Downloaded from tc.bmj.com on 10 November 2006 A strategy for controlling the marketing of tobacco products: a regulated market model R Borland Tob. Control 2003;12;374-382 doi:10.1136/tc.12.4.374 Updated information and services can be found at: http://tc.bmj.com/cgi/content/full/12/4/374 These include: References This article cites 7 articles, 5 of which can be accessed free at: http://tc.bmj.com/cgi/content/full/12/4/374#BIBL 4 online articles that cite this article can be accessed at: http://tc.bmj.com/cgi/content/full/12/4/374#otherarticles Rapid responses You can respond to this article at: http://tc.bmj.com/cgi/eletter-submit/12/4/374 Email alerting Receive free email alerts when new articles cite this article - sign up in the box at the service top right corner of the article Topic collections Articles on similar topics can be found in the following collections Advertising and Marketing (172 articles) Notes To order reprints of this article go to: http://www.bmjjournals.com/cgi/reprintform To subscribe to Tobacco Control go to: http://www.bmjjournals.com/subscriptions/ Downloaded from tc.bmj.com on 10 November 2006 374 SPECIAL COMMUNICATION A strategy for controlling the marketing of tobacco products: a regulated market model R Borland ............................................................................................................................... Tobacco Control 2003;12:374–382 Objective: To outline a novel strategy for controlling the tobacco market. Arguments: More comprehensive controls over the tobacco market are essential and long overdue. Effective controls need to encourage the development of less harmful products; control commercial ....................... communication to ensure that potential harms are highlighted relative to any benefits; and provide Correspondence to: mechanisms to move consumers away from tobacco use, or at least towards less harmful alternatives. Ron Borland, VicHealth Achieving this by regulating the existing industry is one strategy. This paper puts the case for an Centre for Tobacco Control, Cancer Control alternative: to have marketing controlled by an agency (called here the Tobacco Products Agency, or TPA) Research Institute, The which tendered to manufacturers for product and which distributed to retailers in ways that reduce Cancer Council Victoria, 1 incentives to bend or break the law. The TPA would be backed by legislation that made tobacco a Rathdowne Street, Carlton, Vic 3053, Australia; controlled substance with possession sale and use only allowed as permitted by the regulations, which in Ron.Borland@cancervic. reality would be only as provided by the TPA. org.au Conclusions: The overall effect of such a model, which we call a ‘‘regulated market model’’, would be to eliminate most of the incentives and remaining opportunities for commercial promotion of tobacco and to Received 20 July 2003 Accepted create incentives to encourage the development of less harmful tobacco products. Such a model preserves 26 September 2003 the competition inherent in a free market, but directs it towards the challenge of reducing the harm from ....................... tobacco use. obacco smoking causes so much disease12 that it is This paper explores the viability of controlling the tobacco estimated to kill approximately half of its regular long market by focusing on controlling two main ways tobacco Ttime users.3 There is no known safe exposure level to companies influence tobacco use: through designing products smoked tobacco products, although some forms of smokeless to be more attractive to consumers, and by promoting them tobacco product (for example, the Swedish product called in ways that add extrinsic value (fig 1). By promoting their snus) are notably less harmful than smoked products.4 The products and by adding ingredients to their products to make harm caused by tobacco products is predominantly due to them more attractive to consumers, tobacco companies are long term exposure to tobacco related toxins. The world increasing the value of engaging in an inherently dangerous community is currently in the process of ratifying a habit, one that is highly addictive. Framework Convention on Tobacco Control (FCTC) to help The analysis in this paper is grounded in the science base control the problem.5 concerning the composition and formulation of tobacco The challenge of minimising the social costs from tobacco products and the behavioural implications of how that use can be encapsulated in four major tasks: discouraging information is communicated.89 It adapts ideas from people from using tobacco, encouraging existing users to others81011 and from the work of our group.712 There is quit, protecting non-smokers from exposure to harmful now an emerging consensus that tobacco products need to be tobacco smoke, and reducing exposures to tobacco related more strongly controlled,813but no clear consensus as to how toxins among any continuing users. The challenges involved to do this. Currently, no country has anything approaching a in preventing tobacco use and facilitating smoking cessation comprehensive regulatory framework in place: one that can will be minimised if we can eliminate activities of the tobacco effectively control both product composition and product industry that make the task more difficult by making tobacco promotion. One aim of this paper is to broaden thinking use more attractive than it intrinsically is. This effectively towards alternative models of control by outlining one means exercising control over the tobacco market. possibility that minimises the role for a formal regulator. Recently, Liberman and Clough6 have canvassed argu- Major gains have been made in tobacco control in ments about the possible illegality and certain immorality of countries like Australia that have taken the issue ser- many current tobacco industry practices. They make a iously.14 15 There is good evidence that strong restrictions on compelling case that many current industry practices may the promotion of tobacco products and other counter not only be subject to civil sanctions, but may also break measures reduce smoking.16 However, even among the most criminal laws. In Australia, this includes laws to prevent effective and best resourced jurisdictions, anything from conduct endangering life and corporate manslaughter. around 15% of the adult population continue to smoke on a Liberman,7 in a related paper to this one, argues that the daily basis and in most countries many more do so.14 It is also fundamental problem is the nexus between profitability and proving extremely difficult to prevent young people becoming the harm caused by tobacco: the more you sell, the more profit you make, the more people you harm nexus needs to be broken by changing the incentive structures for operating in ................................................................ the tobacco business. He goes on to suggest the desirability of Abbreviations: FCTC, Framework Convention on Tobacco Control; government control over both manufacturers and retailers. RMM, regulated market model; TPA, Tobacco Products Agency www.tobaccocontrol.com Downloaded from tc.bmj.com on 10 November 2006 Controlling the marketing of tobacco 375 Figure 1 Tobacco marketing and major ways it can affect tobacco use. addicted.17 The tobacco industry has been remarkably product which has both a lower harm profile and will be used successful in undermining public health efforts, probably as a substitute for cigarettes by most tobacco users. because only short periods of experimentation are needed for Tobacco companies, like all corporations, exist to maximise dependence to develop, and in part because countries have shareholder value. Monetary profits are an important part of not consistently invested the resources needed to overcome this, but other less tangible benefits, such as pride in owning the effects of tobacco industry marketing. It is inefficient to shares (or in the case of tobacco companies, shame), spend public money to overcome company activity, rather contributes to share and thus company value. Tobacco than more effectively controlling it. companies get no benefit from killing half their long term Better controls will not eliminate tobacco use. At least customers. Unfortunately, without less harmful products, some smoking is due to dependence and experienced benefits they are caught in a dilemma: to keep making money, they (independent of any debate about whether these experiences have to cause harm and can do little to reduce that harm. reflect any enduring benefit). There is likely to be a Tobacco companies have little alternative than to search, or continuing demand for tobacco products, and as a result at least seen to be searching, for less harmful products. prohibition will not eliminate use, and could create social Currently some tobacco companies, like Philip Morris,19 are harm by making lawbreakers of otherwise good citizens. That seeking regulative protection. This is presumably mainly to said, tobacco should not be treated as an ordinary consumer protect them from endless litigation, but this is not product. If tobacco products are to be legally available, there inconsistent with facilitating the search for less harmful need to be controls to ensure that they do not have value products. Any such regulation should give priority to the added to them, and are as harm reduced as possible. It is also goals of public health and broader social wellbeing. A key critical that any reductions in the harmfulness