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All articles written by Karen Evans-Reeves, Ruth Canty, Manuja Niranshi Perera unless otherwise attributed. Ideas and items for News Analysis should be sent to k.a.evans-reeves@bath.ac.uk
Middle-East
Lebanon: Tobacco industry ignores marketing and advertising regulations
In 2011, Lebanon adopted its first comprehensive tobacco control legislation banning all forms of advertising and sponsorship of tobacco products in line with WHO Framework Convention on Tobacco Control (FCTC) Article 13, which came into effect in the country in March 2012. A Ministerial Decree which followed, allowed retailers to display a sign inside their stores stating that tobacco products were sold on the premises. Faced with stringent advertising bans, the tobacco industry successfully replaced these store signs with signs depicting brand colours and logos.
In 2023, for the first time since the implementation of the law banning advertising, tobacco advertisements and point of sale marketing were once again visible in retail shops (figures 1 and 2). In essence, the tobacco industry is ignoring the 2012 ban. The absence of an effective tobacco control programme, a deteriorating economic crisis and changing priorities have created a favourable environment for the tobacco industry to promote their products. The WHO MPOWER reports in 2021 and 2023 confirm that compliance with the advertising ban has dropped in Lebanon. Exploiting an LMIC in crisis has been an approach well documented as a tobacco industry tactic.
Show the tobacco brands displayed inside retailers in Lebanon.
Shows both cigarettes and IQOS in a small retail shop in Lebanon.
The refreshed marketing promotes heated tobacco products such as IQOS as well as traditional combustible cigarettes. Furthermore, airport duty-free images show new cigarette brand releases with flavours and crush balls now prohibited in some other countries (figures 3 and 4). Contrary to the tobacco industry’s claims, of wanting to stop selling cigarettes, the industry’s actions in Lebanon indicate that now it is circumventing tobacco control laws to market cigarettes (including new brand variants) as well as newer products.
Marlboro pack displayed at Lebanese duty free.
Marlboro and Kent brands new editions with flavour ‘surprise your sense’ and ‘impress your sense’.
Despite the economic crisis in Lebanon, heavy marketing, and the low price of tobacco products appeal to people who do and don’t smoke, violating FCTC Article 13 and driving industry profits. The state-owned tobacco monopoly in Lebanon has seemingly done nothing to stop these practices. In light of this, it is not surprising that the WHO global trend report indicates that Lebanon is one of six countries where tobacco use is predicted to increase by 2025.
There is an urgent need for the international community to support Lebanon in fighting tobacco industry violation of existing tobacco control national laws.
Hala Alaouie, PhD student,
Department of Social and Policy Sciences and Department for Health, Tobacco Control Research Group, University of Bath, Bath, UK. ha756@bath.ac.uk
Dr Rima Nakkash, Professor,
Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
and Department of Global and Community Health, College of Public Health, George Mason University, Fairfax, Virginia, USA
Europe
UK: Public health backs smokefree-generation policy proposal but is divided on the best way forward for vaping
In October 2023, Conservative UK Prime Minister Rishi Sunak announced that the government was bringing a new Bill before Parliament to end tobacco sales to all those born after 2008, a policy mirroring that of New Zealand who passed the same restrictions in December 2022. The opposition Labour party have backed the proposals and health advocates hope that Parliament will vote in favour. Sunak has referred to the policy as the ‘biggest public health intervention in a generation’.
While this bold move is to be celebrated, some may consider the policy ‘low-hanging fruit’ as youth smoking prevalence is at an all-time low, with the most recently available figures from 2021 showing just 3 % of 15- year- olds were smoking daily. It is possible that those choosing not to smoke are vaping instead. In 2021, vaping prevalence was 9% among 11–15-year-old children, and 15% among 15-year-old girls. Those favouring e-cigarettes as a smoking cessation device for adults suggest that youth uptake of vaping is simply a reflection of those young people who would otherwise start to smoke. However, vaping prevalence has risen considerably in recent years and exceeds would-be smokers, suggesting that those who may have never taken up smoking are vaping. Availability, a lack of marketing restrictions, as well as attractive colours and flavourings, are all contributing to the youth-appeal of these products.
It is generally accepted that vaping is less harmful than smoking, but there are no longitudinal data yet. Anecdotal stories appear frequently in the UK media citing extreme cases of youth addiction and harms to health. At the same time as announcing the proposal for a generational ban for combustible cigarettes, Sunak announced a public consultation on vaping. Given that vaping has become such a divisive topic in the UK and indeed globally, and with tobacco companies claim to be transitioning to e-cigarettes and heated-tobacco products, the government can expect to be inundated with industry-linked responses to its vaping consultation. Indeed, a previous consultation in 2012 on the then proposed plain packaging for tobacco products received a huge response from tobacco companies and their third-parties and so the government ought to be prepared.
Global
Concordia finally severs ties with Phillip Morris International
Non-governmental organisation Concordia recently announced that it would no longer work with tobacco companies. Concordia describes itself as an organisation that aims to find solutions to global problems by bringing together a diverse range of partners including heads of states, non-profit and industry leaders, and government officials. Links between Concordia and Phillip Morris International (PMI) date back to 2017 according to the University of Bath’s Tobacco Control Research Group’s Tobacco Tactics website. Following years of objections from public health organisations, including the WHO, Concordia severed ties with PMI in September 2023. Concordia rescinded the tobacco company’ s membership and removed PMI’ s CEO as a speaker at their 2023 Annual Summit. The summit took place in September 2023 in New York, alongside the United Nations General Assembly and included speakers such as former UK prime minister Tony Blair and London mayor Sadiq Khan, providing the tobacco industry with opportunities to access and lobby politicians and policymakers. Concordia have been quick to remove all traces of their links to PMI, with several references from this piece examining the links between the two now no longer available on the Concordia website (figure 5).
All traces of PMI have been removed from Concordia’s website.
The move was welcomed by public health leaders including Campaign for Tobacco Free Kids, Action on Smoking and Health and The Union. In response, PMI CEO Jacek Olczak instead delivered his speech intended for the Concordia event via Reuters Plus and live streamed it on X (formerly known as Twitter), asserting PMI’s dedication to a smoke-free future, accusing public health advocates of ‘gaslighting and bullying,’ and claiming that PMI is being silenced by special interest groups. Such claims of victimisation are somewhat ironic, coming from an industry who for decades lied and misled the world about the dangers of their lethal products and who still continue to launch new combustible brands and market and sell these products despite professing that they want to stop selling cigarettes.
Nicotine pouches present a youth risk
The evolving nicotine product landscape has seen the introduction of nicotine pouches in recent years, which are becoming increasingly popular among youth. Although comprehensive data on the use of nicotine pouches are limited, their appeal appears to be growing among young people, in part due to exposure through social media. Their ambiguous classification allows them to evade existing regulations, making them easily accessible to adolescents.
Nicotine pouches are different from traditional tobacco products. They contain 4 to 60 mg of nicotine and are marketed as a discreet way to consume nicotine in smoke-free environments. Their flavours and additives are reminiscent of historical tobacco industry strategies to attract younger users.
Swift action from public health officials and policymakers is required, including global vigilance and adaptive public health policies in response to evolving methods of nicotine delivery. Regulatory oversight must be strengthened to control the sale and promotion of nicotine pouches. In-depth research is needed to understand the prevalence and health impact of the use of the products, and public awareness campaigns are essential to inform the public, especially young people, about their risks. Policy development should aim to address the regulatory gaps currently exploited by nicotine pouch manufacturers.
In short, the rise of nicotine pouches requires immediate attention. They should be included in future tobacco and nicotine control strategies to protect the health of young people.
Professor Oulmann Zerhouni, Professor of Social Psychology, Université de Rouen, Normandy, France zerhounioulmann@gmail.com
Sandra Loisy, Coordinator of national prevention projects, Avenir Santé Association, France
Renaud Bouthier, Director, Avenir Santé Association, France
Valentin Flaudias, Associate Professor in Clinical Psychology, Université de Nantes, France
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Footnotes
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.