Tobacco industry use of judicial seminars to influence rulings in products liability litigation

Objectives

This paper examines the tobacco industry''s efforts to influence litigation by sponsoring judicial seminars.

Methods

Thousands of internal tobacco documents were examined, including memos, reports, presentations, and newsletters. Connections to outside organisations were corroborated by examining tobacco industry financial records, budgets, and letters pledging funds. Facts about outside organisations were triangulated through examining their websites and publicly‐filed financial records, and verifying facts through their representatives'' statements in newspaper and law review articles.

Results

There are direct financial ties between the tobacco industry and groups that organise judicial seminars in an effort to influence jurisprudence, and judges who attend these seminars may be breaching judicial ethics either by not inquiring about the source of funding or by ignoring funding by potential litigants.

Conclusions

The tobacco industry''s attempts to clandestinely influence judges'' decisions in cases to which they are a party endangers the integrity of the judiciary.     

Tobacco industry litigation strategies to oppose tobacco control media campaigns

Objective

To document the tobacco industry''s litigation strategy to impede tobacco control media campaigns.

Methods

Data were collected from news and reports, tobacco industry documents, and interviews with health advocates and media campaign staff.

Results

RJ Reynolds and Lorillard attempted to halt California''s Media Campaign alleging that the campaign polluted jury pools and violated First Amendment rights because they were compelled to pay for anti‐industry ads. The American Legacy Foundation was accused of violating the Master Settlement Agreement''s vilification clause because its ads attacked the tobacco industry. The tobacco companies lost these legal challenges.

Conclusion

The tobacco industry has expanded its efforts to oppose tobacco control media campaigns through litigation strategies. While litigation is a part of tobacco industry business, it imposes a financial burden and impediment to media campaigns'' productivity. Tobacco control professionals need to anticipate these challenges and be prepared to defend against them.     

Asian herbal‐tobacco cigarettes: “not medicine but less harmful”?

Objective

To describe the development and health claims of Asian herbal‐tobacco cigarettes.

Methods

Analysis of international news sources, company websites, and the transnational tobacco companies'' (TTC) documents. PubMed searches of herbs and brands.

Results

Twenty‐three brands were identified, mainly from China. Many products claimed to relieve respiratory symptoms and reduce toxins, with four herb‐only products advertised for smoking cessation. No literature was found to verify the health claims, except one Korean trial of an herb‐only product. Asian herbal‐tobacco cigarettes were initially produced by China by the 1970s and introduced to Japan in the 1980s. Despite initial news about research demonstrating a safer cigarette, the TTC analyses of these cigarettes suggest that these early products were not palatable and had potentially toxic cardiovascular effects. By the late 1990s, China began producing more herbal‐tobacco cigarettes in a renewed effort to reduce harmful constituents in cigarettes. After 2000, tobacco companies from Korea, Taiwan, and Thailand began producing similar products. Tobacco control groups in Japan, Taiwan, and Thailand voiced concern over the health claims of herbal‐tobacco products. In 2005, China designated two herbal‐tobacco brands as key for development.

Conclusion

Asian herbal‐tobacco cigarettes claim to reduce harm, but no published literature is available to verify these claims or investigate unidentified toxicities. The increase in Asian herbal‐tobacco cigarette production by 2000 coincides with the Asian tobacco companies'' regular scientific meetings with TTCs and their interest in harm reduction. Asia faces additional challenges in tobacco control with these culturally concordant products that may discourage smokers from quitting.     

Philip Morris's Project Sunrise: weakening tobacco control by working with it

Objective

To analyse the implications of Philip Morris USA''s (PM''s) overtures toward tobacco control and other public health organisations, 1995–2006.

Data sources

Internal PM documents made available through multi‐state US attorneys general lawsuits and other cases, and newspaper sources.

Methods

Documents were retrieved from several industry documents websites and analysed using a case study approach.

Results

PM''s Project Sunrise, initiated in 1995 and proposed to continue through 2006, was a long‐term plan to address tobacco industry delegitimisation and ensure the social acceptability of smoking and of the company itself. Project Sunrise laid out an explicit divide‐and‐conquer strategy against the tobacco control movement, proposing the establishment of relationships with PM‐identified “moderate” tobacco control individuals and organisations and the marginalisation of others. PM planned to use “carefully orchestrated efforts” to exploit existing differences of opinion within tobacco control, weakening its opponents by working with them. PM also planned to thwart tobacco industry delegitimisation by repositioning itself as “responsible”. We present evidence that these plans were implemented.

Conclusion

Sunrise exposes differences within the tobacco control movement that should be further discussed. The goal should not be consensus, but a better understanding of tensions within the movement. As the successes of the last 25 years embolden advocates to think beyond passage of the next clean indoor air policy or funding of the next cessation programme, movement philosophical differences may become more important. If tobacco control advocates are not ready to address them, Project Sunrise suggests that Philip Morris is ready to exploit them.     

Community guide recommendations and state level tobacco control programmes: 1999-2004

Objective

To identify the level of effort state tobacco control programmes and partners have expended on interventions recommended by the community guide and how those efforts have changed over time between 1999 and 2004.

Design

Longitudinal study.

Setting

United States.

Participants

State tobacco control partners, including the state health department, voluntary agencies and tobacco control coalitions.

Main outcome measure

We used the Strength of Tobacco Control survey responses in 1999, 2002 and 2004 to calculate the mean proportion of state tobacco control partners working on recommended interventions and subsequently analysed changes in effort over time.

Results

The proportion of state tobacco control partners working to promote clean indoor air legislation remained at more than 70% in all three years. The proportion working to increase taxes on tobacco rose significantly between 1999 and 2002 (from 54% to 70%), and those working to reduce patient costs for tobacco cessation treatments never exceeded 31% in any year. Use of mass media targeting youths decreased significantly in all years (from 40% to 32% to 26%), and the proportion of state tobacco control partners participating in a quitline has increased steadily and significantly in all years (from 24% to 36% to 41%). The level of effort in each area varied widely between states and over time.

Conclusions

State tobacco control partners are implementing evidence based interventions, but more focus is needed on the tobacco cessation and mass media campaign components of comprehensive tobacco control programmes.     

Media advocacy and newspaper coverage of tobacco issues: a comparative analysis of 1 year's print news in the United States and Australia.

Tobacco control advocates now recognize the value of influencing news coverage of tobacco; news coverage influences attitudes and behavior as well as policy progression. It is, however, difficult to assess the progress of such efforts within a single national and temporal context. Our data represent the first systematic international comparison of press coverage of tobacco issues. Tobacco articles from major daily newspapers in Australia (12 newspapers; 1,188 articles) and the United States (30 newspapers; 1,317 articles) were collected over 1 year (2001). The analysis shows that coverage in the two countries was similarly apportioned between hard news (>70%) and opinion pieces. Similarly, stories in both countries were most likely to recount positive events. The substantive focus of coverage, however, differed, as did the expression of hostile opinion toward tobacco control efforts (United States, 4%; Australia, 7.1%). Although secondhand smoke and education, cessation, and prevention efforts were covered widely in both settings, these topics dominated coverage in Australia (29.2%) more than in the United States (17.6%), where a more diffuse set of tobacco topics gained relative prominence. The difference in policy conditions seems to offer contrasting opportunities for advocates in the two countries to use newspapers to promote helpful tobacco control messages for both behavior and policy change.     

Disease burden of adult lung cancer and ischaemic heart disease from passive tobacco smoking in China

Objective

To address the health hazards tobacco smoking imposes upon non‐smokers in China, this paper estimates the burden of diseases in adults from passive tobacco smoking for two major diseases—lung cancer and ischaemic heart disease (IHD).

Methods

The disease burden was estimated in terms of both premature mortality and disability adjusted life years (DALYs), a measure that accounts for both the age at death and the severity of the morbidity.

Results

Passive smoking caused more than 22 000 lung cancer deaths in 2002 according to these estimates. When the toll of disability is added to that of mortality, passive smoking was responsible for the loss of nearly 230 000 years of healthy life from lung cancer. Using the evidence from other countries that links IHD to passive smoking, we estimated that approximately 33 800 IHD deaths could be attributable to passive smoking in China in 2002. Passive smoking is also responsible for the loss of more than one quarter of a million years of healthy life from IHD. Although most of the disease burden caused by active smoking occurs among men, women bear nearly 80% of the total burden from passive smoking. The number of deaths among women caused by passive smoking is about two‐thirds of that caused by smoking for the two diseases we examined.

Conclusion

Even without considering the passive smoking risks for other diseases and among children that have been documented in other countries, passive smoking poses serious health hazards for non‐smokers, especially for adult female non‐smokers in China, adding more urgency to the need for measures to be taken immediately to protect the health of non‐smokers and curb the nation''s tobacco epidemic.     

Media advocacy, tobacco control policy change and teen smoking in Florida

Objective

To assess whether media advocacy activities implemented by the Florida Tobacco Control Program contributed to increased news coverage, policy changes and reductions in youth smoking.

Methods

A content analysis of news coverage appearing in Florida newspapers between 22 April 1998 and 31 December 2001 was conducted, and patterns of coverage before and after the implementation of media advocacy efforts to promote tobacco product placement ordinances were compared. Event history analysis was used to assess whether news coverage increased the probability of enacting these ordinances in 23 of 67 Florida counties and ordinary least square (OLS) regression was used to gauge the effect of these policies on changes in youth smoking prevalence.

Results

The volume of programme‐related news coverage decreased after the onset of media advocacy efforts, but the ratio of coverage about Students Working Against Tobacco (the Florida Tobacco Control Program''s youth advocacy organisation) relative to other topics increased. News coverage contributed to the passage of tobacco product placement ordinances in Florida counties, but these ordinances did not lead to reduced youth smoking.

Conclusion

This study adds to the growing literature supporting the use of media advocacy as a tool to change health‐related policies. However, results suggest caution in choosing policy goals that may or may not influence health behaviour.Many scholars contend that media advocacy—the strategic use of mass media and grassroots community organising to advance health policy—is a powerful strategy to generate news coverage about tobacco control, strengthen tobacco control policy and reduce tobacco use.^1,2,3 The news media bring policy initiatives to public and policymaker agendas^4,5 and frame issues in ways of consequence for health policy.⁶ As a result, the short‐term goals of media advocacy are increasing in the volume of news coverage on a public health issue and framing coverage in ways that support policy solutions.^7,8 This is most easily accomplished when grassroots organisations mobilise to draw the attention of news media to an issue.^7,8,9 News coverage of grassroots efforts puts pressure on policymakers to devise and/or implement specific solutions to public health problems. The intermediate goal of media advocacy is thus to facilitate passage of policies conducive to public health. In the long term, these policies should promote healthier environments and create meaningful changes in health behaviour.^7,8However, at the same time several authors note the shortage of research examining the role of news coverage in changing tobacco control policy and behaviour.^10,11,12 The evidence base supporting media advocacy as a reliable strategy for advancing health policy and changing health behaviour is limited.¹³ Although one large study provides strong evidence that media advocacy contributed to meaningful changes in drunk‐driving behaviour,^14,15,16 efforts to document the effectiveness of media advocacy for tobacco control are limited by constraints of case‐study methodologies for causal inferences,^17,18,19,20 characterised by inconsistent results,^20,21,22 focused on short‐run changes in news overage rather than long‐term policy and behaviour change,^21,22,23 and/or confounded by other components within multifaceted community interventions.^24,25 This study adds to this evidence base by assessing the effects of media advocacy, implemented as part of the Florida Tobacco Control Program (FTCP), on news coverage, tobacco control policy and smoking behaviour in Florida.The FTCP was a comprehensive education, marketing, prevention and enforcement campaign launched in 1998 to reduce smoking among Florida teens. The programme had three primary components: “truth”, a youth‐targeted media campaign; Students Working Against Tobacco (SWAT), a statewide youth anti‐tobacco group, and school‐based tobacco use prevention education.^26,27 Evaluators observed substantial reductions in youth behaviour within 2 years of the programme''s inception, far outpacing national declines,^26,27 and several studies show that the FTCP contributed to these reductions.^27,28,29The FTCP''s media advocacy strategy, a secondary programme component, involved sending press releases and working with reporters to promote FTCP programmes, media training for local SWAT leaders and promoting media events coordinated with local SWAT activities. After the budget crisis between March 1999 and June 1999, when the Florida legislature cut annual programme funding from $70 million to $38.7 million,³⁰ the FTCP initiated local mobilisation and media advocacy efforts to promote Tobacco Product Placement Ordinances (TPPOs). These ordinances, designed to reduce youth smoking by removing the visual and physical availability of cigarettes, would require retailers to place cigarettes and other tobacco products behind the counter. Local SWAT chapters used media advocacy to complement other efforts (community mobilisation, local events and presentations to county officials) in a combined effort to promote TPPOs at the county level.These efforts were seemingly met with success; between July 1999 and March 2002, 23 of 67 Florida counties passed TPPOs. However, the extent to which media advocacy and resulting news coverage contributed to these policies is unknown, and studies have not assessed whether these policies reduced teen smoking. Three conditions would strengthen conclusions about whether media advocacy contributed to the programme''s success. Firstly, programme‐related news coverage should increase after the onset of media advocacy efforts (hypothesis 1). Secondly, counties that received greater news coverage of SWAT events should be more likely to adopt TPPOs (hypothesis 2). Thirdly, counties that adopted TPPOs should witness greater subsequent declines in youth smoking than counties that did not (hypothesis 3). This paper tests these hypotheses by combining county news coverage estimates with county‐specific data on tobacco control policy and smoking behaviour.     

Point of purchase cigarette promotions before and after the Master Settlement Agreement: exploring retail scanner data

Background

Evidence indicates that point of purchase (POP) advertising and promotions for cigarettes have increased since the Master Settlement Agreement (MSA). Retail promotions have the potential to offset the effects of cigarette tax and price increases and tobacco control programmes.

Objective

To describe the trend in the proportion of cigarette sales that occur as part of a POP promotion before and after the MSA.

Design

Scanner data were analysed on cigarette sales from a national sample of grocery stores, reported quarterly from 1994 through 2003. The proportion of total cigarette sales that occurred under any of three different types of POP promotions is presented.

Results

The proportion of cigarettes sold under a POP promotion increased notably over the sample period. Large increases in promoted sales are observed following implementation of the MSA and during periods of sustained cigarette excise tax increases.

Conclusions

The observed pattern of promoted cigarette sales is suggestive of a positive relationship between retail cigarette promotions, the MSA, and state cigarette tax increases. More research is needed to describe fully the relationship between cigarette promotions and tobacco control policy.     

German tobacco industry's successful efforts to maintain scientific and political respectability to prevent regulation of secondhand smoke

Objective

To examine the tactics the tobacco industry in Germany used to avoid regulation of secondhand smoke exposure and to maintain the acceptance of public smoking.

Methods

Systematic search of tobacco industry documents available on the internet between June 2003 and August 2004.

Results

In West Germany, policymakers were, as early as the mid 1970s, well aware of the fact that secondhand smoke endangers non‐smokers. One might have assumed that Germany, an international leader in environmental protection, would have led in protecting her citizens against secondhand smoke pollution. The tobacco manufacturers in Germany, however, represented by the national manufacturing organisation “Verband” (Verband der Cigarettenindustrie), contained and neutralised the early debate about the danger of secondhand smoke. This success was achieved by carefully planned collaboration with selected scientists, health professionals and policymakers, along with a sophisticated public relations programme.

Conclusions

The strategies of the tobacco industry have been largely successful in inhibiting the regulation of secondhand smoke in Germany. Policymakers, health professionals, the media and the general public should be aware of this industry involvement and should take appropriate steps to close the gap between what is known and what is done about the health effects of secondhand smoke.     

Smoking too few cigarettes to be at risk? Smokers' perceptions of risk and risk denial,a French survey

Background

Past studies on smokers'' risk perception have produced mixed results. We endorsed a new approach to assess smokers'' perceptions of risk by asking them to estimate threshold values for the cancer risk associated with daily consumption of tobacco and number of smoking years. We expected that many smokers would endorse a “risk denial” attitude, with threshold estimates higher than their own smoking consumption and duration.

Methodology

A French national telephone survey (n = 3820; 979 current smokers) included several questions about smoking behaviours and related beliefs.

Results

Among current smokers, 44% considered that smoking can cause cancer only for a daily consumption higher than their own consumption, and an additional 20% considered that the cancer risk becomes high only for a smoking duration higher than their own. Most smokers also agreed with other “risk denial” statements (“smoking is not more dangerous than air pollution,” “some people smoke their whole life but never get sick”). Those who considered they smoked too few cigarettes to be at risk were less likely to report personal fear of smoking related cancer.

Conclusion

Risk denial is quite widespread among smokers and does not simply reflect a lack of information about health risks related to tobacco. Fully informing smokers about their risks may necessitate changing the way they process information to produce beliefs and limiting their capacity to generate self exempting beliefs.     

Smoking in Scottish youths: personal income, parental social class and the cost of smoking

Objective

To examine the relation of young people''s personal income and parental social class with smoking from early to mid adolescence.

Design

Longitudinal, school based, study of a cohort of 2586 eleven year‐olds followed up at ages 13 and 15.

Setting

West of Scotland.

Participants

93% baseline participation, reducing to 79% at age 15.

Main outcome measures

Ever smoked (age 11), current and daily smoking (ages 13 and 15) and the proportion of income spent on tobacco (13 and 15) based on recommended retail prices of usual brands.

Results

Strong independent effects of parental social class and personal income were found at 11 years, both reducing with age. The higher incomes of lower class participants attenuated the social class effect on smoking at ages 11 and 13, but not at 15. Analysis within class groups showed variation in the effect of income on smoking, being strongest among higher class youths and weak or non‐existent among lower class youths. This was despite the fact that the proportion of weekly income apparently spent on tobacco was greater among lower class youths.

Conclusions

The results confirm the importance of personal income and parental social class for youth smoking, but they also show that personal income matters more for those from higher class backgrounds. This suggests both that lower class youths have greater access to tobacco from family and friends and to cheaper sources of cigarettes from illegal sources. This complicates the relation between fiscal policies and smoking and might have the unintended consequence of increasing class differentials in youth smoking rather than the reverse.     

Industry sponsored anti-smoking ads and adolescent reactance: test of a boomerang effect

Objective

To examine whether adolescents'' exposure to youth smoking prevention ads sponsored by tobacco companies promotes intentions to smoke, curiosity about smoking, and positive attitudes toward the tobacco industry.

Design

A randomised controlled experiment compared adolescents'' responses to five smoking prevention ads sponsored by a tobacco company (Philip Morris or Lorillard), or to five smoking prevention ads sponsored by a non‐profit organisation (the American Legacy Foundation), or to five ads about preventing drunk driving.

Setting

A large public high school in California''s central valley.

Subjects

A convenience sample of 9th and 10th graders (n  =  832) ages 14–17 years.

Main outcome measures

Perceptions of ad effectiveness, intention to smoke, and attitudes toward tobacco companies measured immediately after exposure.

Results

As predicted, adolescents rated Philip Morris and Lorillard ads less favourably than the other youth smoking prevention ads. Adolescents'' intention to smoke did not differ as a function of ad exposure. However, exposure to Philip Morris and Lorillard ads engendered more favourable attitudes toward tobacco companies.

Conclusions

This study demonstrates that industry sponsored anti‐smoking ads do more to promote corporate image than to prevent youth smoking. By cultivating public opinion that is more sympathetic toward tobacco companies, the effect of such advertising is likely to be more harmful than helpful to youth.     

Working to make an image: an analysis of three Philip Morris corporate image media campaigns

Objective

To describe the nature and timing of, and population exposure to, Philip Morris USA''s three explicit corporate image television advertising campaigns and explore the motivations behind each campaign.

Methods

: Analysis of television ratings from the largest 75 media markets in the United States, which measure the reach and frequency of population exposure to advertising; copies of all televised commercials produced by Philip Morris; and tobacco industry documents, which provide insights into the specific goals of each campaign.

Findings

Household exposure to the “Working to Make a Difference: the People of Philip Morris” averaged 5.37 ads/month for 27 months from 1999–2001; the “Tobacco Settlement” campaign averaged 10.05 ads/month for three months in 2000; and “PMUSA” averaged 3.11 ads/month for the last six months in 2003. The percentage of advertising exposure that was purchased in news programming in order to reach opinion leaders increased over the three campaigns from 20%, 39% and 60%, respectively. These public relations campaigns were designed to counter negative images, increase brand recognition, and improve the financial viability of the company.

Conclusions

Only one early media campaign focused on issues other than tobacco, whereas subsequent campaigns have been specifically concerned with tobacco issues, and more targeted to opinion leaders. The size and timing of the advertising buys appeared to be strategically crafted to maximise advertising exposure for these population subgroups during critical threats to Philip Morris''s public image.     

Death at a discount: how the tobacco industry thwarted tobacco control policies in US military commissaries

Background

The US military is perhaps the only retailer consistently losing money on tobacco. Military stores (commissaries and exchanges) have long sold discount‐priced cigarettes, while the Department of Defense (DoD) pays directly for tobacco‐related healthcare costs of many current and former customers. Tobacco use also impairs short‐term troop readiness.

Objective

To examine the long struggle to raise commissary tobacco prices and the tobacco industry''s role in this policy effort.

Methods

Analysis of internal tobacco industry documents, searches of government and military websites and newspaper databases, and interviews with key informants identified in the documents.

Results

Efforts to raise commissary tobacco prices began in the mid‐1980s. Opposition quickly emerged. Some military officials viewed tobacco use as a “right” and low prices as a “benefit”. Others raised issues of authority, and some saw the change as threatening the stores. The tobacco industry successfully exploited complex relationships among the Congress, the DoD, commissaries, exchanges and private industry, obstructing change for over a decade. Leadership from the Secretary and Assistant Secretaries of Defense, presidential support and procedural manoeuvring finally resulted in a modest price increase in 1996, but even then, high‐level military officials were apparently threatened with retaliation from pro‐tobacco Congressmen.

Conclusions

The longstanding military tradition of cheap cigarettes persists because of the politics of the military sales system, the perception within the military of tobacco use as a right, and tobacco industry pressures. Against its own best interests, the US military still makes tobacco available to service members at prices below those in the civilian sector.The US military includes 1.4 million active duty personnel, stationed worldwide. Their smoking prevalence is higher (33.8% in 2002) than the US Department of Defense (DoD) goal of ⩽20%,¹ exceeding the civilian rate of 23.6%.² Smoking diminishes even short‐term troop health and readiness^3,4 and increases medical and training costs.^5,6 As an authoritarian, hierarchical institution, DoD should, theoretically, be able to establish and implement strong tobacco control policies. Nonetheless, DoD sells its personnel tobacco products virtually tax free. Military health personnel and some members of Congress have long sought to address this contradiction. This case study shows how for more than a decade, the tobacco industry worked to defeat policy changes by framing cheap cigarettes as a “benefit”, mobilising Congressional and military‐affiliated allies, and exploiting DoD ambivalence about tobacco.     

Smokers and non-smokers talk about regulatory options in tobacco control

Objective

Community members are occasionally polled about tobacco control policies, but are rarely given opportunities to elaborate on their views. We examined laypeople''s conversations to understand how 11 regulatory options were supported or opposed in interactions.

Design

Qualitative design; purposive quota sampling; data collection via focus groups.

Setting

Three locations in Sydney, Australia.

Participants

63 smokers and 75 non‐smokers, men and women, from three age groups (18–24, 35–44, 55–64 years), recruited primarily via telephone.

Measurements

Semi‐structured question route; data managed in NVivo; responses compared between groups.

Results

Laypeople rejected some regulatory proposals and certain arguments about taxation and the cost of cessation treatments. Protecting children and hypothecating tobacco excise for health education and care were highly acceptable. Plain packaging, banning retail displays and youth smoking prevention received qualified support. Bans on political donations from tobacco corporations were popular in principle but considered logistically fraught. Smokers asked for better cessation assistance and were curious about cigarette ingredients. Justice was an important evaluative principle. Support was often conditional and unresolved arguments frequent. We present both sides of these conflicts and the ways in which policies were legitimised or de‐legitimised in conversation.

Conclusions

Simple measures of agreement used in polls may obscure the complexity of community responses to tobacco policy. Support was frequently present but contested; some arguments that seem self‐evident to advocates were not so to participants. The detailed understanding of laypeople''s responses provided through qualitative methods may help frame proposals and arguments to meet concerns about justice, effectiveness and feasibility.     

Levels of toxins in oral tobacco products in the UK

Objective

This study examined the constituents of smokeless tobacco products available in the UK and compared them with products available in India, Sweden, and the USA

Methods

Seven UK brands of smokeless tobacco, including a tooth cleaning powder, and four international brands of smokeless tobacco were tested for a range of toxins and known carcinogens, such as tobacco specific N‐nitrosamines (TSNA), as well as nicotine availability.

Results

Ten of the 11 brands tested had detectable levels of tobacco specific nitrosamines, which are proven carcinogens, and levels varied 130‐fold. All had detectable levels of benzo(a)pyrene, another proven carcinogen (with around 175‐fold variation) and several toxic metals (with nearly 150‐fold variation). Nicotine availability varied in the UK products from 0.1 mg/g to 63.2 mg/g. All the tobacco products tested are likely to be hazardous to users'' health, but the data indicate that it should be possible to reduce key toxins to non‐detectable levels.

Conclusions

Smokeless tobacco products should be regulated and standards set for maximum levels of toxins and carcinogens.     

Eliminating child labour in Malawi: a British American Tobacco corporate responsibility project to sidestep tobacco labour exploitation

Objectives

To examine British American Tobacco and other tobacco industry support of the Eliminating Child Labour in Tobacco Growing Foundation.

Design

Analyses of internal tobacco industry documents and ethnographic data.

Results

British American Tobacco co‐founded the Eliminating Child Labour in Tobacco Growing Foundation (ECLT) in October 2000 and launched its pilot project in Malawi. ECLT''s initial projects were budgeted at US$2.3 million over four years. Labour unions and leaf dealers, through ECLT funds, have undertook modest efforts such as building schools, planting trees, and constructing shallow wells to address the use of child labour in tobacco farming. In stark contrast, the tobacco companies receive nearly US$40 million over four years in economic benefit through the use of unpaid child labour in Malawi during the same time. BAT''s efforts to combat child labour in Malawi through ECLT was developed to support the company''s “corporate social responsibility agenda” rather than accepting responsibility for taking meaningful steps to eradicate child labour in the Malawi tobacco sector.

Conclusion

In Malawi, transnational tobacco companies are using child labour projects to enhance corporate reputations and distract public attention from how they profit from low wages and cheap tobacco.     

Litigation in Argentina: challenging the tobacco industry

Objective

To evaluate the processes and outcomes of tobacco litigation in Argentina and to analyse the strategies of the tobacco industry to oppose litigation using tobacco industry documents.

Methods

A systematic search of tobacco industry documents on the internet dating from 1978 to 2002. Law library searches using Argentinean official and unofficial reports systems were combined with computerised online searches.

Results

There have been at least 15 failed litigation cases in Argentina and the tobacco industry presented a concerted defence in every claim regardless of cost. We categorised 11 cases as product liability and nicotine addiction, two as health care reimbursement, and two as criminal law and secondhand smoke. Industry strategies included hiring legal consultants from prestigious international and Argentinean law firms and developing litigation prevention programmes. Industry monitored legal academic meetings, controlled the development of new product liability legislation, obtained favourable opinions from experts, and closely observed the development of litigation in Argentina.

Conclusion

The strategies used by the industry have been successful in preventing recovery for tobacco injuries through litigation. Argentinean health advocates and lawyers need to be aware of the roles and strategies of the tobacco industry in order to develop effective litigation in Argentina.