Follow the Data Podcast: Tobacco Industry Watchdogs
The Stopping Tobacco Organizations and Products (STOP) competition was launched by Bloomberg Philanthropies at the March 2018 World Conference on Tobacco or Health in Cape Town, South Africa.
The winning partners have decades of experience thwarting the international tobacco industry’s most duplicitous tactics: The University of Bath’s Tobacco Control Research Group, the Global Center for Good Governance in Tobacco Control (GGTC), and the International Union Against Tuberculosis and Lung Disease (the Union).
For decades, tobacco giants have tried to deceive the public. In addition to aggressively marketing its combustible cigarettes to children and teenagers in low- and middle-income countries, the industry is pushing alternative products, such as heat-not-burn and e-cigarettes, although the evidence about long-term safety is not yet clear. Tobacco industry-funded research has repeatedly been a smokescreen for behavior that has led to worse outcomes for smokers.
Professor Anna Gilmore, director of the Tobacco Control Research Group at the University of Bath spoke to Bloomberg Philanthropies’ Public Health program lead, Dr. Kelly Henning. They discuss the importance of shedding light on tobacco industry tactics, collaborating with STOP partners, and data’s essential role in the fight against misinformation.
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KATHERINE OLIVER: Welcome to Follow the Data, I’m your host, Katherine Oliver.
Tobacco use is the leading agent of death in the world. Approximately 1.1 billion people globally are smokers.
Tobacco can also be deadly for non-smokers. Secondhand tobacco smoke contributes to heart disease, cancer, and other diseases, and causes 900,000 premature deaths annually.
On March 7th, 2018 at the World Conference on Tobacco or Health in Cape Town, Bloomberg Philanthropies announced it would provide $20 million in funding to launch Stopping Tobacco Organizations and Products (referred to as “STOP”), a new global watchdog that will aggressively monitor deceptive tobacco industry tactics and practices to undermine public health. To lead the effort, the initiative welcomed applications from organizations around the world committed to tobacco control.
In August of 2018, Mike Bloomberg announced that the University of Bath was one of the organizations selected to lead the new tobacco industry watchdog. They applied as a group with a current Bloomberg partner, the International Union Against Tuberculosis and Lung Disease (known as The Union) and the Bangkok-based Global Center for Good Governance in Tobacco Control (the “GGTC”). The winning partners have decades of experience thwarting the international tobacco industry’s most duplicitous tactics
In this episode, Dr. Kelly Henning, director of Bloomberg Philanthropies’ Public Health Program speaks with Anna Gilmore, Professor of Public Health and Director of the Tobacco Control Research Group at the University of Bath to discuss the deceptive marketing strategies of the tobacco industry and how initiatives like STOP will shed a light on these harmful tactics.
ANNA GILMORE: Kelly, I just want to say before we start a big thank you, a big thank you for funding us, because we’re very excited.
DR. KELLY HENNING: I’m so glad you could do this today. Thanks for taking the time. I just wanted to start off by asking you if you could set the scene for us, why did you become interested in the tobacco industry and how did you get started?
GILMORE: So I started my working life as a doctor, and initially I thought I was saving lots at lives. Soon I realized actually I was achieving relatively little, and at the time I was doing respiratory jobs so most of the patients were smokers. And they’ve come in again and again with a chronic lung disease. Ultimately I realized all I was doing was putting a plaster on that wound.
What I really needed to do was to prevent those diseases from happening in the first place. So I went into public health. From there you quickly realize that tobacco is the single largest cause of preventable death and disease. It’s the only consumer product when used exactly as the manufacturer intends kills two-thirds of its users.
So from public health I moved into research on tobacco, and from there I realized that the root cause of the tobacco epidemic was the tobacco industry. And so I started to study the tobacco industry. Once you do that, really the product is addicted, but actually studying the industry I think is addictive because you start to understand how reprehensible its behavior is and you feel duty-bound to kind of study and expose it.
HENNING: Anna, that’s great. Could you expand a little bit for us and explain to our audience how the tobacco industry has really prevented progress? I know you’ve uncovered a lot of things along the way and how those tactics that they use have changed over time even?
GILMORE: Okay. So I mean at the time when I first got into work on the tobacco industry, it had just been forced to release millions of documents as a result of litigation. And I was one of the first researchers to come study those documents, particularly the British American Tobacco documents, which at that point were only accessible in the UK. And in my earliest work I’d use those documents to look at what the tobacco industry did when the Soviet Union collapsed. And let me just give you some of these examples.
So first of all the documents showed that they were smuggling vast volumes of their cigarettes into that region. In some markets over 90% of their cigarettes going into those countries were smuggled. And at that time those countries were in the point of collapse. They had no money. And so the industry was avoiding import duties, and excise revenues, and depriving those governments of much needed revenue. And then it would lie to those governments and claim that the reason that smuggling was so high was, not of course because they were smoking cigarettes, but because consumers wanted Western products. And then it would pressure the governments to privatized that industry and sell cheaply to those tobacco companies.
Then the marketing that we saw there, the former Soviet Union had not really known tobacco marketing previously. Almost no women smoked, but by the mid-1990s the industry was gloating that half of billboards in Moscow and must three-quarters of plastic bags in Russia were tobacco adverts. Massive pink advertising. So many brands called Kiss, or Vogue, targeted at women. And we saw within ten years a doubling of female smoking rates, and yet publically the industry was claiming that it was only marketing to existing smokers, but when you looked at its documents you could clearly see plans to target women, to target children.
So you started to see how important these documents were in revealing what the industry was really up to, you started to understand how important it was to get governments to understand how they were being hoodwinked. Another example there is in Uzbekistan, the health minister had enacted this really strong tobacco control decree. And BAT found this just before it was about to invest, and managed to overturn it and put in place a very pathetic and weak voluntary code, but yet publicly what it had claimed is that was an example of its responsible attitude and it’s only when we had seen these documents and understood what had really happened that the truth came out.
HENNING: Those are really powerful examples of industry interference and activity, no question about it. Anna, what do you think is happening now? I understand from your work that things are evolving. So do you want to talk a little bit about where we are more recently perhaps?
GILMORE: How do they influence and how has that changed? Really for the tobacco industry, it’s all about the bottom line. They’ve got to sell as much of that product as profitably as possible and anything that interferes with that, they will try to overcome.
There’s a great Phillip Morris document that I was referred to, and what it says is, “Our overall approach to the issues is to fight aggressively with all available resources against any attempt from any quarter to diminish our ability to manufacture our products and market them.” And it repeats that strategy again and again. And we know from our work, we’ve actually undertaken primary studies and then we’ve systematically reviewed the existing mixture. We know from that that the industry repeats the same arguments and tactics over time, but actually it kind of nuances them to take account for the changing environment.
So for example, in the past they could just walk into the Ministry of Health or the Ministry of Finance and sit at the policy table, but in many places now their credibility is so low that they cannot do that. Increasingly now we’re seeing them operate via third- parties and front groups, and sometimes the scale if this deception feels overwhelming. So when we were looking at plain packaging here in the UK, we came across over a 100 organizations that were opposing plain packaging and that we could link to the tobacco industry.
So in many countries now, in a way the situation is more complex. No longer are we dealing with a straightforward industry, but we’re dealing with a puppet master behind the scenes manipulating other organizations to be its acceptable face. It’s a bit like fighting at a multi-headed Hydra. You cut one arm off and another one replaces it. You expose one front group and another one appears. So that’s a key way that the industry has changed. Another example is science. So the misuse of science has always been at the core of how the tobacco industry influences policy. It’s always thought to create doubt and promote controversy. And initially that science focused on denying the health impacts of active smoking.
So you go back to the 1950’s and secret meetings of industry executives to develop a strategy to create doubt over the evidence of the harm that smoking causes. And by the 1970’s and 80’s the focus of that manipulation of science had move to secondhand smoke. Now we see exactly the same thing happening, but the focus of the science is on evidence for policy. So we see the industry funding scientists to contest the public health evidence and to promote their own, what they claim is evidence promoting their own policies.
The good news is the strategies are repeated again and again, but they evolve very slightly. One of the biggest difficulties really is that they are so massively resourced that sometimes the scale and the numbers of front groups, and arguments, and documentation, and reports is overwhelming.
HENNING: So Anna, that’s a good segue into talking about the STOP initiative and how to push back against these practices of the industry that you’re describing. But before we go to STOP, I just wanted to ask you if you would like to comment on the industry’s tactics around children and adolescents and teens? I know that’s been a big area of concern recently and wondered if you could comment on that?
GILMORE: Well yes, so we know that the industry claims on its marketing for example that it will only market to existing smokers, but when you look at its documents it’s absolutely clear that young people are absolutely essential to its future. Not only are they essential to replace the smokers that they’ve killed effectively, but that they are actively targeted in their marketing. It’s children that take up smoking, and so the industry has to target children. We see that across the world.
HENNING: So why don’t we just move for a moment into this new initiative, this STOP initiative that your organization is involved with now. Could you talk a little bit about why you thought it was a good idea to apply for STOP and why you think it’s an important initiative?
GILMORE: I think this initiative is absolutely essential. I mean the tobacco industry is the single greatest barrier to progress in improving global health. Countries around the world trying to implement tobacco control legislation have repeatedly identified the tobacco industry as their single greatest problem, but simultaneously we know that addressing the tobacco industry and exposing its tactics enables progress. And that’s really why this work is vital.
To me STOP is ultimately about truth and transparency, and it’s about giving the right people the right information so they can act in the public interest and stop the tobacco industry from riding roughshod over governments and people. We know from our previous work, when we’ve done research to understand the industry, infect that research into policymakers, it really has enabled progress in tobacco control policymaking. And so we applied for this because we see this really as vital to moving tobacco control forward and to improving public health globally.
HENNING: You mentioned your work and some of the research that you’ve undertaken already, how do you see STOP as part of that, accelerating it, or integrating with it? What do you see STOP being able to do to push this forward for you?
GILMORE: As you say we have done a lot of work in this sphere, and we actually – we have people coming to us all the time facing problems with the industry and issues they want us to help investigate and research. And up until now we really haven’t had the capacity to respond adequately. STOP provides this real step change in our ability to do this sort of work, and I think perhaps what is most exciting is it brings together three unique partners that will come together and deliver this work in a really novel way.
There are a few key changes for us. One I think it will really enable us to respond in a timely manner to requests for help, and I think when you’re trying to use this type of work to achieve policy change that is absolutely essential. We get these windows of opportunity, policy windows, and we want to be able to step into those windows where the industry is misleading everyone and expose what it’s up to. So that will be a key focus. Of course we’ll be able to expand our focus. Up until now we’ve been focused in large part really on the U.K. and Europe with some scattering of other places, but really now this is about expanding that reach and expanding the monitoring and research system globally.
We’re also really excited to be employing some innovative big data on crowd sourcing methods. We’re going to be analyzing some leaked documents, and as well as being able to take on much more work ourselves, we really hope to build capacity around the world – to increase existing capacity and increase the number of people that can undertake similar work.
HENNING: Talk a little bit more about the request for help that you get. I think maybe some of us aren’t clear what sort of requests come to you?
GILMORE: Maybe I should give you an example. So when the Uganda Tobacco Control Bill was being negotiated and the industry was really fighting hard against this legislation, basically peddling a whole lot of mistruths. We were approached to help look at what the industry was doing and help Uganda address that. We actually did something fairly simple. We looked at the arguments the industry was making and produced some simple documentation outlining those arguments and then basically why they were fundamentally wrong and what the real evidence showed.
And then we also looked at how the industry had been influencing policy and produced an infographic showing that. With those two outputs we worked with partners to circulate those to MPs, and officials, and we also put key information on our website and the press covered really the information we’d put together. And the feedback from politicians and civil servants was incredibly positive. We had MPs thanking us for letting them see what was really happening.
The feedback was that having that information played a key role in getting politicians to change their opinion and enabling the passage of the legislation. Then in terms of other requests for help, “We’ve come across this new organization. Are they a front group for the industry?” That is something we would often look into or try to look into, or queries on data. Recently we’ve been doing some work on data on tobacco smuggling. Is the industry data on tobacco smuggling valid? That is something that we’ve looked into and we’re publishing this week.
HENNING: Anna, I’m assuming that the STOP team, as you mentioned which is three organizations, would be part of responding to a number of these kinds of requests. Could you tell us a little bit more about who those other partner organizations are and what they’ll be doing?
GILMORE: I mean for us what’s really exciting is it’s clearly not just the University of Bath, but we’re working with some wonderful partners. Officially there are three partners, but really there are four for the price of three because one of the organizations, the Union has two parts. We’re the lead on the research and the monitoring, but in addition to the University of Bath we have the Center for Good Governance in Tobacco Control based in Thailand, and very closely linked to SEATCA, which is the South East Asian Tobacco Control Alliance.
GGTC is the Article 5.3 knowledge hub, and really the leading low- middle- income country based global tobacco industry advocacy and accountability organization with extensive experience in securing policy change and working cross-sectorally to achieve that change. The other key partner is the Union and they’re sub-grantee Vital Strategies. Vital Strategies brings key skills and experience in media and communication, and then underpinning really all of those strands is the Union who has an extensive tobacco control program that’s been working across 50 countries since 2007. Both the Union and Vital Strategies are already Bloomberg partners.
So we feel that the team really combines diverse and complementary experience with partners with track records in policy change, capacity building, partnership work, really that are uniquely able to deliver the goals of STOP.
HENNING: Could you tell us what a 5.3 knowledge hub is? That’s a term I’m not sure we’re all so familiar with. Could you mention that?
GILMORE: Okay so it might get a bit complicated. So we have the framework convention on tobacco control, which is the world’s first global public health treaty defense under the auspices of the World Health Organization. That treaty, which is now being signed up to by 180 countries around the world, has a number of articles.
One of the most innovative articles in Article 5.3, which is really all about protecting tobacco control policies from tobacco industry influence. And then the convention secretariat, which is charged with overseeing the treaty, has established a series of knowledge hubs on key elements of the treaty. So one of the latest knowledge hubs is the Article 5.3 knowledge hub, and that sits within the Center for Good Governance in Tobacco Control, and they will be working with the convention secretariat at the parties to the treaty to enable implementation of Article 5.3.
HENNING: Great, great. I assume that at this point you and the partners working on STOP have come together and developed really some overarching goals for your years ahead. Could you just share with us what you’re thinking at this moment about goals?
GILMORE: The ultimate goal really is to hold the tobacco industry to account in order to enable progress in tobacco control. Perhaps the best way of looking at this is, we all say that sunlight is the best disinfectant. We really think that by shining a light on the tobacco industry’s activities we’ll be able to identify its latest marketing and lobbying tactics, its front groups, its spokespeople. In that way we can increase the transparency of policymaking and reduce the industry’s ability to block the work of policymakers around the world and really hold the industry to account. That’s the big vision.
And then within that there’s a whole series of bits of work that we’ll be doing. So obviously monitoring research in the tobacco industry, and using that information to de-normalize the industry, to expose what it is up, to expose its lies, to hold it to account. And also of course once we put all this information together we’ll be able to predict big tobacco’s next move and ultimately use all of this information to secure policy change.
HENNING: Great, so when I look at your monitoring material that you have available already, I’m struck by the enormous amount of research material that is available and I think it’s hard to imagine how one would catalog and use all that. Can you talk a little bit about how that actually works and how you – how one would perhaps look something up if they wanted to and how you imagine STOP enhancing the work on those datasets?
GILMORE: It might be worth focusing on what we’ve got so far. Back in 2012 we set up a website called Tobacco Tactics. And the reason we did that is we were aware that we had this vast amount of information and knowledge on the tobacco industry, but most of it sat in academic journals, or on our computers, or in our heads and the people that needed that information didn’t have it at their fingertips.
So we set up Tobacco Tactics really as a knowledge exchange platform, and that was incredibly innovative for research because most people kind of hide their research until it is published in a peer-reviewed journal. And at the time we set it up we worked with stakeholders to understand what they wanted and how they wanted to use the information. From the outset, the website has been set up in a way to make it easy and accessible for people. What is absolutely key if this is publicly accessible, it’s easily searchable, and instead of having long papers we have more pithy pieces of information. So we will have descriptions of front group or descriptions of tactics explaining what the industry does and why, we’ll have sections which explain its arguments and why they are misleading.
The key thing is that it is searchable and the feedback has been incredibly positive. Key people are using it; civil servants, NGOs, journalists, politicians. So for example, recently the tobacco products directed a major piece of European tobacco control legislation was being negotiated and the lead politician overseeing that directive said that she and her team would routinely look up on our website the names of people that were trying to lobby them to see if that person or that organization was fronting for the tobacco industry.
A key aim of STOP is to build on that. Working with our partners and with this amazing new resource, a key will be develop that into an all singing, dancing platform; make it more user friendly, more accessible, more easily searchable, and also to combine that with other key information on the tobacco industry. So that what we will create ultimately is a one-stop shop with all the information that people need on the tobacco industry.
In addition to that web platform there will be a mobile app that will provide information at people’s fingertips. When a journalist wants to get some information or when a politician is sitting in a meeting, they can tap on the app and get the information that they need at their fingertips. So that is a key way that we see this moving forward.
HENNING: I think the scope and the depth of this initiative is really starting to come through from your discussion. I’m excited to hear about what you’re thinking going forward. I have to believe that the tobacco industry is not excited about this. Can you mention what you think the industry reaction might be realizing that we don’t know for certain?
GILMORE: At the end of the day we should not worry what the industry reaction is. We have to just get on and do this. We can expect that the industry will of course just attempt to continue with impunity. But we do know that exposing the industry’s tactics does help advance policy. So even if it continues, we foresee that this will be effective. And we need to recognize that simultaneously of course the tobacco industry is continuously trying to rehabilitate its image. And its latest installment of that really is the Foundation for a Smoke-Free World, where Phillip Morris is claiming that it is committed to a smoke-free future, despite continuing to market its cigarettes to challenge every effective piece of tobacco control legislation. We can expect business as usual from the tobacco industry.
HENNING: What should we expect to see from STOP in the first year or first several months? What do you imagine will be some of the early wins and early products?
GILMORE: Well, one of the things we’re going to set up as a team that can respond quickly. There will be that increased capacity to respond in that policy windows. So we expect to get that service up and running. We will get a revamped Tobacco Tactics website, and then later on this all singing and dancing website, and also we can expect a kind of a series of exciting new reports, both major reports and then smaller, focused country-specific reports or topic-specific reports responding to whatever the key emerging issues are.
HENNING: Anna, I want to thank you so much for your time today and for talking about these issues. I think this is a very exciting new initiative. It’s really groundbreaking and I look forward to hearing from you in the future and to seeing the work of STOP. Thank you so much.
GILMORE: Thank you Kelly. We’re really excited as well to work with you and work with all the Bloomberg partners and really making something amazing.
OLIVER: We hope you enjoyed this episode of Follow the Data.
Many thanks to Anna Gilmore for joining us. To learn more about STOP partners, follow Bloomberg Philanthropies on Twitter at @BloombergDotOrg. If you haven’t already, be sure to subscribe to Follow the Data podcast.
This episode was produced by Electra Colevas, Jean Weinberg and Ivy Li, music by Mark Piro, special thanks to David Sucherman.
As our founder Mike Bloomberg says, if you can’t measure it, you can’t manage it. So until next time, keep following the data. I’m Katherine Oliver, thanks for listening.