We sought to characterize the involvement of US tobacco companies in the global food industry, where they disseminated ultraprocessed and hyper-palatable foods, and the methods they used to expand globally. We reviewed and extracted data from 113 primary source industry documents. US tobacco companies developed billion-dollar food businesses that were prominent internationally between the 1980s and mid-2000s. Tobacco companies developed their international food businesses with the same strategies they used to establish their international tobacco businesses. Our findings suggest that US tobacco companies used their extensive experiences from their tobacco businesses to maximize the successes of their international food businesses in disseminating ultra-processed foods globally. Regulation of the multiple addictive products that tobacco companies have disseminated to markets globally may be needed to protect public health. (Am J Public Health. 2026;116(7):921-931. https://doi.org/10.2105/AJPH.2026.308501).

We need to know how ultraprocessed foods (UPFs) are designed and formulated to better understand why these products cause overeating and weight gain, and how to apply appropriate guardrails. This information, however, is typically kept hidden by UPF companies as proprietary trade secrets. Using previously undisclosed internal company documents, this study traced product development for Lunchables, a prepackaged meal brand developed at Kraft General Foods while it was owned by the tobacco giant Philip Morris Companies. Findings show that a key reason Philip Morris purchased food companies was to increase revenues by sharing proprietary research and development assets across tobacco and food product lines. Philip Morris applied its product development approach for making cigarettes to Lunchables in 2 important ways: First, it applied its "consumer-driven product development" strategy that optimized products for consumer pleasure and appeal. Second, Phillip Morris applied its "better-for-you" reformulation strategy, first used to create filtered Marlboro cigarettes, to develop Low-Fat Lunchables in efforts to keep consumers worried about childhood obesity loyal to the brand. These findings speak to the need for public health research and policies that extend existing models for regulating tobacco to UPFs. (Am J Public Health. 2026;116(7):940-949. https://doi.org/10.2105/AJPH.2026.308491).

Low- and middle-income countries face a rapidly escalating, alcohol-related public health crisis spanning cancer, injury, liver disease, mental health disorders and the complications of human immunodeficiency virus infections. Despite compelling evidence that alcohol is a leading risk factor for premature death and disability, few countries include comprehensive alcohol control policies in their public health agenda. This gap between evidence and policy is critical because evidence-based interventions could decrease the alcohol-attributable disease burden by up to 30% within a decade. We conducted a policy analysis to synthesize evidence from low- and middle-income countries and propose a comprehensive multicomponent framework for alcohol control adapted from experience with tobacco control. Documented achievements show that simultaneously integrating alcohol control into the existing health-care system, introducing regulation, and building institutional capacity can reduce consumption and generate substantial economic returns. However, interference from the alcohol industry in policy, mirroring the historical approach of the tobacco industry, underscores the need for explicit protections. Evidence-based recommendations on implementing alcohol control policies are presented for international agencies, national governments, health-care systems and civil society. These recommendations also draw on global lessons from the World Health Organization's Framework Convention on Tobacco Control. Today, the convergence of robust scientific evidence, proven interventions, successful implementation models and growing political support present an opportunity to advance alcohol control in low- and middle-income countries. The question is not whether comprehensive alcohol control is feasible in resource-constrained settings but whether the global health community will act decisively on the evidence available.

Evaluation of the links between smoking and conspiracy mentality.

To document the development and implementation of a World Health Organization Framework Convention on Tobacco Control (FCTC)-guided law in Ethiopia. We analyzed 15 publicly available documents, including news articles and government documents. We triangulated findings by interviewing three tobacco control advocates, two academic researchers, and four government officials. We used a thematic framework analysis to analyze the data and documented this through a retrospective policy analysis. Local and international health advocacy groups supported regulation development through capacity-building workshops. The National Tobacco Enterprise/Japan Tobacco International used standard industry arguments to weaken draft regulations, but government officials, supported by health advocacy messages promoting Ethiopia's World Health Organization FCTC obligations, rejected these arguments. Key barriers to implementation included industry interference, lack of funding and resources, monitoring and evaluation system issues, government system coordination issues, and a lack of organizational knowledge. Key facilitators included financial mechanisms and health advocacy support, and government and inter-governmental support, which contributed to increased monitoring, education efforts, and technical support. The tobacco industry remains the biggest barrier to FCTC implementation, continuing to advertise at the point-of-sale, fuel illicit tobacco trade, and push the sale of single-cigarette sticks near schools. Other barriers include a shortage of funding/resources, a lack of strict enforcement, and an absence of local regulations. Financial and technical support and leveraging the FCTC as a legal instrument can help uphold strong regulations. More efforts are needed to educate government authorities and establish local regulations to protect policy implementation. Previous studies have analyzed the adoption of World Health Organization Framework Convention on Tobacco Control (FCTC)-guided policies, but less is known about implementing these policies, especially in World Health Organization African Region. This study analyzed the key barriers and facilitators to developing and implementing FCTC-guided regulations in Ethiopia. Barriers include tobacco industry interference (youth advertising and fueling illicit tobacco), a shortage of funding/resources, and a lack of strict enforcement and local regulations. Financial and technical support and leveraging the FCTC as a legal instrument can help uphold strong regulations. Efforts are needed to educate government authorities and establish local regulations to protect policy implementation.

Pictorial health warnings on tobacco packs stimulate short-term cognitive and emotional responses that can lead to quit attempts. We tested novel product attribute health warnings (PAHWs) that corrected misperceptions about product harmfulness. PAHWs uniquely influenced outcomes assessing knowledge of industry manipulation of cigarettes, industry-centric negative emotional responses and product-specific smoking dissonance. We aimed to examine if these unique short-term responses predicted subsequent quitting-related behaviours. We analysed follow-up data from a between-subjects online experiment during which participants were randomised to view PAHWs alone (PAHW condition) or with a complementary video (PAHW+Video) during a baseline session and daily for 7 days. In the present study, covariate-adjusted logistic regression models examined associations between short-term responses to the PAHWs measured at 8-day follow-up (predictors) and subsequent quitting-related behaviours measured at 4-week follow-up (outcomes). Participants with valid data for the 8-day and 4-week follow-up surveys were analysed (N=301). Two short-term responses to the PAHWs-knowledge of industry manipulation of cigarettes and product-specific smoking dissonance-significantly and positively predicted all three quitting-related outcomes: smoke-limiting microbehaviours (eg, foregoing cigarettes), quit attempts and 7-day sustained abstinence. Industry-centric negative emotional responses positively predicted smoke-limiting microbehaviours and 7-day sustained abstinence but not quit attempts. Short-term responses elicited by PAHWs featuring corrective information about the tobacco industry's manipulation of tobacco products predicted subsequent engagement in smoke-limiting microbehaviours, quit attempts and sustained quit attempts. PAHWs can complement other health warnings featuring the health risks of smoking and may help motivate people who smoke to quit and stay quit.

Following the introduction of comprehensive bans on tobacco advertising, promotion, and sponsorship (TAPS), little is known about how the tobacco industry (TI) adapts its marketing strategies in low- and middle-income countries at point of sale (POS). This study examined post-ban TI marketing practices in Armenia after the 2022 comprehensive TAPS and display ban, focusing on youth exposure. We conducted a qualitative study using structured observations at 132 POS near educational facilities in Yerevan (capital city) and the Kotayk region, in-depth interviews with store owners/workers (n = 8), and focus group discussions with youth aged 15–20 (n = 28). Thematic analysis was applied with triangulation across data sources. Despite the ban, tobacco products remained widely available and visible near educational facilities. Cigarettes, e-cigarettes, and heated tobacco products were prominently displayed using power walls, illuminated fixtures, and placement near youth-appealing items. Advertising persisted through covert, legally ambiguous tactics such as illuminated displays, integrated signage, colour schemes, flavours, and loyalty-based promotions, coupled with misleading messages, often not recognized as advertising by youth or retailers. Retailer incentive schemes, such as financial rewards, gifts, and staff engagement, were used to secure product prominence and drive sales. Youth access restrictions were weakly enforced, with poor visibility of age-of-sale signage, inconsistent ID checks, and reports of informal access routes. Comprehensive TAPS and POS display bans alone are insufficient to eliminate youth exposure to tobacco marketing. Stronger enforcement, regulation of indirect and retailer-focused marketing, and sustained monitoring of POS environments are essential to protect youth from ongoing TI influence.

A systematic review and synthesis of qualitative research on stakeholder views on commercial tobacco endgame goals and policies.

The tobacco industry exploits legislative loopholes by introducing products with novel constituents, sensory features and/or branding to bypass flavour restrictions and maintain appeal, particularly among young populations. Post California's 2022 flavour ban, the leading oral nicotine pouch (ONP) brand (ZYN) started marketing two new 'unflavoured' products, Classic and Original, but it is unknown if they differed from preban products marketed as 'flavour-ban approved' (Chill and Smooth) in their chemical composition, sensory characteristics and human appeal. Nicotine, menthol and synthetic coolants, WS-3 and WS-23, were quantified using gas chromatography-mass spectrometry. Menthol receptors (TRPM8 and TRPA1) activity was measured by calcium-microfluorimetry to assess cooling- and irritation-potential. ONP sensory attributes and appeal were assessed in young adults (21-25 year old) after 5 min standardised use in a double-blind, randomised remote trial. 'Chill' and 'Classic' ONPs contained WS-3 exclusively (0.24±0.02 mg/pouch), with consistent levels across nicotine strengths; 'Smooth' and 'Original' contained neither menthol nor WS-3. Extracts of 'Chill' and 'Classic' robustly activated the cold/menthol TRPM8-receptor with similar potency and efficacy while weakly activating the sensory irritant TRPA1 receptor. Compared with 'Smooth', human participants rated 'Chill' and 'Classic' as having stronger cooling sensations (p<0.05), while 'Classic' was rated as more minty flavoured (p<0.005). Preban and postban ONPs showed similar chemical, sensory and appeal profiles based on WS-3 presence. By using concept names and sensory cues to disguise flavours and additives, the industry exploits regulatory loopholes to sustain marketing of banned products. NCT06506162.

Tobacco industry interference during policy development is well documented, yet evidence on how the industry responds after policies are adopted and enter into force remains fragmented across policy domains and jurisdictions. This study systematically examines post-adoption tobacco industry conduct across key tobacco control measures and develops a cross-policy taxonomy of post-adoption tactics. We conducted as scoping review and qualitative evidence synthesis of peer-reviewed and grey literature, searching six data bases and Tobacco Control's News Analysis archive. Using inductive coding, we identified recurring forms of post-adoption industry activity and synthesised these into a conceptual taxonomy - the Policy Implementation Playbook (PIP). We included 308 sources (210 peer-reviewed articles and 98 News Analysis items) spanning approximately 50 countries across all WHO regions, although documentation was concentrated in a limited number of settings. The PIP identifies five recurrent tactics. One - pre-emptive adaptation - occurs before a policy enters into force and includes stockpiling, transitional packaging, and early product or marketing adjustments. After a policy enters into force, the industry may disregard requirements, adopt token implementation that signals formal compliance while reducing practical impact, circumvent regulation through product-, design-, or channel-based tactics, or seek to influence implementation indirectly through retailers, hospitality actors, public authorities, and enforcers. Circumvention was the most frequently documented response across most policies, though its specific form varied across regulatory domains. Disregard and pre-emptive adaptation were also common, while token implementation was largely confined to health warning requirements. Smoke-free regulations more often elicited intermediary-focused strategies aimed at shaping interpretation, enforcement, and compliance. By conceptualising policy implementation as a contested political arena and synthesising recurrent tobacco industry tactics across policies, the PIP extends existing models of corporate political activity. The taxonomy provides a structured basis for anticipating post-adoption corporate conduct and strengthening regulatory design, implementation, and governance in tobacco control and the regulation of other unhealthy commodities. Not applicable.

espite Iran's ban on e-cigarettes since 2012, their use continues among adults due to complex individual, social, and cultural factors. Qualitative evidence exploring these determinants in Iran remains limited. This study examined the motivations and experiences of adult e-cigarette users aged 19-52 years in southern Iran. A qualitative study using thematic analysis, guided by Braun and Clarke's six-step framework, was conducted in 2024. Participants were recruited using a combination of purposive and snowball sampling techniques and Data were gathered through semi-structured interviews with 45 current (past 30 days) e-cigarette users residing in Bandar Abbas. Two researchers independently coded and analyzed the data, employing strategies to enhance trustworthiness, including investigator triangulation and member checking. In this study, 45 people (37 men and 8 women) with a mean age of 25.8 years and an age range of 19 to 52 years participated. Our analysis identified six key themes: (1) Sensory and experiential appeal (e.g., diverse flavors, pleasant sensations, modern design), (2) Emotional regulation and stress alleviation, (3) Social contexts and normalization (e.g., peer pressure, familial acceptance, influencer marketing), (4) Perceived practical benefits and misconceptions (e.g., perceived harm reduction, use as a smoking cessation aid), (5) The role of the tobacco industry (e.g., product design, marketing strategies, and availability), and (6) Physical and psychological dependence. In our analysis, social contexts and normalization were the most important contexts for e-cigarette use, given the target group population. E-cigarette use among adults aged 19-52 years in Bandar Abbas is driven by a complex interplay of sensory appeal, emotional regulation needs, social normalization, widespread safety misconceptions, and aggressive tobacco industry marketing. Despite Iran's ban, use persists and is reinforced by physical and psychological dependence, peer influence, and limited healthy recreational alternatives. Culturally tailored, multi-level interventions are urgently needed, including evidence-based public education to counter misconceptions, strict regulation of industry advertising and accessibility, and the development of alternative stress-coping resources, especially for younger users.

Tobacco Industry and Cannabis: A New Public Health Challenge for Türkiye.

Tobacco industry introduced cigarettes with synthetic cooling agents (hereafter, 'flavour ban-proof' cigarettes) with similar packaging to menthol cigarettes and targeted at people who smoke menthol in response to the California flavour ban. We chemically analysed (a) seven flavour ban-proof cigarettes purchased in California (Camel and Newport), (b) three brand-matched 'unflavoured' regular and two menthol cigarettes purchased in Ohio and Georgia and (c) four Marlboro cigarettes with labels emphasising cooling sensation purchased in Ohio. We tested filtered little cigars and loose pipe tobaccos for comparison. We used liquid-liquid extraction followed by gas chromatography-mass spectrometry analysis to quantify nicotine and cooling agents in the cigarette and cigar rod, and total particulate matter (TPM) collected on filter pads from machine smoking according to standardised puffing regime. We assessed the transfer of nicotine and cooling agents from the rod to the smoke and compared the cooling strength of tested cigarettes. We only detected Wilkinson Sword (WS-3) in flavour ban-proof cigarettes (0.88-1.77 mg/rod). The level of WS-3 per rod was approximately 10% of nicotine (9.3-15.52 mg/rod) and similar to menthol levels in the mentholated counterparts (0.59-3.78 mg/rod). The transfer of nicotine, WS-3 and menthol to the TPM ranged from 7%-14%, 14%-30% and 20%-51%, respectively. However, the calculated cooling strengths of flavour ban-proof cigarettes and menthol cigarettes were similar. Menthol was replaced with WS-3 in flavour ban-proof cigarettes, and WS-3's higher cooling power may result in a comparable cooling experience and thus has the potential to undermine local, state or federal bans on menthol cigarettes.

This study examines the impact of excise tax increases on cigarette prices in Montenegro, offering insights into the tobacco industry’s pricing strategies. Using both panel quantile regression and fixed-effects models, the research estimates excise tax pass-through to cigarette prices across different price ranges and market segments. The analysis is based on monthly price data from 2010 to 2022 for 269 cigarette brands. The findings reveal partial tax pass-through for lower-priced brands, while premium brands experience over-shifting, meaning tax increases are more than fully passed on to consumers. Slim cigarettes remain relatively affordable, as their prices never fully reflect tax increases. This pricing strategy allows the industry to maintain a substantial price gap between premium and low-cost cigarettes while sustaining profitability. Industry-driven cross-price subsidies for low-cost cigarettes undermine the intended impact of excise tax increases by maintaining their affordability and consumption. This highlights the need for comprehensive reforms in Montenegro’s tobacco tax policy to ensure effective tobacco control.

Nicotine, a tobacco alkaloid with biological activity and unique pharmacological characteristics, holds significant value across pharmaceutical, agricultural, and industrial applications. Given these attributes, there is a growing demand for efficient nicotine extraction from tobacco and its by-products. In this study, a novel ionic liquid (IL)-decorated boron nitride/poly(N-isopropylacrylamide) composite hydrogel (IL-BNNs@P) was synthesized for the effective extraction of nicotine from tobacco absolute oil. Scanning electron microscopy and Fourier-transform infrared analyses confirmed the successful integration of IL-functionalized BNNs within the gel's network structure. This hydrogel revealed an adsorption capacity of 81.49 mg·g-1 with 93.5% extraction efficiency. Furthermore, this hydrogel exhibited exceptional selectivity, with distribution coefficients (Kd) for nicotine (6.27 L·g-1) being 1-2 orders of magnitude higher than those for co-existing impurities, yielding selectivity coefficients (α) of 62.6-174.9. Additionally, after five consecutive adsorption-desorption cycles, the extraction efficiency showed a slight decrease from 93.5% to 90.0%, demonstrating excellent reusability. Notably, rapid nicotine desorption was achieved at 40°C within 15min. This strategy streamlines the nicotine extraction process while providing a promising pathway for advancing green chemistry techniques in the tobacco industry and related fields.

North Carolina's robust tobacco industry faces a new threat from Meloidogyne enterolobii, the guava root-knot nematode, which was first identified in the state in 2011. This species can overcome host resistance in tobacco that is effective in managing other root-knot nematode (RKN) species such as M. incognita. Novel sources of host resistance are therefore needed for this pathogen. This study evaluated potential tobacco host resistance to M. enterolobii through a series of greenhouse bioassays. Genotypes of Nicotiana tabacum and other Nicotiana species (n=84) were assayed for response to M. enterolobii. Materials were selected to represent commercially important cultivars, resistance to other RKN species, resistance to other plant-parasitic nematodes and pathogens, genetic diversity, and those carrying introgressed chromosomal segments from wild Nicotiana relatives. Plants were inoculated with 10,000 eggs per plant of a North Carolina isolate of M. enterolobii and eggs from resultant infections were extracted 60 days post inoculation. Data were collected for eggs per gram of root and root galling severity. Resistance and susceptibility were quantified by calculating each line's reproductive factor (RF, final population/initial population). All materials were assessed for response through two independent bioassay trials, and genotypes displaying resistance were subsequently retested in replicates of ten in a confirmation screening. Six genotypes of wild Nicotiana species were found to be either highly resistant or moderately resistant to M. enterolobii. These lines may offer useful germplasm for future resistance breeding efforts and further characterization of resistance in Nicotiana to M. enterolobii.

Contemporary tobacco and nicotine products, particularly e-cigarettes, are deliberately designed, marketed, and distributed to maximize youth appeal, uptake, dependence, and use. Youth uptake is a predictable outcome of systems designed to maximize product availability, appeal, and addictiveness.

The tobacco industry (TI) is a globalised enterprise whose interference activities transcend national borders, undermining tobacco control policies and implementation of the WHO Framework Convention on Tobacco Control (WHO FCTC). Sub-Saharan Africa (SSA) has been a particular target for market expansion by the TI. While individual-country studies have documented policy interference activities in SSA, no comparative studies about the depth or scale exist. This study provides the first cross-country comparative analysis quantifying the frequency and distribution of TI interference activities in six SSA countries: Ethiopia, Kenya, Nigeria, Senegal, South Africa and Uganda. Qualitative content analysis was conducted to compare and analyse information from reports of TI interference activities in the six countries. The frequency of TI interference activities in the reports was coded and mapped to six categories defined in the 2012 WHO document 'Tobacco Industry Interference: A Global Brief.' A total of 234 distinct TI interference events were identified. The most common tactics involved manipulating public opinion (40%) and hijacking political and legislative processes (28%), followed by use of front groups (14%) and litigation threats (9%). Although the frequency and distribution of these activities differed across the six countries, manipulating public opinion was the most common activity and discrediting proven science was the least common activity. Findings indicate the pervasive and evolving nature of TI interference in SSA and highlight the need for sustained regional collaboration to monitor activities, share data and strengthen enforcement of WHO FCTC Article 5.3. Further research is needed to understand different contexts.

BackgroundIn South Korea, where plain packaging has not been adopted, tobacco packaging continues to function as a key marketing tool for the tobacco industry, using texts, colors, and imagery to attract consumers. Among these, flavor cues are especially important as they enhance product appeal. Cigarette sticks also serve marketing functions through design features such as colors and capsule indicators.ObjectiveThis study aimed to examine flavor-related cues on cigarettes and heated tobacco products (HTPs) packaging and stick design and to assess the presence of flavor additives in these products.MethodsThis surveillance study was conducted in November 2024. Tobacco products were purchased from convenience stores located in Seoul, supplemented by cross-referencing with national market monitoring data. Of 353 identified products, 214 products (150 cigarettes and 64 HTPs) were collected. Flavor cues were categorized by pack and stick design features, and additives were identified through sensory analysis of product components.ResultsAmong the collected products, 63.1% (54% for cigarettes and 84.4% for HTPs) had both flavor cues and flavor additives, while 20.6% (27.3% for cigarettes and 4.7% for HTPs) had neither. Flavor cues were found in 67.3% of cigarettes and 95.3% of HTPs (P<.001), and flavor additives in 59.3% of cigarettes and 84.4% of HTPs (P<.001). Pack color was the most common cue, and additives were most often delivered through crushable capsules. HTPs used a wider range of flavoring methods, including flavoring in tobacco leaves and inner wrappers.ConclusionsTobacco packaging and stick design in South Korea remain important marketing tools for the tobacco industry. Flavor cues and additives are widely used in tobacco products, particularly in HTPs. These findings highlight the need for plain packaging policies and bans on flavor additives in tobacco products.

Electronic Nicotine Delivery Systems (ENDS) present persistent public health challenges. Marketed for cessation, they may initiate the nicotine-naïve into addiction, and regulation has not curbed the appeal of flavors. Recent policies targeting menthol cigarettes and flavored cartridge-based ENDS are being challenged as the industry pivots to "copy-cat" coolants that users perceive similarly to menthol. Building on our prior work showing deleterious effects of vape components on craniofacial-derived cells, we examined acute in vitro exposures to coolant formulations. We assessed cell viability, apoptosis, autophagy, and senescence in murine craniofacial derived cells with and without ENDS constituents, nicotine, propylene glycol (PG), and glycerin (G). Consistent with previous findings that nicotine increases and nicotine+PG/G decreases cell viability, we observed that menthol and synthetic coolants WS3 and WS23 produced similar toxicological profiles by MTS assay. When combined with nicotine and PG/G, these coolants further decreased viability. Senescence occurred only for menthol when combined with PG/G and/or nicotine. Apoptosis and autophagy showed no changes. These results demonstrate that WS3 and WS23 act like menthol in craniofacial-derived cells under acute exposure conditions when assessed for cell viability. As the tobacco and ENDS industries adopt synthetic alternatives to navigate flavor regulations, safety evaluations must explicitly include menthol like ingredients. Our data provide a biologically relevant basis for including coolant analogs in regulatory toxicology based in mesenchymal and skeletal precursor cell health. These findings support inclusion of coolant flavorants in hazard screening frameworks, especially given youth driven exposure and evolving products and device chemistries.