Countering the influence of tobacco.

Tobacco advertising regulations need to adapt if they are to meet the challenges posed by a rapidly evolving social media and tobacco product landscape. Gary Humphreys reports.

Quality evaluation of natural monomer flavors for Chinese tobacco industry based on dual mode combined Fourier transform ion cyclotron resonance mass spectrometry and isotopic fine structures.

RATIONALE: Natural monomer flavors can modify the taste of cigarettes. However, no report was published to establish the quality control method for their chemical compositions. METHODS: In this study, licorice, a traditional natural monomer flavor used in tobacco aroma processing, was selected, and the fingerprint was developed by high-performance liquid chromatography (HPLC). Next, the chemical markers of samples from different places of origin were discovered by multivariate statistical analysis. Then, its chemical constituents were identified by combination of HPLC-Fourier transform ion cyclotron resonance mass spectrometry (FT-ICR-MS), direct infusion FT-ICR-MS (DI-FT-ICR-MS), and the technology of isotopic fine structures (IFSs). Moreover, its characteristic constituents were quantitatively analyzed using HPLC. RESULTS: The 14 common peaks were assigned in the fingerprint, and 8 of them were considered as qualitative markers by multivariate statistical analysis. A total of 42 chemical constituents were detected using HPLC-FT-ICR-MS, and 13 of them were unambiguously identified by references. Meanwhile, the elemental compositions of other eight unknown chemical components were decisively determined using IFSs. Subsequently, the contents of five characteristic constituents in 11 batches of samples were determined. CONCLUSIONS: The integration strategy established here can discover and quantify the chemical markers for improving the quality control standard of natural monomer flavor of licorice. It is expected that the strategy will be valuable for further quality control of other natural monomer flavors in Chinese tobacco industry.

Adopting a WHO Framework Convention on Tobacco Control-Based Tobacco Control Law in Ethiopia: Sustained Transnational Health Advocacy and Multi-Sectoral Institutionalized Support.

OBJECTIVE: The objective of this study was to document how Ethiopia adopted a WHO Framework Convention on Tobacco Control (FCTC)-based tobacco control law. METHODS: We analyzed publicly available documents, including news media articles, advocacy reports, and government documents. We triangulated these findings by interviewing nine key stakeholders. Data were analyzed to construct a historical and thematic narrative and analyzed through a retrospective policy analysis. RESULTS: Local and international health advocacy efforts helped introduce and support WHO FCTC-based legislation by (1) educating policymakers about the WHO FCTC, (2) providing legal assistance in drafting legislation, (3) generating local data to counter industry claims, and (4) producing media advocacy to expose industry activity. Health advocates worked closely with government officials to create a multi-sectoral tobacco committee to institutionalize efforts and insulate tobacco companies from the policymaking process. Japan Tobacco International bought majority shares of the government-owned tobacco company and attempted to participate in the process, using standard industry tactics to undermine legislative efforts. However, with health advocacy assistance, government officials were able to reject these attempts and adopt a WHO FCTC-based law in 2019 that included 100% smoke-free indoor places, a comprehensive ban on tobacco advertising, and large pictorial health warning labels, among other provisions. CONCLUSION: Sustained local health advocacy efforts supported by international technical and financial assistance can help establish WHO FCTC-based tobacco control laws. Applying a standardized multi-sectoral approach can establish coordinating mechanisms to further institutionalize the WHO FCTC as a legal tool to build support with other government sectors and insulate the tobacco industry from the policymaking process.

Tobacco policy (in)coherence in Mozambique: an examination of national and subnational stakeholder perspectives.

Mozambique ranks fifth on the list of tobacco producing countries in Africa, while also being a Party to the WHO Framework Convention on Tobacco Control (FCTC). Tobacco farming is regarded by some governments as a strategic economic commodity for export and remains deeply entrenched within Mozambique's political and economic landscape. This study uses a qualitative description methodology to identify tensions, conflicts and alignment or misalignment in policy on tobacco across government sectors and levels in Mozambique. We conducted semi-structured qualitative interviews with 33 key informants from sectors across national and subnational levels including health, agriculture, economic and commercial sectors, as well as non-state actors from civil society organizations, the tobacco industry, farmers unions and associations and individual farmers. Incoherence was present across sectoral mandates, perspectives on industry's presence in the country and regions and between FCTC provisions and informant perceptions of tobacco production as a development strategy. Despite tobacco being viewed as an important economic commodity by many informants, there was also widespread dissatisfaction with tobacco from both farmers and some government officials. There were indications of an openness to shifting to a policy that emphasizes alternatives to tobacco growing. The findings also illustrate where points of convergence exist across sectors and where opportunities for aligning tobacco policy with the provisions of the FCTC can occur.

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.

What if your research is suddenly affiliated with a tobacco manufacturing company?

The tobacco industry is accountable for an annual global death toll of approximately 8 million people and cigarette smoking is the foremost risk factor for several types of cancer. In addition, the tobacco industry has a long and controversial history of trying to influence scientific research and of engaging in other morally problematic practices. In September 2021, the respiratory community was alarmed by the takeover of Vectura Group (Vectura) by Philip Morris International. As a reaction to this acquisition, strict measures were imposed by the International Respiratory Societies to prohibit the involvement of Vectura in respiratory research and its participation in societies' activities. International Respiratory Societies argued that Vectura had become part of the tobacco industry due to this takeover and is, therefore, subject to the same rules and restrictions. From a healthcare and historical perspective, the reaction and imposed measures are very understandable. However, for researchers that were already affiliated with Vectura through long-standing agreements and for research that was funded by Vectura, the imposed measures have serious consequences. With this article, we provide an example of these consequences. By reflecting on this issue, we would like to start a conversation regarding the current measures and to encourage the respiratory community to begin thinking of a way to avoid these consequences in the future. In addition, we hope that with this conversation the Respiratory Societies can set an example for other medical societies on how to cope with possible morally tainted affiliations (eg, fast food companies, alcohol manufacturing companies) in the future.

O consumo de tabaco está diminuindo, apesar dos esforços da indústria do tabaco para comprometer o progresso

Em todo o mundo, há 1,25 bilhão de adultos usuários de tabaco, de acordo com as últimas estimativas do relatório de tendências de tabaco da Organização Mundial da Saúde (OMS) divulgado hoje.

Addressing tobacco industry influence in tobacco-growing countries.

Protecting policy-making from tobacco industry influence is central to effective tobacco control governance. The inclusion of industry actors as stakeholders in policy processes remains a crucial avenue to corporate influence. This influence is reinforced by the idea that the tobacco industry is a legitimate partner to government in regulatory governance. Addressing the influence of the tobacco industry demands a focus on the government institutions that formalize relationships between industry and policy-makers. Industry involvement in government institutions is particularly relevant in tobacco-growing countries, where sectors of government actively support tobacco as an economic commodity. In this paper, we discuss how controlling tobacco industry influence requires unique consideration in tobacco-growing countries. In these countries, there is a diverse array of companies that support tobacco production, including suppliers of seeds, equipment and chemicals, as well as transportation, leaf buying and processing, and manufacturing companies. The range of companies that operate in these contexts is particular and so is their engagement within political institutions. For governments wanting to support alternatives to tobacco growing (Article 17 of the Framework Convention for Tobacco Control), we illustrate how implementing Article 5.3, aimed at protecting tobacco control policies from tobacco industry interference, is fundamental in these countries. Integrating Article 5.3 with Article 17 will (i) strengthen policy coherence, ensuring that alternative livelihood policies are not undermined by tobacco industry interference; (ii) foster cross-sector collaboration addressing both tobacco industry interference and livelihood development; and (iii) enhance accountability and transparency in tobacco control efforts.

Éviter que l'élaboration de politiques soit influencée par l'industrie du tabac est essentiel pour assurer une gestion efficace de la lutte antitabac. L'inclusion d'acteurs de l'industrie comme parties prenantes des processus législatifs demeure l'un des principaux leviers employés par les sociétés. Cette influence est renforcée par l'idée que l'industrie du tabac constitue un partenaire légitime du gouvernement dans le domaine de la gouvernance réglementaire. Pour lutter contre l'ingérence du secteur, il faut se concentrer sur les institutions gouvernementales qui officialisent les relations entre l'industrie et les responsables politiques. L'implication de l'industrie dans les institutions publiques est surtout observée dans les pays producteurs de tabac, où certains niveaux de gouvernement soutiennent activement le tabac en tant que bien économique. Dans le présent document, nous abordons le fait qu'une lutte contre l'influence de l'industrie du tabac requiert une attention particulière dans les pays producteurs, où un large éventail d'entreprises encouragent la production de tabac: approvisionnement en semences, équipements et produits chimiques, mais aussi transport, achat des feuilles, transformation et fabrication. La variété des entreprises œuvrant dans de tels contextes est spécifique, tout comme leur engagement au sein des organes politiques. Pour les gouvernements qui souhaitent privilégier les alternatives à la production de tabac (selon l'article 17 de la Convention-cadre pour la lutte antitabac), nous montrons à quel point l'application de l'article 5.3, qui vise à protéger les politiques de lutte antitabac contre l'ingérence de l'industrie, est fondamentale dans ces pays. Intégrer l'article 5.3 dans l'article 17 permettra (i) de renforcer la cohérence des politiques en vigueur, afin que les politiques relatives à des activités de remplacement ne soient pas contrecarrées par l'industrie du tabac; (ii) de favoriser la collaboration entre les secteurs pour lutter contre l'influence de l'industrie tout en développant des moyens de subsistance; et enfin, (iii) d'accroître la responsabilisation et la transparence dans les efforts menés dans la lutte antitabac.

Proteger la formulación de políticas contra la influencia de la industria tabacalera es fundamental para una gobernanza eficaz del control del tabaco. La inclusión de los actores de la industria como partes interesadas en los procesos políticos sigue siendo una vía crucial para la influencia corporativa. Esta influencia se ve reforzada por la idea de que la industria tabacalera es un asociado legítimo del gobierno en la gobernanza reglamentaria. La lucha contra la influencia de la industria tabacalera exige centrarse en las instituciones gubernamentales que formalizan las relaciones entre la industria y los responsables de formular políticas. La participación de la industria en las instituciones gubernamentales es especialmente relevante en los países productores de tabaco, donde algunos sectores del gobierno apoyan activamente el tabaco como un bien económico. En este documento, se analiza cómo el control de la influencia de la industria tabacalera requiere una consideración especial en los países productores de tabaco. En estos países, existe una gran variedad de empresas que apoyan la producción de tabaco, incluidos los proveedores de semillas, equipos y productos químicos, así como las empresas de transporte, de compra de hojas y de procesamiento y fabricación. La variedad de empresas que operan en estos contextos es particular y también lo es su compromiso dentro de las instituciones políticas. Para los gobiernos que desean apoyar alternativas al cultivo de tabaco (es decir, el artículo 17 del Convenio Marco para el Control del Tabaco), se ilustra cómo la aplicación del artículo 5.3, destinado a proteger las políticas de control del tabaco de la interferencia del tabaco, es fundamental en estos países. La integración del artículo 5.3 con el artículo 17 (i) reforzará la coherencia política, asegurando que las políticas de medios de vida alternativos no se vean perjudicadas por la interferencia de la industria tabacalera; (ii) fomentará la colaboración intersectorial al abordar tanto la interferencia de la industria tabacalera como el desarrollo de los medios de vida; y (iii) mejorará la rendición de cuentas y la transparencia en los esfuerzos de control del tabaco.

Association between Tobacco Industry Interference Index (TIII) and MPOWER measures and adult daily smoking prevalence rate in 30 countries.

BACKGROUND: This study aimed to investigate the impact of tobacco industry interference on the implementation and management of tobacco control and the tobacco epidemic using the Tobacco Industry Interference Index (TIII) and MPOWER-a package of measures for tobacco control-and adult daily smoking prevalence in 30 countries. METHODS: The TIII was extracted from the Global Tobacco Industry Interference Index 2019 and Global Center for Good Governance in Tobacco Control (GGTC). MPOWER measures and adult daily smoking prevalence rate were extracted from the World Health Organization (WHO) report on the global tobacco epidemic in 2021. We assessed the ecological cross-lagged association between TIII and MPOWER scores and between TIII and age-standardized prevalence rates for adult daily tobacco users. RESULTS: Tobacco industry interference was inversely correlated with a country's package of tobacco control measures (ß = -0.088, P = 0.035). The TIII was correlated with weaker warnings about the dangers of tobacco (ß = -0.016, P = 0.078) and lack of enforcement of bans on tobacco advertising promotion and sponsorship (ß = -0.023, P = 0.026). In turn, the higher the TIII, the higher the age-standardized prevalence of adult daily tobacco smokers for both sexes (ß = 0.170, P = 0.036). Adult daily smoking prevalence in males (ß = 0.417, P = 0.004) was higher in countries where the tobacco industry received incentives that benefited its business. CONCLUSION: Where the interference of the tobacco industries was high, national compliance with the Framework Convention on Tobacco Control (FCTC) was lower, and the prevalence of adult daily smokers higher. National governments and global society must work together to minimize the tobacco industry's efforts to interfere with tobacco control policies.

Use of Brand Engagement Appeals in US Cigarette and E-Cigarettes Ads (2019-2020).

Background: The tobacco industry has historically used brand engagement - communication tactics companies use to increase customer attachment to a brand and brand loyalty - to recruit and retain consumers. Limited information is available to assess the brand engagement tactics used to promote the two most popular tobacco products in the US - cigarettes and electronic cigarettes (e-cigarettes) - across different advertising platforms (e.g., direct-to-consumer (DTC), social media). Material and methods: We acquired 520 cigarette and 5,502 e-cigarette ads that ran in the US January 2019 to December 2020 from market research firms (Kantar, Numerator), Rutger's University ad surveillance website (trinketsandtrash.org), and branded social media accounts. Ads were double-coded for eight types of brand engagement tactics: Price Promotion, Sweepstakes, Mobile App, Email/Mail List, Free Gift, Social Media engagement request, Sponsored Events, and Auto-Ship subscription program. We report presence of brand engagement tactics by product type and advertising platform. Results: Overall, 62.9% of cigarette ads and 49.9% of e-cigarette ads contained at least one brand engagement tactic. For cigarette ads, the most common tactics were Sweepstakes and Mobile App requests, which were most commonly featured in DTC ads. For e-cigarettes, the most common tactic was Price Promotion which was featured in most DTC and online e-cigarette ads. Conclusions: Brand engagement was common in this sample of cigarette and e-cigarette ads. Our findings highlight key differences in the type of brand engagement tactic used to promote each product on different advertising platforms. Results can inform continued advertising surveillance studies and regulatory efforts.

Denormalization of tobacco and its industry by civil society: Implementation and evaluation of the "Pouvoir de vivre" campaign by ACT ­ Alliance Contre le Tabac (Alliance Against Tobacco) / Dénormalisation du tabac et de son industrie par la société civile : mise en œuvre et évaluation de la campagne « Pouvoir de vivre ¼ par l'ACT ­ Alliance contre le tabac

This article examines the "denormalization" approach, which has gradually gained ground in the field of tobacco control. This process encompasses a wide range of practices and aims to renew tobacco control by extending its scope beyond the usual individual and health considerations; it also considers smoking as a societal problem. This contribution illustrates the implementation of this approach, as embodied in France by the Alliance Contre le Tabac denormalization program launched in 2019, through campaigns addressing a diverse range of themes. The latest campaign, carried out in January 2023, demonstrates that smoking also exacerbates the social and economic difficulties of the most disadvantaged members of society. Its presentation illustrates the deployment of such a campaign, the methodology used, the tools mobilized, and the results obtained by carrying out a post-test.

Cet article présente l'approche dite de dénormalisation, qui s'est progressivement imposée dans le champ de la lutte contre le tabac. Cette démarche regroupe un ensemble varié de pratiques et entend renouveler les méthodes de la lutte contre le tabac en élargissant sa portée au-delà des considérations individuelles et sanitaires habituelles ; elle envisage le tabagisme en tant que problématique sociétale. Cette contribution illustre la mise en œuvre de cette approche, incarnée en France par les campagnes de dénormalisation de l'Alliance Contre le Tabac depuis 2019. La dernière campagne réalisée en janvier 2023 démontre que le tabagisme, au-delà de son impact sanitaire, aggrave aussi les difficultés financières quotidiennes des personnes les plus modestes. La présentation de ce dispositif permet d'illustrer le déploiement de ce type de campagne, la méthodologie utilisée, les outils mobilisés et les résultats obtenus, grâce à la réalisation d'un post-test.

Popular Votes on Tobacco Tax Increases, 2012-2022.

CONTEXT: Researchers have examined the campaign strategies, messaging, and outcomes of popular votes on tobacco tax increases from 1998 to 2008, but no study has investigated measures that have appeared since 2008. METHODS: The author uses state newspaper archives, voter pamphlets, academic reports, advocacy websites, and personal interviews to obtain information about the 11 tobacco tax increase ballot measures that appeared from 2012 to 2022. FINDINGS: The three measures that succeeded during 2012-2022 featured sufficient financial resources, collaboration with influential stakeholders, and early public support. Two of the three successful measures offered significant concessions to the tobacco industry, and both were designed as legislatively referred statutes. Elsewhere, proponents sought unsuccessfully to enact citizen-led initiatives that would allocate revenue to progressive policy priorities. In contrast to previous eras, tobacco industry arguments often centered around antitax and antigovernment rhetoric, which was viewed as especially compelling in conservative states. The industry's success rate was higher than in the past, and it continued to outspend its opponents, sometimes by staggering margins. CONCLUSIONS: Campaign spending and early support remain critical to the success of tobacco tax ballot measures. Big Tobacco can extract significant concessions even in defeat, and direct democracy is an effective but imperfect ally to tobacco control advocates.

Litígios no Brasil: Aditivos

A Resolução da Diretoria Colegiada da Anvisa (RDC) 14/2012 regula o uso de aditivos em produtos de tabaco. A norma prevê a relação exaustiva de aditivos proibidos de serem utilizados em produtos de tabaco (art. 6º), assim como daqueles expressamente permitidos (art. 7º), e franqueou às empresas fabricantes apresentarem novos requerimentos, a qualquer tempo, para uso dos aditivos proibidos, mediante justificativa (§ 2º, art. 7º). Essa resolução consiste em medida de prevenção ao tabagismo. Não há cigarro seguro para consumo, e a razão para a proibição de aditivos, como de sabor e aromas, é que eles aumentam a atratividade e palatabilidade de produtos do tabaco e, portanto, facilitam a iniciação ao tabagismo, principalmente entre crianças e adolescentes. Alguns aditivos aumentam a capacidade do produto causar dependência química.