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  1. Marita Hefler1,2,
  2. John Baker2
  1. 1 Wellbeing & Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
  2. 2 Community and Allied Health, La Trobe Rural Health School, Flora Hill, Victoria, Australia
  1. Correspondence to Dr Marita Hefler, Wellbeing & Preventable Chronic Disease, Menzies School of Health Research, Casuarina, NT 0811, Australia; marita.hefler{at}menzies.edu.au

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The Netherlands/World: big tobacco brands, teenagers, sex & smoking fetishes

Social media are an unregulated frontier regarding depictions of tobacco product use, in stark contrast to the increasing restrictions on such portrayals in mainstream media. In particular, it is much easier for content which promotes tobacco products to reach young audiences, since rules prohibiting tobacco product advertising through such media can be circumvented or simply ignored. Given the ubiquity and influence of social media use among young people, the opportunity to lure young “replacement smokers” offers a marketing paradise where anonymous or fabricated accounts and missing or inadequate control by the platforms make tracing the source of content extremely challenging.

Enter “smoking” as a keyword on Instagram and you will be referred to dozens of accounts with names referring to smoking girls and women, which feature images of young women smoking. Regardless of who is behind the accounts – and it is usually unclear – they are a great promotional tool for the tobacco industry. Browsing such sites leads to new accounts appearing on one’s timeline, with account names that include references to smoking and fetishes. These feature hundreds of pictures and videos of busty women with low necklines in seductive poses, sometimes only wearing lingerie or even topless - and always with a cigarette in their hand or mouth. In videos shown in many of the posts, the girls inhale deeply and then exhale the cigarette smoke towards the camera with a sultry look.

In this universe of scantily clad and provocatively smoking models, frequent references in accompanying texts to certain cigarette brands raise questions about how and by whom they might be financed. One YouTube channel which has in its description “Just posting smoking fetish related content”, is filled with short preview videos of heavily smoking young women in lingerie. In almost every video, Marlboro packs are displayed multiple times. A search query on YouTube using the term ‘smoking fetish’ results in hundreds of channels with the same kind of videos, which in many cases, are at least blocked behind an age verification that requires an ID (when viewed in the Netherlands).

Video description on https://www.smokingsweeties.com showing story of teenage smoking uptake.

On related websites which include promises like “Beautiful Glamour Smoking Models”, videos are offered on a pay-per-view basis. To entice visitors, a few moving images are provided with descriptions which describe what the model is wearing, alongside how and what she smokes. In almost every accompanying text, references are made to Marlboro Red, Marlboro Red 100s, 100s, Reds, and sometimes other Altria/Philip Morris International brands including Saratoga and Virginia Slims.

Facebook also offers up smoking fetish pages, with one page stating: “If sexy women who smoke turn you on, or if you have a smoking fetish, this is the place for you.” Posts make liberal references to Marlboro and ‘Reds’. The hashtag #marlbororeds also features. As with Instagram, one page leads to other Facebook pages as well as standalone websites. One such website features videos of voluptuous women and a lot of smoke. Visitors must pay to watch these videos, roughly the price of a pack of cigarettes. But in most cases, a free preview of one or 2 min is included, plus a detailed description. The young women on this site are scantily clad and regularly topless. In the descriptions of the videos and the comments by ‘viewers’, regular references are again found to ‘100 s’, Marlboro’s Red 100 s variant. Curiously, no other brands are featured. The site is nominally for adults, but the only age verification is to click on a button confirming one is over 18.

The descriptions accompanying the videos also contain references to very young smokers. One description of a video called ‘Proud to be a heavy smoker’, explains that the model first found smoking awful, until she tried it at 13 years old with her boyfriend. She became a regular smoker and started buying her own cigarettes when she was 15. Her favourite brand is Red 100s, and she says “I like to feel the smoke in my lungs, it feels good”. According to the site, the most viewed video is ‘Teaching A Beginner To Inhale’, which presents a young woman who teaches her friend to inhale. Another highly viewed video is called ‘The Beginner Gets Fully Trained’, with the explanation “She loves to powersmoke through her nostrils while dangling her 10 s!”

It is not difficult to imagine a curious young person enticed by sites heavily loaded with eroticism, in which smoking features heavily, adjacent to other videos which essentially form instructional videos for the novice smoker. It’s also hard to imagine a more perfect scenario for the tobacco company whose brands feature so heavily.

Research about smoking fetish imagery on the internet is very limited, particularly in recent years. The most comprehensive study was in 2010 and examined smoking fetish videos on YouTube. With the constant evolution of both social media, and new tobacco marketing strategies – particularly the emergence of influencer-based promotions, there is an urgent need for detailed studies of this phenomenon, its impact on teenage smoking and potential regulatory options.

This is an adapted version of a longer story (in Dutch) by Bas van Lier for TabakNee, a Dutch website exposing the marketing and lobby techniques of the tobacco industry. The full story is at: https://www.tabaknee.nl/nieuws/item/2315-tabaksindustrie-lokt-pubers-met-erotiek-in-de-val.

Bas van Lier

TabakNee.nl

redactie@tabaknee.nl

USA: menthol shows Black Lives don’t matter to Big Tobacco

A new report titled ‘Stopping Menthol, Saving Lives’ released by the African American Tobacco Control Leadership Council (AATLC), the Campaign for Tobacco-Free Kids and a large number of other health and welfare groups, highlights how the tobacco industry has targeted Black Americans with marketing for menthol cigarettes, and the devastating impact on the health and lives of Black Americans.

A picture from the CTFK report ‘Stopping Menthol, Saving Lives’. Image source: https://www.tobaccofreekids.org/what-we-do/industry-watch/menthol-report.

The culmination of decades of (largely volunteer) work by the AATLC, the report was released to support efforts to end the sale of menthol cigarettes and other flavoured tobacco products at the federal, state and local levels. Its release was particularly timely, during Black History Month in the USA, and in the wake of Black Lives Matter protests around the world in 2020.

Menthol cigarettes are the tobacco products most used by Black Americans. For the past 60 years the tobacco industry has deliberately targeted Black Americans, particularly children, with menthol cigarettes, which facilitate initiation, are more addictive, and are harder for smokers to quit. Less than 10% of Black smokers used menthol cigarettes in the 1950s, compared with 85% today.

The industry has targeted Black Americans with pervasive marketing of menthol cigarettes through magazine advertising, mobile vans supplying free samples of cigarettes, sponsorship of music and community events, and retail promotions. Menthol cigarettes continue to be heavily advertised, widely available and discounted in Black communities, increasing their appeal to price-sensitive youth.

Tobacco use is the number one cause of preventable death among Black Americans, claiming 45 000 lives every year. It is a major contributor to three of the leading causes of death among Black Americans, who die from these conditions at far higher rates than other Americans.

At the federal level in 2020, a number of public health and medical organisations filed a lawsuit in the U.S. District Court for the Northern District of California against the U.S. Food and Drug Administration to act on both its own recommendations and the conclusions of its own Tobacco Products Scientific Advisory Committee (TPSAC). Comprehensive scientific reviews by both the TPSC in 2011 and the FDA in 2013 found that menthol cigarettes cause substantial public health harms beyond those caused by other cigarettes. TPSAC concluded that the “Removal of menthol cigarettes from the marketplace would benefit public health in the United States.” The FDA also reported that menthol cigarettes were associated with increased smoking initiation by youth and young adults, and greater addiction and reduced success in quitting smoking, particularly among Black American smokers. The U.S. District Court for the Northern District of California was informed by the FDA that a decision will be released by 29 April 2021.

At the state and local level, the states of Massachusetts and California have passed laws ending the sale of menthol cigarettes and other flavoured tobacco products. However, the implementation of the legislation in California has been delayed as the tobacco industry is seeking to overturn it through a referendum. Despite this setback, at least 120 other localities across the U.S. have passed similar laws. The actions of the tobacco industry to prevent these laws starkly show the hollowness of any commitment the tobacco industry pretends to have to social responsibility. By challenging laws which will disproportionately save Black Lives, the tobacco industry demonstrates unequivocally that it does not believe Black Lives Matter as much as its continued profits.

All articles written by Marita Hefler and John Baker unless otherwise attributed. News Analysis submissions should be sent to: marita.hefler@menzies.edu.au.

Until the FDA acts, it is recommended that cities and states continue their efforts to prohibit the sale of menthol and flavoured tobacco products. Congress could also act to prohibit menthol cigarettes and other flavoured tobacco products, as the U.S. House of Representatives did in February 2020 when it passed the ‘Protecting American Lungs and Reversing the Youth Tobacco Epidemic Act of 2020’ to outlaw menthol cigarettes and other flavoured tobacco products. The legislation is now awaiting consideration by the Senate in order to progress. These actions will improve health and save lives among Black Americans.

Germany: new supply chain law a start, but inadequate

A new supply chain law was passed by the German government in March 2021. The law, which had been championed by civil society, creates a legal obligation for companies to examine their supply chain for human rights and environmental risks, and take remedial action. While it is a positive development, initial analysis by the organisation Unfair Tobacco (https://unfairtobacco.org/en/supply-chain-act-also-for-the-tobacco-industry/%23/) has identified significant weaknesses and loopholes.

Initially, the law will apply to German-based companies with more than 3000 employees, extending to those with 1000 employees from 2024. Subsidiaries for Japan Tobacco International, Philip Morris and Imperial Brands will be covered by the law. However, several other companies which import tobacco from countries including Malawi, Bangladesh and Zambia, where child labour is rampant, will not be covered.

The law also has a number of other weaknesses, which fall far short of the UN Guidelines on Business and Human Rights. In its current form, it is unlikely to proactively protect either human rights or the environment.

Unfair Tobacco is calling for the law to be improved in several ways. First, that full due diligence for the entire supply chain be required, both in Germany and in source countries. Second, that explicit civil liability be included, ensuring that companies will be liable in German civil courts for damage caused by failures in their duties of care. Finally, that there be independent environmental due diligence, as well as extension of the scope to all companies that are based in Germany or do business there.

Germany has a dismal record in tobacco control, frequently favouring tobacco industry interests over the health and well-being of its own citizens. Whether it can act as a good global citizen to enact the important human rights and environmental protections needed remains to be seen.

Australia: big tobacco wins in defeat of T21 age bill

An innovative legislative reform in Tasmania, Australia has been defeated, after what appears to be tobacco industry interference via third parties, with support from vaping lobby groups.

A 2018 bill to gradually phase in and raise the minimum legal sales age of e-cigarettes and tobacco to 21 years (T21), now law in Singapore and across all states and federally in the USA, was lost 12 votes to three in the Tasmanian Legislative Council on 23 March 2021.

It was hoped the legislation would reduce Tasmania’s smoking prevalence, which is the second highest of all Australian states and territories at more than 17%. This bill had been preceded by a bill for the Tobacco Free Generation, (TFG), a proposal developed by Prof Jon Berrick, which would have phased out tobacco sales to anyone born after the year 2000. That bill was tabled in Parliament in 2012 but lapsed due to the 2014 election being called.

The sponsor of both these bills was Hon. Ivan Dean, an Independent MP and former senior police officer. Mr Dean was motivated by his father, a smoker, who died a painful death from lung cancer. It was supported by all the major health organisations in Tasmania, some organisations from other states, and some US organisations including the Preventing Tobacco Addiction Foundation Tobacco21. The Western Australian Minderoo Foundation assisted with funding research projects to provide background to the T21, including analysis of the economic effects on small to medium enterprises. These research projects and summaries can be accessed on the SmokeFree Tasmania website (https://www.smokefreetasmania.com/).

Tasmania is one of the few places in the world where the tobacco industry is not permitted by law to “tell lies” about the health effects of tobacco, nor about legislation, under Sections 74 and 74AA of the Public Health Act 1997. Therefore, in Tasmania the industry is hamstrung and can only campaign via front groups. This is a problem for the tobacco industry further exacerbated by Article 5.3 of the FCTC to which Australia is a signatory, and which rules out legislators dealing with the tobacco industry except in transparent circumstances on the public record.

Tasmania has a long history of fighting political barriers, including crony capitalism and corruption in relation to big tobacco interference in its affairs. One Tasmanian government was brought down by British Tobacco (now British American Tobacco) through a bribery scandal in the 1970s. These constraints have impelled the tobacco industry to infiltrate some retailer trade organisations. A recent news story also detailed evidence of apparent links between a Hong Kong based public relations firm used by Philip Morris International and the vaping advocacy organisation the Australian Tobacco Harm Reduction Association. According to the report, ATHRA members were unable to explain the apparent links. Both retailer organisations and vaping advocacy groups campaigned vociferously against T21, the latter under the guise of “harm reduction”. Advocates also organised meetings and events with members of parliament. During the debate on the T21 bill, some MPs used tobacco industry-favoured language such as “freedom of choice”, “unintended consequences”, and claiming the supposed ineffectiveness of policy measures.

In the end, rather than adopt this strong, evidence-based measure, the government opted to support a weak program of school-based education, which already exists and has not been found to be effective in Tasmania. Surprisingly, the industry seems to have abandoned the nanny state” epithet for reforms, perhaps because some researchers have effectively challenged the concept.

This is an edited version of an article originally published on the Tobacco Control website. The fully referenced article is at https://blogs.bmj.com/tc/2021/04/02/australia-big-tobacco-wins-in-defeat-of-t21-age-bill/.

Kathryn Barnsley

University of Tasmania, Australia

kathryn.barnsley@utas.edu.au

World No Tobacco Day 2021: commit to quit

In December 2020 the WHO launched a global campaign titled ‘Commit to Quit’ and a publication “More than 100 reasons to quit tobacco” for World No Tobacco Day 2021. World No Tobacco Day (WNTD) is held on 31 May each year.

Some research suggests that the COVID-19 pandemic has prompted more smokers to want to quit. Earlier this year the WHO released a scientific brief showing that smokers are at higher risk of severe disease and death from COVID-19. Worldwide, around 780 million people say they want to quit, however only 30% have access to tools that can assist.

Cessation policies are still among the least implemented of all WHO Framework Convention on Tobacco Control (WHO FCTC) measures. The ‘Commit to Quit’ initiative focuses on 22 countries where the majority of the world’s tobacco users live, and where the burden of tobacco use is greatest. The year-long campaign aims to support at least 100 million people to quit through both digital platforms and other initiatives.

The WHO developed the ‘Access Initiative for Quitting Tobacco’ which provides free access to digital counselling. WHO has partnered with Facebook, WhatsApp and Soul Machines using chatbots and digital health workers to raise awareness about quitting and to support tobacco users to quit. Florence, a digital artificial intelligence counsellor, guides participants to mobile applications, free quit lines within participants’ respective countries, and assists with developing personalised quit plans. WhatsApp has developed the ‘Quit Challenge’, which sends participants free messages on how to quit.

“Millions of people worldwide want to quit tobacco…we must seize this opportunity and invest in services to help them be successful, while we urge everyone to divest from the tobacco industry and their interests,” said Dr Ruediger Krech, Director of Health Promotion.

These cessation tools will be introduced as part of World No Tobacco Day 2021, which will advocate for governments around the world to implement and fund strong cessation services to improve health, save lives and save money. Population-level, cost-effective tobacco cessation interventions must be a priority for countries, including using innovative approaches and mobile technologies to improve access to large populations and hard-to-reach groups. All smokers around the world have access to brief advice, toll-free quit lines, mobile and digital cessation services, nicotine replacement therapies and other tools that are proven to help people quit.

From the tobacco control blog

In March, we announced our 2020 Reviewers of the Year to honour reviewers who have gone “above and beyond” in contributing their expertise towards ensuring the high quality of papers the journal publishes. In alphabetical order, the six awardees Reviewers of the Year were: Noel Brewer, University of North Carolina (USA), Guillermo Paraje, Adolfo Ibáñez University (Chile), Jamie Pearce, University of Edinburgh (UK), Ce Shang, Ohio State University (USA), Hai-Yen Sung, University of California, San Francisco (USA), and Andrew (Anaru) Waa, University of Otago (New Zealand). Read more at: https://blogs.bmj.com/tc/2021/03/25/tobacco-control-reviewers-of-the-year-for-2020/.

‘Planet Earth: another victim of the tobacco epidemic’, by FCTC Secretariat Head Dr Adriano Blanco Marquizo, highlights the often overlooked environmental destruction caused by tobacco cultivation and uset, and need to include tobacco control in environmental protection measures. See: https://blogs.bmj.com/tc/2021/02/11/planet-earth-another-victim-of-the-tobacco-epidemic/.

Footnotes

  • Twitter @m_hef

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.