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Plain, standardised cigarette pack

We want cigarette packs to look like this

We’re engaged in an epic battle with the tobacco industry over plain packaging.

The government has an open mind on the matter, and has extended its consultation until 10th August (i.e. this Friday).

But despite Big Tobacco claiming the policy will have no effect, Japan International Tobacco has launched a £2m advertising offensive to try to convince the British public to let Big Tobacco cling on to its last marketing outpost – the pack.

So we wanted to highlight three studies published in June that, taken together, reinforce the urgent need to stop cigarette companies marketing their deadly wares.

The first two studies show how tobacco companies manipulated national and international policy – first in the early days of the Czech Republic, then as the World Health Organisation tried to draw up its landmark Framework Convention on Tobacco Control.

The third looks at the change in lung cancer death rates over time, in different US states, where different degrees of tobacco control were in operation.

Individually, each paints a depressing picture. Collectively, they show why we must act urgently to put limits on tobacco marketing – here’s a link to our petition, but there’s another at the bottom of this post.

Cunning tactics

The first two studies appeared in the June edition of PLoS Medicine. Both drew on the Legacy Tobacco Documents Library – a vast, searchable, online repository of internal tobacco company memos and documents, spanning from 1989 to 2005. We’ll summarise their findings below, but both papers are freely and accessibly written – we recommend you download and digest them for the full picture (here and here).

Czech-ered history

“I support the fight against restrictions on smoking. … This is something other than the promotion of smoking… This is stupid; it is unreasonable and something that politicians should not do.”

- Vaclav Klaus, Czech Prime Minister, 2010

In 1989 communism collapsed. Four years later in 1993, Czechoslovakia split into Slovakia and the Czech Republic. The new Republic inherited a large, state-owned tobacco industry, which made several home-grown brands of cigarettes.

Over the next few years, this was privatised and sold off to multinational tobacco companies. By the time the Czech Republic joined the European Union in 2004, the country was awash with imported brands like Marlboro and Silk Cut, and many domestic cigarette factories had closed.

By this time, the Czech Republic had one of the highest rates of lung cancer in the developed world, and one of the poorest tobacco control records in Europe. In recent years, its senior politicians have frequently challenged international tobacco regulation in public.

But to what extent did Big Tobacco have a hand in this state of affairs?

To find out, a team of international researchers searched the Legacy Tobacco Documents Library for relevant references, interviewed key stakeholders and participants, and cast their net wider for newspaper articles, market reports and other sources that might help them piece together what had gone on.

Their collected evidence painted a shocking picture, showing how tobacco companies systematically:

  • ignored, weakened and ultimately overturned attempts to restrict tobacco advertising;
  • lobbied, with some success, for favourable tax structures (e.g. on import duties);
  • conspired to keep tobacco prices low, to stave off possible tax rises; and,
  • donated large sums of money to political parties to attempt to influence policy.

Perhaps as a result, the proportion of Czechs who smoke has changed little since 2000, and tobacco sales actually increased between 2000-2007 (although they’ve declined in recent years, “largely due to market conditions”, i.e. the recession, say the paper’s authors).

This isn’t a ‘scientific’ study in the traditional sense – but it’s a thoroughly researched historical and social analysis, drawing on thousands of archived sources and documented experiences, many of which were never intended for public consumption.

As such it represents a rare window into how these organisations operate outside North America.

But tobacco companies are multinational organisations. Do they operate in a similar way to try to manipulate international efforts to control tobacco use?

Globalised hypocrisy

The World Health Organisation’s Framework Convention on Tobacco Control is a landmark international treaty between 175 countries, who have all agreed to implement coordinated national policies on tobacco control. It took six years to negotiate: discussions kicked off in 1999 and the treaty came into force in February 2005.

It was the first international treaty specifically focused on improving global health.

Naturally, multinational tobacco companies campaigned heavily against the treaty which, in their own words, represented an “unprecedented challenge to the tobacco industry’s freedom to continue doing business”.  But no-one had ever carried out a comprehensive analysis of the methods they used.

Again relying on the Legacy Tobacco Documents Library, the researchers (who were part-funded by Cancer Research UK) examined how the same multinational tobacco companies behaved on the international stage, during the negotiations over the Framework.

The documents show how industry insiders developed and promoted several lines of argument, or ‘frames’, to try to block or water down the treaty. These included claims that:

  • The treaty would damage the world economy – despite it having the backing of free-market institutions such as the World Bank.
  • The treaty would “disrespect the poor” because tobacco-related diseases were a rich country’s issue (despite the fact that tobacco-related diseases are on the rise in most developing nations).
  • The treaty allegedly conflicted with international obligations on free trade (contrary to the opinion of the World Trade Organisation itself).
  • The treaty would interfere with nations’ sovereign rights.
  • It would be a ‘slippery slope’ leading to tighter regulation on other issues.

The documents also reveal a range of tactics, such as:

  • commissioning scientists to produce and disseminate reports supporting these arguments,
  • using the consultation process to try to slow the treaty’s progress,
  • mobilising other agencies and organisations (notably the International Tobacco Growers Association) to represent them,
  • and creating conflict between delegations from different nations.

(Again, we urge you to read the full report, which expands on all these points. It’s free to view or download from the PLoS Medicine website).

But is this really so surprising? In the world of political campaigning and lobbying, none of these issues or actions is illegal, or even unusual. And it could be argued that, as global corporations, tobacco companies have a legal duty to their shareholders to maximise their profit margins.

In this light, tobacco companies are behaving no differently than any other globalised industry.

But tobacco companies market an addictive product that sends an estimated 5 million people to an early grave every year – a number that’s predicted to grow to more than 8 million in 2030. By 2015, tobacco is projected to kill 50 per cent more people than HIV/AIDS, and to be responsible for one death in ten.

No other global industry can claim such a lethal degree of brand loyalty.

Let’s look at a third piece of research, which rams home why we at Cancer Research UK are desperate to see an end to tobacco marketing.

A sad state of affairs

The final piece in our jigsaw puzzle is a study of how lung cancer death rates changed in different US states between 1973 and 2007.

Since there there’s been considerable migration in the US over this period, and because Hispanic and black people have different risks of lung cancer to white people (for a variety of reasons), the researchers restricted their analysis to white women. This allowed them to exclude any effects that were due to changes in the balance of ethnic populations.

Using SEER – a large, population-level database of health records, they looked at what happened to women who were born in different years, tracking the death rates in the elderly, middle aged and young, state by state.

Publishing their findings in the June 2012 edition of Journal of Clinical Oncology, the researchers elegantly show how, in the state with the strictest tobacco control policy – California – lung cancer death rates continued to fall (in most age groups), while rates tended to plateau in states with less stringent regimes.

But in states with lax tobacco policy – for example, tobacco-growing Alabama (which had a tobacco tax of 42 cents per pack, under half that of New York’s $1/pack) lung cancer death rates continued to climb – especially in younger women, born since 1950.

Because of the statistical rigour of the study, the researchers are convinced that the effects they’re seeing are due to changes in smoking rates. As they argue:

Factors in addition to smoking that may contribute to differences in lung cancer mortality trends [include] occupational and environmental exposures. However, the contributions from these are likely to be modest or minimal, since cigarette smoking in the United States accounts for more than 70% of lung cancer deaths in women.

Further, cigarette smoking and subsequent lung cancer mortality patterns by birth cohorts have shown parallel trends in the United States.

What this study underlines is that the ultimate goal of tobacco control policies – to prevent people from dying prematurely of diseases like cancer – is achievable.

In other words, taking action against tobacco saves lives.

Take action now

And yet tobacco companies stubbornly resist these policies. As we’ve seen, they take advantage of globalised markets, yet cry foul when policy makers draw up globalised health policies. They say they want to work with policy makers, yet fund groups to oppose them. They say international policy is a breach of nations’ sovereign rights, yet spend hundreds of thousands of pounds to influence politicians.

And they say plain packaging won’t work, but spend £2 million on advertising to campaign against it.

We want the government to force these companies to sell their addictive, deadly products in plain packaging, to make them less attractive to children. There’s solid evidence it will work, which you can read here.

You need to ask yourself, right now, are you going to sign our petition? The answer is plain.

Petition button

Please sign this before Friday (August 10th) to make your voice heard.

And we’d love it if you could forward a link to this post, or the petition, to your friends and family.

Together we can end the packet racket.

Henry


References:

  • Shirane, R. et al (2012). Tobacco Industry Manipulation of Tobacco Excise and Tobacco Advertising Policies in the Czech Republic: An Analysis of Tobacco Industry Documents, PLoS Med, 9 (6) DOI: 10.1371/journal.pmed.1001248.t003
  • Weishaar, H. et al (2012). Global Health Governance and the Commercial Sector: A Documentary Analysis of Tobacco Company Strategies to Influence the WHO Framework Convention on Tobacco Control, PLoS Med, 9 (6) DOI: 10.1371/journal.pmed.1001249.t002
  • Jemal, A., Ma, J., Rosenberg, P.S., Siegel, R. & Anderson, W.F. (2012). Increasing Lung Cancer Death Rates Among Young Women in Southern and Midwestern States, Journal of Clinical Oncology, 30 (22) 2744. DOI: 10.1200/JCO.2012.42.6098

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Comments

John Farley August 10, 2012

PLAIN PACKAGING OF TOBACCO – ANOTHER ASSAULT ON OUR SOCIAL LIVES

When New Labour lost the last 2012 election many of us hoped we would at last be free of government intolerance and interference in our social lives and that we might get a break from ‘the nanny state’.

Neither The Conservatives nor The Lib Dems seemed to realize that and we now have a coalition government. Had The Conservations agreed to amend the smoking ban to allow smokers – 20% of the population – to smoke indoors in public places they would probably have won the election outright. But they did not and smokers continued to be forced outside to smoke in freezing temperatures risking colds, flu, pneumonia and days off work.

The health of the smoker should be respected as well as the health of the non-smoker. Smokers should be allowed to smoke indoors in warm public places and non-smokers should be protected from passive smoking. A free society should allow that.

Plain packaging for cigarettes and tobacco will create more demand and curiosity amongst children especially if hidden and sold ‘under the counter’ like an illegal substance – cannabis, cocaine and heroin do not come in attractive packets.

When New Labour brought in the ban in 2007 I immediately purchased 200 cigarettes and started smoking again. Stopping smoking is said to increase life by about ten years. However not all of us want to end our days on a geriatric ward, a place that will become more and more unbearable as successive governments struggle to find enough funding.

The laws against smoking were brought about by the
intolerance of one part of society inflicting its values on another part of society. It is outrageous arrogance that will create unexpected consequences. Today, many parents of poorer families compromise their children’s diet by spending less on food in order to afford the ever-increasing price of cigarettes and alcohol.

Yours sincerely,
John Farley

email@democraticchoice.co.uk

Michael Farthing August 10, 2012

As a result of listening to you views on plain packaging I shall never support Cancer UK and shall use my best endeavours to discourage others from doing so.

This is at heart an issue of the rights of human beings to govern there own lives. It is clear that Cancer Research believes and believes deeply that human beings should at best be coerced and bribed and at worst compelled to behave in a way that others consider to be in their best interest. It is a subtle form of attack on basic human freedoms to argue on the basis that you are doing good: it is the same defence used for wars, religious intolerance, anti-gay propaganda and the attack on the right to end ones own life.

I am a non-smoker, have always been a non-smoker, and find the habit disgusting and repulsive, but I shall defend till my dying breath the right of others to freely choose their own lifestyle, without bribery or coercion. If they die as a result, or decide they regret their choice, then that is part of being a human being, in much the same way that those who climb Everest risk death is so doing.

Henry Scowcroft August 8, 2012

C Winfield: Decades of research have proven that smoking is a major cause of cancer. In fact, it is the single biggest preventable cause of cancer, and is responsible for one in four UK cancer deaths, and nearly a fifth of all cancer cases. We want to beat cancer, so smoking is not something we are willing to ignore.

If you want to read more about the preventable causes of cancer, you may be interested in this blog post:

http://scienceblog.cancerresearchuk.org/2011/12/07/the-causes-of-cancer-you-can-control/

And we suspect your final point “chemotherapy causes healthy cells to feed growth of cancer tumours” may be down to some misguided headlines this week. Please read our blog, which explains the research:

http://scienceblog.cancerresearchuk.org/2012/08/06/headlines-about-backfiring-chemotherapy-are-misleading/

Steve: Thanks for your support – yes £433m is an awful lot of money, but scientific research is expensive, and cancer is incredibly complex. You might find these links interesting:

http://scienceblog.cancerresearchuk.org/2009/10/27/the-multi-million-pound-question/

http://scienceblogs.com/insolence/2011/02/21/why-cant-we-cure-cancer/

The first is about how we spend our money each year; the second is a really excellent post from a US blogger about quite how phenomenally complex cancer is – it’s a long one, but worth it.

Henry
Cancer Research UK

Steve August 8, 2012

Strange comment from ”the archivist”. If people didn’t smoke, then the money raised could be spent on researching cures for diseases which aren’t 100% self-inflicted. Although I have to say I was astounded to read thet £433 MILLION was raised last year alone – where does all this money go? That is an insane amount, surely if money is the answer you must be very close to a cure? How on earth does it cost that every year?

That aside, Cancer Research are doing fantastic work not just on smoking (and yes I’m a smoker) but in so many other areas. keep it up!!

C Winfield August 8, 2012

Whe is CRUK going to stop preaching anti-smoking propaganda and start looking for the real cause and cure for cancers.Chemotherapy causes healthy cells to feed growth of cancer tumors

Henry Scowcroft August 8, 2012

We’re sorry you feel that way. Tobacco is responsible for one in four cancer deaths. Half of long-term smokers die from an addiction, which, for most smokers, begins in their teens – it’s not an adult choice. 85 per cent of smokers tell us they regret ever starting.

Putting tobacco in plain packs will help protect the next generation, by preventing tobacco companies from using the surface of tobacco packs as an advertising space – a space that’s part of an advertising/marketing strategy aimed at encouraging people to smoke.

We have a long record of funding research into how to reduce the harms from smoking, and then advocating to have that research implemented. Campaigning to put tobacco in plain packs is part of that effort.

Henry
Cancer Research UK

The Archivist August 7, 2012

I think you are an absolute disgrace for the simple reason that you are invading people’s rights of choice. It is none of your business if someone chooses to smoke, it is their business. You doing nothing but killing businesses and causing poverty.
Last year you garnered £433,000,000 from people wanting to see a cure for cancer, yet you spend hundreds of thousands of donators money on plain packaging campaigns. You are a complete disgrace!