The World Health Organisation (WHO) Framework Convention on Tobacco Control (FCTC) is an international treaty that aims to reduce the demand and supply of tobacco. It entered into force in February 2005, and as of 2023, there are 183 Parties to the treaty.¹

Article 3 of the WHO FCTC establishes that “the objective of this Convention and its protocols is to protect present and future generations from the devastating health, social, environmental and economic consequences of tobacco consumption and exposure to tobacco smoke by providing a framework for tobacco control measures to be implemented by the Parties at the national, regional and international levels in order to reduce continually and substantially the prevalence of tobacco use and exposure to tobacco smoke”.²

What is the endgame?

The tobacco ‘endgame’ is the concept of moving beyond a focus on tobacco control, towards implementing policies and strategies that could phase out tobacco products entirely.³ According to Cancer Research UK, among others, this would require systemic changes, including:

“initiatives designed to change/eliminate permanently the structural, political and social dynamics that sustain the tobacco epidemic, in order to achieve within a specific time an endpoint for the tobacco epidemic.” ⁴⁵

This could involve the reduction of prevalence of smoking to – or very close to – zero.

Policy Options

Research conducted into potential endgame strategies has identified plausible new policies for reducing smoking to minimal levels. These include:

• A tobacco-free generation policy, which precludes the sale and supply of tobacco to individuals born after a certain year⁶⁷
• A ‘sinking-lid’ strategy, which involves establishing steadily decreasing quotas on the sales or imports of tobacco products⁶⁷⁸
• Substantially reducing the number of tobacco product retailers, which could include restricting retailer density, location, type, or licensing, or restricting tobacco sales to government run outlets⁶⁷⁹¹⁰
• Mandating low-nicotine levels in tobacco products⁶¹¹
• Banning the sale of one or more tobacco products¹⁰⁶
• Shifting control of the supply and distribution of tobacco products away from tobacco companies³¹²

Implementation of endgame policies

National goals and policies

The first countries to propose tobacco endgame goals, and start developing legislation to achieve these targets, were Finland,¹³¹⁴ New Zealand,¹⁵ Ireland,¹⁶ Scotland,¹⁷ Sweden¹⁸ Canada,¹⁹²⁰ and Malaysia.²¹ Other countries that have more recently adopted endgame goals include the Netherlands,²²²³ Australia,²⁴ and the UK.²⁵ Typically, the goal is to have a smoking prevalence of less than 5% of the population.

As of 2023, the Campaign for Tobacco Free Kids (CTFK) policy database shows that 13 countries have banned the sale of waterpipe tobacco products, and 19 countries have banned the sale of smokeless tobacco products.²⁶ A review carried out in 2020 showed that 40 countries had active or pending flavoured tobacco product policies that ranged from banning flavoured tobacco, to banning flavour descriptors and images on packaging.¹⁰²⁷ No countries have yet implemented mandatory denicotinisation, substantial retailer reductions or the sinking lid strategy at a national level.

In 2010, Bhutan was the first country to ban the sale, manufacture and distribution of tobacco products.²⁸ However, the legislation was reversed in 2021 due to concerns that increased tobacco smuggling could result in cross-border transmission of COVID-19.²⁸

Subnational policies

Several US cities have also implemented endgame strategies. Brookline, Massachusetts introduced a generational tobacco ban in 2021 which prohibited the sale of tobacco products and e-cigarettes to anyone born after 1 January 2000.²⁹³⁰ Despite litigation brought by retailers in Brookline, which argued that the policy was pre-empted by state law, the Massachusetts Supreme Judicial Court upheld the generational ban in 2024.³¹ Some cities in California have prohibited the sale of tobacco and nicotine products within their jurisdictions,³² and others have restricted the number or types of retailers permitted to sell tobacco products.³³

In 2016, Balanga City in the Philippines banned the sale and use of all tobacco and nicotine products to those born after 1 January 2000. It also expanded the coverage of an existing smoking ban in the city’s University Town to cover a wider radius. However, both measures were overturned in 2018 after the tobacco industry pursued litigation.³⁴³⁵

Tobacco industry interference

As of 2023, Malaysia, New Zealand and the UK are the only countries that have announced plans to adopt a generational endgame policy. New Zealand also proposed introducing mandated denicotinisation and substantial retailer reduction.

Tobacco industry interference to prevent, delay or undermine the legislation has been observed in each of these countries, and is detailed below.

Malaysia

Proposed legislation

In 2022, Malaysia proposed the ‘Control of Tobacco Products and Smoking Bill 2022’ which aimed to phase out tobacco products and e-cigarettes by introducing a generational endgame policy, prohibiting their use and sale to everyone born on or after 1 January 2007.³⁶

However, when the latest version of the bill was tabled in 2023, the generational ban clause was omitted for all products.³⁷

Interference from industry and associated organisations

Prior to the bill being tabled, several organisations lobbied against the inclusion of e-cigarettes in the generational endgame policy.³⁸³⁹⁴⁰ One of these organisations, the Malaysian Vapers Alliance (MVA), is a member of the World Vapers’ Alliance,⁴¹ which has received funding from the Consumer Choice Center and BAT. The MVA urged the government to exclude e-cigarettes from the generational ban, and stated that it had conducted a survey of 5000 adult vape users, 96.6% of which did not agree with the ban.⁴²

When the generational endgame clause was removed from the bill, Malaysia’s former health minister stated that this was due to strong lobbying from tobacco companies.³⁷ According to local advocates the bill had seen an “unprecedented level of industry interference, some of which have been done in clear violation of the WHO Framework Convention on Tobacco Control”.⁴³

It is not clear what actions were taken by the tobacco industry to oppose the bill, however industry interference in government activities in Malaysia is high, and has continued to rise in recent years.⁴⁴⁴⁵

New Zealand

Proposed legislation

In December 2022, as part of its ‘Smokefree Aotearoa 2025 Action Plan’,⁴⁶ New Zealand passed the ‘Smokefree Environments and Regulated Products’ Amendment Act’ into law, which would have implemented several tobacco endgame policies.⁴⁷ The legislation included three key approaches: a ban on tobacco products being sold to anyone born on or after 1 January 2009, a significant reduction in the amount of nicotine permitted in tobacco products (an 0.8mg/g nicotine limit, compared to 15-16mg/g present in full strength cigarettes), and a huge reduction in the number of retailers allowed to sell tobacco products across the country (from 6000 to 600).⁴⁷⁴⁸

The legislation was due to be implemented progressively starting with the reduction in retailer numbers from July 2024, however in November 2023, as part of an agreement between parties forming a new coalition government, it was announced that all three endgame proposals would be repealed. The new finance minister stated that the additional tobacco tax revenues resulting from repealing the smokefree legislation would be used to finance tax cuts promised during the election campaign.⁴⁹⁵⁰ The repeal was later confirmed in February 2024.⁵¹ It was reported that health officials had urged the coalition government to maintain elements of the bill and suggested compromises such as introducing a purchase age of 25, however the Associate Health Minister, Casey Costello, rejected this.⁵²

In February 2024, public health experts published a briefing pointing to channels of potential tobacco industry influence on the new coalition government.⁵³ The briefing highlighted past connections between coalition politicians and tobacco companies or industry linked organisations, and noted that the arguments used by the coalition government against tobacco endgame policies aligned with those used by tobacco companies.⁵³⁵⁴ It also called for all government members to declare any past and current industry connections.⁵³⁵⁵

Interference from industry and associated organisations

In 2021, following the release of the Smokefree Aotearoa 2025 Action Plan, Imperial Brands, BAT and JTI all submitted responses to the government consultation opposing the major endgame policies.⁵⁶ Industry linked organisations and individuals also submitted responses opposing the legislation. These included submissions from Centre for Research Excellence: Indigenous Sovereignty and Smoking (COREISS),⁵⁷ which is funded by the Foundation for a Smoke Free World, and The New Zealand Initiative,⁵⁸ a think tank whose members include BAT and Imperial Brands.⁵⁹

In June 2021, BAT reportedly facilitated a protest amongst convenience store owners to contest the proposed tobacco product restrictions.⁶⁰ BAT supplied the dairy owners with postcards which opposed the measures, including the comment “If nicotine is slashed, filters banned and price goes up, many people will go to the black market – these will badly hurt my business, increase risk of robbery to personal safety and could force store to close.” Thousands of these postcards were reportedly delivered to the New Zealand Parliament.⁶⁰

In August 2023, the ‘Save our Stores’ campaign, another seemingly grassroots initiative supported by convenience store owners,⁶¹ called for users to sign a petition urging the government to repeal the latest Smokefree 2025 laws. The campaign website stated that it was “supported by” BAT New Zealand and Imperial Brands New Zealand. The campaign website argued that “A ban on normal strength cigarettes will just mean the illicit trade in tobacco products will boom and be controlled by criminal networks”. It also stated that the legislation would destroy small businesses, and that taking away the tax revenue raised by tobacco sales would “hurt families who are already struggling to make ends meet”.⁶² These narratives were repeated in a series of Facebook adverts published as part of the campaign between August and November 2023, with one advert also stating “tobacco taxes pay for 35,000 police officers”.⁶³

This kind of astroturfing is a well-documented industry tactic.

UK

Proposed legislation

In October 2023, the UK Prime Minister announced plans to introduce a generational endgame policy. The new legislation would prohibit the sale of tobacco products to anyone born after 1 January 2009. All tobacco products, cigarette papers, waterpipe tobacco and herbal smoking products were included in the proposal.²⁵⁶⁴ Later that month, the Westminster government opened a four nations consultation on the tobacco endgame policy, as well as on potential measures to curb the rise in youth e-cigarette use.⁶⁵

The consultation closed on 6 December 2023.⁶⁶ In response to the submissions, the Westminster government confirmed its plans to introduce a generational tobacco ban, ban disposable e-cigarettes and bring forward new powers which would allow the government to restrict e-cigarette flavours, packaging and retail display.⁶⁷ The Scottish and Welsh governments stated that they would also be introducing the new legislation.⁶⁸⁶⁹

Interference from industry and associated organisations

After the generational policy was announced, tobacco control researchers outlined arguments that they anticipated the industry would use to in an attempt prevent or undermine the UK legislation, based on previously used tactics. These included invoking libertarianism and arguments around personal freedom; claiming that the policy would be unworkable and impossible to police; and that it would have unintended consequences, such as increasing cigarette smuggling.⁷⁰

In December 2023, there were reports that the tobacco industry was lobbying the government to increase the age of smoking to 21, instead of introducing the new generational endgame legislation.⁷¹ An industry source quoted by The i newspaper stated that the generational ban was “unenforceable, and the inevitability of such a ban leading to a black market run by dangerous criminal gangs, there’s a large number of libertarian Tory MPs that do not like the idea the government is limiting people’s free choice…if the Prime Minister does cancel the plan, then [the industry] won’t object to him raising the smoking age to 21”.⁷¹ The illicit tobacco trade has often been used by tobacco companies to promote key misleading narratives that advance their own business goals.  See also Arguments and Language.

The i also revealed that the tobacco industry had been “inundating MPs with lobbying material in a bid to persuade them to oppose the changes”. It also reported that a letter was sent to MPs, seemingly from constituents, but in fact drafted by employees of tobacco companies, which called the generational ban “ridiculous” and “impractical, illiberal and untested”.⁷¹ Andrea Leadsom MP, Parliamentary Under Secretary of State in the Department of Health and Social Care, warned that the industry was working behind the scenes to block the policy.⁷²

Tobacco company lobbying

Tobacco companies lobbied the UK Department of Health and Social Care (DHSC) directly, using many of the same arguments, although only Philip Morris International (PMI) went as far as to issue a legal threat.

In November 2023, PMI sent a pre-action protocol (PAP) letter to the DHSC.⁷³⁷⁴ The PAP letter argued that the consultation was predetermined and that it failed to give adequate reasons regarding the inclusion of heated tobacco products (HTPs). It also argued that  the consultation period was not long enough did not allow the submission of sufficient additional evidence.⁷³ In a preliminary response (December 2023), the government stated that it was already possible for organisations to upload supporting documents, but to make this clearer, this instruction had been added to the consultation landing page.⁷⁵

The government’s full response a week later stated that the legal challenge was “misguided and wholly without merit” and would be “an unjustified attempt to delay or derail important legislative change”.⁷⁶ With regard to HTPs, it stated that some of PMI’s claims were “highly subjective and lack supporting independent evidence”. The response concluded that:

“The Government does not intend to enter into any negotiations with the tobacco industry…and will not as you propose “discuss, on an urgent basis, the potential removal of HTP from the scope of the proposed legislation”…the proposed claim has no merit and your client is urged to reconsider its intention to pursue the claim”.⁷⁶

The Telegraph newspaper reported that PMI later withdrew the threat, stating “We notified the government of procedural flaws in the consultation process. They subsequently amended the consultation procedure to allow substantive responses and answered other enquiries. As such, we withdrew the claim on 15^th January”.⁷⁴ PMI told the newspaper  that it agreed with the UK’s smoke-free 2030 plans, but did “not believe that reduced-risk smoke-free products—including heated tobacco—should be included alongside combustible cigarettes in any potential legislation”.⁷⁴ In December 2023, PMI reportedly held roundtable events with UK MPs in to lobby for its heated tobacco products (HTPs) to be exempt from future smoking bans.⁷¹

In November 2023, a law firm acting on behalf of British American Tobacco (BAT) contacted the DHSC, arguing that  the proposals would “materially impact the rights of our clients and others”. It also argued that there was not enough information “regarding the impacts and costs and benefits of the proposals to permit intelligent consideration”, and – as had PMI – stated that consultation period was not long enough, and did not allow the submission of sufficient supporting evidence.⁷⁷ BAT were reported to be sponsoring a roundtable due to be hosted by MP Graham Brady on behalf of the Centre for Policy Studies in December 2023 to “discuss the Government’s smokefree ambitions, what policies could support the goal, and what a Conservative approach to public health should look like.”⁷¹⁷⁸ BAT stated that the proposed legislation would be difficult to enforce, and risked creating a new category of “under-age adults”.⁷⁹ It also published briefing in response to the consultation, which outlined its stance on e-cigarette restrictions.⁸⁰

Imperial Brands and the Tobacco Manufacturers’ Association also reportedly engaged with MPs and government officials regarding the proposals, with a spokesperson for Imperial Brands stating “We understand the Government’s desire for new tobacco control measures, because of the health risks associated with smoking. But, like any prohibition, the proposal to ban the legal sale of cigarettes over time threatens significant unintended consequences.”⁷¹

In December 2023, Imperial also wrote to the DHSC, arguing that the consultation was “materially deficient and unfair in several important respects”. As with PMI and BAT, Imperial stated that the consultation period was not long enough, and did not allow the submission of sufficient supporting evidence. It also argued that the evidence base for the proposal should be shared.⁸¹ Imperial published a summary of its response to the government consultation. It said it opposed the generational ban, as it would be “unworkable and unenforceable, and would see an explosion of illicit trade in tobacco”. It also argued that it would not reduce smoking rates.⁸² Imperial’s UK head of corporate and legal affairs stated in the retail press in January 2024 that it was having “direct conversations with government” and talking to MPs “to make them aware of illicit trade that is already a problem in their constituencies” including highlighting “loss of revenue for the average retailer”. Imperial also stated that it did not support e-cigarette restrictions including plain packaging, device standardisation, or flavour bans.⁸³

In November 2023, Japan Tobacco International (JTI) carried out a survey of 1000 convenience retailers in the UK, and reported concerns that a smoking ban would harm business, increase illicit trade, make ID checks more complicated for retailer staff and impact staff training around underage sales.⁸⁴⁸⁵ A JTI feature in Talking Retail, ‘The Generational Ban: Explained’, described the ban as “an experimental policy not supported by evidence”, and encouraged retailers to respond to the government consultation.⁸⁶

Lobbying by industry-linked organisations

The Institute of Economic Affairs, a British think tank with a history of tobacco industry funding, published a briefing paper in November 2023 titled ‘Prohibition 2.0: Critiquing the Generational Tobacco Ban’.⁸⁷ The report echoed the industry narrative that a smoking ban would drive illicit trade and “bolster criminal gangs”. It also stated that a ban would “lead to a grey market in sales between friends” and that it “infantilises one cohort of adults, discriminates on the basis of age and raises issues of intergenerational unfairness.”⁸⁷ The report disregarded figures published in a review commissioned by the UK’s Department of Health in 2022 relating to the cost of smoking to the NHS, and stated “The reality is that smokers pay far more in tobacco duty than they cost the state in healthcare, while nonsmokers cost the state more, on average, in both healthcare and social security payments”.⁸⁷ Action on Smoking and Health (ASH) published an analysis in December 2023 which found that smoking costs England £49.2 billion each year in lost productivity and service costs, plus an additional £25.9 billion lost quality adjusted life years due to premature death from smoking – far outweighing the money brought in from tobacco taxes.⁸⁸

The Consumer Choice Center (CCC), a US lobby group with a history of tobacco industry funding and links to the Atlas Network, launched a campaign titled ‘No2Prohibition’ which urged the public to contact their MP to oppose the new legislation.⁸⁹ The campaign used the argument that the legislation would result in an increase in illicit trade and stated “Discriminating against adult consumers, depending on what year they were born, is unheard of and would set a dangerous precedent for future regulations. What’s next? Alcohol? Sugar? Fat? We can only imagine”.⁸⁹ The campaign included a series of social media adverts centred on messages of freedom of choice and prohibition.⁹⁰ These ads were removed by Meta as they did not include verified “paid for by” disclaimers.⁹⁰

Forest, a British based Smokers’ rights group with a history of tobacco industry funding, stated that it had urged the government not to introduce a generational ban, ahead of the government consultation deadline in December 2023. It also commissioned a consultancy to carry out a survey, which it states found that “58% of respondents think that if a person can vote, drive a car, buy alcohol, or possess a credit card at 18, they should also be allowed to purchase tobacco”.⁹¹

The Association of Convenience Stores (ACS) is an organisation that represents local stores in the UK. Its “Premier Club” members include BAT, JTI, PMI, Imperial Brands and JUUL.⁹² ACS stated in December that it had responded to the government consultation, and in its submission “set out a number of concerns about the practical implications of the [generational endgame] policy”. It also stated that it did not support a ban on disposable e-cigarettes.⁹³

The Scottish Grocers Federation (SGF), a trade association for convenience stores with tobacco company members, published an article opposing several possible new retail regulations, which included the generational tobacco policy and restrictions on the sale and visibility of e-cigarettes, stating that it would harm retail businesses.⁹⁴ Regarding the disposable e-cigarette ban, the SGF Chief Executive warned against “unintended consequences such as an increase in illicit trade” and said that it would “engage with both governments to ensure the best outcome for retailers and their communities”.⁹⁵ SGF also protested its exclusion from the government’s response to the consultation, due to SGF’s connections with the tobacco industry.⁹⁶

The World Vapers Alliance (WVA), which has links to BAT, criticised the generational smoking ban. It argued that the UK should instead be “doubling down on its harm reduction strategy”.⁹⁷ WVA also urged the public to respond to the government consultation to oppose e-cigarette flavour restrictions, the disposable e-cigarette ban and inclusion of heated tobacco products in the generational smoking ban.⁹⁸ After the consultation closed, WVA published a press release which urged the government to reconsider its stance on banning disposable e-cigarettes.⁹⁹

The UK Vaping Industry Association (UKVIA) published a press release opposing the e-cigarette regulations, stating “the tobacco industry and illicit markets will be the only winners from bans on disposables and flavoured vapes”.¹⁰⁰ (UKVIA stated in September 2023 that all of its tobacco company memberships had ended. For details see the UKVIA page).

Relevant Links

• Sunset Plans: Progress on Tobacco Endgame Around the World, ASH (US) website
• Tobacco endgames, ASH Scotland website

TobaccoTactics Resources

• Tobacco Industry Tactics
• Illicit tobacco trade
• Price and Tax
• Menthol and Flavoured Tobacco

Tobacco Control Research Group (TCRG) Research

Sunak’s smoke-free generation: spare a thought for the tobacco industry, G. Hartwell, A.B. Gilmore, M.C.I . van Schalkwyk, M. McKee, BMJ, 2023; 383 :p2922 doi:10.1136/bmj.p2922

References

The post Tobacco Industry Interference with Endgame Policies appeared first on TobaccoTactics.

There have been multiple instances of lobbying by ambassadors and other diplomats from the UK, as well as Japan and Switzerland. Much of this lobbying activity has taken place in low and middle-income countries (LMICs).¹⁰⁶ These countries are important sources of new customers for tobacco companies as markets in higher income countries where consumption is generally falling.^107108109

Diplomats are also involved in activities which help promote the tobacco industry via local media, such as visiting tobacco farms or factories. Other engagement supports tobacco companies’ product promotions, or corporate social responsibility strategy. These activities help to raise the profile of tobacco companies, enhance their reputations, and support the ‘normalisation’ of the industry.^105110111

Background

Parties to the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) have an obligation to protect public health policies from the “commercial and vested interests of the tobacco industry” and any contact with tobacco industry representatives, or others seeking to further their interests, must be “limited” and “transparent”.¹¹² The implementation guidelines to Article 5.3 of the WHO FCTC recommend that Parties limit interactions with the tobacco industry to those that are absolutely necessary to regulating the industry, and ensure the transparency of those interactions that do occur.¹¹²  The guidelines also recommend parties treat state-owned tobacco companies in the same way as any other tobacco company, including avoiding any “preferential treatment”.¹¹²

In addition, the guidelines state that “… Whenever possible, interactions should be conducted in public, for example through public hearings, public notice of interactions, disclosure of records of such interactions to the public”.¹¹²

However even in countries with a high level of compliance with the WHO FCTC requirements, diplomatic missions rarely achieve this level of transparency. Information on tobacco industry engagement has largely been found through media investigations and Freedom of Information requests (FOIs).

In October 2014, the 6^th Conference of the Parties (COP) decided to urge parties: “to raise awareness and adopt measures to implement Article 5.3 and its implementing Guidelines among all parts of government including diplomatic missions.”¹¹³ Another decision required governments to “take into account their public health objectives in their negotiation of trade and investment agreements”.¹¹⁴

Nevertheless, diplomats continue to lobby for tobacco companies around the world.¹⁰⁵

Countries whose diplomatic representatives have lobbied on behalf of tobacco companies overseas  include the UK, Germany and Japan, who are all Parties to the WHO FCTC,¹¹⁵ as well as the United States and Switzerland. BAT, PMI and Japan Tobacco all have offices in Geneva, Switzerland, the location of the World Health Organization and other key international bodies.

UK

There are specific guidelines covering the engagement of British (UK) officials working overseas designed to limit contact with tobacco companies, and support compliance with Article 5.3. After the UK Ambassador to Panama lobbied on behalf of British American Tobacco (BAT),¹¹⁶ the guidelines were revised in 2013.¹¹⁷ These guidelines state that “Posts must not…Engage with local foreign governments on behalf of the tobacco industry, except in cases where local policies could be considered protectionist or discriminatory”.¹¹⁷

Engagement and lobbying

Despite having guidelines in place to support compliance with the WHO FCTC, FOI requests and media investigations have revealed that British diplomats continue to interact with the tobacco industry more than is necessary. UK diplomats have lobbied for BAT in Bangladesh,¹¹⁸¹¹⁹ Hungary,¹²⁰ and Pakistan.^{116121122123124}

UK officials have also disclosed contact with tobacco companies in Panama and Venezuela,¹²⁵¹²⁶ Laos,¹²⁷ Cuba,¹²⁸ and Burundi.¹²⁹

In 2018, UK advocacy organisation Action on Smoking & Health (ASH) called this a “global pattern of engagement” by British officials to defend BAT’s interests.¹³⁰

• For more details see UK Diplomats Lobbying on Behalf of BAT.

Tobacco industry events

UK government guidelines state that staff must not:

“Attend or otherwise support receptions or high-profile events, especially those where a tobacco company is the sole or main sponsor and/or which are overtly to promote tobacco products or the tobacco industry (such as the official opening of a UK tobacco factory overseas)”.¹¹⁷

However, UK staff have attended such events, generating considerable local media coverage.

For example, in 2019 the British ambassador to Yemen opened a cigarette factory in a free trade zone in Jordan, celebrating the expansion of the tobacco company Kamaran which is part-owned by BAT.^105131132133

In 2020, staff from the UK high commission in Pakistan attended a promotional event for a BAT product in Pakistan.¹³⁴

• See UK Diplomats Lobbying for BAT for details.

Engaging with industry allies

The links between diplomatic missions and tobacco companies can be more indirect, via funding third party allies of the industry. The UK guidelines state that diplomats should not “endorse projects which are funded directly or indirectly by the tobacco industry”.  However, a 2019 investigation by The Guardian found that the British high commission in Malaysia had given funding to a Kuala Lumpur based think tank (IDEAS) for several years. At the same time the think tank was also receiving money from tobacco companies and was lobbying against plain packaging regulation and tobacco taxes.¹³⁵  While the UK had already implemented plain packaging regulations, tobacco control was being undermined overseas.

Attending meetings with the tobacco industry

Tobacco companies attend meetings and events organised directly by UK government departments, such as the FCO (now FCDO) or the DIT (now Department for Business and Trade).¹²⁵  They also attend those held by regional, national or local business organisations such as chambers of commerce.

Responses to FOI requests show that when the attendance of UK government officials at such events is disclosed, there is little detail about the specific purpose or content of these meetings,¹¹⁸¹²⁰ It may simply be described as relating to ‘doing business’ in the country.¹²⁶

Business vs public health interests?

The UK guidelines for overseas staff (last updated in 2013) allow for the communication of “basic trade, investment and political information”, although this is not defined.¹¹⁷ One of the activities used to justify interaction by UK diplomats is “resolving business problems that are potentially discriminatory”.^{116118120136137} This has been criticised as running counter to the WHO FCTC guidelines.¹⁰⁵¹³⁸

While transparency is required for tobacco industry interactions in 2018, the UK government told Parliament that it “does not catalogue the representations it makes on behalf of companies”.^139140141  Research by the Tobacco Control Research Group (TCRG) concluded that the stated WHO FCTC goal of “maximum transparency” is not being achieved in the UK.¹⁰⁵¹³³

Japan

In 2021, the Ambassador of Japan to Bangladesh lobbied the government of Bangladesh on behalf of Japan Tobacco International (JTI).  In a letter to the Bangladesh Finance Minister the Ambassador criticised 2019 taxation changes for their impact on JTI. It also complained about the activities of competitors, and licensing demands.¹⁴²

• For details, including the lobbying letter, see Japanese Diplomats Lobbying for JTI

The Japanese Ambassador to Ethiopia was present at the signing of a deal between the Ethiopian government and JTI in 2016,  when the Ministry of Public Enterprise sold 40% of its National Tobacco Enterprise to the Japanese company.¹⁴³ Japanese diplomats have also toured tobacco farms and JTI factories in Tanzania and Zambia.¹⁴⁴¹⁴⁵

Japan Tobacco International is the overseas subsidiary of Japan Tobacco (JT), which is one third-owned by the Japanese government.¹⁴⁶

Germany

In May 2022, the German ambassador to Beirut visited the offices of Regie, the Lebanese Tobacco and Tobacco Inventory Administration.¹⁰⁵¹⁴⁷

Denmark

The Imani Centre for Policy and Education, a Ghana-based think tank,  received money from the Danish embassy while lobbying against tobacco control.¹³⁵¹⁴⁸

Switzerland

Switzerland is not Party to the WHO FCTC.

In 2019, Swiss diplomats approached the government of the Republic of Moldova on behalf of Philip Morris International (PMI) seeking an opportunity to discuss new tobacco legislation.^149150151  The proposed legislation included significant tax increases on heated tobacco products, in which PMI has invested.¹⁴⁹¹⁵²

The same year, PMI helped fund an inaugural event for the new Swiss Embassy in Moscow.¹⁵³¹⁵⁴

• For more details see Swiss Diplomats Lobbying for PMI

USA

Although the US is not Party to the WHO FCTC, it has specific laws and guidance that prohibit its diplomats from promoting the sale or export of tobacco, or influencing non-discriminatory restrictions on tobacco marketing.^155156157158 However, US diplomats have enabled meetings between tobacco companies and government representatives.

The US ASEAN Business Council organises delegations of US businesses, including Philip Morris International (PMI), which meet high level officials in the ASEAN region.¹⁵⁵  PMI was at the time a vice chair of its Customs & Trade Facilitation Committee and used this opportunity to meet with government officials from the Ministry of Industry and Trade of Vietnam.¹⁵⁵¹⁵⁹

Why it matters

The examples above illustrate contraventions of the WHO FCTC, an international treaty, and in many cases breaches of national guidelines. As TCRG research points out, all of these activities also undermine the spirit of these laws, by apparently serving the commercial interests of transnational tobacco companies and helping to ‘normalise’ the industry in the eyes of policy makers and the public.¹⁰⁵

The implementation guidelines of Article 5.3 urge Parties to exclude the tobacco industry completely from the public health policy arena.  The guidelines also urge them not to participate in corporate social responsibility (CSR) activities which are used by the tobacco industry and as an alternative means to access policy makers, as well as for public relations and product promotion.¹⁰⁵

In August 2019, in direct response to the exposure of lobbying by Swiss diplomats, the WHO released a statement urging governments to comply with Article 5.3 and to “proactively aspire to reduce the number of people starting and continuing smoking, to promote health and preserve future generations”.¹⁶⁰

TobaccoTactics Resources

• UK Diplomats Lobbying for BAT
• UK Diplomats Lobbying for BAT: Bangladesh
• UK Diplomats Lobbying for Tobacco: Burundi
• Swiss Diplomats Lobbying for PMI
• Japanese Diplomats Lobbying for JTI
• Third Party Techniques

TCRG Research

A “willingness to be orchestrated”: Why are UK diplomats working with tobacco companies?, R. Alebshehy, K. Silver, P. Chamberlain, Frontiers in Public Health, 17 March 2023, Sec. Public Health Policy, Volume 11 – 2023, doi: 10.3389/fpubh.2023.977713

For a comprehensive list of all TCRG publications, including TCRG research that evaluates the impact of public health policy, go to the Bath TCRG’s list of publications.

References

The post Diplomats Lobbying for Tobacco Companies appeared first on TobaccoTactics.

• Menthol and flavoured cigarettes are widely available in low and middle-income countries (LMICs) many of which have high smoking rates
• LMICs have young populations – flavours appeal to young people, who may not understand the harms of flavoured tobacco
• Recently high-income countries have put bans in place; at the same time there has been marked growth of menthol market share in some LMICs
• There is a lack of regulation to reduce the appeal of flavours e.g. plain packs and advertising bans at point-of-sale or near schools
• Targets for new and improved bans include flavour capsules, and flavour references on packaging and cigarette sticks
• A ban on all flavourings may be easier and more effective in preventing product substitution
• A lack of data, especially in low-income countries, hinders the development of good regulation
• Multinational tobacco companies can threaten income from tobacco exports if governments attempt to put tobacco controls in place

This page covers flavoured tobacco, including menthol cigarettes, in low and middle-income countries (LMICs).¹⁶⁹¹⁷⁰

Background

Flavoured tobacco products are available in various forms around the world, including products previously only used in particular regions or countries. For example in Indonesia, the vast majority of smokers use kretek, clove-flavoured cigarettes,¹⁷¹¹⁷² and they are now available in other countries.¹⁷³¹⁷⁴

Flavoured tobacco is used in waterpipe, a device which originated in middle-eastern countries and is increasingly popular elsewhere, including among young people.¹⁷⁵

Here we focus on what are often called ‘conventional’ products, like cigarettes and cigarillos, which are sold by large transnational tobacco companies (TTCs): Philip Morris International (PMI), British American Tobacco (BAT), Imperial Brands (IMB, previously Imperial Tobacco) and Japan Tobacco International (JTI) (JTI also owns Nakhla in Egypt, which produces flavoured waterpipe) We summarise findings from Tobacco Control Research Group (TCRG) research on the extent of flavoured and menthol cigarette use in LMICs and the development of the market for ‘capsule’ products (cigarettes with flavour capsules in the filter).

We describe specific challenges for LMICs, including flavour regulation and evidence gathering. We then summarise flavour market evidence and research, first relating to LMICs in general and then by World Health Organization (WHO) region and individual countries (where available).

• For general background and evidence, including information on the global market, and details of specific bans and associated industry interference, see Flavoured and Menthol Tobacco.

For details of product regulation at country level, see the searchable database on the Tobacco Control Laws website, published by the Campaign for Tobacco Free Kids (CTFK). For countries that are parties to the WHO Framework Convention on Tobacco Control (FCTC) progress towards implementation of relevant articles, including newer products, is detailed in the FCTC implementation database

Specific challenges for LMICs

LMICs with no ban often have other major tobacco control policy gaps that are not necessarily menthol/flavour related but worsen the negative impact of menthol/flavours.¹⁷⁶ One such policy is plain, or standardised, packaging,  which can include restrictions on flavour descriptors as well as colours on packaging which are known to signify flavour (e.g. green for menthol).¹⁷⁷ However, plain packaging policies have yet to be implemented in many countries, including some high-income countries, so this would be a significant challenge in LMICs. Another relevant policy is the prohibition of marketing, especially near schools.¹⁷⁸

Governments have more conflicts of interest in tobacco growing areas as they receive much needed foreign currency for tobacco exports,  and multinational companies can threaten this income stream if governments attempt to put tobacco controls in place.¹⁷⁶¹⁷⁹  However, apart from rare exceptions the tobacco industry contributes little overall to the balance of payments.¹⁸⁰¹⁸¹

Regulatory challenges

The WHO published brief guidance on the regulation of menthol and flavoured tobacco which summarised some regulatory options including restrictions on: the sale of menthol branded products,  the use of menthol at noticeable levels (giving a ‘characterising flavour’),  or banning any menthol ingredients.¹⁸²  The report points to likely opposition from the tobacco industry in countries or regions with an established menthol market.¹⁸² This was the case with the European Union (EU) menthol ban which only came into full force in 2020, after the tobacco industry had successfully lobbied for a delay. Testing for characterising flavour is more difficult and expensive than a ban on ingredients; this makes banning menthol as an ingredient particularly efficient for LMICs.

The WHO noted that:

“A ban on all flavour agents that increase tobacco product attractiveness, rather than focusing on menthol exclusively, can provide an alternate route to restricting menthol, and may prevent the unwanted introduction of menthol substitutes.”¹⁸²

Research and data

As of 2021, when TCRG researchers conducted a review of evidence on menthol/flavour in LMICs,¹⁸³ there were very few research papers from countries in Eastern Europe, the Eastern Mediterranean region, and Africa.

Lack of data means that it is hard to monitor markets and company shares in specific countries.  Market research service Euromonitor (which receives project funding from Philip Morris International) includes no low-income countries and is proprietary, making it expensive and hard to access even for the middle-income countries which are included.

More research is needed on menthol and flavour in LMICs to help governments monitor the tobacco industry and its products, as recommended by the WHO: “An evidence base using data collected from the region of interest can provide more direct support for regulation.”¹⁸²

Market in LMICs

Evidence suggests menthol and flavoured tobacco products are widely used in LMICs.  Data from the International Tobacco Control (ITC) Policy Evaluation Project suggests that menthol is smoked by more than 20% of smokers in several middle-income countries. Although the dates vary (see the note above on data challenges) this research gives an indication of the scale of the problem. The highest rates were found in Zambia (42% in 2014) and Thailand (35% in 2012). Kenya and India also had over 20% menthol smokers, with China just under just under that level.¹⁸⁴

A study from Johns Hopkins University, between 2015 and 2017, found a range of flavoured and capsule cigarettes on the market in those LMICs with the highest number of smokers: Bangladesh, Brazil, China, India, Indonesia, Philippines, Russia, Thailand, and Vietnam.¹⁸⁵

The main TTCs operating in these countries (PMI, JTI, and BAT) mostly sold menthol or mint flavours. China National Tobacco Corporation (CNTC) sold  a mix of flavours.¹⁸⁵

There is also evidence from a number of studies that menthol and flavour tobacco use is rising, either as a proportion of the market or substantively.  Evidence from TCRG research shows that after the implementation of the European Union (EU) menthol ban in 2020, there was a marked increase in the share of menthol/flavoured products in some LMICs.¹⁸³ A study of cigarette packs in Brazil, Indonesia, the Philippines, Russia, Thailand, and Vietnam, between 2013 and 2016, found that the number of flavour capsule variants on the market was growing.¹⁸⁶ Most were mint and menthol flavour but with others the flavour was unclear from the product name.¹⁸⁶

A number of studies have identified related marketing activities.  Marketing strategies for flavour capsules are likely driving their global growth particularly among young people in LMICs.¹⁸⁷

TCRG’s review  of tobacco industry strategies underpinning the growth of menthol/flavoured tobacco use in LMICs  highlighted widespread marketing in stores (including retailers near schools), on billboards, on TV, online and via brand ambassadors. The packaging of flavoured and menthol products, legally displayed in stores, was  found to be colourful with non-conventional, appealing names for flavours.¹⁸³

Tobacco companies also use symbols on cigarette sticks to indicate that they contain capsules.¹⁸⁸ Researchers studying this form of marketing in LMICs have described the space on a cigarette as “valuable communicative real estate” for tobacco companies, which could be better used to display public health messages.¹⁸⁸

Research and data from specific regions and countries is summarised below. We refer in many places to TCRG research based on 2019 cigarette market data from Euromonitor. In this data ‘high market share’ means 20% or more of the total cigarette market in that country in 2019. ‘High market share growth’ means that the share doubled between 2005-19 and was growing from 2017.¹⁸³ We link to regional and country profile pages on TobaccoTactics, where available.

Africa

Nigeria has high menthol/flavour market share and high market share growth.¹⁸³

Cameroon has high market share, the only other country in the region for which this data was available. (For Egypt see Eastern Mediterranean region below.)¹⁸³

Tanzania

JTI sells a menthol cigarette called Sweet Menthol through its subsidiary in Tanzania. It describes this product as “the leading local mainstream menthol brand”.¹⁸⁹

Zambia

JTI owned brand Sweet Menthol is the third most popular cigarette in Zambia.  It is cheap and is usually sold as single sticks.¹⁹⁰  On its webpage for Zambia, JTI describes itself  as a leaf farming company, and does not mention that it sells cigarettes in the country. A locally owned company, Roland Imperial,  also sells menthol cigarette brands.¹⁹¹

ITC survey data showed a high prevalence of menthol smokers in Zambia, with 43% of smokers choosing the product.¹⁹² Menthol was most commonly used among younger smokers, those with a middle income, and those that don’t smoke every day. Over a third of smokers indicated that they thought menthol cigarettes were less harmful than non-menthol.¹⁹²

Kenya

ITC survey data from Kenya also suggests a high prevalence of menthol smokers.¹⁹²¹⁹³ In 2018, 21% of smokers with a regular cigarette brand smoked menthol or sweet menthol (although Euromonitor estimates that only 7% of cigarette sales are menthol).¹⁸³  More women smoke menthol than men in Kenya, and two thirds of smokers believed that menthol is less harmful than other cigarettes.¹⁹²¹⁹³

Ethiopia

In 2015, Ethiopia enacted a total flavour ban on all forms of tobacco.

• For details see Flavoured and Menthol Tobacco

This was a pre-emptive ban as flavour sales were low. However there has been a lack of enforcement at the retail level.¹⁷⁶ Flavoured products are not made in Ethiopia and more collaboration with customs is needed to prevent illicit importation.¹⁷⁶ There is also a lack of awareness that the ban includes waterpipe products.¹⁸²

Since 2017, two years after the ban was enacted, JTI has owned 70%  the state owned tobacco company, NTE.¹⁹⁴

Latin America

Menthol cigarettes are popular in Latin America, and increasingly so in some countries.¹⁸³ Guatemala and Peru have high market share and high market share growth. There is high market share in Columbia and the Dominican Republic, and high market share growth in Argentina, Bolivia and Costa Rica.¹⁸³

Use of flavour capsule cigarettes is particularly high in Chile and Mexico.¹⁹⁵  According to BAT’s annual report in 2014,  sales of  flavour capsule cigarettes had increased in the region despite price rises, while overall cigarette sales were down.¹⁹⁶

A study of over 1,000 retailers located close to schools in Latin American cities (Argentina, Bolivia, Brazil, Chile and Peru) found that the majority (85%) sold flavoured cigarettes, and most (71%) sold capsule versions.¹⁷⁸ (Similar findings were reported in Uruguay, a high income country, immediately before the implementation of plain pack regulations in 2020.)¹⁹⁷

These products were frequently displayed near the point of sale, or confectionary. Some stores also had advertisements and price promotions.¹⁷⁸ Unconventional flavour descriptors such as “fusion blast” and “ruby ice” were very common.¹⁹⁸

Brazil

Survey data from 2016-2017 among adult smokers in Brazil found that over 50% supported a ban on menthol and over 60% supported a ban on all additives.¹⁹⁹ Support did not vary across sociodemographic groups. When menthol smokers were asked what they would do if menthol cigarettes were banned, a third reported they would quit, around 20% would reduce the amount they smoked and a similar number would switch to non-menthol cigarettes. Slightly fewer said they would still find a way to get menthol cigarettes.¹⁹⁹

ITC survey data from the same period suggested that 8% of smokers with a regular cigarette brand smoked menthol.²⁰⁰ 13% believed that menthol cigarettes were less harmful than non-menthol cigarettes, and over a third reported that they were smoother on the throat and chest.  Nearly two thirds  of surveyed smokers supported a complete ban on all cigarette additives, including flavourings.²⁰⁰

An online sample of women aged 16- 26 (smokers and non-smokers) preferred packs with flavour descriptors.²⁰¹

• The tobacco industry has used a range to tactics to undermine and delay Brazil’s menthol ban. For details see Flavoured and Menthol Tobacco

Chile

In 2013, Chile sought to implement a law banning substances that cause higher levels of addiction, harm or risk, leading to tobacco industry resistance and interference.¹⁸²

• For details see Flavoured and Menthol Tobacco

Mexico

Studies of retailers in Mexican cities, found that the majority sold menthol and flavoured products, and more than half of stores situated near schools sold flavour capsule cigarettes.²⁰²²⁰³ Many flavoured cigarettes have descriptors which suggest there is a flavour, but the type of flavour is unclear: chemical analysis of dual flavoured cigarettes suggested flavours were menthol and another flavour, for example fruit.²⁰⁴

A study in Mexico City found that colour and flavour descriptors on cigarette packs made the products more appealing, and some smokers believed they would taste better.²⁰⁵

Guatemala

A study of convenience store retailers in Guatemala found that all sold flavoured tobacco products.²⁰⁶

The majority (88%) of indoor tobacco advertisements in Guatemala were found to be for capsule cigarettes.²⁰⁶

South East Asia & Western Pacific

There is high market share of menthol/flavour in India, Malaysia, Philippines and Thailand, and high market share growth in Vietnam.¹⁸³  A 2010 study noted that governments in the region had no legislation banning exotic flavours of cigarettes and cigarettes with new flavours had appeared in Cambodia, Indonesia, Malaysia and the Philippines.²⁰⁷

Philippines

Menthol has been advertised to appeal to young women in the Philippines since the 1970s with menthol brands common for many decades.²⁰⁸ PMI, JTI, BAT and Korea Tobacco & Ginseng (KT&G) all sell flavoured capsule cigarettes in the Philippines.²⁰⁹

Menthol packs studied in the Philippines were harder than non-menthol (for capsule protection) giving a quality feel. Flavoured capsule brands had a greater technological appeal,²⁰⁹ and packs were rated as more attractive by young adults.²¹⁰

Blue and white packs were perceived to be less harmful than other colours, as were the descriptors ‘light’ and ‘cool’, whereas the term ‘strong’ was perceived as more harmful.²¹⁰  Researchers called for greater action and support for banning flavour additives.

Malaysia

In Malaysia, menthol cigarette marketing has been aimed at young people and women.  In the 1980s Brown and Williamson’s Newport menthol cigarettes were marketed in Malaysia with youthful American images and were sold at a cheap price point.²¹¹ An internal document from 1993 reveals how the company was developing sweet and fruit flavours for the Malaysian market. ²¹¹²¹² A 2003 study noted that the menthol variant of Cartier Vendome (a BAT brand at the time) was described as ‘pearl tipped’ so likely to appeal to women.²¹³

In 2013, vanilla, mint and fruit flavoured cigarettes were on sale, and strawberry cigarette packs with pink packaging were documented.²¹⁴

China

In China ‘flavour capsule’ was found to be one of the most common cigarette terms used in online tobacco marketing.  One website explicitly linked flavour capsules with female smokers.²¹⁵

Indonesia

In Indonesia the dominant cigarettes are kreteks which are flavoured with cloves.  Industry attempts to introduce their own cloved flavoured products had failed at least to 2004.²¹⁶  In 2009 PMI and BAT acquired two domestic manufacturers which allowed them access to the kretek market.²¹⁷ In 2009 PMI launched the first super slims kretek for women and Marlboro black menthol for young men.  By 2012 BAT had launched several kretek brands. Both companies were aware that kreteks  are particularly carcinogenic due to the presence of toxic chemical compounds: Anethole, Coumarin and Eugenol.²¹⁷

In Indonesia the flip lid of the cigarette packet was used by Esse (owned by Korean Tobacco & Ginseng, KT&G) to promote the brand with phrases evoking flavour, like “sweet surprise” and “its honey”.  Research found seven cigarette brands with capsules.  Flavours included mint, menthol, berry and honey.²¹⁸

Eastern Mediterranean

There is high market share growth in in Pakistan and Egypt .¹⁸³

• See also Waterpipe for information on the role of flavours in promoting these products.

Eastern Europe

Data shows that in Russia menthol/flavour has both a high market share and high market share growth.¹⁸³

Other LMICs in the region with high market share growth are Ukraine, Bosnia Herzegovina, Belarus, Azerbaijan, Kazakhstan and Uzbekistan.¹⁸³

Relevant Links

WHO Advisory note: banning menthol in tobacco products (2016)

WHO Case studies for regulatory approaches to tobacco products: menthol in tobacco products (2018)

WHO FCTC decision on banning waterpipe flavour (2016)

A global map of menthol bans is available on Tobacco Atlas: Product Sales

TobaccoTactics Resources

• Flavoured and Menthol Tobacco
• Menthol Cigarettes: Industry Interference in the EU and UK

TCRG Research

A growing menace: menthol and flavoured tobacco products in LMIC, M. Zatonski, K. Silver, S. Plummer, R. Hiscock, Tobacco Induced Diseases, 2022;20(April):39, doi:10.18332/tid/146366
STOP research summary (May 2022)

Marketing of flavour capsule cigarettes: a systematic review, C. Kyriakos, M. Zatonski, F. Filippidis, Tobacco Control, Published Online First: 18 January 2022, doi: 10.1136/tobaccocontrol-2021-057082[/ref]

Flavour capsule cigarette use and perceptions: a systematic review, C.N. Kyriakos, M.Z. Zatoński, F.T. Filippidis, Tobacco Control, Published Online First: 04 October 2021, doi: 10.1136/tobaccocontrol-2021-056837

For a comprehensive list of all TCRG publications, including research that evaluates the impact of public health policy, go to TCRG publications.

References

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