Pharmaceuticalisation as the tobacco industry's endgame.

CONTEXT: Declining smoking prevalence and denormalisation of tobacco in developed countries reduced transnational tobacco company (TTC) profit during 1990s and 2000s. As these companies faced increasingly restrictive policies and lawsuits, they planned to shift their business to socially acceptable reduced-harm products. We describe the internal motivations and strategies to achieve this goal. METHODS: We analysed previously secret tobacco industry documents available through the Truth Tobacco Documents Library. These documents were triangulated with TTCs' investor and other professional reports, websites and public statements. FINDINGS: Mimicking pharmaceutical business models, tobacco companies sought to refurbish their image and ensure long-term profitability by creating and selling pharmaceutical-like products as smoking declined. These products included snus, heated tobacco products, e-cigarettes, nicotine gums and inhalers. Tobacco companies created separate divisions to develop and roll out these products, and the majority developed medical research programmes to steer these products through regulatory agencies, seeking certification as reduced-harm or pharmaceutical products. These products were regarded as key to the survival of the tobacco industry in an unfriendly political and social climate. CONCLUSIONS: Pharmaceuticalisation was pursued to perpetuate the profitability of tobacco and nicotine for tobacco companies, not as a sincere search to mitigate the harms of smoking in society. Promotion of new pharmaceuticalised products has split the tobacco control community, with some public health professionals and institutions advocating for the use of 'clean' reduced-harm nicotine and tobacco products, essentially carrying out tobacco industry objectives.

'No-Barriers' tobacco product? Selling smokeless tobacco to women, people of colour and the LGBTQ+ community in the USA.

BACKGROUND: In both Sweden and the USA, smokeless tobacco (ST) is legal and used predominantly by men. Starting in the 1970s, US tobacco companies attempted to expand the ST market to women, African Americans, Hispanic Americans and lesbian, gay, bisexual, transgender, queer and other sexual orientation (LGBTQ+) people. DESIGN: We analysed industry documents from the Truth Tobacco Industry Documents Library triangulating findings with recent ST advertising and publicly available literature. FINDINGS: We found tobacco companies used design innovations such as pouched moist snuff, snus and dissolvable products to expand the market. In addition, diverse advertising campaigns targeted women, people of colour (Hispanic, African American) and LGBTQ+ communities with identity-targeted messages emphasising novelty, convenience, cleanliness and use in smoke-free environments. However, stereotypes of ST users as rural white males endured, perpetuated by continued marketing aimed at this customer base, which created cognitive dissonance and stymied marketer's hopes that pouch products would 'democratize' ST. CONCLUSION: These failed campaigns suggest novel products such as nicotine pouch products may provide a 'clean slate' to similarly target women and other low-ST-using groups. Based on this history, the risk of new tobacco and nicotine products to increase health disparities should be closely monitored.

Mobilizing COVID-19 level public health interventions for climate breakdown is necessary.

The COVID-19 pandemic has proven that extraordinary public health measures can pivot every aspect of society. Norms, politics, economics, and business practices rapidly responded to coordinated simultaneous policies worldwide. This begs the question of why such advancements have not yet been similarly executed to reduce the short- and long-term morbidity and mortality due to environmental destruction and climate change. This article reviews various reasons explaining the discrepancy between the policies of these two health threats, using a terror management theory lens. Exploring how anthropogenic climate change potentiated the contagion and outcomes of COVID-19, the environmental determinants of health deserve increased attention in public discourse. The industry-driven response to COVID-19 also has exacerbated preexisting health inequalities and vulnerabilities, suggesting that a just transition for climate change must not repeat some of the same mistakes taken in global pandemic measures. Finally, addressing emergency health harms in ways that create increased environmental health harms is deemed iatrogenic, displacing rather than truly treating disease. Thus, a planetary health model focused on multisolving health issues is recommended for the basis of addressing COVID-19 and other health disasters.

The environmental externalities of tobacco manufacturing: A review of tobacco industry reporting.

Growing research and public awareness of the environmental impacts of tobacco present an opportunity for environmental science and public health to work together. Various United Nations agencies share interests in mitigating the environmental costs of tobacco. Since 2000, transnational tobacco industry consolidation has accelerated, spotlighting the specific companies responsible for the environmental and human harms along the tobacco production chain. Simultaneously, corporate social responsibility norms have led the industry to disclose statistics on the environmental harms their business causes. Yet, independent and consistent reporting remain hurdles to accurately assessing tobacco's environmental impact. This article is the first to analyze publicly available industry data on tobacco manufacturing pollution. Tobacco's significant environmental impact suggests this industry should be included in environmental analyses as a driver of environmental degradation influencing climate change. Countries aiming to meet UN Sustainable Development Goals must act to reduce environmental harms caused by the tobacco industry.

I am a fake loop: The effects of advertising-based artificial selection.

Mimicry is common among animals, plants, and other kingdoms of life. Humans in late capitalism, however, have devised an unique method of mimicking the signs that trigger evolutionarily-programmed instincts of their own species in order to manipulate them. Marketing and advertising are the most pervasive and sophisticated forms of known human mimicry, deliberately hijacking our instincts in order to select on the basis of one dimension only: profit. But marketing and advertising also strangely undermines their form of mimicry deceiving both the intended targets and the signaler simultaneously. Human forms of mimicry have the regular consequence of deceiving the imitator, reducing meta-cognitive awareness of the act and intentions surrounding such deception. Therefore, the deceiver in the end deceives himself as well as intended targets. Drawing on scholarship applying Niko Tinbergen's the ethological discovery of supernormal stimuli in animals to humans, this article analyzes sophisticated mass mimicry in contemporary culture, in both intended and unintended forms.

Public versus internal conceptions of addiction: An analysis of internal Philip Morris documents.

BACKGROUND: Tobacco addiction is a complex, multicomponent phenomenon stemming from nicotine's pharmacology and the user's biology, psychology, sociology, and environment. After decades of public denial, the tobacco industry now agrees with public health authorities that nicotine is addictive. In 2000, Philip Morris became the first major tobacco company to admit nicotine's addictiveness. Evolving definitions of addiction have historically affected subsequent policymaking. This article examines how Philip Morris internally conceptualized addiction immediately before and after this announcement. METHODS AND FINDINGS: We analyzed previously secret, internal Philip Morris documents made available as a result of litigation against the tobacco industry. We compared these documents to public company statements and found that Philip Morris's move from public denial to public affirmation of nicotine's addictiveness coincided with pressure on the industry from poor public approval ratings, the Master Settlement Agreement (MSA), the United States government's filing of the Racketeer Influenced and Corrupt Organizations (RICO) suit, and the Institute of Medicine's (IoM's) endorsement of potentially reduced risk products. Philip Morris continued to research the causes of addiction through the 2000s in order to create successful potentially reduced exposure products (PREPs). While Philip Morris's public statements reinforce the idea that nicotine's pharmacology principally drives smoking addiction, company scientists framed addiction as the result of interconnected biological, social, psychological, and environmental determinants, with nicotine as but one component. Due to the fragmentary nature of the industry document database, we may have missed relevant information that could have affected our analysis. CONCLUSIONS: Philip Morris's research suggests that tobacco industry activity influences addiction treatment outcomes. Beyond nicotine's pharmacology, the industry's continued aggressive advertising, lobbying, and litigation against effective tobacco control policies promotes various nonpharmacological determinants of addiction. To help tobacco users quit, policy makers should increase attention on the social and environmental dimensions of addiction alongside traditional cessation efforts.