Nefely Taravira, Louis Laurence and Filippos T Filippidis

Article 5.3 of the World Health Organization’s (WHO) Framework Convention on Tobacco Control (FCTC) explicitly recommends that parties should not form partnerships with or participate in activities of the tobacco industry. Although more than 180 signatories have ratified the FCTC, including the European Union (EU) and all its member states, compliance across the EU is incomplete. This lack of compliance is illustrated by the recent pattern of partnerships between Phillip Morris International (PMI) and local authorities in three European countries; Greece, Spain, and the Czech Republic.

Astypalaia is a small Greek island in the Aegean Sea. In October 2018 Astypalaia’s Mayor announced, in a public event, a collaboration with Papastratos (the Greek subsidiary of PMI) with the aim to make the island “smoke-free”. The Mayor of Astypalaia was joined by the Regional Governor of Southern Aegean (both elected officials) and the Marketing Director of Papastratos. They all highlighted the stated aim of the collaboration was to improve the health and wellbeing of citizens and tourists through smoking bans in enclosed spaces and eventually in outdoor spaces. Smoking in enclosed public spaces has been banned in Greece since 2008 (law 3730/2008), although poorly enforced. The initiative described above was not accompanied by enforcement measures; locals and visitors were simply informed through videos, volunteers, brochures and posters provided by Papastratos and encouraged to comply. The Marketing Director of Papastratos stated publicly that “[…] a world without cigarettes is the future” and committed to supporting the Astypalaia initiative through worldwide promotion and acts of corporate social responsibility on the island. The Mayor of Astypalaia also suggested that in a smoke-free environment, smokers “[…] could attempt to stop smoking, […]but we understand that some people won’t quit, so we will inform them of the alternatives available”.

The example of Astypalaia has been followed by La Graciosa, a small Spanish island and by the spa city of Karlovy Vary in the Czech Republic. In all three cases, the pattern is similar. Participating cities partner with PMI and receive a ‘Smoke-free culture’ certification by TÜV Austria which, among others, requires them to “responsibly inform the employees of the organization who are cigarette smokers and consciously wish to continue smoking, regarding the potential and scientifically suggested alternative to cigarette choices”. Such references to alternative tobacco products, including heated tobacco products (HTP) are consistently made in official webpages and press releases and constitute a key element of this strategy.

This approach seems entirely consistent with PMI’s efforts to promote its HTP IQOS through its self-proclaimed commitment to a ‘smoke-free world’. To this end, PMI seeks opportunities to engage with local and national governments, as well as state-owned organisations, such as the Thessaloniki International Fair (TIF), the main international annual trade and consumer exhibition in Greece, which is organised by a state organisation (HELEXPO). TIF was self-declared smoke-free in 2018 with the support of Papastratos. Not surprisingly, in February 2020 the CEO of Papastratos clearly suggested a ‘better’ regulatory environment in the presence of multiple Greek government officials. A few months later, new legislation (law 4715/2020, article 36) was passed by the Greek government setting up a mechanism through which producers of novel tobacco products can receive approval to communicate claims of reduced harm to consumers.

The case of Astypalaia and the subsequent increased presence of PMI in Greek public affairs highlights the risks of the tobacco industry’s involvement in tobacco control policies. PMI seems determined to continue with this approach despite strong opposition from the public health community which hasn’t been able to reverse the decision of La Graciosa to partner with the tobacco industry. There is no doubt that the above mentioned activities are clear breaches of Article 5.3 of the FCTC; stronger implementation of the WHO’s recommendations at the local, national and EU level can limit the tools that the tobacco industry can employ to influence policies and indirectly promote its harmful products.

Aikaterini Nefeli Taravira is an MSc Public Health Student at the University of Bristol

Louis Laurence is a Researcher and writer for TobaccoTactics.org, part of the University of Bath’s Tobacco Control Research Group which is the research partner of the STOP project funded by Bloomberg Philanthropies.

Filippos T Filippidis is a Senior Lecturer in Public Health at Imperial College London.