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  1. Marita Hefler
  1. Sydney, New South Wales, Australia
  1. Correspondence to Marita Hefler; marita.hefler{at}menzies.edu.au

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World: Philip Morris’ smoke, mirrors, revolving doors & cash showers

The most recent leaders announced for Philip Morris’ ‘Foundation for a Smoke Free World’ (FSFW) reveal a new recruit following Derek Yach from sugary beverage giant PepsiCo. James Lutzweiler, has been appointed Vice President, Agriculture and Livelihoods. According to his LinkedIn profile, he worked at PepsiCo from May 2016 to November 2017, where he ‘Hired and developed an international team as part of the Global Public Policy and Government Affairs Group contributing to PepsiCo’s public policy agenda and development of strong policy positions that address key issues facing the business. Included developing strategies focused on achieving health and wellness objectives, uptake of expanded nutrition brand/product portfolio, and driving positive consumer choice in retail and convenience stores.’

Figure 1

Ehsan Latif. A photo showing new Programme Director at PMI’s ‘Foundation for a smoke free world’ presenting at the European Conference on Tobacco or Health, in his previous role with The Union. The slide highlights tobacco industry efforts to block effective tobacco control and the fact that ‘history tells us – we can never trust the tobacco industry’. Source: Twitter/@Gera Nagelhout.

Figure 2

PMI initiative screenshot. A screenshot of the Philip Morris impact project funding details. Source: https://www.pmi-impact.com.

PepsiCo’s actions to protect its interests from effective public health policy have clearly been shaped by lessons from tobacco industry experiences: use donations and funding to neutralise opponents, create a research agenda to distract from the harm of its products, oppose all but the most benign tax and advertising restrictions, promote the idea that the industry is ‘part of the solution,’ and engage in ‘reinvention’ by promoting ‘healthier products’. No doubt the experience gained at PepsiCo will be invaluable for the new PMI initiative. Both PMI and Pepsi need ‘strong policy positions that address key issues facing the business,’ given their respective contributions to the global rise in non-communicable diseases.

More disappointingly for those in tobacco control who adhere to the principles and spirit of FCTC Article 5.3, Ehsan Latif was announced as the Programme Director at the PMI Foundation. Latif is a former Director, Tobacco Control at the International Union Against Tuberculosis and Lung Disease (The Union), where he worked for 8 years. His decision is a stunning about-face for a man who only in March 2017 presented a slide at the European Conference on Tobacco or Health that stated unequivocally the tobacco industry uses all its resources to block effective tobacco control measures, and finished with ‘history tells us – we can never trust the tobacco industry’.

In a blog post on the organisation’s website, Latif explains his motivation for joining the Foundation. He starts by acknowledging his previous position: ‘Through my 20 years in tobacco control, I have often been asked, ‘What is the main challenge faced by the tobacco control movement?’ I’ve heard the question so many times, the answer has become reflexive: ‘Tobacco industry interference.’ Industry interference is often blamed for tobacco control woes – and rightly so.’

Having got the obvious out of the way, he then pivots and leapfrogs to an interesting justification of why it was apparently necessary to join an initiative created by an industry that can never be trusted: ‘But I wonder if something else is impeding progress, something that is often overlooked. What if the tobacco control movement is inadvertently holding itself back?’ The industry is acknowledged, but the ‘problem’ frame is shifted to those working for public health.

He goes on to state that the FCTC articles related to cessation, research and tobacco agriculture have not received the attention they deserve, reflects on the fact that many people continue to smoke and then suggests that this is because of a ‘rigid attitude’ adopted by many tobacco control advocates (how many billions of dollars has PMI wasted on its ‘Be Marlboro’ advertising campaign, when all that is needed to keep cigarettes flying off the shelves is ‘rigid attitudes’ in public health?)

He finishes his post with a statement about the ‘need to rethink our approach to tobacco control’, which is ‘inclusive of all the innovative thinkers across the world who exist inside and outside public health’, neatly aligning himself with the ‘dialogue’ approach to resolving the tobacco epidemic which positions the tobacco industry as a legitimate stakeholder.

It is rare for such whiplash-inducing changes in conviction to happen out of the blue. The public health community would be forgiven for assuming that it is something more than a true belief in the potential of PMI’s latest brainchild that has motivated Mr Latif’s newfound conviction. He could have chosen to refuse, as many others reportedly have done, to associate with an initiative created by an industry that ‘history tells us we can never trust,’ and instead pushed within the diverse public health community for greater emphasis on what he considered were neglected FCTC articles. Instead he opted to work with an organisation created by one of the key obstacles to effective FCTC implementation.

Another recent appearance on the FSFW website is an invitation to provide input on its research priorities and apply for scoping grants. The focus of the latter provides a clear insight into how FSFW sees the tobacco epidemic. Most aspects of the FCTC are ignored; it contains nothing about prevention, proper implementation of tobacco advertising and promotion bans, ensuring full implementation of smoke-free public spaces, stopping tobacco industry interference in policy-making, health warning labels – including graphic health warnings in those countries that don’t yet have them, taxation, social marketing and education about the harms of smoking, or reducing retail availability and supply of combustible tobacco.

Instead, the focus is on harm reduction technologies, ‘clarifying’ the epidemiology of smoking in chronic conditions, determinants of switching to non-combustible products, predictive measures of long term smoking and reduced risk products to ‘support individual smokers in their decisions about smoking’, tobacco farming, and a generous sprinkling of ‘finding out what other research is needed’. Although smoking cessation is mentioned, it is integrated with priorities that are largely able to work around PMI’s commercial imperatives. Almost certainly, that is the whole point. Only the most naïve (or perhaps easily bought) would think otherwise.

While PMI’s ‘Smoke Free Foundation’ has received significant attention since its launch, another part of the PMI behemoth has been busy showering money across Europe and beyond. Established in 2016, PMI’s ‘Impact’ initiative describes itself as ‘a global initiative to support projects dedicated to fighting illegal trade and related crimes, such as corruption, organised crime and money laundering.’

In September 2017, the Impact initiative announced funding totaling US$28 million for 32 projects. Organisations which received funding included several universities, public sector agencies, consulting organisations which have previously worked with the tobacco industry, including KPMG, and several free market think tanks.

According to the website, included in the funded projects are ‘activities to enhance the capacity and proficiency of law enforcement and customs officers, relevant public institutions, and the expert community’, as well as ‘educational and awareness programme for opinion leaders and the broader public, including forums for greater cross-sectoral collaboration.’ Together these initiatives sound like a great way for PMI to gain access to, and build alliances with, non-health government agencies and gain a seat at the policy table. 

Southeast Asia: tobacco industry policy interference

The fourth Tobacco Industry Interference Index, published by the Southeast Asia Tobacco Control Alliance (SEATCA) in late November, provides a comprehensive analysis of governments’ actions to protect their health policies from tobacco industry interference. The report findings put paid to the notion that any tobacco company is serious about anything other than growing its business and derailing tobacco control measures.

Nowhere is this more apparent in Southeast Asia than Indonesia, the only country in the region which is not yet a Party to the FCTC and is effectively a rogue state when it comes to tobacco control. As in 2015, Indonesia ranked worst among the nine countries surveyed in 2016. It was the country that allowed the most tobacco industry participation in policy development, provided the greatest level of benefits to the industry, and together with Vietnam, was the most supportive of tobacco industry ‘corporate social responsibility’ activities, helping to provide a veneer of respectability to the industry.

Vietnam and Laos were close behind Indonesia in the rankings. Both performed very poorly on the measure of unnecessary interactions and cooperation between government and the tobacco industry, with Vietnam ranked worse than Indonesia. Vietnam also tied with Indonesia for worst performer when it came to transparency on tobacco and government interactions.

The indicator on which the most countries fared particularly poorly was preventive measures. It examined whether governments have procedures for disclosing interactions with the tobacco industry, if they have codes of conduct for government officials dealing with the tobacco industry, requirements for the tobacco industry to periodically disclose production, marketing, lobbying and political contributions, FCTC Article 5.3 awareness raising, and prohibition of tobacco industry contributions to government officials. On this measure, Myanmar received the worst ranking, followed by Vietnam and Laos, then Brunei. The Philippines received the best ranking, followed by Thailand.

Overall, the report concluded that progress is happening, although at a snail’s pace. Brunei Darussalam and the Philippines were the best performers, although Brunei received the same score in 2016 as 2015, and the Philippines improved by only one point. Thailand improved, but both Malaysia and Myanmar deteriorated. Several countries improved in some areas but deteriorated in others, resulting in little overall improvement. Highlighted in the recommendations for improvement were the need for a whole-of-government approach to FCTC Article 5.3 implementation, transparency in dealing with the tobacco industry, and banning corporate social responsibility activities.

The report is available at https://seatca.org/dmdocuments/TI%20Index%202017%209%20November%20FINAL.pdf.

USA/world: call for USA tobacco industry ‘WE LIED’ ads to go global

The first corrective advertisements paid for by the tobacco industry against itself were broadcast and published nationally in the USA in November 2017. The advertisements, which will run for a year, were originally ordered by a federal court in 2006, for a lawsuit first filed nearly 20 years ago.

Figure 3

Australia version of US corrective ads. An advertisement by the Western Australian Cancer Council, modelled on the ‘corrective ads’ currently running in the USA.

The industry being forced to tell the truth about its decades of lies, deception and manipulation is welcome. However, the advertisements reveal far more about the tobacco industry than the information in the corrective statements, and highlight the fact that the tobacco industry should never be allowed any say in policy and legal decisions that are intended to minimise the negative impact of their products.

The campaign is in many ways a study of what can be achieved by the tobacco industry when they employ one of their favourite undermining tactics: delay. When the court ruling was made in 2006, MySpace was the world’s dominant social media platform, riding the peak of its brief but spectacular wave of popularity. In June 2006, visits to the site in the USA surpassed those of Google. Both Facebook and YouTube were still in their infancies. While smartphones had been around for a while in 2006, they had not yet come close to the ubiquity of today – most people still used laptop or desktop computers to access the internet.

In the 11 years of legal wrangling about the form and content of the advertisements since the court ruling was made, the media landscape has transformed so thoroughly it is almost unrecognisable. With the newspaper industry in freefall, on-demand television viewing the norm, and widespread use of social media personalising media consumption, the advertisements’ reach will be limited. The requirements for the advertisements to be run on all major television networks and in newspapers could be implemented just as easily in 1957 as today. The difference is that in 1957, the advertisements would have achieved near saturation coverage.

Even if the ruling had been updated to reflect the changed media landscape for how they should be published and broadcast, the form of the advertisements has also been diluted, diminishing their potential impact. Several aspects were chipped away as legal appeals dragged on. Judge Gladys Kessler, who presided over the case in 2006, originally ordered that the statements should begin with a statement that the tobacco industry had ‘deliberately deceived the American public’ about the dangers of smoking and ‘here is the truth’. This was watered down to “A Federal Court has ordered RJ Reynolds, Philip Morris USA, Altria and Lorillard to make this statement about the health effects of smoking.’ While the requirement remained for cigarettes companies to disclose that they ‘intentionally designed cigarettes with enough nicotine to create and sustain addiction’, the other missing corrective elements make the advertisements look like little more than echoes of the health warnings on all tobacco packages.

It was also clear when the advertisements finally made it to television, that the tobacco industry had creative control over the design elements. As one article drily put it, they picked a ‘disenchanted robot’, a ‘primitive relative of Siri’ to deliver the message in a ‘bored, monotonous incantation’. For an industry that has been very adept at using advertising to convince people to try and persevere with a product that many initially find disgusting, these design features are unlikely to be an unfortunate accident.

Despite these shortcomings, such advertisements may go some small way towards correcting the misinformation of the past. addition, they have prompted calls in other countries for the tobacco industry to run similar advertisements. President of the New Vois Association of the Philippines was quoted in Philippines news outlet InterAksyon for the US court order to ‘inspire our public officials to demand accountability from tobacco companies and implement policies that will protect public health against the industry’s business interests’.

In Australia, the CEO of the Public Health Association (and also President of the World Federation of Public Health Associations) said he had written to the Board Chairs of the British American Tobacco and Philip Morris International companies, which have over 70% of the Australian market to call on them to come clean with Australians, as they are doing in the US. In the absence of a response from the tobacco companies, the Cancer Council of Western Australia ran its own version of the advertisements in newspapers and on television.

World: International labour organization tarred by tobacco links

The International Labour Organization (ILO) has continued to be an outlier among by United Nations agencies by failing to cut ties with the tobacco industry. The issue was on the agenda for the ILO governing body meeting held in early November 2017, having already been deferred from the March 2017 meeting. Following some confusion about the decision, it was again deferred to the next meeting to be held in March 2018.

In a commentary published on the Tobacco Control website,Mary Assunta and Ulysses Dorotheo from the Southeast Asia Tobacco Control Alliance (SEATCA) outlined the processes and recommendations to date. An edited extract of their commentary is below

The ILO at its previous Governing Body meeting (330th Session) in March 2017decided to postpone the decision on whether it should (a) continue in its collaboration which includes grants, or (b) cut ties with the tobacco industry. These two options, which were offered in the previous background document, have altogether disappeared for this 331st Session. The current document merely proposes that the Governing Body decide to request the Director-General to further develop and implement a strategy on the ILO’s engagement with the tobacco sector subject to certain conditions.

The many years of the tobacco industry’s corporate social responsibility activities in addressing child labour in tobacco growing have not made a significant dent in the problem. More years of ILO collaboration with the industry will not solve the problemIn fact, through all the years of expressing concern for child labour on one hand, the tobacco industry continued on the other hand to buy cheap leaves grown and harvested using child labour.

Currently, through its public-private partnership (PPP) programme, the ILO has two grants from the tobacco industry to address child labour in tobacco growing in about 5 countries: US$ 10 114 200 from Japan Tobacco International (JTI) (2011 – 2018) and US$ 5 332 835 (three grants since 2002) from Eliminating Child Labour in Tobacco Growing Foundation (ECLT) a non-profit organization funded and governed by transnational tobacco manufacturers and leaf tobacco trading companies. Both grants run out in 2018.

In its latest background document, the Office extolls the virtues of the tobacco industry’s good works of addressing child labour, while admitting it has no idea of the exact number of children involved in producing tobacco leaves. It also reports that despite great efforts at fundraising, it simply cannot do without tobacco money. It even claims that should the funds cease, it will ‘cause serious harm in the many communities where the ILO is operating with tobacco industry funding’. The ILO’s work is much wider and bigger than just specifically addressing child labour in tobacco growing, but the background document appears to have some input from tobacco industry lawyers justifying the industry’s continued support

While citing Malawi as an example where tobacco growing contributes significantly to the national economy and where collaboration with the tobacco industry must continue, the Office has also apparently totally ignored the Tobacco and Allied Workers Union of Malawi (TOAWUM) letter to the ILO Governing Body requesting they ‘prohibit cooperation and public-private partnerships with the tobacco industry at the upcoming 331st session of the Governing Body.’ According to the TOAWUM, the structure of the public-private partnerships with the tobacco industry almost by definition excludes the participation of the organization representing the workers on the ground and is an inappropriate model to fund ILO programs.

The ILO should take its cue from the UN Global Compact (UNGC), which on 13 September 2017 announced its decision to permanently exclude the tobacco industry from participating in the UNGC. Companies whose business involves manufacturing or producing tobacco products will be delisted, effective 15 October 2017, along with businesses associated with producing landmines or nuclear, chemical, and biological weapons. This would clearly exclude ECLT and JTI, which are members of the Child Labour Platform of the UNGC Human Rights and Labour Working Group, for which the ILO Office provides the Secretariat.

If the ILO had any doubts, these recent policy developments by international agencies should be sufficient to dispel any confusion on the need to disengage from the tobacco industry They provide clear guidance for the ILO to sever its ties with the tobacco industry; however, the Office is advising its Governing Body to go rogue and continue its collaboration with the tobacco industry.

It is perhaps not coincidental that at this historical moment, a new ‘foundation’ funded solely by Philip Morris International proposes to tackle the problems of tobacco growers through ‘independent’ research and advocacy.

Continuing to partner with and accept money from the tobacco industry through any form will tarnish the ILO’s reputation. The ILO governing body must adopt the Model Policy and cut ties with the tobacco industry.

This is an edited extract of an online article authored by Mary Assunta and Ulysess Dorotheo of the Southeast Asia Tobacco Control Alliance. The full article with links and references can be accessed at: http://blogs.bmj.com/tc/2017/10/27/ilo-must-shake-off-tobacco-industry-yoke/