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How to dramatically reduce smoking without banning tobacco sales

21 Sep, 15 | by Becky Freeman, Web Editor

Micah Berman, Ohio State University

Last November, the Board of Health for Westminster, a town in central Massachusetts, proposed prohibiting all tobacco sales – even e-cigarettes – in the town.

Westminster’s three-person Board of Health said that the proposal was meant to protect the next generation from tobacco and nicotine products. The board expressed frustration at its inability to keep up with the seemingly endless barrage of new tobacco products that appealed to minors. Ending all tobacco sales seemed like a clean and quick fix.

But in the face of intense opposition, Westminster’s Board of Health voted to drop the proposal. While banning tobacco sales might have protected children, many felt the proposal infringed on the “rights” and “freedoms” of adults. Some also suggested that people would simply go to other towns to buy tobacco products.

In proposing to ban all tobacco sales at once, Westminster’s Board of Health got ahead of itself. But there are plenty of other strategies that cities and towns can use to effectively reduce tobacco use – especially in young people – that don’t go as far as a total sales ban.

These measures, while aggressive, might help diffuse complaints of “prohibition” and instead keep the focus on dramatically reducing the 480,000 deaths caused each year by tobacco products. And, critically, these policies avoid the pitfalls that doomed the Westminster proposal.

Too young?
Smoking teen via

To protect kids, make it harder for them to buy cigarettes

While tobacco sales to people under 18 are prohibited, most high school students report that they have little difficulty in gaining access to cigarettes.

There are two policy options that would make it a whole lot harder for kids to start smoking, while not preventing adults from buying tobacco products: raise the legal buying age to 21 and restrict cigarette sales to adult-only retailers.

Raising the age to 21 works because high school students get tobacco primarily from friends who can legally purchase tobacco. Ninety percent of those who supply cigarettes to minors are under 21. Raising the minimum sales age to 21 puts legal purchasers outside the social circle of most high school students.

A recent study found that raising the tobacco-buying age to 21 in the Boston suburb of Needham led to a nearly 50% decline in youth smoking, a much steeper decline than was seen in surrounding communities.

Already, more than 90 communities around the country, including New York City and the entire state of Hawaii, have looked at the evidence and decided to raise their tobacco sales age to 21.

Obviously this helps prevent sales to minors. But raising the tobacco buying age doesn’t shield minors from tobacco advertising. Since other avenues of tobacco advertising (TV, billboards, sports sponsorships) have been sharply limited or prohibited, tobacco companies have focused nearly all of their advertising dollars on retail stores where tobacco is sold.

In effect, the tobacco industry has used marketing contracts with retailers to transform the nearly 400,000 retail stores around the country that sell tobacco products into recruitment centers for new tobacco users. And numerous studies confirm that the more time youth spend in convenience stores (70% visit them at least once a week), the more likely they are to smoke.

Limiting tobacco sales to retail locations that only adults are permitted to enter would remove this barrage of tobacco advertising from the convenience stores where teens spend a significant amount of time. It would also make it easier to prevent minors from purchasing cigarettes.

This is not a radical strategy; it’s similar to how liquor sales are currently regulated in most states. Ideally, limiting cigarette sales to adult-only retail outlets would be done in conjunction with raising the minimum buying age for tobacco from 18 to 21.

These policies wouldn’t prevent adults from purchasing tobacco, but they would help keep youth from taking up smoking (while also making it easier for current smokers to quit).

Neil Hall/Reuters

Focus on the most dangerous tobacco products

Westminster’s Board of Health proposal to ban the sale of all tobacco products also included e-cigarettes, which contain nicotine derived from tobacco. This struck many as radical and unwarranted.

The vast majority of all tobacco related deaths result from the use of only one particular product: the cigarette.

People use tobacco products primarily because nicotine is addictive. Nicotine itself is not benign, but on its own it’s much less harmful than the smoke and tar produced by burning tobacco. E-cigarettes and other vaporized nicotine products are almost certainly less toxic and less harmful when used instead of conventional cigarettes.

A bold yet more incremental step would be to allow the sale of potentially less harmful products, like e-cigarettes, while sharply limiting sales of conventional cigarettes and other combusted products. This might take the form of exempting e-cigarettes from the adult-only retailer policies described. Or, potentially, a community might consider prohibiting all cigarette sales, while allowing sales of non-combustible products.

If cigarettes were harder to come by, the “harm reduction” potential of e-cigarettes would be much more likely realized. As summarized by the Surgeon General:

The impact of noncombustible [e-cigarettes] on population health is much more likely to be beneficial in an environment where the appeal, accessibility, promotion, and use of cigarettes and other combusted tobacco products are being rapidly reduced, especially among youth and young adults.

But the evidence to date indicates that e-cigarettes are primarily being used along with cigarettes, rather than instead of them. In addition, use of e-cigarettes by youth, which is rapidly expanding, puts these youth in danger of “graduating” to cigarette use.

A recently published study found that adolescents who had used e-cigarettes were more than twice as likely as their peers to subsequently start smoking. Making it harder for adolescents to obtain cigarettes would help reduce the likelihood that minors using e-cigarettes move on to smoking.

Get community support before acting

The most important lesson of Westminster’s experience may be that policymakers cannot get too far ahead of their communities. As public health law scholar Wendy Parmet recently wrote:

Public health laws that are strongly rooted in, and indeed arise from, the public, may face a quite different fate than those that derive from the good intentions of public health policymakers alone.

Rather than announce a plan to ban the sale of all tobacco products, the Westminster board of health could have instead started a series of community discussions about the problem of tobacco use – and youth tobacco use in particular.

It is likely that such discussions would have quickly produced broad consensus about the need to better protect youth from tobacco, which could have then led to a discussion about potential policy solutions (such as those discussed above).

It is also notable that some of the loudest critics of the proposed Westminster law were proponents (and users of) e-cigarettes, many of whom struggled for years to quit cigarettes. Including this community in early discussions could have led to a shared vision about how to minimize the dangers of e-cigarettes while focusing on the much more significant harms caused by cigarettes.

Making sustainable public health policy requires the slow but important processes of community engagement, education, compromise, and consensus building. With deliberate and incremental steps to reduce the prevalence of tobacco in our communities, we can save countless lives.

The Conversation

Micah Berman, Assistant Professor of Public Health and Law, Ohio State University

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

Jamaica: United Way charity under pressure over tobacco industry links

10 Jun, 15 | by Marita Hefler, News Editor

Tobacco industry corporate philanthropy and social responsibility has been under the international spotlight recently with the revelation that the American Red Cross continues to accept tobacco industry donations, despite concerns of the International Red Cross that US Red Cross risks damaging the global reputation of the network. Accepting tobacco industry donations is particularly problematic for charitable organisations that work to improve public health, given tobacco industry profitability is only possible at the expense of the health – and lives – of the industry’s best customers.

Barbara McGaw of the Jamaica Coalition for Tobacco Control and Deborah Chen of the Heart Foundation of Jamaica report of a charitable organisation accepting tobacco industry funds, causing a split in the charity sector in Jamaica:

United Way of Jamaica (UWJ) is a key charitable organisation in Jamaica. Through its umbrella group, the Council of Voluntary Social Services (CVSS), it has membership of all of the Non-Government Organisations (NGOs) in the country, including health-related NGOs such as the Heart Foundation of Jamaica, the Jamaica Cancer Society and the Diabetes Association of Jamaica. UWJ and CVSS are sister organisations; their offices, secretariat and CEO are shared, and they have 4 board members in common. United Way Jamaica provides funding for a range of CVSS member organisation projects.

At a function to celebrate the 29th National Builders Awards Ceremony of UWJ in September 2014, Carreras Limited (a subsidiary of BAT) was lauded as UWJ highest corporate donor for 2013. Jamaica’s Minister of Industry, Investment and Commerce, who was a guest speaker at the function, presented the award. The Minister’s involvement contravenes Article 5.3 of the WHO Framework Convention on Tobacco Control, the guidelines of which state that Parties “should not endorse, support, form partnerships with or participate in activities of the tobacco industry described as socially responsible”. The Jamaica Coalition for Tobacco Control (JCTC) wrote to the Minister about the issue; according to his response, the event invitation did not indicate that he would be presenting awards. However, he acknowledged that his role in presenting to Carreras would not be in keeping with the spirit of Article 5.3 of the FCTC.

Against this background, in September 2014, the JCTC wrote to the Chairman of UWJ and suggested that the organisation cease accepting funds from the tobacco industry. Despite further correspondence from the JCTC and the Heart Foundation of Jamaica, the only response received was “We acknowledge receipt of your letter dated September 24, 2014 in which you have raised concerns regarding United Way accepting funds from the tobacco industry. The matter has been brought to the attention of our Board and your concerns have been noted.”

The Heart Foundation also wrote to the Chair of CVSS. Although a more positive response was received stating that consideration could be given to reviewing the criteria for accepting funds at UWJ, to date there has been no change in policy. It is noteworthy that at a celebratory function held in January 2015 by Carreras Ltd (BAT) to honour its CEO for being awarded  “Top CEO for 2014”  by Business Suite magazine , the Chairman of UWJ was present and gave the vote of thanks at the function.

The UWJ’s mission on its website is “to improve lives by mobilizing the caring power of communities to advance the common good”. The website further states that “The United Way of Jamaica envisions a society where individuals and families achieve their human potential through education, financial stability and healthy living”. Accepting funds from the tobacco industry is not in keeping with United Way’s vision. Despite this, the United Way has accepted funding from the tobacco industry in other countries. It seems that there is no policy against accepting donations from this source. Altria’s 2012 reporting of Recipients of Charitable Contributions from Altria Family of Companies (USA), listed 11 United Way individual organizations that benefitted from donations. Total donations to charitable institutions reported were US$40.8 million.

The Heart Foundation of Jamaica has been a member of CVSS for over 40 years. It has previously written about the problem of United Way accepting donations (see herehere and here). In view of the current situation, the Heart Foundation of Jamaica has suspended its membership as of April 30, 2015. The Heart Foundation of Jamaica hopes that one day there will be a review in the UWJ/CVSS policy such that the HFJ can reinstate its membership. The matter of United Way accepting funds from the tobacco industry globally is an issue which deserves further investigation and exposure.

Urgent action to amend Austria’s tobacco control laws

27 Apr, 15 | by Becky Freeman, Web Editor

Prof. Manfred Neuberger writes:

Since 2007 Austria has received the poorest score on the Tobacco Control Scale. While smoking prevalence and tobacco consumption decreased on average in the European Union, an opposite trend has occurred in Austria. Child smoking has increased dramatically since the 1990s. Cigarettes are available around the clock in thousands of vending machines, circumventing advertising bans and enabling easy access by children.

Legally, cigarettes can be bought at age 16, but half of 13-15 year olds smokers reported having bought cigarettes in tobacco shops. At age 15 already 18% of boys and 21% of girls are smoking daily. Tobacco shops are permitted to sell goods aimed at children and both indoor smoking and tobacco advertising is permitted. Tobacconists also distribute newspapers and are a powerful lobby group. Annual state revenues from cigarette consumption by minors in Austria exceeded 60 million €, but none of this revenue was budgeted for tobacco use prevention. With minor exceptions much of this work is left to unpaid volunteers (e.g.

Children are permitted to enter smoking rooms and public smoking is visible to children as a normal adult behavior in most hospitality venues. While Austria ratified the WHO FCTC in 2005, it has had limited impact until now. Partial smoking bans were introduced in 2001 in workplaces and in public places in 2009 (with sanctions for violations), but this law is not well enforced. A further summary of the law and the associated problems can be read here.

littel girl smoking

Legally, cigarettes can be bought at age 16, but half of 13-15 year olds smokers reported having bought cigarettes in tobacco shops Piulet/flikr CC BY-NC-ND 2.0

The smoking ban in hospitality venues larger than 50m² provided the possibility of smoking rooms and the provisions that smoke should not leak into the nonsmoking areas was infringed regularly. Other violations of the partial smoking ban in the hospitality industry had to be reported by customers and were treated with long delays by local municipalities, a time-consuming method to enforce the law and frequently unsuccessful, even if taken to court.

Because partial smoking bans have failed, amendments to the tobacco law were prepared by the government, foreseeing a total ban in all schools (up to now in compulsory schools only), in the hospitality industry (including clubs, tents, multipurpose rooms), in hotels (except for smoking rooms, which must not serve for eating, drinking or sleeping), in all commercial transportation, and in tobacco shops used for mailing and other purposes, which still need to be specified. Use of water pipes or electronic cigarettes will also be banned where smoking is forbidden.

Crucial elements still missing from the legislation are: technical specifications for smoking rooms, such as a clear definition of their use for smoking only, clarification that the smoking ban applies to all rooms of hospitality venues (including kitchen, corridors, etc.), a ban on smoking and tobacco advertising in all shops and rooms accessible to minors, and a smoking ban in hospitals, on children’s playgrounds and in private cars carrying children.

The EU Tobacco Product Directive still needs to be included in the draft Austrian legislation and necessitates that the law enters into force in May 2016. The present plan to postpone this date until May 2018 is irresponsible and demonstrates the weakness of the government against the chamber of commerce.

The worst omission of the new Austrian draft is the lack of improvement in implementation and enforcement of the law. The present system of reporting violations by customers has failed, especially in small communities with only one inn where filing a complaint would be too personally risky. For example, some people who reported local innkeepers were pictured on a “wanted poster” at the entrance of the inn and were then forbidden to reenter.

Officials who were sent to venues for inspections only after customer complaint, could downplay the offence or postpone the decision by up to 28 months. During this time no other complaint about the same venue would be investigated.

It appears that this ineffective enforcement system will be continued. The draft law only names work inspection and food inspection as additional possibilities for control, but only during routine visits done for other purposes, and in the case of serious offences. Additionally, the draft law states that these controls must not incur extra costs. It is doubtful that rare and announced controls by such inspectors will improve the already poor compliance. Improving compliance for the better may require police assistance, as they could make unannounced controls during busy periods, such as at night in discotheques and other venues where young people meet.

Comments on the draft legislation are accepted until May 8th, 2015 at the ministry of health <>, the ministry of finance <> and the parliament <>

Tobacco industry confronted with child labour

27 Jan, 15 | by Marita Hefler, News Editor


By Laura Graen,

In late 2014, the tobacco industry was confronted with the revelation of child labour on US tobacco farms, detailed in a well-researched 139 page report published by Human Rights Watch (HRW). The USA is not alone; most major tobacco producing countries use child labour in tobacco growing. In other words, almost no cigarette can be guaranteed to be free from child labour

The US Department of Labor lists 17 countries which use child and forced labour in tobacco and bidi production. Although extensive, the list is incomplete – for example, the United States itself is not included. Prior to the 2014 report about US tobacco farms, research reports on Kazakhstan in 2010 by Human Rights Watch and Malawi in 2009 by Plan Malawi attracted worldwide media coverage.

Despite the known scale of the problem, every time a new report is published tobacco companies react with apparent surprise, and depict the problem as an isolated local rather than global issue, detached from the structural power relations within which the industry operates. In the wake of the HRW report on Kazakhstan, Philip Morris said it was ‘grateful’ that the NGO raised the issue, despite the fact that it sent officers to its contract farms on a regular basis.

The child labour issue is nothing new for the tobacco industry, as can be easily researched with the internal documents database. In 1999, British American Tobacco (BAT) for example showed its awareness of the problem when one of its representatives discussed how it could best ‘get value for [its] cash and time contribution’ to the International Tobacco Growers’ Association (ITGA). “I would in particular very much like them to delve more into the child labour and WHO issues…Otherwise what is the point of having the membership and paying the money?” wrote Shabanji Opukah, BAT’s corporate social responsibility manager. Sixteen years later, little appears to have been done to find and implement sustainable solutions to improve tobacco workers’ lives.

On December 10th, 2014, tobacco companies through their Eliminating Child Labour in Tobacco Growing (ECLT) foundation announced a pledge to end child labour in their supply chains. In particular, they announced a commitment to adhere to international labour laws and children’s rights’ conventions that prohibit hazardous work for children under 18 – commitments that have already been signed by most countries.

Reuters published an article that boils down to HRW praise of the pledge as a ‘first time’ thing, lending legitimacy to the move and tobacco industry as a whole, although it noted that significant gaps remain and some key players such as China National Tobacco Corporation and Reynolds Tobacco are not ECLT members. At the end of December, a New York Times editorial also discussed the issue. While putting an emphasis on the need for the US government to pass a law that prohibits the work of children under 18 in tobacco, it praises the tobacco industry. Among others, the article says: “Given Big Tobacco’s shameful history of marketing cigarettes to children, it is noteworthy that the industry is willing to do the right thing in the case of child workers.”

While any move to improve its business practices is welcome, given its history, it seems the tobacco industry is more focused on doing the right thing for its public image than safeguarding the rights of child workers. The industry is particularly keen to embrace voluntary agreements which provide good public relations, while being unenforceable. With articles like the New York Times editorial, big tobacco succeeds in being seen as part of the solution rather than the problem. This obscures the fact that tobacco industry is extremely monopolised, has a record of collusion and suppression of leaf prices, interferes with policy development and invests in NGOs such as ITGA, ECLT and many others in tobacco growing countries, in order to be seen as a good corporate citizen.

For many farming households in developing countries, tobacco production is a precarious livelihood, overshadowed by debt and the threat of poverty. If smallholder farmers – who produce much of the world’s tobacco leaf – do not receive enough money in exchange for their tobacco, they have little choice but to enlist their children to work. Human Rights Watch, in its otherwise well-researched report, fails to analyse the structures and power relations of the global leaf market, and the role of tobacco industry financing in encouraging the expansion of tobacco cultivation.

Lay people, and unfortunately also development professionals, may believe that voluntary industry pledges are a shortcut to improving human rights and reducing poverty. Companies seem to react quickly while governments take longer to develop, debate, pass and implement laws. However, examining the history of tobacco industry pledges regarding child labour, little has changed in the past 16 years. To achieve sustainable human rights improvements, properly-enforced laws that make corporations accountable and change power relations between workers and companies are needed, rather than voluntary industry codes.

It is noteworthy that the industry found it necessary to pledge to abide by national and international laws. Do they really deserve congratulations for trying not to break the law?

India: Powerful ‘Voice of Tobacco Victims’ campaign wins BMJ health advocacy award

30 Oct, 14 | by Marita Hefler, News Editor


Pankaj Chaturvedi, Prakash C Gupta, Sanjay Seth, Ashima Sarin

Voice of Tobacco Victims

Voice of Tobacco Victims Campaign (VOTV) was launched on 31st May 2009 by a dozen cancer survivors of Tata Memorial Hospital, Mumbai under the leadership of Dr Pankaj Chaturvedi. The campaign aims to make Tobacco Victims (cancer survivors and their relatives) the public face of the anti-tobacco campaign and get them justice. There are more than 300 patients and their relatives who are engaged in battling a powerful industry that sold them cancer and suffering. Most are cancer patients who were treated by Dr Chaturvedi in Tata Memorial Hospital, Mumbai. They are supported by 168 motivated oncologists all over India who are performing exemplary voluntary advocacy with highest policy makers. 

Led by cancer survivors, VoTV conducted a sensitization programs for the Chief Ministers, Members of Parliament, State legislators, Police Departments, Education Departments, Food inspectors and other government officials. We took up the matter in several High Courts and the Supreme Court, where Dr Chaturvedi made a deposition in front of Justice Singhvi in Ankur Gutka matter. 

The Campaign played a pivotal role in the Gutka ban introduced throughout India, ban on all forms of flavoured, scented, packaged chewing tobacco in 9 states and the ban of flavoured supari (pan masala without tobacco) in Maharashtra. They were also instrumental in tax increases in several states. Prior to the recent budget, 300 doctors wrote to the Honorable Prime Minister to raise taxes on tobacco. 

VoTV team is also working with state governments for better implementation of tobacco control laws. VoTV has been instrumental in India’s most graphic campaign for awareness in society. The clip is shown in all cinema halls and TV channels. 

VOTV youtube









VOTV films are available on Youtube here.

Some patients filed compensation cases in the consumer court, actions that have rocked the tobacco industry.

VoTV has been recognised by the World Health Organization as an outstanding campaign. Dr Chaturvedi was nominated as a Global Cancer Ambassador by the American Cancer Society, invited as a speaker in special United Nations Summit, and served on various committees for the Ministry of Health. The campaign also received the Judy Wilkenfield Award by Campaign for Tobacco Free Kids, Washington. Most recently, on September 22, 2014, Dr Chaturvedi and VoTV won the British Medical Journal Awards in the Health Advocacy category.

According to several studies and Euromonitor, the campaign has contributed to a 26% reduction in volumes of chewing tobacco and 3% in cigarette volume. I am sure it will translate into reduction in prevalence of tobacco usage and eventually reduce the tobacco related mortality.

For more information visit

About tobacco in India:

  • In India, there are 275 million tobacco users – that means every third Indian adult uses some form of tobacco. It is the number one cause of preventable death.
  • Tobacco is responsible for nearly 50% cancers in India and 90% of mouth cancers. Half of the mouth cancer patients die within 12 months of diagnosis.
  • Around 1 million Indians die from tobacco-related diseases each year in India. This epidemic kills more people than tuberculosis, accidents, homicides, suicide, AIDS and malaria combined.
  • Among kids aged 13-15, 4 percent smoke cigarettes and almost 12 percent use other types of tobacco products. As with elsewhere in the world, children are the new consumer base for the industry.
  • Tobacco costs and enormous amount due to death, disability and diseases. According to government figures, the total revenue from tobacco excise makes up 17% of the health care cost.
  • While essential food items have become expensive over decades, tobacco has become cheaper every year.
  • The main form of tobacco consumption in India is chewing and bidis. These two industries are run by only a few dozen families in India.

VOTV award

Uganda: MP accuses British American Tobacco of blackmail

25 Jul, 14 | by Marita Hefler, News Editor

A Ugandan MP who has put forward a private members bill to reduce smoking in Uganda has accused British American Tobacco  (BAT) of blackmail. Dr Chris Baryomunsi revealed  he has received a letter from BAT advising that the company will stop doing business with farmers in his constituency because his bill  has meant existing arrangements are ‘increasingly less economically viable’, the Guardian newspaper reported on 13 July.

Dr Baryomunsi is defiant in the face of such pressure:  “They thought that the farmers would rise against me and disorganise me politically, but I told them I was not moved. I actually assured them that what mattered to me was not the number of years I spend in parliament but what I do when in parliament. I assured them that no amount of blackmail and intimidation would shake me.”

Read the full Guardian report here.

#DortmundKills campaign: the legal, moral and ethical case against Inter-tabac Asia

30 Jan, 14 | by Marita Hefler, News Editor

As reported in News Analysis in the January edition of Tobacco Control, the Dortmund city-owned company Westfalenhallen Dortmund GmbH (Germany) is organising Inter-tabac Asia, a trade fair for the tobacco industry, to be held on the Indonesian island of Bali on 27 & 28 February. An international campaign against the event has attracted support from around the world, and a petition on has been signed by more than 11,5000 people. The Dortmund mayor has indicated he will refuse to receive the petition. Meanwhile, the Bali Governor Made Mangku Pastika has reportedly blocked the fair, drawing praise from the Southeast Asia Tobacco Control Alliance (SEATCA).

On January 10, Pascal Diethelm, President of Swiss NGO OxyRomandie, joined nearly 18 international health organisations and German politicians in sending an open letter to the mayor of Dortmund, the Honourable Ullrich Sierau, urging the cancellation of Inter-tabac Asia 2014. On 23 January, he received a reply from Dr Andreas Weber, from the Marketing and Corporate Communications Department at Messe Westfalenhallen Dortmund GmbH. In it, Dr Weber advises that the trade fair is directed at professional visitiors, and that children and young people are not permitted. He goes on to state: Tobacco is a legal product in Indonesia, as it is in Germany. Economic stakeholders therefore have a right to a trading platform of this kind, as in any other industry. Messe Westfalenhallen Dortmund GmbH respects all political laws and regulations in countries where it organises trade fairs and will of course continue to do so in the future.”

Mr Diethelm’s response, reproduced in full below, outlines how Messe Westfalenhallen Dortmund Gmbh’s organisation of Inter-tabac likely breaches Germany’s legal obligations under the WHO Framework Convention on Tobacco or Health, as well as the moral and ethical implications of its involvement:

Dear Mr Dr Weber,

Thank you for communicating to us the position of Messe Westfalenhallen Dortmund GmbH concerning the organization of Inter-tabac ASIA 2014 by the city of Dortmund.

Unfortunately, I have to say that your company’s statement misses our point entirely.

The official implication of the municipality of Dortmund in such an event, even indirectly through your company, of which the city of Dortmund is the sole shareholder, clearly violates Germany’s legal obligations emanating from article 5.3 of the Framework Convention on Tobacco Control (FCTC), an international treaty ratified by your country on 16 December 2004. The treaty was also ratified by the European Union on 30 June 2005 and all EU Member States are now Parties to the treaty, which could therefore be also considered as providing a European  legal framework for tobacco control.

The Guidelines on Article 5.3 of the treaty (see attached German translation) indicate to parties how to fulfill their obligations emanating from the Convention. The city of Dortmund breaches several key dispositions of these Guidelines:

–      It violates point 2.1 which states that “Parties should interact with the tobacco industry only when and to the extent strictly necessary to enable them to effectively regulate  the tobacco industry and tobacco products.” The organization of Inter-tabac ASIA by the city of Dortmund can hardly be described as “strictly necessary.”

–      It violates point 3.1, which states that “Parties should not accept, support or endorse partnerships and non-binding or non-enforceable agreements as well as any voluntary arrangement with the tobacco industry or any entity or person working to further its interests.” The organization of Inter-tabac ASIA will inevitably lead the city of Dortmund, via Messe Westfalenhallen Dortmund GmbH, to conclude multiples agreements with the tobacco companies who are exhibitors in the tobacco trade fair.

–      It violates point 4.7, which states that “Government institutions and their bodies should not have any financial interest in the tobacco industry.” By organizing Inter-tabac ASIA, the city of Dortmund has a vested interest in the tobacco industry. The return on its investment is directly linked to the commercial success of its exhibitors, the tobacco companies.

–      It violates point 7.1, which states that “Parties should not grant incentives, privileges or benefits to the tobacco industry to establish or run their businesses.” By facilitating their business in Asia, the city of Dortmund grants privilege and benefits to the tobacco industry.

Your company’s statement misses the point in even a more worrying way. You company does not seem to understand, or even have minimal appreciation, of the ethical and moral implications of the decision of the city of Dortmund to organize a trade fair in Bali aimed at promoting tobacco in Indonesia and Asia.

Currently, tobacco kills 6 million people per year and this toll continues to rise while it is at the same time shifting from the highly developed world to lower income countries. In the 20th Century, tobacco was responsible for 100 million deaths. If nothing is done to change the course of the tobacco epidemic, the World Health Organization and all public health authorities predict that the number of tobacco deaths will reach 1 billion in the 21th Century.

In Indonesia, where over two-thirds of the men smoke and where the age of initiation of smoking is commonly below 10, the toll caused by tobacco is taking genocidal proportions. Tobacco kills 260’000 Indonesians each year and this number is rising rapidly. Nowhere in the world can we witness a more striking manifestation of what professor Robert Proctor, historian of science at the University of Stanford, calls the Golden Holocaust.(1)

In such a context, we were stupefied when we read that your company, Messe Westfalenhallen Dortmund GmbH, and therefore the city of Dortmund, feel comfortable with having contributed to this Golden Holocaust for 30 years, as it claims to have done it “with integrity”. This line of defense evokes some of the darkest memories, having connotations of what Hannah Arendt calls “the banality of evil.

Fortunately, there are people in this world with a conscience, a high sense of morality and who are prepared to act in conformance with their values. This is the case of our tobacco control colleagues in Indonesia, who, with insignificant means compared to the financial power of the tobacco industry, are fighting with courage and determination to reduce the tobacco epidemic in their country and eliminate the grip tobacco multinationals have on it. Over the recent days, they scored a major victory by rallying the support of the Governor of Mali, Made Mangku Pastika. The Governor has publicly announced his commitment to prevent Inter-tabac ASIA from taking place in his province. He has issued orders that no permit be granted to the tobacco trade fair.

This decision of a man with real integrity sends a clear signal to the city of Dortmund, whose reputation is being tarnished in this affair. Let us hope Mr. Ullrich Sierau listens and learns the lesson and does not miss this opportunity to get better educated in the ethical and moral implications of the tobacco trade.(2)

The ties between Dortmund and the tobacco industry are indeed highly detrimental to the city’s reputation: a lot of people in the world now know Dortmund mainly through the slogan “Dortmund Kills.” Your company and the mayor should realize that the city’s involvement in Inter-tabac is irremediably doomed – soon or later, Dortmund will have to give up all activities linked – directly or indirectly – to the tobacco industry and comply with the legal requirements of the FCTC. The tobacco issue is not going to fade away – on the contrary, it is now considered a priority risk factor in the global fight against non-communicable diseases.

Today, the FCTC has 177 Parties, covering 90% of the population of the world. Situations where a public institution is in bed with the tobacco industry are no longer acceptable and will be increasingly targeted as aberrations to eliminate. It is illusory to think that Dortmund’s Inter-tabac will escape this worldwide phenomenon. The sooner Messe Westfalenhallen Dortmund GmbH will cut all links with the tobacco industry, the better and less painful the process will be. On behalf of my association, I urge your company and the mayor of Dortmund to do it without delay.

Yours sincerely,

Pascal Diethelm

(1)   Proctor, Robert N. (2012). Golden Holocaust: Origins of the Cigarette Catastrophe and the Case for Abolition. Berkeley: University of California Press.ISBN 9780520270169

(2)   For example, see : Deutsches Krebsforschungszentrum (2005). Die Tabakindustriedokumente I: Chemische eränderungen an Zigaretten und Tabakabhängigkeit, Heidelberg (…/Tabakindustriedokumente_I.pdf)


Japan: Prime Minister appoints tobacco executive to board of national broadcaster

28 Nov, 13 | by Marita Hefler, News Editor


Earlier this year, tobacco control advocates from around the world supported an effort by their counterparts in Japan to block a proposed appointment of Mr Katsuhiko Honda, former President of Japan Tobacco, to serve on the Board of Governors of NHK, Japan’s public broadcaster (Japan’s equivalent of the BBC). Unfortunately, the temporary success there has been fully reversed.

This month, Honda’s name came through again, this time after the summer election where a coalition led by the powerful Liberal Democratic Party (LDP) obtained a majority in the Upper House and accordingly the LDP gained essentially complete control over the nation’s legislative affairs. Renominated by Prime Minister Abe, Mr. Honda’s appointment was approved by both houses of Japan’s national Parliament on Friday 10 November.

According to the University of Hawai’i’s William S. Richardson School of Law Professor Mark Levin, author of a Spring 2013 law journal article on Japanese tobacco control law and policy: “This appointment is troubling for many reasons, work in tobacco control being just one. Nonetheless, the fact that this appointment violates Japan’s international obligations under the World Health Organization Framework Convention on Tobacco Control Article  5.3 seems very clear. At the very least, this matter deserves to be noted and criticised accordingly with regards to international tobacco control advocates’ reports on and discussions with Japan.”

Tobacco control advocates in Japan are dismayed both for the immediate implications to their efforts and the challenge to the application of Article 5.3’s principles more broadly. Katsuhiko Honda still serves as an adviser to Japan Tobacco Inc., while this posting will give him direct authority over important management and policy decisions and presumably indirect sway in NHK’s daily operations as well. The Japan Society for Tobacco Control has condemned the move. (Japanese)

However, Levin points out that context here also matters. “Of course, Mr Honda’s desire to serve might well be driven by his unmitigated pro-tobacco industry agenda. But it’s important to note that the motivation for Abe’s selection of Honda may be barely related to tobacco control, at least from Mr Abe’s perspective.”

As widely reported in the national press, the appointment comes as part of a larger political move by Abe to secure a strong say in the selection of NHK’s next president and general affairs of management and budget. Abe seems to be getting many players in place for a dramatic set of legal, political, and even constitutional changes to swing Japan to the right. In this, Honda is a truly long-standing and trusted friend, having been Abe’s private home academic tutor in the future Prime Minister’s high school days.


Shadowy lobbying against Tobacco Products Directive

11 Oct, 13 | by Becky Freeman, Web Editor

This post is republished with full permission from Tobacco Unpacked.

A guest blog by Andy Rowell, research fellow at the Tobacco Control Research Group, University of Bath, and editor of

  • Landmark TPD debated in Europe this week.
  • Multi-million-pound lobbying campaign inflicted on Brussels by tobacco industry.
  • This week is crunch time in Brussels for public health.

European Parliament MEPs will debate the landmark Tobacco Products Directive, seen by public health advocates as a crucial measure in reducing the harm from tobacco across the EU.

For the last two-and-a-half years, we have been monitoring the activities of the tobacco industry under a ground-breaking academic project at the University of Bath, which has been part funded by Cancer Research UK. Instead of just focusing our output on academic journals we have also developed a wiki, called, which has more timely access to our research findings.


Tobacco is unique. No other product kills one in two of its long-term users. If someone invented the cigarette today, it would never make it onto a supermarket shelf. It is now over 60 years since the link between cancer and smoking was first discovered, but millions of us remain addicted.

The reason for this, in part, is one of the most sophisticated and well-funded public relations campaigns ever undertaken by an industry. The tobacco companies set out to deny the scientific evidence of the harmfulness of their product and the addictiveness of nicotine. The object is always to try to sow confusion and doubt and delay action.

Such tactics have again been evident in the multi-million-pound lobbying campaign the industry has inflicted in recent months on Brussels. New leaked documents from Philip Morris International (PMI) reveal the extent of this campaign, which targeted the three pillars of Brussels decision-making: the European Parliament, the European Commission and European Council.


The documents reveal that by mid-2012, the overall strategic objective of PMI’s lobbying campaign was to either “Push” (i.e. amend) or “Delay” the Directive and “block” the proposals coming from the relevant Directorate on health, DG Sanco, which was in charge of the proposals. To this end, PMI employed a two-fold technical and political strategy to ensure it received as many “negative opinions” from other Commission DGs as possible, as well as to try and ensure a political commitment from other business-friendly Commissioners to oppose what PMI was labelling as excessive legislation. PMI identified key messages to push in its lobbying campaign, especially in relation to the Inter-Service Consultation between the directorates, arguing there was a need to “break” into the “silo” of the European Commission. The main lobbying messages used by the company were that the TPD proposals lacked “legal basis”, “evidence”, “logic” and a “market analysis”.


Just as PMI had done fighting proposals on Point of Sale and Plain Packaging in the UK, the tobacco giant was keen to highlight the “illicit trade problem”, despite its historical involvement in smuggling. For more information on this see on smuggling. The company set out to “trigger negative opinions” amongst other Commissioners or their senior advisors, known as their cabinet, and set out to get other “high-level influencers” to directly engage with the Commissioners. The tobacco companies such as PMI have a history of using so-called third party techniques in their lobbying campaign, using other organisations or people to influence the debate on the industry’s behalf.

The reason is simple: the use of third parties removes the message from the interested messenger. Moreover, the tobacco industry is such a discredited voice that it has to look for someone else to be its ventriloquist dummy. The public or a politician may be sympathetic about a corner shop going out of business, but they would have less sympathy towards an industry which kills its long-term customers and whose profits stretch into billions.


The documents reveal that PMI’s anti-TPD lobbying campaign, via social and traditional media, would be “led by third parties”. The tobacco giant identified tobacco growers, small and medium-sized businesses, other trade organisations, unions, suppliers, intellectual property organisations, employers’ associations and even consumer associations to front its campaign for it.
And just as the industry used retailers against Point of Sale Display Ban and Plain Packaging in the UK, so they have been central to PMI’s lobbying campaign in Brussels. PMI outlined how the retailers would lobby other parts of the Commission and “promote events to gain visibility” for the campaign. As well as retailers based in Brussels, national retailers associations across the EU were also brought in to help, too.

Another key constituency to front the campaign were tobacco growers and processors. PMI organised meetings between tobacco growers’ unions, such as UNITAB, the European Association of Tobacco Growers and Fetratab, the European Federation of Tobacco Processors, with key officials at the Commission, including a meeting with the Cabinet of the European President Manuel Barroso.


The leaked documents also outline in detail PMI’s strategy in the European Parliament. This time, the tobacco giant undertook direct lobbying as well as indirect. By mid-2012, nearly a third of MEPs had been lobbied by PMI, some 233 MEPs in total. Some MEPs by then had met the tobacco giant four to five times, with meetings happening on a regular basis. Almost half of the European People’s Party and European centre-right groups met with PMI’s lobbyists, the documents show.

At the parliament, the company also focused its lobbying efforts on two influential committees, ENVI and IMCO. The ENVI committee – Environment, Public Health and Food Safety – was tasked with overseeing the TPD through the Parliament. PMI set out to “Break ENVI’s full control on the dossier.” Heads of national delegations were lobbied, as were the “political heavyweights” from each political party. The company sought to “secure political agreement though top level contacts”.


PMI also set out to lobby the Council, in order to create a “blocking majority” against any public health measures it deemed “extreme”. One of these measures is the banning of certain flavours including menthol. PMI’s objective was “exclude” menthol from the TPD. It wanted to get different member states with “significant menthol segments to oppose a menthol ban in TPD at the Council”.

In order to do this it wanted to “neutralise” lead countries in the menthol debate, such as Germany. The use of language such as this is indicative. Here we have a transnational company effectively planning to politically nullify the most powerful EU country. This multi-million-euro lobbying campaign raises all kinds of issues, two of which are deeply important for public health and the political process. The fact that PMI has had such extensive access to the Commission and hundreds of MEPs is clearly a breach of the Framework Convention on Tobacco Control. Article 5.3 of the Convention requires signatories to protect their health policies “from commercial and other vested interests of the tobacco industry”. This clearly has not happened in this case.


Last week, 11 public health and transparency NGOs wrote to President of the European Parliament to argue these meetings constitute “a serious violation” of the Convention.

“We are deeply concerned about the astounding level of access to MEPs by tobacco lobbyists which has been exposed in the leaked Philip Morris International documents,” they wrote.

PMI has also voluntarily signed up to the EU’s Transparency Initiative and is meant to accurately record how many lobbyists and how much money it is spending lobbying in Brussels. The documents reveal that PMI has been using a significant number of lobbyists and consultants. One spread-sheet outlines that 161 employees and consultants were engaged in lobbying concerning the TPD. By mid-2012, the documents also reveal, PMI had spent €1.25 million on consultancy and expenses fighting the proposals.


In contrast, PMI only declares nine lobbyists in its entry to the EU Transparency Register. For the whole of 2012, the company estimated that its lobbying spend had been €1 million–€1.25 million. Behind the scenes we know the lobbying will continue right up to any vote. Via the documents we only have a small snapshot of how widespread and pervasive PMI’s lobbying campaign has been. PMI’s key aims are to reduce the size of health warnings and ensure menthol cigarettes are not banned. If the industry can delay the vote at the Parliament and also at the council again, the whole Directive may be put back years. So, just as it has done many times before, the industry will have delayed action, whilst the profits keep rolling in

Eurovegas and the challenge to Spain’s smoke-free law: neoliberalism vs public health

3 Oct, 13 | by Marita Hefler, News Editor


Aser García Rada, Madrid

The Spanish law banning smoking in all public premises since January 2010 has become one of the greatest national public health achievements in decades. It modified a previous law from 2006 that banned smoking in enclosed working environments but allowed it in certain bars and restaurants. The tobacco lobby fought strongly against this change as they were interested in exporting what was known as “the Spanish model”: allowing smoking in places of entertainment maintained the social acceptance of a drug that kills 700,000 Europeans annually. To Big Tobacco´s dismay, the 2010 model soon spread to other countries.

According to the Spanish National Institute of Statistics, smoking prevalence has decreased from 26.2% in 2006 to 23.95% in 2012, the lowest rate in 25 years. Heart attacks have dropped by 11% after the 2006 legislation was established, so further drops are expected from 2010 on. The EU Commission has stated that Spain has experienced the largest decrease in passive smoking of the EU over the last years: 70% less, well above the EU average of 46%. In addition, 82% of the population –including many smokers- agree with current legislation, says a poll by the Spanish Society of Family and Community Medicine (SEMFYC). In fact, social acceptance is increasing, according to the last health barometer of the Ministry of Health, Social Services and Equality.

The current law has only been weakened once. It was done by the previous social democrat Government of Jose Luis Rodriguez Zapatero following pressure from the largest Spanish department Store El Corte Inglés to allow the sale of smoking products in convenience stores such as their Opencor chain. Now Sheldon Adelson, Las Vegas Sands casino chairman, 12th on the Forbes 400 list of the richest Americans and one of the most important magnates of the gambling industry, has announced the construction of the largest casino resort in Europe in the autonomous community of Madrid, a project popularly known as Eurovegas. Adelson, whose company is under criminal investigation for possible violations of the U.S. Foreign Corrupt Practices Act, and has just agreed to pay $47 million to the U.S. to settle a money-laundering case, has requested that Spain’s smokefree law be weakened to allow  smoking in the casino’s premises. He promises that the casino project will create 200,000 jobs and bring prosperity to the region.

Thus, the regional and national governments are salivating. Amendments to labor and urban planning laws and tax breaks have already been negotiated. The repeated requests from the president of the autonomous community of Madrid, Ignacio González, from the conservative People´s Party (PP), that the central government amends the law seem to be having their effect. Recently the minister of health, social services and equality, Ana Mato, also from the PP, said that the Government is “looking for ways” to “reconcile the protection of health with the creation of jobs”. In fact, according to the newspaper El Mundo, the change has already been decided: smoking will be allowed in certain areas on all current 41 casinos throughout the country and on those to be built in Eurovegas. The daily La Razón states that the law will be amended before November.

The EU Commission considers that the economic impact of banning smoking across the EU has been limited, neutral and even positive in bars and restaurants industry except for maybe on gambling premises, a probably correct estimate according to the available scientific literature. However, the comorbidity between tobacco smoking and gambling seems clear. Tobacco might have neurochemical effects that enhance gambling behaviour (1) and problem gambling severity and amount of money spent, have been related to smoking (2). Must we create further death and disease to have jobs?

Health professionals are fighting the change and the global community is watching. An umbrella platform of different tobacco control organizations ( has launched the campaign Don´t touch the law to request international support to prevent the weakening of these public health protections. But the tobacco lobby´s tentacles remain long. The presidents of five autonomous communities in which tobacco is cultivated –Extremadura, Andalusia, La Rioja, the Canary Islands and Cantabria-  recently signed a document opposing the new stronger Directive on tobacco control under discussion at the EU during a joint meeting celebrated in the headquarters of the tobacco company Altadis. Meanwhile, according to members of the Directorate General for Health & Consumers of the European Commission, there is a growing concern that former health commissioner John Dalli’s resignation may have been related to Big Tobacco’s strategies.

Health workers and other citizens must be aware of these manoeuvres and press health authorities at all levels that no concessions must be given to tobacco companies or others whose interests in profit threaten public health.


1.- Mcgrath, DS and Barret, SP (2009), The comorbidity of tobacco smoking and gambling: A review of the literature. Drug and Alcohol Review, 28: 676–681. doi: 10.1111/j.1465-3362.2009.00097.x

2.- McGrath DS, Barrett SP, Stewart SH, and McGrath PR. A Comparison of Gambling Behavior, Problem Gambling Indices, and Reasons for Gambling Among Smokers and Nonsmokers Who Gamble: Evidence from a Provincial Gambling Prevalence Study Nicotine Tob Res (2012) 14 (7): 833-839

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