Conceived and designed the experiments: JC AG. Performed the experiments: HW KES TG SM. Analyzed the data: HW JC KES TG SM AG. Contributed reagents/materials/analysis tools: JC AG KES. Wrote the first draft of the manuscript: HW. Contributed to the writing of the manuscript: JC KES TG AG.
JC and AG were both part of a WHO Tobacco Free Initiative (TFI) Expert Committee convened to develop recommendations on how to address tobacco industry interference with tobacco control policy, and as such their travel to a meeting in Washington DC was reimbursed by WHO TFI. All other authors have declared that no competing interests exist.
Heide Weishaar and colleagues did an analysis of internal tobacco industry documents together with other data and describe the industry's strategic response to the proposed World Health Organization Framework Convention on Tobacco Control.
In successfully negotiating the Framework Convention on Tobacco Control (FCTC), the World Health Organization (WHO) has led a significant innovation in global health governance, helping to transform international tobacco control. This article provides the first comprehensive review of the diverse campaign initiated by transnational tobacco corporations (TTCs) to try to undermine the proposed convention.
The article is primarily based on an analysis of internal tobacco industry documents made public through litigation, triangulated with data from official documentation relating to the FCTC process and websites of relevant organisations. It is also informed by a comprehensive review of previous studies concerning tobacco industry efforts to influence the FCTC. The findings demonstrate that the industry's strategic response to the proposed WHO convention was two-fold. First, arguments and frames were developed to challenge the FCTC, including: claiming there would be damaging economic consequences; depicting tobacco control as an agenda promoted by high-income countries; alleging the treaty conflicted with trade agreements, “good governance,” and national sovereignty; questioning WHO's mandate; claiming the FCTC would set a precedent for issues beyond tobacco; and presenting corporate social responsibility (CSR) as an alternative. Second, multiple tactics were employed to promote and increase the impact of these arguments, including: directly targeting FCTC delegations and relevant political actors, enlisting diverse allies (e.g., mass media outlets and scientists), and using stakeholder consultation to delay decisions and secure industry participation.
TTCs' efforts to undermine the FCTC were comprehensive, demonstrating the global application of tactics that TTCs have previously been found to have employed nationally and further included arguments against the FCTC as a key initiative in global health governance. Awareness of these strategies can help guard against industry efforts to disrupt the implementation of the FCTC and support the development of future, comparable initiatives in global health.
Every year, about 5 million people die worldwide from tobacco-related causes and, if current trends continue, annual deaths from tobacco-related causes will increase to 10 million by 2030. In response to this global tobacco epidemic, the World Health Organization (WHO) has developed an international instrument for tobacco control called the Framework Convention on Tobacco Control (FCTC). Negotiations on the FCTC began in 1999, and the international treaty—the first to be negotiated under the auspices of WHO—entered into force on 27 February 2005. To date, 174 countries have become parties to the FCTC. As such, they agree to implement comprehensive bans on tobacco advertising, promotion, and sponsorship; to ban misleading and deceptive terms on cigarette packaging; to implement health warnings on tobacco packaging; to protect people from tobacco smoke exposure in public spaces and indoor workplaces; to implement taxation policies aimed at reducing tobacco consumption; and to combat illicit trade in tobacco products.
Transnational tobacco corporations (TTCs) are sometimes described as “vectors” of the global tobacco epidemic because of their drive to maximize shareholder value and tobacco consumption. Just like conventional disease vectors (agents that carry or transmit infectious organisms), TTCs employ a variety of tactics to ensure the spread of tobacco consumption. For example, various studies have shown that TTCs have developed strategies that attempt to limit the impact of tobacco control measures such as the FCTC. However, to date, studies investigating the influence of TTCs on the FCTC have concentrated on specific countries or documented specific tactics. Here, the researchers undertake a comprehensive review of the diverse tactics employed by TTCs to undermine the development of the FCTC. Such a review is important because its results should facilitate the effective implementation of FCTC measures and could support the development of future tobacco control initiatives and of global initiatives designed to control alcohol-related and food-related disease and death.
The researchers analyzed documents retrieved from the Legacy Tobacco Documents Library (a collection of internal tobacco industry documents released as a result of US litigation cases) dealing with the strategies employed by TTCs to influence the FCTC alongside data from the websites of industry, consultancy, and other organizations cited in the documents; the official records of the FCTC process; and previous studies of tobacco industry efforts to influence the FCTC. Their analysis reveals that the strategic response of the major TTCs to the proposed FCTC was two-fold. First, the TTCs developed a series of arguments and “frames” (beliefs and ideas that provide a framework for thinking about an issue) to challenge the FCTC. Core frames included claiming that the FCTC would have damaging economic consequences, questioning WHO's mandate to develop a legally binding international treaty by claiming that tobacco was not a cross-border problem, and presenting corporate social responsibility (the commitment by business to affect the environment, consumers, employees, and society positively in addition to making money for shareholders) as an alternative to the FCTC. Second, the TTCs employed multiple strategies to promote and increase the impact of these arguments and frames, such as targeting FCTC delegations and enlisting the help of diverse allies including media outlets and scientists.
These findings illustrate the variety and complexity of the tobacco industry's efforts to undermine the FCTC and show the extent to which TTCs combined and coordinated tactics on a global stage that they had previously used on a national stage. Indeed, “the comprehensiveness and scale of the tobacco industry's response to the FCTC suggests that it is reasonable to speak of a ‘globalisation of tobacco industry strategy’ in combating the development of effective tobacco control policies,” write the researchers. Awareness of the strategies employed by TTCs to influence the FCTC should help guard against industry efforts to disrupt the implementation of the FCTC and should support the development of future global tobacco control initiatives. More generally, these findings should support the development of global health initiatives designed to tackle cardiovascular disease, cancer, chronic respiratory diseases and diabetes – non-communicable diseases that together account for 60% of global deaths and are partly driven by the commercial activities of food, alcohol, and tobacco corporations.
Please access these Web sites via the online version of this summary at
The World Health Organization provides information about the dangers of
For information about the tobacco industry's influence on policy, see the 2009 World Health Organization report
The
The
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The WHO Framework Convention on Tobacco Control (FCTC), the first international public health treaty initiated by the World Health Organization (WHO), arguably represents the most significant tobacco control initiative to date and has been central to WHO's efforts to reestablish its strategic significance. The treaty constitutes a landmark in global health governance
In their drive to maximise shareholder value and global tobacco consumption, transnational tobacco corporations (TTCs) have been described as a “vector” of this epidemic
This paper is based on analysis of previously confidential tobacco industry documents made publicly available through litigation in the United States and is informed by a comprehensive review of the existing literature concerning TTCs' strategies to influence the FCTC. Online searches of the Legacy Tobacco Documents Library (
A qualitative, hermeneutic methodology was employed to analyse the documents
Regarding the comprehensive review of the existing published literature concerning tobacco industry efforts to influence FCTC negotiations, systematic searches were conducted using the search terms “Framework convention on tobacco control” OR (FCTC AND tobacco) between November 2011 and January 2012 in the following databases: Global Health (CABI, 172 hits), PubMed (140 hits), Web of Knowledge (119 hits), the Centre for Tobacco Control Research and Education's e-scholarship website (
The methodological approach of the study was approved by the Research Ethics Committee of the University of Bath's School for Health.
Our literature review identified 12 country-specific case studies showing, for example, how TTCs tried to use their influence on German politicians to weaken the FCTC
Our documentary analysis revealed that all major TTCs were considerably alarmed about the FCTC from its initiation
The Results section is divided into two subsections which outline the frames and tactics TTCs employed in an FCTC context, respectively. Both sections focus primarily on the documentary data, but the findings from the literature review are incorporated into
Frame | Goal | Evidence of Application |
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1. |
To depict tobacco control as detrimental to the economy and threaten policy makers and politicians; particularly effective during economic recession | |
2. |
To divert attention away from tobacco control; to cause and increase dissent and hostility | |
3. |
To stall tobacco control initiatives, including regulation of tobacco ingredients, health warning labels, plain packaging, etc. | |
4. |
To question the legal basis for tobacco control initiatives and particularly prevent legislation spanning across national and regional borders | |
5. |
To increase opposition against tobacco control and the policy makers responsible for it; to stall the process of tobacco control policy making |
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6. |
To make the case that international tobacco control undermines national sovereignty, including by questioning the legitimacy of international tobacco control and in so doing, to raise opposition of nation states | |
7. |
To create an illusion of being a “changed,” more socially responsible company; to regain political and public credibility | |
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8. |
To enlist allies in debates by claiming relevance to other health issues and potential implications for other industries | |
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9. |
To stress that tobacco is a legal product which should be treated like any other issue |
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10. |
To depict stringent tobacco regulation as rigid and unreasonable | |
11. |
To portray tobacco control advocates and their positions as unacceptable and, by contrast, tobacco industry positions as moderate and reasonable | |
12. |
To maintain the tobacco industry's ability to market their products; and to maintain the social acceptability of smoking |
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13. |
To cast doubt on the scientific evidence that smoking is health damaging and play down the seriousness of the health problem |
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14. |
To appear to help prevent underage smoking and to depict smoking as an adult choice, although research suggests industry-sponsored programmes are usually ineffective (often linked to CSR programmes) |
Tactic | Related Goals | Evidence of Application |
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1. Targeting national FCTC delegations and political actors (via lobbying and infiltration of organisations and committees with influence) | • To promote particular ideas and information, attempt to make deals, and generally influence political processes• To persuade policymakers that tobacco control proposals conflict with other, existing legislation (such as trade agreements)• To infiltrate decision-making bodies and influence political decisions• To mobilise decision makers with opposing views in order to increase opposition against tobacco control legislation and influence political debates and decisions• To preempt FCTC legislation by passing TTC favoured regulation with the aim of forestalling or delaying stronger regulation | |
2. Use of scientists | To create doubt and undermine evidence about the negative impacts of tobacco use and the efficacy of tobacco control measures | |
3. Enlisting and mobilising allies (including other industry sectors, umbrella business organisations, trade unions, international agenciesand other political actors) | • To enhance the credibility of tobacco industry campaigns• To create an impression of spontaneous, grassroots public support for particular (TTC favoured) positions• To provide advice to TTCs or to lend credibility to positions favoured by TTCs | |
4. Using stakeholder consultation to secure industry participation and delay decisions | • To ensure tobacco TTC participation and representation in policy discussions• To facilitate agenda setting and tobacco industry influence throughout political discussions• To gain time to frame debates, implement other tactics, and continue to make profits | |
5. Using the media | • To influence public opinion• To promote positions favourable to the industry |
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6. Countering nongovernmental organisations | To fight and weaken opposition against TTCs, discredit those who challenged the TTCs' positions, and divide the tobacco control community | |
7. Intimidation | To use legal and economic power or arguments as a means of harassing and frightening supporters of tobacco control and threaten policymakers that they will lose elections | |
8. Obstructing ratification and effective implementation of tobacco control | To dilute and neutralise the effect of tobacco control legislation | |
9. Roadshow-type activities | To shift the public opinion and debate |
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10. Achieving joint manufacturing and licensing agreements and policy agreements with governments | To form joint ventures with state monopolies to gain market share and subsequently pressure governments to privatize monopolies |
The concept of “framing” describes a strategy based on generating beliefs and ideas that provide a framework for thinking about an issue
(1)
In 1999, a World Bank report demonstrated that economic fears of tobacco control legislation having negative impacts were largely unfounded, and that tobacco control policies would benefit most national economies
In an attempt to highlight the FCTC's alleged economic impacts, BAT tried to alert national governments “to the costs of a WHO tobacco police state”
(2)
Notwithstanding the rapidly escalating health and economic burdens of tobacco use in developing countries
Such arguments allowed TTCs to portray the FCTC as a neocolonial initiative that would benefit richer nations at the expense of poorer ones. For example, BAT's then-chairman, Martin Broughton, used a speech at the 1999 World Economic Forum to redirect public attention to what he termed the “real issues in the developing world like malnutrition, sanitation and infant mortality”
(3)
TTCs also sought to depict the proposed FCTC as inconsistent with obligations under existing international agreements, notably those of the World Trade Organisation (WTO). Such arguments were central to negotiations, and tensions between public health and trade policies were widely discussed by academics, advocates, and officials
(4)
TTCs questioned WHO's authority and competence to develop a legally binding international treaty, claiming that tobacco was “not a ‘cross-border’ problem”
(5)
A variation on questioning WHO's mandate was to attack the FCTC process as infringing principles of “good governance” and “sensible regulation”
(6)
BAT also depicted WHO, an international organisation, as essentially undemocratic
(7)
In line with their broader emphasis on CSR
The use of CSR initiatives and voluntary measures aimed to position TTCs as credible and legitimate stakeholders who merited inclusion in discussions
(8)
BAT also sought to expand the “threat” posed by the FCTC beyond tobacco, depicting the convention as part of broader, “worrying anti-business trends that many companies have identified within the UN and multi-lateral system”
TTCs also employed tactics to actively influence the development of the FCTC, including efforts to effectively disseminate the frames and arguments outlined above. We identified five such tactics in our documentary analysis, each of which is outlined below and a further five tactics in our comprehensive literature review of publications relating to the FCTC. All ten tactics are outlined in
(1)
Building on various frames (e.g.,
TTCs also sought to stimulate inter-ministerial conflicts within governments
A related tactic was to push national governments to implement weak legislation, in an effort to preempt more stringent regulation arising from FCTC ratification. Preemption measures apparently met with some success in Mexico
(2)
(3)
Enabling “credible third part[ies]” to support the campaign against the Tobacco Free Initiative was seen as essential
In autumn 1999, Broughton accepted an invitation to join the ICC UK Governing Body
“One of the difficulties we face is a lack of awareness of the responsible face of the tobacco industry. We are working hard to address this situation and I would be interested to know if there are any opportunities for me, or other company members, to represent the ICC in dialogue with multilateral agencies.”
BAT reports show that the company enjoyed high-level access to ICC and illustrate BAT's hopes to impact the ICC's agenda in the context of the FCTC
BAT used the ITGA particularly intensively in its lobbying efforts to undermine the FCTC. In a 1999 document, Shabanji Opukah (then BAT Head of International Development Issues) explained how he envisaged the relationship between BAT and the ITGA functioning:
“[T]hey are supposed to be working for us at extreme arms length […] It is in cases like this that this whole ITGA relationship should be leveraged for our business advantage and I always aim at doing that and also ensuring that we are in the ITGA's driver's seat”
It was hoped that the ITGA would use discussions and publications about the economic impact of the FCTC for “lobbying goverments [sic] and allies and briefing media on the role of tobacco in the economy”
Another ally was the International Organization for Standardization (ISO)
Available evidence suggests that TTCs' efforts to generate concerns among these agencies may have met with some success. For example, documents claim that WHO “met with major resistance, particularly by the tobacco growing countries” when presenting the framework convention proposal to the UN Economic and Social Council in July 1999
(4)
Ensuring that their concerns were voiced in FCTC discussions and negotiations both enabled the TTCs to address stakeholders and decision-makers and was perceived as a tactic that could delay the FCTC
(5)
Previous research has highlighted how TTCs have successfully used journalists and media outlets to advance their political interests at a national level
This paper provides the first comprehensive analysis of TTC tactics to undermine the development of the FCTC. The findings illustrate the variety and complexity of tobacco industry efforts to undermine the FCTC and demonstrate the extent to which TTCs are able to combine and coordinate these approaches on an international stage. In total, our documentary data enabled us to identify eight frames developed by TTCs to advance arguments against the treaty (section A,
Our comprehensive literature review identified a further six frames and five tactics that were employed by the tobacco industry in their efforts to influence the FCTC. The 14 frames and ten tactics identified in the documents do not consistently match the frames and tactics identified in the literature review which might reflect the primarily national focus of previous analyses of the negotiations. National case studies may be more likely to identify frames which were geared to circumvent the consequences of the FCTC at country level, like the
All of the frames and tactics we identify as having been used in an FCTC context have roots in strategies previously deployed by TTCs. A review of tobacco industry interference with tobacco control published by WHO in 2008
Considering the success which TTCs enjoyed in framing political and public debates
The analysis of the TTCs' fight to prevent, then undermine and weaken the FCTC can further serve as a case study for research into how corporate tactics can be employed on a global scale to undermine the development of international initiatives. These findings can inform subsequent efforts to develop tobacco control strategies (including via the implementation of the FCTC). Arguably, however, their greater value lies in their broader relevance to the challenges of developing innovative, international approaches to combat the global burden of NCDs, including via proposals to extend the FCTC governance model to other NCDs. The four leading NCDs (cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes) account for an estimated 60% of all deaths globally and, in contrast to the picture painted by TTCs, 80% of this burden occurs in low- and middle-income countries
The broader difficulties confronting WHO and other agencies in responding to the escalating global burden of NCDs and the global expansion of the related commercial interests have long been evident; epitomised, for example, by the efforts of the US sugar industry to undermine the Global Strategy on Diet, Physical Activity and Health
Although the arguments and frames analysed above may often be dismissed as spurious or cynical when known to originate with the tobacco industry and considered in the context of public health evidence, they may nevertheless resonate with, and be advanced by, actors with greater credibility, legitimacy, and influence within policy debates. TTCs' assertions that WHO should focus on infectious diseases in developing countries, for example, have much in common with pressures periodically placed on WHO by leading states including the US and UK
Research already documents significant similarities between the tobacco industry and a variety of other industries, including alcohol
German translation of the abstract.
(DOC)
We thank Cathy Flower for providing administrative support for the project.
British American Tobacco
corporate social responsibility
European Science and Environmental Forum
United Nations Food and Agriculture Organization
Framework Convention Alliance
WHO Framework Convention on Tobacco Control
International Advertising Association
International Chambers of Commerce
International Negotiating Body
International Organization for Standardization
International Tobacco Growers' Association
International Union of Food, Agricultural, Hotel, Restaurant, Catering, Tobacco and Allied Workers' Associations
Mongoven, Biscoe & Duchin
non-communicable disease
Philip Morris
transnational tobacco corporation
United Nations Conference on Trade and Development
Union of Industrial and Employers' Confederations of Europe (now BusinessEurope)
International Union of Tobacco Growers
Verband der Cigarettenindustrie
World Health Organization
World Trade Organization