Challenges in realising the end game: Dealing with the tobacco industry


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Anna B Gilmore1
1University of Bath, Bath, UK

Abstract

The transnational tobacco companies (TTCs) have been described as the vectors of the tobacco epidemic. Overwhelming evidence that TTCs have "operated for years with the express intention of subverting the role of governments and of WHO in implementing public health policies to combat the tobacco epidemic" led to the inclusion of Article 5.3 in the WHO's Framework Convention on Tobacco Control (FCTC). This Article requires that Parties to the treaty shall act to protect their public health policies "from commercial and other vested interests of the tobacco industry in accordance with national law" (http://www.who.int/fctc/guidelines/article_5_3.pdf).

Yet securing effective implementation of Article 5.3 is complex, in part because the TTCs have influenced the regulatory framework through which public policies are assessed in a way that embeds corporate influence over policy making and favours corporate interests (see http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000202). Consequently TTCs remain highly influential. Moreover, although tobacco sales are falling in many countries and global sales are stagnating, TTC profits have been increasing, providing ample funding for their lobbying activities (see, for example, http://tobaccocontrol.bmj.com/content/21/2/119.abstract and http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2981493/).

This presentation will examine the difficulties of implementing effective public health policies when there is a powerful vested interest opposing them. It will do so using two contemporary case studies that build on earlier presentations in this session including TTC efforts to prevent the implementation of standardised tobacco packaging in the UK. It will go on to argue that these difficulties require novel solutions. In this light it will explore a variety of ‘end-game' solutions that propose changes to the way tobacco is supplied or industry is regulated.