Background Germany has been identified as one of a few high-income countries that opposed a strong Framework Convention on Tobacco Control (FCTC), the WHO's first global public health treaty. This paper examines whether the tobacco industry had influenced the German position on the FCTC.
Methods Analysis of previously confidential tobacco industry documents.
Results The tobacco industry has identified Germany as a key target within its global strategy against the FCTC. Building on an already supportive base, the industry appears to have successfully lobbied the German government, influencing Germany's position and argumentation on key aspects of the FCTC. It then used Germany in its efforts to weaken the FCTC. The evidence suggests that the industry enjoyed success in undermining the Federal Health Ministry's position and using Germany to limit the European Union negotiating mandate. The tactics used by the tobacco industry included the creation of controversy between the financial, trade and other ministries on one side and the health ministry on the other side, the use of business associations and other front groups to lobby on the industry's behalf and securing industry access to the FCTC negotiations via the International Standardization Organization.
Conclusion The evidence suggests that Germany played a major role in the tobacco industry's efforts to undermine the FCTC. Germany's position consistently served to protect industry interests and was used to influence and constrain other countries. Germany thus contributed significantly to attempts to weaken an international treaty and, in doing so, failed in its responsibility to advance global health.
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Funding This work was supported by the Smoke Free Partnership (SFP) through a Cancer Research UK (CR-UK) grant. CR-UK is one of the SFP partners (http://www.cancerresearchuk.org), the others currently being the European Respiratory Society (http://www.ersnet.org) and the European Heart Network. The funders had no influence on the study design, data collection, data interpretation, the writing of this article or the decision to submit the paper for publication. ABG is supported by a Health Foundation Clinician Scientist Fellowship. ABG and JC also receive research funding for tobacco document research from the National Cancer Institute of the United States, National Institutes of Health (grant number: 2 R01 CA091021-05).
Competing interests TG and HW have no competing interests. JC and ABG were part of a WHO Tobacco Free Initiative (TFI) Expert Committee convened to develop recommendations on how to address tobacco industry interference with tobacco control policy, and as such their travel to a meeting in Washington DC was reimbursed by WHO TFI.
Provenance and peer review Not commissioned; externally peer reviewed.
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