News analysis Tob Control: first published as 10.1136/tobaccocontrol-2012-050525 on 18 April 2012. Downloaded from

Worldwide news and comment

LEBANON: TESTING TIME AS NEW AD BAN TAKES EFFECT Since early March, when a ban on advertising, promotion and sponsorship took effect, health advocates have had Lebanon: a collage showing how a new shop their hands full monitoring what looks all front contains elements of previously legal Kent too like tobacco companies and their brand promotions. agents trying to ignore, delay compliance with, or just get round the ban. Under the new regulations, no advertising of any sort Lebanon: a sculptured camel in a glass case in fi is permitted anywhere, including in or an area of Beirut noted for art shows and suf cient evidence for a court to order outside shops or other points of sale, where nightlife. their removal. cigarette packs alone may be displayed, and then only in places where consumers INDIA/AUSTRALIA: ROW OVER ORAL cannot take them directly themselves. shop, showing a Kent TOBACCO CRICKET ADS Even before the ban took effect, ciga- before the ban, was replaced by a design In February, an Indian oral tobacco brand rette companies appeared to be jostling for that at first sight appeared to be abstract. received television coverage as the Indian advantage. In January, for example, a large A moment’s examination, however, cricket team began a test match series in glittering camel sculpture in a glass case showed identifiable elements of the Kent four Australian cities against the home suddenly appeared in the middle of St pack, as well as the brand’s colours and country’s team. Cricket is a highly Nicolas stairs, a central pedestrian way in echoes of previous Kent billboard ads, in popular game of the masses, with the Gemmayze district, a key location for the new fascia. Health advocates and their substantial audiences in both countries for art exhibitions and a burgeoning centre of advisors realised that considerable thought television coverage of top level test copyright. nightlife in the capital, Beirut. Camel must have gone into the new designs, matches. Viewers noticed boundary rope had only just been launched on apparently to include brand imagery and advertisements in English and Hindi for the Lebanese market, and the solid camel’s subliminal cues for cigarette brand Chaini, the brand of a range of oral appearance coincided with a widespread promotion. They sent a collage to the tobacco, as well as other oral products, billboard advertising campaign. health ministry illustrating how the new some containing tobacco, marketed as After the ban, however, things became fascia design related to previous Kent ads, mouthwash or breath freshener. Oral even more desperate. As the cigarette- and urging the ministry to use the new tobacco causes even more disease and http://tobaccocontrol.bmj.com/ adorned fascias of small- to medium-sized law to ban all such promotions. In addi- premature death in India than cigarettes shops were replaced, it became apparent tion, lawyers have been consulted, to see and other smoked tobacco. that many shopkeepers knew little about whether tobacco company funding of As virtually all forms of tobacco the new law. Some, questioned by health such new advertisements could provide promotion are banned in both countries, workers, confirmed that they received Indian and Australian health advocates significant payment for renting out the filed complaints to their respective spaces above their shop windows, and left it governments. Australian health workers to the tobacco companies or their contrac- also complained to the country’s cricket tors to undertake the necessary alterations. authority, Cricket Australia, which said it However, some of the new fascias appeared had asked the Indian government for to retain unmistakeably familiar elements a translation of the ads, to be reassured on September 26, 2021 by guest. Protected of the cigarette brand colours and designs that they promoted a brand of mouth- that were supposed to have been removed. wash, or at least not a tobacco product. A shop advertising both Camel and However, health organisations in India Winston brands before the ban, became said most Indians who saw them would a new-style Winston shop after it, using instantly associate the ads with oral the brand’s city skyscape and blue and red tobacco. colours. Cricket Australia was later persuaded Kent cigarette ads also appeared in that there appeared to be ‘strong parallels’ anomalies spotted by health advocates. between the product advertised during the One large advertisement above a Beirut matches and a brand of oral tobacco, and ordered the removal of the ads. It may be fi All articles written by David Simpson liable, nevertheless, to a ne of A$66 000 unless otherwise attributed. Ideas and (US$69 400). Meanwhile, in India, a items for News Analysis should be sent health organisation which in the past has fi to: [email protected] Lebanon: a shop front before (top) and after the led many similar complaints about advertising ban came into force. tobacco brand stretching, said health

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updating. The new health warnings were chosen from among 24 possible messages, following focus group testing with citi- zens from all 27 EU member states. The warnings were also discussed and agreed with the 27 member state governments. It has long been known that while most adult smokers in the EU are probably aware that is harmful for their health, they tend to underestimate or ignore the scale and nature of the risks India/Australia: how the ad for Chaini brand, involved. In addition, evidence of lesser which includes an oral tobacco product, known negative consequences of tobacco appeared on television. use, such as mouth and throat cancers, visual impairments and dental and gum advocates expected a long wait for disease, is still accumulating. In recogni- a response from their ‘sleeping’ govern- tion of this, and of well established ment. evidence that parental smoking acts as an incentive for children’s uptake of smoking, UK: 50 YEARS ON, PLAIN PACKS GOAL IN the new warning texts include: ‘Smoking SIGHT causes mouth and throat cancer’; For many who work in public health, ‘Smoking increases the risk of blindness’; tobacco control began in 1962. That was ‘Smoking damages your teeth and gums’; the year that the first report was and ‘Smokers’ children are more likely to start smoking’. published by an established medical orga- UK: a Benson and Hedges cigarette pack nisation reviewing the fast accumulating featuring a device resembling Lego toy building Member states have 2 years to intro- evidence that tobacco was a major cause blocks, recently introduced onto the British duce the new written health warnings. ’ of disease, disability and premature death. market. The EU s Tobacco Products Directive also The publication of Smoking and Health enables member states to combine text copyright. by the Royal College of Physicians of warnings with graphic images and pictorial London was a radical move for such an and Hedges pack featuring what look like health warnings are currently in place in august and innately conservative body. It Lego toy building blocks, popular among Belgium, Romania, the UK, Latvia, France, fi was the rst such publication about a British children, have only increased Malta, Spain, Hungary and Denmark. Other fi speci c topic of public health in its already health demands for plain packs. member states have passed or are planning long history (the college will celebrate its A major campaign has been started to similar legislation. ’ http://tobaccocontrol.bmj.com/ 500th anniversary in just 6 years time). In gather support for plain packaging legisla- NEW ZEALAND: TRADE AMBASSADOR addition, after a thorough review of the tion, co-ordinated by Smokefree South fi PARTIES WITH TOBACCO scienti c evidence, the report contained West, a health promotion organisation ’ recommendations for action, mostly by sponsored by the National Health Service While New Zealand s health ministry has government, a feature that was under- in south west England. In addition to committed the nation to going smoke-free fi ’ standably absent from the rst report by planning events and publicity campaigns by 2025, the country s ambassador to the the government-based US Surgeon around the country, the Plain Packs Protect USA, former prime minister Mike Moore, General, published 2 years later, which it campaign (http://www.plainpacksprotect. recently gave out a very different signal directly inspired. co.uk/) has recruited a wide range of health about tobacco. In February, Mr Moore, who ’ A conference held in the college s head- and welfare organisations, politicians and is also a former director general of the quarters in March naturally looked back at World Trade Organisation (WTO), co-

opinion leaders to sign up to its aims, to try on September 26, 2021 by guest. Protected fi what had been achieved over the rst half to ensure the greatest degree of demand for hosted a glamorous event in Washington fi century of rm knowledge about the the government to follow Australia’s DC, the Governors and Ambassadors World tobacco problem, but most speakers example. Just as with the policy it antici- Trade Reception, sponsored by tobacco focused on what was still required to pates, one sure evaluation of its importance company Phillip Morris International. make tobacco use history. As the UK tops has been the emergence of an equivalent The reception was held for ambassadors the European Union list of tobacco control campaign against plain packs, funded by currently engaged in negotiations of the fi action taken to date, much of the focus on tobacco companies and others with vested Trans-Paci c Partnership Agreement future work concerned the single largest interests in maintaining business as usual. (TPPA), which aims to secure multilateral policy box still waiting to be ticked: plain free trade between nine countries: New packaging. EUROPEAN UNION: NEW WARNING TEXTS Zealand, the USA, Australia, Brunei, Chile, The British government is engaged in In March, the European Commission, Malaysia, Peru, Singapore and Vietnam. consultations about plain packaging, secretariat of the European Union (EU), Although negotiations are being although the health secretary assured the adopted 14 new health warnings to appear conducted in secret, leaked documents Royal College of Physicians meeting that on tobacco packs. Written health warn- indicate that the TPPA will provide far- his ministry was not consulting with the ings on tobacco products sold in the EU reaching protection for industries and . New pack designs have been compulsory since 2003 and investors. If so, the threat of litigation or coming onto the market, such as a Benson current legislation foresees their periodic trade sanctions would effectively curtail

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any significant further tobacco control of an amendment to the country’s health improvements that health advocates legislation to ban smoking in all enclosed could otherwise have worked towards. public spaces, including restaurants and For instance, if the New Zealand bars, and near school premises and play- government were to introduce a policy to grounds, is a highly ambitious move. incrementally reduce the amount of There is a partial ban already, but unsur- tobacco available for sale in New Zealand, prisingly in a country that has recently or to remove additives from tobacco, or to emerged as a popular holiday destination reduce and eventually remove nicotine for western European visitors, the hospi- from cigarettes, tobacco companies could tality industry has been voicing a litany of use investor-state dispute clauses to have complaints. their case heard in secret international According to opinion polls, a majority tribunals. If found in breach of the TPPA, oppose the extension of the ban. Smoking governments could be forced to pay prevalence is still highdfor example, 55% compensation and costs, or face trade of Bulgarians aged 26e40 still smoke. A sanctions. recent poll found that around eight out of New Zealand, unlike the USA, is a Party 10 of adults questioned, including seven to the WHO Framework Convention on out of 10 non-smokers, said that a total Tobacco Control, which under Article 5.3 ban would be unlikely to be properly obligates governments to protect public enforced. However, the country’s health health policies from commercial and other minister is reported to be firmly behind vested interests of the tobacco industry. the measure, which still has to be agreed Mr Moore’s hosting of the event spon- by cabinet, and repeatedly reassures the sored by the tobacco industry is clearly in New Zealand: Tariana Turia, associate health country that it will turn out to be popular, direct conflict with the FCTC. In contrast, minister, who pointed out the conflict in her and will not hurt the economy. country’s ambassador to the USA being the the Australian ambassador to the USA, co-host of a trade reception in Washington DC INDONESIA: PERSONAL ATTACK ON Kim Beazley, reportedly withdrew from sponsored by Philip Morris. [Photo: Crown HEALTH ADVOCATES the same event in protest at Phillip Copyright 2007] Morris’s involvement. People working in tobacco control all over copyright. Public health groups in both New the world were shocked to hear of a public to be a threat to Mr Moore’s career, nor Zealand and the USA have expressed and personal attack on colleagues in will the protests prevent the sovereignty outrage at the reception. In New Zealand, Indonesia in February. A large billboard of nation states being undermined over this included calls for the ambassador’s appeared in prominent locations in several cocktails and canapés. The TPPA and New dismissal. Hone Harawira, leader of the cities in the island of Java, showing Zealand’s entry into a trade agreement Mana Party, said, “Moore’s attendance at pictures of 10 people claimed to be the

that would prevent it from implementing http://tobaccocontrol.bmj.com/ this party is a slap in the face for all those enemies of tobacco farmers and cigarette policies to achieve a smoke-free New who have worked hard to stop the workers. Those pictured say the poster Zealand by 2025 needs to be seriously tobacco companies killing thousands of was commissioned by a pro-tobacco questioned while there is still a chance to New Zealanders every year, and an insult group, the national coalition of do so. to those families who have lost loved ones (Indonesian clove-flavoured cigarettes) to the country’s most addictive drug.” MAREWA GLOVER protection. Tariana Turia, associate minister of health Nathan Cowie Centre for Tobacco Control The ‘enemies’din fact, a roll of honour  and co-leader of the Maori Party, said New Research, University of Auckland, New Zealand in a country that is increasingly isolated in Zealand had a moral and ethical duty to [email protected] the region for its failure to take serious eradicate cigarette smoking. “.Our trade action on tobacco at the national interests should align with our social BULGARIA: PUBLIC PLACES BAN leveldare all strong and prominent development goals,” she said; “We have set Bulgaria was once the principal tobacco supporters of tobacco control: on September 26, 2021 by guest. Protected a goal of having a smoke free Aotearoa supplier to the central and eastern Euro- < Hakim Sorimuda Pohan, a former [New Zealand] by the year 2025. We need pean countries aligned politically and member of parliament; to commit to that goal, and our foreign economically with the former Soviet < Dr Kartono Muhammad, a former representatives should be promoting this Union. Local consumption was high, too, leader of the Indonesian medical asso- wonderful vision for New Zealand.” even in the medical and health profes- ciation, which plays a prominent part In addition, a group of 24 doctors and sions: male doctors in Bulgaria had even in tobacco control advocacy in other medical professionals wrote to the higher smoking prevalence than all males Indonesia; prime minister, John Key, expressing in the early 1990s. Foreign visitors to < Endang Rahayu Sedyaningsih, the disappointment at his support for Mr Bulgaria reported some of the smokiest minister of health, whose strong Moore, and pointing out the short-sight- conditions they had ever experienced; and support for tobacco control is in edness and inconsistency with the one who set about learning Bulgarian marked contrast to that of her government’s stated aims and its interna- reported that the first complete sentence predecessor; tional treaty obligations. in her language primer was a statement < Abdillah Ahsan, a health economist Unfortunately, the social development about where tobacco was grown. whose research on tobacco tax, values held by some of New Zealand’s Seen in context, therefore, the recent tobacco and poverty, tobacco farming Maori (indigenous) politicians are unlikely approval by the Bulgarian parliament and on the myths and facts about the

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commercial loss they could have sustained from copyright infringement. However, if the products in question have positive associations, especially if they appeal to children, instances of apparent brand copying almost always seem to go unnoticed, without any action or repercussions, except where health advocates report or publicise them, when the manufacturers may be forced to contact the ‘pirates’ of their trademarks, requesting them to desist. So it was not surprising that when Philip Morris, manufacturer of Marlboro cigarettes, was preparing to sue the Australian government last November over its law on , there was no word of any legal action or other complaint in Laos about a confec- Jamaica: part of a newspaper advertisement for the bama’s brand of cigarettes when they were tionery item on sale that strongly resem- launched on the market in January. bled a Marlboro cigarette pack, seen and photographed there at around the same Indonesia: one of the billboards put up by time. In addition to the name and slogan a pro-tobacco group in Java, depicting particularly young people. Those working in English the product carries text in prominent tobacco control advocates. to prevent continuing recruitment to Chinese, suggesting that it was made in smoking in Jamaica, and to reduce the China. burden of death and disease that it causes, tobacco industry has underpinned say they are still awaiting any significant support for increasing tobacco tax, action on tobacco control by their copyright. and hence revenue. He has also shown government. Complaints have been sent that contrary to industry propaganda, to the health ministry about the new ’ tobacco s contribution to the Indone- brand, but are considered unlikely to elicit sian economy is small and decreasing; any useful response. < Tulus Abadi of the Indonesian consumers association; PAKISTAN: FROM SMOKING TO PRAYING

< Fauzi Bowo, governor of the Indone- Health advocates in Pakistan recently http://tobaccocontrol.bmj.com/ sian capital, Jakarta, who instigated reported a significant success, after regulations to make indoor public a campaign to remove designated smoking places 100% smoke-free in the city; areas in airports which, they say, are not < Arist Merdeka Sirait and Seto Mulyadi permitted under national tobacco control of the national commission for child legislation. In response to their campaign, protection, which has actively moni- the airport authorities in Karachi, the tored and protested against concerts country’s largest city, have now turned sponsored by the tobacco industry; a designated smoking area into a special < Azas Tigor Nainggola of the Jakarta mosque where women at the airport can citizens’ forum, key supporters of the say their prayers. Jakarta smoke-free law; on September 26, 2021 by guest. Protected LAOS: MARLBORO LOOKALIKE SWEET < Todung Mulya Lubis, a lawyer prom- CIGARETTES inent in his support for tobacco control. For many years and in every corner of the world, the big international cigarette JAMAICA: NEW BRAND OF CIGARETTES companies have guarded assiduously their Jamaica has become the latest market for ‘intellectual property’, including the a cigarette brand called ‘bama’s’. Imported copyright of their brands’ designs, from an American company by a local distinctive colour schemes and typefaces. Laos: a pack of confectionery in a pack strongly businessman, the brand’s name is printed If 'lookalike' designs are discovered on resembling a Marlboro cigarette pack, found on on the pack inside a large letter O, products or in publications that carry sale in Laos last year. shamelessly exploiting the name of US negative messages about smoking, the President Barack Obama. As the first manufacturers typically take immediate African American President of the USA, legal action, threatening severe financial Tobacco Control 2012;21:302e305. Mr Obama is a hero of many Jamaicans, damages, usually far in excess of any doi:10.1136/tobaccocontrol-2012-050525

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