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Allan Hackshaw lecture

Professor Allan Hackshaw gave a public lecture at UCL

The success of global tobacco marketing is undeniable.

Over decades, tobacco companies have somehow managed to maintain common myths about smoking: it makes you look cool, relieves stress, and manages to make both men and women look sexy.

As a result, and in defiance of the long-established health risks associated with smoking (including increased risk of cancer, heart disease and respiratory diseases) – which result in half of long-term smokers dying as a result of their habit – the tobacco industry continues to make eye-watering profits.

And rates of smoking are increasing in countries with the highest levels of population growth.

Indeed, as the tobacco industry itself likes to boast – “If you can market a product that kills people, you can sell anything”. Smoking causes 6 million deaths each year around the world, yet 1 billion people worldwide still smoke.

So, asked Professor Allan Hackshaw, in the last in a series of ‘Lunchtime Lectures’ at University College London: Are cigarettes the most ‘successful’ product ever?

Lethal marketing

Allan Hackshaw

Professor Allan Hackshaw

That lung cancer was responsible for the death of the actor who modelled ‘The Marlboro Man’ is “quite shocking”, said Hackshaw, deputy director of the Cancer Research UK/UCL Clinical Trials Centre. But the fact that this happened twice is “simply tragic”.

Such overt advertising has thankfully been banned in many countries – including the UK – and, as a result, smoking rates in these areas have generally been in decline for decades.

Yet still the tobacco industry outspends governments by large margins.

For example, in 2011, the US Government spent $517.9 million (£343.5 million) on programmes to educate people about tobacco’s harms, and dissuade young people from smoking. By contrast, in 2008, the tobacco industry spent a combined $9.9 billion dollars on marketing and advertising in the USA. When the USA – the richest country in the world – is outspent by nearly 20 to 1, the efforts of countries with far fewer resources risk being stubbed-out.

As a result, even where advertising restrictions are in operation, tobacco has continued to be a massively profitable industry.             

Professor Hackshaw pointed out that globally, in 2010, the six biggest tobacco companies made $35.1billion in profit; that’s the same as the profits from Microsoft, McDonald’s and Coco-Cola put together. This illustrates that even with high-taxation, a billion addicted smokers worldwide means the volume of sales is staggering – and the profit follows.

But these profits come at a cost. There is a common misconception, said Hawkshaw, that nearly all the price of a pack of cigarettes goes towards tax revenues. But in fact, the opposite is true: tax revenue from UK tobacco sales is actually slightly less than its social costs, according to the 2010 report “Cough Up” from the think-tank Policy Exchange.

In fact, the report calculated, each cigarette smoked in England costs the UK taxpayer 6.5 pence.

Declining markets

Professor Hackshaw explained that on the face of it, the tobacco industry has an uphill struggle; not only does its product kill its customers, smoking is becoming less socially acceptable – despite the industry’s best efforts. In the UK, tobacco use has fallen steadily, from 82 per cent of men and 41 per cent of women in 1948, to 21 per cent for both sexes by 2010.

So, as attitudes change, the tobacco industry needed to find new consumers for its products and so has moved towards developing markets. 80 per cent of smokers are now from low and middle income countries .

Professor Hackshaw graphically illustrated the power of the tobacco industry’s influence with an example from China.

In May 2008, a devastating 7.9 magnitude earthquake struck China’s Sichuan province.  One of the most generous philanthropic donations to rebuild the country came from the state-owned China National Tobacco Corporation. It re-built 69 schools in the aftermath of the earthquake, but adorned them with motivational sentiments, as illustrated here:

Chinese school

The slogan on this school reads:
“Genius comes from hard work. Tobacco helps you to be successful”

This sort of outrageous behaviour is mercifully rare in most countries – more than 170 states across the world have committed to implementing the World Health Organisation’s Framework Convention on Tobacco Control (FCTC), a comprehensive approach to reducing tobacco use.

But as Professor Hackshaw pointed out, the tobacco market in low and middle income countries is growing, due to the poor levels of health education: the dangers of smoking are simply not well known or understood.

And where governments are yet to implement the necessary tobacco control policies, the tobacco industry continues to use the well-developed marketing techniques that are now banned in many other countries.

Tobacco use in the UK

But what about the problems faced in this country? Although UK tobacco use has decreased significantly since the 1950s, about a fifth of us still smoke. Though the gap in prevalence between men and women has closed, there is an alarming socio-economic split in smoking prevalence. 28 per cent of adults in households employed in ‘routine and manual work’ smoke, compared to 13 per cent of adults in ‘managerial and professional’ households.

Professor Hackshaw also highlighted that 1 in 7 British women smoke during pregnancy. The percentage of women who do so changes with age, with 45 per cent of pregnant women under the age of 20 smoking compared with just nine per cent of women over the age of 35. Smoking during pregnancy can increase the risk of a number of health problems such as premature birth, low birth-weight, preterm-related deaths and cot death, and a range of physical birth defects.

So, even in the UK, with what by international standards is a reasonably comprehensive tobacco control policy, smoking related problems are not yet in the past.

So what next?

Professor Hackshaw insisted we need to continue with bold thinking when it comes to tobacco control. Even 15 years ago, banning smoking in public places seemed an unachievable task – but this was brought in successfully around the UK since 2007, and will prevent an estimated 40,000 deaths over the next 10 years.

There needs to be continual development of tobacco control policies in all countries: Professor Hackshaw pointed to effective measures such as increasing prices, banning smoking in public places, and restrictions on tobacco advertising – with standardised packaging for tobacco products being a key next step. Cancer Research UK is campaigning hard for the introduction of standardised packaging, and is calling on the UK government to be ‘Setting the Standard’ in protecting children from tobacco marketing.

So are cigarettes the most ‘successful’ product ever…?

The facts Hackshaw outlined are simple and stark.

Smoking is irrefutably responsible for the death of millions, yet 1 billion people across the world still smoke.

The addictive nature of nicotine is clearly a factor in maintaining such a large customer base – but the real and most cynical success, has come from marketing techniques used to get people hooked in the first place. Tobacco companies have carefully moulded the public perception of cigarettes for years, in spite of advertising and sponsorship bans in many countries.

And, ultimately, this demonstrates why we need continued tobacco control policies to restrict industry marketing, to ensure the next generation are not the future market for tobacco.

Catriona

  • Catriona Coull is a policy intern at Cancer Research UK
  • For more information about Cancer Research UK’s work in tobacco control please visit cruk.org/tobacco
  • The Lunchtime lecture series at UCL will re-start in June 2013.