International tobacco companies

David Simpson

Director, International Agency on Tobacco and Health

Visiting Professor, London School of Hygiene & Tropical Medicine

Honorary Fellow, Clinical Trial Service Unit, Oxford

Editor, News Analysis, Tobacco Control journal

World’s smokers

1.2

1.64

0123456789

billions

1999 2025

SmokersPopulation

From the US Bureau of the Census and World Bank, Curbing the epidemic: Governments and the economics of tobacco control, 1999.

Smoking prevalence: men

4248

25

45

0

10

20

30

40

50

60

70

80

90

100

%

1999 2025

Industrialisedcountries

Developingcountries

WHO data

Smoking prevalence: women

24

7

20 20

0

10

20

30

40

50

60

70

80

90

100

%

1999 2025

Industrialisedcountries

Developingcountries

WHO data

World tobacco deaths

4.2

10

0123456789

10

millions

2001 2030

WHO World Health Report 1999 ..

Cumulative tobacco deaths

116

430

140

20

140

0

50

100

150

200

250

300

350

2000-2024 2025-2049

Avoidable if adult smokinghalved by 2020

Avoidable if uptake halvedby 2020

Remaining tobacco deaths

millionsper annum

WHO World Health Report 1999.

Tobacco addiction is a communicated disease:

The vector? Big tobacco

Trans-national tobacco companies’ sales (1990)

0 10 20 30 40 50 60US$ billions

TNC sales &developing countries’ gross domestic product (GDP)

0 10 20 30 40 50 60US$ billions

Philip Morris

BAT

Japan Tobacco

Peru

Bangladesh

Kenya

Senegal

Sri LankaGhana

Hungary

BAT(highest paid director)

£0

£500,000

£1,000,000

£1,500,000

1991 1992 1993 1994 1995 1996 1997 1998 1999 2000

IATH BAT director

IATH(total income)

&

Annual earnings:

The international tobacco industry

Philip Morris – PM (holding company now known as ‘Altria’)

British American Tobacco – BAT (includes Rothmans)

Japan Tobacco International – JTI (still state-controlled; former JT + non-US business of RJR Reynolds)

Marlboro, Chesterfield,Philip Morris

State Express 555, Lucky Strike, Benson & Hedges, Rothmans

Mild Seven, Salem

also: Altadis (France/Spain, formerly SEITA & Tabacalera);

Imperial (UK), incl. Reemtsma (Germany) ; ITC India (part-BAT);

Monopolies, e.g. Tekel (Turkey), Sampoerna (Indonesia), etc

A brief tobacco industry history of the tobacco epidemic

1940s +50s

1960s + 70s

1980s

1990s

2000-2003

- scientific evidence forces health-related scientific research

- development of government health policy; - industry scientists lose power to marketing executives

- expand international activities; - use toxic reduction health policy as hostage to preserve advertising

- litigation increases; - Minnesota case releases millions of papers; - health advocacy increases

- ‘We’ve changed!’ programmes, e.g. BAT’s ‘Social reports’; - FCTC process puts tobacco on health agenda worldwide; - continue to expand markets as fast as possible

Two unique aspects of the tobacco industry:

The product: highly addictive

very dangerous, at any level of consumption; largest cause of disease, disability & premature death

The people: self-selected group, not concerned by scientific evidence of diseases caused by tobacco

One simple truth about the tobacco industry:

The companies will always fight every effective health policy measure

Senegal

Cape Times, South Africa, Oct 1993

Trinidad, 1998

Uganda, Tanzania & Kenya, Dec 2001

- “We don’t want kids to smoke”

- global ad code (self-regulation…)

- “Let us back into the scientific community”

- community aid programmes

Tobacco industry ‘We’ve changed’ strategy:

Tobacco industry ‘We’ve changed’ strategy:

“We don’t want kids to smoke”

Industry ‘Youth Prevention’ programmes:

- public relations strategy: improve image

- ‘proactive’ - industry avoids ad bans

- programme says little on dangers of tobacco

- programmes shown to be ineffective*

- “adult activity” - may encourage kids to smoke *

* DiFranza J & McAfee T. The Tobacco Institute: Helping youth to say ‘yes’ to tobacco.• J Fam Prac 1992,34(6)

“The youth program... support[s] the [Tobacco] Institute’s objective of discouraging unfair... federal, state and local restrictions on cigarette advertising,

by...”

US Tob. Inst. 1/1991

• “Reinforcing the belief that peer pressure - not advertising - is the cause of youth smoking.

US Tob. Inst. 1/1991

• “Reinforcing the belief that peer pressure - not advertising - is the cause of youth smoking.

• “Seizing the political center and forcing the antismokers to an extreme…”

US Tob. Inst. 1/1991

“The strategy is fairly simple:

“1. Heavily promote industry opposition to youth smoking.”

US Tob. Inst. 1/1991

“The strategy is fairly simple:

“1. Heavily promote industry opposition to youth smoking.

“2. Align industry with broader, more sophisticated view of the problem - that is, parental inability to offset peer pressure.”

US Tob. Inst. 1/1991

“The strategy is fairly simple:

“1. Heavily promote industry opposition to youth smoking.

“2. Align industry with broader, more sophisticated view of the problem - that is, parental inability to offset peer pressure.”

“3. Work with and through credible child welfare professionals and educators to tackle the ‘problem’.”

US Tob. Inst. 1/1991

“The strategy is fairly simple:

“1. Heavily promote industry opposition to youth smoking.

“2. Align industry with broader, more sophisticated view of the problem - that is, parental inability to offset peer pressure.”

“3. Work with and through credible child welfare professionals and educators to tackle the ‘problem’.”

“4. Bait anti-tobacco forces to criticise industry efforts.”

US Tob. Inst. 1/1991

Industry youth programmes:

Uzbekistan

Industry youth programmes:

Middle East

Tobacco industry ‘We’ve changed’ strategy:

‘global advertising code’ (self-regulation)

“We have analyzed the 9-page agreement and believe that the multinationals' strategy is proactive and is a way to improve their image.”

- Herzog B, Credit Suisse , investors’ briefing.

Oct ‘01

Tobacco industry global advertising code

- a Wall Street analyst’s view:

Tobacco industry ‘We’ve changed’ strategy:

“Let us back into science”

- make health policy dependent on tobacco

- split the scientific community

- tie up research resources on non-tobacco topics

- corporate ‘blackmail’ against legislation

‘Tobacco industry ‘We’ve changed’ strategy:“Let us back into science”

“We all decided not to accept the tobacco company [money] in the end & now trying to find alternate source of funding …

“Some time I feel isolated in Pakistan when I give my strong feelings against the tobacco..”

IATH Contact, Karachi, Nov ‘01

Tobacco industry’s ‘science’ programmes

- a note from Pakistan:

Botswana

Senegal, May 1998

Philippines, 1995

Pakistan, May 2000

246

87

105

142 144

123131

175

222

188

241

70

5869

80 8697 97

104 108 109 113112

47

0

50

100

150

200

250

300

1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003

Contacts Countries

IATH’s Contacts / Countries

1991

2002

International Agency on Tobacco and Health (IATH)

Contacts’ e-mail & web access, Nov 2001

no network accessemail accessemail + web

by Contact (n = 240)

no emailemail/+

by Country (n = 112)