Tob Control: first published as 10.1136/tobaccocontrol-2020-056358 on 9 December 2020. Downloaded from Editorial

Framework Convention on Tobacco The tobacco industry, 2020: a snapshot Control includes Article 5.3, which urges governments to take measures to exclude Ruth E Malone ‍ the tobacco industry from such policy-­ making. It is needed now as much as ever. As Willemsen and Fooks show in a Tobacco Control as a journal has long been new products, which can serve as an early 3 study of tobacco control governance in focused not only on addressing the nega- warning of increased uptake. It may 13 the Netherlands, the tobacco industry tive disease-promoting­ impacts of tobacco also involve, as McKelvey and colleagues worked to try to shift governance of products but on the industry that produced illustrate in a study with youth,4 trying tobacco control in the Netherlands from them. From its inception, the journal has to navigate how the blunt instrument of the Ministry of Health to the Ministry had a normative aim. Tobacco Control is policy can address public perceptions of of Economics, regarded as more favour- focused primarily on research and analysis ‘reduced exposure’ and ‘reduced risk’ able to industry positions. The e-cigarette­ that advance understanding of how best to claims such as those now being made by industry seems determined to follow the develop, defend and extend public policy tobacco companies about a broad range same path. Ollila14 describes how govern- measures to protect the public from an of newer tobacco and nicotine products ment attempts in Finland to regulate e-­cig- industry that promotes products that harm being marketed with minimal independent arettes have been thwarted by multiple and kill people. Tobacco Control’s very evidence to support such claims. legal challenges. first issue in 1992 featured an analysis by 5 Tsourounis et al examined all warning Deceptiveness has been a hallmark of now-­Editor Emeritus Simon Chapman on letters sent by the US Food and Drug the tobacco industry since the days when the Australian tobacco industry’s massive Administration’s (FDA) Center for Tobacco it denied that cigarettes caused lung cancer media campaign to derail an advertising Products to online retailers of e-­liquids and nicotine was addictive. Have they ban. Many of the arguments in use then regarding violations. The majority were changed? Maybe not so much. Risi and have a strangely familiar smell to them.1 violating provisions on sales to minors or Proctor used computational linguistics to This special e-issue­ features a wide range featured advertising appealing to children. examine language patterns used by tobacco of papers about the tobacco industry. While most corrected their websites after company lawyers in the courtroom to Taken together, they provide an updated, receiving warnings from FDA, almost 17% show how they try to put plaintiffs harmed partial snapshot of multiple aspects of of retailers did not fully do so. The FDA by tobacco products on trial, deceptively this industry and the ways in which it and other regulators are faced with playing diverting attention from industry practices continues to aggressively promote use a continuing game of hide and seek as by suggesting the plaintiffs simply made of both old and new harmful, addictive copyright. companies develop products intended to bad ‘decisions’ and ‘assumed risks’.15 The products, thwart and undermine public thwart public health policies, as Cwalina decisions made by tobacco companies are health policy measures, engage in neoco- and colleagues show in their discussion of thus effectively obscured. Deception can lonialist exploitation and disseminate PUFF Krush, a product created to circum- also mean obscuring the industry face deceptive messages about itself, its prod- 6 vent flavour bans, and Delnevo and by creating front groups. Lewis et al16 ucts and about policies it regards as threats colleagues report regarding other illegal conducted a content analysis of industry-­ to its profits. Unfortunately, some within 7 ‘pod mod’ products. In an accompanying sponsored political websites made to (or formerly within) the tobacco control 8 commentary, Hemmerich calls attention appear as though they were grassroots http://tobaccocontrol.bmj.com/ movement have convinced themselves that to the FDA’s failure to enforce its own groups fighting against policy measures; the tobacco industry is now creating the premarket review policies. Since these with names like Citizens for Tobacco solution to the tobacco disease pandemic. papers went to press, the agency has sent Rights and sponsorship from Philip Morris Yet the shiny veneer of faux sincerity additional warning letters, but other work International (PMI), they promoted pro-­ cannot effectively cover over the many 9 10 in this issue suggests new products are tobacco industry activism. industry activities that increase harm to so likely to continue to pop up in response to In recent years, the industry has gone many around the world. regulatory measures. to great lengths to try to scare govern- However, the tobacco industry has Despite assurances by several multi- ments out of instituting various policies, indeed changed since 1992. In addition nationals that they really, really want always claiming they will lead to massive to considerable consolidation among the everyone to quit smoking, they seem illicit trade, and to assure governments major multinational cigarette compa- intent on continuing the longstanding that anti-illicit­ trade measures the tobacco on September 27, 2021 by guest. Protected nies, the development of e-cigarettes­ practice of fighting against the most effec- companies had a hand in developing are and multiple other nicotine and tobacco tive tobacco control policies, including just fine, thank you, no need to worry products has created acquisition oppor- 11 taxes. Apollonio and Glantz describe about that any more. Evans-­Reeves et tunities, as Levy and colleagues discuss in how the industry developed an extensive al17 draw on media accounts to demon- their analysis of why Altria bought JUUL.2 lobbying campaign to protect manufac- strate that tobacco companies used third Public health work at all levels increasingly turer discounts, keeping tobacco cheap parties to conduct tobacco purchases in involves surveilling for the plethora of even when states set minimum price poli- prespecified areas, aimed at promoting new, unregulated products which contin- cies. In Mauritius, as Berthet Valdois and to authorities the idea that standardised ually appear on the market, sometimes 12 colleagues show, they manipulated prices packaging of cigarettes would increase even in violation of existing policies, and to keep discount brands cheap, undercut- illicit trade. Gallagher and colleagues tracking the expenditures for promoting ting the potential public health benefit of demonstrate how the tobacco industry has tobacco taxes on encouraging more price worked to exert influence over the Euro- Correspondence to Professor Ruth E Malone, sensitive consumers to quit. pean Union’s track and trace system for Department of Social and Behavioral Sciences, University of California, San Francisco, CA 94118, USA; Because of the industry’s interference illicit tobacco products. They first created ruth.​ ​malone@ucsf.​ ​edu with public health policies, the WHO an entity called Codentify, which was then

Malone RE. Tob Control December 2020 Vol 29 No e1 e1 Tob Control: first published as 10.1136/tobaccocontrol-2020-056358 on 9 December 2020. Downloaded from Editorial sold to a supposedly independent organi- flavoured tobacco products. Availability policies and deceptive promotion of prod- sation, INEXTO; leaked documents show of flavoured products in youth-­accessible ucts that hurt people. INEXTO continued to have financial and venues decreased and few customer issues organisational relationships with tobacco were reported. In two papers by Watts Twitter Ruth E Malone @MaloneRuth 18 companies. and colleagues, Australian retailers’ views Contributors I am the sole author of this work. Tobacco companies pioneered many on selling tobacco and their relationships Funding The authors have not declared a specific innovations in product marketing, and the with tobacco companies were explored. grant for this research from any funding agency in the pieces in this issue illustrate both aspects of Retailers who had stopped selling tobacco public, commercial or not-­for-­profit sectors. that history as well as recent developments. indicated that reduced sales or profits were Competing interests See statement: https://​ 19 30 Parascandola uses industry documents the primary reason. A telephone survey tobaccocontrol.​bmj.​com/​pages/​wp-​content/​uploads/​ to look back at the history of tobacco of retailers31 found one-­third were offered sites/​49/​2019/​10/​DOI-​Statement-​Ruth-​Malone.​pdf company involvement with the Olympics, some benefit by tobacco companies in the Patient consent for publication Not required. which shamefully still lacks a comprehen- form of price discounts, rebates and gifts Provenance and peer review Not commissioned; sive policy against tobacco advertising and in exchange for prominence on the stock not peer reviewed. sponsorship that applies across the many list or influence over product range and © Author(s) (or their employer(s)) 2020. No levels of organisations affiliated with the stock levels. As New Zealand moves to commercial re-­use. See rights and permissions. Games. The industry has likewise used legalise e-cigarettes,­ Hoek et al32 found Published by BMJ. marketing channels that are challenging to that tobacco retailers were ill prepared to regulate, including social media. O’Brien et offer guidance to customers about their al20 explored social media use by tobacco use, health effects or use in cessation. To cite Malone RE. Tob Control 2020;29:e1–e3. and vape products companies, finding that The Industry Watch has long been a although cigarettes were rarely seen, e-cig­ - closely followed feature of the journal, Tob Control 2020;29:e1–e3. arette, hookah and cigar brands commonly identifying usual and unusual, curious, doi:10.1136/tobaccocontrol-2020-056358 had pages on at least two platforms, rarely and sometimes illegal and unethical ORCID iD used age gating, did not display health warn- industry activities. This issue features Ruth E Malone http://​orcid.​org/​0000-​0002-​3324-​2183 ings, and many featured youthful imagery pieces illuminating how the industry or mentioned flavours. The industry has used trade and investment treaties REFERENCES often claims that it will self-­regulate, but to undermine national tobacco control 1 Chapman S. Anatomy of a campaign: the attempt 21 33 Forsyth and McDaniel, exploring tobacco efforts, how JUUL is entering Indo- to defeat the New South Wales (Australia) tobacco content in video games, demonstrate that nesia34 and how a wholly owned insur- advertising Prohibition bill 1991. Tob Control copyright. racing video games popular with young ance company subsidiary of Philip Morris 1992;1:50–6. people continue to feature Marlboro brand International offers discounts for users of 2 Levy DT, Sweanor D, Sanchez-­Romero LM, et al. Altria-­Juul Labs deal: why did it occur and what does it imagery despite voluntary measures taken PMI’s IQOS heated tobacco products that mean for the US nicotine delivery product market. Tob by Philip Morris and video game makers are greater than those offered for people Control 2020;29 (e1):e171–4. to address the issue. Marketing is also who quit smoking, with no discount for 3 Ali FRM, Marynak KL, Kim Y, et al. E-­Cigarette about building relationships with potential use of nicotine replacement therapy prod- advertising expenditures in the United States, 2014- consumers. Just as the cigarette companies ucts.35 Churchill et al. document IQOS’ 2018. Tob Control 2021;29(e1):e124–6. 36 4 McKelvey K, Baiocchi M, Halpern-­Felsher B. PMI’s did in an earlier era, the first exploration of introduction into the US market. Yadav heated tobacco products marketing claims of reduced http://tobaccocontrol.bmj.com/ 37 e-­cigarette industry scholarships for high-­ and colleagues show how a tobacco risk and reduced exposure may entice youth to try school students found 21 e-­cigarette enti- company is brand stretching in India and continue using these products. Tob Control ties offering 40 scholarships for youth, the in apparent violation of existing law by 2020;29(e1):e18–24. applications calling for essays on topics like applying its brand to non-­tobacco prod- 5 Nguyen H, Dennehy CE, Tsourounis C. Violation of US regulations regarding online marketing and sale of ‘what are the different types of e-­cigarettes ucts. The industry’s deceptive and colo- e-­cigarettes: FDA warnings and retailer responses. Tob 22 and which would you recommend?’. nialist exploitation of indigenous people Control 2020;29(e1):e4–9. In a series of Ad Watch pieces, authors is highlighted in a report from Thompson 6 Cwalina SN, Leventhal AM, Barrington-­Trimis demonstrate the multiple ways in which et al38 and an accompanying commentary. JL. E-­Cigarette flavour enhancers: flavoured pod attachments compatible with JUUL and other pod-­ tobacco companies continue to link their 39 23 based devices. Tob Control 2020;29(e1):e127–8. products to popular social causes, target As public health increasingly turns its 7 Delnevo C, Giovenco DP, Hrywna M. Rapid proliferation 24 disadvantaged groups, deploy Native attention to corporate vectors of disease of illegal pod-­mod disposable e-­cigarettes. Tob Control on September 27, 2021 by guest. Protected American and indigenous imagery25 26 and commercial determinants of health, 2020;29(e1):e150–1. to suggest ‘natural’ tobacco products are the tobacco industry remains first among 8 Hemmerich N. Flavoured pod attachments score big 25 as FDA fails to enforce premarket review. Tob Control better, and convey misleading messages several that serve up suffering, addiction 2020;29(e1):e129. suggesting FDA’s approval of new prod- and premature death to millions. But 9 Hiscock R, Silver K, Zatoński M, et al. Tobacco 27 ucts. As in the past, military personnel advocates can effectively fight back when industry tactics to circumvent and undermine the have been targeted, this time by the e-­cig- they take on industry claims directly and menthol cigarette ban in the UK. Tob Control arette product JUUL.28 forthrightly. Ackert and colleagues, in 2020;29(e1):e138–42. 10 Williams R. The rise of disposable JUUL-­type e-­ While we often think of the tobacco an Advocacy in Action piece, show how cigarette devices. Tob Control 2020;29(e1):e134–5. industry in terms of big companies, they used an evidence-­based infographic 11 Apollonio DE, Glantz S. Tobacco manufacturer researchers are turning more attention to for policy-makers­ to debunk industry lobbying to undercut minimum price laws: an retailers as supply side policy measures are claims.40 Tobacco control advocates every- analysis of internal industry documents. Tob Control passed or contemplated. where must redouble their efforts to pull 2020;29(e1):e10–17. 29 12 Berthet Valdois J, Van Walbeek C, Ross H, et al. Kephart and colleagues explored back the curtain on industry practices and Tobacco industry tactics in response to cigarette retailer compliance after Boston, Massa- name the basic problems: continued polit- excise tax increases in Mauritius. Tob Control chusetts, instituted a ban on sales of ical interference with sound public health 2019;29(e1):e115–8. e2 Malone RE. Tob Control December 2020 Vol 29 No e1 Tob Control: first published as 10.1136/tobaccocontrol-2020-056358 on 9 December 2020. Downloaded from Editorial

13 Willemsen MC, Fooks G. Tobacco industry access to 22 Baler G, Paci K, Kowitt SD, et al. Vaping industry-­ through the provision of incentives and benefits to policy elites and the implementation of article 5.3 of funded academic scholarships. Tob Control retailers. Tob Control 2020;29(e1):e119–23. the who framework convention on tobacco control. 2020;29(e1):e181–2. 32 Bateman J, Robertson L, Marsh L, et al. New Tob Control 2020;29(e1):e50–5. 23 Hunt D, Hefler M, Freeman B. Tobacco industry Zealand tobacco retailers’ understandings of and 14 Ollila E. See you in court: obstacles to enforcing the exploiting International Women’s Day on social media. attitudes towards selling electronic nicotine delivery ban on electronic cigarette flavours and marketing in Tob Control 2019;29(e1):e157–8. systems: a qualitative exploration. Tob Control Finland. Tob Control 2020;29(e1):e175–80. 24 Garner W, Brock B, Seth E. ’Kool Mixx’ remix: how 2019;29(e1):e25–30. 15 Risi S, Proctor RN. Big tobacco focuses on the facts to al Capone cigarillos infiltrated Hip-­Hop to promote 33 MacKenzie R, Lee K. PMI’s proxy trade dispute with hide the truth: an algorithmic exploration of courtroom cigarillos use among African-­Americans. Tob Control Thailand. Tob Control 2020;29(e1):e132–4. tropes and taboos. Tob Control 2020;29(e1):e41–9. 2019;29(e1:e159–60. 34 Orlan EN, Parascandola M, Grana R. JUUL from the 16 Lewis MJ, Ackerman C, Ling P. ’Being politically active 25 Lewis MJ, Jeong M, Ackerman C. Naturally similar: USA to Indonesia: implications for expansion to LMICs. does not have to be difficult.’ A content analysis of Natural American Spirit and Nat Sherman’s new Tob Control 2020;29(e1):e155–56 tobacco industry-­sponsored advocacy websites. Tob cigarette. Tob Control 2020;29(e1):e161–2. 35 Prochaska JJ, Henriksen L. Pmi reduced-risk­ claims and Control 2020;29(e1):e98–105. 26 Ganz O, Delnevo CD, Lewis MJ. Following in the upselling of IQOS via Reviti life insurance. Tob Control 17 Evans-­Reeves K, Hatchard J, Rowell A, et al. Illicit footsteps of natural American spirit: the emergence of 2020;29(e1):e136–7. tobacco trade is ’booming’: UK newspaper coverage of Manitou cigarettes. Tob Control 2020;29(e1:e164–6. 36 Churchill V, Weaver SR, Spears CA, et al. IQOS debut in data funded by transnational tobacco companies. Tob 27 Leas EC, Cohen JE, Ayers JW. A Philip Morris the USA: Philip Morris International’s heated tobacco Control 2020;29(e1):e78–86. advertisement for its heated tobacco product device introduced in Atlanta, Georgia. Tob Control 18 Gallagher AWA, Gilmore AB, Eads M. Tracking and IQOS sets a troubling precedent. Tob Control 2020;29(e1):e152–4. tracing the tobacco industry: potential tobacco 2020;29(e1):e168–70. 37 Yadav A, Ling P, Glantz S. Smokeless tobacco industry influence over the EU’s system for tobacco 28 Fahey MC, Krukowski RA, Talcott GW, et al. JUUL traceability and security features. Tob Control targets military personnel and veterans. Tob Control industry’s brand stretching in India. Tob Control 2020;29(e1):e56–62. 2020;29(e1):e163–34 2020;29(e1):e147–9. 19 Parascandola M. Smokeless tobacco Olympics: 29 Kephart L, Setodji C, Pane J, et al. Evaluating tobacco 38 Thompson S, Smith J, Lee K, et al. Industry the US tobacco company, the IOC and the 1980 retailer experience and compliance with a flavoured sponsored harm reduction conference courts lake Placid Olympic winter games. Tob Control tobacco product restriction in Boston, Massachusetts: Indigenous peoples in Canada. Tob Control 2020;29(e1):e106–12. impact on product availability, advertisement and 2020;29(e1):e130–31. 20 O’Brien EK, Hoffman L, Navarro MA, et al. Social consumer demand. Tob Control 2020;29(e1):e71–7. 39 Waa A, Maddox R, Nez Henderson P. Big tobacco using media use by leading US e-­cigarette, cigarette, 30 Watts C, Burton S, Phillips F, et al. Understanding why Trojan horse tactics to exploit Indigenous peoples. Tob smokeless tobacco, cigar and hookah brands. Tob some Australian retailers have stopped selling tobacco, Control 2020;29(e1):e132–3. Control 2020;29(e1):e87–97. some might and some are unlikely. Tob Control 40 Ackert K, Brock B, Friedrichsen SC, et al. Countering 21 Forsyth S, McDaniel PA. ’Cease and desist?’ the 2020;29(e1):e63–70 tobacco industry tactics on the economic costs persistence of Marlboro brand imagery in racing video 31 Watts C, Burton S, Freeman B, et al. ’Friends with of restricting menthol tobacco. Tob Control games. Tob Control 2020;29(e1):e31–40. benefits’: how tobacco companies influence sales 2020;29(e1 :e11 – 4 .)3 copyright. http://tobaccocontrol.bmj.com/ on September 27, 2021 by guest. Protected

Malone RE. Tob Control December 2020 Vol 29 No e1 e3