Lobbying against tobacco tax increases in France: arguments and strategies of the tobacco industry and tobacconists analysed through their trade press.

INTRODUCTION: Raising taxes is one of the most cost-effective measures to reduce tobacco use. France has a unique profile: it has high tobacco use prevalence and a state monopoly on tobacco sales for tobacconists who are both agents of the customs administration and a recognised tobacco industry (TI) front group. In this paper, we investigate the lobbying tactics and arguments against tobacco taxation mobilised by the TI and tobacconists in France. METHODS: We conducted a quantitative and qualitative analysis of the two leading French tobacco trade media outlets (La Revue des Tabacs and Le Losange) between 2000 and 2020. We performed a manual thematic content analysis based on existing conceptual models of TI political activity, including the policy dystopia model. RESULTS: Tobacconists actively lobbied against tobacco taxation, using traditional arguments highlighted in conceptual models (ie, the claim that 'taxation increases illicit trade and is ineffective'), but also France-centric arguments (ie, tobacconists denounced the impact of cross-border shopping and highlighted their role as pivotal to community life in rural areas). We also found lobbying strategies mirroring those identified previously (ie, coalition, information management and direct influence in public policy). CONCLUSIONS: Tobacconists in France hold a specific status that gives them privileged access to government bodies that can be exploited to successfully lobby against tobacco taxation. NGOs need to expose these lobbying activities and alert the public authorities to Article 5.3 of the WHO Framework Convention on Tobacco Control that requires countries to protect policies from TI interests.

[Society. Why ban cigarette filters?] / Pourquoi faut-il interdire les filtres de cigarettes ?

WHY BAN CIGARETTE FILTERS? Tobacco consumption in the form of cigarettes is still perceived as being so ordinary that its result, the production of cigarette ends and their disposal, has long been invisible and overlooked. A cigarette end is composed of two parts: a remnant of unsmoked tobacco and a single-use plastic filter made of cellulose acetate. These two components are saturated with the many toxic products generated by cigarette combustion. The relatively recent growing awareness of the major contribution of cigarette filters to plastic pollution of soil, waterways, seas, and oceans has led to active national and international debate on the possibility and desirability of banning the use of these filters for environmental purposes. If such a ban were to be considered, it would be essential to anticipate the possible health consequences for cigarette smokers of such a measure. According to the World Health Organization (WHO), cigarette filters have no beneficial effect on smokers'health, and banning them is therefore becoming an ecologicalemergency.

POURQUOI FAUT-IL INTERDIRE LES FILTRES DE CIGARETTES ? La consommation de tabac sous la forme de cigarettes reste considérée comme tellement banale que ses conséquences, la production de mégots et leur élimination, ont longtemps été invisibles et négligées. Un mégot est constitué de deux parties : un reste de tabac non fumé entouré de papier et un filtre plastique à usage unique composé d'acétate de cellulose. Ces deux composants sont imprégnés par les nombreux produits toxiques résultant de la combustion de la cigarette. La prise de conscience, relativement récente, de l'importance majeure de la responsabilité des filtres de cigarettes dans la pollution plastique et chimique des sols, des cours d'eau, des mers et des océans conduit à une réflexion active, nationale et internationale, sur la possible et souhaitable interdiction de l'usage de c es filtres dans un bu t environnemental. Dans l'hypothèse où une telle interdiction serait envisagée, il est nécessaire d'anticiper les éventuelles conséquences sanitaires pour les fumeurs de cigarettes. Selon l'Organisation mondiale de la santé, les filtres de cigarettes n'ont aucun effet bénéfique sur la santé des fumeurs, et leur interdiction devient une urgence écologique.

Analyzing arguments on tobacco tax increases. Focus on French parliamentary questions and responses, 2000-2020.

INTRODUCTION: Tax increases are the most effective but still the least-used tobacco control measure. The tobacco industry (TI) employs lobbying strategies to oppose the implementation of tax policies on its products. Over the past two decades, French tobacco tax policies have been characterized by a relative inconsistency. This research aims to understand why, by analyzing the arguments of French policymakers (MPs and government) between 2000 and 2020 in favor or against tax increases. METHODS: To capture parliamentary debates, we performed an advanced term search on the French National Assembly website, using the keyword 'tobacco'. The search returned 5126 available documents out of which 1106 (12.6%, 645 questions, 461 responses) covered price and taxation and were included. They were analyzed using descriptive statistics and thematic content analysis (NVivo) and were compared, when relevant, to arguments raised in the international literature on TI lobbying against taxation increases. RESULTS: We found 3176 arguments on tobacco taxation: 77.2% were against tobacco tax increases and 22.7% were in favor of tax policies. Arguments varied depending on the source: 92.4% of MPs' arguments were against tax increases, while 52.1% of arguments from government responses were in favor. The anti-tax arguments were similar to those identified in the international literature that singled out negative economic and social consequences (illicit trade, penalizing tobacconists). Other arguments that were more specific to the French context, highlighted the key economic and social role played by tobacconists in France. Pro-tax arguments highlighted the health, economic and social benefits of tax policies. CONCLUSIONS: This is the first French tobacco research on parliamentary documents, although Parliament is a place of direct TI lobbying. It will enable public health actors to better understand the arguments used by the TI in order to counter them in front of MPs, and to better monitor debates in Parliament.

["Nicotine industry: risk reduction,an exclusively financial objective"]. / "Industriede la nicotine : réduction des risques, un objectif exclusivement financier".

Nicotine industry: harm reduction, an exclusively financial objective The knowledge of tobacco smoking health effects, combined with the implementation of measures efficient on its use, leads to tobacco sale reduction with tobacco industry financial losses that, in order to survive, has to recruit new young consumers, and maintain current smokers' use. The industry promotes a new way for tobacco use that, according to it, would reduce harm: heat-not-burn tobacco. But, there is currently no independent scientific proof for such a harm reduction. In the meantime, it promotes a confusion among electronic cigarettes and heat-not-burn tobacco. Heat-not-burn tobacco is promoted via foundations, NGOs, prestigious third parties, mechanic sports financing, and publicity with a strong marketing targeting young people through social networks. The current French regulation concerning smoked tobacco, including plain pack and high taxes, doesn't apply on heat-not-burn tobacco.

"Industrie de la nicotine : réduction des risques, un objectif exclusivement financier La connaissance des risques liés au tabac fumé associée à la prise de mesures efficaces pour réduire sa consommation conduit à la baisse des ventes avec chute des profits de l'industrie du tabac qui, pour survivre, doit recruter de nouveaux jeunes consommateurs et maintenir les usagers actuels dans leur consommation. L'industrie propose un nouveau mode de consommation qui, selon elle, permettrait de réduire les risques : le tabac chauffé. Or, aucune preuve scientifique indépendante n'existe d'une telle réduction de risques. En même temps, elle entretient la confusion entre cigarettes électroniques et tabac chauffé. Le tabac chauffé est promu par le biais de fondations, associations, relais prestigieux, financement des sports mécaniques et publicités avec un marketing intense ciblant les jeunes par les réseaux sociaux. La réglementation française concernant le tabac fumé ne s'applique pas au tabac chauffé, lui permettant ainsi d'échapper au paquet neutre et autorisant des profits majeurs par taxation plus légère."

[Tobacco industry strategies to attract new and young smokers]. / Stratégie de l'industrie du tabac pour recruter de nouveaux et jeunes fumeurs.

"Tobacco industry strategies to attract new and young smokers .Tobacco consumption, the paradigm of an industrial pandemic, has been declining in recent years around the world, following implementation of the recommendations of the WHO Framework Convention on Tobacco Control (FCTC). To survive, the four transnational companies that control the market must adapt their strategy, which they do by shifting from the tobacco trade to the wider nicotine trade through the promotion of new products (electronic cigarettes and heated tobacco products). However, two intangible but well-established facts remain: the initiation to tobacco/nicotine consumption occurs almost exclusively during childhood; on the other hand and that age group is very sensitive to marketing and purchasing impulses. Therefore, the industrials must target young people and ease their access to their products. Once the initial nicotine intake has been established, the drug takes over and enforces continuous consumption due to its highly addictive nature. Nonetheless, as explicit targeting of the youth is not a socially acceptable practice, the industry will conceal its strategy behind the façade of promoting harm reduction for adult smokers who wish to do this. Although communication channels are recent, such as the Internet, social media, platforms and more generally, what is commonly accepted as « communication below the line  ¼, the methods that aim at reinforcing established nicotine consumption as a social norm are of the same nature as those previously used for the promotion of cigarettes: glamour, seduction, youth, motorsports, tech, adventure, independence, maturity. Unfortunately, the rate of smoking among young people in France remains high due to the effectiveness of this marketing, combined with the easy accessibility to the product, due to non-compliance by tobacco sellers with the current legislation prohibiting sales to minors."

"Stratégie de l'industrie du tabac pour recruter de nouveaux et jeunes fumeurs .Paradigme d'une pandémie industrielle, la consommation de tabac baisse depuis quelques années dans le monde, à la suite de la mise en oeuvre des recommandations de la Convention-cadre de l'Organisation mondiale de la santé pour la lutte antitabac (CCLAT). Pour survivre, les quatre compagnies transnationales qui contrôlent le marché doivent adapter leur stratégie, ce qu'elles font en glissant du commerce du tabac vers celui, plus large, de la nicotine à travers la promotion de nouveaux produits (cigarettes électroniques et tabac chauffé). Toutefois, deux faits connus de longue date restent intangibles  : l'initiation à la consommation de tabac/nicotine se fait presque exclusivement dans l'enfance, et cet âge est très sensible au marketing et aux impulsions d'achat. Les industriels doivent donc cibler les jeunes et leur faciliter l'accessibilité à ses produits. Une fois la première consommation de nicotine assurée, celle-ci prend le relais en imposant la poursuite de son usage par son pouvoir addictif majeur. Cependant, cibler les jeunes n'étant pas énonçable, car socialement inacceptable, les industriels vont cacher leur stratégie derrière le faux nez que constitue la promotion d'une réduction des risques aux fumeurs adultes qui le souhaitent. Si les canaux de communication sont nouveaux, tels internet, les réseaux sociaux, les plateformes et, plus globalement, ce qu'il est convenu d'appeler « la communication sous le radar  ¼, les thèmes visant à conforter la consommation de nicotine comme une norme sociale établie sont de même nature que ceux utilisés précédemment pour la promotion des cigarettes  : glamour, séduction, jeunesse, sports mécaniques, technicité, aventure, autonomie, maturité. Malheureusement, le tabagisme des jeunes en France demeure encore élevé du fait de l'efficacité de ce marketing, combinée à la facilité d'achat de ces produits due au non-respect par les buralistes de la réglementation actuelle interdisant leur vente aux mineurs."

[Preventing tobacco sales to minors]. / Pour qu'acheter du tabac ne soit plus un jeu d'enfant !

Preventing tobacco sales to minors. Since 2009, selling tobacco products in France to minors less than 18 years of age is forbidden by law, but this law is poorly enforced even though tobacco use mainly begins at adolescence. The aim of this study was to identify measures implemented by foreign countries leading to a better enforcement of tobacco sale ban to minors. The main measures are: organizing tobacco retailers training programs; using automated age-verification systems; requiring a valid photo ID from anyone who looks under the age of 25; developing communication campaigns directed to the general public in order to explain and promote age control for customers. Furthermore, in all studied countries, the only effective controls rely on "mystery shopping" with underage shoppers accompanied by dedicated inspectors, attempting to purchase tobacco products. In case of non-compliance with the law, these controls must lead to dissuasive financial as well as administrative penalties. In all studied countries, an efficient implementation of these measures has led to reduced tobacco sales to minors, and thus contributed to bring down underage smoking.

Pour qu'acheter du tabac ne soit plus un jeu d'enfant ! En France, la vente de tabac est interdite aux moins de 18 ans depuis 2009, mais la loi est peu respectée alors que la plupart des nouveaux fumeurs commencent leur consommation à l'adolescence. Cette étude a pour objectif d'identifier les mesures mises en œuvre par des pays tiers permettant une meilleure application de l'interdiction de vente de tabac aux mineurs. Parmi ces mesures : la formation des détaillants de tabac ; l'utilisation dans les points de vente de systèmes de vérification automatisée de l'âge ; une vérification de l'âge de toute personne ayant l'apparence d'avoir moins de 25 ans ; le développement de campagnes de communication grand public pour expliquer et promouvoir le contrôle de l'âge des clients. Par ailleurs, les inspections « clients mystères ¼ apparaissent dans tous les pays étudiés comme le seul moyen de contrôle efficace. En cas de non-respect de la loi, ces inspections doivent donner lieu à des sanctions réelles et dissuasives, financières et administratives. Dans les pays étudiés, la mise en place conjointe de ces différentes mesures a permis de réduire la vente de tabac aux mineurs et de contribuer ainsi à diminuer le tabagisme des adolescents.

[Tobacco control in France: what's new ?] / Lutte contre le tabagisme en France : quoi de nouveau ?

French governments only very recently introduced comprehensive tobacco control policies including several measures recommended by WHO Framework Convention on Tobacco Control, leading to a speeding-up of tobacco smoking decrease, but still with a high current level of use. In the meantime, research confirms that nicotine is highly addictive, that smoking just a cigarette a day is highly detrimental for health, and that health professionals are efficient in helping smokers to give up. These measures are such diverse as tobacco taxes increases, introducing plain packs, promoting November as month without tobacco, getting tobacco cessation medications paid for by health insurances, implementing a comprehensive advertising ban of tobacco products in retailor shops, and increasing protection of public health policies from tobacco industry intrusion. This industry via frenzied marketing reacts by promoting "heat not burn tobacco" as a harm reduction mean, which it is not, and invests in e-cigarettes, whose most recent ones are as addictive as classic tobacco cigarettes.

LUTTE CONTRE LE TABAGISME EN FRANCE: QUOI DE NOUVEAU ?. Les gouvernements français proposent depuis seulement quelques années des programmes complets de mesures contre l'usage du tabac en s'appuyant sur les recommandations de la convention-cadre de l'Organisation mondiale de la santé pour la lutte anti-tabac, ce qui se traduit par une accélération de la baisse de sa consommation, avec toutefois une prévalence encore élevée. Parallèlement, les études confirment que la nicotine est une drogue forte, que fumer une seule cigarette par jour présente des risques sanitaires majeurs, et que les professionnels de santé peuvent aider les fumeurs à arrêter. Les mesures prises sont variées : augmentation des taxes, paquet neutre, Mois sans tabac, remboursement des traitements de la dépendance au tabac, interdiction de la publicité sur les lieux de vente, protection des politiques publiques de l'ingérence de l'industrie du tabac… Cette industrie réagit en promouvant le tabac chauffé via un marketing forcené sur une réduction des risques inexistante, et investit dans les cigarettes électroniques, dont les plus récentes sont aussi addictogènes que les cigarettes classiques.

Consumer Perceptions of Cigarette Design in France: A Comparison of Regular, Slim, Pink and Plain Cigarettes.

INTRODUCTION: The cigarette, like the cigarette pack, is used by tobacco companies as a promotional tool. We explore how the cigarette could potentially be used as a dissuasive tool. METHODS: An online survey was conducted with 15-30-year-old smokers and nonsmokers (N = 998) in France to explore their perceptions of a plain cigarette (gray with no brand name) and three branded cigarettes (regular, slim, pink). Participants were randomly assigned to view the plain cigarette and either the regular, slim, or pink cigarette. They were asked to rate the cigarettes by Appeal (tastiest, highest quality, and most expensive), Harm (most dangerous and most effective for motivating people to talk about tobacco dangers), and Perceived behavioral impact (most effective to convince teenagers not to start and to motivate smokers to reduce consumption and quit). RESULTS: In comparison to the gray cigarette, each of the branded cigarettes were considered more appealing, less harmful, and more likely to motivate teenagers to start and less likely to motivate smokers to reduce consumption or quit. CONCLUSIONS: The study suggests that altering the appearance of the cigarette may reduce cigarette appeal, increase harm perceptions, and deter both young people and smokers. IMPLICATIONS: Very little research has focused on dissuasive cigarettes whereas the cigarette stick has become very important for tobacco companies for communication purposes. This is the first study to compare the effect of various branded cigarettes (regular, slim, and pink) with a plain gray cigarette on young adult smokers and nonsmokers. The findings suggest that a plain gray cigarette can reduce cigarette appeal, increase perceptions of harm, and may deter use among both smokers and nonsmokers.

Perceptions of plain packaging among young adult roll-your-own smokers in France: a naturalistic approach.

BACKGROUND: We explored, for the first time, young adult roll-your-own smokers' response to using plain packaging in real-world settings. METHODS: Naturalistic research was employed, where 133 French young adult smokers (18-25 years of age) used plain roll-your-own packs for 10 days; the plain packs they were provided with contained their usual brand of rolling tobacco and displayed the name of their usual brand. Participants were recruited in five cities in France (Paris, Marseille, Metz, Nantes, Toulouse) and completed two questionnaires to measure their response to their own branded packs and the plain packs. Both questionnaires assessed pack perceptions, brand attachment, product perceptions (eg, taste, quality, natural), feelings about smoking (satisfying, pleasurable), feelings when using the pack in front of others (embarrassment, image), warning response (credibility, awareness of risks) and smoking-related behaviour (eg, consumption, quitting). RESULTS: Compared to their own fully branded packs, plain packs were associated with less positive pack and product perceptions, lower brand attachment and less positive feelings about smoking and feelings when using the pack in front of others. Participants were also more likely to report feeling like reducing consumption and quitting when using the plain packs, and more likely to feel like missing out on rolling a cigarette. No significant differences between the two pack types (plain and branded) were found in terms of credibility of warnings and perceptions of level of tar. CONCLUSIONS: The study suggests that the impacts of plain packaging for roll-your-own cigarette smokers are the same as for smokers of factory-made cigarettes.

Consumer perceptions of cigarette pack design in France: a comparison of regular, limited edition and plain packaging.

BACKGROUND: In the face of comprehensive bans on the marketing of tobacco products, packaging has become an increasingly important promotional tool for the tobacco industry. A ban on the use of branding on tobacco packaging, known as 'plain' packaging, has emerged as a promising regulatory strategy. The current study sought to examine perceptions of cigarette packaging among adults in France. METHODS: Adult smokers and non-smokers (N=836) were surveyed using computer-assisted personal interviewing to assess perceptions of pack design by comparing 'regular' branded packs and 'limited edition' packs (with novel designs or innovations) with 'plain' versions of these packs with all branding, including colour, removed. RESULTS: Plain packs (PP) were less likely than regular packs, and particularly limited edition packs, to be considered attractive, attention grabbing and likely to motivate youth purchase. PPs were also rated as the most effective in convincing non-smokers not to start and smokers to reduce consumption and quit. Logistic regression showed that smokers motivated to quit, in comparison to smokers not motivated to quit, were significantly more likely to consider the PPs as the packs most likely to motivate cessation. CONCLUSIONS: Novel cigarette packaging, in the form of limited edition packs, had the highest ratings of consumer appeal, ahead of regular branded packs and also PPs. Interestingly, PPs were perceived to be the packs most likely to promote cessation among those adults with quitting intentions. Plain packaging, therefore, may be a means of helping existing adult smokers motivated to quit to do so.

Consumer understanding of cigarette emission labelling.

The optimal way to display constituent levels (e.g. tar) on tobacco packaging has not received adequate attention but has important policy implications. Adult smokers and non-smokers (n = 836) were surveyed in France using Computer Assisted Personal Interviewing to assess perceptions of constituent levels displayed numerically (brand-specific tar and nicotine numbers from smoking machines and the current format in European Union), descriptively (a short sentence describing chemicals and their health effects but without any brand-specific numbers) or as a pack insert (a card placed on the inside of the pack describing the presence of chemicals and their health effects in more detail, as well as information on cessation). We also assessed perceptions of identically packaged cigarettes differing only on nicotine levels. Displaying information regarding ingredients either descriptively or on pack inserts was perceived as more comprehensible and informative than displaying them numerically. Numeric yields were associated with false beliefs: almost half the sample perceived packs with lower nicotine levels (0.8 mg vs. 0.9 mg) to be safer.

Tobacco advertising through French TV in 2005: frequent illicit broadcasting; its impact on teenagers and young adults.

BACKGROUND: Sports sponsorship is one of the tobacco industry's main strategies to recruit new smokers among teenagers and young adults. METHODS: Monitoring Motor sports illicit broadcasting based on six channels in 2005; Dakar Rally (DR) and China Grand Prix impact evaluated with a one on one questionnaire administered on 12-24-year-old males and females (n = 805). RESULTS: 75,000 TV tobacco sponsoring appearances (90 h) were observed, total value: euro200.10(6); Mild Seven, Marlboro, West, Lucky Strike, Gauloises Blondes accounted for 92% appearances and 95% of euro values, with illegal broadcasting value worth euro19.10(6). A high interest in DR (71%) and Formula One (F1) (66%) was observed among males (versus females; P < 0.001), increasing with age (P < 0.05). Levels of spontaneous and assisted recall of cigarette brands were high among individuals interested in DR and F1, with better recall of brand names (versus non interested; P < 0.01); all individuals made correct associations between tobacco brands and car colors (P < 0.01). A non-significant higher percentage of daily smokers was observed among respondents interested in DR (34 versus 21%; P < 0.01) and F1 (30 versus 24%; P = 0.10). CONCLUSION: This high level of indirect advertising for tobacco through motor sport sponsoring confirms the urgent need for a worldwide absolute ban on tobacco advertising in motor sports.