Introduction by Croakey: Four industries – tobacco, ultra-processed foods, fossil fuels and alcohol – are wholly or partially responsible for 2.7 million deaths in the European region each year, according to a new report by the World Health Organization’s Regional Office for Europe.
The report highlights the powerful influence of the commercial determinants on health and wellbeing, emphasising the urgent need for multi-faceted action.
At the launch of the report in Belgium last week, Frank Vandenbroucke, Belgian Deputy Prime Minister and Minister of Social Affairs and Public Health, said:
For too long we have considered risk factors as being mostly linked to individual choices. We need to re-frame the problem as a systemic problem, where policy has to counter ‘hyper-consumption environments’, restrict marketing and stop interference in policy-making.”
Vandenbroucke urged all newly elected European parliamentarians and policymakers to recognise the scale and far-reaching impact that industry has on public health and “indeed our democratic processes”.
Meanwhile in Australia, the Albanese Government is forging ahead with a multi-faceted campaign to tackle smoking and vaping (as also reported in this week’s edition of The Zap).
In addition to legislative changes to “regulate the importation, domestic manufacture, supply, commercial possession and advertisement of all vapes” – currently before Parliament – last week they launched the national “Give up for Good” campaign.
Below Dr Nicola Ball and Associate Professor Raglan Maddox at the National Centre for Epidemiology and Population Health, Australian National University, discuss some of the strategies and tactics the tobacco industry uses to undermine public health.
Nicola Ball and Raglan Maddox write:
Australia’s Vaping Reforms Bill 2024, which ensures that e-cigarettes are legally available only on prescription, is currently before the Federal Senate. Despite widespread support in the public health community and by the Senate Community Affairs Legislation Committee, majority support in the Senate is not guaranteed.
The precarious position of the Bill highlights the urgent and ongoing need for public health action to continue Australia’s impressive record on tobacco and e-cigarette control.
As the World Health Organization’s “Stop the lies” campaign reminds us, pervasive tobacco industry tactics pose the largest threat to eliminating the scourge of these people-harming products once and for all.
These strategies are not limited to commercial tobacco and e-cigarettes: other people-harming industries consult the tobacco industry’s playbook to resist public health action and remain profitable.
However, it is important to highlight how the tobacco industry’s actions continue to cause disease and death, contributing to the deaths of more than 20,000 Australians each year.
As tobacco control researchers working to eliminate tobacco-related harms, we recognise that the antidote includes awareness. We must pull back the curtain to expose the shady industry strategies and misleading buzzwords that harm health.
Policy makers and the health sector must play an important role here: to educate themselves, to promote public awareness of industry tactics, and to ensure commercial interests never interfere with politics and policy making.
Science
Spot “denial of risk” when you see: science (“PR”) that diverges from established scientific opinion.
In 1994, American tobacco company executives testified under oath that they did not believe nicotine to be addictive. This public display followed decades of lying about the dangers of smoking and denial of the risks, which continues in recent times.
The alcohol industry has similarly obfuscated well-established health risks, and misrepresents the true association between alcohol consumption and many types of cancer.
Funding science and scientists
Spot conflicts of interest when you see: research of questionable independence… and merely disclosing industry funding does not address or absolve the inherent conflict of interest.
Desperate not to be undone by legitimate public health research, the tobacco industry has long funded scientists and think tanks as vehicles for spin. To name a few – Tobacco Industry Research Committee, Centre for Indoor Air Research and The Advancement of Sound Science Coalition.
The tobacco industry argues it is important to provide “good science” and “open scientific debate”. However, there is a clear conflict between public health and the interests of the tobacco industry and its partners.
Disclosing conflicts of interest and funding sources in an open manner is not enough to protect against biases and commercial influences, that is, the tobacco industry’s legal obligations to act in the best interest of their shareholders.
In a similar move, Coca-Cola funded The Global Energy Balance Network, which emphasised the role of exercise in weight control…the role of sugary drinks seemingly wasn’t a research priority.
The law
Spot resisting reform when you see: arguments that progressive tobacco control reform will have unintended negative consequences – for example, increasing the illicit market and increases in crime.
The tobacco industry levels delay tactics and litigation against any attempt to strengthen tobacco control legislation. For example, the tobacco industry worked discreetly in the Save our Stores campaign across Aotearoa/New Zealand, supported by British American Tobacco NZ and Imperial Brands Australasia, to oppose the planned reduction in retail outlets.
The campaign suggested that reducing tobacco retail outlets would have profound consequences, and was reflected by the New Zealand Prime Minister Christopher Luxon and tobacco industry in these 2023 comments:
Imperial Brands Australasia: “The other side of tobacco related criminal activity is the ongoing stream of violent robberies and assaults of which ‘ram raids’ are a key feature. These have been well documented in the media over a number of years with the brunt of them being borne by dairy stores. This will only intensify if the number of businesses selling tobacco is reduced significantly. Those left retailing tobacco will become more attractive targets to gangs due their larger stock holdings.”
British American Tobacco: “Such a swift and drastic reduction will deliver several concerning outcomes… A smaller and more attractive list of 500 retailers for ram raids and robberies.”
Luxon: “To say that actually, you can concentrate all that distribution in a few shops and you have one smoke shop in one small town in New Zealand, you can’t not tell me that will be a massive target for ram raids and crime.”
The Australian Government’s world-leading plain packaging legislation was also met with fierce resistance from industry, which took concerns about their intellectual property to the High Court.
In Chile, a labelling scheme that highlighted foods high in sugar, salt, saturated fat and calories was met with complaints to the World Trade Organization. Like Australia’s plain packaging legislation, the interests of public health won out, setting a public health precedent for countries to follow.
Loopholes
Spot loopholes when you see: people-harming industries skating very close to the law or driving trucks through loopholes.
When reforms pass that do not serve the bottom line, the industry seeks loopholes.
A ban on the sale of menthol cigarettes in California prompted the release of cigarettes that appeared similar to menthol, and contained synthetic cooling agents that imitated the menthol effect.
Marketing
Spot the creation and expansion of markets when you see: yet another nicotine delivery device ‘trending’ and ‘all good to take to school’ messages.
Racism, promotion to youth and pushing wellness shots on students – the tobacco industry does not let ethics or boundaries stand in the way of creating a new and expanding market to addict people to harmful products. The connection between tobacco and wellness brands is “healthwashing”, with a goal to make the brand appear healthier or less harmful.
Despite targeting their products to young people, the tobacco industry maintains that nicotine addiction is a free adult choice. This carefully curated narrative of personal blame contrasts with reality.
The majority of people who smoke have their first cigarette before they turn 18, when our brains are primed for addiction – a fact carefully forgotten by the industry when it leads to lifelong addiction and health harms.
Claims of transformation
Spot claims of transformation when you see: linguistic gymnastics around smokefree and harm reduction products, while tobacco sales continue to grow in many countries.
To stay profitable in a world well aware of tobacco harms, the tobacco industry is “transforming” – claiming to be focused on the sale of new, “safer” products while continuing to sell and profit from conventional cigarettes.
In the fossil fuel world, big players are pitching a transformation to renewable energy. However, analysis of social media shows natural gas is promoted heavily alongside renewable sources, with claims both are necessary into the future.
Politics
Spot the revolving door when you see: lobbyists turned Members of Parliaments or political advisers and vice versa.
Tobacco and fossil fuel and mining industries alike engage in-house and lobbying firm employees to agitate for change in Canberra.
In a merry-go-round revolving door, many ex-tobacco lobbyists hold senior roles in government (or vice versa) – often moving into and out of government within one year of working on behalf of the Tobacco Industry.
Fake grassroots campaigns
Spot astroturfing when you see: “grassroots campaigns for vaping”… #CueTheTrolls
In an attempt to clean up its public image and appear popular with the masses, the tobacco and e-cigarette industry covertly fund fake ‘grassroots’ campaigns.
It’s difficult for this to remain undetected when the real people behind the stock photos tell the truth – they’ve never vaped.
Tackling smoking
Stopping smoking is hard, but there are programs to help.
The Tackling Indigenous Smoking Program, for example, is a successful public health initiative designed to implement locally tailored health promotion activities to prevent the uptake of smoking and vaping, promote quitting, and encourage referrals to smoking cessation services, as recently outlined by Professor Tom Calma AO at the 2024 Lowitja O’Donoghue Oration.
Ultimately this program helps to protect Aboriginal and Torres Strait Islander communities nationally from the harms of the tobacco industry and their tactics. This work is beginning to pull back the curtains and expose the shady strategies and misleading buzzwords of an industry that places profits above health.
We can do better to protect our children and young people from the influence of people-harming industries and uphold the human right to health.
Support available
For help to quit, please see your doctor, visit your local Aboriginal Medical Service, call the Quitline (13 74 48) or visit www.quit.org.au
About the authors
Dr Nicola Ball is a public health registrar and research fellow with an interest in health equity, at the National Centre for Aboriginal and Torres Strait Islander Wellbeing Research at the Australian National University..
Associate Professor Raglan Maddox’s (Bagumani (Modewa) Clan, Papua New Guinea) program of research has focused on population-based information-systems using community driven processes, focusing on commercial tobacco use. This research has been generating and returning data to Indigenous communities to better understand and improve health outcomes.
See Croakey’s extensive archive of articles on the commercial determinants of health
