North East: Campaign launched as hospital is set to become a smokefree zone
North Tees and Hartlepool NHS Foundation Trust is raising awareness about smoking cessation services among patients and staff, as part of a pledge to go smokefree by March 2019.
The trust is offering nicotine replacement therapy and a referral to the community stop-smoking service for patients who smoke.
Clare Henry, the trust’s specialist alcohol and tobacco nurse advisor, said: “over the next few months we will be spreading the message to as many people as possible about what we can all do to help go smokefree. We understand there are many reasons why people might choose to smoke outside the hospital… what we are looking to stress to people is the importance to have a healthy environment around our hospital sites… we are here to help smokers to quit.”
Source: Hartlepool Mail, 9 August 2018
Ireland: Casual smokers dangerously unaware of the health risks
A study published by the Royal College of Physicians of Ireland (RCPI) has found that people who only smoke a few cigarettes a week have a 40% greater risk of dying from a smoking-related disease compared with non-smokers.
Casual smokers, who account for one fifth of Irish smokers, are dangerously unaware of the risks associated with casual smoking, particularly over longer time periods. This problem is particularly acute for women aged 35 to 49 who smoke between one and four cigarettes a day, increasing their chances of developing lung cancer by one fifth.
Doctor Des Cox, chairman of the policy group on tobacco at the RCPI, said that casual smokers “carry almost the same risk of cardiovascular disease as daily smokers. While great progress has been made to reduce smoking rates in Ireland, we still have 20 per cent of under-25s taking [it] up. This pattern of smoking is often perceived to have lesser risk and people continue this pattern of smoking over longer periods, increasing their long-term exposure to tobacco smoke.”
Source: The Times, 9 August 2018
China: Xi’an city to ban smoking indoors
Xi’an, capital of Northwest China’s Shaanxi province has announced a ban on smoking indoors in public places.
The ban, which will come into force on 1 November, will also prohibit smoking in some outdoor public venues and will issue fines of up to ¥1000 for venue owners who fail to enforce the regulation.
China currently has around 300 million smokers and has pledged to reduce the smoking rate from 27.7% to 20% by 2030.
Source: China Daily, 8 August 2018
Tariffs on Chinese goods could harm US vaping industry
Proposed levies on US imports from China could increase the price of e-cigarettes by around 15%. The US vape industry imported 91% of its vaping products from China in 2016, leaving them vulnerable to the US government’s proposed tariff on Chinese goods.
According to a study in the Journal of Tobacco Control, this could cause a knock-on reduction in sales of approximately 12% and 19% for disposable and reusable e-cigarettes respectively. The vape industry is particularly sensitive to price increases due to the relative affordability of vaping compared to smoking.
Euromonitor International’s Head of Tobacco Research, Shane MacGuill, said the tariff could have a “significant detrimental impact on the vapour product industry.”
Source: Reuters, 8 August 2018
Journal of Tobacco Control: The impact of price and tobacco control policies on the demand for electronic nicotine delivery systems
Smoking estimated to cost Japan over ¥2 trillion
Japan’s Health Ministry has said that smoking cost the country ¥2.05 trillion in 2015, equivalent to around £14 billion.
Smoker’s medical fees accounted for over half the total at ¥1.26 trillion, with cancer treatment and treatment for passive smoking costing ¥500 billion and ¥330 billion respectively. This is in addition to a further ¥260 billion in nursing care fees for smoking-related diseases and ¥98 billion for smoking-related fires.
Ataru Igarashi, a member of the Health Ministry’s team and a specially appointed associate professor at the University of Tokyo, said: “We have found that smoking not only increases medical costs but also leads to financial losses in a range of areas such as nursing care.”
Source: Japan Today, 9 August 2018
Link of the week
Londis recommends stores replace tobacco gantries
Londis has recommended to its stores to replace visible tobacco gantries with craft alcohol and vaping products in its new and refitted stores. It has said that this move could significantly increase sales.
The symbol group’s brand director Martin Swadling said the strategy would help future-proof the company’s estate. “Tobacco is still important, but it’s declining and selling it from a big cupboard isn’t using space very well,” he said.
Raj Aggarwal, of Spar Wigston in Leicester, said weekly vape sales increased from £100 to £400 after he replaced his gantry with e-liquids. He said: “Traditional gantries aren’t relevant anymore because customers immediately ask for certain brands or the cheapest pack. Vaping is more profitable. We make between 25% to 40% margins.”
A retailer, who asked not to be named, said weekly alcohol sales grew by £1,600 when she replaced her gantry with craft gin this year. “There’s no future in tobacco gantries. Ours was replaced with 22 gin products and we added lights to make it more attractive. Alcohol sales rose immediately,” she said.
Source: Better Retailing, 3 July 2018
Blog: Duncan Selbie, Public Health Matters
On Tuesday new PHE and ONS smoking prevalence figures for England showed that rates have dipped below 15% for the first time representing a near quarter reduction over the past five years. Notwithstanding, smoking remains the nation’s biggest killer and there is still much to do to achieve the first-ever smokefree generation in England.
Source: Public Health England, 6 July 2018
Increasing number of holiday destinations completely banning vaping
Holidaymakers are being urged to check vaping laws before their summer getaway after five more destinations banned e-cigarettes with punishment ranging from fines to prison. India, the Philippines, Lebanon, Cambodia and Vietnam have all recently clamped down on the devices.
In some countries the punishment can be particularly strict. In Thailand, tourists face a 10-year jail sentence for bringing e-cigarettes or e-liquid refills into the country.
Source: Daily Mail Online, 6 July 2018
Swedish study: Mother’s health linked to foetus’s future fertility
Women who are overweight or who smoke during pregnancy are more likely to have daughters who develop polycystic ovary syndrome, a nationwide Swedish study has found.
Polycystic ovary syndrome affects about one in 10 women and is the most common cause of female infertility. It is typically characterised by ovarian cysts, irregular menstrual cycles and high testosterone levels. The exact causes are unknown, but mounting evidence suggests that the syndrome can be triggered by environmental factors in the uterus.
Source: New Scientist, 3 July 2018 (Print only)
See also: BJOG, An International Journal of Obstetrics and Gynaecology, Prenatal exposures and birth indices, and subsequent risk of polycystic ovary syndrome: a national registry‐based cohort study
Oral evidence given by Simon Stevens at the Health Select Committee
Simon Stevens’ oral evidence to the Health & Social Care Select Committee on Monday 2 July 2018 covered the issue of smoking cessation – see below for extracts.
“It is pretty clear that we will have to keep pushing harder on smoking, and smoking cessation is part of that. That cannot all be done through local authority commissioned services; we are going to have to look at whether the NHS can embed smoking cessation in more of the routine contacts that we have with vulnerable groups who are still smoking. ASH and the Royal College of Physicians have put out an important set of proposals in the last 10 days, which we will take a very careful look at.”
“The point is that smoking has been going down, and we want it to go down even further. ASH talks about 5% as being the smoking level at which you could say that we are almost smoke free. As a result of the judgments that Public Health England has made, we have a big hypothesis in this country that moving on a harm minimisation basis away from smoked tobacco to e-cigs represents a good thing to do.
“That is different from the judgment that some other countries have come to, but it is the judgment that our public health experts have come to. We absolutely have to look at smoking because of its obvious impact on cardiac disease and cancer. We know that two fifths of cancers are preventable, so, to the extent that we can give ourselves headroom for continued gains there, it means that whatever funding the country wants to put into health services we can actually deploy on new therapies for conditions that could not otherwise have been prevented.”
Source: Parliament, 2 July 2018
Read oral question
Parliamentary business: Lord Faulkner’s speech in the NHS debate
Lord Faulkner spoke in the debate on the 5th July in the House of Lords on the Creation of the NHS in 1948, and the case for integration of health, mental health, social and community care to equip the NHS for the next 70 years. He asked the Minister to confirm that he would ensure that NHS England takes into account the evidence and the recommendations set out in the recent RCP report on treating tobacco dependency as it develops the new Plan for the NHS.
Watch full debate here (Lord Faulkner’s speech starts 16:26:34)
Lord Shaugnessy’s response to Faulkner’s challenge
In response to Lord Faulkner’s challenge the Minister said, “Our Tobacco Plan lays out an ambition to reduce smoking among adults to 12% or less and I can confirm that the Plan does align with the RCP report recommendations.”
Source: Parliament live TV, 5 July 2018
Launch of the Smoking in Pregnancy Challenge Group report: Review of the Challenge 2018
This report details how smoking in pregnancy rates have stalled in the last few years at just below 11%. The current ambition is to reduce SATOD rates to less than 6% by 2022. However on the current sluggish trajectory, by 2022 SATOD rates will be around 8.7%. The Challenge Group report makes a number of policy recommendations to address the ongoing slowdown.
Release of RCP report and newspaper responses
Release of RCP report and newspaper responses
Royal College of Physicians (RCP) releases ‘Hiding in plain sight, Treating tobacco dependency in the NHS’
Hiding in plain sight: Treating tobacco dependency in the NHS demonstrates that clinicians working in almost all areas of medicine will see their patients’ problems improved by quitting smoking, and that systematic intervention is a cost-effective means of both improving health and reducing demand on NHS services. Smoking cessation is not just about prevention. For many diseases, smoking cessation represents effective treatment.
It calls on doctors to recognise that recognising and treating tobacco dependence is their business, and to incorporate smoking cessation as a systematic and opt-out component of all NHS services, delivered in smoke-free settings.
Source: Royal College of Physicians, 26 June 2018
The Times – coverage of RCP report: Help smokers quit, doctors tell hospitals
The NHS’s failure to help smokers quit is “as negligent as not treating cancer”, top doctors say.
Sanjay Agrawal said: “This is an open goal for the NHS. We can save lives and save money by applying simple effective treatments in the same way that we do for millions of other patients — these treatments are very low cost. The changes would be pretty straightforward to make and we would start reaping the benefits in the first year, taking some of the strain off the NHS. The changes we have recommended have been tried and tested in the UK and Canada and have made a significant impact, so it’s time to apply this approach across the NHS.”
Smokers “put a particular strain on the NHS”, the college warned, with a 36% greater likelihood of being admitted to hospital.
Professor John Britton, chairman of the Tobacco Advisory Group, said: “Smoking, the biggest avoidable cause of death and disability in the UK, is hiding in plain sight in our hospitals and other NHS services; the NHS must end the neglect of this huge opportunity to improve our nation’s health.”
Source: The Times, 26 June 2018
The Independent – coverage of RCP report: NHS staff smokers cost health service £200m a year with cigarette breaks and sick days, report finds
Lost productivity from smoking breaks alone cost £99m with total per smoker approaching £3,000 a year.
NHS staff smoking habits cost the health service more than £200m a year in cigarette breaks, sick days and treatment, a report on the £1bn a year avoidable cost of tobacco dependency has found.
There are more than 73,000 smokers among the 1.2 million NHS employees in England and the lost working hours from their combined smoking breaks add up to £99m a year, the Royal College of Physicians’ tobacco advisory group has said.
Smokers also had 56 per cent more sick days, amounting to £101m in NHS costs, and cost £6m in treating staff with preventable diseases caused by tobacco. In total, the RCP panel said, this amounts to £2,800 per staff smoker.
Professor John Britton, the chair of the RCP tobacco advisory group, told The Independent: “The NHS must end the neglect of this huge opportunity to improve our nation’s health.”
Source: The Independent, 26 June 2018
Daily Mail – coverage of RCP report: Patients ‘should be recommended e-cigarettes as a way to quit smoking and be allowed to use them at hospitals’
Patients should be recommended e-cigarettes as a way to quit smoking and be allowed to use them at hospitals, doctors’ leaders say. They are calling for patients to be routinely offered help in kicking the habit at GP appointments, outpatient clinics and when admitted to hospital.
The NHS’s failure to help smokers quit is as serious as not treating cancer patients, they added. The recommendations have been drawn up by the Royal College of Physicians which has accused the NHS of being ‘negligent’ in not doing enough to help smokers quit.
Source: Daily Mail, 26 June 2018
Ospreys back anti-smoking campaign at sports grounds across Wales
The Welsh rugby club Ospreys have put their weight behind a campaign by ASH Wales for local sport clubs to adopt no smoking policy at their playing fields. Although most Welsh stadiums have become smokefree zones, many grounds where children train and play have yet to follow suit.
The Ospreys in the Community will work with the charity to encourage regional clubs to adopt a no smoking policy with the aim of protecting young players from being influenced to smoke.
The club will promote the initiative at a beach rugby festival in front of 600 kids.
Source: ITV News, 26 June 2018
Child labour rampant in tobacco industry
Child labour in tobacco is widespread and on the increase in poorer countries, a major Guardian investigation has revealed, in spite of claims by multi billion-dollar companies that they are tackling the issue.
Evidence from three continents shows how children aged 14 and under are kept out of school and employed in hard and sometimes harmful physical labour to produce the tobacco leaf that fills cigarettes sold internationally, including in the UK, US and mainland Europe.
Families are trapped in generational poverty while salaries at the top of the industry run to millions of dollars a year. The companies say they monitor child labour and remove children from the fields to go to school, but experts have told the Guardian that the numbers are going up, not down, as tobacco growing increases in Africa and Asia.
Source: The Guardian, 25 June 2018
BMJ blog: The Kuala Lumpur Charter on Smoke-Free Homes
In accordance with article 8 of the Framework Convention on Tobacco Control, governments, health practitioners and wider society all have a duty to protect non-smokers from the harms caused by second-hand tobacco smoke (SHS) exposure. Considerable attention over the past two decades has been given to implementing smoke-free public spaces and workplaces in many countries.
However, there is the risk that the tobacco control and wider public health research community now wrongly perceives that the ‘SHS exposure problem’ has been successfully resolved and no longer requires international attention. It is possible that this has caused a widening in exposure inequality with adults in countries where smoke-free laws are comprehensive benefitting most while children in poorer communities in those countries where smoke-free laws are partial or poorly enforced have seen almost no improvement.
My name is Nick Voulvoulis. I’m a Professor of Environmental Technology here at Imperial College in the Centre for Environmental Policy. My work is mainly on the interface between human systems and natural systems; so understanding how we interact with the environment and live more sustainably.
The problems we face around the planet has to do with how we consume resources. We create waste and pollute, forcing the planet to it limits. Global cigarette consumption has grown dramatically in the last decades with annual production and consumption have been significantly increasing in the developing world.
This summer here at Imperial, with Maria, we worked on trying to understand the environmental impact of the whole of the supply chain of tobacco from cultivation all the way to smoking and final disposal. We tried to capture the resource needs and also the emissions and environmental impact of cigarette smoking. We did this using life cycle analysis and material flow analysis, two popular tools in capturing the environmental footprint in different products.
Using figures based on the year 2014, a total of 32.4 million tonnes of green tobacco leaf were cultivated on 4 million hectares of land, across 125 countries, producing 6.48 million tonnes of dry tobacco, used to manufacture in nearly 500 factories worldwide, making 6 trillion cigarettes sticks that were used in 2014. There are significant resource needs and emissions and waste produced at every stage of the supply chain. The global contribution of the tobacco industry to climate change is around 84 million tonnes of CO2 equivalent. When you add it all up, it doesn’t sound fair to expend valuable resources on things that create hospital admissions and cancer in the end.
Smoking does not just affect our health but limits people’s ability to prosper. Sooner or later, the industry will have to face the question of what it has done for us.
Unless we can prove that it is not just for the pockets of multinational companies it will be very difficult to make a case for this to keep going on.
“Giving back to the community matters to PMI. In #Mexico our team donated gifts to local organizations that help vulnerable youth. #InsidePMI”
This Tweet, published in 2017 by Philip Morris International, one of the world’s largest tobacco companies, is part of a strategic communication plan to reshape the battered reputation of the tobacco industry. In reality, for a company that targets these same vulnerable youth to use its deadly products, the donation of “gifts” is little more than corporate window dressing.
Tweets of this nature are not uncommon. Our paper published in Tobacco Control found that 21% of tweets published by transnational tobacco companies highlighted the supposed positive impact that they are having on society and the environment.  Our study analysed all 3301 tweets published by British American Tobacco, Imperial Brands, Philip Morris International and Japan Tobacco International, up until May 2017, to uncover common themes. Tweets that critiqued or opposed tobacco control policies were found to be the most common, making up over 30% of the total number of tweets analysed.
A communication platform for false and misleading information
The tobacco industry has a long history of opposing tobacco control policy and promoting socially responsible business practices. However, with the rapid rise of social media platforms like Twitter, tobacco companies are enabled to readily and easily communicate these messages in a public domain. Online communications through social media are poorly regulated and the tobacco industry is attempting to take advantage of this. The industry has a platform where they can publish information that is either false or misleading, with little to no retribution.
Take this tweet for example:
“Myth 5: Tobacco Control said #plainpacks would stop young ppl from taking up smoking. Govt stats show this isn’t true”
This was published by Imperial Brands PLC in 2014, despite published evidence that showed plain packaging reduces the appeal of cigarette packs to adolescents.  Many other tweets were found to be misleading as the information published either only told half the story or painted the tobacco industry in a very positive light. The following tweet was published by British American Tobacco, despite the fact that the tobacco industry is the cause of 1.5 billion hectors of deforestation since the 1970s:
“140 million trees planted between 2007 and 2012 through our afforestation programmes #trees #afforestation http://t.co/WtdnRGHuUY”
British American Tobacco, Imperial Brands, Philip Morris International and Japan Tobacco International’s Twitter accounts also frequently tweeted about being favourable employers and the benefits that employees receive. Almost 20% of all tweets were of this nature. The “Top Employer” award was heavily promoted across all accounts. On the surface this award appears to be notable, but certification can be received by virtually any company upon application to the ‘Top Employers Institute’ — a small not-for-profit organisation in the Netherlands.
In tobacco control research, intelligence on tobacco industry strategies to oppose public health was once drawn from annual reports, leaked tobacco industry documents, court cases and websites. Now, the tobacco industry has an online platform where they can also publish and promote their key messages openly and freely, even when false or misleading. But for the first time, it is possible to also engage with and respond to this messages in real time.
Comprehensive regulation is needed
Tighter regulation of online activities by tobacco companies is urgently needed. While it could be argued that the reach of these PR messages on Twitter is small and inconsequential, they form part of a wider plan to insert the tobacco industry as a key partner in public health and to weaken tobacco control. 
Australia has signed and ratified the World Health Organisation Framework Convention on Tobacco Control (WHO FCTC) and is bound by the terms of the treaty. Guidelines to the implementation of Article 13 of the WHO FCTC outline that publically promoting corporate social responsibility initiatives is a form of sponsorship, and should be included in comprehensive bans on tobacco advertising, promotion, and sponsorship.
Equally important is the need for current gaps in the WHO FCTC to be addressed. Although Article 13 of the FCTC includes cross-border advertising, implementation guidelines are yet to be developed in an operational way. This should be made a priority to ensure the WHO FCTC’s enforcement is comprehensive, relevant for today’s changing media landscape and free of loopholes that the industry can exploit.
Tobacco advertising and promotion has been banned in Australia for decades, yet tobacco companies are continuing to falsely promote themselves as ‘good corporate citizens’, alongside strongly opposing evidence-based tobacco control polices on publicly on social media. These strategies serve only to promote the tobacco industry’s interests and its deadly products.
by Christina Watts, Becky Freeman and Marita Hefler
 Watts C, Hefler M, Freeman B. ‘We have a rich heritage and, we believe, a bright future’: how transnational tobacco companies are using Twitter to oppose policy and shape their public identity. Tobacco Control. 2018.
 Germain D, Wakefield MA, Durkin SJ. Adolescents’ perceptions of cigarette brand image: does plain packaging make a difference? J Adolesc Health. 2010;46:385–92.
 Daube M, Moodie R, McKee M. Towards a smoke-free world? Philip Morris International’s new Foundation is not credible. The Lancet. 2018.
Article originally published at Croakey.
In the week of its AGM, ASH is urging British American Tobacco (BAT) to stop turning a blind eye to child labour and unacceptable working conditions on Zimbabwean tobacco farms which supply 6% of the company’s tobacco leaf.
BAT’s ‘Supplier Code of Conduct and Child Labour Policy’, published in 2016, outlined its commitment to ensuring a safe working environment and prohibiting child labour. Yet a report from Human Rights Watch published this month entitled ‘A Bitter Harvest’ finds farmers in Zimbabwe are ill-informed of the risks associated with nicotine exposure, and are not receiving the necessary training or equipment to protect themselves. 
As a result, many tobacco farmers reported symptoms consistent with acute nicotine poisoning, such as sickness and dizziness, which happens when workers absorb nicotine through their skin while handling tobacco plants. Others claimed they were pushed to work excessive hours without overtime compensation, denied their wages, and forced to go weeks or months without pay.
This ill-treatment is not confined to adults. BAT’s code specifically identifies hazardous tasks which under 18’s should not perform in tobacco farming. These include harvesting, topping and suckering. Yet child labour continues to be widespread within the tobacco industry in Zimbabwe, with many under 18s working in conditions that threaten their health and safety or interfere with their education. Children are more vulnerable to nicotine poisoning than adults, and new evidence also shows that children are, in some cases, mixing, handling, or applying pesticides directly to crops, putting them at further risk. Compounding this, children who engaged in tobacco farming were frequently absent from school during the tobacco growing season, causing them to fall behind with school work.
Most workers said that, as far as they knew, union organizers were the only people to inspect conditions at their workplaces and speak with them about grievances. Very few of the hired workers on small or large-scale farms who were interviewed said they had ever seen a labour inspector or other government official visit their workplace to inspect working conditions.
In response to criticisms from Human Rights Watch about the rigour and effectiveness of BAT’s implementation of its code, the company said a revised audit system due to be implemented in 2018 would include visits to tobacco farms and in-depth analyses of suppliers’ policies, processes, and practices. However, the on-site review will only last four days, with only one day of field visits. It also does specify how many auditors are involved in these visits or how many farms will be visited. BAT has also committed to ‘undertake an interim review on human rights via unannounced farm visits by BAT to Zimbabwe farms, planned for early 2018’, but what this will amount to has never been made clear.
These are fine words, but the track record to date in Zimbabwe does not encourage confidence, and BAT’s processes lack transparency or detail. BAT must go a great deal further, and commit to adopting the recommendations set out in the Human Rights Watch report. To do less is unacceptable.
 Human Rights Watch. A Bitter Harvest: Child Labor and Human Rights Abuses on Tobacco Farms in Zimbabwe. 2018. Available at: https://www.hrw.org/sites/default/files/report_pdf/zimbabwe0418_web_2.pdf
British diplomats have defended BAT’s overseas activities, a company under investigation for corruption by the Serious Fraud Office
Despite the perennially gloomy economic forecasts about Britain, it stubbornly remains one of the world’s most powerful economies. The UK is currently the 5th largest economy by GDP  and a number of British companies are listed as some of the biggest in the world.
Unfortunately, amongst the remaining titans of commerce, monsters remain. Two of the largest tobacco conglomerates in the world are British. These are Imperial Tobacco, the world’s fourth-largest cigarette manufacturer  with its head office in Bristol. And the largest publicly traded tobacco company in the world, British American Tobacco (BAT) , which is based in the appropriately named Globe House, London.
The Government’s Tobacco Control Plan for England commits to creating the first “Smokefree generation” , and at current rates of decline in smoking prevalence we are on track to achieve this by 2030. However, it is an unpleasant fact that the transnational tobacco industry is compensating for declining markets in rich countries like ours, by marketing aggressively in poorer ones.
The two British tobacco giants both have significant global operations. BAT controls a myriad array of brands which are active across the world, and are particularly dominant in many Commonwealth countries. This is something that BAT proudly talks about on its slick, modern website, a gleaming example of digital sophistry.
However, behind the assured corporate slogans and sickly professionalism, the transnational tobacco industry is in retreat, under attack from a concerted global effort coordinated by the WHO Framework Convention on Tobacco Control . Since it came into force in 2005 the FCTC has been ratified by 181 countries, including the UK, covering over 90% of the world’s population. As well as implementing the treaty itself, the UK Department of Health is supporting low and middle income countries to do so too, with an investment of £15 million of Official Development Assistance funds . A central plank of the project is increasing tobacco taxation to drive down tobacco consumption, a policy very successfully pursued by the UK.
The profits of Big Tobacco are under threat, and they know this. In an attempt to protect its revenue streams, BAT has been enlisting the help of British government officials in the Foreign Office and the Department for International Trade, to fight back against the very taxes and regulations recommended by another part of the British government.
The UK has guidelines which should prevent this, stating that “Posts must not: Engage with foreign governments on behalf of the tobacco industry, except in cases where local policies could be considered protectionist or discriminatory.”  Unfortunately this exception appears to be being used as a catch-all, get-out clause.
Initially it appeared to be a one off incident in Bangladesh. BAT had enlisted the British high commissioner to pressurise the Bangladeshi government to overturn a legal decision handed down by the courts on an unpaid VAT bill of £170 million. But an investigation by The Observer has revealed a global pattern of engagement by British officials to actively defend BAT’s interests overseas.  This included meetings between embassy staff and BAT in Panama, a UK government trade advisor being seconded to BAT’s Hungary HQ and 25 meetings involving both the international trade department and BAT Venezuela.
When this was exposed the UK government tried to deny what was going on, telling The Observer: “Interactions with the tobacco industry are only permitted where necessary, and we do not allow our staff to encourage investment in the tobacco industry, or provide any assistance in helping tobacco companies influence local business policies like taxation to their advantage.” But it’s hard to see how the behaviour of British officials in embassies around the world are in accord with this statement. Furthermore BAT is a company currently under investigation by the UK’s Serious Fraud Office over allegations of corrupt business practices,  so it beggars belief that the British government should act as its lobbyist.
 Investopedia, The World’s Top 10 Economies, 7 July 2017
 The Telegraph, Alison Cooper: lighting up Imperial Tobacco, 21 March 2010
 Chicago Tribune, Shareholders back British American Tobacco buying Reynolds, 19 July 2017
 Department of Health. The Tobacco Control Plan for England, 18 July 2017
 The WHO Framework Convention on Tobacco Control (WHO FCTC) adopted by the Conference of the Parties to the WHO FCTC. Geneva. 2003
 Department of Health. Business Case: Official Development Assistance Project: Strengthening tobacco control in low and middle income countries. August 2017
 Department of Health/ Foreign & Commonwealth Office, United Kingdom’s revised guidelines for overseas posts on support to the tobacco industry, December 2013
 The Observer, (Jamie Doward). British diplomat lobbied on behalf of big tobacco, 10 September 2017
 The Observer, (Jamie Doward). UK accused of hypocrisy on overseas tobacco control, 27 January 2018
 Serious Fraud Office. British American Tobacco.
*All links active 25th April 2018
Tih Ntiabang is the Regional Coordinator — AFRO, for the Framework Convention Alliance.
The latest ‘sustainability’ report published by British American Tobacco (BAT) states: “we are committed to operating to the highest standards of corporate conduct and transparency.”  In pursuit of its strategic goals, the multinational even tries to portray itself as being in alignment with the 2030 agenda for sustainable development. Is it necessary to remind anyone of BAT’s historic and ongoing appalling business conduct across the globe — specifically in low and middle-income countries, with the African region being a key target?
Legacy tobacco industry documents show that BAT has been implementing a long-agreed strategy to gradually shift their markets from societies with higher regulatory systems to those with little or no regulatory systems and rising potential markets. In one such document, BAT proclaims that “Africa is also projected to continue growing…BAT is strongly placed to take advantage of the growth in these markets.” 
Africa has embraced the world’s only global health treaty, the World Health Organization Framework Convention on Tobacco Control (WHO FCTC). However, tobacco companies including BAT have held the continent hostage with the lure of corporate social responsibility initiatives, which contravene Article 5.3 of the Treaty.
In Malawi, Mozambique Tanzania, Uganda and others, BAT has successfully used front groups to portray itself as an indispensable partner in providing solutions to a problem — child labour — that they cause. They manipulate decision-makers, and public opinion to ensure they maintain a ‘positive’ image in the eyes of the government and public.
In March 2018, during the 332nd meeting of the International Labour Organization (ILO) governing body, a delegate representing Uganda delivered a disturbing statement urging the ILO to continue taking money from the tobacco industry. According to this delegate, the statement was delivered on behalf of the African region. This is an example of the tobacco industry’s strong grip on the continent.
BAT also flouts tobacco control laws in many African countries, in ways it would never try to get away with in its home country Britain. In Nigeria and Uganda, despite the fact it’s illegal, BAT continues to advertise around schools. In Benin and Nigeria, the law is flouted by making single cigarettes easily available, especially around schools. BAT branded kiosks even target schools for children as young as six. 
It is no surprise that the public health community in Africa questions the relevance of BAT’s supposed “highest standards of corporate conduct and transparency.” BAT’s determination to market its products to the poor and children tells a different story. Africa will only avoid a rapidly growing epidemic of tobacco caused diseases if it fully implements the FCTC, including by rejecting BAT’s appeals for sustainable development partnerships.
 From www.tobaccotactics.org — British American Tobacco, Talk to TMDP-Chelwood August 1990, 24 July 1990, Bates no. 502619006–502619029, accessed June 2014; note: The document is a 24-page speech with no author mentioned. However, the speaker introduces himself as sharing his “views from the perspective of a BAT Industries Board member as well as that of BATCo Chairman”. In 1990, Barry Bramley was the company’s Chairman, and at the trial MINNESOTA V. PHILIP MORRIS INC., the speech was attributed to him Deposition of RAYMOND J. PRITCHARD
 African Tobacco Control Alliance — Big Tobacco Tiny Targets : Tobacco Industry Targets Schools In Africa
Headquartered in London, British American Tobacco (BAT) is one of the biggest transnational tobacco companies. This Wednesday BAT is hosting its Annual General Meeting in London. In line with the “Polluter Pays Principle” ASH is calling on the Government and political leaders to hold Big Tobacco financially responsible for the damage it causes. We must #MakeThemPay.
In 2009, six of the top tobacco producing countries had undernourishment rates between 5–27%.  If the 5.3 million hectares of land used for growing tobacco instead grew food, between 10–20 million people could be fed. Instead, companies like BAT ensure that tobacco continues to be grown, and attempt to do so with as little regulation as possible.
BAT has a history of using unethical tactics to ensure it continues to turn a high profit. In Kenya, where BAT holds approximately 70% of the tobacco market, it took 13 years to pass the Tobacco Control Act due to BAT’s “intimidation”, according to a report by the Ministry of Public Health and Sanitation and the International Institute for Legislative Affairs. The report states that this delay “was due to the Industry’s manipulation of the parliamentarians; including providing lavish holidays in the guise of building their capacity on the legislation.” 
According to the British Medical Journal, in 2012 BAT was responsible for $152 billion of the $1.4 trillion dollar cost that smoking causes the world economy, based on their 11% share of the global market. Big Tobacco should not get away with the harm it cause the world. The $152 billion strain placed on the global economy by BAT is money wasted which could be better spent on reducing smoking prevalence, environmental care, and finding ways to prevent undernutrition. 
BAT’s operating profits totalled £6.4 billion in 2017. With such a large profit, BAT should be held financially accountable for the harm it causes both people and the environment. 
Over the next two weeks, use the hashtag #MakeThemPay to communicate the different ways the Tobacco Industry can take financial responsibility for the damage they cause:
· Share your stories about how tobacco has affected you and tag them with #MakeThemPay.
· Take photos of smoking related litter or other pollution and share them on social media with the tag #MakeThemPay.
· Take photos of smoking related litter or other pollution and share them on social media with the tag #MakeThemPay.
· Contact BAT directly and tell it that it must take financial responsibility for the harm its business causes. Email or tweet at the press office using the hashtag #MakeThemPay, or phone its offices on 020 7845 1000. If you’re outside the UK you can find a list of country specific contacts here.
Share this story with your networks and encourage them to do the same.
 World Health Organization. The Millennium Development Goals and Tobacco Control: An Opportunity for Global Partnership. 2015.
 Eriksen M, Mackay J, Ross H. The Tobacco Atlas. American Cancer Society, and New York, NY: World Lung Foundation. 2012.
 Ministry of Public Health and Sanitation, International Institute for Legislative Affairs. Tobacco Industry Interference in Kenya: Exposing the tactics. 2013.
 Goodchild M, Nargis N, Tursan d’Espaignet E. Global economic cost of smoking-attributable diseases. Tobacco Control. 2017;27(1):58–64.
 British American Tobacco. British American Tobacco p.l.c. Preliminary Announcement — Year Ended 31 December 2017. 2018.
Throughout the whole life cycle of tobacco — from farming through to manufacture and consumption — there is a pronounced threat to the environment.
Despite its enormous profitability, the industry bears few of the health and environmental costs caused by producing tobacco.
The life cycle of tobacco causes deep and often irreparable damage through deforestation, water consumption and the use of pesticides. Greenhouse gases are emitted at every stage, contributing in no small part to climate change . The soil where it is grown is left weak and arid, often turning previously fertile areas into deserts .
A recent report by the United Nations Environmental Programme found that if the tobacco industry was made to pay for the harm that it causes, it would not turn a profit .While smoking rates may be declining in many high-income countries, they are on the rise across many middle- and low-income countries. As consumption increases so does the global environmental impact of the tobacco industry. It is unacceptable that the industry can continue to make billions in profits while washing its hands of the destructive costs of smoking.
So what do we mean when we say ‘the environment’?
The obvious link between ‘tobacco’ and ‘pollution’ draws to mind cigarette smoke, discarded packaging and cigarette butts. This is important, of course, as cigarette butts are the single most littered item in England, but there is more to this issue.
Commercial tobacco farming takes place across 124 countries, primarily in Brazil, India and China. Tobacco companies have shifted 90% of their cultivation and production to lower income countries , in order to cut costs and circumvent regulation. They have chopped down billions of hectares of rainforest  to clear space for tobacco growing, which has increased greenhouse gas emissions and caused largely irreversible damage .
The industry-wide practice of growing tobacco as a ‘monocrop’, which means growing the same crop on the same land year after year, has left over 4 million hectares of this land weak and vulnerable to pests and diseases .
To combat the problems that arise from monocropping, the tobacco industry uses chemicals and pesticides, often ones banned in high-income countries, which are deeply harmful to the environment and the farmers. This practice leads to desertification of the land through wrecking the topsoil and groundwater. It also leaves farmers destitute and dependent on tobacco, since they cannot grow their own food on ruined land. When citizens fight back against this, the transnational tobacco corporations simply pack up and move.
This stage is certainly the least well-documented. Imperial Tobacco has stated that: “our greatest direct impact on the environment comes from our product manufacturing activities” .
Despite this admission, the data on the actual environmental costs are scant. The industry’s own reports on environmental impact are often opaque and use ill-defined data, which makes it difficult to assess the true impact of manufacturing on the environment.
In 2012, 967 million daily smokers consumed over 6 trillion cigarettes worldwide , equating to significant pollution and waste.
The 2014 global estimation for discarded cigarette waste ranges from 340–680 million kilos, of which filters comprise the vast majority. These filters, falsely introduced by the industry on the pretence of being healthier, do not biodegrade under most circumstances . Instead, they can break into smaller plastic pieces, causing them to leach some of the 7,000 chemicals they contain into land and water .
Tobacco industry profits are not only built on a dreadful legacy of death and disease caused by consumption of their products but also made at a major cost to our environment. If the tobacco industry was made to pay for the harm that it causes, it would not turn a profit.
 Cairney P et al. Global Tobacco Control: Power, Policy, Governance and Transfer. [Accessed January 2018]
 Reddy K et al. Report on tobacco control in India. Technical Report New Delhi: Government of India: 142.
 Trucost PLC and TEEB for Business Coalition. Natural capital at risk: the top 100 externalities of business. [Accessed January 2018]
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 USDHHS, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health. A Report of the Surgeon General: How Tobacco Smoke Causes Disease: What It Means to You. [Accessed January 2018]
The Imperial Tobacco AGM takes place today. Wendell C Balderas is Media and Communications Manager of the Southeast Asia Tobacco Control Alliance (SEATCA). In this blog post he reveals a side of the company they would prefer to hide.
In May 2016, Lao PDR’s Ministry of Health issued the Pictorial Health Warnings (PHWs) Regulation requiring all tobacco companies to print 75% health warnings on cigarette packs — an international best practice and a crucial investment in the health of the Lao people.
Because they are easily understood, PHWs are vital to educate smokers and the public on the harms caused by tobacco use, and thereby, help motivate quit attempts and discourage Lao PDR’s vulnerable groups, particularly the poor and the youth, from smoking. PHWs are also remarkably cost-effective communication channels, especially among the low literacy population.
However, tobacco companies Imperial-controlled Lao Tobacco Company Ltd and Lao-China Hongta Good Luck Company Ltd., who control over 80 percent of the cigarette market, have been violating the law by not printing PHWs on their cigarette packs. These companies have requested and been granted three extensions of the implementation deadline (a total of 19 months). In contrast, other countries in the ASEAN region gave tobacco companies only three to six months to comply with their PHWs regulation.
The latest deadline given by the Ministry of Industry is the 1st of January 2018, but monitoring done by SEATCA in several locations in Vientiane Capital City after the January deadline showed that the most popular and widely sold cigarettes brands in Lao PDR, ‘A Deng’ and ‘Dok Mai Deng’ produced by these two companies, still do not have the PHWs required by the law. The Lao government has already given the tobacco industry more than ample time to comply, but these companies have chosen to ignore the law.
In a letter to Lao PDR Prime Minster Thongloun Sisoulith, SEATCA requested the Prime Minister to urgently take action for the regulation to be implemented well. SEATCA has also urged him to endorse and certify the draft penalty decree by the Ministries of Health and Justice so that the companies that violate the law can be penalized.
SEATCA has also published an open letter to the Shareholders of Imperial Brands demanding them to respect the Lao people by complying with the tobacco control law to apply 75% pictorial health warnings on cigarette packs immediately.
More than 73,000 adolescent boys and half of all men smoke in Laos. About 28% of the population lives below the poverty line, with one third of the population living on 10,400 LAK (£0.89) a day.
This means money for basic household expenses is spent on tobacco, and breadwinners are at high risk of financial ruin from tobacco-caused diseases and death. About 6,200 Lao people die from tobacco-related diseases annually.
Caroline Flint MP was public health minister from 2005 to 2007 and oversaw the introduction of the smoking ban, which she describes below.
On 1 July England celebrated a decade since the ban on smoking in enclosed public spaces came into force. It’s been a huge success for public health and today, as smoking is becoming increasingly marginalised, it’s easy to forget just how controversial the ban was at the time.
The numbers are significant. There are around 10% fewer deaths caused by smoking in the over-35s today, compared to 2007. Deaths from strokes are down 14.5%, and heart disease by 20.8%, just because of the decline in smoking, and exposure to secondhand smoke. These are not fractional gains — thousands of lives have been saved, many more improved.
When I became the public health minister, the policy situation was difficult. On the one hand, there was plenty of evidence of the negative health impact of secondhand smoke. On the other, there was nervousness in some quarters that a smoking ban would be seen as a “nanny state” measure, and many were concerned about the effect it may have on the hospitality industry. As a result, some MPs called for pubs that didn’t serve food and private members’ clubs to be exempted.
Quite rightly, the exemptions were labelled by the Health Select Committee, chaired by MP Kevin Barron, as “unfair, inefficient and unworkable”. How do you define food? Where do you draw the line, do crisps count, what about pickled eggs? My department looked at the potential for problems that might result from such legislation and there were plenty. It was also clearly unfair to protect the health of people working in some pubs and not others.
The Opposition agreed to allow a free vote and Kevin Barron and I, with the backing of the chief whip, pushed for the Government to allow a free vote on the issue too. We won, and the exemptions were removed by an overwhelming majority of 200 votes.
We spent eighteen months ensuring that the legislation would be properly implemented. Scotland had already implemented a smoking ban, and we learned a lot from their success. From day one it was supported by the majority of the public and compliance rates were over 98 per cent, and now most smokers too say they support the legislation. Fewer smokers are now smoking in the home in front of their children, something that was of concern to some MPs at the time the legislation was passed. The number of under-16s who smoke is half what it was in 2007.
Clearly, we have come a long way and, a decade on, smoking rates are down to their lowest recorded level at 15.5%. But this is not the end. Smoking is still the leading cause of preventable death killing 78,000 people in England last year, and hundreds of children still start smoking every day. But looking back, I’m reminded that politics can make a difference, and not a smoke-filled room in sight.
Caroline Flint is a Labour MP and was Public Health Minister from 2005–2007. You can follow her on Twitter @CarolineFlintMP
A chronology of tobacco control events from early history to the modern day, focusing mainly on laws and policies made in the United Kingdom.Key dates in the history of anti-tobacco campaiging
A briefing summarising the impact of the UK’s vote to leave the European Union on tobacco control laws.Briefing: Impact of "Brexit" on UK tobacco control legislation
In 2010 Philip Morris International initiated a law suit with an arbitration panel of the World Bank alleging that two of Uruguay’s tobacco control laws violated a bi-lateral treaty with Switzerland. On 8 July 2016, the tribunal dismissed all of PMI’s claims and ordered the company to pay Uruguay’s legal costs. The following briefings by the Campaign for Tobacco Free Kids summarise the tribunal’s findings.
PMI v Uruguay ruling - key findings CTFK 2016