Tobacco Advertising Research Articles

Author Meets Critics: Pushing Cool: Big Tobacco, Racial Marketing, and the Untold Story of the Menthol Cigarette

Abstract: This Author Meets Critics conversation focuses on Keith Wailoo’s book Pushing Cool: Big Tobacco, Racial Marketing, and the Untold Story of the Menthol Cigarette (University of Chicago Press, 2021). Wailoo met with marketing and advertising specialists from various disciplines to discuss the following topics: racialized marketing and its role in the history of the menthol cigarette in the United States; the interconnections between Big Tobacco and the advertising industry; the connection between the asphyxiation of Black people at the hands of law enforcement and Big Tobacco’s targeting of Black people to consume menthol cigarettes; the creation of markets based on race; the role of motivational research consultants like Ernest Dichter in the 1950s and 1960s; the Master Settlement Agreement archive housing decades of Big Tobacco’s internal documents, including marketing research and plans; regulation’s impact on Big Tobacco’s changing tactics and priorities to sell menthol cigarettes; the contradictory roles of civil rights activists and the Black press in the history of the menthol cigarette; the need to find and eliminate legal loopholes that can lead to taking advantage of minority communities; the power and dangers of diverse representation in advertising for dangerous products like cigarettes; and advice for professors, students, and practitioners. The videos include a wealth of examples of tobacco and public service advertisements.

The Presence of Smoking and Alcohol Imaginary in Popular Movies Available in Netflix Online Streaming Platform.

Exposure of tobacco and alcohol consumption in media and filmmaking has been related to promotion of smoking and drinking in adults. Current regulation aims to restrict tobacco and alcohol advertising in order to avoid alcohol consumption and smoking habits. We aimed to assess the impact of smoking and drinking habits in video-on-demand services. Three independent investigators watched the 50 most popular movies available in Netflix streaming platform, according to York Times and recorded incidence of smoking and drinking scenes for both primary and secondary actors. 45 movies were included in our analysis. Main characters appeared to smoke in 19 movies and to consume alcohol in 33 movies, while secondary characters in 32 movies with 121 scenes and consumed alcohol in 38 movies, respectively. First actors were males in 22 movies, females in 7 movies and both males and females in 6 movies. Movies' directors were males in 29 movies and females in 6 movies. Our analysis found increased content of smoking and drinking scenes in online movies and showed that recently released movies presented with increased incidence of drinking and smoking scenes, while era depicted in movies also affects smoking and drinking content.

Smoking Behavior Among High School Students In Padang City

Youth is a phase of transition from children to adults, marked by the acceleration of physical, mental, emotional, and social development. They are still looking for self-identity, tend to follow trends, are still unstable, and are very easily influenced by peers, including the influence of smoking. This study aims to determine the influence of knowledge, pocket money, access to cigarettes, mass media, family, and peers to smoking behaviour among high school students in the city of Padang. The method of this study is a cross-sectional survey by interviewing 220 male students in 5 (five) Public High Schools in Padang City who were selected by multistage random sampling. Data was collected using a structured questionnaire that had been tested for validity and reliability. Multiple logistic regression is used to determine the relationship. The study showed 59.1% of high school male students in Padang smoked. Most of them them have knowledge about smoking (62.3%) and are exposed to cigarette advertisements in the mass media (52.3%), have peers smokers (60.5%), and have families who smoke (51.4%) . Students who have peers smokers 10.1 times more likely to start smoking (OR 10.1, 95% CI 5.5 - 19.5). Knowing that adolescents first smoke at the age of 7 years and peer behavior is the biggest risk factor for starting smoking in adolescents, precautionary measures are recommended, such as health counseling as early as possible (starting in primary or secondary school).

E-cigarette company tactics in sports advertising

John Bunyan coined the phrase “The Captain of all these the men of death” and applied it to consumption (ie, tuberculosis); Sir William Osler subsequently applied the phrase (“Captain of the men of death”) to pneumonia in the pre-antibiotic era; but both diseases gave way to tobacco-related lung disease, which now has the unanswerable claim on that title. Eventually, the pioneering work of Sir Richard Doll and many others was recognised, demonstrating the toll of premature death caused by the tobacco industry, but only after many decades of harm. Despite an industry campaign of disinformation supported by physicians lauding the virtues of smoking, legislation to restrict smoking in public and ban advertising was passed and resulted in many demonstrable health benefits. The sight of a tobacco advertisement in a public place or a tobacco-sponsored sporting event today would be shocking, and it seemed attitudes towards tobacco and public health were improved and heading in the right direction.

Progress in adopting bans on tobacco advertising, promotion, and sponsorship in the Americas: lessons from Uruguay and Argentina.

ABSTRACTObjective.To assess progress in and barriers to implementing bans on tobacco advertising, promotion and sponsorship (TAPS) in Uruguay, which has a complete ban, and Argentina, with a partial ban.Methods.Legislation on TAPS bans in Uruguay and Argentina was reviewed and relevant published literature, news stories, civil society reports and tobacco industry reports retrieved to analyze progress in implementing TAPS bans.Results.In Uruguay, the complete TAPS ban, which includes standardized tobacco packaging, maintains high compliance and severely limits exposure of TAPS, despite a few problems with corporate social responsibility, social media, and transnational advertising. In Argentina, the partial TAPS ban has more problems with compliance and exposure to TAPS. The most important barriers to implementing TAPS bans in both countries are the tobacco companies. In Uruguay, tobacco companies do not comply in a few areas but the complete ban greatly minimizes this. In Argentina, however, tobacco companies can more easily exploit gaps in the partial TAPS ban, such as advertising at the points of sale, promoting contests, and using influencers on social media.Conclusions.The partial TAPS ban in Argentina illustrates the problems with enforcement and the tobacco industry’s ability to exploit loopholes and continue to market their products, especially to young people. A complete TAPS ban, including standardized tobacco packaging, as in Uruguay, is easier to implement and enforce and is effective in reducing exposure to tobacco advertising. Nevertheless, governments should prioritize implementing TAPS bans on social media, which remains a difficult sphere to monitor and allows tobacco companies to continue recruiting and targeting young people.

Tobacco advertisement, promotion and sponsorship in Arabic media between 2017 and 2019.

Nineteen out of 22 countries in the Eastern Mediterranean region, including the Gulf Cooperation Council countries, have ratified the World Health Organization Framework Convention on Tobacco Control (FCTC) treaty. One of FCTC's provisions prohibits tobacco advertisement, promotion and sponsorship (TAPS). The TAPS provision requires nations to ban direct and indirect tobacco ads in media, as exposure to tobacco use in the media encourages smoking initiation. A limited number of studies have examined TAPS in Arabic media. This study examined the occurrence of tobacco use across Arabic television (TV) series released between January 2017 and December 2019 to assess compliance with the FCTC provision banning TAPS. The content analysis examined incidents of tobacco use in Arabic TV series, types of tobacco products used and the portrayal of second-hand smoking exposure. Out of 92 Arabic TV series (2952 episodes), there were 32 044 incidents of tobacco use. Incidents of tobacco use per episode fluctuated over time. During Ramadan, the median number of tobacco incidents declined from 6 in 2017 to 3 in 2019; however, it increased to 8 in 2018. Regular cigarettes and water pipes were the most common tobacco products used in TV series. While 27% of tobacco use showed characters who smoked tobacco products alone, 13% of the incidents portrayed characters who were smoking in the presence of children. This study concludes that tobacco imagery is not completely banned in Arabic media and its continued representation weakens tobacco control measures.

Exposure to e-cigarette advertising and provaping websites, and the social acceptability of their use among nicotine users.

ABSTRACTObjectives.To evaluate the prevalence of exposure to Internet communications on and advertising of electronic cigarettes (e-cigarettes) and their association with perceptions of the social acceptability of e-cigarettes in Mexico.Methods.Data were analyzed from eight surveys (2018–2021) of an online sample of Mexican adult (> 18 years) smokers and dual users (of combustible and electronic cigarettes). Self-reported exposure to e-cigarette advertising across various marketing channels was assessed, as well as visits to e-cigarette websites. Logistic regression analysis was used to evaluate the association between perceptions of the social acceptability of e-cigarette use and level of advertising exposure and visits to e-cigarette websites.Results.The Internet and outside e-cigarette stores were where exposure to advertising most occurred, as reported by 47.4% and 46.8% of respondents, respectively. Respondents who noticed e-cigarette advertisements on the Internet (adjusted odds ratio (OR) 1.43, 95% confidence intervals (CI) 1.25, 1.63), outside e-cigarette stores (adjusted OR 1.31, 95% CI 1.14, 1.50), and in temporary outlets (adjusted OR 1.16, 95% CI 1.01, 1.34), and those who visited e-cigarette websites (adjusted OR 1.48, 95% CI 1.25, 1.76) were more likely to perceive e-cigarettes as socially acceptable. Noticing advertisements across more channels was also associated with higher perceived social acceptability of e-cigarette use.Conclusions.Being exposed to e-cigarette marketing, either online or through traditional marketing channels, is associated with perceived social acceptability of e-cigarette use, as is contact with provaping sites. Regulatory options to avoid the proliferation of promotional websites disguised as opinion or user sites need to be considered.

Ex ante evaluation of the impact of tobacco control policy measures aimed at the point of sale in the Netherlands

IntroductionThe Netherlands aims to implement stricter tobacco control policies targeting the retail environment. This paper is an ex ante policy evaluation of the potential impact of the current tobacco display...

Online Tobacco Advertising and Current Chew, Dip, Snuff and Snus Use among Youth and Young Adults, 2018-2019.

Objective: To understand the relationship between exposure to online tobacco advertising and current smokeless tobacco use in the context of tobacco control policies. Methods: Three waves of a national probability-based sample of (n = 15,985) youth and young adults were used. Analysis consisted of GEE logistic models controlling for social media use, demographics, tobacco use, average price of smokeless tobacco inclusive of taxes, smoke-free indoor air laws (SFIA) and state tobacco control expenditures. Results: Frequent exposure to tobacco advertising on social media is associated with greater odds of current smokeless use (aOR: 2.05, 95% CI: 1.62, 2.60). Higher prices and SFIA coverage were associated with reduced current smokeless use when examined separately from other tobacco policy variables (aOR: 0.79, CI: 0.73, 0.85; aOR: 0.44, CI: 0.28, 0.70). Conclusions: Greater exposure to tobacco advertising online is associated with greater odds of smokeless use among surveyed youth and young adults. This effect of social media marketing exposure on smokeless use outweighs the mitigating impact of existing tobacco control policies. The findings underscore the need for strong advertising regulation of evolving tobacco products, including smokeless products, on social media and surveillance of digital marketing tactics to young people.

Prevalence and correlates of current tobacco use and non-user susceptibility to using tobacco products among school-going adolescents in 22 African countries: a secondary analysis of the 2013-2018 global youth tobacco surveys

BackgroundOur study examined the prevalence and associated factors of tobacco product use and non-users’ susceptibility to using tobacco products among school-going adolescents in 22 African countries.MethodsWe analyzed the cross-sectional 2013-2018 Global Youth Tobacco Survey (GYTS) data from 22 African countries. We conducted complex sampling descriptive and logistic regression analyses.ResultsThe overall prevalence of current use of any tobacco product among adolescents was 19.1%, with more males (23.7%) than females (13.7%) being current users. Zimbabwe and Morocco were the highest (47.1%) and least (12.6%) reported prevalence, respectively. Being male (AOR = 1.93;95%CI:1.61-2.32), being 16 and older(AOR = 1.37;95%CI:1.01-1.86), exposure to secondhand smoke within (AOR = 1.98;95%CI:1.69-2.32) and outside (AOR = 1.37;95%CI:1.13-1.65) the home, not knowledgeable about the harmful effect of secondhand smoke (AOR = 1.44;95%CI:1.20-1.74), exposure to tobacco industry promotion (AOR = 3.05;95%CI:2.68-3.47) and not in favour of banning smoking in enclosed places (AOR = 1.32;95%CI:1.08-1.60) were associated with current use of any tobacco product.The prevalence of the susceptibility to using tobacco products among never users of tobacco products was 12.2%, with no significant gender difference. Mozambique (24.6%) and Algeria (4.5%) had the highest and least prevalence of susceptibility to using tobacco products among never users, respectively. Exposure to tobacco industry promotion (AOR = 1.54;95%CI:1.31-1.82), those not in favour of banning smoking in enclosed places (AOR = 1.29;95%CI:1.14-1.45) and those not exposed to anti-smoking school education (AOR = 1.24;95%CI:1.06-1.46) were associated with susceptibility to using any tobacco product among never users of tobacco products.ConclusionOur study reports that tobacco use and non-user susceptibility to using tobacco products among school-going adolescents in the 22 African countries is high. As part of public health efforts, governments and other stakeholders need to fully implement anti-tobacco use campaigns, enforce a complete ban on tobacco promotion and advertising, institute educational programs for families, and anti-tobacco use education for the general public and in schools in line with WHO Framework Convention on Tobacco Control guidelines.

A Content Analysis of Promotional Features in US Direct-Mail From Advertisements Across Tobacco Products From 2018 to 2020.

Direct-mail advertising is a crucial channel through which tobacco companies deliver price incentives that lower the barrier to tobacco use while promoting tobacco products via thematic appeals not legally permitted on other marketing channels. We examine the prevalence of price incentives and ad characteristics used in tobacco product advertisements (ads) mailed directly to US consumers. We analyzed the content of direct-mail tobacco ads (N = 1047) in circulation between January 2018 and December 2020 as captured by Mintel Comperemedia Direct. These ads were coded for product type, manufacturer/brand type, model characteristics, price incentives, and themes known to appeal to vulnerable subgroups. Ads across all tobacco products included price incentives (96%) and contained themes that appealed to rural white (40%) and black audiences (15%). Themes known to appeal to youth and young adults were present in 40% of ads across all products, including 78% of ads promoting electronic nicotine delivery systems (ENDS). Moreover, the ENDS ads featuring youth appealing themes (51%), also featured young models. Expanding on previous research which focused on combustible and smokeless tobacco products, this analysis examines direct-mail ads across the full range of tobacco products. Our findings highlight the need for regulations to address (1) the high prevalence of price incentives that undermine the effectiveness of excise taxes on tobacco use, and (2) ad themes and characteristics that appeal to groups vulnerable to tobacco use, both of which have the potential to further exacerbate tobacco-related health disparities. This study reinforces the importance of examining direct-mail as the dominant medium for tobacco advertising, particularly by including coupons and discount codes that reduce product price and thus circumventing the effect of tobacco-related tax legislation. Direct-mail encourages continued product loyalty and use and engages new consumers using price incentives and advertising strategies likely to appeal to price-sensitive consumers and other vulnerable populations. Substantial use of youth-appealing elements in ENDS ads contradicts the tobacco industry's mandate to not appeal to youth, warranting highlighting the gaps in current regulations that allows them to continue appealing to this population.

Understanding the ethical legitimacy of tobacco advertising, promotion and sponsorship in Indonesia in the context of increased government regulation: a legitimacy-as-perception perspective

PurposeThe authors explore the metaphors people from Indonesia use to describe their propriety beliefs about the ethical legitimacy of tobacco advertising, promotion and sponsorship (TAPS). This paper aims to understand why there is a consensus of propriety beliefs about the ethical legitimacy of TAPS in the face of increased government regulations and international criticism of such marketing practices.Design/methodology/approachThe data were collected from 71 study participants using both focus groups and in-depth photo-elicitation interviews.FindingsThe participants use three sets of metaphors to describe propriety beliefs. First, participants used metaphors that described the centrality of TAPS and smoking in Indonesian society. Second, they used metaphors that described TAPS regulations and regulators and third, they used metaphors that described the activities of tobacco firms. Participants’ photographs revealed strong collective validity of TAPS within Indonesia and strong propriety beliefs consensus.Research limitations/implicationsThis study is one of the first to integrate legitimacy-as-perception theory and the ecological systems framework to gain a multilevel insight into the TAPS activities are perceived as legitimate and, therefore, not unethical.Practical implicationsThe findings have important implications for tobacco control regulators who wish to curtail TAPS in a country where all levels of the ecological system reinforce their collective validity. Policy and regulative initiatives must, therefore, be used in a systemic way to change this collective validity.Originality/valueTo the best of the authors’ knowledge, this study is one of the first to use a legitimacy perspective to understand the ethical legitimacy of TAPS in marketing literature. It is also the first, to the best of the authors’ knowledge, to use the three legitimacy-as-perception constructs: propriety beliefs, collective validity and consensus of propriety beliefs. The authors show that despite increased government regulations and international disapproval, TAPS continues to be considered ethically legitimate in Indonesia.

Commentary: Electronic Nicotine Delivery Systems: Seeing Through the Clouds.

Commentary: Electronic Nicotine Delivery Systems: Seeing Through the Clouds.

Environmental risk factors for cardiovascular diseases using geographic information systems in an urban slum, Bengaluru

Background: Cardiovascular disease (CVD), a growing epidemic, is influenced by various environmental factors, and the potential connection is not studied adequately. Objective: Hence, our study was aimed at assessing the environmental risk factors for CVD and assessing perceptions about the same among the adults residing in an urban slum, Bengaluru. Methods: A cross-sectional descriptive study was conducted using a validated environmental assessment tool – Environmental Profile of Community Health. It consists of two parts: (i) an assessment of the physical environment for CVD-risk behaviors and (ii) a questionnaire to collect residents' perceptions of their community's environmental risks for CVD. Results: The community had two environmental risk factors for CVD-tobacco stores and fast-food restaurants. The community had ten convenience stores, all of which sold tobacco products. Vegetables and fruits were available, and the community also had a park for recreation. We interviewed a total of four study participants with a mean age of 38.5 ± 5.4 years. All participants reported that they have seen people smoke outside public places and inside residences. They felt that society disapproved of women and children smoking while men were excluded. Study participants have reported seeing tobacco and junk food advertisements. Tobacco was easily accessible and available to all ages. Conclusions: The urban community was not CVD-friendly. Awareness regarding risk factors for CVD was good. Adequate urban planning, policy-level advocacy, and tailor-made lifestyle changes for patients are the key to preventing CVD.

Tobacco-Related Images on Instagram’s Persian-Language Pages and Audience Attraction Rates

Background: Social media can be powerful tools to influence high-risk behaviors. This study aimed to evaluate tobacco-related images on Instagram’s Persian-language pages and their audience attraction rates. Materials and Methods: This cross-sectional study included 1870 Instagram posts with cigar, cigarette, e-cigarette, tobacco, vape, and shisha/waterpipe/hookah hashtags. The number of likes and comments for these posts were recorded, and the image type, the attitude of the audience, and the type of caption were noted as well. Results: In general, 500 images (26.7%) had #cigar/cigarette, while 30 (1.6%), 470 (25.1%), 650 (34.8%), 70 (3.7%), and 150 (8%) images had #e-cigarette, #shisha/#waterpipe/#hookah, # tobacco, #juice, and #vape hashtags, respectively. The most common type of image was product images (52.4%). The audience’s attitude towards the images was mostly positive (93.2%). In addition, the most common caption type was sales (76.5%). There was a significant correlation between the number of likes and comments with image hashtags, audience attitude, and caption type. The highest number of likes and comments belonged to images with shisha/waterpipe/hookah hashtags and a positive audience attitude. The sales caption type had the highest number of likes, while the encouragement caption type had the highest number of comments. Eventually, text image types had the highest number of comments. Conclusion: Given the high promotion of tobacco-related posts on Instagram, policymakers should take the necessary measures to reduce the volume of tobacco advertisements.

Evidence of Youth-Appealing Cigarette Advertising Tactics from a Randomized, Controlled Experiment.

Receptivity to tobacco advertising is an important component in the progression from exposure to advertising to use behavior, yet little is known about current tobacco advertising tactics that increase receptivity. This study tests the effect of three advertising features identified in earlier work as potentially appealing to adolescents and young adults: flora imagery, eco-friendly language, and sweepstakes. We conducted an online survey in which 1,000 US adolescents (age 15-17) and 1,000 US young adults (age 18-24), equally stratified by smoking status, were exposed to three experimental modules manipulating presence/absence of each feature of interest on cigarette ads. After viewing each ad, participants reported their receptivity to the advertisement. Bivariable analysis and multivariable logistic regression analyses were used to assess the effect of each appeal's presence on receptivity. Adolescents (aOR = 1.55, 95%CI: 1.12-2.14) and young adults (aOR = 1.43, 95%CI: 1.06-1.93) were more likely to be receptive to ads with flora imagery. The effect of sweepstakes on receptivity was modified by the specific ad for young adults. Ecofriendly language did not significantly impact receptivity among either group. Exploratory subgroup analysis found a significant ad by sweepstakes interaction among young adult noncurrent smokers. These findings provide evidence that use of flora imagery increases cigarette advertising receptivity among adolescents and young adults, while the effect of sweepstakes on young adults might additionally depend on the ad shown. Restrictions on youth appealing advertising tactics, such as those identified in this study, as well as broader content-neutral advertising restriction policies, should be considered. This study provides evidence for the appeal of flora imagery in cigarette advertising for both adolescents and young adults, as well as the complexity of how use of sweepstakes interacts with branding in specific ads to predict receptivity among young adults. Because receptivity to cigarette advertising is a documented step in the pathway between advertising exposure and product use, restrictions on use of these tactics should be implemented, and broader content-neutral advertising restriction policies should be considered.

Emerging Marketing Research on Healthcare and Medical Decision Making: Toward a Consumer-Centric and Pluralistic Methodological Perspective

Emerging Marketing Research on Healthcare and Medical Decision Making: Toward a Consumer-Centric and Pluralistic Methodological Perspective

Flavored Tobacco Sales Restrictions Reduce Tobacco Product Availability and Retailer Advertising.

Objective: This study examined differences in the availability and advertising of flavored tobacco products before and after flavored tobacco sales restrictions were enacted in Alameda and San Francisco Counties in California. Main outcome measures: Data were collected from a sample of tobacco retailers in Alameda and San Francisco Counties at two time points: 2015, before flavored tobacco policies were enacted, and in 2019–2020, after some cities had enacted policies. Retailers were separated by city into Category 1 (n = 442)—retailers in cities that enacted a flavored tobacco policy between the two data collection periods, and Category 2 (n = 89), those that had not. Means comparison tests were conducted to evaluate significant differences over time and by category. Results: There was significantly reduced availability of menthol cigarettes, flavored little cigars, smokeless tobacco, vape pens, and Blu brand menthol e-cigarettes between 2015 and 2020 in Category 1 retailers. Category 2 retailers had reduced availability only for Blu menthol e-cigarettes and demonstrated an increase in smokeless tobacco availability. Exterior store advertising for cigarettes, little cigars, cigars, and e-cigarettes also decreased significantly in Category 1 cities relative to Category 2 cities; 8.1% of Category 1 stores were advertising flavored tobacco products in 2019–2020 compared to 36.2% of Category 2 stores. There was also a 78% reduction in flavored ads between 2015–2019 in Category 1 cities compared to a 38% decrease in Category 2 cities. Tobacco advertising inside Category 2 stores increased. Finally, Category 2 cities had significantly greater availability of cigalikes, mod or tank vapes, flavored e-cigarettes, and e-liquids compared to Category 1 cities. Conclusions. Comprehensive flavored sales restriction policies reduce flavored tobacco availability and tobacco advertising, which may help prevent youth tobacco initiation and exposure.

Spatial Distribution and Factors Associated With Risky Health Behavior Among Adult Males Aged 15-59 Years in Ethiopia: Generalized Structural Equation Modeling.

BackgroundAlcohol drinking and tobacco smoking are the largest preventable causes of death and important risk factors for a number of non-communicable diseases and cause premature death and many socioeconomic consequences. Therefore, the present study is aimed to assess the spatial distribution of risky health behavior and its associated factors among adult males in Ethiopia.MethodsAll men (12,688) within the age range of 15–59 years were included in the final analysis. The distribution of risky health behavior across the country was observed by using ArcGIS software. In SaTScan software, the Bernoulli model was fitted by Kulldorff methods to identify the purely spatial clusters of risky health behavior. Generalized Structural Equation Model (GSEM) was used to determine factors associated with risky health behavior (regular alcohol drinking and tobacco smoking).ResultsRisky health behavior had spatial variation across the country. The primary clusters were located in Tigray, Amhara, and north-eastern Benishangul national regional states. Spatial scan statistics identified 118 primary clusters [Log-Likelihood ratio (LLR) = 524.8, p < 0.001]. Residence, frequency of listening to a radio, occupation, and frequency of watching television were significantly associated with drinking alcohol, whereas wealth index was associated with tobacco smoking. Age, region, educational status, marital status, and religion had association with both domains of risky health behavior.ConclusionRisky health behavior had spatial variation across the country. Bans on advertising and promotion of alcohol and tobacco on national press media should be strengthened. Aggressive health education efforts should be directed toward this high-risk population (Tigray, Amhara, and north-eastern Benishangul regional states). Improving risky health behavior is an important approach to reducing health disparities and promoting a more cost-effective utilization of scarce resources in the public health sector.

Tobacco industry thwarts ad ban legislation in India in the 1990s: Lessons for meeting FCTC obligations under Articles 13 and 5.3

Bans on tobacco advertising are important for reducing tobacco-caused disease. Previously secret internal tobacco industry documents and organizational and newspaper websites related to tobacco control efforts in India during 1990s were analyzed. The Ministry of Health and Family Welfare, World Health Organization, Indian Council of Medical Research, and civil society played important roles in pushing for tobacco control legislation beginning in the 1980s. Guided by transnational tobacco companies, especially British American Tobacco, Philip Morris International, and RJ Reynolds, Indian cigarette companies formed the Tobacco Institute of India (TII). Following the industry’s global strategy, TII proposed voluntary advertising codes, used diplomatic channels and high level political and judicial lobbying, and allied with other industry, sports and trade groups to delay legislation for ten years. TII argued for the social and economic importance of tobacco and that laws were unnecessary, unconstitutional, and would hurt the economy. These early global strategies were continuing in 2022 to delay and evade legislative efforts to ban tobacco advertising. Understanding these strategies can inform public health efforts to counter industry efforts to thwart the WHO Framework Convention on Tobacco Control in 2022 not only in India, where the Ministry of Health and Family Welfare has proposed strengthening India’s tobacco control law, but globally.