In 2009, when tobacco plain packaging legislation was first being considered in Australia, the president of the US Chamber of Commerce in Washington made a submission to the country’s preventative health taskforce, which was appointed by the Australian Government to provide recommendations about national tobacco control measures.

At the time, the move by the US group was considered highly unusual. Although internal tobacco industry documents made public during the US tobacco trials showed the US Chamber of Commerce had long had a cosy relationship with big tobacco to influence USA domestic policy, the attempt to do so in another country marked a turning point.

Now, it has been revealed that the US Chamber, which spends more on lobbying than any other US interest group, is engaged in a global, systematic approach to fight tobacco control measures. Investigative reports in the New York Times, together with a report titled US Chamber of Commerce: Blowing Smoke for Big Tobacco published earlier this month by a coalition of health and civil society organisations, have documented the extensive tactics by the both the US Chamber and its network of more than 100 local affiliates (known internationally as AmCham).

Countries that have been targeted by the US Chamber and/or local AmCham branches include Nepal, Jamaica, Uruguay, Moldova, the Philippines, El Salvador, Australia, New Zealand, Indonesia, Croatia, Estonia, Ireland, Poland, Lithuania and Ukraine. It has also been an active lobbyist for the tobacco industry in EU policy making.

The reports detailed a three-pronged approach that includes bullying governments with direct lobbying and letters from the US Chamber or its local affiliate. The letters typically open by noting that the chamber is the world’s largest business federation, which has significant investments in the country of interest. The implied threat is that it may withdraw such investments if decisions are not favourable to its interests. A second strategy is to prompt countries to initiate trade disputes against tobacco control measures by other countries – as in the case of Ukraine, where Prime Minister Arseniy Yatsenyuk recently revealed that the country initiated its case against Australia’s plain packaging legislation in response to a complaint from the Ukraine AmCham office.

The third strategy is to lobby against tobacco-related exceptions within trade policy. US Chamber of Commerce president Thomas Donohue has been personally involved in lobbying to preserve the right of the tobacco industry to sue under international trade agreements, particularly the Trans Pacific Partnership (TPP). The TPP is currently being negotiated by several Pacific Rim countries, and has attracted fierce criticism for the secrecy surrounding the negotiation process, as well as lively debate about whether tobacco should be ‘carved out’ of the agreement.

In a response to the New York Times, Donohue defended the chamber’s advocacy on behalf of the tobacco industry on the basis of  protecting intellectual property and compliance with international commitments – perhaps selectively oblivious to the need for countries to comply with their commitments under the WHO Framework Convention on Tobacco Control (FCTC). His response ignores the fact that tobacco is the subject of the world’s only health treaty precisely because the unique harms wrought by tobacco justify singling out the industry. It also fails to explain why the chamber has opposed smoke free public places and attempted to discredit other policies, such as warning labels, as not being evidence-based.

Donohue also expresses concern that ‘discriminatory treatment’ (of particular industries) ‘can easily spread’ – another way of advancing the ‘slippery slope’ argument the tobacco industry has consistently used against plain packaging. On its website, the US Chamber argues that carving out tobacco is unnecessary because the TPP (like other trade agreements) won’t limit governments’ ability to enact public health regulations – conveniently ignoring the numerous disputes the tobacco industry has already initiated under just such agreements in order to delay, weaken or avert tobacco control legislation (as highlighted in John Oliver’s hilarious expose of big tobacco earlier this year).

The chamber and its local affiliates are aided in their international efforts by a misperception that it represents, or is an official part of, the US government. Given the crossover between AmCham office holders and US government officials in some countries, this is understandable. In Estonia, the US Ambassador serves as the honorary president of the local affiliate; in Australia, the Chief Executive Officer of the local AmCham, Niels Marquardt, was the US consul general in Sydney immediately prior to his appointment. Local AmCham branches also advertise membership benefits including introductions, and in some cases access, to the US embassy and government.

The chamber siding with the tobacco industry is highly problematic for businesses such as health insurers, healthcare providers and hospitals that sit on the US Chamber of Commerce board, many of which publicly promote quitting smoking and offer services to support cessation. A New York Times editorial on the issue noted that while many US businesses which are members of the US Chamber of Commerce are focused on domestic issues, tobacco companies prioritise foreign growth markets, particularly low and middle income countries with young populations. While some members have been silent in response to the revelations, US health corporation CVS – which stopped selling tobacco in its pharmacies in 2014 – withdrew from its chamber membership in protest following the NY Times reports.

Criticism of the chamber has also come from more unexpected sources. Global public relations giant Burson-Marsteller is well-known for its work to ‘shape the debate’ on behalf of controversial industries and companies, as well as governments responsible for human rights atrocities. It has also hopped on the climate change denial bandwagon; in 2014, it teamed up with the world’s biggest coal company to promote ‘coal for poor people’ in a campaign aimed at derailing policies to limit carbon pollution by changing the conversation to focus on ‘energy poverty’ and position coal-fired power as a solution. Criticisms of Burson-Marsteller are perhaps best encapsulated by its work with big tobacco; for many years it worked closely with Altria/Philip Morris, and it established front group the National Smokers’ Alliance in the US to oppose smoke free legislation.

While Burson-Marsteller continues to work on many contentious issues, in 2010 it ceased working with clients operating in the tobacco industry, and has publicly criticised the chamber’s advocacy on behalf of big tobacco. David Earnshaw, president of Burson-Marsteller’s Brussels office, told the NY Times “It’s pretty obvious that you don’t want to be seen doing the bidding of an interest which is no longer legitimate”. As WHO Director General Dr Margaret Chan said in a statement “so long as tobacco companies continue to be influential members of the chamber, legitimate businesses will be tarred with the same brush.”

article by Simon Chapman, University of Sydney

I recently noticed a tweet from @CareersatBAT about how British American Tobacco South Africa had packed 200,000 meals of donated food for the Million Meal Challenge being run by Stop Hunger Now Southern Africa.

BAT South Africa is stamping out hunger by packing 200k meals as part of @StopHungerNowSA‘s #MillionMealChallenge pic.twitter.com/MHUbte0M9p

— BAT Careers (@CareersatBAT) July 21, 2015

Careers at BAT is a twitter feed designed to profile staff working for one of the world’s largest tobacco companies, and the many attractions of working for the global transnational. Today it has nearly 6,000 followers.

But it is oddly silent on the impact of the company’s core business: promoting tobacco use, particularly in the stratospheric markets of impoverished nations where governments tend to have thin and poorly implemented tobacco control policies.

BAT has the third-largest share of the global tobacco market: 12% in 2013. The World Health Organisation puts the current annual global attributable tobacco death toll at 5.4 million, with one billion such deaths forecast for this century. So, 12% of a billion is 120 million deaths; 12% of 5.4 million is 648,000 deaths a year, or 74 every hour.

But tobacco doesn’t just kill its users directly. When you are dirt poor and cannot afford essentials, even smoking a few cigarettes a day can have widespread population health impacts. In 2001, researchers in Bangladesh detailed the impact on malnutrition of smoking by impoverished Bangladeshis.

Expenditure on tobacco, particularly cigarettes, represents a major burden for impoverished Bangladeshis. The poorest (household income of less than $24/month) are twice as likely to smoke as the wealthiest (household income of more than $118/month).

Average male cigarette smokers spend more than twice as much on cigarettes as per capita expenditure on clothing, housing, health and education combined. The typical poor smoker could easily add over 500 calories to the diet of one or two children with his or her daily tobacco expenditure.

An estimated 10.5 million people currently malnourished could have an adequate diet if money on tobacco were spent on food instead. The lives of 350 children could be saved each day.

 

When I saw the BAT tweet, I tweeted back:

.@CareersatBAT @stophungernowsa Not sure I get this. Dying of hunger=bad; dying from tobacco use OK?

— Simon Chapman AO (@SimonChapman6) July 21, 2015

I had two more interactions from the food charity before being blocked by both the charity and by @CareersatBAT.

Now, I am certain that not a single hungry southern African who ate one of the BAT packed food parcels would have refused to eat it had they known. All would have been extremely happy to have a meal that day. After all, the founder of the Salvation Army, William Booth argued that he would take money from the devil himself and wash it in the tears of the widows and orphans.

But that’s the thing with charitable activities. Supporting charities such as Stop Hunger Now in doing their life-saving, vital work provides inviolate “air cover” from criticism for companies wanting to distract public attention from their core business. The charity told me to butt out, just as high-profile sportspeople once regularly told health agencies they would be killing cricket, football and many other sports if they persisted in advocating for bans on tobacco sponsorship.

Tobacco companies such as BAT have publicised their donations to a wide variety of good causes, including tsunami relief and domestic violence prevention. In Australia, Phillip Morris donated to the Red Nose Day SIDS charity in 1999 even though environmental tobacco smoke is a risk factor for SIDS. In 2014, it spent £13.4m of its £13,971m revenue on its “corporate social investments” including charities. That represented 0.096% of its revenue, or one pound for every £1,043 earned.

Stop Hunger Now has an impressive array of corporate sponsors, and doubtless some will have some dubious reputations in some aspect of their business activities, environmental footprint or labour practices. Such considerations can invite a form of ethical nihilism with arguments about how there’s no such thing as clean money. But tobacco companies are utterly peerless when it comes to the death and misery leading up to those deaths that is the direct outcome of their business plans.

The people retweeting @CareersatBAT are proud they work for a company that saves lives. But at their annual performance reviews their key performance indicators are all inextricably tied to increasing the use of a product that will kill up to two in three of its long-term users.

There is no other industry which has a global, legally binding treaty focussed on driving it out of business, with 168 nations now having ratified the Framework Convention on Tobacco Control. It’s a given that all charities want to maximise their donations, but when it involves helping to ethically scrub clean tobacco companies’ net impact on society, it is important that an ethical audit extends to the those unintended effects.

In this editorial, written with Canadian colleague Stan Shatenstein, I explored the “ethics of the cash register” and why many universities now refuse to accept tobacco industry research support, again unique among all industries. The charity sector needs to go through the same examination of the ethics of inadvertently assisting tobacco companies to distract attention from its core business.

Simon Chapman is Professor of Public Health at University of Sydney.

Follow Simon on Twitter.

This article was originally published on The Conversation.
Read the original article.

In excellent news for public health and bad news for big tobacco, Yahoo! news reports:

Ministers from 10 countries gathered in Paris Monday to launch a common drive to introduce plain cigarette packaging with the aim of stubbing out high smoking rates among young people.

Representatives from nations as far afield as New Zealand, Australia, South Africa and Uruguay issued a joint statement saying that “significant scientific proof justified … plain cigarette packaging”.

The ministers said plain packaging had been shown to “reduce the attractiveness of the product for consumers, especially amongst women and young people” as well as increase the effectiveness of health warnings on packets.

Hosting the conference, French Health Minister Marisol Touraine said the aim was “a world without tobacco” and that “the generation that is born today should be a generation without tobacco”.

Full story here.

Dr Pankaj Chaturvedi, Professor and Head and Neck Surgeon at Tata Memorial Hospital, Mumbai, India.

Head and cancers are a major cause of death and disability globally, and the most common cancer in low-income countries. To draw the world’s attention to effective care and control of head and neck cancers, the International Federation of Head and Neck Oncologic Societies, (IFHNOS) has marked 27th July World Head and Neck Cancer Day (WHNCD).

The day is supported by numerous governments, NGOs, the Union for International Cancer Control and more than 52 Head & Neck societies from across the world. In some parts of the world, such as south Asia, head and neck cancers make up 30-40% of the entire cancer burden, straining national health care systems and impoverishing individuals, families and society. Though the vast majority can be prevented, millions continue to suffer from delayed diagnosis, inadequate treatment and rehabilitation and poor palliative care.

Tobacco is the main risk factor for nearly two thirds of head and neck cancers. Tobacco in any form is causally linked to cancers of the oral cavity, pharynx and larynx. Areca nut chewing contributes to the very high burden of oral cancer in South and Southeast Asia. In order to effectively counter the aggressive marketing of tobacco products, a multi-sectoral response is needed from governments, NGOs, health care professionals, civil society, academia, and industry. To achieve this, WHNCD encourages advocacy for a) effective policies for prevention, b) strengthening health care system, c) community-based approaches for awareness and early detection of head and neck cancers. Events may include public awareness campaigns, group discussions by patients, families and support groups, media coverage, and free screening activities.

A major concern is lack of expertise among physicians with regards to counselling for tobacco use cessation (as well as other risk factors such as alcohol use), awareness and opportunistic screening for head and neck cancers, skills for policy advocacy etc. Even those who specialise in the treatment of head and neck cancers need to constantly enhance their knowledge and skills. WHNCD urges organisation of such educational programs by government and non-government organizations, civil society, medical societies and schools, patient support groups, medical facilities and hospitals.

To know more about WHNCD, visit the website http://www.ifhnos.org/world-cancer-day.

Please sign the petition to support WHNCD at http://www.ahns2014.org/petition/.

IFHNOS is an international body bringing together specialists involved in the care of patients with head and neck cancer worldwide. It was established to enhance information exchange and improve knowledge, as well as to explore new directions in the diagnosis, treatment and rehabilitation of patients with head and neck cancer. The Federation has a membership of 52 Head and Neck oncology organisations, representing 65 countries, from every part of the world. The Federation is able to reach over 5000 specialists providing care to patients with head and neck cancer through membership of its component societies. To know more about IFHNOS please visit http://www.ifhnos.org/home.