevada, 1664 N. Virginia Street, Reno, NV, USA.,Ozmen Institute for Global Studies, University of Nevada, 1664 N. Virginia Street, Reno, NV, USA
| | - Arian Hatefi
- Department of Medicine, University of California San Francisco, 505 Parnassus Avenue, San Francisco, CA, USA.,Institute for Global Health Sciences, University of California San Francisco, 550 16th Street, Third Floor, San Francisco, CA, USA
| | - Laura Schmidt
- Institute for Global Health Sciences, University of California San Francisco, 550 16th Street, Third Floor, San Francisco, CA, USA.,Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, 3333 California Street, Ste 265, San Francisco, CA, USA.,Department of Anthropology, History and Social Medicine, University of California San Francisco, 3333 California Street, Ste 485, San Francisco, CA, USA
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14
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Hiscock R, Augustin NH, Branston JR, Gilmore AB. Standardised packaging, minimum excise tax, and RYO focussed tax rise implications for UK tobacco pricing. PLoS One 2020; 15:e0228069. [PMID: 32053603 PMCID: PMC7017998 DOI: 10.1371/journal.pone.0228069] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 01/07/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Standardised packaging for factory made (FM) and roll your own (RYO) tobacco was fully implemented in the UK in May 2017. Around the same time, several changes to the tax system were applied (a Minimum Excise Tax (MET) for FM products and tax increases weighted towards RYO products). The tobacco industry claims that standardised packaging will lower prices (a disincentive for quitting) by commoditising the product, yet had itself taken advantage of the previous tax regime to achieve large profits from premium brands while also keeping some products' prices relatively low. Here we evaluate the impact of standardised packaging, the MET and the RYO focussed tax changes on price and industry profitability. METHODS AND FINDINGS Nielsen electronic point of sale (EPOS) data (May 2015 to April 2018) were used to calculate real (inflation adjusted) monthly price per stick overall, by cigarette type (FM and RYO) and by seven market segments. Trend estimation, using additive mixed models, assessed weighted average price (weighted by volume of sales) and tobacco industry net revenue changes. The beginning and end of the data series were compared in terms of: (a) average monthly price growth, (b) average monthly net revenue growth, and (c) undershifting and overshifting patterns after tax changes. FM and RYO real prices changed little over the 3-year period-overall prices rose by about 1p per stick. There was no evidence of commoditisation with prices of all FM segments (but not RYO) rising faster after the implementation of standardised packaging than immediately beforehand. The prices of the cheapest FM brands rose with the implementation of the MET. RYO price increases did not close the gap to FM pricing levels despite RYO focussed tax increases. Tax changes following the implementation of standardised packaging and the MET were more widely and quickly passed on to smokers in the form of higher prices than the tax change pre-implementation. The main limitations are first that because we do not know the exact mechanism by which Nielsen scales up sample data to provide UK estimates, we could only use data for a set three year period during which the same adjustments are made. Second, the tax and standardised packaging events were sometimes too close in time to separate their consequences statistically. Third, tobacco prices may also be affected by external factors such as changes in smokers' disposable income or availability of electronic nicotine delivery systems. CONCLUSIONS There was no long-term lowering of tobacco prices after the implementation of standardised packaging as predicted by the industry. The introduction of the MET was successful in increasing the price of the cheapest FM cigarettes and narrowing the price gap between FM brands. The RYO tax increases were, however, insufficient to narrow the price gap between RYO and FM. Overall, undershifting became less extensive indicating that tobacco industry manipulation of the tax system which had previously kept cheap products available had declined. This suggests that standardised packaging and a MET will likely contribute to further declines in UK tobacco use.
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Affiliation(s)
- Rosemary Hiscock
- Tobacco Control Research Group, Department for Health, University of Bath, Bath, England, United Kingdom
| | - Nicole H. Augustin
- Department of Mathematical Sciences, University of Bath, Bath, England, United Kingdom
| | | | - Anna B. Gilmore
- Tobacco Control Research Group, Department for Health, University of Bath, Bath, England, United Kingdom
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Response to the letter to the editor regarding: Removing the last billboard for the tobacco industry: Tobacco standardized packaging in Ireland. Health Policy 2020; 124:115. [DOI: 10.1016/j.healthpol.2019.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Removing the last billboard for the tobacco industry: Tobacco standardized packaging in Ireland. Health Policy 2019; 123:932-935. [PMID: 31327545 DOI: 10.1016/j.healthpol.2019.06.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 06/20/2019] [Accepted: 06/28/2019] [Indexed: 11/20/2022]
Abstract
The World Health Organization's Framework Convention on Tobacco Control (FCTC) implementation guidelines recommend that governments adopt plain packaging (also known as standardized packaging (SP)) along with pictorial health warning labels covering 50% or more of the tobacco package. The 2014 revised European Union Tobacco Product Directive also supports EU member states to introduce SP. Following these developments and recommendations, in 2013 the Department of Health launched a "Tobacco Free Ireland" policy which aimed to reduce the smoking prevalence rate to less than 5% by 2025. Tobacco Free Ireland set out 60 recommendations and measures to reach the 2025 target, including introducing SP. Tobacco companies and trademark and intellectual property organizations opposed the SP proposal claiming it would; 1) not work to reduce smoking levels, 2) increase illicit tobacco trade, 3) create unnecessary problems for retailers, and 4) violate domestic and international laws governing trademarks. However leading health groups in Ireland presented evidence on how SP would communicate the harms of tobacco to smokers and discourage young people from beginning to smoke. These efforts combined with strong political will helped Ireland to become the second country in the world to enact standardized packaging for all tobacco products.
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MacKenzie R, Mathers A, Hawkins B, Eckhardt J, Smith J. The tobacco industry's challenges to standardised packaging: A comparative analysis of issue framing in public relations campaigns in four countries. Health Policy 2018; 122:1001-1011. [PMID: 30139670 DOI: 10.1016/j.healthpol.2018.08.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 08/01/2018] [Accepted: 08/03/2018] [Indexed: 12/30/2022]
Abstract
Tobacco industry public relations campaigns have played a key role in challenges to standardised cigarette packaging. This paper presents a comparative analysis of industry campaigns in Australia and the United Kingdom, which have implemented standardised packaging legislation; Canada, where policy has been adopted but not yet implemented; and the Netherlands, which has considered, but not enacted regulation. Campaigns were identified via Google searches, tobacco industry websites, media coverage, government submissions and previous research; analysis focused on issue framing and supporting evidence. Public relations campaigns in all case study countries drew on similar frames - the illicit trade in tobacco products, the encroaching 'nanny state', lack of evidence for the effectiveness of standardised packaging, a slippery slope of regulation, and inherent threats to intellectual property rights. These claims were supported by industry research, front groups and commissioned reports by accountancy firms, but were not with verifiable research. Independent evidence that contradicted industry positions was overlooked. Similarities in structure and content of public relations campaigns in countries that have enacted or considered regulation points to a strategic co-ordinated approach by cigarette manufacturers. Countries considering standardised packaging policy can expect powerful opposition from the tobacco industry. Tobacco control communities and policy makers can learn from previous experience, and share best practise in countering industry arguments.
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Affiliation(s)
- Ross MacKenzie
- Faculty of Human Sciences, Macquarie University, Sydney, New South Wales 2109, Australia.
| | | | - Benjamin Hawkins
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, United Kingdom
| | - Jappe Eckhardt
- Department of Politics, Faculty of Social Sciences, University of York, United Kingdom
| | - Julia Smith
- Global Tobacco Control Program, Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada
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Crosbie E, Thomson G. Regulatory chills: tobacco industry legal threats and the politics of tobacco standardised packaging in New Zealand. THE NEW ZEALAND MEDICAL JOURNAL 2018; 131:25-41. [PMID: 29649194 PMCID: PMC6490166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
AIMS To describe the process of enacting tobacco standardised packaging (SP) amidst tobacco industry legal threats in New Zealand. METHODS Relevant government and NGO documents, and media items were reviewed. Policymakers and health advocates in New Zealand were interviewed. The data were triangulated and thematically analysed. RESULTS In 2011, the New Zealand Government announced the goal of becoming a smokefree country (reducing smoking prevalence to 5%) by the year 2025, and considered adopting SP. In April 2012, the Government announced it would introduce SP, but tobacco companies threatened the Government with litigation in international courts for violating investment and intellectual property rights. In response, the Government adopted a 'wait and see' approach, waiting until two legal challenges against Australia's SP law were resolved before it enacted its legislation in September 2016. Health advocates, limited due to funding constraints, attempted to alter the Government's approach to the legal threats without success. Interviews with policymakers and health advocates confirmed these threats helped produce a regulatory chill, delaying the policymaking process by three years. CONCLUSION The New Zealand case illustrates how the threat of a potential international lawsuit can create a chilling effect by helping delay the implementation of public health policies.
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Affiliation(s)
- Eric Crosbie
- Center for Tobacco Control Research and Education, University of California, San Francisco, CA
| | - George Thomson
- Department of Public Health, University of Otago, Wellington
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