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.”