Tobacco Research

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

Posts By: Jodie Harris

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

 

Plain packaging opposition in the UK

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📥  Industry tactics

Australian_packs

A public consultation aimed to help the government gather evidence on the potential impacts of plain packaging ran between the 16th April 2012 and the 10th August 2012.

In response to this consultation, the tobacco industry and its allies launched what appears to be coordinated anti-plain packaging campaigns.

A Short History of Plain Packaging illustrates that the tobacco industry has been working on a defence strategy against the threat of plain packaging since the 1990s. In 2010, industry analyst Citigroup noted that plain packaging is the “biggest regulatory threat to the industry, as packaging is the most important way tobacco companies have to communicate with the consumer and differentiate their products.”  Therefore, it's unsurprising that there has been such a strong response from the tobacco industry.

Tobacco companies’ political advertising

Tobacco companies such as British American Tobacco (BAT), Imperial Tobacco, Japan Tobacco International (JTI) and Philip Morris International (PMI) have publicised their views on plain packaging on their corporate websites, including their arguments against plain packaging (e.g. encourages illicit trade, trade mark infringement etc). BAT have included such arguments in two emotive adverts.

Imperial and JTI, who in 2011 collectively held just over eighty per cent of the UK cigarette market share, have also engaged in Corporate Political Advertising to influence both the views of ‘government and of decision makers’. For example, a You Tube ad called 'Britain - 2020 Vision', which misleadingly suggests that in the future all perceived unhealthy products could be sold in plain packaging, has a small disclaimer saying that it was funded by Imperial Tobacco.

The 2020 Vision ad has been promoted on leaflets distributed on petrol forecourts, with the message ‘Say NO to plain packs’. These leaflets are not openly attributable to any organisation. (see images 1 and 2).

300px-Imperial_say_no_1

Image 1

Image 2

Image 2

Imperial Tobacco has also used Corporate Political Advertising in an attempt to influence UK Members of Parliament (MPs) views on plain packaging. The company funded an advertisement in ‘The House’ magazine (a weekly political magazine delivered directly to MPs, Peers, and civil servants). The advert mimicked the possible plain packackaging for cigarettes  by covering the normal cover pages in dark brown/gold paper and a warning message which read, “WARNING Plain Packaging: Bad for business Good for Criminals”.  The double spread cover page did not disclose it was an Imperial Tobacco anti-plain packaging advertising campaign. However on page 19 of the magazine, a second gold coloured full-page advert claimed that plain packaging would not benefit wholesalers, consumers, business, retailers or the government, but would only benefit criminals. This advert featured the logo of Asian Trader, a trade magazine and, in a smaller font than the rest of the text, at the bottom of the page explained: “This advert has been produced and placed by Imperial Tobacco in association with Asian Trader magazine.”

Furthermore, approximately 24-hours after the British government announced a four-week extension to the consultation on standardised packaging, JTI launched a campaign costing £2 million to “share its views” on the potential outcomes of plain packaging legislation. The campaign is centred on print adverts in national newspapers. According to JTI, this amount of spending is to ensure a wide reach of its messages to JTI’s target audience, “both government and decision makers”.  In July 2012, these ads were included in a number of daily newspapers including The Financial Times (see Image 3).

Front group anti-plain packaging campaigns

Pro-smoking group Forest, which receives funding from tobacco companies, runs the Hands Off Our Packs campaign which argues that plain packaging is the nanny state gone too far. The campaign is run by Angela Harbutt of Liberal Vision.

The Hands Off Our Packs campaign, which has a dedicated website, a Twitter and a Facebook account, has produced anti-plain packaging literature, You Tube ads (featuring retailers),and provides guidance on how to respond to the consultation in support of the continued branding of tobacco products. The website includes a petition to register one’s opposition to plain packaging. Visitors to the website are also encouraged to distribute leaflets and promote the campaign online via social networking sites such as Facebook, Twitter and blogs.

Speaking to the Grocer Magazine in February 2012, Simon Clark, Director of Forest, said that the Hands Off Our Packs campaign "was a response to the Plain Packs Protect campaign launched last month by an alliance of anti-tobacco groups". However, Clark registered the handsoffourpacks.com website back in September 2011, indicating that Forest may have planned this campaign long before the Plain Packs Protect campaign was launched in January 2012.

Retailers have been a particular campaign target of industry front groups. Mobilising retailer support to oppose tobacco control measures is a well-documented industry tactic and a prime example of how the industry uses front groups to promote their agenda. For example, the Tobacco Retailers Alliance (TRA), a coalition of retailers that sell tobacco products, was set up by the tobacco industry to promote its own viewpoint but with the explicit intention that it would appear separate from the tobacco industry. When the Tobacco Alliance (which later became the TRA) was established the industry stated that it “would encourage its supporters to act either as individuals or as representatives of their own organisations” in order to appear as a separate entity to the industry. It was also “stressed that the Alliance was needed because in order to be heard the entire tobacco family must speak with a unified voice and with confident command of the facts…”

In 1983, Tony St Aubyn, the then assistant director of the Public Relations subcommittee of the Tobacco Advisory Council stated in a workshop detailing how to set up a tobacco alliance that “Early on we decided that it would be preferable to keep the Alliance at arm’s length from TAC Tobacco Advisory Council, the predecessor to the Tobacco Manufacturers' Association and the industry and with its own identity and address, to emphasize to supporters, as far as is practical, that it had a degree of independence. Thus while the industry determines policy and provides the funds, the day to day management is the responsibility of our PR agents Daniel J Edelman."

Since the launch of the public consultation on plain packaging in April 2012, retail magazines such as the Grocer and Retail Newsagent have consistently featured opposition messages to plain packaging. They have also highlighted campaigns such as the ‘plain packaging postcard campaign’ run by the TRA (funded by the Tobacco Manufacturers' Association) which claims that plain packaging would have a negative impact on business and encourages retailers to ‘have your say’ in response to the government’s consultation. In July 2012, the TRA reported that 30,000 retailers had so far signed postcards, demonstrating how public consultations on tobacco control measures can be flooded with industry influenced opinion.

For full references on this article, please visit  TobaccoTactics.org

 

Smokeless tobacco illegally sold via the internet

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📥  Public policy

snus_shutterstock_88312414-res72-width-250

We discovered that snus, a smokeless tobacco banned in all EU countries except Sweden, is easily obtainable online - contravening three pieces of EU legislation. Are Swedish authorities doing enough to prohibit exports to other EU countries?

The sale of snus, a Scandinavian smokeless tobacco product, was banned in the EU in 1992; an action reaffirmed in the 2001 Tobacco Products Directive which is currently under review. Only Sweden was given an exemption to this ban, provided it ensured that snus would not be placed for sale on the markets of other EU countries.

We carried out online snus test purchases in ten EU countries, and found that snus was easily purchased in all sample countries; of the 43 purchases attempted, only two failed due to credit card issues. In the majority of successful purchases, taxes were levied inappropriately in the country of the vendor rather than the country of destination as required by EU legislation.

The results also indicated that most online vendors operate from Sweden, and deliberately target non-Swedish EU citizens, despite Swedish legislation making it illegal to sell snus outside Sweden.

We analysed the websites from which our purchases were made and revealed that age verification measures to prevent under-aged sales are inadequate. Also vendors frequently use promotions (many price-based such as bulk-buy discounts) to encourage the use of snus despite EU legislation banning tobacco advertising over the internet.

This is the only peer-reviewed study to date to examine online snus sales in the EU and assess the conduct of online snus vendors. This study provides evidence that the online sale of snus to non-Swedish EU citizens contravenes three pieces of EU legislation – a ban on selling snus outside Sweden, a requirement for the excise on distance sales of tobacco to be collected in the destination country, and a ban on cross-border tobacco advertising. Furthermore, the findings suggest that Swedish legislation which prohibits snus exports to other EU countries is not being enforced.

This research is published in Tobacco Control.  If you already have a subscription to this journal, the following link will direct you to the paper.

http://tobaccocontrol.bmj.com/content/early/2012/01/21/tobaccocontrol-2011-050209.full

 

Smoking ban linked to drop in adults’ second-hand smoke exposure

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📥  Public policy

no-smoking_shutterstock_1799965-res72-width-250

Levels of second-hand smoke  exposure among non-smoking adults fell by almost 30 per cent after smoke free legislation was introduced in England in 2007.

The most comprehensive study to date of second-hand smoke exposure among non-smoking adults in England, which was funded by the Department of Health, was published on 13 December 2011 in the journal Environmental Health Perspectives.

Researchers analysed data from seven national surveys conducted between 1998 and 2008. These surveys measured cotinine, an indicator of tobacco smoke exposure, in saliva samples from over 30,000 people aged 16 and over.

They showed that levels of exposure to second-hand smoke in non-smokers had been declining in the ten years leading up to smoke free legislation. But even when this decline was taken into account, the introduction of smoke free public places led to significant, additional reductions in exposure. Average exposure fell by 27 per cent immediately following the legislation.

The results further revealed that while there was a marked reduction in the levels of second-hand smoke exposure among those who lived in a smoke free home, those who lived in a home where there was smoking inside showed no significant change in exposure following the implementation of smoke free public places.

Dr Michelle Sims, the first author of the paper, said: “Smoke exposure fell after the introduction of England’s smoke free legislation above and beyond the underlying long-term decline, demonstrating the positive effect of the legislation.

“Nevertheless, some population subgroups appear not to have benefited significantly from the legislation, suggesting that these groups should receive more support to reduce their exposure.

“There is now a large body of evidence documenting the adverse effects of second-hand smoke exposure.  In adults it is now known to be linked with coronary heart disease, lung and various other cancers, stroke, chronic respiratory symptoms and adverse pregnancy outcomes.”

Other research has shown that smoke free legislation is also associated with reductions in hospital admissions for heart attacks and asthma in the UK and other countries.

Professor Anna Gilmore, who directed the study, said: “The importance of this study is that it examines the impacts of smoke free policies on adults’ exposure using a specific biological-marker of smoke exposure (rather than self-reported exposure) while simultaneously controlling for underlying declines in exposure.

“To our knowledge it is the first study to do this. The fact it shows marked declines in adult exposure provides further evidence of the important public health benefits of smoke-free policies.”

Smoke-free legislation was implemented in England on the 1st July 2007, making virtually all enclosed public places and workspaces smoke-free. The aim of the legislation was to protect non-smokers and children from the negative consequences of second-hand smoke exposure.

The full text of this article can be accessed here:

http://ehp03.niehs.nih.gov/article/info%3Adoi%2F10.1289%2Fehp.1103680

 

Adults know that smoking harms others. Or do they really?

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📥  Public understanding

child-hand-smoke_shutterstock_24813175-res72-width-250

Children are still exposed to second-hand smoke in the home even though there is evidence that people know that it's harmful. However there’s little evidence to show that people know about the specific illnesses that second-hand smoke can cause.

We examined levels of and trends in knowledge of second-hand smoke related illnesses using the Omnibus Survey from 1996-2008 and we explored whether knowledge predicted smoke-free homes.

We found that when it comes to knowledge of specific illnesses caused by second-hand smoke, people do not know as much as we think they do. Amongst the general population in England, which includes both smokers and non-smokers, only 55 per cent knew that exposure to second-hand smoke can cause cot death in infants and only a third knew that it is causally linked with ear infections in children. Furthermore, a quarter were unaware that second-hand smoke exposure can cause heart attacks in non-smoking adults. Among smokers, these figures were even lower.

Smokers with good knowledge of the illnesses that can be caused by second-hand smoke were much more likely to make their homes smoke-free and were also more likely not to smoke when in the same room as a child.

We found that knowledge increased the most between 2003 and 2006; a period when mass media campaigns highlighting the toxicity of second-hand smoke were being aired on television.

In conclusion:

  • People’s knowledge of certain illnesses is poor.
  • People’s knowledge increased the most when targeted mass-media campaigns were aired.
  • Knowledge is positively associated with both smoke-free homes and refraining from smoking in a room with a child.

Our research suggests there is a valid case for reinstating mass-media campaigns as part of efforts to reduce children’s exposure to second-hand smoke.

The published paper can be accessed here:

http://jpubhealth.oxfordjournals.org/content/early/2011/12/26/pubmed.fdr104.full.pdf+html?sid=f6814a48-1fed-4e63-9885-6c3b7bbc1645

 

Links between political influence and corporate social responsibility uncovered

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📥  Industry tactics

Until now, how corporate social responsibility (CSR) works to secure access to public and elected officials has remained 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 to look at how the company used CSR to re-establish access with the UK Department of Health following its decision to restrict contact with major tobacco companies and then shape the agenda of subsequent meetings. In the event, Department of Health officials blocked BAT’s attempts to change the course of tobacco control policy.

The British government’s Public Health Responsibility Deal shows clearly the increasing importance of corporate social responsibility (CSR) for large corporations wishing to securing political influence. It suggests that political CSR is being used effectively by companies in the food and alcohol sectors to provide an ostensibly robust case for voluntary regulation and free them of any concerns they may have about working in partnership with big corporations.

Our study found that CSR facilitates government access by focusing discussions on the importance of cooperation and consensus. Companies can convey the sense that they are offering support for government health policies by linking their political priorities to widely accepted social and political values. BAT linked its preferred policies to politically salient values such as harm reduction, child health, and the importance of cooperation between business and government. This enabled BAT employees to represent their dialogue as benign and unlikely to compromise government policy on tobacco control. Once the company had secured access to health officials, it then tried to use CSR to influence their priorities. It encouraged them to take notice of alternative modes of (voluntary) regulation, and revise their concerns about whether the industry could be trusted to work in partnership.

Gary Fooks, Research Fellow at the Tobacco Control Research Group said,

“It’s becoming increasingly apparent that big corporations are using CSR to pre-empt legislation and generally influence public policy, but we don’t really know much about how CSR works to produce these effects. Our study provides grist to the idea that the constructive veneer that CSR gives to corporate lobbying – particularly its seductive appeal to values such as partnership and co-operation - makes proposals which are not in the public interest appear less threatening, good for everyone and, therefore, easier to swallow for policymakers. Whilst this isn’t such a problem where officials have a strong sense of the public interest and are knowledgeable and sceptical of the intentions of corporate lobbyists, it’s likely to be a big problem where they don’t adequately consider the differences between corporate interests and those of the broader electorate.”

Anna Gilmore, Director of the Tobacco Control Research Group said,

“Our study underlines corporations’ increasing use of CSR for political ends. One of the brilliant things about research based on previous confidential industry documents is that we get quite a frank portrait of what companies are doing and why. The problem with contemporary government CSR-based initiatives, such as the Public Health Responsibility Deal, is that what’s going on is quite opaque to public scrutiny. This needs to be corrected. There’s some interesting work being done by NGOs but it’s just not enough. Governments across Europe need to be a lot more transparent in their dealings with multinational companies which look set to have an increasing impact on global health.”

“The international presence of BAT and its promotion of CSR across its subsidiaries suggest that the problems we’ve identified are likely to be widespread. What’s particularly worrying is that government departments across the world are opening themselves up to corporate social responsibility, expanding the number of access points and providing a very porous policy environment for these sorts of political strategies.”

The Story in Brief

Historically, BAT had enjoyed privileged access to policymakers and was regularly consulted on plans for new government policy. However, during the 1990s, its relationship with the British Government steadily deteriorated. By the end of the decade senior BAT managers were expressing increasing concerns about the company’s declining political influence which culminated in the Department of Health’s refusal to meet with members of the company. Martin Broughton (BAT’s chair between 1998 and 2004) described the relationship as a “Mexican stand-off” which had potentially serious ramifications for its ability to manage the impact of EU enlargement on its business in Eastern Europe.

BAT concluded that its ability to project itself as a good corporate citizen was key to its ability to normalise relations with the Department. Its platform for engagement was its Partnership for Change Programme (see below) – the blueprint for its current CSR programme. After trying unsuccessfully to persuade Alan Milburn, Secretary of State for Health, to work in partnership, Broughton went over Milburn’s head and lobbied Tony Blair to use his influence to encourage a more conciliatory approach from the Department of Health. Whilst rejecting BAT’s arguments on a number of other issues, Blair gave Broughton the green light to talk to Department of Health officials about Partnership for Change.

Having been granted access, BAT employees used CSR initiatives and themes to set the agenda of discussions with health officials and encourage a continuing dialogue. According to BAT documents the content of meetings that subsequently took place closely mapped the themes BAT officials wanted discussed. BAT documents from the time are consistent with BAT using CSR initiatives strategically to influence the policy alternatives under discussion within the Department of Health. More recent evidence in the public domain suggests that BAT’s use of CSR as an agenda setting tool is ongoing.

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 CSRP.

British American Tobacco’s Partnership for Change Programme: BAT’s Partnership for Change programme covered a number of key areas such as voluntary marketing codes, youth smoking initiatives, accommodation of smokers and non-smokers, and reduced risk cigarettes. BAT also used the programme as an organising platform to frame its CSR initiatives in the early 2000s. By emphasising the value to public health of meetings between tobacco companies, government officials, and public health groups in the form of summits and forums the initiative was well designed to generate dialogue with the Department of Health.

Public Health Responsibility Deal: Companies from the food and alcohol sectors are currently enjoying greater success in influencing public health policy in the UK through the government’s Public Health Responsibility Deal. The Deal encompasses five cross-sectoral networks established to drive forward improvements in public health. At the time of writing, corporations and business organisations outnumbered non-business organisations and individuals (academics, nongovernmental organisations, representatives of public institutions) two to one in the food and alcohol networks that are responsible for setting immediate public health objectives in these areas. By devolving policy formation and delivery to companies whose products and marketing practices constitute the key proximate drivers of alcohol- and diet-related ill health and mortality this marks a potentially important shift in public health policy towards coregulation. The organising principles of the Deal draw heavily on the idea that CSR can be exploited to promote public health. Further, devised when the Conservative Party were in opposition, the existence of the Deal owes much to the success that large food and drink companies had in using CSR as a means of both gaining access to senior Conservative Party members and developing an alternative agenda for public health policy, which attempts to reconcile public health with business competitiveness. Our findings—and the absence of strong evidence suggesting that co regulation is capable of aligning the business models of big food and drinks companies with the demands of public health —suggest that the role of CSR in the Deal needs to be subjected to closer scrutiny.

Read the press release: http://www.eurekalert.org/pub_releases/2011-08/plos-tcu081911.php

Read the paper: http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001076

<!--[if !mso]> <! st1:*{behavior:url(#ieooui) } -->Link:

http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001076

Gary J. Fooks Anna B.Gilmore1 , Katherine E.Smith , Jeff Collin3, Chris Holden , Kelley Lee2

(2011) Corporate Social Responsibility and Access to Policy Élites: an Analysis of Tobacco Industry Documents PLoS Med 8(8): e1001076. doi:10.1371/journal.pmed.1001076

Links between political influence and corporate social responsibility and are uncovered

Until now, how corporate social responsibility (CSR) works to secure access to public and elected officials has remained 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 to look at how the company used CSR to re-establish access with the UK Department of Health following its decision to restrict contact with major tobacco companies and then shape the agenda of subsequent meetings. In the event, Department of Health officials blocked BAT’s attempts to change the course of tobacco control policy.

The British government’s Public Health Responsibility Deal shows clearly the increasing importance of corporate social responsibility (CSR) for large corporations wishing to securing political influence. It suggests that political CSR is being used effectively by companies in the food and alcohol sectors to provide an ostensibly robust case for voluntary regulation and free them of any concerns they may have about working in partnership with big corporations.

Our study found that CSR facilitates government access by focusing discussions on the importance of cooperation and consensus. Companies can convey the sense that they are offering support for government health policies by linking their political priorities to widely accepted social and political values. BAT linked its preferred policies to politically salient values such as harm reduction, child health, and the importance of cooperation between business and government. This enabled BAT employees to represent their dialogue as benign and unlikely to compromise government policy on tobacco control. Once the company had secured access to health officials, it then tried to use CSR to influence their priorities. It encouraged them to take notice of alternative modes of (voluntary) regulation, and revise their concerns about whether the industry could be trusted to work in partnership.

Gary Fooks, Research Fellow at the Tobacco Control Research Group said,

“It’s becoming increasingly apparent that big corporations are using CSR to pre-empt legislation and generally influence public policy, but we don’t really know much about how CSR works to produce these effects. Our study provides grist to the idea that the constructive veneer that CSR gives to corporate lobbying – particularly its seductive appeal to values such as partnership and co-operation - makes proposals which are not in the public interest appear less threatening, good for everyone and, therefore, easier to swallow for policymakers. Whilst this isn’t such a problem where officials have a strong sense of the public interest and are knowledgeable and sceptical of the intentions of corporate lobbyists, it’s likely to be a big problem where they don’t adequately consider the differences between corporate interests and those of the broader electorate.”

Anna Gilmore, Director of the Tobacco Control Research Group said,

“Our study underlines corporations’ increasing use of CSR for political ends. One of the brilliant things about research based on previous confidential industry documents is that we get quite a frank portrait of what companies are doing and why. The problem with contemporary government CSR-based initiatives, such as the Public Health Responsibility Deal, is that what’s going on is quite opaque to public scrutiny. This needs to be corrected. There’s some interesting work being done by NGOs but it’s just not enough. Governments across Europe need to be a lot more transparent in their dealings with multinational companies which look set to have an increasing impact on global health.”

“The international presence of BAT and its promotion of CSR across its subsidiaries suggest that the problems we’ve identified are likely to be widespread. What’s particularly worrying is that government departments across the world are opening themselves up to corporate social responsibility, expanding the number of access points and providing a very porous policy environment for these sorts of political strategies.”

The Story in Brief

Historically, BAT had enjoyed privileged access to policymakers and was regularly consulted on plans for new government policy. However, during the 1990s, its relationship with the British Government steadily deteriorated. By the end of the decade senior BAT managers were expressing increasing concerns about the company’s declining political influence which culminated in the Department of Health’s refusal to meet with members of the company. Martin Broughton (BAT’s chair between 1998 and 2004) described the relationship as a “Mexican stand-off” which had potentially serious ramifications for its ability to manage the impact of EU enlargement on its business in Eastern Europe.

BAT concluded that its ability to project itself as a good corporate citizen was key to its ability to normalise relations with the Department. Its platform for engagement was its Partnership for Change Programme (see below) – the blueprint for its current CSR programme. After trying unsuccessfully to persuade Alan Milburn, Secretary of State for Health, to work in partnership, Broughton went over Milburn’s head and lobbied Tony Blair to use his influence to encourage a more conciliatory approach from the Department of Health. Whilst rejecting BAT’s arguments on a number of other issues, Blair gave Broughton the green light to talk to Department of Health officials about Partnership for Change.

Having been granted access, BAT employees used CSR initiatives and themes to set the agenda of discussions with health officials and encourage a continuing dialogue. According to BAT documents the content of meetings that subsequently took place closely mapped the themes BAT officials wanted discussed. BAT documents from the time are consistent with BAT using CSR initiatives strategically to influence the policy alternatives under discussion within the Department of Health. More recent evidence in the public domain suggests that BAT’s use of CSR as an agenda setting tool is ongoing.

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 CSRP.

British American Tobacco’s Partnership for Change Programme: BAT’s Partnership for Change programme covered a number of key areas such as voluntary marketing codes, youth smoking initiatives, accommodation of smokers and non-smokers, and reduced risk cigarettes. BAT also used the programme as an organising platform to frame its CSR initiatives in the early 2000s. By emphasising the value to public health of meetings between tobacco companies, government officials, and public health groups in the form of summits and forums the initiative was well designed to generate dialogue with the Department of Health.

Public Health Responsibility Deal: Companies from the food and alcohol sectors are currently enjoying greater success in influencing public health policy in the UK through the government’s Public Health Responsibility Deal. The Deal encompasses five cross-sectoral networks established to drive forward improvements in public health. At the time of writing, corporations and business organisations outnumbered non-business organisations and individuals (academics, nongovernmental organisations, representatives of public institutions) two to one in the food and alcohol networks that are responsible for setting immediate public health objectives in these areas. By devolving policy formation and delivery to companies whose products and marketing practices constitute the key proximate drivers of alcohol- and diet-related ill health and mortality this marks a potentially important shift in public health policy towards coregulation. The organising principles of the Deal draw heavily on the idea that CSR can be exploited to promote public health. Further, devised when the Conservative Party were in opposition, the existence of the Deal owes much to the success that large food and drink companies had in using CSR as a means of both gaining access to senior Conservative Party members and developing an alternative agenda for public health policy, which attempts to reconcile public health with business competitiveness. Our findingsand the absence of strong evidence suggesting that co regulation is capable of aligning the business models of big food and drinks companies with the demands of public health suggest that the role of CSR in the Deal needs to be subjected to closer scrutiny.

Link:

http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001076

Gary J. Fooks[1] Anna B.Gilmore1 [2] , Katherine E.Smith[3] , Jeff Collin3, Chris Holden[4], Kelley Lee2

(2011) Corporate Social Responsibility and Access to Policy Élites: an Analysis of Tobacco Industry Documents PLoS Med 8(8): e1001076.

Until now, how corporate social responsibility (CSR) works to secure access to public and elected officials has remained 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 to look at how the company used CSR to re-establish access with the UK Department of Health following its decision to restrict contact with major tobacco companies and then shape the agenda of subsequent meetings. In the event, Department of Health officials blocked BAT’s attempts to change the course of tobacco control policy.

The British government’s Public Health Responsibility Deal shows clearly the increasing importance of corporate social responsibility (CSR) for large corporations wishing to securing political influence. It suggests that political CSR is being used effectively by companies in the food and alcohol sectors to provide an ostensibly robust case for voluntary regulation and free them of any concerns they may have about working in partnership with big corporations.

Our study found that CSR facilitates government access by focusing discussions on the importance of cooperation and consensus. Companies can convey the sense that they are offering support for government health policies by linking their political priorities to widely accepted social and political values. BAT linked its preferred policies to politically salient values such as harm reduction, child health, and the importance of cooperation between business and government. This enabled BAT employees to represent their dialogue as benign and unlikely to compromise government policy on tobacco control. Once the company had secured access to health officials, it then tried to use CSR to influence their priorities. It encouraged them to take notice of alternative modes of (voluntary) regulation, and revise their concerns about whether the industry could be trusted to work in partnership.

Gary Fooks, Research Fellow at the Tobacco Control Research Group said,

“It’s becoming increasingly apparent that big corporations are using CSR to pre-empt legislation and generally influence public policy, but we don’t really know much about how CSR works to produce these effects. Our study provides grist to the idea that the constructive veneer that CSR gives to corporate lobbying – particularly its seductive appeal to values such as partnership and co-operation - makes proposals which are not in the public interest appear less threatening, good for everyone and, therefore, easier to swallow for policymakers. Whilst this isn’t such a problem where officials have a strong sense of the public interest and are knowledgeable and sceptical of the intentions of corporate lobbyists, it’s likely to be a big problem where they don’t adequately consider the differences between corporate interests and those of the broader electorate.”

Anna Gilmore, Director of the Tobacco Control Research Group said,

“Our study underlines corporations’ increasing use of CSR for political ends. One of the brilliant things about research based on previous confidential industry documents is that we get quite a frank portrait of what companies are doing and why. The problem with contemporary government CSR-based initiatives, such as the Public Health Responsibility Deal, is that what’s going on is quite opaque to public scrutiny. This needs to be corrected. There’s some interesting work being done by NGOs but it’s just not enough. Governments across Europe need to be a lot more transparent in their dealings with multinational companies which look set to have an increasing impact on global health.”

“The international presence of BAT and its promotion of CSR across its subsidiaries suggest that the problems we’ve identified are likely to be widespread. What’s particularly worrying is that government departments across the world are opening themselves up to corporate social responsibility, expanding the number of access points and providing a very porous policy environment for these sorts of political strategies.”

The Story in Brief

Historically, BAT had enjoyed privileged access to policymakers and was regularly consulted on plans for new government policy. However, during the 1990s, its relationship with the British Government steadily deteriorated. By the end of the decade senior BAT managers were expressing increasing concerns about the company’s declining political influence which culminated in the Department of Health’s refusal to meet with members of the company. Martin Broughton (BAT’s chair between 1998 and 2004) described the relationship as a “Mexican stand-off” which had potentially serious ramifications for its ability to manage the impact of EU enlargement on its business in Eastern Europe.

BAT concluded that its ability to project itself as a good corporate citizen was key to its ability to normalise relations with the Department. Its platform for engagement was its Partnership for Change Programme (see below) – the blueprint for its current CSR programme. After trying unsuccessfully to persuade Alan Milburn, Secretary of State for Health, to work in partnership, Broughton went over Milburn’s head and lobbied Tony Blair to use his influence to encourage a more conciliatory approach from the Department of Health. Whilst rejecting BAT’s arguments on a number of other issues, Blair gave Broughton the green light to talk to Department of Health officials about Partnership for Change.

Having been granted access, BAT employees used CSR initiatives and themes to set the agenda of discussions with health officials and encourage a continuing dialogue. According to BAT documents the content of meetings that subsequently took place closely mapped the themes BAT officials wanted discussed. BAT documents from the time are consistent with BAT using CSR initiatives strategically to influence the policy alternatives under discussion within the Department of Health. More recent evidence in the public domain suggests that BAT’s use of CSR as an agenda setting tool is ongoing.

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 CSRP.

British American Tobacco’s Partnership for Change Programme: BAT’s Partnership for Change programme covered a number of key areas such as voluntary marketing codes, youth smoking initiatives, accommodation of smokers and non-smokers, and reduced risk cigarettes. BAT also used the programme as an organising platform to frame its CSR initiatives in the early 2000s. By emphasising the value to public health of meetings between tobacco companies, government officials, and public health groups in the form of summits and forums the initiative was well designed to generate dialogue with the Department of Health.

Public Health Responsibility Deal: Companies from the food and alcohol sectors are currently enjoying greater success in influencing public health policy in the UK through the government’s Public Health Responsibility Deal. The Deal encompasses five cross-sectoral networks established to drive forward improvements in public health. At the time of writing, corporations and business organisations outnumbered non-business organisations and individuals (academics, nongovernmental organisations, representatives of public institutions) two to one in the food and alcohol networks that are responsible for setting immediate public health objectives in these areas. By devolving policy formation and delivery to companies whose products and marketing practices constitute the key proximate drivers of alcohol- and diet-related ill health and mortality this marks a potentially important shift in public health policy towards coregulation. The organising principles of the Deal draw heavily on the idea that CSR can be exploited to promote public health. Further, devised when the Conservative Party were in opposition, the existence of the Deal owes much to the success that large food and drink companies had in using CSR as a means of both gaining access to senior Conservative Party members and developing an alternative agenda for public health policy, which attempts to reconcile public health with business competitiveness. Our findings—and the absence of strong evidence suggesting that co regulation is capable of aligning the business models of big food and drinks companies with the demands of public health —suggest that the role of CSR in the Deal needs to be subjected to closer scrutiny.

Link:

http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001076

Gary J. Fooks Anna B.Gilmore1 , Katherine E.Smith , Jeff Collin3, Chris Holden , Kelley Lee2

(2011) Corporate Social Responsibility and Access to Policy Élites: an Analysis of Tobacco Industry Documents PLoS Med 8(8): e1001076. doi:10.1371/journal.pmed.1001076

Contact:

Dr Gary Fooks

Department for Health, University of Bath

doi:10.1371/journal.pmed.1001076

Contact:

Dr Gary Fooks

Department for Health, University of Bath


[1] School for Health, University of Bath, Bath, United Kingdom.

[2] London School of Hygiene and Tropical Medicine, London, United Kingdom.

[3] Centre for International Public Health Policy, University of Edinburgh, Edinburgh, United Kingdom.

[4] Department of Social Policy and Social Work, University of York, York, United Kingdom.

 

Smoking ban linked to drop in admissions for heart attacks

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📥  Public policy

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We have observed a 2.4 per cent drop in the number of emergency admissions to hospital for a heart attack  following the implementation of smokefree legislation in England.

The legislation was introduced on 1 July 2007 and this study was the first to evaluate its impact on heart attacks.

The team, led by Dr Anna Gilmore, Director of the Tobacco Control Research Group, part of the UK Centre for Tobacco Control Studies, found there were 1200 fewer emergency hospital admissions for myocardial infarction, commonly known as heart attacks, in the year after the legislation was introduced.

First author of the paper Dr Michelle Sims said: “After the implementation of smokefree legislation there was a statistically significant drop of 2.4 percent in the number of emergency admissions for myocardial infarction. This implies that just over 1200 emergency admissions for myocardial infarction were prevented over a 12 month period.”

Numerous studies show that passive smoking increases the risk of coronary heart disease, with recent evidence suggesting that the risk may be increased by as much as 60 per cent, similar to that observed in light active smokers. Exposure to other people’s tobacco smoke also appears to have an acute impact on the heart, within minutes of exposure, and thus trigger acute coronary events.

Measures that reduce exposure to second hand smoke, such as smokefree legislation, are therefore likely to reduce the occurrence of acute coronary events, including myocardial infarction, with almost immediate effect.

This study builds on a growing body of evidence linking the introduction of smokefree legislation with a reduction in hospital admissions for acute coronary events.  It finds a smaller reduction in admissions than many other studies and the authors propose two reasons for this. First, levels of exposure to other people’s smoke in England were already quite low before the legislation was introduced and thus the potential for health benefits following the legislation will be lower. Second, the analysis helped eliminate other reasons for a decline in admissions including accounting for the fact that admissions for heart attacks have been reducing anyway.

Dr Gilmore said: “Given the large number of heart attacks in this country each year, even a relatively small reduction has important public health benefits. This study provides further evidence of the benefits of smokefree legislation.”

The study was funded by the Department of Health and published in June 2010 in the British Medical Journal.

 

Children’s exposure to second-hand smoke on decline

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📥  Public policy

We have found that the second-hand smoke exposure among children has declined markedly in the past 14 years.

Our research, the most comprehensive study to date of second-hand smoke exposure among children in England, was funded by the Department of Health and published on 8 February 2010 in the journal Addiction.

The study, carried out by Dr Anna Gilmore and her team from the University of Bath’s School for Health, reveals that exposure to second-hand smoke among children aged four to 15 has declined steadily since 1996.

We wanted to find out if there were ways to predict the levels of second-hand smoke that children in England are exposed to and whether those levels were changing over time. It was also important for us to understand the levels of childhood second-hand smoke exposure in the years preceding the legislation, to be able to accurately assess the effects of the smoke-free legislation implemented in England in July 2007,

We analysed data from the Health Survey for England conducted between 1996 and 2006 including saliva samples taken from approximately 14,000 children aged between four and 15. The saliva samples were analyzed for a substance called cotinine, an indicator of tobacco smoke exposure.

The results showed that children’s exposure fell by 59 per cent over the 11 year period (from 0.59ng/ml in 1996 to 0.24ng/ml in 2006) indicating that children’s exposure to second-hand smoke has decreased markedly since the mid-nineties. The greatest decline occurred between 2005 and 2006, a period when targeted mass media campaigns on the dangers of second-hand smoke were routinely aired.

The study highlighted that the largest decline was between 2005 and 2006, a time of increased public debate and public information campaigns about second-hand smoke in the lead-up to the 2007 implementation of smoke-free legislation for public spaces.

The research also reveals that second-hand smoke exposure in non-smoking children is highest when one or both parents smoke, when the children are looked after by carers that smoke, and when smoking is allowed in the home. Children from more deprived households were more exposed, and this was still the case even when we took parental smoking status into account.

Declines over this period were greater in children with two smoking parents, with average annual falls of 0.115ng/ml, compared children with a mother who smoked (average annual decline of 0.065ng/ml) and children with non-smoking parents (average annual decline of 0.019ng/ml). As declines were greatest for those children who were most exposed to begin with, the gap in children’s second-hand smoke exposure between children with smoking parents and children with non-smoking parents has lessened.

Dr Michelle Sims, first author of the paper, explained: “The importance of carer and parental smoking and household exposure tells us that reducing exposure in the home is the key to reducing the health risks associated with second-hand smoke exposure in children.”

Dr Anna Gilmore, who led the project, said: “This study shows that the factors which most strongly influence children’s exposure are modifiable. Parents and carers can reduce their children’s exposure to smoke by giving up smoking, or failing this, only smoking outside the house.

“Stopping others from smoking in their house is also important. The fact that children’s exposure has already fallen so markedly shows that making these changes is feasible.”

This research highlights the need for public health interventions aimed at decreasing smoking prevalence and for those who are unable to quit, decreasing smoking in the home.

The published research paper can be accessed here:

http://web.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=e4b569c8-93f0-4cd9-9d36-9d4e28e1c795%40sessionmgr10&vid=2&hid=15