Tobacco industry tactics for resisting public policy on health

The tactics used by the tobacco industry to resist government regulation of its products include conducting public relations campaigns, buying scientific and other expertise to create controversy about established facts, funding political parties, hiring lobbyists to influence policy, using front groups and allied industries to oppose tobacco control measures, pre-empting strong legislation by pressing for the adoption of voluntary codes or weaker laws, and corrupting public officials. Formerly secret internal tobacco industry documents provide evidence of a 50-year conspiracy to "resist smoking restrictions, restore smoker confidence and preserve product liability defence". The documents reveal industry-wide collusion on legal, political and socially important issues to the tobacco industry and clearly demonstrate that the industry is not disposed to act ethically or responsibly. Societal action is therefore required to ensure that the public health takes precedence over corporate profits. Recommendations for reducing the political influence of the tobacco industry include the following. Every tobacco company in every market should publicly disclose what it knew about the addictiveness and harm caused by tobacco, when it obtained this information, and what it did about it. The industry should be required to guarantee internationally recognized basic consumer rights to its customers. Trade associations and other industry groupings established to deceive the public should be disbanded. These recommendations should be incorporated into WHO's Framework Convention on Tobacco Control.     

Consent and Counter-Mobilization: The Case of The National Smokers Alliance

Throughout the 1990s, health advocates engaged in a significant mobilization against the dangers of tobacco use and the tobacco industry. In 1993, the tobacco industry countermobilized through the National Smokers Alliance (NSA), a public relations created front group funded by the tobacco industry, which operated nationally from 1994 to 1999 to advocate for adults using tobacco products without vigorous regulation or increased tobacco taxes. The mobilization by health groups utilized traditional political lobbying and education of the public and public officials without a national public relations created front group to mold public opinion. The countermobilization by the NSA was based on traditional lobbying approaches in conjunction with the use of the public relations oriented consent engineering theory of Edward Bernays, Harold Lasswell, and others. This consent engineering theory calls for public relations specialists using public relations to mold public opinion to support a client's preferred public policy outputs. Despite the use of traditional lobbying in conjunction with the use of public relations efforts, attempts by the NSA to dominate public policy to weaken or neutralize stronger tobacco regulations and taxes were effective only for some campaigns.     

Consent and counter-mobilization: the case of the national smokers alliance

Throughout the 1990s, health advocates engaged in a significant mobilization against the dangers of tobacco use and the tobacco industry. In 1993, the tobacco industry counter-mobilized through the National Smokers Alliance (NSA), a public relations created front group funded by the tobacco industry, which operated nationally from 1994 to 1999 to advocate for adults using tobacco products without vigorous regulation or increased tobacco taxes. The mobilization by health groups utilized traditional political lobbying and education of the public and public officials without a national public relations created front group to mold public opinion. The counter-mobilization by the NSA was based on traditional lobbying approaches in conjunction with the use of the public relations oriented consent engineering theory of Edward Bernays, Harold Lasswell, and others. This consent engineering theory calls for public relations specialists using public relations to mold public opinion to support a client's preferred public policy outputs. Despite the use of traditional lobbying in conjunction with the use of public relations efforts, attempts by the NSA to dominate public policy to weaken or neutralize stronger tobacco regulations and taxes were effective only for some campaigns.     

"A whole 'nother smoke" or a cigarette in disguise: how RJ Reynolds reframed the image of little cigars

Present-day consumption of little cigars rivals that of the early 1970s when sales of little cigars boomed. This boom was largely attributed to RJ Reynolds, and documents reveal how and why they became a powerful force in little cigar sales. RJ Reynolds designed a little cigar, Winchesters, for cigarette smokers and produced one as close to a cigarette as legally possible. Initially, RJ Reynolds intended to capitalize on the cigarette advertising broadcast ban, but the price and tax structure was more critical to Winchester's success. Today, the tobacco industry is fighting again to sustain its unique application of federal definitions for little cigars. Regulatory efforts are needed to close taxation loopholes for the little cigar.     

The Duluth clean indoor air ordinance: problems and success in fighting the tobacco industry at the local level in the 21st century

Case study methodology was used to investigate the tobacco industry's strategies to fight local tobacco control efforts in Duluth, Minn. The industry opposed the clean indoor air ordinance indirectly through allies and front groups and directly in a referendum. Health groups failed to win a strong ordinance because they framed it as a youth issue rather than a workplace issue and failed to engage the industry's economic claims. Opponents' overexploitation of weaknesses in the ordinance allowed health advocates to construct a stronger version. Health advocates should assume that the tobacco industry will oppose all local tobacco control measures indirectly, directly, or both. Clean indoor air ordinances should be framed as workplace safety issues.     

Tobacco industry allegations of "illegal lobbying" and state tobacco control

OBJECTIVES: This study assessed the perceived effect of tobacco industry allegations of "illegal lobbying" by public health professionals on policy interventions for tobacco control. METHODS: Structured interviews were conducted with state health department project managers in all 17 National Cancer Institute-funded American Stop Smoking Intervention Study (ASSIST) states. Documentation and media records related to ASSIST from the National Cancer Institute, health advocates, and the tobacco industry were analyzed. RESULTS: The tobacco industry filed formal complaints of illegal lobbying activities against 4 ASSIST states. These complaints had a temporary chilling effect on tobacco control policy interventions in those states. ASSIST states not targeted by the tobacco industry developed an increased awareness of the industry's tactics and worked to prepare for such allegations to minimize disruption of their activities. Some self-reported self-censorship in policy activity occurred in 11 of the 17 states (65%). CONCLUSIONS: Public health professionals need to educate themselves and the public about the laws that regulate lobbying activities and develop their strategies, including their policy activities, accordingly.     

"If you know you exist, it's just marketing poison": meanings of tobacco industry targeting in the lesbian, gay, bisexual, and transgender community

In the public health literature, it is generally assumed that the perception of "targeting" as positive or negative by the targeted audience depends on the product or message being promoted. Smoking prevalence rates are high among lesbian, gay, bisexual, and transgender (LGBT) individuals, but little is known about how they perceive tobacco industry targeting. We conducted focus groups with LGBT individuals in 4 US cities to explore their perceptions. Our findings indicated that focus group participants often responded positively to tobacco company targeting. Targeting connoted community visibility, legitimacy, and economic viability. Participants did not view tobacco as a gay health issue. Targeting is a key aspect of corporate-community interaction. A better understanding of targeting may aid public health efforts to counter corporate disease promotion.     

Our Challenge: Beware of A- Literacy

For more than three decades , public policy makers and public health officials have had conclusive evidence of the hazards of tobacco use , yet tobacco products remain legal , accessible , and acceptable in our society . Public health advocates have been unable to develop a consistent , coordinated message powerful enough to combat the influence of the tobacco industry . Studying the way in which the tobacco issue has been framed in the mass media over the past decade may provide important clues as to why public health efforts to overcome the tobacco industry's influence on public policy and on tobacco use have not been entirely successful . This paper describes and analyzes the predominant framing tactics used by the tobacco industry and by tobacco control advocates for the last 11 years by reviewing 179 front - page articles from the New York Times and the Washington Post during this period . We conclude that while the tobacco industry has created a central message and theme which has been used constructively and consistently over time , the tobacco control movement has not developed a consistent , powerful , and compelling message . Developing such a message may be important if the nation is to restore progress in reducing tobacco use .     

Tobacco industry efforts at discrediting scientific knowledge of environmental tobacco smoke: a review of internal industry documents

STUDY OBJECTIVE: Using tobacco industry internal documents to investigate the use of tobacco industry consulting scientists to discredit scientific knowledge of environmental tobacco smoke (ETS). DESIGN: Basic and advanced searches were performed on the Philip Morris, Tobacco Institute, R J Reynolds, Brown and Williamson, Lorillard, and the Council for Tobacco Research document web sites, with a concentration on the years 1985-1995. Guildford depository files located on the Canadian Council on Tobacco Control website were also searched. The documents were found in searches undertaken between 1 March and 30 June 2000. MAIN RESULTS: The industry built up networks of scientists sympathetic to its position that ETS is an insignificant health risk. Industry lawyers had a large role in determining what science would be pursued. The industry funded independent organisations to produce research that appeared separate from the industry and would boost its credibility. Industry organised symposiums were used to publish non-peer reviewed research. Unfavourable research conducted or proposed by industry scientists was prevented from becoming public. CONCLUSIONS: Industry documents illustrate a deliberate strategy to use scientific consultants to discredit the science on ETS.     

Tobacco industry attempts to counter the World Bank report Curbing the Epidemic and obstruct the WHO framework convention on tobacco control

In 1999 the World Bank published a landmark study on the economics of tobacco control, Curbing the Epidemic: Governments and the Economics of Tobacco Control (CTE), which concluded that tobacco control brings unprecedented health benefits without harming economies, threatening the transnational tobacco companies' ability to use economic arguments to dissuade governments from enacting tobacco control policies and supporting the WHO Framework Convention on Tobacco Control (FCTC). We used tobacco industry documents to analyze how tobacco companies worked to discredit CTE. They hired public relations firms, had academics critique CTE, hired consultants to produce "independent" estimates of the importance of tobacco to national economies, and worked through front groups, particularly the International Tobacco Growers' Association, to question CTE's findings. These efforts failed, and the report remains an authoritative economic analysis of global tobacco control during the ongoing FCTC negotiations. The industry's failure suggests that the World Bank should continue their analytic work on the economics of tobacco control and make tobacco control part of its development agenda.     

Boards of Health as venues for clean indoor air policy making

OBJECTIVES: This study sought to determine the tobacco industry's strategies for opposing health board actions and to identify elements necessary for public health to prevail. METHODS: Newspaper articles, personal interviews, and tobacco industry documents released through litigation were reviewed. RESULTS: Twenty-five instances in which the tobacco industry opposed health board regulations were identified. It was shown that the tobacco industry uses 3 strategies against health boards: "accommodation" (tobacco industry public relations campaigns to accommodate smokers in public places), legislative intervention, and litigation. These strategies are often executed with the help of tobacco industry front groups or allies in the hospitality industry. CONCLUSIONS: Although many tobacco control advocates believe that passing health board regulations is easier than the legislative route, this is generally not the case. The industry will often attempt to involve the legislature in fighting the regulations, forcing advocates to fight a battle on 2 fronts. It is important for health boards to verify their authority over smoking restrictions and refrain from considering non-health factors (including industry claims of adverse economic impacts) so as to withstand court challenges.     

健康服务业内涵、属性分析及政策启示

目前国内对健康服务业的内涵、属性等问题研究仍不够深入,认识尚不统一,发展定位也不清晰。本文通过综述健康服务业理论研究和政策实践的进展,提出了健康服务业是以维护和促进健康为目的,主要由提供健康服务的消费性和相关生产性服务业组成,广义上也可以包含产品制造等相关支撑产业和其他服务关联产业。通过深入分析健康服务业所具有的服务业、医疗卫生行业、福利性、产业经济、公共服务业等属性和特点,提出如下政策启示:发展健康服务业要遵循服务业和经济产业发展的一般规律,注重发挥政府在政策规制等方面的主导作用,充分发挥市场机制在优化资源配置、激发行业活力等方面的独特优势,大力推动健康服务提供主体的多元化发展等。     

Salud,hostelería e industria del tabaco

To present the strategies used by the tobacco industry to meet government regulatory measures of its products. To demonstrate the relationship between tobacco industry and the hospitality sector. Note that the arguments and strategies used routinely by the hospitality industry have been previously provided by the tobacco industry.Location of key documents by meta-search, links to declassified documents, specific websites of the tobacco and hospitality industry, news sources and published articles in health journals.This review reveals the close relationship between tobacco industry and hospitality sector. It highlights the strategies carried out by the tobacco industry, including strategic hoarding of information, public relations, lobbying, consultation program, smoker defence groups, building partnerships, intimidation and patronage. The arguments and strategies used by the hospitality industry to match point by point that used by the tobacco industry.These arguments are refutable from the point of view of public health as it is scientifically proven that totally smoke-free environments are the only way to protect non-smokers from tobacco smoke exposure and its harmful effects on health.     

Antismoking advertisements for youths: an independent evaluation of health, counter-industry, and industry approaches

OBJECTIVES: We used a validated copy test method to examine the effectiveness of 8 types of antismoking advertisements representing health, counterindustry, and industry approaches. We tested the hypothesis that health ads about tobacco victims can lower most adolescents' intent to smoke if the ads elicit disgust and anti-industry feelings rather than fear. We hypothesized null effects for adolescents with conduct disorder because of their abnormally low empathy. METHODS: Ninth-grade students from 8 California public schools (n=1725) were randomly assigned to view 1 of 9 videotapes containing a TV show with ads that included either a set of antismoking ads or a set of control ads. Participants completed baseline measures assessing personality traits and postexposure measures assessing smoking intent, feelings, beliefs, and ad evaluations. RESULTS: Ads focusing on young victims suffering from serious tobacco-related diseases elicited disgust, enhanced anti-industry motivation, and reduced intent to smoke among all but conduct-disordered adolescents. Counterindustry and industry ads did not significantly lower smoking intention. CONCLUSIONS: Sponsors of tobacco use prevention ad campaigns should consider using ads showing tobacco-related disease and suffering, not just counterindustry ads. Ads should be copy tested before airing.     

Tobacco industry surveillance of public health groups: the case of STAT (Stop Teenage Addiction to Tobacco) and INFACT (Infant Formula Action Coalition)

OBJECTIVES: The goal of this study was to describe how the tobacco industry collects information about public health groups. METHODS: Publicly available internal tobacco industry documents were reviewed and analyzed using a chronological case study approach. RESULTS: The industry engaged in aggressive intelligence gathering, used intermediaries to obtain materials under false pretenses, sent public relations spies to the organizations' meetings, and covertly taped strategy sessions. Other industry strategies included publicly minimizing the effects of boycotts, painting health advocates as "extreme," identifying and exploiting disagreements, and planning to "redirect the funding" of tobacco control organizations to other purposes. CONCLUSIONS: Public health advocates often make light of tobacco industry observers, but industry surveillance may be real, intense, and covert and may obstruct public health initiatives.     

The "global settlement" with the tobacco industry: 6 years later

On June 20, 1997 a group of attorneys and health advocates proposed a "global settlement" of all public and private litigation against the tobacco industry. This agreement was controversial, and the subsequent implementing legislation was defeated. We sought to determine whether the global settlement represented a "missed opportunity" or a dead end. We compared the global settlement with subsequent laws, regulations, settlements, and judgments against the tobacco industry and found that other than Food and Drug Administration regulation of tobacco, tobacco control advocates have achieved many of the policies included in the global settlement and several beyond it. The policies that have been developed since 1997 have advanced tobacco control substantially, often beyond the provisions of the global settlement.     

The atlas network: a “strategic ally” of the tobacco industry

Amid growing academic and policy interest in the influence of think tanks in public policy processes, this article demonstrates the extent of tobacco industry partnerships with think tanks in the USA, and analyzes how collaborating with a network of think tanks facilitated tobacco industry influence in public health policy. Through analysis of documents from tobacco companies and think tanks, we demonstrate that the Atlas Economic Research Foundation, a network of 449 free market think tanks, acted as a strategic ally to the tobacco industry throughout the 1990s. Atlas headquarters, while receiving donations from the industry, also channeled funding from tobacco corporations to think tank actors to produce publications supportive of industry positions. Thirty‐seven per cent of Atlas partner think tanks in the USA received funding from the tobacco industry; the majority of which were also listed as collaborators on public relations strategies or as allies in countering tobacco control efforts. By funding multiple think tanks, within a shared network, the industry was able to generate a conversation among independent policy experts, which reflected its position in tobacco control debates. This demonstrates a coherent strategy by the tobacco industry to work with Atlas to influence public health policies from multiple directions. There is a need for critical analysis of the influence of think tanks in tobacco control and other health policy sectors, as well as greater transparency of their funding and other links to vested interests. © 2016 The Authors The International Journal of Health Planning and Management Published by John Wiley & Sons Ltd     

The power of a frame: an analysis of newspaper coverage of tobacco issues--United States, 1985-1996

For more than three decades, public policy makers and public health officials have had conclusive evidence of the hazards of tobacco use, yet tobacco products remain legal, accessible, and acceptable in our society. Public health advocates have been unable to develop a consistent, coordinated message powerful enough to combat the influence of the tobacco industry. Studying the way in which the tobacco issue has been framed in the mass media over the past decade may provide important clues as to why public health efforts to overcome the tobacco industry's influence on public policy and on tobacco use have not been entirely successful. This paper describes and analyzes the predominant framing tactics used by the tobacco industry and by tobacco control advocates for the last 11 years by reviewing 179 front-page articles from the New York Times and the Washington Post during this period. We conclude that while the tobacco industry has created a central message and theme which has been used constructively and consistently over time, the tobacco control movement has not developed a consistent, powerful, and compelling message. Developing such a message may be important if the nation is to restore progress in reducing tobacco use.     

The tobacco industry’s challenges to standardised packaging: A comparative analysis of issue framing in public relations campaigns in four countries

Tobacco industry public relations campaigns have played a key role in challenges to standardised cigarette packaging. This paper presents a comparative analysis of industry campaigns in Australia and the United Kingdom, which have implemented standardised packaging legislation; Canada, where policy has been adopted but not yet implemented; and the Netherlands, which has considered, but not enacted regulation. Campaigns were identified via Google searches, tobacco industry websites, media coverage, government submissions and previous research; analysis focused on issue framing and supporting evidence. Public relations campaigns in all case study countries drew on similar frames - the illicit trade in tobacco products, the encroaching ‘nanny state’, lack of evidence for the effectiveness of standardised packaging, a slippery slope of regulation, and inherent threats to intellectual property rights. These claims were supported by industry research, front groups and commissioned reports by accountancy firms, but were not with verifiable research. Independent evidence that contradicted industry positions was overlooked. Similarities in structure and content of public relations campaigns in countries that have enacted or considered regulation points to a strategic co-ordinated approach by cigarette manufacturers. Countries considering standardised packaging policy can expect powerful opposition from the tobacco industry. Tobacco control communities and policy makers can learn from previous experience, and share best practise in countering industry arguments.     

Attempts to undermine tobacco control: tobacco industry "youth smoking prevention" programs to undermine meaningful tobacco control in Latin America

We sought to understand how the tobacco industry uses "youth smoking prevention" programs in Latin America. We analyzed tobacco industry documents, so-called "social reports," media reports, and material provided by Latin American public health advocates. Since the early 1990s, multinational tobacco companies have promoted "youth smoking prevention" programs as part of their "Corporate Social Responsibility" campaigns. The companies also partnered with third-party allies in Latin America, most notably nonprofit educational organizations and education and health ministries. Even though there is no evidence that these programs reduce smoking among youths, they have met the industry's goal of portraying the companies as concerned corporate citizens and undermining effective tobacco control interventions that are required by the World Health Organization Framework Convention on Tobacco Control.