Tobacco's Gulf war against health
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No country is too small to escape the attentions of multinational tobacco companies, especially if they have special political or cultural influence. Recent experience shows that even in the comparatively small, albeit oil rich countries of the Gulf Cooperation Council (GCC), the industry is trying to forestall serious action with child “education” campaigns, and to buy political favours with gifts to worthy charitable organisations. Underneath the intended gloss of responsibility and generosity, however, lie the familiar stains of lobbying and propaganda efforts every bit as sinister as those found in the companies' home countries, as shown by internal documents released under US litigation settlements.

Earlier this year, the Qatar Handicapped Educational Centre received a Philip Morris (PM) “grant for charitable institutions” in appreciation of its support for handicapped people in Qatar, becoming only the second Gulf charitable institution to receive one of these grants. PM says its grant scheme aims to honour institutions that care about handicapped and elderly people in the GCC states. It has not specified whether institutions looking after people with disabilities caused by smoking are eligible to apply.

Meanwhile, a brochure distributed in Oman by the industry's Middle East Tobacco Association (META) to retailers, full of industry language affirming that “smoking is an adult choice”, ended with the assertion, “Supported by the Department of Health Education and Information”. META, a coalition of companies including PM, BAT, and Japan Tobacco International, claimed the scheme was launched in 1998 with full governmental approval, but on receiving a strong demand for its removal a year later, agreed to drop any mention of the ministry of health in future educational materials. META's response could not resist the repetition of the very essence of the industry's cynical and opportunistic line on youth education: that whatever disagreements there might be with health experts, “the issue of juvenile smoking is one where there is total accord”. 

![Figure1](http://tobaccocontrol.bmj.com/https://tobaccocontrol.bmj.com/content/tobaccocontrol/9/2/129.7/F1.medium.gif)

[Figure1](http://tobaccocontrol.bmj.com/content/9/2/129.7/F1)

USA: Virginia Slims find your voice campaign. In what appears to be an appeal to back to roots sentiments, this advert portraying a woman in Africa is thought to be aimed at US African American women. It contrasts with cigarette advertising in African countries where western, especially American, models are often featured.

Instructive background information on both types of activity described above can be found in PM's draft corporate affairs plan dated 25 November 1987. Boasting that PM and the industry are “positively impacting the government decisions of Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and the UAE [United Arab Emirates] through the creative use of market specific studies, position papers, [and] well briefed distributors who lobby media owners and consultants”, the plan detailed some of the strategies for continued success. These included cooperation with Rothmans and Gallaher to try to prevent a GCC consensus on tax harmonisation and, interestingly, the need to continue to support “our UAE distributor and his business partner, the finance minister, with arguments and studies”.

Fighting further emission reductions and disclosure requirements, working closely with Kuwaiti media owners to fight the proposals of the minister of health, the need to use organisations supported through sports sponsorships to “publicise the benefits”, and strengthening the GCC chapters of the International Advertisers Association, were also spelt out.

Perhaps most sinister, however, were the plans to “[r]ecruit a consultant who can help us monitor and influence the Alexandria based WHO office which helps prepare GCC health plans”, and to “[w]ork to develop a system by which Philip Morris can measure trends on the issue of smoking and Islam. Identify Islamic religious leaders who oppose interpretations of the Quran which would ban the use of tobacco and encourage support for these leaders”.

Since then, fortunately, WHO's position and infrastructure on tobacco control has been significantly strengthened, and there are also signs of progress in the involvement of religious leaders in support of health. Countries in the Gulf region are relatively free from concerns about employment in the tobacco sector, and their wealth can help guard against undue influence from tobacco money. However, as is clear from current activities and past plans, tobacco companies have no intention of letting health policy take its course in the region, and health advocates will have to fight every inch of the way.