Thank you, Neil, for raising these important questions. [ https://www.hifa.org/dgroups-rss/tobacco-67-q4-do-public-health-professi... ]
ABOUT THE REASONS FOR SLOW IMPLEMENTATION OR NON-IMPLEMENTATION OF THE FCTC AT THE NATIONAL LEVEL?
Yes, you are right. Industry interference is not the only factor justifying slow implementation or lack of implementation in many countries. But still today, the reports that Parties to the FCTC are required to submit every two years or their statements at public events continue to point to Tobacco Industry interference as the major factor halting progress.
States also point to other factors, including:
- lack of collective political will (governments with a liberal political and economic philosophy are less prone to tobacco control)
- changes in political leadership (political leaders are essential, but governments change signs every 4-5 years, and their tobacco control gains may be attenuated or even regressed)
- Little involvement of civil society and academia in tobacco control policies or lack of skills/capacities to practice advocacy, as well as lack of appropriate leaders.
- Insufficient human and financial resources,
- concerns about the potential economic impact that tobacco control measures could have and potential difficulties for effective implementation of the FCTC. Which is a mixture of ignorance and having listened to the message of the tobacco industry.
WHAT ARE THE MAIN METHODS THAT THE TOBACCO INDUSTRY IS USING TO BLOCK PROGRESS?
There is evidence that the tobacco industry began preparing a response to the Convention at the same time as negotiations to develop the treaty. In 1997, Philip Morris International (PMI) commissioned a consultancy group to write white papers exploring the international framework process. The consultants ultimately advised PMI to “insert itself into the policy-making process” by “mimicking NGO behavior.” Entre 1999 y 2001, British American Tobacco (BAT), Philip Morris (PM) y Japan Tobacco International (JTI) carried out the Cerberus Project with the objective of developing a global voluntary regulatory regime as an alternative to the WHO FCTC, which would focus on the prevention of youth smoking. During the FCTC negotiation process, and later, during the COPs sessions, tried to influence a small group of countries to intervene on their behalf.
Some confidential tobacco industry documents noted that they even attempted to use bribery and intimidation to influence the FCTC process. The tobacco industry understood early on that the development of the FCTC would threaten their business.
Once the FCTC was adopted, they sought to present themselves as socially responsible and have used multiple tactics to interfere with the passage of, or weaken, evidence-based legislation and regulations, which they continue to use today as well. These strategies are global, but developing countries are the most vulnerable. They are pursued at different levels and by various actors, including manufacturers, advertisers, public relations firms, vendors, government officials associated with the tobacco industry as well as lobbyists.
The most frequent tactics are: financing political campaigns, having direct access to decision-makers, requesting to participate in bodies that define regulatory policies and draft bills, exaggerating the contribution of IT to the economy, discrediting independent scientific evidence , conducting their own biased studies , establishing front groups and promoting “alternative” products as part of their harm reduction strategy, using the media to get their messages across (and oppose strong regulations).Other strategies used are: 1. increased use of litigation to oppose the implementation of the FCTC, via intimidating governments. There would be over 1000 cases documented. 2. Using international trade agreements as an argument to oppose the FCTC: The industry has claimed (at least since 1992) that tobacco control measures are in breach of international trade agreements before
During the pandemic, they increased their corporate social responsibility activities, for example through donations of masks, ventilators for respiratory support, and funds for supporting COVID-responses, thus taking advantage of the needs and anguish of governments.
The industry’s efforts to undermine WHO_FCTC continues today. A Reuters exposé from 2017 put forth detailed allegations that PMI attempted to infiltrate an FCTC meeting of the governing body, the Conference of the Parties (COP), despite knowing it was officially barred from participating. The COP appears to have been targeted again in 2018—this time digitally—after analysis suggested industry-linked Twitter accounts were attempting to influence conversations around the COP and, specifically, novel products.
Leaked PMI documents, as Reuters pointed out, reveal the truth: that PMI “has focused its vast global resources on bringing to heel the world’s tobacco control treaty.”
HOW WELL IS THE FCTC BRING COMMUNICATED TO POLICYMAKERS? DO POLICYMAKERS FULLY UNDERSTAND THE SOCIAL, HEALTH, AND ECONOMIC COSTS OF TOBACCO? HOW EASY (OR HARD) IS IT FOR NATIONAL POLICYMAKERS TO USE THE FCTC GUIDANCE FOR NATIONAL POLICYMAKING?
Although the WHO-FCTC's 15-year impact assessment showed that the treaty was a key factor in the development of national tobacco control legislation and regulations in many countries, its impact has been uneven.
The key factors to successfully enact FCTC-compliant legislation and/or regulations: (1) building a strong case for tobacco control; (2) mobilizing political will; (3) establishing and/or strengthening collaboration with international and subregional partners and experienced countries; (4) establishing and/or strengthening multi-sectoral and multistakeholder collaboration; (5) ensuring capacity building, sensitization and early involvement of legal officers at different Ministries; (6) implementing a public relations (PR) strategy to sensitize stakeholders, including the general public; and (7) conducting a WHO FCTC needs assessment by the WHO-FCTC Secretariat.
Is it a problem of political will or competing priorities or (lack of?) public pressure? This question is partly answered by the previous one. If the factors above are absent or weak, the political will is likely minor or absent. And yes, the issue of competing interests always exists. It is in the tobacco control community to present a good business case to make politicians understand both the magnitude and the characteristics and the health, economic, and social repercussions of smoking, as well as what the States lose (economic and sanitary) if the status quo is maintained.
References
1. Pan American Health Organization. Advancing implementation of the WHO Framework Convention on Tobacco Control (WHO FCTC) in the Caribbean Community: Meeting Report (Washington, D.C., 31 August 2018). Washington, D.C.: PAHO; 2018.
2. Bialous S. Impact of implementation of the WHO FCTC on the tobacco industry’s behavior. Geneva, 2016.
3. Mamudu HM, Hammond R, Glantz SA. Project Cerberus: tobacco industry strategy to create an alternative to the Framework Convention on Tobacco Control. Am J Public Health 2008;98:1630–42.
4. Carter SM. Mongoven, Biscoe & Duchin: destroying tobacco control activism from the inside. Tob Control 2002;11:112–8.
5. Bialous SA. Tob Control 2019;28:s94–s96.
6. Sullivan C. BAT investigated by Serious Fraud Office over bribery allegations: Financial Times, 2017.
7. Reuters. The Philip Morris Files. 2017. https://www.reuters.com/investigates/section/ pmi/ (cited 10 Jan 2018).
8. STOP. What Is the WHO FCTC? July 28, 2021 https://exposetobacco.org/news/what-is-the-fctc/
Dr. Eduardo Bianco
Director, International Policy Education
Email: ebianco@nextgenu.org
Web: NextGenU.org
HIFA profile: Eduardo Bianco is a medical doctor and Cardiologist, Certified Tobacco Cessation Expert with a Master’s in Prevention and Treatment of Addictive Disorders. Currently, he is Chair of the World Heart Federation Tobacco Expert Group. Dr. Bianco’s research examines tobacco control and cessation, and he is a prominent member of several organizations that address tobacco control in Latin America. Dr. Bianco has worked for 25 years in Uruguay and Latin America to promote and train in smoking cessation treatment and tobacco control policies. He is also the former Regional Coordinator for the Americas of the Framework Convention Alliance and former Technical Director of the MOH Center for International Cooperation for Tobacco. He is a member of the HIFA working group on substance use disorders. https://www.hifa.org/support/members/eduardo Email: ebianco AT nextgenu.org
