You don't need to be signed in to read BMJ Blogs, but you can register here to receive updates about other BMJ products and services via our site.

Archive for October, 2015

An Australian perspective on tobacco control in the 21st Century

29 Oct, 15 | by Marita Hefler, News Editor

Neil Francey, Barrister at Law, Whitsunday Chambers

E Haydn Walters, University of Tasmania; The Alfred, Melbourne; and Royal Hobart Hospital

and Adrian Reynolds, Southern Mental Health and Statewide Services Tasmanian Health Organisation; and School of Medicine, University of Tasmania

The Australian experience in recent years is that tobacco control measures should be viewed according to their integrated effectiveness in denormalising smoking and reducing smoking prevalence

The tobacco industry has long sought to retard tobacco control measures, dating from a meeting of US tobacco companies in December 1953 and a meeting of US and UK tobacco companies in June 1977 (see Professor Robert Proctor’s  comprehensive history of the tobacco industry Golden Holocaust: Origins of the Cigarette Catastrophe and the Case for Abolition).

Over time these efforts have moved from disputing that smoking causes various diseases to questioning whether tobacco control proposals are practical, workable and effective.  These industry tactics have, amongst other things, sought to:

  • impede restrictions on advertising and promotion of tobacco products;
  • resist the imposition of increased tax/excise on tobacco products;
  • hinder the introduction and extension of smoke free areas.

In Australia these efforts have most recently been directed to rejecting both plain packaging and a tobacco free generation proposal (legislation barring the sale of tobacco products to persons born on or after 1 January 2000).

The industry’s opposition seems to involve now conceding that smoking is harmful, but dissecting individual tobacco control measures and attacking the contribution they may make to achieving the overall objective of reducing the prevalence of smoking.

It is instructive therefore to put tobacco control measures in perspective so they may be considered in a sensible, practical and rational manner, the current suite of effective tobacco control measures being:

  1. Education programs, to inhibit the uptake of smoking.
  2. Restrictions on advertising and promotion, to neutralise the ‘glamorisation of smoking’ (eg plain packaging).
  3. Imposition of tax/excise/licence fees, which results in a price increase, thereby providing a disincentive to purchase.
  4. Reduced access by increasing the legal age to purchase cigarettes (now up to 21 in some US states), and the current proposal for any person born on or after 1 January 2000 as part of Tobacco Free Generation legislation in the Australian state of Tasmania.
  5. Introduction and extension of smoke free areas, which restrict opportunities for smoking.

All of these measures contribute to what may be called the ‘integrated effectiveness of tobacco control measures’ and/or the ‘denormalisation of smoking’ (by counteracting specific tobacco industry objectives of providing ‘smoker reassurance’ and preserving the ‘social acceptability’ of smoking).

Accordingly, and in order to rebut the tobacco industry’s tactic of dissecting these measures, and introducing ‘red herrings’ of unlawful sales of tobacco products (something which falls within enforcement of the existing law) and the controversial subject of e-cigarettes (potentially a form of preserving the ‘social acceptability’ of smoking – albeit in the form of a different nicotine delivery device), the Australian experience suggests that any proposed tobacco control measure be considered for the contribution it may make to the overall objectives of tobacco control and not as one to be viewed in isolation.

Finally, these efforts by the tobacco industry may be seen anywhere as an attack on “state sovereignty”, that is attempting to undermine and pervert the decision making process of Parliaments and Governments to act in the best interests of their constituents.

 

The problem with comparing meat and smoking cancer risk

26 Oct, 15 | by Becky Freeman, Web Editor

The Guardian reports:

Comparing meat to tobacco, as most news organisations who’ve chosen to report this have done, makes it seem like a bacon sandwich might be just as harmful as a cigarette. This is absolutely not the case.

 

This Cancer Research UK infographic elegantly shows that while the evidence that processed meat causes cancer is as strong as for tobacco, the RISK from smoking is so much higher:

(click to enlarge image)

infograph

 

Southeast Asia: new tobacco tax index

11 Oct, 15 | by Marita Hefler, News Editor

The world’s first tobacco taxation index by a civil society organisation has been published by the Southeast Asia Tobacco Control Alliance (SEATCA). The report monitors implementation of the WHO Framework Convention on Tobacco Control (FCTC) Article 6 guidelines on price and tax measures.

Southeast Asia is home to approximately 10% of the world’s 1 billion smokers and is a prime growth market for tobacco companies.

The report can be accessed by clicking this link.

SEATCA report

Tobacco Carve-Out in TPP

6 Oct, 15 | by Becky Freeman, Web Editor

While good news for tobacco control, it is important to note that other important health regulations are not likely to be given similar treatment. The necessity of a carve out for tobacco control shows that health laws are extremely vulnerable to corporate abuse of investor-state dispute settlement provisions.

from Action on Smoking and Health

Tobacco Carve-Out in TPP, Major Victory for Public Health

Removes New Weapon for Tobacco Industry

WASHINGTON, DC – Monday, October 5, 2015 – In a major victory for public health, negotiations for the Trans-Pacific Partnership (TPP) Agreement concluded this morning with built-in protections to prevent private corporations from suing governments over anti-tobacco regulations. The victory comes after years of pressure from a vast coalition of health groups and pro-health legislators, including Action on Smoking and Health (ASH), to protect the right of governments to regulate tobacco without fear of expensive lawsuits. The tobacco industry, along with its allies in the U.S. Chamber of Commerce and other groups, fought hard to ensure that overseas marketing of tobacco products – the only consumer product to kill when used as intended – could continue unabated.

“We would have preferred a blanket exemption for tobacco in the Agreement, denying increased rights for the tobacco industry across the board,” said Laurent Huber, Executive Director of Action on Smoking and Health. “However, ISDS was the most worrisome aspect of the TPP, and now the tobacco industry cannot use it to block or delay life-saving measures.” Malaysia proposed just such a full carve-out for tobacco, but ultimately could not achieve full consensus.

The carve-out represents a sea change in the U.S. stance on tobacco and trade. When TPP negotiations began in 2008, the office of the United States Trade Representative insisted that no product should be singled out for special treatment, whatever the damage to the public. Under pressure from health groups, the U.S. offered a so-called “safe harbor” proposal in 2012, which paid lip service to the unique nature of tobacco but did little to legally protect regulations from trade lawsuits. A year later, U.S. negotiators backed away from even this small step after a concerted campaign by the Chamber of Commerce and pro-tobacco legislators.

tpp

ISDS clauses can be subject to corporate abuse. Image source: flickr/backbone_campaign CC BY 2.0

 

Last week in the final round of negotiations, the U.S. formally proposed an exemption in the investor-state dispute settlement (ISDS) mechanism for tobacco products, effectively blocking the tobacco industry from launching trade disputes under the TPP. The proposal was agreed to by the other 11 countries.

The TPP, if ratified by the twelve nations involved, will become the world’s largest free trade agreement, incorporating about 40% of the global economy. Once submitted, the U.S. Congress will have 90 days to consider the Agreement. Earlier this year, Congress granted the Obama Administration Trade Promotion Authority, or “fast-track,” which means that Congress cannot offer amendments but must vote the Agreement up or down. A small number of pro-tobacco legislators have vowed to try to kill the Agreement over the tobacco carve-out.

The tobacco industry has a long history of using costly litigation to inspire “regulatory chill,” or a fear among governments that enacting tobacco control measures will be too expensive to defend. As ISDS mechanisms in trade and investment agreements have multiplied, Big Tobacco has become an eager user. One of the Parties to the TPP, Australia, is in the midst of an ISDS challenge launched by Philip Morris International over its implementation of plain packaging for tobacco products. Several other countries have held off on plain packaging due to the likely legal costs. The TPP is the first major trade agreement to carve-out protections for tobacco measures.

In spite of a global treaty to address tobacco – the WHO Framework Convention on Tobacco Control – trade ministries have continued to treat tobacco products like any other commodity, working to increase consumption while health ministries have struggled in the opposite direction.

“We can’t end the tobacco epidemic unless we’re all rowing in the same direction,” said Alfred Munzer, Chair of Action on Smoking and Health. “The language in the TPP is a stroke in the right direction.”

Southeast Asia: Tobacco Industry Interference Index

1 Oct, 15 | by Marita Hefler, News Editor

Southeast Asia Tobacco Control Alliance (SEATCA)

Tobacco industry interference  in public health policy making continues to be a significant problem in ASEAN countries. This is the main finding of the recent report, Tobacco Industry Interference Index: 2015 ASEAN Report on Implementation of WHO Framework Convention on Tobacco Control Article 5.3, released last month by the Southeast Asia Tobacco Control Alliance (SEATCA). The report found that overall there is only marginal improvement in the implementation of FCTC Article 5.3 in the ASEAN region in 2013 compared to previous years (2010-2012).

Brunei Darussalam continues to deliver the best performance in ensuring its tobacco control policies are not compromised and are strictly implemented. Indonesia, on the other hand, remains at the bottom with the government allowing the tobacco industry to participate fully in the development of policies as well as accommodating its requests in delaying tobacco control measures.

Countries were ranked in the order of their implementation of protective measures, from best to poor, as follows: Brunei, Thailand, Lao PDR, Cambodia, Philippines, Malaysia and Indonesia.

Although it is a tobacco growing country, and despite the government owning the Thai Tobacco Monopoly, Thailand showed the biggest improvement in protecting public health policies from industry interference. The government does not accept contributions from the tobacco industry and government officials do not endorse or participate in tobacco industry corporate social responsibility initiatives.  There was a slight improvement in efforts undertaken by Cambodia, Lao PDR, Malaysia and Philippines; however progress remains inadequate agains the grim toll of the tobacco epidemic confronting these countries.

Countries that face high levels of unnecessary interaction with the tobacco industry, such as Indonesia, Malaysia and the Philippines, are vulnerable to high levels of tobacco industry meddling in policy development. The Philippines however continues to show leadership in implementing a Civil Service Commission and Department of Health Joint Memorandum Circular (JMC), which provides a Code of Conduct for all government officials when interacting with the tobacco industry.

“Transparency is important when dealing with the tobacco industry. Many governments do not have a procedure for disclosing their interactions with the industry. This is an important first step to prevent and reduce tobacco industry interference,” said Dr. Mary Assunta, Senior Policy Advisor of SEATCA. “We are dealing with an industry that continues to sell a product that kills. It misleads the public and intimidates governments. Governments need to do better to protect the public’s health.”

The ASEAN region has about 125 million smokers and more than 500,000 tobacco-related deaths a year. The tobacco industry has targeted the ASEAN region, which has a large young population, to grow its profits.

The report, Tobacco Industry Interference Index: 2015 ASEAN Report on Implementation of WHO Framework Convention on Tobacco Control Article 5.3, is available at: http://seatca.org/dmdocuments/TII%20Index%202015_F_11Aug.pdf

 

TC blog homepage

TC Blog

Analysis and debate of the latest tobacco control research findings and policy developments. Visit site



Creative Comms logo

Latest from Tobacco Control

Latest from Tobacco Control