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Tob Control 11:94-104 doi:10.1136/tc.11.2.94
  • Original Articles

Tobacco industry manipulation of the hospitality industry to maintain smoking in public places

  1. J V Dearlove,
  2. S A Bialous,
  3. S A Glantz
  1. Center for Tobacco Control Research and Education, Institute for Health Policy Studies, Cardiovascular Research Institute, School of Medicine, University of California, San Francisco, San Francisco, California, USA
  1. Correspondence to:
 Stanton A Glantz, PhD, Box 0103, University of California, San Francisco, San Francisco, CA 94143-0130, USA;
 glantz{at}medicine.ucsf.edu
  • Received 12 December 2001
  • Accepted 13 March 2002
  • Revised 12 March 2002

Abstract

Objective: To describe how the tobacco industry used the “accommodation” message to mount an aggressive and effective worldwide campaign to recruit hospitality associations, such as restaurant associations, to serve as the tobacco industry's surrogate in fighting against smoke-free environments.

Methods: We analysed tobacco industry documents publicly available on the internet as a result of litigation in the USA. Documents were accessed between January and November 2001.

Results: The tobacco industry, led by Philip Morris, made financial contributions to existing hospitality associations or, when it did not find an association willing to work for tobacco interests, created its own “association” in order to prevent the growth of smoke-free environments. The industry also used hospitality associations as a vehicle for programmes promoting “accommodation” of smokers and non-smokers, which ignore the health risks of second hand smoke for employees and patrons of hospitality venues.

Conclusion: Through the myth of lost profits, the tobacco industry has fooled the hospitality industry into embracing expensive ventilation equipment, while in reality 100% smoke-free laws have been shown to have no effect on business revenues, or even to improve them. The tobacco industry has effectively turned the hospitality industry into its de facto lobbying arm on clean indoor air. Public health advocates need to understand that, with rare exceptions, when they talk to organised restaurant associations they are effectively talking to the tobacco industry and must act accordingly.

The tobacco industry has recognised since the 1970s that declining social acceptability of smoking is the most serious problem it faces.1,2 This decline has been accelerated by the evidence, which started accumulating in the 1970s, that second hand smoke endangers non-smokers.3–7 Smoke-free environments have led to a drop in cigarette consumption and loss of profits for the tobacco industry.8–15 The industry recognised that declining social acceptability also increases voluntary quitting and weakens the industry's ability to develop allies.16 The industry used this threat to its financial viability in 197817 as part of the justification to oppose a California initiative that would have created smoking and non-smoking sections.18,19 In 1993, a Philip Morris (PM) analyst observed that the “Financial impact of smoking bans will be tremendous. Three to five fewer cigarettes per day will reduce annual manufacturer profits a billion dollar plus per year.”20 By the late 1980s and early 1990s, the industry realised that it urgently needed to address these issues in a proactive manner, rather than simply reacting to tobacco control initiatives.16,21,22

The decline in social acceptability of smoking and the support for more regulatory measures on public smoking has not been an exclusive US phenomenon. Despite the fact that few tobacco control advocates in Europe have made clean indoor air a high priority, a 1989 survey conducted by PM of smokers and non-smokers in 10 European countries found that “the perception that ETS [environmental tobacco smoke] represents a danger to health is widespread” and that “annoyance levels and frequency of annoyance are as high in Europe as in the US”.23

The industry adopted two main approaches to address the problem of declining social acceptability of smoking: attacking the science demonstrating that second hand smoke was dangerous 2,14,24–33 (as it had done with active smoking) and working to change the public's perception of smoking in public. The industry's original defence against restrictions on smoking (creation of non-smoking sections) in the 1970s was to invoke arguments about “courtesy,” “choice”, and “freedom” as well as to claim that any limitations on smoking would hurt businesses that restricted smoking (without mentioning the fact that tobacco industry sales and profits would suffer).1,18,19,34 In the 1980s they also began to promote ventilation as a solution.35 This argument eventually lost credibility because a consensus developed that workers should not be forced to breathe the toxic chemicals in second hand smoke, and business saw no need to install expensive ventilation systems (that would not solve the problem anyway).36,37 In addition, many employers (particularly large employers) independently concluded that smoke-free workplaces were good for business.

As a result of these pressures, the tobacco industry has increasingly focused the debate over clean indoor air and smoke-free environments in the hospitality industry (restaurants, bars, and casinos). The core message used to recruit allies in the hospitality industry has been “accommodation” of smoking and non-smoking patrons (without mentioning employees). A key element of this effort has been to commission and release studies claiming that smoking restrictions have major negative economic effects on the hospitality industry,38,39 a claim even a PM lobbyists reported was untrue.40

The tobacco industry, knowing that it has no public credibility, has a well established practice of speaking through front groups.14,16,18,22,25,41–44 The tobacco industry's campaign has not only been directed at convincing individual restaurants to continue to support smoking, but has had a major institutional element through hospitality organisations. The tobacco industry's use of restaurant associations to protect its interests has only been studied in Massachusetts41 and as it relates to smoke-free measures considered by states' boards of health.45 The industry has used the “accommodation” message to mount an aggressive and effective worldwide campaign to recruit hospitality associations to serve as the tobacco industry's surrogate in fighting against smoke-free environments.

METHODS

We analysed tobacco industry documents publicly available on the internet as a result of litigation in the USA. Documents were accessed between January and November 2001. Search terms included “accommodation”, “restaurant”, “hospitality”, “downunder”, “courtesy”, “ventilation”, “HORECA” (International Association of Hotels, Restaurants and Cafes), “IHA” (International Hotel Association), “HOTREC” (a lobbying office for 12 national restaurant associations in the European Union), and the names of key players and organisations as identified in the initial searches. We did not search documents from the British American Tobacco depository in Guildford, England because of their general lack of availability to the research community.46 While we searched all the industry websites, the majority of documents come from the PM website (www.pmdocs.com), probably because PM was the first tobacco company to promote the accommodation message in the hospitality industry.

RESULTS

The idea of “accommodation” emerges

Figure 1 shows how the tobacco industry developed its strategy to co-opt and manipulate the hospitality industry into opposing smoke-free public places beginning in the 1970s and that the industry's response intensified as more evidence accumulated against second hand smoke.

Figure 1

Time line showing developments in the relationship between the tobacco and hospitality industries.

Arizona was the first state to pass clean indoor air legislation (in 1973),47 followed by Minnesota in 1975. Although weak by current standards, these early measures marked the beginning of the non-smokers' rights movement in the USA. The first major industry public opposition to smoking restrictions occurred in 1978, when it defeated a proposed California law modelled on the Minnesota Clean Indoor Air Act. Ironically, the provisions to create smoking and non-smoking sections were much weaker than the current accommodation strategy the industry advocates, because it did not couple the creation of separate sections with a ventilation system that would supposedly prevent smoke from moving from the smoking to the non-smoking section.

The industry's experience in California1,18 and Dade County, Florida48,49 prompted it to consider changing its key message in opposing clean indoor policies to promoting “accommodation” of smokers and non-smokers. In the late 1980s, the now extinct US Tobacco Institute, the industry's lobbying and political arm, proposed “Operation Downunder” to its member companies.50–56 This project would have changed the tobacco industry's policy from unilaterally opposing all smoking restrictions to accepting weak smoking restrictions. Because weaker restrictions accommodated smokers, the tobacco industry referred to this new policy as “accommodation.” The Tobacco Institute ultimately decided against this policy change57 because it was concerned that such accommodation policies would bring the issue of smoking in public places to the forefront of public debate and would weaken the industry's ability to oppose smoking restrictions.53,57

PM, however, disagreed with the Tobacco Institute's decision and began its own version of Operation Downunder in 1989.55,58–61 PM believed that the industry should be proactive in shaping the public smoking debate to preempt attempts to pass smoke-free policies, and created a public relations campaign based on “accommodation”. Eventually, other tobacco companies developed similar programmes.

The Belgium Royal Decree

In 1987 the Belgian government passed a Royal Decree requiring that restaurants install ventilation and create smoking sections.62 While we were unable to determine what role, if any, the tobacco industry played in the development of this decree, we do know that PM successfully capitalised on this decree to promote its new “courtesy campaign”. PM took advantage of the fact that the 1987 Royal Decree was not accompanied by an information campaign on the part of government making it clear how to comply with the Decree. PM considered this a prime opportunity to test an accommodation campaign and promote the idea of indoor air quality and the use of ventilation systems as opposed to smoking restrictions.63–65

PM met its goal of preventing stricter smoking restrictions by using this project to convince Belgians that smokers and non-smokers could coexist, and by working with the Belgian national tobacco manufacturers association to help draft the text of the 1993 Royal Decree62,64 regarding smoking in workplaces issued by the Minister of Employment:

“[Tobacco use] must be based on mutual tolerance, respect of individual liberties, and courtesy. If necessary, the employer must take additional technical measures [ventilation systems] in order to eliminate the annoyance caused by environmental tobacco smoke.”66

PM considered the adoption of accommodation language in the 1993 Belgian Royal Decree a major success.66

Building the relationship with the hospitality industry

PM focused on the hospitality businesses—restaurants, bars and recreational centres—as the most promising allies to enlist in political battles to protect cigarette consumption:

“The Accommodation Program serves as link between PM and the hospitality industry. Our ability to interact effectively with the hospitality industry is critical to our ultimate objective, which is to maintain the ability for our consumers to enjoy our products in public venues such as restaurants, hotels, bowling centres, and shopping malls. This relationship becomes even more important as legislative threats continue to mount at local, state, and federal levels.”67 [emphasis added]

The tobacco industry used the hospitality industry to meet its legislative goals: defeat smoke-free policies and support accommodation legislation that enacts weak smoking restrictions, thereby taking the issue of public smoking off the public agenda without doing anything to protect public health.68

PM recognised that there were barriers in establishing this alliance because the hospitality industry did not actually have a stake in protecting the interests of the tobacco industry; it observed:

“The Hospitality Industry is our greatest potential ally . . .But not necessarily a natural partner

• PM products, for the most part, not sold in these venues

• We do not have a strong business connection to the industry . . .”67

PM's primary recruiting message was to promote the hospitality industry's fear of losing money due to smoke-free policies, and offered accommodation as an alternative.68

The industry's efforts to use the hospitality industry have two major components. There is a proactive element in the form of an educational campaign, transmitted through national or regional hospitality associations, to familiarise individual restaurateurs and bar owners with the idea of accommodation and convince them that instituting smoke-free policies will harm their business. There is also a reactive element to fight clean indoor air laws. When faced with a specific legislative threat, the tobacco industry will send lobbyists and public relations firms to a specific locality in order to oppose legislative smoke-free proposals and offer accommodation policies as alternatives. If local hospitality and business associations do not cooperate with the tobacco industry, the industry creates its own hospitality organisation to serve as a front group and meet its legislative and strategic needs.

The Beverly Hills Restaurant Association

The first time the tobacco industry used a restaurant front group to lead opposition to a clean indoor air ordinance was in Beverly Hills, California, in 1987.18,43 Beverly Hills was the first city in California to pass a 100% smoke-free restaurant ordinance. The ordinance passed its first reading with little opposition. By the time of the second (and final) vote by the city council, the Beverly Hills Restaurant Association (BHRA) was vigorously opposing it, claiming that there would be a drop in business. It was not disclosed that the BHRA was created by a public relations firm for the tobacco industry.9,69 The council enacted the ordinance and it went into effect. Over the next several months, the BHRA loudly claimed that business was down 30% and eventually succeeded in getting the ordinance amended to create smoking and non-smoking sections. (Even so, it remained the strongest ordinance in California at the time.) Sales tax data later revealed that there was no effect on business revenues.10,70

Impressed with this success, PM developed plans to use this model to promote the accommodation concept internationally71 and began to provide testimonials at hospitality industry gatherings and to oppose legislation elsewhere.18,69,72

The Accommodation Program

In 1989, PM formalised the concepts of tolerance and courtesy into a US public relations campaign called the Accommodation Program. As it developed into a nationwide strategy, this programme built around three core themes: (1) harmony between smokers and non-smokers; (2) smoke-free policies are associated with businesses losses in the hospitality industry; and (3) ventilation removes second hand smoke, allowing smokers and non-smokers to share the same environment.

The Pittsburgh experience

The programme first emerged in Pittsburgh, Pennsylvania in June 1989. Just before the launch of the Accommodation Program, Pittsburgh passed a law restricting smoking in public places. Earlier analysis of the Pittsburgh events concluded that the Accommodation Program was launched to delay or obstruct the implementation of the smoking law, by causing confusion about implementation.73 The crux of the programme was a symbol that restaurants and other businesses could post on their door to indicate that they accommodated smokers (fig 2). The symbol resembled a yin/yang sign implying that smokers and non-smokers could coexist in harmony. This symbol, called “The New Sign of the Times”, was half red and half green with a lit cigarette featured in the green half. Underneath this symbol was the phrase, “Smokers and Non-Smokers Welcome.”58,60,74–76 This logo was presented as an alternative to the international no-smoking sign, which needed to be posted in certain areas to comply with the ordinance.73

Figure 2

Logos for the original Philip Morris Accommodation Program and the IHA's Courtesy of Choice Program.

Internal tobacco industry documents indicate that, in fact, PM was more concerned about testing the Accommodation Program as a public relations campaign aimed at increasing the social acceptability of smoking than simply confusing implementation of the Pittsburgh ordinance.59,77,78 Before the launch of the Accommodation Program, PM arranged for one-on-one meetings and presentations to obtain the support of potential allies, and recruited parties who were interested in participating in the campaign, such as restaurants, hotels, and taxi firms.78 The programme featured advertisements on 50 billboards and print advertisements in almost all local publications promoting the idea of accommodation as well as specific businesses that agreed to cooperate. PM was able to recruit about 100 restaurants to participate in the programme at a total cost of $2–4 million.75 The fact that the Accommodation Program's messages were difficult to criticise became a hallmark of the accommodation/courtesy strategy; according to Guy Smith, PM's vice president of corporate affairs:

“ . . .this [Pittsburgh Accommodation] program seems to be working extremely well and it is widely acclaimed in the community as very reasoned and calm. It also had the satisfying result of having the antis [tobacco control advocates] all tied up in their underwear because it is so difficult to criticize.”79

At the end of the campaign PM conducted survey research to evaluate the programme58,59 and deemed it a success because it “received overwhelming acceptance from both the Pittsburgh business community and the general public”.77 This success led PM to expand the programme to other US cities and to European markets.78

Hospitality associations with tobacco ties in the USA

Since the tobacco industry's initial success in working through restaurants in Beverly Hills, it has rapidly expanded its links to the hospitality industry (table 1) in ways that have been replicated around the world. In some cases, the industry worked with existing groups and in other cases it formed groups to meet its specific political needs.

Table 1

Hospitality groups with known affiliations* with the tobacco industry

For example, in addition to the BHRA, in California the tobacco industry created the California Business and Restaurant Alliance,40 Sacramento Restaurant and Merchant Association,18,42 and the California Tavern Association18,44 to oppose local and state smoke-free restaurant laws. (In California the tobacco industry had a particular problem because the legitimate state restaurant association, the California Restaurant Association, was supporting a state law making all restaurants and bars smoke-free, largely out of concern for legal liability associated with workers being exposed to second hand smoke.80) In New York, the industry created the Long Island Hospitality Coalition and built the Empire State Restaurant & Tavern Association (which also called itself the United Restaurant, Hotel and Tavern Association, the New York Tavern and Restaurant Association, and the Manhattan Tavern and Restaurant Association) from a small, non-influential group that the tobacco industry infused with cash and used as a front to lobby against local clean indoor air policies and to promote preemptive legislation in the state of New York.44 It was also used to circumvent the lobbying disclosure and spending limits laws in the state.

In total, the tobacco industry provides funds to and works with more than 65 hospitality groups around the USA (table 1), including state restaurant associations, and national organisations including the National Restaurant Association,81 the American Beverage Institute, and the National Licensed Beverage Association.

These groups also provide the tobacco industry with a public face for opposition to clean indoor air legislation and regulation in a way that allows the industry to remain in the shadows. For example, in Ohio, the state Licensed Beverage Association was instrumental in supporting legislation that would have removed authority from all local health boards to regulate smoking.82,83 Restaurant groups have been very active in opposing smoke-free legislation throughout the USA, as experience from Alaska, Louisiana, New Hampshire, Ohio, and Oregon in 2001 demonstrate.84–87 For example, the New Hampshire Lodging and Restaurant Association, which receives funding from PM and RJ Reynolds, opposed House Bill 713 which would end smoking in all restaurants. The bill was held in the Commerce Committee, which had originally recommended passage of the bill.84

International HORECA

The tobacco industry's alliances with the hospitality industry extend worldwide through existing hospitality organisations. In 1989, HORECA (International Association of Hotels, Restaurants and Cafes) published a newsletter with an “Alert” regarding smoking restrictions in restaurants. The “Alert” explained that public smoking restrictions resulted in conflicts at hospitality businesses and often led to the loss of revenue.88 While HORECA is active mainly in Europe, the tobacco industry used the model developed there in other parts of the world, including Latin America and Asia, through the International Hotel Association (IHA, later IH&RA, discussed below).

An October 1989 issue of the HORECA newsletter, released as a “special report”, went into detail about the measurement of tobacco smoke, relying on research conducted by Healthy Buildings International,89 a consulting firm the tobacco industry financed to support its political agenda.89–91 The issue promoted the industry position that ventilation was the solution to second hand smoke.

Later in 1989, HORECA produced a pamphlet titled “Managing an evolving issue” introducing the “Preserve Our Traditions” campaign with the objective to promote accommodation and the business owners' “right” to decide on smoking policies.92 The “Preserve our Traditions” campaign was developed by PM for HORECA,93 using the same yin/yang symbol as the campaign in Pittsburgh.91

PM anticipated that the national associations would begin their own accommodation campaigns based on this material.94 The material contained suggestions on keeping ventilation systems clean, a model customer survey, a letter from the president and general secretary of HORECA promoting “Preserve Our Traditions”, and other suggestions regarding promotion of the campaign. By 1993, PM considered “Preserve Our Traditions” a great success, not only in promoting accommodation within the hospitality industry, but also in mobilising other tobacco companies:

“The HORECA initiative was particularly successful and was adopted or adapted in several European countries. Sometimes, it had the effect of making the local national [tobacco] monopolies take up its own initiatives, if only not to be “shown up” by a foreign company.95

In 1994 PM paid $200 000 to International HORECA for support of the organisation's magazine, development of materials for HORECA's management curriculum, support for two different HORECA initiatives, and for membership dues.96

PM's “Three year plan for 1994-1996” included plans to continue a relationship with hospitality associations and to use these groups to generate and lobby for preemptive legislation that would stop enactment of clean indoor air laws and encourage pro-industry voluntary measures that would not affect smoking:

“In order to avoid adverse national legislation affecting public places and especially [the hotels, restaurants and cafes sector] in the member states which have not yet introduced any legislation, we shall prepare together with the industry associations pre-emptive national legislation and/or voluntary measures and encourage adoption via the [the hotels, restaurants and cafes] associations. Together with the National [Tobacco] Manufacturers Associations, we should prepare and implement restaurant Accommodation Programs in all EC markets . . .[These programs] should be directed to the restaurant owners via [the hotels, restaurants and cafes] associations to promote reasonable voluntary smoking policies based on principles of accommodation and good ventilation.”97

PM saw the national hospitality associations as such an important channel that in 1996 it was ready to create one if one was not already in existence; its 1996 “Worldwide strategy and plan” included the goal: “Develop, as needed, creation of national hospitality associations where none exist and encourage their affiliation with HORECA International.”98 By influencing the publications and conferences put out by these organisations, PM was able to create alliances and influence organisations around the world to support its accommodation message and create coalitions.99

HOTREC

HOTREC is the European Community lobbying office of 12 national hotel and restaurant associations and PM considered its relationship with HOTREC “of prime importance”.100 PM first approached HOTREC about contributing to their White Book in 1993. The White Book was a position paper HOTREC used to lobby for its members' interests. According to PM, “The White Book will provide an analysis of the various developments at the European level affecting the [hospitality] sector and the presentation of HOTREC's position on each issue.”101 PM was particularly interested in the 1993 White Book because it included a section on smoking in public places. HOTREC's secretary general, Marguerite Sequaris, told PM that they would welcome the tobacco's company help in addressing the issue of smoking and the hospitality sector.101

PM considered this project a way to influence the organization's position on smoking in public places and contributed $20 000 towards the printing, distributing, and promoting of the White Book.101,102 Although HOTREC had not expressed its own opinion on this matter, PM planned to include “studies proving that smoking policy measures imply increased cost for management in the [hospitality sector and] HOTREC position's in favor of appropriate measures to meet customers' wishes” in the “Smoking in Public Places” section of the White Book.”101

PM was also involved in promoting the White Book and its findings. In a 1993 letter to secretary general Sequaris, PM government affairs manager Gerard Wirz stated:

“We once talked about presenting and promoting the White Book at a cocktail party for EC decisions makers and readers of Europe hotel and restaurant industry.”102

Despite its willingness to accept PM's input on their position paper, HOTREC did not want to be publicly associated with a tobacco company. Helene Lyberopoulos of PM Corporate Affairs Europe wrote to David Bushong of PM Corporate Services in Belgium:

“HOTREC and its national members do not feel comfortable with being publicly associated with PM, as the name representing the tobacco business. They underline the fact that a support from our side would be valuable for their organization but it should be either under the KJS [Kraft Jacob Suchard] company name or remain as discreet as possible (i.e. PM name should not appear on any of their materials).”101

Keeping PM's name off the materials also met PM's need to remain in the background and take advantage of HOTREC's seeming independence on the passive smoking issue.

Industry documents indicate that HOTREC continued to represent PM's positions to the European Union at least through 1996.98

International Hotel Association

The International Hotel Association (IHA) represents national hotel associations, international and national hotel groups, independent hotels, training institutes, and suppliers to the hotel industry in 145 countries.103 The IHA engages in regular dialogue with intergovernmental organisations, and has “consultative status” with the United Nations, the Organisation for Economic Co-Operation and Development (OECD), the International Labor Organization, and the Council of Europe.104 PM first approached the IHA for a “collaboration” in 1993.104 PM wanted to deliver a presentation about the Accommodation Program during a meeting of the IHA's chief executives. The IHA agreed, and also organised a session during which the executives discussed the experiences of their national associations and the implications of the Accommodation Program. In addition, the two organisations began discussions about the PM sponsorship of the IHA's White Paper.105

The White Paper is a document that serves both as a lobbying tool for the IHA and to recruit members for IHA member organisations. It includes statistics about the hospitality industry worldwide and states IHA's position on several issues.106 The 16 December 1993 White Paper draft outline contained a section titled “Concerns of the Industry”; the “Smoking and Non-smoking” caption included the notation, “Philip Morris involvement.”

Not only was PM able to influence the IHA's official position paper in 1993, but it was optimistic that “the contents [of the 1993 White Paper] will likely set the tone for future IHA position papers.”107 Furthermore, PM hoped that the national and regional hotel associations would adopt this position statement.107 PM anticipated that this project would publicise accommodation worldwide:

“Essentially, our involvement in this project could reap long term and widespread benefits in terms of pro-Accommodation publicity. The White Paper is intended for use in all media, government and NGO [non-governmental organisation] contacts at national and international level by IHA worldwide.”107

As a result of surveys conducted by PM to demonstrate interest,108 PM began working with the IHA on an accommodation programme titled “Courtesy of Choice”. PM's objectives were:

“Promote self regulation of accommodating the preferences of smokers and non-smokers on a worldwide network of hoteliers, restauranteurs, and hospitality associations.

Establish a framework for self-regulation which enhances customer satisfaction and helps guard against intrusive legislation or regulations . . .

Develop a world-wide network within the hospitality sector in which PM can be involved locally, if appropriate.”108

A memorandum dated 23 June 1994 announced the Courtesy of Choice programme to PM executives around the world. The memo revealed that the Courtesy of Choice programme is essentially the European version of the US Accommodation Program and an extension of HORECA's “Preserve Our Traditions” campaign.109

PM tested the Courtesy of Choice programme materials during August and September 1994 as part of a pilot project at the Langham Hilton hotel in London. The company anticipated releasing the materials to IHA national members in early September to formally introduce the programme and “solicit interest in PM's presentation at the IHA annual meeting in Sydney in October (presentation will consist of the London pilot project results).”110

A list of invoices and billing indicates that PM paid the IHA $50 000 on 24 May 1994. 111 In addition, PM spent $160 000 on the IHA for a pilot hotel project with Hyatt Regency for the preparation and translation of Accommodation/Courtesy materials, and $60 000 to pay for PM membership in the IHA.96 Documents indicate that PM planned to conduct the pilot hotel project in Hyatt hotels located in England, Germany, and the United Arab Emirates.95

In the mid 1990s, the tobacco industry planned a worldwide expansion and implementation of the Courtesy of Choice programme.66,98,112 (By 1994, Courtesy/Accommodation campaigns run by PM through other third party allies were being planned or administered in several European, Latin American, and Asian countries.113) A 1995 pamphlet published by PM titled “Courtesy and tolerance: common sense solutions for smokers and non-smokers” stated that the Courtesy of Choice programme had been or would be implemented in the UK, Belgium, Ireland, Germany, and Finland.114

PM planned to emphasise ventilation in future Courtesy of Choice campaigns. A 1996 document titled “Ensuring reasonable smoking policies by accommodating the preferences of smokers and non-smokers” stated that PM wanted to use the IHA to “enhance rules of ventilation and other technological options with existing cooperative programs with the hospitality industry.”98 Specifically, PM wanted to “support continued application of the IAQ [Indoor Air Quality] elements of the International Hotel Associations (IHA) Courtesy of Choice program.”98

In late 1990s, the IHA changed its name to the International Hotel and Restaurant Association (IH&RA) and began to represent the restaurant industry as well. Although publicly available industry documents regarding IHA/IH&RA and the Courtesy of Choice programme end at about 1997, in late 2001 the IH&RA maintained a website115 that defended the continuation of accommodating smoking in the hospitality industry and perpetuated the tobacco industry claims that “inflexible and restrictive legislation on smoking in public places . . .[would] almost certainly have harmful repercussions on their business, whilst not satisfying the needs of all clients.”115 In addition, the website “encourages self-regulation through the promotion of the `Courtesy of Choice' program” and that “IH&RA support HOTREC's opposition to any action at the European level to impose restrictive legislation on smoking in hotels and restaurants.”115

The IHR&A website contains a link to the Courtesy of Choice programme page (fig 2). This page displays the yin/yang symbol associated with the US Accommodation Program and the HORECA Preserve Our Traditions programme. It also lists over 50 countries worldwide where the programme is currently operating.116 The 1998 and 1999 IHR&A annual congress reports of the IH&RA acknowledged support from PM Management Corporation,117,118 suggesting that PM sponsorship is continuing.

DISCUSSION

The tobacco industry has co-opted and manipulated the hospitality industry to promote its agenda of preserving the social acceptability of smoking and preventing and opposing smoke-free restaurant policies by promoting the idea of “accommodation” of smokers and non-smokers as an alternative to creating smoke-free hospitality venues. When existing hospitality associations refuse to align themselves with the tobacco industry, the industry simply creates its own hospitality associations to promote industry arguments.18,41–43

Another variation of the accommodation programme is “Red Light Green Light” laws.119 These laws are introduced to local level policymakers (typically by restaurateurs) in places where citizens are pressing for a 100% smoke-free ordinances. Like the Accommodation Program, “Red Light Green Light” laws only establish minimum restrictions and require signs be posted outside establishments saying whether smoking is allowed inside. These proposals have great appeal to local policymakers who feel pressured to address smoking in public places since these weak laws give the appearance of taking action without having any protective health effect. Introducing “Red Light, Green Light” laws is an industry tactic aimed at delaying and weakening popular smoke-free efforts.

For more than a decade the tobacco industry disseminated misinformation asserting that the hospitality industry will suffer financially when smoke-free environments are instituted. Despite the fact that these claims of negative impact are unfounded,10,38,39,46,70,120–122 this argument has been widely accepted in the hospitality business, thanks to the relationship the tobacco industry has established with organisations whose alleged purpose is to protect the interests of businesses in the hospitality sector. This situation creates problems for public health advocates because individual restaurateurs and bar owners, having heard these claims repeatedly from organisations they trust, oppose smoke-free policies out of fear.

The ventilation “solution” is another important component of the accommodation strategy because it reduces potential for conflict between smokers and non-smokers. While ventilation does not protect against toxic effects of second hand smoke,36,37 it may make it harder to perceive it. PM established the “PM Options” programme in the late 1990s to expand the ventilation component.123,124 (Long time tobacco industry ventilation consultant Chelsea Group provides technical support to the Options Program through its “INvironment” project.123,125,126) Options also sponsored the creation of several other hospitality initiatives promoting ventilation, such as the Hospitality Coalition on Indoor Air Quality,127 the “Atmosphere Plus” of the National Licensed Beverage Association,128 and several state “Indoor Air Quality” coalitions.129–131 A similar programme in the UK titled, “The Atmosphere Improves Results (AIR)” initiative, launched in 1997, received funding from the national tobacco manufacturers association.132

At the same time that it is promoting a ventilation “solution,” the tobacco industry is careful to avoid claiming that ventilation will resolve the health dangers caused by second hand smoke.126133,134 The PM “Options” website states: “Options, Philip Morris, USA does not purport to address health effects attributed to environmental tobacco smoke.”125 By convincing hospitality businesses to invest in expensive ventilation equipment, the tobacco industry creates a constituency to oppose smoking restrictions. Once the investment is made, hospitality businesses will probably be even more likely to oppose creation of smoke-free environments.

The irony is that the tobacco industry has convinced many in the hospitality industry to embrace expensive ventilation systems to avoid non-existent losses in business of going smoke-free.

The tobacco industry works to stay out of the public spotlight during any debates over tobacco control policies because of its low credibility. In recent years, the tobacco industry, led by PM, has effectively turned the hospitality industry into its de facto lobbying arm on clean indoor air. Public health advocates need to understand that, with rare exceptions, when they are talking to the organised restaurant associations, they are talking to the tobacco industry, and act accordingly.

What this paper adds

When public health advocates seek to enact clean indoor air laws, they inevitably find the opposition coming from the hospitality industry rather than the tobacco industry. This paper demonstrates that the tobacco industry has had a worldwide programme to infiltrate and coopt the hospitaility industry to serve the tobacco industry's political needs. Public health advocates, decision makers, and the media should understand that opposition to smoke-free restaurants and bars that appears to come from the hospitality industry is really being orchestrated by the tobacco industry.

Acknowledgments

This work was supported by US National Cancer Institute Grants CA-61021 and CA-87472.

REFERENCES