Quality evaluation of natural monomer flavors for Chinese tobacco industry based on dual mode combined Fourier transform ion cyclotron resonance mass spectrometry and isotopic fine structures

RATIONALE

Natural monomer flavors can modify the taste of cigarettes. However, no report was published to establish the quality control method for their chemical compositions.

METHODS

In this study, licorice, a traditional natural monomer flavor used in tobacco aroma processing, was selected, and the fingerprint was developed by high-performance liquid chromatography (HPLC). Next, the chemical markers of samples from different places of origin were discovered by multivariate statistical analysis. Then, its chemical constituents were identified by combination of HPLC-Fourier transform ion cyclotron resonance mass spectrometry (FT-ICR-MS), direct infusion FT-ICR-MS (DI-FT-ICR-MS), and the technology of isotopic fine structures (IFSs). Moreover, its characteristic constituents were quantitatively analyzed using HPLC.

RESULTS

The 14 common peaks were assigned in the fingerprint, and 8 of them were considered as qualitative markers by multivariate statistical analysis. A total of 42 chemical constituents were detected using HPLC-FT-ICR-MS, and 13 of them were unambiguously identified by references. Meanwhile, the elemental compositions of other eight unknown chemical components were decisively determined using IFSs. Subsequently, the contents of five characteristic constituents in 11 batches of samples were determined.

CONCLUSIONS

The integration strategy established here can discover and quantify the chemical markers for improving the quality control standard of natural monomer flavor of licorice. It is expected that the strategy will be valuable for further quality control of other natural monomer flavors in Chinese tobacco industry.

Culturally Tailored Anti-Smoking Messages: A Randomized Trial With U.S. Sexual Minority Young Women

INTRODUCTION

This study evaluated effects of exposure to culturally tailored anti-smoking ads versus control ads on quitting intentions, cigarette purchase intentions, and tobacco industry perceptions among young adult, cisgender and transgender, sexual minority women (SMW).

STUDY DESIGN

An online randomized controlled experiment with 1-month longitudinal follow-up was conducted.

SETTING AND PARTICIPANTS

About 2,214 U.S. SMW ages 18-30 were recruited via online survey panels (The PRIDE Study and Prolific), social media ads and posts, and HER dating app ads. Data were collected in 2021-2022.

INTERVENTION

Participants were randomly assigned to receive up to 20 tailored ads containing LGBTQ+ branding versus 20 control ads without LGBTQ+ branding over 4 weeks. Both conditions used identical anti-smoking statements and photographs (including several photographs of individuals who self-identified as SMW).

MAIN OUTCOME MEASURES

One-month follow-up intention to purchase cigarettes, intention to quit, marketing receptivity, pro-industry attitudes, and pro-industry beliefs were measured. Analyses were conducted in 2022-2023. Linear regression models predicted outcomes at 1-month follow-up with the randomized arm, adjusted for baseline measures of each outcome and stratified by smoking status (those who currently smoked and those who did not smoke).

RESULTS

Among those who smoked, follow-up intention to quit increased and intention to purchase cigarettes, marketing receptivity, pro-industry attitudes, and pro-industry beliefs decreased versus baseline in both arms. Follow-up pro-industry beliefs were significantly lower (B=-0.331, 95% CI -0.652, -0.010, p=0.043) in the tailored versus control arm, adjusted for baseline beliefs. Among those who did not smoke, marketing receptivity, pro-industry attitudes, and pro-industry beliefs decreased versus baseline in both arms. Follow-up outcomes did not differ significantly between arms.

CONCLUSIONS

These findings can inform future anti-smoking campaign development to reduce cigarette smoking-related disparities among young adult, cisgender and transgender, sexual minority women and serve as the basis for developing similar ads for other LGBTQ+ audiences.

TRIAL REGISTRATION

This study was registered in ClinicalTrials.gov (NCT04812795).

Comparison of Publications on Heated Tobacco Products With Conventional Cigarettes and Implied Desirability of the Products According to Tobacco Industry Affiliation: A Systematic Review

INTRODUCTION

Heated tobacco products (HTPs) have been advertised as "reduced-harm" tobacco products compared to conventional cigarettes (CC); however, no direct evidence supporting HTPs being desirable for human health exists. A previous systematic review reported that evidence on HTPs published in 2017 or earlier was primarily drawn from industry-related papers. We aimed to investigate whether tobacco industry-affiliated studies are more likely to conclude that HTPs are more desirable than CC.

METHODS

PubMed and Ichushi-Web were searched up to March 15, 2022, for studies on HTPs published in 2017 or after. We selected studies that assessed any measures of HTPs and CC, including secondary analyses using gray literature in English or Japanese. We excluded review articles except for a meta-analysis that met the aforementioned criteria. Data on the authors' affiliations, grant, conflict of interest, category of research subjects, and interpretation were extracted. Research members in two groups independently assessed the papers; discrepancies were solved by discussion between the groups.

RESULTS

Overall, 134 studies met the criteria. Eighty-seven (64.9%) of them were affiliated with the tobacco industry. Of the 134 studies, 56.3% (49/87) of the industry-affiliated studies versus 19.1% (9/47) of nonindustry-affiliated studies concluded that HTPs were more desirable than CC (p < .01). No study investigated clinically relevant outcomes, such as disease occurrence.

CONCLUSIONS

Publications on HTPs in the biomedical literature from January 2017 to March 2022 were dominated by tobacco industry-affiliated studies. More than half of them concluded that HTPs were more desirable than CC compared to independent studies.

IMPLICATIONS

Tobacco industry advertises HTPs as "reduced-harm" tobacco products compared to CC. HTP users tend to consider HTPs as alternative tobacco products less harmful than CC (ie, products for "harm reduction"). Our results demonstrated that papers written by tobacco industry-affiliated authors concluded that HTPs were more desirable than CC compared to papers by independent authors. However, all their judgments were based on surrogate outcomes. Surrogate outcomes are not necessarily linked to clinically relevant outcomes such as disease occurrence. Further studies on HTPs using clinically relevant outcomes are warranted by independent authors from tobacco industry.

Online e-cigarette promotion in Indonesia

BACKGROUND

The decline in the global prevalence of cigarette smoking has prompted tobacco companies to expand their business by producing and marketing new nicotine-based products in various countries, including Indonesia. The study aims to assess e-cigarette promotional frequency and content on social media in Indonesia.

METHODS

Monitoring was conducted on Instagram in October 2021. A total of 45 Instagram influencer accounts were monitored to assess the frequency of posting and interactions from 4 to 20 October for InstaStories and from 4 to 31 October for Instagram Feeds. Content analysis was carried out on 310 posts collected from 10 randomly selected accounts from 1 to 31 October (one post per account per day) to evaluate the form, type and characteristics of the promotions.

RESULTS

There were a total of 2 897 327 followers across the 45 Instagram accounts. On average, the 45 accounts posted about 185 stories and 43 feed posts per day. Of the 310 feed posts analysed from 10 randomly selected accounts, 64% featured images of women; 50% highlighted or displayed the product; and 32% showed enjoyment of the product flavours.

CONCLUSIONS

The tobacco industry has successfully taken advantage of the e-cigarette promotion regulatory void. The Indonesian government needs to ban the promotion of these products, including those on online platforms.

Magnitude of illicit cigarette trade in Malaysia: empirical evidence compared with industry studies

BACKGROUND

The tobacco industry contends that the illicit market in Malaysia occupies 62.3% of the total cigarette market. If this is true, Malaysia has one of the largest shares of illicit cigarettes in the world.

METHODS

This study employs a rigorous gap analysis to measure the size of the illicit cigarette trade in Malaysia and compare it with the industry estimates.

FINDINGS

We found that in 2019, the illicit cigarette market share ranged from 38.2% to 52.5%, depending on assumptions with respect to consumption under-reporting, which is substantially less than the industry estimates. We found that the size of the illicit cigarette market was not driven by higher excise tax: doubling the excise tax rate from RM0.20 to RM0.40 per stick in November 2015 resulted in only a slight increase in the illicit cigarette market share and no increase in the number of illicit cigarettes in the market.

CONCLUSIONS

Therefore, a reduction in cigarette excise taxes, as suggested by the industry, will not solve the problem of illicit cigarette trade in Malaysia. Instead, the government should ratify the Framework Convention on Tobacco Control's Protocol to Eliminate Illicit Trade in Tobacco Products and implement the strategies outlined in the protocol.

Tobacco policy (in)coherence in Mozambique: an examination of national and subnational stakeholder perspectives

Mozambique ranks fifth on the list of tobacco producing countries in Africa, while also being a Party to the WHO Framework Convention on Tobacco Control (FCTC). Tobacco farming is regarded by some governments as a strategic economic commodity for export and remains deeply entrenched within Mozambique's political and economic landscape. This study uses a qualitative description methodology to identify tensions, conflicts and alignment or misalignment in policy on tobacco across government sectors and levels in Mozambique. We conducted semi-structured qualitative interviews with 33 key informants from sectors across national and subnational levels including health, agriculture, economic and commercial sectors, as well as non-state actors from civil society organizations, the tobacco industry, farmers unions and associations and individual farmers. Incoherence was present across sectoral mandates, perspectives on industry's presence in the country and regions and between FCTC provisions and informant perceptions of tobacco production as a development strategy. Despite tobacco being viewed as an important economic commodity by many informants, there was also widespread dissatisfaction with tobacco from both farmers and some government officials. There were indications of an openness to shifting to a policy that emphasizes alternatives to tobacco growing. The findings also illustrate where points of convergence exist across sectors and where opportunities for aligning tobacco policy with the provisions of the FCTC can occur.

Popular Votes on Tobacco Tax Increases, 2012-2022

CONTEXT

Researchers have examined the campaign strategies, messaging, and outcomes of popular votes on tobacco tax increases from 1998 to 2008, but no study has investigated measures that have appeared since 2008.

METHODS

The author uses state newspaper archives, voter pamphlets, academic reports, advocacy websites, and personal interviews to obtain information about the 11 tobacco tax increase ballot measures that appeared from 2012 to 2022.

FINDINGS

The three measures that succeeded during 2012-2022 featured sufficient financial resources, collaboration with influential stakeholders, and early public support. Two of the three successful measures offered significant concessions to the tobacco industry, and both were designed as legislatively referred statutes. Elsewhere, proponents sought unsuccessfully to enact citizen-led initiatives that would allocate revenue to progressive policy priorities. In contrast to previous eras, tobacco industry arguments often centered around antitax and antigovernment rhetoric, which was viewed as especially compelling in conservative states. The industry's success rate was higher than in the past, and it continued to outspend its opponents, sometimes by staggering margins.

CONCLUSIONS

Campaign spending and early support remain critical to the success of tobacco tax ballot measures. Big Tobacco can extract significant concessions even in defeat, and direct democracy is an effective but imperfect ally to tobacco control advocates.

Countering the influence of tobacco

Tobacco advertising regulations need to adapt if they are to meet the challenges posed by a rapidly evolving social media and tobacco product landscape. Gary Humphreys reports.

The Challenges of Tobacco Fiscal Policy Implementation in Mexico From the Perspective of Key Actors

INTRODUCTION

Raising tobacco taxes is considered the most effective strategy to avoid smoking initiation and discourage its use, especially among vulnerable groups. However, few low- and middle-income countries have adopted high tobacco taxes. Raising taxes is, therefore, an opportunity to strengthen and accelerate tobacco control. The objective of this study is to analyze the barriers and facilitators to the tobacco tax increase in Mexico.

AIMS AND METHODS

Based on the Governance Analytical Framework, data were generated through 17 in-depth interviews with key intersectoral actors for fiscal policy. The interviews were transcribed and coded according to Hufty's theory of governance.

RESULTS

Robust scientific evidence, intersectoral coordination, and the presence of "champions" boosted progress in tobacco control (facilitators). The main barriers were the incomplete implementation of the World Health Organization-Framework Convention on Tobacco Control (WHO-FCTC) and MPOWER package and lack of commitment ("political will") by government decision makers and legislators, misinformation about the effects of tobacco taxes, and strong tobacco industry interference.

CONCLUSIONS

Robust evidence is necessary but not sufficient to advance the implementation of the MPOWER (WHO-FCTC) actions. To achieve tobacco tax increases and public policies that protect people from unhealthy products in general, the implementation of policies or legal frameworks against industry interference in the development of public policies is imperative.

IMPLICATIONS

By analyzing the barriers and facilitators to increasing the tobacco tax in Mexico, this study identifies two key messages: (1) The need to sensitize legislators and the general population to the problem of smoking not only through epidemiological data but also through testimonies that highlight the life experiences and adversities faced by people who smoke. (2) The need for a regulatory framework to prevent industry interference in public affairs and conflicts of interest. The same framework could be very useful for public health policies to control the consumption of ultra-processed food products or alcohol.

Examining the Peer-Reviewed Literature on Tobacco-Related Social Media Data: Scoping Review

INTRODUCTION

Tobacco researchers have used social media data to examine tobacco industry marketing practices (eg, influencers), and to document user experience with tobacco products. This study summarized the literature that analyzed tobacco-related social media data, including domain, social media platform, tobacco product type, and themes of findings, among other variables.

AIMS AND METHODS

PubMed, PsycINFO, Web of Science, and Communication Source were searched between 2004 and 2022. Peer-reviewed articles were included if they were written in English, included at least one tobacco-related term, and one social media-related term, and analyzed a social media post. Two coders screened all-titles and abstracts. The final sample consisted of (n = 255) articles. Studies were coded for domain, social media platform, tobacco product type, data source, type of data, coding and analytic method, and presence of validation procedure, among other variables.

RESULTS

A total of 10 504 820 581 tobacco-related social media posts were assessed across 255 studies. User experience (54.1%) and promotion (23.1%) were the most researched domains. Researchers used data from Twitter the most (42.7%). Text (43.1%) was the most common type of data analyzed. Thematic analysis (80.8%) was the most common analytic technique. Themes of findings from content analyses often pertained to the health effects of tobacco use (61.0%) and promotion (44.2%).

CONCLUSIONS

Researchers have analyzed billions of tobacco-related social media posts to describe user experience with, and promotions related to, tobacco products like e-cigarettes on platforms like Twitter. Future research may examine tobacco-related social media data from newer platforms like TikTok.

IMPLICATIONS

Real-time surveillance of tobacco-related content on social media can keep the tobacco control community abreast of tobacco industry promotional strategies, user experience with tobacco products, and perceived health effects of tobacco use. A framework may be developed to establish best-practices for social media data collection and analysis, including strategies to identify posts from bot accounts and validate methodological approaches used in thematic analysis.

Examining Tobacco-Related Social Media Research in Government Policy Documents: Systematic Review

BACKGROUND

Social media data have been used to describe tobacco industry marketing practices, user experiences with tobacco, and youth-oriented protobacco content.

OBJECTIVE

Examine the extent to which tobacco-related social media research is cited in government policy documents.

SEARCH METHODS

Peer-reviewed tobacco-related social media studies were searched for on Web of Science, PubMed, and other databases from 2004 to 2022. The DOI number for each identified article was then used to search the Overton database to find policy documents citing such research. A secondary, manual search of national and international governmental agency websites was also conducted.

SELECTION CRITERIA

Documents were included in this study if they were tobacco-related, written in English, cited social media research in the document text and reference section, and were published by a governmental office or agency.

DATA COLLECTION AND ANALYSIS

The analytic sample consisted of (n = 38) government policy documents, and were coded for content themes, agency type, document type, and subsequent citations.

MAIN RESULTS

When this research was utilized, it was often in the context of highlighting tobacco industry marketing practices, bringing attention to an issue (eg, youth e-cigarette use), and/or describing how social media platforms can be used as a data source to understand tobacco-related attitudes and behaviors. Agencies that often cited this research were the WHO, FDA, and CDC. The document types included research reports, policy recommendations, industry guidance, legal complaints, and practice-based recommendations.

CONCLUSIONS

Tobacco-related social media research has been utilized by government agencies in the last decade to guide the policy process.

IMPLICATIONS

Tobacco-related social media research has been used in government policy documents to detail tobacco industry marketing and bring attention to youth exposure to protobacco content online. Continued surveillance of social media may be necessary to track the changing tobacco landscape.

Going 'Super Value' in New Zealand: cigarette pricing strategies during a period of sustained annual excise tax increases

BACKGROUND

Between 2010 and 2020, the New Zealand (NZ) Government increased tobacco excise tax by inflation plus 10% each year. We reviewed market structure changes and examined whether NZ tobacco companies shifted excise tax increases to maintain the affordability of lower priced cigarette brands.

METHODS

We cluster-analysed market data that tobacco companies supply to the NZ Ministry of Health, created four price partitions and examined the size and share of these over time. For each partition, we analysed cigarette brand numbers and market share, calculated the volume-weighted real stick price for each year and compared this price across different price partitions. We calculated the net real retail price (price before tax) for each price partition and compared these prices before and after plain packaging took effect.

RESULTS

The number and market share of Super Value and Budget brands increased, while those of Everyday and Premium brands decreased. Differences between the price of Premium and Super Value brands increased, as did the net retail price difference for these partitions. Following plain packaging's implementation, Super Value brand numbers more than doubled; contrary to industry predictions, the price difference between these and higher priced brands did not narrow.

CONCLUSIONS

Between 2010 and 2020, NZ tobacco companies introduced more Super Value cigarette brands and shifted excise tax increases to reduce the impact these had on low-priced brands. Setting a minimum retail price for cigarettes could curtail tobacco companies' ability to undermine tobacco taxation policies designed to reduce smoking.

How much to pay for a track and trace system: a simulation model for South Africa

BACKGROUND

The illicit trade in tobacco reduces the effectiveness of tobacco-control policies. Independent track and trace (T&T) systems are considered one of the most effective measures available to reduce the illicit tobacco trade. South Africa, with an illicit trade estimated at over 35% of the total market, is yet to implement a T&T system.

METHODS

An Excel-based simulation model is used to determine the break-even T&T marker cost per pack. At the break-even cost per pack, the government would recover all costs associated with implementing T&T by collecting additional revenues. We conduct a scenario analysis to provide a range of break-even marker costs.

FINDINGS

A marker cost of between R2.68 (US$0.17) and R5.24 (US$0.34) per pack allows the South African government to collect enough additional revenue to recover all costs associated with T&T. Implementing such a system would reduce cigarette consumption by between 5% and 11.5%. Given that comparable systems cost significantly less than this range (roughly US$0.02 per pack), the government would in all likelihood be able to implement a system at a cost below the break-even rate, thus generating additional revenue.

CONCLUSION

The break-even simulation model provides a practical tool for the government to plan the implementation of T&T and to set up an evaluation criteria for the T&T tender process. The simulations illustrate that implementing T&T in South Africa would both reduce consumption (licit and illicit) and generate additional revenue. With some modifications, the model can be applied to other countries as well.

Pharmaceuticalisation as the tobacco industry's endgame

CONTEXT

Declining smoking prevalence and denormalisation of tobacco in developed countries reduced transnational tobacco company (TTC) profit during 1990s and 2000s. As these companies faced increasingly restrictive policies and lawsuits, they planned to shift their business to socially acceptable reduced-harm products. We describe the internal motivations and strategies to achieve this goal.

METHODS

We analysed previously secret tobacco industry documents available through the Truth Tobacco Documents Library. These documents were triangulated with TTCs' investor and other professional reports, websites and public statements.

FINDINGS

Mimicking pharmaceutical business models, tobacco companies sought to refurbish their image and ensure long-term profitability by creating and selling pharmaceutical-like products as smoking declined. These products included snus, heated tobacco products, e-cigarettes, nicotine gums and inhalers. Tobacco companies created separate divisions to develop and roll out these products, and the majority developed medical research programmes to steer these products through regulatory agencies, seeking certification as reduced-harm or pharmaceutical products. These products were regarded as key to the survival of the tobacco industry in an unfriendly political and social climate.

CONCLUSIONS

Pharmaceuticalisation was pursued to perpetuate the profitability of tobacco and nicotine for tobacco companies, not as a sincere search to mitigate the harms of smoking in society. Promotion of new pharmaceuticalised products has split the tobacco control community, with some public health professionals and institutions advocating for the use of 'clean' reduced-harm nicotine and tobacco products, essentially carrying out tobacco industry objectives.

What if… your research is suddenly affiliated with a tobacco manufacturing company?

The tobacco industry is accountable for an annual global death toll of approximately 8 million people and cigarette smoking is the foremost risk factor for several types of cancer. In addition, the tobacco industry has a long and controversial history of trying to influence scientific research and of engaging in other morally problematic practices. In September 2021, the respiratory community was alarmed by the takeover of Vectura Group (Vectura) by Philip Morris International. As a reaction to this acquisition, strict measures were imposed by the International Respiratory Societies to prohibit the involvement of Vectura in respiratory research and its participation in societies' activities. International Respiratory Societies argued that Vectura had become part of the tobacco industry due to this takeover and is, therefore, subject to the same rules and restrictions. From a healthcare and historical perspective, the reaction and imposed measures are very understandable. However, for researchers that were already affiliated with Vectura through long-standing agreements and for research that was funded by Vectura, the imposed measures have serious consequences. With this article, we provide an example of these consequences. By reflecting on this issue, we would like to start a conversation regarding the current measures and to encourage the respiratory community to begin thinking of a way to avoid these consequences in the future. In addition, we hope that with this conversation the Respiratory Societies can set an example for other medical societies on how to cope with possible morally tainted affiliations (eg, fast food companies, alcohol manufacturing companies) in the future.

Use of Brand Engagement Appeals in US Cigarette and E-Cigarettes Ads (2019-2020)

Background: The tobacco industry has historically used brand engagement - communication tactics companies use to increase customer attachment to a brand and brand loyalty - to recruit and retain consumers. Limited information is available to assess the brand engagement tactics used to promote the two most popular tobacco products in the US - cigarettes and electronic cigarettes (e-cigarettes) - across different advertising platforms (e.g., direct-to-consumer (DTC), social media). Material and methods: We acquired 520 cigarette and 5,502 e-cigarette ads that ran in the US January 2019 to December 2020 from market research firms (Kantar, Numerator), Rutger's University ad surveillance website (trinketsandtrash.org), and branded social media accounts. Ads were double-coded for eight types of brand engagement tactics: Price Promotion, Sweepstakes, Mobile App, Email/Mail List, Free Gift, Social Media engagement request, Sponsored Events, and Auto-Ship subscription program. We report presence of brand engagement tactics by product type and advertising platform. Results: Overall, 62.9% of cigarette ads and 49.9% of e-cigarette ads contained at least one brand engagement tactic. For cigarette ads, the most common tactics were Sweepstakes and Mobile App requests, which were most commonly featured in DTC ads. For e-cigarettes, the most common tactic was Price Promotion which was featured in most DTC and online e-cigarette ads. Conclusions: Brand engagement was common in this sample of cigarette and e-cigarette ads. Our findings highlight key differences in the type of brand engagement tactic used to promote each product on different advertising platforms. Results can inform continued advertising surveillance studies and regulatory efforts.

Association between Tobacco Industry Interference Index (TIII) and MPOWER measures and adult daily smoking prevalence rate in 30 countries

BACKGROUND

This study aimed to investigate the impact of tobacco industry interference on the implementation and management of tobacco control and the tobacco epidemic using the Tobacco Industry Interference Index (TIII) and MPOWER-a package of measures for tobacco control-and adult daily smoking prevalence in 30 countries.

METHODS

The TIII was extracted from the Global Tobacco Industry Interference Index 2019 and Global Center for Good Governance in Tobacco Control (GGTC). MPOWER measures and adult daily smoking prevalence rate were extracted from the World Health Organization (WHO) report on the global tobacco epidemic in 2021. We assessed the ecological cross-lagged association between TIII and MPOWER scores and between TIII and age-standardized prevalence rates for adult daily tobacco users.

RESULTS

Tobacco industry interference was inversely correlated with a country's package of tobacco control measures (β = -0.088, P = 0.035). The TIII was correlated with weaker warnings about the dangers of tobacco (β = -0.016, P = 0.078) and lack of enforcement of bans on tobacco advertising promotion and sponsorship (β = -0.023, P = 0.026). In turn, the higher the TIII, the higher the age-standardized prevalence of adult daily tobacco smokers for both sexes (β = 0.170, P = 0.036). Adult daily smoking prevalence in males (β = 0.417, P = 0.004) was higher in countries where the tobacco industry received incentives that benefited its business.

CONCLUSION

Where the interference of the tobacco industries was high, national compliance with the Framework Convention on Tobacco Control (FCTC) was lower, and the prevalence of adult daily smokers higher. National governments and global society must work together to minimize the tobacco industry's efforts to interfere with tobacco control policies.

Addressing tobacco industry influence in tobacco-growing countries

Protecting policy-making from tobacco industry influence is central to effective tobacco control governance. The inclusion of industry actors as stakeholders in policy processes remains a crucial avenue to corporate influence. This influence is reinforced by the idea that the tobacco industry is a legitimate partner to government in regulatory governance. Addressing the influence of the tobacco industry demands a focus on the government institutions that formalize relationships between industry and policy-makers. Industry involvement in government institutions is particularly relevant in tobacco-growing countries, where sectors of government actively support tobacco as an economic commodity. In this paper, we discuss how controlling tobacco industry influence requires unique consideration in tobacco-growing countries. In these countries, there is a diverse array of companies that support tobacco production, including suppliers of seeds, equipment and chemicals, as well as transportation, leaf buying and processing, and manufacturing companies. The range of companies that operate in these contexts is particular and so is their engagement within political institutions. For governments wanting to support alternatives to tobacco growing (Article 17 of the Framework Convention for Tobacco Control), we illustrate how implementing Article 5.3, aimed at protecting tobacco control policies from tobacco industry interference, is fundamental in these countries. Integrating Article 5.3 with Article 17 will (i) strengthen policy coherence, ensuring that alternative livelihood policies are not undermined by tobacco industry interference; (ii) foster cross-sector collaboration addressing both tobacco industry interference and livelihood development; and (iii) enhance accountability and transparency in tobacco control efforts.

Tobacco industry's human rights makeover: an archival review of British American Tobacco's human rights rhetorical veneer

BACKGROUND

British American Tobacco (BAT) released an industry-first human rights report in 2020, which extolled the efforts and objectives of the tobacco industry giant for promoting human rights. How BAT came to brand itself as a human rights champion, being a leader in an industry long accused of enabling human rights violations from leaf-to-stub including profiting from a product which inherently violates the right to health, is unknown. Exploring BAT's evolution through reviewing its materials and Tobacco Industry Documents could shed light on their development and what it means in the tobacco control and human rights context.

METHODOLOGY

We reviewed publicly available materials from BAT as well as conducted archival research in the Tobacco Industry Documents digital archives at University of California San Francisco. We focused on how and when BAT used terms such as 'human rights', 'right to health', 'sustainable development goal' and 'harm reduction' as well as 'Framework Convention on Tobacco Control'.

RESULTS

We reviewed 48 BAT publications and 45 documents from the Tobacco Industry Documents archives. These materials demonstrate both BAT's increasing utilisation of human rights language as well as BAT's reuse of the same language, concepts and general rhetoric. BAT has not engaged significantly or meaningfully on the human right to health.

CONCLUSION

BAT's increasing use of human rights rhetoric does not appear to reflect a shift in the company's human rights positions, particularly with respect to the right to health of consumers and BAT's lack of impactful measures to eliminate the harms of its tobacco products.

Tobacco industry presence and practices in Mozambique: a 'chaotic' but worthy market

BACKGROUND

Mozambique has experienced a series of tobacco industry consolidations both in tobacco leaf buying and processing, and in cigarette manufacturing and marketing. The growth of the tobacco industry presence in Mozambique was followed by an increase in tobacco industry's Corporate Social Responsibility (CSR) activities. This is the first paper to describe the history of tobacco industry activities in Mozambique, a party to the WHO Framework Convention on Tobacco Control (FCTC).

METHODS

We reviewed industry documents and associated web-based information. Industry documents (1990-2021) were identified through University of California San Francisco's Truth Tobacco Industry Documents Library. We followed with a search of web-based sources pertaining to the tobacco industry in Mozambique. We complemented our analysis with select media sources to identify statements by government officials in relation to the tobacco industry. We mapped major tobacco industry players, industry partnerships and corresponding CSR activities.

RESULTS

Tobacco production increased substantially in Mozambique in the 1990s when tobacco companies began targeting African countries. The increased attention to tobacco production, trade and sales in Mozambique was coupled with greater industry involvement in CSR activities. We identified 10 tobacco industry CSR programmes in Mozambique. Most of the CSR programmes focus on health including HIV/AIDS, social issues and environmental issues.

CONCLUSIONS

Similar to other tobacco-growing countries, the industry facilitated an increase in tobacco production and continues efforts to increase the tobacco consumption market while engaging in CSR activities focused on social and environmental issues. As in other countries, CSR initiatives in Mozambique enhance industry's reputation. Importantly, these CSR programmes and partnerships breach national laws and the provisions of the FCTC. The continuation of these programmes suggests limited attention within government to protect public policy from industry interference in compliance with Article 5.3 of the FCTC.

Tobacco industry pricing strategies for single cigarettes and multistick packs after excise tax increases in Colombia

INTRODUCTION

Taxes on tobacco products are an efficient way of reducing consumption. However, they are only effective if passed on to consumers with higher prices. This study aims to examine tobacco industry (TI) pricing strategies in response to tax increases, and whether they differ by price segments or presentation (packs or individual sticks) in Colombia. This is the first such academic study in Latin America and the first anywhere to include the market for single sticks.

METHODS

Using data on cigarette pricing/taxation from a survey of smokers (2016-2017) and official government data on pricing (2007-2019), the TI's pricing strategies were examined, split by brand, price segments, different sized packs and single cigarettes.

RESULTS

The TI employed targeted pricing strategies in Colombia: differentially shifting taxes; and launching new brands/brand variants. The industry overshifted taxes when increases were smaller and predictable, but used undershifting more when there was a larger increase in 2017, after which it mostly overshifted on budget and premium (but undershifted mid-priced) brands. The prices for single sticks increased more than the tax increase in 2017 when their consumption also increased.

CONCLUSION

The pricing strategies identified suggest excise taxes can be increased further, particularly the specific component, to reduce the price gap between brand segments. Brands should be restricted to a single variant along with prohibitions on launching new brands/brand variants. Lastly, since the pricing of single sticks does not match the pattern of packs, more monitoring of their sales and distribution is required, especially since they promote consumption and hinder effective implementation of tobacco tax policies.

How tobacco companies use the revolving door between government and industry to influence policymaking: an Australian case study

Objectives and importance of the study: The study investigates and documents how tobacco companies are using the revolving door between government and industry as a tactic to try to influence public health policymaking in Australia. This is the first Australian study to systematically investigate the revolving door tactic in tobacco lobbying and highlights the importance of strengthening integrity and transparency legislation and oversight bodies to eliminate the political influence of tobacco companies in Australia.

STUDY TYPE

Mixed-methods including non-experimental descriptive and exploratory case studies.

METHODS

To build a picture of tobacco lobbying through the revolving door in Australia, data was triangulated from multiple publicly available sources: 1) Australian federal, state and territory government lobbyist registers, 2) the online social networking platform, LinkedIn; and 3) Australian news media reports.

RESULTS

Tobacco companies lobby the Australian government using 'in-house' employees, lobbyists working in firms acting on their behalf, and third-party allies with common interests. Almost half (48%) of internal tobacco company lobbyists had held positions in the Australian government (state, territory and/or federal) before or after working in the tobacco industry. Likewise, 55% of lobbyists acting on behalf of tobacco companies had held government positions before or after working as a lobbyist. In-house tobacco industry lobbyists, as well as those working on behalf of tobacco companies within lobbying firms, were found to have held senior governmental positions, such as a Member of Parliament (MP) or Senator, chief or deputy chief of staff, or senior advisor in a ministerial office, and many had moved into or out of government within 1 year of working for a tobacco company (56%) or as a lobbyist (48%).

CONCLUSIONS

Tobacco companies are strategically using the revolving door between the government and the tobacco industry as a key political lobbying mechanism to try to influence public health policy in Australia.

Mapping alcohol and tobacco tax policy interventions to inform health and economic impact analyses: A United Kingdom based qualitative framework analysis

BACKGROUND

Alcohol and tobacco have different policy regimes and there is little understanding of how changes to policy on each commodity might combine to affect the same outcomes or to affect people who both drink and smoke. The aim of this study was to deepen understanding of the policy objectives of UK alcohol and tobacco tax options being considered at the time of the interviews with a set of UK policy participants in 2018, and the factors affecting the implementation and outcomes of the policy options discussed.

METHODS

Ten tax policy experts were recruited from government arms-length organisations and advocacy groups in England and Scotland (4 alcohol, 4 tobacco, 2 alcohol and tobacco). Alcohol and tobacco experts were interviewed together in pairs and asked to discuss alcohol and tobacco tax policy objectives, options, and the mechanisms of effect. Interviews were semi-structured, supported by a briefing document and topic guide, audio-recorded, transcribed and then analysed deductively using framework analysis.

RESULTS

Alcohol and tobacco tax policy share objectives of health improvement and there is a common set of policy options: increasing duty rates, duty escalators, multi-rate tax structures, industry levies and the hypothecation of tax revenue for investment in societal benefits. However, participants agreed that the harms caused by alcohol and tobacco and their industries are viewed differently, and that this influences the impacts that are prioritised in tax policymaking. Working-out how alcohol and tobacco taxes could work synergistically to reduce health inequalities was seen as desirable. Participants also highlighted the importance of avoiding the combined effects of price increases on alcohol and tobacco widening economic inequalities.

CONCLUSIONS

Impact analyses should consider the combined effects of alcohol and tobacco tax policies on health and economic inequalities, and how the effects of changes to the tax on each commodity might trade-off.

Potential Implications for Tobacco Industry Transformation of the Acquisition of Swedish Match by Philip Morris International

Philip Morris International's recent purchase of Swedish Match may prove to be a vital tobacco industry development. We focus on PMIs potential progress in moving from primarily selling cigarettes toward primarily selling noncombustible nicotine delivery products (NCNDPs). We also consider the potential contribution of the acquisition to industry transformation whereby other cigarette firms may potentially move toward primarily selling NCNDPs. We examine the potential impact on noncombustible nicotine delivery product use, including nicotine pouches (a major Swedish Match product), e-cigarettes, heated tobacco products, and, most importantly, on sales of the industry's staple, combustible cigarettes. We focus on the United States as a special case, where PMI is limited from entering the cigarette market. Implications: Philip Morris International's purchase of Swedish Match and policies regarding nicotine pouches (NPs) have been overlooked in the tobacco control literature. The acquisition indicates the importance of the NP market to the largest nonstate-owned tobacco company. The acquisition has the potential through pricing and marketing tactics to either encourage or discourage the use of NPs, e-cigarettes, heated tobacco products, and most importantly cigarettes. Due to its inability to sell cigarettes in the United States, PMI will have incentives to use its alternative nicotine delivery products, including its newly acquired NPs, to reduce the sale of cigarettes by other companies. However, the potential effects in other countries, where PMI does sell cigarettes, are less clear. Monitoring and analyzing tobacco company acquisitions is essential to studying future transitions in using different kinds of tobacco products, especially from cigarettes to lower-risk alternative nicotine delivery products.

Philip Morris International's Formula 1 Sponsorship-Linked Marketing: Transformation From Marlboro to Mission Winnow

INTRODUCTION

Transformation describes a dramatic modification in appearance or character. Philip Morris International (PMI)'s sponsorship-linked marketing of Formula 1 auto racing is illustrative of transformation. The company's flagship cigarette brand, Marlboro has been replaced as the identified partner by their newly developed brand, Mission Winnow. This study examines the tobacco company's marketing objectives for transforming the brand identity of its Formula 1 Ferrari race team partnership.

AIMS AND METHODS

We provide a case study, and our method of qualitative enquiry is textual analysis. We review marketing planning documents from Philip Morris, which would normally be proprietary, but are publicly accessible because of litigation. Additionally, we review Mission Winnow's social media posts, over a 3-year span, from the brand's Facebook, Instagram, and Twitter accounts.

RESULTS

PMI initiated its Formula 1 sponsorship in 1972. Through Marlboro, the company's sponsorship-linked marketing was largely centered on building brand image and reinforcing Marlboro's brand identity of rugged masculinity, independence, heroism, and adventure. When Mission Winnow replaced Marlboro as the identified brand sponsor in 2018, the company's marketing communication shifted to highlighting transformation, progress, open dialogue, teamwork, innovation, technology, and science.

CONCLUSIONS

Despite Article 5.3 of the World Health Organization's Framework Convention on Tobacco Control (WHO FCTC) calling for Parties to protect public health policies from the commercial and vested interests of tobacco companies, PMI still seeks to be an important stakeholder in such consultations, including those pertaining to harm reduction. Mission Winnow's sponsorship-linked marketing points to a larger company narrative about trying to gain or reclaim legitimacy and credibility.

IMPLICATIONS

PMI's continued sponsorship of Formula 1 is a strategic means of drawing attention to the company's "next-generation products" and communicating their supposed "transformation." The company's sponsorship-linked marketing initiatives point to a need for Parties to enforce Article 13 of the WHO FCTC, which calls for a comprehensive ban on tobacco advertising, promotion, and sponsorship.

Hosting the Tobacco Industry Supply Chain and Political Interference

INTRODUCTION

We found no comprehensive studies on the location of transnational tobacco and leaf company (TTLC) subsidiaries (business entities they control) or the consequences of their presence on health policy.

AIMS AND METHODS

Here we assess (1) the global reach of TTLCs by mapping their tobacco growing and manufacturing subsidiaries and (2) the relationship between in-country presence of the tobacco industry and their power and interference. Data on subsidiaries were collated through systematic searching for countries' supply chain activities in documents and web pages. Cross-sectional multiple regression analysis was used to assess the association between the number of agricultural and manufacturing TTLCs and the Tobacco Industry Interference score, and the degree to which these were mediated by tobacco control, good governance, and economic importance of tobacco.

RESULTS

TTLC supply chain activity had global reach. As the number of TTLCs with tobacco growing and manufacturing activities rose, interference increased significantly. Interference was associated with poorer tobacco control. The association with more TTLCs undertaking final product manufacturing was related to higher-value tobacco exports but was not related to tobacco making a bigger contribution to the economy.

CONCLUSIONS

TTLCs continue to control the global tobacco supply chain through their globe-spanning subsidiaries. The presence of TTLCs in a country is associated with political interference. Countries should consider their participation in the tobacco supply chain alongside the understanding that they are likely to cede political power to TTLCs, potentially undermining the health of their populations.

IMPLICATIONS

Tobacco control research has traditionally concentrated on the demand side of tobacco. Our results lend support to calls for more research on the supply of tobacco. Governments should require tobacco companies to provide detailed, up-to-date information in an easily accessible format on in-country supply chain activities. Policymakers should take the likelihood of political interference in health and environmental policy into account when making decisions about foreign direct investment offered by the tobacco industry.

The Compassion Club: A New Proposal for Transformation of Tobacco Retail

INTRODUCTION

One major assumption in the current tobacco industry is the distribution of tobacco products through a system of commercial for-profit retail. However, other models of distribution that do not rely on this mechanism exist.

AIMS AND METHODS

In this review, we examine the potential of a nonprofit Compassion Club model and discuss how the current existence of independent vape stores might provide the infrastructure to allow the transformation of tobacco distribution.

RESULTS

Compassion Clubs exist internationally with different levels of regulation and legality and have generally been focused on the distribution of illegal drugs or hard-to-access pharmaceuticals. They provide access to drugs for existing users, limit access by novices, limit negative impacts from illicit markets, and provide social support focused on reducing harms associated with drug use.

CONCLUSIONS

With decreasing prevalence of tobacco use in many countries and growing interest in a tobacco endgame, a Compassion Club model of distribution could help transition tobacco away from the model of commercial widely available distribution. More work is needed to develop the regulations and policies that might guide a compassion club model.

IMPLICATIONS

Compassion clubs are a model for the distribution of psychoactive substances that are focused on harm reduction and social support rather than profit. There has been little discussion about the possibility that this promising model could be applied to help transform the tobacco industry. Many independent vape stores already demonstrate aspects of the compassion club model that could be used to support a transition.

Implementation of the polluter pay's principle in tobacco control in the UK: a stakeholder analysis

BACKGROUND

The polluter's pay principle (PPP) aims to internalise external costs and assign liability to the polluter for the harmful cost of their products to society. Tobacco companies continue to manufacture and sell harmful cigarettes, earning billions in profits each year from these products. Meanwhile, governments and their people are left to 'clean up' and deal with the detrimental health consequences. This paper explores with expert stakeholders how the PPP could be implemented within the context of tobacco control in the United Kingdom (UK).

METHODS

Twenty-four semi-structured interviews and two follow-up discussion groups were conducted with UK and international experts on tobacco control, public health, economics, or law from the academic, public, private and third sector. Participants considered the facilitators and barriers to implementing the PPP to tobacco control in the UK. Thematic analysis was employed, aided by NVivo 12, and data were compared to examine the views expressed by the different types of experts.

RESULTS

Stakeholders favoured the implementation of the PPP in the context of tobacco control and indicated that it could be acceptable and feasible to implement and that it would likely have support from policymakers and the public alike. Stakeholders unanimously agreed that any legislation and administration should be free from tobacco industry influence; however, differences arose concerning who should oversee the implementation.

CONCLUSION

The PPP from environmental law was predominantly seen as an approach that could be usefully applied to the tobacco industry. However, there is no one size fits all template, therefore its implementation would need to be adapted to fit the UK context.