Tobacco Research

The latest updates from the University of Bath's Tobacco Control Research Group

Extent of tobacco industry's lobbying tactics unveiled by new paper

📥  Industry tactics, Public policy

Policy-makers need to ‘wise-up’ to the methods used by the tobacco industry in attempts to influence marketing regulations, according to the authors of a new study published today.

The systematic review, published in PLOS ONE, from researchers in our Tobacco Control Research Group , looked at evidence from around the world to identify the tactics and arguments tobacco companies use to influence and prevent policy aimed at regulating the marketing of tobacco.

Commenting on the research findings, author Professor Anna Gilmore, of the Tobacco Control Research Group and UK Centre for Tobacco & Alcohol Studies, said: “The tobacco companies have a diverse repertoire of tactics and arguments they repeat time and time again to prevent policies which protect the public from its deadly products. Governments around the world need to wise up to when the industry is lying and protect policy development from the vested interests of the tobacco companies.”

This comes amidst the lengthy delay to new plain packaging legislation in the UK. Last year, the government appeared to distance itself from standardised packaging, saying further evidence was needed to show whether it would be effective. As part of this evidence review, Sir Cyril Chantler is currently looking at the likely effect on public health, particularly for children, if standardised tobacco packaging is introduced, with findings expected in mid-March.

The research will also help policy-makers in low and middle income countries who are fighting an uphill battle against big tobacco companies to introduce regulations under the World Health Organisation’s Framework Convention on Tobacco Control (FCTC).

Study author Emily Savell added: “The WHO’s Framework Convention on Tobacco Control recognises the significant influence that tobacco industry marketing has on smoking prevalence and initiation, and recommends that countries comprehensively ban tobacco advertising, promotion and sponsorship. Understanding how the tobacco industry attempts to shape, delay or stop these policies is therefore vital.”

Significantly the paper found that the same tactics and arguments are being used across multiple jurisdictions, showing that the tobacco industry is repeating its activities in high, middle, and low income countries around the world. This suggests that the tobacco industry believes that what works best to influence policy-makers in developed countries will have a similar effect on policy-makers in developing countries. Importantly the paper also identifies a broader range of corporate tactics and arguments than previous studies have suggested.

The researchers found that whilst tobacco industry arguments made to oppose or derail policy appear diverse, on closer inspection they point to a common theme: that the benefits of health reform are marginal whilst the costs to society are likely to be significant. They identify common arguments put forward by the tobacco industry to oppose public policy interventions including:

  1. That a proposed policy will have negative unintended consequences – for example for the economy or public health.
  2. That there is insufficient evidence that a proposed policy will work.
  3. That there are legal barriers to regulation – including that it infringes the legal rights of a company.
  4. That a proposed regulation is unnecessary because the industry does not market to young people and / or adheres to a voluntary code.

The paper also highlights tobacco industry reliance on third parties, making it difficult for the public and policy-makers to assess the credibility and motivation behind efforts to shape the political agenda.

Although over half of the evidence studied for this new systematic review focused on activity in North America, Europe and Australasia, the geographic base was far more diverse than some previous reviews of industry activity.

Click here to access a copy of this systematic review.

Notes on the paper

- This work is supported by the National Cancer Institute of the United States National Institutes of Health [Grant Number R01CA160695], and the Economic and Social Research Council [Grant Number ES/I900284/1]. The funders played no role in the study design, analysis and interpretation of data, nor writing of the report or the decision to submit the article for publication. The content is solely the responsibility of the authors and does not necessarily represent the views of the funders.

- The UK Centre for Tobacco and Alcohol Control Studies (UKCTAS), is a strategic partnership comprising 13 University teams working on tobacco and alcohol research. UKCTAS is one of six UK Centres for Public Health Excellence funded by the UK Clinical Research Collaboration – comprising the Economic & Social Research Council, The British Heart Foundation, Cancer Research UK, the National Institute for Health Research and the Medical Research Council. More information on the Centre can be found at .

- The systematic review included 48 articles. Each article made reference to tobacco industry efforts to influence marketing regulations; supported claims with verifiable evidence; were written in English; and concerned the period 1990-2013.

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Study finds ‘serious flaws’ in EU report on illicit tobacco – January 2014

 

Supporting snus as a harm reduction tool: the need for caution

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📥  Harm reduction, Industry tactics, Public policy

There has been a long, polarising debate among public health experts in Europe about the potential benefits of tobacco harm reduction, and whether the wider availability of smokeless tobacco (particularly snus, a Swedish smokeless tobacco) and e-cigarette will lead to population level benefits or harms.  While no public health professionals would dispute that, for an individual smoker, a complete and permanent switch from cigarettes to snus or e-cigarettes will lead to health benefits, some have concerns that the wider availability of snus and e-cigarettes be detrimental to public health. Harm could occur if, for example, their use encouraged continued smoking rather than cessation, or snus and e-cigarette use acted as a gateway to smoking. While there is little evidence of the latter in Europe, some are specifically concerned that transnational tobacco companies (TTCs) (which make the vast majority of their current profits from cigarettes) will promote snus or e-cigarette use in a way that sustains and promotes, rather than reduces, smoking. Findings of our study, published today in PLOS Medicine and freely available here show that these concerns are not unfounded.

What we did

Our research centred on TTCs’ smokeless tobacco interest and investment in Europe, with a focus on British American Tobacco, and to a lesser degree Philip Morris. We qualitatively analysed a combination of historic internal tobacco industry documents dating from 1971 to 2009, available through the Legacy Tobacco Documents Library (http://legacy.library.ucsf.edu/), and more contemporary materials including tobacco company investor presentations dating from 2008 to 2012.

What we found

TTCs started investing in the snus from 2002, leaving an insignificant number of snus manufacturers fully independent of cigarettes interests. However BAT has been scoping other SLT opportunities as early as the 1970s, driven by the threat of increased regulation (e.g. smoke-free policies) and growing health concerns about smoking, both likely to result in less cigarette sales.  BAT considered SLT an opportunity to create a new form of tobacco use among a) smokers who were considering quitting, b) a new generation of ‘better educated’ consumers no longer interested  in taking up smoking,  and c) smokers in smokefree places. Young people were a key target.

When TTCs actually entered the Scandinavian snus market in 2002 (the only snus market in Europe), three issues converged: cigarette volumes started declining in Western Europe, discussions started at EU level about smokefree legislation, and crucially, unlike the 1970s, the public health community showed significant support for tobacco harm reduction. 

Despite these investments, we found little evidence in TTC’s corporate reporting that snus is or was a core part of their business strategy and recent snus test markets have failed. Since 2009, the focus of TTC’s investment in less harmful products has shifted to pure nicotine, and moved to e-cigarettes in 2012.

Why does it matter?

Although it is still early days to understand the TTCs motives behind their move away from tobacco into nicotine, a recent BAT investor presentation suggested that non-smokers rather than smokers could be the target of BAT’s reduced harm products. Our research on TTCs’ interest in SLT, shows that TTCs’ rhetoric about snus and harm reduction is inconsistent with historical and recent TTC documents and action, both of which suggest that TTCs may have little intention of promoting SLT use in a way envisioned by public health, as this would eat into their existing cigarette profits. TTCs’ snus investments have been defensive instead, turning snus from a threat (a product that may have competed with cigarettes) into a major opportunity (one that enables the TTCs to claim a joint agenda with public health and to rehabilitate their image via claims of wishing to reduce harm). By investing in snus, and perhaps more recently nicotine, cigarette companies are slowly eliminating competition between cigarettes and snus, thus helping maintain the current market balance in favour of highly profitable cigarettes while ensuring TTCs' long-term future should cigarette sales decline further and profit margins be eroded.

Importantly, what are the policy implications?

Currently snus sales are prohibited in all EU countries (except in Sweden) under legislation that regulates all tobacco products in Europe (Tobacco Products Directive 2001/37/EC). As the current legislation was adopted in 2001, the European Commission had proposed a revised text, which the European Parliament will vote on next month.  The proposal maintains the sales ban on snus. Similarly, our study suggest that legalising snus sales in Europe may have considerably less benefit than envisaged and could have a number of harmful consequences.

Perhaps more concerning are the recent TTC investments in pure nicotine. Should such investments continue, competition between cigarettes and clean nicotine products will be reduced, and with it the potential for harm reduction to benefit public health.  Also, it may enable TTCs to present themselves as purveyors of nicotine rather than tobacco products, and use this to undermine Article 5.3 of the Framework Convention on Tobacco Control which aims to protect public health policy from commercial and other vested interests of the tobacco industry.

For more detail, check out our paper Transnational tobacco company interests in smokeless tobacco in Europe: analysis of internal industry documents and contemporary industry materials

 

The public health implications of tobacco industry pricing

📥  Industry tactics

Every year, around March/April, the government puts up taxes on cigarettes. This is an important means of both reducing and preventing tobacco use, particularly amng price sensitive smokers such as the young and the least well off. The impact of these tax increases will depend on tobacco industry pricing strategy - whether they decide to pass on the tax increase or absorb it. Yet very little is known about tobacco industry pricing and no studies had addressed this issue in the UK. Using cigarette price and volume data from a variety of sources we therefore examined cigarette pricing in Britain in a paper just published in Addiction.

We found that:

  1. Tobacco companies are using their pricing strategy to win in two ways because when taxes increase each year they do two things. On their more expensive brands they add their own price increase on top of the tax increase. On their very cheapest brands (known as “ultra-low price” brands), they absorb the tax increase and cut prices. The first ensures their profits rise and that consumers are hoodwinked into believing the price increase is due to the government’s tax increase, the second ensures fewer smokers quit than would otherwise, providing a win-win for industry.
  2. Over the period 2006-2009, the average real price (ie once inflation has been taken into account) of ultra-low price cigarettes has remained virtually static in real terms. If we look at the individual brands within this group, the price of some has increased by around 1 pence, while the price of others has fallen by around 5p over this period in real terms.
  3. Across the market as a whole, and on all of its more expensive brands, however, the industry increased prices on top of the tax increases. Consequently the price gap between the most and least expensive cigarettes has increased over time.
  4. Unsurprisingly, given these pricing trends, the market share of ultra-low price brands has doubled in recent years while the market share of the most expensive (premium) brands has fallen.
  5. These issues were not identified before because the way in which government monitored cigarette prices focused on premium brands which make up a falling share of the market.

Why are these findings important?

  1. We know that the young and the least well off are most sensitive to price increases and the industry’s own documents show that low priced brands are developed to target young smokers. The way industry prices its cheapest brands is therefore likely to have particular implications for these groups.
  2. The growing gap between cheap and expensive cigarettes provides an incentive for smokers to switch to cheaper cigarettes rather than quitting when taxes increase each year and is likely to help explain the growing gap in smoking between the rich and the poor. (Currently there is a 3-fold difference in smoking rates between those in routine (31%) and those in higher managerial/professional (10%) occupations. Click here for the data.)
  3. Smuggling: Despite its long history of involvement in the illicit tobacco trade, the tobacco industry consistently argues that tax and price increases lead to smuggling (click here for example), but here we show clearly how the tobacco companies are increasing cigarette prices over and above inflation and tax increases. This suggests they are not genuinely concerned about the illicit trade, but instead want to ensure that price increases occur via their own price increases rather than tax increases enabling them to further increase profits at the expense of government revenue. Given the already very large tobacco industry profits, this indicates a missed opportunity for government.
  4. These findings help explain why tobacco industry profits are increasing despite cigarette sales falling.

What are the policy implications?

Narrowing the price gap between the most and least expensive cigarettes and helping to ensure that tobacco tax increases on the cheapest brands are fully passed onto consumers would help address the public health implications of our findings. There are changes that can be made to the way tobacco taxes are set that would help, notably increasing the “fixed” (specific) element of tobacco excise and ensuring that the minimum excise tax allowed under European Union legislation is set at the highest level. A ban on price promotions and below cost selling would also help.

However, these changes may be insufficient, particularly as EU legislation requires us to have some element of ad valorem (proportional) taxes on cigarettes which tend to increase the price gap between cheap and expensive brands. A system of price cap regulation that we recently suggested could fully address the issues identified and bring other public health benefits. It would place put a cap on the price manufacturers can charge, but not the price consumers face and in that way would shift the excess profit from the tobacco companies to government raising around £500M a year in the UK.

The study also shows that governments need to be far more sophisticated in the way that they monitor cigarette prices. Using weighted average prices will help but it is also essential to monitor price trends by price segment.

Public Attitudes to tobacco tax increases

A recent pan-European survey (including the UK) asked about public attitudes to tax increases. Overall, approximately 80% of non-smokers and 50% of current smokers were in favour of a 5% increase in prices if the revenues were used for tobacco control. Moreover, 74% of non-smokers and 40% of current smokers were in favour of a 20% increase in price.

 

Emergency asthma admissions drop by nearly 2000 a year following smokefree law

📥  Public policy

Numbers of adults admitted to hospital for emergency treatment for asthma have dropped by over four per cent since smokefree legislation was introduced in England, Bath researchers have found.

The researchers from the UK Centre for Tobacco Control Studies, based at the University of Bath, found there was an immediate 4.9 per cent reduction in emergency hospital admissions for asthma in the adult population. This implies almost 1900 admissions were prevented during the first year after legislation was introduced and a similar number in the subsequent two years.

In order to investigate the law that made enclosed public places and workplaces smoke-free in England from 1 July 2007 onwards, the study, funded by the Department of Health and published this week in the journal Thorax, identified monthly numbers of emergency admissions for asthma from April 1997 to December 2010 in the population aged 16 and over. Admission rates in the ten years before the introduction of smokefree legislation were then compared to those in the period after it came into force, taking into account underlying trends in admissions and variations in other factors liable to influence asthma admission rates, such as seasonal flu and temperature.

Dr Michelle Sims, the first author of the paper, said: “Second hand smoke exposure has significant adverse health effects on the adult respiratory system with current evidence suggesting that it contributes to the onset and exacerbation of asthma.

There is already evidence that smokefree legislation in England is associated with reductions in secondhand smoke exposure among non-smoking adults and fewer emergency hospital admissions for heart attacks and childhood asthma. Our findings show that these health benefits extend to adult asthma.”

The prevalence of asthma in England is among the highest in the world with approximately 5.9 per cent of the population having the condition.

There are furthermore stark regional differences in emergency hospital admissions for asthma across England that have widened in recent years.

Professor Anna Gilmore, who led the study, said “Our findings add to the expanding body of evidence that smokefree policies are associated with positive health outcomes.”

Only four previous studies have examined whether the introduction of smokefree legislation was associated with immediate reductions in asthma admissions among adults and collectively these findings are inconclusive. This paper, the largest study of its kind and addressing limitations of previous studies, makes a unique contribution to the evidence on smokefree laws and asthma.

The full results are reported in the paper Short-term impact of the smokefree legislation in England on emergency hospital admissions for asthma among adults published in the journal Thorax.

NOTE

The paper is an independent report commissioned and funded by the Department of Health’s Policy Research Programme.  The views expressed are not necessarily those of the funders.

 

New research suggests that government cap cigarette prices and raise an extra £500m per year in doing so

📥  Industry tactics, Public policy

An independent regulatory agency to cap the wholesale prices of tobacco would curb the excessive profits made by tobacco manufacturers and should raise an extra £500 million per year of tobacco tax revenue for the Treasury, say researchers from the University of Bath. The creation of an ‘Ofsmoke’ agency to regulate the industry, similar to those in force for utility companies, would increase tax revenue and help protect public health, according to the article recently published in the journal Tobacco Control.

The study starts by highlighting how cigarette manufacturers currently make roughly double the profits of most other companies. Imperial Tobacco for example is reported as having profit margins in the UK of 67 per cent, meaning 67p out of every £1 it receives from tobacco sales is profit, making it one of the most profitable companies in the UK.

Dr Robert Branston, from the Centre for Governance and Regulation at the University of Bath’s School of Management; and Professor Anna Gilmore, from the University’s Department for Health and the UK Centre for Tobacco Control Studies, say that capping the pre-tax cigarette manufacturers’ prices would safeguard society from the market failure behind manufacturers’ pricing power and associated high profits. Regulation would set a maximum price that cigarette companies could charge for their product, based on an assessment of genuine operational costs. Retail mark-up would not be affected and nor would the price that consumers pay, but the excess profit currently accrued by cigarette manufacturers would be transferred to the Treasury through increased tobacco taxes.  The system would be set up at no cost to the consumer or taxpayer, funded instead through a levy or licence fee paid by tobacco companies.

The study finds that the potential increase in UK annual tobacco tax revenues were approximately £500 million using 2009 and 2010 data, even allowing the costs of putting the system in place.  The money raise would fund, twice over, UK wide anti-tobacco smuggling measures and smoking cessation services in England including the associated pharmacotherapies to help people stop smoking.

Dr Robert Branston, Deputy Director of the University’s Centre for Governance & Regulation, said: “A handful of companies dominate the market and cream off massive profits. With such a deadly product, competition isn’t attractive, so we’ve identified regulation as an attractive alternative that stands to benefit both government and public health.

“Clamping down on the extreme profitability of cigarettes would reduce the incentive for tobacco companies to fight public health measures and mean they have fewer funds at their disposal. It would also raise the small matter of £500m for the nation.

“A move to regulation would make it easier to expand tobacco control policies as companies would be partially insulated against their impact on revenue and, therefore, less able to argue against them.”

He went on to say that regulation could also be a way of preventing tobacco companies from using price as a marketing strategy and might even help restrain the behaviour of companies when it comes to supporting cigarette smuggling and marketing to young people.

Professor Anna Gilmore, Director of the University’s Tobacco Control Research Group said, “The tobacco industry is likely to argue that this type of direct economic regulation is an extreme reaction, but it’s hard to argue that nothing should be done given the extent of market power that these firms are enjoying and the number of deaths the sector causes.

“If it came to a choice between increasing income tax or capping the excess profits of companies whose products kill one in two users, I could hazard a guess which one the public would prefer”

Deborah Arnott chief executive of health charity Action on Smoking and Health said, “Tobacco multinationals are unique, they make excessive profits despite the fact their products kill half all their customers. They can continue to charge premium prices and make excess profits because their products are cheap to make, highly addictive and competition in such a highly regulated market is so limited. Capping their profits is not extreme it’s essential.”

The paper is based on the UK but researchers are confident that the system could be applied to any country where tobacco companies enjoy significant market power and are therefore able to make excessive profits.

To read the full text click here.

 

New research explains why Corporate Social Responsibility is unlikely to change Big Tobacco

📥  Corporate Social Responsibility, Industry tactics

“Smoking is an activity much as dressmaking which has not been declared illegal anywhere in the world.” British American Tobacco executive

Overview

It’s now widely accepted that tobacco companies use corporate social responsibility (CSR) initiatives to influence policymakers and weaken public health policies. Until now what tobacco industry executives think about this and what it tells us about the limits of tobacco companies’ CSR programmes has been a mystery. For the first time researchers at the University of Bath have been able to explore this question using internal British American Tobacco (BAT) documents.

The authors traced the development of British American Tobacco’s (BAT) CSR programme from the late 1990s, when company executives first became aware of their declining political influence, through to the present. Criticism of the tobacco industry had reached a climax following reports of industry executives knowing, but publicly denying, the carcinogenic and addictive nature of tobacco products, chemically altering cigarettes to increase their addictiveness, promoting ‘low-tar’ cigarettes to offer false reassurance without health benefits, and targeting the young in marketing campaigns. Rather than finding a company desperate to demonstrate contrition however, the researchers found a culture riven with a huge sense of injustice at how they were being represented in the media and beyond. Internally, company executives contrived a long list of excuses and justifications which helped them deny responsibility for the accusations levelled against them and question the fairness of increased regulation of the tobacco industry. The extent of denial within the company was summed up by one executive who stated that, “the simple fact is that smoking is an activity much as dressmaking which has not been declared illegal anywhere in the world”.

Having rejected the substance of the criticism directed towards the tobacco industry, BAT executives pointed to failings in the firm’s in-house public relations department to get its message across using traditional public relations techniques. As one internal survey of senior BAT staff reported: “Essentially staff believed that British-American Tobacco was a good international citizen currently, but had failed historically to project itself as such.”

The research shows that BAT executives felt resentful and frustrated at the success of public health professionals in influencing the smoking debate which, they believed, bordered on persecution. Health professionals and advocates were characterised as extreme, skilled in the dark art of using “emotionally charged” arguments, and unscientific. Judges and plaintiff lawyers were accused of attempting to “rig trials”, the World Health Organisation was portrayed as promoting unreasonable regulation, and the House of Commons Select Committee investigating the tobacco industry was dismissed as an ill informed and poorly briefed “kangaroo court” (BAT executive). This analysis encouraged BAT to experiment with using CSR practices to influence policymakers. A key element of this strategy was to create divisions between health professionals and the public in the hope of reducing political pressure for further tobacco regulation.

Efforts to fundamentally change the company seem to have been doomed from the start. The research reveals that BAT managers already felt they were investing heavily in socially responsible activity, but were not doing enough—through branding and publicity—to convey this to a sceptical public. They, therefore, set about using CSR practices to structure how politicians and journalists understood the problems relating to tobacco and its control. The research reveals how these efforts reprise the original excuses used by BAT executives in the late 1990s and reject further regulation as unreasonable and represent lobbying as a civic duty.

Alert to the sheer range of excuses and justifications used by BAT, the researchers matched them to similar techniques used by juvenile delinquents in the US and found BAT’s repertoire to be far more extensive and sophisticated. As Gary Fooks, lead author of the study, explains, “BAT’s ability to explain away their bad behaviour with excuses seems to be more highly developed than that of juvenile delinquents. However, what they’re doing isn’t so apparent, because their excuses are dressed up as positive principles which seek solutions and indicate a willingness to work with government.”

Company documents suggest this approach has been guided by the “potential benefits” on offer, such as “increased marketing freedoms, increased self-regulation, greater intention to buy”. (BAT document). Moreover, it has specifically been prized for its potential to shape health policy in low and middle income countries where greater levels of ignorance over tobacco and health “issues” gave BAT a “much better chance of being able to manage the situation” (BAT executive).

Gary Fooks, lead author of the study, said:

“On one level our analysis indicates how a deviant subculture emerges within large corporations which excuses using CSR practices to weaken public health policy. It explains how corporate executives justify first to themselves and then to the watching world what would otherwise appear unjustifiable. The sense of injustice amongst BAT executives at public health regulation is absolutely fascinating.”

"Our work also says something which, in many ways, is more interesting about the capacity of large corporations to develop political narratives that excuse socially harmful behaviour. Companies, and not just tobacco companies, have invested vast amounts of money in this. BAT has proved itself to be hugely inventive in dreaming up justifications and excuses for defending what they see as a fundamental right to market a product that kills.”

Anna Gilmore, head of the Tobacco Control Research Group, said:

“BAT’s CSR messages are primarily an exercise in repackaging what the company has always done rather than transforming the business. It’s important to remember that the behaviour of tobacco company executives is not unique. Litigation against corporations tells us that company executives in other sectors have been dishonest about the degree of harm their businesses cause and misrepresented scientific knowledge to reduce regulatory and litigation risk. In fact, many of the political strategies used by the tobacco industry are common tools of the public relations industry. If managers typically start from an assumption that a firm is already socially responsible, and that criticism directed at the firm is unjustified or politically motivated, then they are more likely to regard CSR as a public relations tool than as a medium for undertaking meaningful change.”

Notes

British American Tobacco: British American Tobacco is the second largest tobacco company (by profitability) after Philip Morris International. Its CSR programme has been steadily accepted and approved by large parts of the investment and CSR communities. Senior employees are now frequently invited to speak at public engagements on CSR and business ethics and the company has won numerous awards for its CSR activities.

Funding: This worked was funded by the US National Cancer Institute (at the National Institutes of Health).

The Tobacco Control Research Group: The University of Bath’s Tobacco Control Research Group is part of the UK Centre of Tobacco Control Studies (UKCTCS) a network of nine universities in the UK working in the field of tobacco control.

Link: http://link.springer.com/article/10.1007%2Fs10551-012-1250-5

Citation: Fooks, G., Gilmore, A., Collin, J., Holden, C., Lee, K. and Smith, K. (2013) The Limits of Corporate Social Responsibility: Techniques of Neutralisation, Stakeholder Management and the Political use of CSR, Journal of Business Ethics, 112(2):  283-299.

Contact: Dr Gary Fooks, Department for Health, University of Bath. E-mail: G.Fooks@bath.ac.uk

 

Tobacco Control in Practice: A Postgraduate CPD module

📥  Events

Registration is open for the fifth Continuing Professional Development module at the University of Edinburgh. The course will take place from the 13th-16th May 2013.

The module aims to provide participants with an overview of key concepts and issues in tobacco control. The module is aimed at professionals, at all levels, working in public health, health promotion and related fields. Taught by leading academics and practitioners in the field of tobacco control, the module comprises a balance of lectures, seminars and small group work.

To register and to find out more information please click here.

 

Impact of smoking ban on the most exposed children

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📥  Public policy

High levels of secondhand smoke exposure in children are known to have adverse consequences for arterial health. However, there is no information about the proportion of children in England that are exposed to these levels, whether it has changed over time and whether it has changed in response to the introduction of smoke-free legislation in 2007. 

Evidence suggests that legislation making enclosed public places and work-places smoke-free has reduced secondhand smoke exposure in non-smoking adults. There have however been concerns that smokers may smoke more at home if they cannot smoke in public places.  This displacement of smoking to the home could increase exposure among children.    In a paper published in Addiction, we report on trends in the proportion of children with high exposure, above a threshold level known to be detrimental to arterial health.  Understanding the impact of legislation is important because children who are not so heavily exposed may, by displacement of adult smoking to the home, be exposed to more secondhand smoke and are then pushed over this threshold. 

We analysed data from the Health Survey for England conducted between 1996 and 2008. These surveys measured cotinine, an indicator of tobacco smoke exposure, in the saliva collected from 16,000 children aged between 4 and 15.

We found that the proportion of children exposed to damaging levels of second-hand smoke has fallen over time. Amongst children in England, the percentage fell from 24% in 1996 to 13% in 2008. Despite the reduction over time, a large proportion of children continue to be highly exposed to second-hand smoke. In 2008, 49% of children living in homes allowing smoking inside and 34% of those with at least one parent who smokes had levels of exposure known to have adverse consequences for arterial health.

The research also reveals that legislation did not increase the proportion of children exposed to damaging levels of secondhand smoke. This strengthens evidence from England and other countries of the United Kingdom that legislation to prohibit smoking in public places and work-places does not displace adult smoking to the home.

 The study was funded by the Department of Health.

 The published paper can be accessed here:

http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2012.03924.x/abstract

Commentary on the paper can be accessed here:

http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2012.04014.x/pdf

 

Imperial Tobacco criticised for pre-empting packaging laws

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📥  Industry tactics

On the 1st December 2012, plain packaging will be introduced in Australia. Cigarettes will be required to be sold in olive green packaging with large pictorial health warnings and brand names appearing in standardised font. Ahead of the legislation, Imperial Tobacco has changed the packaging of their Peter Stuyvesant brand to show a ripped branded pack exposing plain packaging underneath with the accompanying slogan “it’s what on the inside that counts”.

Australia’s Federal Health Minister, Tanya Plibersek has spoken out, “For a company to have produced packs that contain the line, ‘It’s what’s on the inside that counts’ must surely be the ultimate sick joke from big tobacco…Diseased lungs, hearts and arteries are the reality of what is happening on the inside to a smoker.”

Speaking on ABC News today in Australia on 12th September 2012, Plibersek claimed that the Imperial campaign is a “last desperate attempt for them [Imperial Tobacco] to use their branding to retain and attract new smokers..."

For more information on tobacco industry advertising to consumers click here and for other information on how the industry attempts to influence decision makers see corporate political advertising.

 

500,000 against plain packaging? The figures just don’t add up.

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📥  Industry tactics, Public policy

Plain packaging for cigarettes would require cigarettes to be sold in packets of a standard colour and shape with brand names written in a standardised font and pictorial health warnings covering a substantial proportion of the packet. The public consultation on plain packaging in the UK came to a close on the 10th August 2012. A few days later the Tobacco Manufacturer’s Association (TMA) publicly claimed that ‘half a million oppose plain packaging.' There are three significant issues with this figure:

1. Conjecture

In the misleadingly titled press release ‘half a million oppose plain packaging’, the TMA included a disclaimer that in fact the final figure was unknown as the Department of Health (to whom the consultation submissions were made) had not yet informed them of the number. “We await final confirmation of the number of responses from the DoH.” Nevertheless in his blog, the director of Forest, (an industry-funded pro-smokers’ rights organisation), Simon Clark, said that there were ‘at least 500,000 in opposition.’ Forest ran the Hands Off Our Packs (HOOPs) campaign.

2. Double Counting

The TMA release stated that 236,033 of the ‘half a million in opposition’ were signatures to the HOOPs petition, with the remainder based on “estimated responses into [sic] the consultation including signatures, postcards, letters, emails, online responses, consultation response forms etc…” The TMA did not disclose whether duplicate responses were accounted for in reaching their figure of 500,000. For example, it is highly probable that at least some of the 236, 033 signatories of the HOOPs petition would also have submitted other forms of response: either a formal response to the consultation or a signature on a parallel campaign such as the TMA-funded postcard campaign run by the Tobacco Retailers Alliance specifically for retailers.

3. Falsifying signatures

The DoH made a number of its documents public following a recent Freedom of Information request . Amongst the documents are several letters written to Simon Clark. On the 14th June 2012 the DoH’s Tobacco Programme Manager wrote to inform Clark of an instance whereby the manager saw a member of the HOOPS campaign staff falsifying at least a page of signatures to the petition in the street. A follow up letter was sent on the 20th June 2012 asking Clark to comment on the methods HOOPS employed to gather signatures and how Forest was “verifying that the petition only includes the names and addresses of actual people, who have signed the petition of their own accord?”

This second letter was written following a complaint from the Chair of the Royal College of Physicians’ Tobacco Advisory Group. The Chair described how he had been told by his students at the University of Nottingham that friends of theirs at the University were being paid by HOOPs to gather signatures for the petition. On the 16th July an email was sent to Clark by the DoH’s Tobacco Programme Manager in response to a question Clark had directed at then Health Minister Andrew Lansley. The Tobacco Programme Manager took the opportunity to ask Clark whether he had received the two letters and mentioned new complaints that had been sent to the DoH about the HOOPs campaign. The three further complaints were again concerned with the methods used to gather signatures, with members of the public voicing concerns that HOOPs campaigners were:

  • targeting parents in play grounds telling them that plain packets would be completely plain with no health warnings;
  • gathering signatures in loud nightclubs;
  • targeting adolescents in the street telling them that the government was trying to ban cigarettes

Clark has published a number of blog posts in response to the release of these documents, defending the credibility of the HOOPs campaign and diverting attention away from the HOOPs scandal by directing criticism at the Plain Packs Protect campaign.