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Page 1: International tobacco companies David Simpson Director, International Agency on Tobacco and Health Visiting Professor, London School of Hygiene & Tropical.

International tobacco companies

David Simpson

Director, International Agency on Tobacco and Health

Visiting Professor, London School of Hygiene & Tropical Medicine

Honorary Fellow, Clinical Trial Service Unit, Oxford

Editor, News Analysis, Tobacco Control journal

Page 2: International tobacco companies David Simpson Director, International Agency on Tobacco and Health Visiting Professor, London School of Hygiene & Tropical.

World’s smokers

1.2

1.64

0123456789

billions

1999 2025

SmokersPopulation

From the US Bureau of the Census and World Bank, Curbing the epidemic: Governments and the economics of tobacco control, 1999.

Page 3: International tobacco companies David Simpson Director, International Agency on Tobacco and Health Visiting Professor, London School of Hygiene & Tropical.

Smoking prevalence: men

4248

25

45

0

10

20

30

40

50

60

70

80

90

100

%

1999 2025

Industrialisedcountries

Developingcountries

WHO data

Page 4: International tobacco companies David Simpson Director, International Agency on Tobacco and Health Visiting Professor, London School of Hygiene & Tropical.

Smoking prevalence: women

24

7

20 20

0

10

20

30

40

50

60

70

80

90

100

%

1999 2025

Industrialisedcountries

Developingcountries

WHO data

Page 5: International tobacco companies David Simpson Director, International Agency on Tobacco and Health Visiting Professor, London School of Hygiene & Tropical.

World tobacco deaths

4.2

10

0123456789

10

millions

2001 2030

WHO World Health Report 1999 ..

Page 6: International tobacco companies David Simpson Director, International Agency on Tobacco and Health Visiting Professor, London School of Hygiene & Tropical.

Cumulative tobacco deaths

116

430

140

20

140

0

50

100

150

200

250

300

350

2000-2024 2025-2049

Avoidable if adult smokinghalved by 2020

Avoidable if uptake halvedby 2020

Remaining tobacco deaths

millionsper annum

WHO World Health Report 1999.

Page 7: International tobacco companies David Simpson Director, International Agency on Tobacco and Health Visiting Professor, London School of Hygiene & Tropical.

Tobacco addiction is a communicated disease:

The vector? Big tobacco

Page 8: International tobacco companies David Simpson Director, International Agency on Tobacco and Health Visiting Professor, London School of Hygiene & Tropical.

Trans-national tobacco companies’ sales (1990)

0 10 20 30 40 50 60US$ billions

Page 9: International tobacco companies David Simpson Director, International Agency on Tobacco and Health Visiting Professor, London School of Hygiene & Tropical.

TNC sales &developing countries’ gross domestic product (GDP)

0 10 20 30 40 50 60US$ billions

Philip Morris

BAT

Japan Tobacco

Peru

Bangladesh

Kenya

Senegal

Sri LankaGhana

Hungary

Page 10: International tobacco companies David Simpson Director, International Agency on Tobacco and Health Visiting Professor, London School of Hygiene & Tropical.

BAT(highest paid director)

£0

£500,000

£1,000,000

£1,500,000

1991 1992 1993 1994 1995 1996 1997 1998 1999 2000

IATH BAT director

IATH(total income)

&

Annual earnings:

Page 11: International tobacco companies David Simpson Director, International Agency on Tobacco and Health Visiting Professor, London School of Hygiene & Tropical.

The international tobacco industry

Philip Morris – PM (holding company now known as ‘Altria’)

British American Tobacco – BAT (includes Rothmans)

Japan Tobacco International – JTI (still state-controlled; former JT + non-US business of RJR Reynolds)

Marlboro, Chesterfield,Philip Morris

State Express 555, Lucky Strike, Benson & Hedges, Rothmans

Mild Seven, Salem

also: Altadis (France/Spain, formerly SEITA & Tabacalera);

Imperial (UK), incl. Reemtsma (Germany) ; ITC India (part-BAT);

Monopolies, e.g. Tekel (Turkey), Sampoerna (Indonesia), etc

Page 12: International tobacco companies David Simpson Director, International Agency on Tobacco and Health Visiting Professor, London School of Hygiene & Tropical.

A brief tobacco industry history of the tobacco epidemic

1940s +50s

1960s + 70s

1980s

1990s

2000-2003

- scientific evidence forces health-related scientific research

- development of government health policy; - industry scientists lose power to marketing executives

- expand international activities; - use toxic reduction health policy as hostage to preserve advertising

- litigation increases; - Minnesota case releases millions of papers; - health advocacy increases

- ‘We’ve changed!’ programmes, e.g. BAT’s ‘Social reports’; - FCTC process puts tobacco on health agenda worldwide; - continue to expand markets as fast as possible

Page 13: International tobacco companies David Simpson Director, International Agency on Tobacco and Health Visiting Professor, London School of Hygiene & Tropical.

Two unique aspects of the tobacco industry:

The product: highly addictive

very dangerous, at any level of consumption; largest cause of disease, disability & premature death

The people: self-selected group, not concerned by scientific evidence of diseases caused by tobacco

Page 14: International tobacco companies David Simpson Director, International Agency on Tobacco and Health Visiting Professor, London School of Hygiene & Tropical.

One simple truth about the tobacco industry:

The companies will always fight every effective health policy measure

Page 15: International tobacco companies David Simpson Director, International Agency on Tobacco and Health Visiting Professor, London School of Hygiene & Tropical.
Page 16: International tobacco companies David Simpson Director, International Agency on Tobacco and Health Visiting Professor, London School of Hygiene & Tropical.

Senegal

Page 17: International tobacco companies David Simpson Director, International Agency on Tobacco and Health Visiting Professor, London School of Hygiene & Tropical.

Cape Times, South Africa, Oct 1993

Page 18: International tobacco companies David Simpson Director, International Agency on Tobacco and Health Visiting Professor, London School of Hygiene & Tropical.

Trinidad, 1998

Page 19: International tobacco companies David Simpson Director, International Agency on Tobacco and Health Visiting Professor, London School of Hygiene & Tropical.

Uganda, Tanzania & Kenya, Dec 2001

Page 20: International tobacco companies David Simpson Director, International Agency on Tobacco and Health Visiting Professor, London School of Hygiene & Tropical.

- “We don’t want kids to smoke”

- global ad code (self-regulation…)

- “Let us back into the scientific community”

- community aid programmes

Tobacco industry ‘We’ve changed’ strategy:

Page 21: International tobacco companies David Simpson Director, International Agency on Tobacco and Health Visiting Professor, London School of Hygiene & Tropical.

Tobacco industry ‘We’ve changed’ strategy:

“We don’t want kids to smoke”

Page 22: International tobacco companies David Simpson Director, International Agency on Tobacco and Health Visiting Professor, London School of Hygiene & Tropical.

Industry ‘Youth Prevention’ programmes:

- public relations strategy: improve image

- ‘proactive’ - industry avoids ad bans

- programme says little on dangers of tobacco

- programmes shown to be ineffective*

- “adult activity” - may encourage kids to smoke *

* DiFranza J & McAfee T. The Tobacco Institute: Helping youth to say ‘yes’ to tobacco.• J Fam Prac 1992,34(6)

Page 23: International tobacco companies David Simpson Director, International Agency on Tobacco and Health Visiting Professor, London School of Hygiene & Tropical.

“The youth program... support[s] the [Tobacco] Institute’s objective of discouraging unfair... federal, state and local restrictions on cigarette advertising,

by...”

US Tob. Inst. 1/1991

Page 24: International tobacco companies David Simpson Director, International Agency on Tobacco and Health Visiting Professor, London School of Hygiene & Tropical.

• “Reinforcing the belief that peer pressure - not advertising - is the cause of youth smoking.

US Tob. Inst. 1/1991

Page 25: International tobacco companies David Simpson Director, International Agency on Tobacco and Health Visiting Professor, London School of Hygiene & Tropical.

• “Reinforcing the belief that peer pressure - not advertising - is the cause of youth smoking.

• “Seizing the political center and forcing the antismokers to an extreme…”

US Tob. Inst. 1/1991

Page 26: International tobacco companies David Simpson Director, International Agency on Tobacco and Health Visiting Professor, London School of Hygiene & Tropical.

“The strategy is fairly simple:

“1. Heavily promote industry opposition to youth smoking.”

US Tob. Inst. 1/1991

Page 27: International tobacco companies David Simpson Director, International Agency on Tobacco and Health Visiting Professor, London School of Hygiene & Tropical.

“The strategy is fairly simple:

“1. Heavily promote industry opposition to youth smoking.

“2. Align industry with broader, more sophisticated view of the problem - that is, parental inability to offset peer pressure.”

US Tob. Inst. 1/1991

Page 28: International tobacco companies David Simpson Director, International Agency on Tobacco and Health Visiting Professor, London School of Hygiene & Tropical.

“The strategy is fairly simple:

“1. Heavily promote industry opposition to youth smoking.

“2. Align industry with broader, more sophisticated view of the problem - that is, parental inability to offset peer pressure.”

“3. Work with and through credible child welfare professionals and educators to tackle the ‘problem’.”

US Tob. Inst. 1/1991

Page 29: International tobacco companies David Simpson Director, International Agency on Tobacco and Health Visiting Professor, London School of Hygiene & Tropical.

“The strategy is fairly simple:

“1. Heavily promote industry opposition to youth smoking.

“2. Align industry with broader, more sophisticated view of the problem - that is, parental inability to offset peer pressure.”

“3. Work with and through credible child welfare professionals and educators to tackle the ‘problem’.”

“4. Bait anti-tobacco forces to criticise industry efforts.”

US Tob. Inst. 1/1991

Page 30: International tobacco companies David Simpson Director, International Agency on Tobacco and Health Visiting Professor, London School of Hygiene & Tropical.

Industry youth programmes:

Uzbekistan

Page 31: International tobacco companies David Simpson Director, International Agency on Tobacco and Health Visiting Professor, London School of Hygiene & Tropical.

Industry youth programmes:

Middle East

Page 32: International tobacco companies David Simpson Director, International Agency on Tobacco and Health Visiting Professor, London School of Hygiene & Tropical.

Tobacco industry ‘We’ve changed’ strategy:

‘global advertising code’ (self-regulation)

Page 33: International tobacco companies David Simpson Director, International Agency on Tobacco and Health Visiting Professor, London School of Hygiene & Tropical.

“We have analyzed the 9-page agreement and believe that the multinationals' strategy is proactive and is a way to improve their image.”

- Herzog B, Credit Suisse , investors’ briefing.

Oct ‘01

Tobacco industry global advertising code

- a Wall Street analyst’s view:

Page 34: International tobacco companies David Simpson Director, International Agency on Tobacco and Health Visiting Professor, London School of Hygiene & Tropical.

Tobacco industry ‘We’ve changed’ strategy:

“Let us back into science”

Page 35: International tobacco companies David Simpson Director, International Agency on Tobacco and Health Visiting Professor, London School of Hygiene & Tropical.

- make health policy dependent on tobacco

- split the scientific community

- tie up research resources on non-tobacco topics

- corporate ‘blackmail’ against legislation

‘Tobacco industry ‘We’ve changed’ strategy:“Let us back into science”

Page 36: International tobacco companies David Simpson Director, International Agency on Tobacco and Health Visiting Professor, London School of Hygiene & Tropical.

“We all decided not to accept the tobacco company [money] in the end & now trying to find alternate source of funding …

“Some time I feel isolated in Pakistan when I give my strong feelings against the tobacco..”

IATH Contact, Karachi, Nov ‘01

Tobacco industry’s ‘science’ programmes

- a note from Pakistan:

Page 37: International tobacco companies David Simpson Director, International Agency on Tobacco and Health Visiting Professor, London School of Hygiene & Tropical.

Botswana

Page 38: International tobacco companies David Simpson Director, International Agency on Tobacco and Health Visiting Professor, London School of Hygiene & Tropical.

Senegal, May 1998

Page 39: International tobacco companies David Simpson Director, International Agency on Tobacco and Health Visiting Professor, London School of Hygiene & Tropical.

Philippines, 1995

Page 40: International tobacco companies David Simpson Director, International Agency on Tobacco and Health Visiting Professor, London School of Hygiene & Tropical.

Pakistan, May 2000

Page 41: International tobacco companies David Simpson Director, International Agency on Tobacco and Health Visiting Professor, London School of Hygiene & Tropical.
Page 42: International tobacco companies David Simpson Director, International Agency on Tobacco and Health Visiting Professor, London School of Hygiene & Tropical.

246

87

105

142 144

123131

175

222

188

241

70

5869

80 8697 97

104 108 109 113112

47

0

50

100

150

200

250

300

1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003

Contacts Countries

IATH’s Contacts / Countries

Page 43: International tobacco companies David Simpson Director, International Agency on Tobacco and Health Visiting Professor, London School of Hygiene & Tropical.

1991

Page 44: International tobacco companies David Simpson Director, International Agency on Tobacco and Health Visiting Professor, London School of Hygiene & Tropical.

2002

Page 45: International tobacco companies David Simpson Director, International Agency on Tobacco and Health Visiting Professor, London School of Hygiene & Tropical.

International Agency on Tobacco and Health (IATH)

Contacts’ e-mail & web access, Nov 2001

no network accessemail accessemail + web

by Contact (n = 240)

no emailemail/+

by Country (n = 112)


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