Big losses for Big Tobacco

By Abbhirami Rajagopal

Six million people die annually as a result of tobacco. Many governments have adopted the WHO framework for tobacco control and have since taken measures (policy changes, cessation programs, etc.) to reduce mortalities and morbidities that occur due to tobacco. Not surprisingly, big tobacco companies like Philip Morris International have pushed back against countries that have enacted stringent packaging laws.

In a much-awaited decision, Australia won an international legal battle to uphold its tobacco policies that include the plain packaging laws. Australia has enacted some of the toughest measures to reduce the harm caused by tobacco and plain packaging laws are among them. These laws are intended to prevent the tobacco companies from displaying their distinctive designs, colors or even their brand logos (companies can include their names and logos, but they cannot have flashy, enticing packaging). Instead, the companies would be required to use olive-green packs with health warnings and graphic color images that would cover nearly 75% of the front of the packs. The Plain Packaging Act passed by the Australian parliament became law in 2011 and, shortly thereafter, Hong Kong-based PMI sought legal action against Australia citing that, by stripping logos off the packs, these stringent laws violated the bilateral investment treaty between Australia and Hong Kong, thereby severely diminishing their brand value.

This is not the first time Philip Morris has dragged governments into legal battles over stricter anti-smoking and tobacco laws.

While global rate of lung cancer mortality was increasing between 1990 and 2013, owing to stricter anti-tobacco measures, Uruguay saw a 15% reduction in lung cancer mortality. PMI, a company whose revenues were nearly $80 billion in 2013, sued Uruguay, a small country of 3 million with a GDP of about $56 billion, in 2013. The lawsuit was brought to the International Center for Settlement of Investment Disputes (ICSID) in 2010 and the company is seeking $25 million in damages from Uruguay, once again, citing violation of bilateral investment treaty between Uruguay and Switzerland. The ICSID is expected to settle this case by arbitration.

The upholding of the anti-tobacco laws in Australia will hopefully set a precedent and allow countries to move forward with legitimate public health actions to curb the global tobacco epidemic without interference from tobacco companies.

John Oliver takes on Big Tobacco in Last Week Tonight

Many thanks to Dr. Don Zeigler, who passed this on through APHA’s Trade and Health Forum listserv. In a recent episode of Last Week Tonight (har), John Oliver explains how the tobacco industry is compensating for the fall in smoking rates here in the US by utilizing impressively convoluted international legal tactics and taking its business to developing countries in its usual style – shady as hell. The video is long (about 18 minutes), but is seriously worth every second.

Petition to Exclude Tobacco from TPP Negotiations

The following petition was forwarded to the IH leadership by section member Mary Anne Mercer, liaison to APHA’s Trade and Health Forum.


U.S. Trade Proposal Caves to Big Tobacco

U.S. Medical, Public Health, Public Interest Groups Urge Protection for Health & Wealth

Please sign here to protect tobacco controls from attacks by tobacco multinationals and their corporate allies.

The U.S. Trade Representative intends to introduce a proposal on tobacco at negotiations to create the Trans Pacific Partnership (TPP), a trade agreement among 12 nations, at meetings in Brunei this week. The proposal capitulates to multinational tobacco corporations, jeopardizing the nation’s health and economic welfare.

Tobacco companies have recently accelerated their use of trade rules to attempt to delay and reverse tobacco control measures that limit marketing  in the U.S., Australia, Uruguay, Norway, and Ireland. Trade rules grant corporations rights to contest nations’ public health and other policies. Countries that lose trade challenges face stiff financial penalties, payable to the complaining corporation.

Public health and medical advocates in the U.S. and abroad have urged the USTR to exclude tobacco control protections from trade challenges under the TPP.  The USTR informally floated a policy in 2012 that could create a “safe harbor” for some tobacco control regulations. Many legal and medical experts noted that tobacco companies could easily exploit the remaining substantial loopholes.

But the tobacco industry marshaled opposition claiming that the U.S. proposal might actually reduce tobacco use, tobacco-related deaths, and tobacco sales.  Other corporations backed up Big Tobacco, expressing concern that addressing the uniquely lethal effects of tobacco in trade agreements could set a precedent for reining in their own practices. On Aug. 15, USTR announced it would not advance that proposal.

The new proposal offers less than a fig leaf for trade rules that grant corporations rights over public health protections, and often eliminate them.  It proposes simply to refer to the TPP the general health exception described in two multilateral agreements under the jurisdiction of the World Trade Organization (WTO): Article XX of the General Agreement on Tariffs and Trade (GATT), and Article XIV of the General Agreement on Trade in Services (GATS), and inserts a statement into the exception that repeats the self-evident observation that tobacco measures are health measures.These exceptions offer significant loopholes that favor companies asserting trade charges.[1] The exceptions do not apply to investment claims that tobacco companies could bring under the TPP.  Even in trade disputes, the exceptions apply with great uncertainty in very limited situations.  They require multi-year, multi-million-dollar litigation to mount a defense – a burden that many countries cannot afford.  The tobacco industry exploits the cost and uncertainty of using the exceptions. (As a regional agreement, the TPP claims some latitude in varying from WTO rules.)

It also tacks on an additional layer of consultation among Health Ministers in the case of tobacco-related trade challenges between nations, added to the procedures and rules already provided.  In effect, it conscripts health officials to consult in the context of trade rules they had no role in shaping, over trade challenges they did not initiate and have no power to adjudicate.

Tobacco use costs the U.S. far more in lives and health care expenses than tobacco farming or manufacturing contribute to the economy.

  • Tobacco use kills 1,200 Americans daily. Cigarette smoking is responsible for an estimated $193 billion in annual health-related economic losses in the U.S. (nearly $96 billion in direct medical costs and an additional $97 billion in lost productivity).[2]
  • In contrast, total tobacco exports generate 0.10 percent (one tenth of one percent) of total U.S. annual exports (.07% unmanufactured, and .03% manufactured).[3] Tobacco manufacturing has declined exponentially in the U.S., and tobacco farming is also in decline, due in part to U.S. programs intended to facilitate the transition to more sustainable crops.[4]
  • Exports of cigarettes and other U.S.-manufactured tobacco products dropped from $3.9 billion in 1999 to $488 million in 2011, as large U.S. manufacturers sold off their international businesses or formed subsidiaries located abroad.[5] Ninety-eight percent of exported U.S. cigarettes go to 5 countries, only one of which is a TPP partner (Japan). Lower tariffs would lower the price of tobacco products, resulting in cheaper prices and increased consumption and use, especially among younger people. For this reason, international health policy and U.S. law prohibit the U.S. from using trade agreements to promote the sale or export of tobacco products. Yet the U.S. proposes to eliminate tariffs on tobacco products. Other TPP partners can reasonably object to encouraging the import of U.S. brand cigarettes.

Tobacco is the only legal consumer product that kills when used as intended. Tobacco use is the leading preventable cause of death worldwide, accounting for 6 million preventable deaths annually,[6] and is a major contributor to the global pandemic of non-communicable diseases, including childhood morbidity and mortality. As a unique product, it must be treated differently from other products and services that are traded across borders.

We urge TPP Partner countries to advance proposals that promote public health and stem preventable deaths from diseases related to tobacco, by guaranteeing nations’ sovereign domestic rights and abilities to adopt or maintain measures to reduce tobacco use and to prevent tobacco-related deaths and diseases:

  1. Exclude tobacco control measures from existing and future trade agreements.
  2. Do not request or agree to lower tariffs on tobacco leaf or products.
  3. Remove investor-state dispute settlement (ISDS) provisions; these grant tobacco corporations rights to contest nations’ public health and other policies directly for financial damages through the global trade arena.
  4. Set trade policy through a transparent public process.

President Obama’s 2013 State of the Union message promised to lead an economy for the 21st Century, to reduce preventable deaths among youth, and to conduct policy transparently. Trade negotiations that expand corporate rights and powers, while undermining the public’s health, cannot advance sustainable economic growth or wellbeing.

PleaseSign the petition to protect tobacco controls from attacks by tobacco multinationals and their corporate allies – and send this note to your lists. 

If the link does not work for you, please go to this web address: http://trustwomen.civicactions.org/CPATH/smoke_out_tobacco_from_the_tpp

Post on Facebook:  Sign the Open Petition to Smoke Out Tobacco from the TPP!

Twitter: Sign on to protect tobacco controls from attacks by tobacco multinationals and their corporate allies.  Please sign here: http://bit.ly/171EnTD #StopTPP #TobaccoOutTPP #SmokeOutTPP@CPATH @USTradeRep @CouncilofCDNs

Initial Sponsoring Organizations:

Action on Smoking and Health (ASH), Chris Bostic, MSFS, JD, Deputy Director for Policy

American College of Obstetricians and Gynecologists, Barbara S. Levy, Vice President, Women’s Health Policy

American College of Physicians

Center for Policy Analysis on Trade and Health (CPATH), Ellen R. Shaffer, PhD, and Joe Brenner, MA, Co-Directors

Corporate Accountability International, John Stewart, Campaign Director, Challenge Big Tobacco

Human Rights and Tobacco Control Network (HRTCN), Carolyn Dresler, MD, Chair

International Association for the Study of Lung Cancer, Mike Cummings, MD, Chair, Tobacco Control Committee

Initial Sponsoring Individuals:

Tom Houston, MD, McConnell Heart Health Center, Columbus, Ohio

Don Zeigler, PhD, Adjunct Associate Clinical Professor, UIC School of Public Health

[1] R. Stumberg, Safeguards for Tobacco Control: Options for the TPPA. America Journal of Law and Medicine, 39 (213); 382-441.
[2] Centers for Disease Control and Prevention. Smoking-Attributable Mortality, Years of Potential Life Lost, and Productivity Losses—United States, 2000–2004. Morbidity and Mortality Weekly Report 2008;57(45):1226–8 [accessed Aug. 17, 2013].
[3] FDA, Report to Congress. United States Tobacco Product Exports That Do Not Conform to Tobacco Product Standards. 3/8/13.
[4] http://www.fsa.usda.gov/FSA/webapp?area=home&subject=toba&topic=landing
[5] U.S. Government Accountability Office report, “Illicit Tobacco: Various Schemes are Used to Avoid Taxes and Fees,” accessed August 18, 2013, from http://www.gao.gov/assets/320/316372.pdf
[6] Thomas H. Frieden. http://www.upi.com/Health_News/2012/06/14/US-smoking-related-diseases-cost-96B/UPI-56571339724113/#ixzz2cH5erl4c

WHO Video: Ban tobacco advertising, promotion and sponsorship (World No Tobacco Day 2013)

Here is another short anti-tobacco video (PSA?) from the WHO marking World No Tobacco Day this year. Like last year’s video, it portrays Big Tobacco as the sinister bad guy who controls us all without us knowing it. I know these videos are meant to appeal to a wide audience, and send a strong and simple message, but I wish that the anti-tobacco videos would feature more actual information and statistics, rather than just showing us that Big Tobacco is some big, bad puppeteer.



Every year, on 31 May, WHO and partners mark World No Tobacco Day, highlighting the health risks associated with tobacco use and advocating for effective policies to reduce tobacco consumption. Tobacco kills nearly six million people each year, of which more than 600 000 are non-smokers dying from breathing second-hand smoke.

IH News Global Health Weekly News Round-Up

Politics and Policies:

  • Somalia signs its new Healthcare Plan. It has moved away from the emergency-level health provision towards more mainstream national health systems.
  • Kenya’s President elect promises much needed free primary healthcare for the citizens and raising the financing from 6-15%
  • Five memorandums of understandings has been signed by Egypt with South Sudan in the healthcare, livestock and agriculture sectors.
  • Tanzania and Japan sign Sh802 million project grant. It will help Tanzania in various sectors including health, education and water supply.
  • Kansas, United States, doctors may be required to tell patients that abortion causes breast cancer.

Programs:

  • The World Bank will help Cameroon to build safety net system aimed at reducing poverty and vulnerability. Households will get training to improve their health.
  • Solar power in Africa helps people to grow nutritional vegetables and improve their basic needs including health.
  • The United Nations Population Fund (UNFPA) calls for more reproductive health resources.
  • UNAIDS and other health organizations support new TB and HIV initiative in Africa.  It will include a package worth more than US$120 million to be used to expedite this process.
  • South Sudan through its community health workers detect and treat tuberculosis. This strategy is helping to fight tuberculosis draws communities themselves to detect and treat cases of tuberculosis.
  • UC San Francisco receives $2 million from billionaire Li K-shing for transforming its medical care by integrating data from the human genome and disease research with information from patient’s records and environmental data.

 Research:

  • According to a study about 570 United Kingdom children start smoking every day. This has made the UK government to consider whether to introduce plain packaging for tobacco products.
  • According to a study published in the New England Journal of Medicine physiotherapy results are as good as knee surgery.
  • According to a study, as part of prevention of mother-to-child transmission of HIV virus, antiretroviral therapy has to be initiated before the last trimester of pregnancy to achieve an undetectable RNA plasma viral load before delivery.
  • A report of United Nation states that about four and a half billion people have access to toilet (as compared to six billion people who have access to mobile phones) of the world’s seven billion people.
  • Researchers are working to tackle obstacles to medical aid.
  • According to the World Health Organization and Global Fund Africa and Europe has not yet reached the millennium tuberculosis goal. They say that strains of tuberculosis with resistance to multiple drugs could spread widely.
  • According to a report by the UNICEF, about 66 million Nigerians are without portable water.  It is the leading cause of diseases and deaths especially among under five aged children.
  • Doctors have discovered a women’s mysterious bone condition due to drinking a pitcher of tea every day for past 17 years.
  • Reports indicate that only 28% of Ugandans have access to hand-washing facilities. Statistics from the Uganda Demographic and Household Survey show that 190,000 Ugandan children die every year due to diarrhea.
  • A report publish by the World Health organization (WHO), among South-East Asia Region, Indonesia has achieved an amazing 90% success rate for TB treatment.
  • Scientists from the John Hopkins University have developed a new innovative method known as Predicting Infectious Disease Scalable Model (PRISM) extracts relationships between clinical, meteorological, climatic and socio-political data in Peru and the Philippines.
  • According to a study flu sufferers can spread the virus by sneezing, while talking, breathing by at least 6 feet.
  • A new method to treat blinding cornea diseases in children is now available in Singapore.
  • According to a study breast cancer radiation therapy increases a women’s risk of suffering a heart attack or other heart problems.
  • A study indicates an increase in the number of parents who won’t vaccinate daughters against Human Papilloma Virus (HPV).
  • A study shows that parents seem to be increasingly worried about the vaccine’s safety.
  • Low-GI protein blends have been designed to be eaten about 30 minutes before meals to reduce satiety is being marketed by a Swedish form Indevex. It increases release of incretin hormone which can provoke insulin release before blood glucose levels due to meal consumption.
  • A research done by Lund University in Sweden shows that we can modify the function of genes through epigenetic changes that can take place over the course of time.
  • United States tuberculosis rates reach all-time low but resistance of bacteria is a continuous threat.
  • Researchers have indicated that menstrual blood cells can be used to treat heart failure patients.
  • Researchers say that females with ovarian cancer too often get insufficient treatment.

Diseases and Disasters:

  • Chinese Public call for tackling water pollution.
  • Reports indicate that about 40 patients have lost their lives in drug trials in Maharashtra, India.
  • According to a report released by the CDC, from early December, 2012 to mid-February 2013, the Salmonella Typhimurium outbreak linked to ground beef had sickened a total of 22 people.
  • Natives of United States call for increased HIV testing per Centers for Disease Control and Prevention (CDC) recommendations.