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Responding to the global tobacco industry: Canada and the Framework Convention on Tobacco Control.

Tobacco use is the leading cause of preventable death throughout the world, resulting in 4.9 million tobacco-related deaths per year) Major cigarette brands from multinational tobacco companies account for over 75 per cent of all worldwide cigarette sales. (2) Yet until recently, tobacco control efforts were focused at the regional or national level, rather than at the global level.

There is substantial evidence that the global perspective of tobacco companies contributes to their success. In a continuing quest to build and defend world markets for tobacco products, multinational tobacco companies are able to share information effectively across national borders within their own organizations. Tobacco companies also share some of their less sensitive information with competitors through national and international trade organizations, in order to facilitate joint efforts at lobbying governments in many countries.

The international nature of the tobacco industry's efforts has made it difficult until recently for public health agencies in individual countries to fight effectively against the global might of the tobacco industry. To compete successfully against the international efforts of the tobacco industry, the Framework Convention on Tobacco Control (FCTC) was developed by the World Health Organization in conjunction with public health agencies and tobacco control organizations from countries around the world. (3) As the first cross-national public health treaty, the FCTC is intended to reduce tobacco use worldwide, and it exemplifies the new trend toward global thinking among public administrators. In order to institute effective tobacco control policy to help reduce the toll of tobacco-related death and disease, the FCTC helps policy-makers to become equally astute at sharing information across national boundaries and more adept at considering the transnational implications of policy and legislation. (4)

This article will first illustrate why transnational worldwide action on tobacco control was necessary, by presenting excerpts from tobacco industry documents which demonstrate the global power of the tobacco industry. While some of these excerpts were initially located in secondary sources, the original documents have been checked through online PDF sources to ensure the accuracy of the quotations or excerpts. A review of these excerpts clearly illustrates the need for tobacco control efforts to operate on a cross-national or global basis. Canada's role in developing the FCTC will be reviewed, and an overview of Canada's efforts to come into compliance with the FCTC will be outlined. The implications for public administrators involved in other health-related areas will be discussed.

Methodology

During the 1990s over 35 million pages of subpoenaed tobacco industry corporate documents were publicly released as a result of high profile us court cases, and many of these are available online at http://tobaccodocuments.org. (5) These include documents from the Tobacco Institute (a lobbying organization for the us tobacco industry) and from all of the major us tobacco companies, as well as documents from corporate headquarters outside of the United States (i.e., British American Tobacco in the UK). The documents discuss a variety of corporate issues, including marketing, advertising, finances, operations, product development and research into product and health issues related to tobacco. (6) Documents also include information about international operations of the multinational tobacco companies, including details of the mergers and acquisitions that have made large tobacco companies become even larger, as well as information about industry trade organizations and international lobbying efforts. Similar documents from Canadian tobacco companies and the Canadian Tobacco Manufacturers Council have also been made public as a result of court challenges to Canada's 1988 Tobacco Products Control Act and 1997 Tobacco Act, (7) and some of these are also available online at http://tobaccodocuments.org.

These documents provide a rich pool of information about the international tobacco industry's actions and contribute substantially to an understanding of the full extent of the tobacco industry's international cooperation. Excerpts from these documents are used in this paper to illustrate the need for tobacco control efforts to operate on a transnational or global basis.

The tobacco industry as a global entity

Tobacco industry documents show that as long ago as the mid-1960s, tobacco companies understood that growth in the tobacco industry was dependent on the development of international networks and strategies. (8) While individual tobacco firms maintained competitive strategies to acquire market share and maximize profits, global tobacco networks were utilized to address issues of mutual concern. These networks were used primarily to engage in three major activities: to challenge and subvert domestic regulations; to lobby governments; and to counter health accusations. By working jointly on issues that affected the entire tobacco industry, the tobacco industry exerted greater power and effectiveness than its member companies could have achieved by working individually. (9)

Circumventing domestic regulations

Tobacco industry documents clearly demonstrate the global power of the tobacco industry, in terms of circumventing and subverting domestic regulations, particularly in the area of advertising. (10) To cite one example, executives from British American Tobacco (parent company of Imperial Tobacco Canada) attended a five-day marketing conference in May 1978, and one of the documents from this conference recommended taking advantage of international media: "As advertising bans tend to fall unevenly on countries within regions, companies should explore the opportunities to co-operate with one another by beaming TV and radio advertising, for example, into a 'ban' country." This excerpt demonstrates the extensive inter-country cooperation that has taken place within the tobacco industry for decades, intended in some cases to circumvent national laws regarding advertising.

Another recommendation from this same conference recommended evasion of domestic tobacco regulations using additional methods that involved international cooperation, including the introduction of non-tobacco advertising vehicles:

Opportunities should be explored by all companies so as to find non-tobacco products and other services which can be used to communicate the brand or house name, together with their essential visual identities. This is likely to be a long-term and costly operation, but the principle is nevertheless to ensure that cigarette lines can be effectively publicized when all direct forms of communication are denied. (11)

This recommendation laid the groundwork for a 1998 decision by British American Tobacco (BAT) to circumvent the European Union cigarette advertising regulations. Complementary non-tobacco products developed by BAT included Benson & Hedges coffee brand, Lucky Strike clothing, John Player Special whiskey, and Kent Travel. David Bacon, the head of corporate communications at BAT, discussed the viability of non-tobacco advertising vehicles, a technique also known as 'brand-stretching,' in an interview with the London Sunday Times on 18 January 1988:

"Yes, these products share the trademarks of our tobacco products--luxury products have done that for years--but they should not be caught by any marketing restrictions because we are not selling cigarettes with them," he said. "The regulators could rightly be suspicious if the products do not stand on their own feet, but as serious revenue-generating products then I think the regulators do not have a case."

Axel Gietz, spokesperson for Japan Tobacco International, admits the association of the Salera brand name with music stores is not a coincidence but also contends that it is not a method for gaining market share for the tobacco brand. "We are not gaining market share because there are Salem Cool Planet record stores ... It is a good way of capitalizing on the image of the brand. This is perfectly legal." (12)

In spite of these denials, it seems highly likely that the non-tobacco products which share tobacco-product trademarks are intended to market cigarettes, particularly when the corporate documents from two decades earlier state that this was an explicit intention. Such products provide substantial international marketing opportunities. (13) For example, there are currently 163 Marlboro Classics clothing stores and 310 in-store Marlboro Classics clothing departments found in scores of countries throughout the world. There are several Benson & Hedges bistros, including one in Kuala Lumpur, Malaysia, where tobacco advertising is illegal; according to the bistro's manager, the use of the brand name is not coincidental: "Of course this is all about keeping the Benson & Hedges brand name to the front. We advertise the Benson & Hedges Bistro on television and in the newspapers. The idea is to be smoker-friendly. Smokers associate a coffee with a cigarette. They are both drugs of a type." (14)

This appears to confirm the notion that brand-stretching, or applying a tobacco brand name to a non-tobacco product, is a method for promoting the cigarette brand. Internationally, this technique has provided significant scope for circumventing national bans on tobacco advertising. (15) It should be noted that sponsorship of sports and entertainment events presents similar opportunities for circumventing national bans on tobacco advertising. (16)

Closer to home, the Canadian tobacco company Imperial Tobacco recognized the importance of international dynamics in subverting domestic regulations in areas other than advertising, such as using international trade to avoid taxation. In the following excerpt from a 1993 document, Imperial Tobacco writes to its parent company, BAT, regarding Canadian exports to the us market. The memo reveals that Imperial Tobacco fully realizes that when they export Canadian brands duty-free to the United States, these exports will then be returned to the Canadian market by smugglers:

As you are aware, smuggled cigarettes (due to exorbitant tax levels) represent nearly 30% of total sales in Canada, and the level is growing. Although we agreed to support the Federal government's effort to reduce smuggling by limiting our exports to the U.S.A., our competitors did not. Subsequently, we have decided to remove the limits on our exports to regain our share of Canadian smokers. To do otherwise would place the long-term welfare of our trademarks in the home market at great risk. Until the smuggling issue is resolved, an increasing volume of our domestic sales in Canada will be exported, then smuggled back for sale here. (17)

This presents a very calculated effort by the Canadian office of an international tobacco company to subvert domestic tax laws, by using international trade arrangements in such a way that smuggling is facilitated.

Lobbying governments

The networks of personal relationships established by the tobacco industry have proved effective in slowing the implementation of government tobacco regulations. Lobbying efforts by the tobacco industry often extend beyond government executives to include the international community, diplomatic delegations, and media professionals. BAT'S 1993 Plan and Estimated Budget details lobbying efforts of its Public Affairs Regional Group (PARG), in partnership with Philip Morris International (PMI), as follows:

The PARG promotes the re-activation of industry presentations before the Latin American and Caribbean Group (GRULAC) and FAO with the assistance of BATCO'S Government and Corporate Relations Manager. As in the past, for this initiative to be successful, it requires the participation of PMI and all BATCO. and BAT Industry (Souza Cruz) companies in the region. The main objectives of this initiative are: 1. To influence the vote of diplomatic delegations participating in the International Organizations at Geneva, so as to counteract propositions against the tobacco industry, specifically the ones proposed at OMS [World Health Organization] General Assembly. (18)

This illustrates the ability of the tobacco industry to identify and influence negative situations in cooperation with one another, even at the international level of the Organisation Mondiale de la Sante (OMS). Tobacco companies can rapidly and effectively mobilize an influential lobbying campaign in partnership with each other, using their contacts within the media and government. (19)

The power wielded by the tobacco industry is further illustrated when considering the 1992 presidential veto of the "Neri Bill." (20) In 1990 the Argentine lower house approved a bill which would effectively eliminate all cigarette advertising and promotion, restrict smoking in public or enclosed areas and require disclosure of ingredients. On 30 September 1992, the Senate also approved the Neri Bill, leaving the Argentine president, Carlos Menem, exactly ten days to approve or veto the bill. During that ten-day period, it is estimated the tobacco industry received us $2.8 million in media coverage, with the 105 out of 129 articles presenting arguments favourable to the industry, and President Menem ultimately vetoed the bill. The tobacco industry was hard at work behind the scenes, as evidenced by this mention of a meeting that took place during this ten-day time period: "On October 5, tobacco industry organized a closed door working session with media owners, sports figures, advertising executives, and other interested parties to initiate a campaign in favor of a presidential veto" (21)

The strong ties that have been established between the tobacco industry and the media can be explained by the extensive media targeting undertaken by the tobacco industry. To this end, BAT and Philip Morris initiated a series of media briefings in Latin America and the Far East to attempt to downplay the link between environmental tobacco smoke (ETS) and negative health effects. In continuing this effort in the African market in 1993, BAT recommended the following strategy for media briefings:

In Africa, briefings would be supported by Rothmans, Rembrandt and BAT. We would control the programme. The most successful [briefings] have adopted the following format:

i) A maximum of 15-20 journalists are invited to a seminar during which they will be addressed by independent experts and tobacco industry experts on a range of issues including active smoking, ETS, young people and smoking, WHO/health priorities, economic impact studies, politicisation of science and social costs.

ii) Location is somewhere pleasant, usually a beach resort. This motivates the journalists to attend as well as increasing the chances of having their undivided and uninterrupted attention ...

iii) The briefing session is typically run over two days with a half day of presentations and a half day free on each of the two days ... iv) Care should be taken in selection of journalists. (22)

International cooperation within the tobacco industry ensures the organization of ever more effective lobbying efforts. For example, in 1992 the British American Tobacco Company planned to lobby the World Bank/ International Monetary Fund (IMF) with regard to tobacco control policies in the African region:

The increasing impact of the World Bank/IMF policy in the region together with the spread of multi party politics has resulted in a need for more focused and effective lobbying nationally, regionally and internationally. Action:

--BATCO to supply lobbying guidelines.

--All companies to supply information about local NGO representatives for compilation of regional data base. BATCO to co-ordinate.

--Briefing paper on World Bank//IMF to be circulated to Public Affairs Managers.

--BATCO to re-establish links with African representatives at the World Bank in Washington. (23)

Some of the lobbying efforts of the tobacco industry have resulted in public attacks on the legitimacy of international organizations. By enlisting the help of so-called independent scholars, the tobacco industry has been able to shift international focus away from itself and into areas which do not affect the industry's revenues. For example, it has used its influence and monetary incentives to persuade scholars to publish articles which argue against WHO tobacco control efforts in third world countries, as shown in this excerpt: "An effective anti-smoking campaign might allow people with a life expectancy of 70 to live a couple years longer. But in a country where most children go without basic vaccination and where infant mortality is over 100 for every 1,000 live births, an anti-smoking program is a cruel waste of precious resources." (24) These efforts may, at times, have shifted the WHO's focus and funding away from the global growth of tobacco use. Overall, the tobacco industry's lobbying efforts, both domestically and internationally, are extremely effective.

Countering health accusations

By the early 1950s the link between smoking and lung cancer had been established in the medical literature, but the tobacco industry had a vested interest in casting doubt on the negative health effects of tobacco. The expertise of leading public relations firms were engaged by the Us tobacco industry, leading to the publication of an advertisement headlined "A Frank Statement to Cigarette Smokers" on 4 January 1954. The advertising copy read:

Distinguished authorities point out:

1. That medical research of recent years indicates many possible causes of lung cancer.

2. That there is no agreement among the authorities regarding what the cause is.

3. That there is no proof that cigarette smoking is one of the causes.

4. That statistics purporting to link smoking with the disease could apply with equal force to any one of many other aspects of modern life. Indeed the validity of the statistics themselves is questioned by numerous scientists. (26)

This advertisement, which ran in more than four hundred newspapers across the United States reaching an estimated 43 million people, was the beginning of a decades-long worldwide effort by the tobacco industry to obscure the relationship between cigarette smoking and disease. Although the tobacco industry has contributed substantial funding to medical research over the years, much of this research has been focused on showing the benefits of smoking, or attempting to obscure the relationship between smoking/ETS and disease.

A 1978 public opinion poll conducted by the Roper Organization for the tobacco industry provided this advice regarding a strategy for dealing with the public's concerns about second-hand smoke (passive smoking): "The strategic and long run antidote to the passive smoking issue is, as we see it, developing and widely publicizing clear-cut, credible, medical evidence that passive smoking is not harmful to the non-smoker's health." (27)

Philip Morris took this advice seriously and engaged the prominent Covington and Burling law firm to help develop the Environmental Tobacco Smoke (ETS) initiative. In 1991 the ETS Consultants Project was initiated in Latin America, which included engaging thirteen ETS scientists ("consultants") from seven countries. This Latin American project was described in a Philip Morris document as follows:

The consultants represent a wide variety of scientific disciplines, including chemistry and biochemistry, epidemiology, oncology and pulmonary and cardiovascular medicine ... The Latin Project is managed by Covington and Burling [law firm]. Unlike many other regional ETS consultant programmes sponsored by the industry, the Latin project was initiated in anticipation, rather than in reaction to, the full-force arrival of the ETS issue to Central and South America ... Critical to the success of the Latin Project is the generation and promotion of solid scientific data not only with respect to ETS specifically but also with respect to the full range of potential indoor and outdoor air contaminants. This approach encourages government agencies and media in Central and South America both to resist pressure from antismoking groups and to assign ETS its proper place among the many potential indoor and outdoor air contaminants found in these regions. (28)

The ETS consultants were funded by the tobacco industry to produce and disseminate research which downplayed the harmfulness of second-hand smoke, while highlighting the harmfulness of other indoor air contaminants.

This was intended to thwart the efforts of tobacco control efforts to ban smoking in public places.

A 1988 BAT report outlined the process for finding the ideal consultants for the ETS project:

The consultants should, ideally, according to Philip Morris, be European scientists who have had no previous connection with tobacco companies ... The mechanism by which they identify their consultants is as follows:--they ask a couple of scientists in each country ... to produce a list of potential consultants. The scientists are then contacted by these coordinators or by the lawyers and asked if they are interested in problems of Indoor Air Quality; tobacco is not mentioned at this stage, CVS are obtained and obvious "anti-smokers" or those with "unsuitable backgrounds" are filtered out. The remaining scientists are sent a literature pack containing approximately 10 hours reading matter and including anti-ETS articles. They are asked for a genuine opinion as independent consultants, and if they indicate an interest in proceeding further a Philip Morris scientist makes contact. Philip Morris then expect the group of scientists to operate within the confines of decisions taken by PM scientists to determine the general direction of research, which apparently would then be "filtered" by lawyers to eliminate areas of sensitivity. (29)

The use of tame scientists in helping to create a "controversy" around the impact of environmental tobacco smoke allowed the tobacco industry to keep the tobacco and health controversy alive. Over the previous rive decades the industry has repeatedly funded and published research which supports its position, while suppressing research which goes against it. The industry's biased interpretation of risks associated with tobacco smoking is then relayed to the lay press and directly to policy-makers, in order to ensure continued support for tobacco-friendly policies. (30)

Since the 1970s, smoking prevalence in developed countries has declined, and as a result the tobacco industry has shifted its marketing campaigns, lobbying efforts, and advocacy campaigns to developing countries in Asia, Africa, and Latin America. (31) This excerpt shows how the tobacco industry treats developing countries as markets of opportunity and potential growth:

We should not be depressed simply because the total free world market appears to be declining. Within the total market, there are areas of strong growth, particularly in Asia and Africa; there are new markets opening up for our exports, such as Indo-China and the COMECOM countries; and there are great opportunities to increase our market share in areas like Europe ... The industry is consistently profitable, and there are opportunities to increase that profitability still further." (32)

With the implementation of numerous international trade agreements, markets that were once inaccessible are now opening up to multinational tobacco companies. It is estimated that in China alone there are approximately three hundred million smokers. (33) By 2025 it is estimated that the world's smoking population will increase to 1.6 billion from 1.1 billion in 1998. Further, the ratio of smokers from developed countries to smokers from developing countries is expected to shift from 2:1 smokers to 1:2 smokers, unless drastic action is taken. (34) Global cooperation on tobacco control is essential to combat the global efforts of the tobacco industry. The initiatives developed in the Framework Convention on Tobacco Control (FCTC), discussed below, provide countries with tools to work toward dismantling the global power of the tobacco industry.

The framework convention on tobacco control

Over a period of rime the global tobacco control community came to recognize that in order to combat the international tobacco industry, it was necessary to generate international cooperation that was equally powerful. The idea for an international tobacco control agreement began in May 1995 at the 48th World Health Assembly. The following year, a resolution was adopted that instructed the director-general to initiate the development of an international treaty on tobacco control. This represented the first time that the WHO had initiated work on an international treaty. Dr. Gro Harlem Brundtland, the WHO director-general, was instrumental in making global tobacco control a priority of the WHO in 1998.

Negotiations for the FCTC began in 1998 and were followed by six official rounds of negotiations, involving delegates from over 170 countries and dozens of non-governmental organizations (NGOS). On 21 May 2003 the WHO Framework Convention on Tobacco Control was unanimously adopted by all 192 member states of the World Health Organization at the 56th World Health Assembly. This represented the world's first public health treaty and was the first legal instrument designed to reduce tobacco-related deaths and disease around the world.

The convention came into force in February 2005. Its primary objective is "to protect present and future generations from the devastating health, social, environmental and economic consequences of tobacco consumption and exposure to tobacco smoke by providing a framework for tobacco control measures to be implemented by the Parties at the national, regional and international levels in order to reduce continually and substantially the prevalence of tobacco use and exposure to tobacco smoke." (35)

It is a comprehensive legal document that includes both demand and supply measures intended to reduce both exposure to tobacco products and consumption of tobacco products. Signatories to the FCTC must implement a wide range of regulations governing issues including protection from second-hand smoke, tobacco taxes, contents of tobacco products, tobacco packaging and labelling, health warning messages, tobacco advertising and sponsorship, tobacco smuggling, and reducing tobacco sales to minors. As well, signatories must implement tobacco cessation programs, create education and public awareness campaigns, and develop methods to help farmers find economically viable alternatives to growing tobacco. The 168 countries that are signatories to the agreement are expected to eventually implement the FCTC guidelines domestically, as well as in cooperation with one another. To date, 140 of these countries, including Canada, are parties to the agreement and are in full (or relatively full) compliance with these guidelines.

Canada's role in developing and implementing the FCTC

Historically, Canada has taken an activist role in controlling the sale, consumption, and promotion of tobacco products domestically. (36) The first criminal prohibition of tobacco sales to minors was passed in 1980. Repealed in 1993, the prohibition was replaced with the Tobacco Sales to Young Persons Act (TSYPA), making it an offence to sell tobacco to persons under the age of eighteen (or nineteen in some jurisdictions, according to provincial legislation). To further reduce the sale of tobacco to minors, vending machines were prohibited in public places other than bars or taverns. In 1988 the Tobacco Products Control Act (TPCA) was enacted, and its stipulations took effect on 1 January 1989. In 1997 both the TSYPA and the TPCA were replaced with the new Tobacco Act.

The Tobacco Act includes clauses dealing with topics such as manufacturing standards; shared information between the manufacturer, government, and consumer on emissions; minimum age requirements and publicly posted signs indicating the illegality of selling tobacco products to young persons; labelling requirements requiring information about the product, its emissions, and the health hazards arising from use; and restrictions on the promotion and advertisement of tobacco brands. These restrictions include a ban on lifestyle advertising, but allow the use of "information" advertising and "brand preference" advertising. In 1998 Parliament amended the Tobacco Act in order to ban tobacco sponsorship programs within rive years, and this sponsorship prohibition took effect on 1 October 2003.

In the meantime, the federal government introduced the Federal Tobacco Control Strategy (FTCS), (37) which had several key objectives: reducing smoking prevalence; decreasing the number of cigarettes sold; increasing retailer compliance with tobacco-sales-to-youth laws; reducing the number of people exposed to second-hand smoke in enclosed public spaces; and exploring how to mandate changes to tobacco products to reduce health hazards within ten years time. As well, a national strategy entitled New Directions for Tobacco Control in Canada was developed by a coalition of tobacco control groups in 1999. (38) This document outlined the national goals for a renewed tobacco control strategy for NGOs and all levels of government in Canada.

By the end of 2003 Canada had introduced legislation requiring warning labels to be introduced on cigarette packages. The Canadian labels feature a rotating selection of sixteen full-colour graphic health warnings, which cover more than 50 per cent of the package front and back. Detailed health risk and cessation information appears on the inside of packages. (39)

A 2004 study indicates that the health warnings resulted in a public health benefit, as approximately one-third of those surveyed reported an increased likelihood of smoking cessation as a result of the labels. However, the warnings were less effective for adults with low literacy rates, and respondents generally indicated that the toxic emissions statements were confusing. (40) To address this issue, Health Canada has recommended the adoption of a series of health warnings which would include messages tailored to low-literacy Canadians. Also recommended are combination messages that include both a health warning and the positive benefits associated with quitting. Messages regarding toxic emissions and their associated health effects have also been recommended.

To comply with requirements of the FCTC, new Canadian regulations have been proposed that would require every tobacco advertisement to display a health warning in a black-bordered box that would include black text on a white background. The warning would occupy a minimum of 20 per cent of the total surface area of the advertisement. These warning labels would also be required on advertisements for any tobacco accessories carrying a tobacco related brand element.

The success of Canadian federal government initiatives has been complemented by proactive legislative actions undertaken in a number of the provinces. For example, as of January 2005 approximately 80 per cent of an the municipalities in Canada have implemented by-laws governing smoke-free public spaces, including restaurants and bars. The majority of the provinces and territories have also implemented such laws. (41) These federal and provincial efforts have resulted in significant reductions in smoking rates in Canada over the last four decades (see Figure 1).

[FIGURE 1 OMITTED]

Based on Canada's existing legislation and recently proposed legislation, Canada is already in substantial compliance with the FCTC, and has ratified the convention. In fact, much of Canada's legislation served as a model for the FCTC, since Canada has long been a pioneer in the world of tobacco control. (42) Canada acted as host for the first and second meetings of public health and legal experts on the development of FCTC and was among the leading sources of funds for the process. Therefore, it is perhaps not surprising that the convention bears a strong resemblance to Canada's current tobacco regulations.

This is not to suggest that Canadian tobacco regulations are in complete compliance with the FCTC. For example, despite the ability of the Canadian minister of health to implement bans on misleading terms such as "light" and "mild," until recently there has been limited action taken to date by the Canadian government to comply with this aspect of the FCTC. This has led to accusations by tobacco control NCOS that the government is stalling. (43) A second criticism, directed to a few of the provinces, has been the slow implementation of bans on smoking in public places, some of which are phased in over a period of time. (44) The full implementation of the FCTC will require intergovernmental cooperation in Canada at the municipal, provincial, territorial, and federal levels in addition to the development of strong ties to the international community. This will not be easy. However, the flexible nature of the FCTC regarding how the demand and supply control measures are implemented, as well as a generous time frame, will allow Canada to meet its commitments effectively in the near future.

Canada and the world: fighting the tobacco industry

One area in which international cooperation is particularly needed is with regard to litigation. The tobacco industry frequently uses litigation as a tool to fight legislation and regulation. For example, in Canada the tobacco industry fought a successful five-year legal battle against the 1988 Tobacco Products Control Act; the industry succeeded in having parts of the act overturned because it contravened the Canadian Charter of Rights and Freedoms. A similar ten-year constitutional legal battle is being fought over the 1997 Tobacco Act. A recent decision by the Quebec Court of Appeal overturned part of the act's sponsor provisions, so both parties appealed the decision to the Supreme Court of Canada. As a result, the resolution of this legal battle is expected to be concluded some time in 2007. The tobacco industry draws on international resources to fight these legal battles, and the tobacco control movement must be prepared to do the same. Countries can learn from one another when it comes to fighting the industry in court.

For example, Canada has already learned from the us example, where the litigation tables have been turned on the tobacco industry. Some states successfully sued the industry for repayment of health care costs to treat sick smokers, resulting in the National Settlement Agreement with payouts of $25 billion over twenty-five years. British Columbia and other provinces have followed this example by launching (or preparing to launch) lawsuits against the tobacco industry to recover health care costs. The power of litigation is substantial, and international cooperation is essential to ensure that such litigation is used successfully. (45)

Conclusion

As a worldwide leader in the development of tobacco control regulations, Canada has had significant success in its efforts, and has already implemented many of the requirements of the FCTC. By ratifying the FCTC, Canada has entered a global partnership that will enable the worldwide tobacco control community to collectively combat the industry in a manner that could not be achieved by individual efforts. Canada's commitment to the FCTC will ensure that Canada lives up to a strict code of tobacco control measures. This provides public administrators with important tools to reduce the health burden associated with tobacco use. Implementation of the FCTC provisions should result in a reduction in the number of smokers in Canada and around the world, as well as a reduction in the number of people exposed to second-hand smoke. This will ultimately lead to a healthier Canadian and world population, with a corresponding reduction in health care costs related to treating tobacco-related illness.

An earlier version of this paper was presented at the annual Institute for Public Administration of Canada conference held in Regina, 29-31 August 2005. This research is supported by a grant from the Social Sciences and Humanities Research Council and Canadian Tobacco Control Research Initiative with funds from the Canadian Cancer Society, Canadian Institutes of Health Research, National Cancer Institute of Canada, and Health Canada. We offer our sincere thanks to the two anonymous reviewers whose comments were very helpful in revising this paper.

Notes

(1) World Health Organization, "An International Treaty for Tobacco Control," World Health Organization (Geneva: WHO, 2003), at http://www.who.int/features/2003/08/en/ (accessed 10 July 2006).

(2) Thomas E. Novotny and D. Carlin, "Ethical and legal aspects of global tobacco control," Tobacco Control 14, (2005), pp. 26-30; Kelley Lee, Globalization and Health: An Introduction (London: Palgrave Macmillan, 2003), pp. 1-10.

(3) World Health Organization, "Tobacco Free Initiative," World Health Organization at http:// www.who.int/tobacco/framework/en/(accessed 10 July 2006).

(4) Jeff Collin, Kelley Lee, and Karen Bissell, "The framework convention on tobacco control: the politics of global health governance," Third World Quarterly 23, no. 2 (April 2002), pp. 265-82.

(5) Ruth E. Malone and Edith D. Balbach, "Tobacco industry documents: treasure trove or quagmire?" Tobacco Control 9 (2000), pp. 334-38; Edith D. Balbach, Rebecca J. Gasior, and Elizabeth M. Barbeau, "Tobacco industry documents: comparing the Minnesota depository and internet access," Tobacco Control 11, no. 1 (2002), pp. 68-72; and K. Michael Cummings and Richard W. Pollay, "Exposing Mr. Butts' tricks of the trade," Tobacco Control 11, Suppl. 1 (2002), pp. 11-14.

(6) Lisa A. Bero, "Implications of the tobacco industry documents for public health and policy," Annual Review of Public Health 24, no. 3 (2003), pp. 267-88.

(7) Richard W. Pollay and Timothy Dewhirst, "A Premiere example of cigarettes in the 1990s," Tobacco Control 12, no. 3 (2003), pp. 322-32.

(8) Clive Bates and Andy Rowell, "Tobacco Explained ... The truth about the tobacco industry ... in its own words," Tobacco Control Reports on Industry Activity, World Health Organization, Paper [WHO.sub.4], 1999, at http://repositories.cdlib.org/context/tc/article/1104/type/ pdf/viewcontent/(accessed 10 July 2006).

(9) Stella Aguinaga Bialous and Stan Shatenstein, "Profits over People: Tobacco Industry Activities to Market Cigarettes and Undermine Public Health in Latin America and the Caribbean," Pan American Health Organization Report, edited by Heather Selin, November 2002, at http://www.paho.org/English/HPP/HPM/TOH/profits_over_people.pdf (accessed 10 July 2006).

(10) Rob Cunningham, Smoke and Mirrors: The Canadian Tobacco War (Ottawa: IDRC--International Development Research Centre, 1996).

(11) "Guidelines on Communication Restrictions and New Opportunities in Marketing," British American Tobacco, 13-17 May 1979 (Jesteburg). Marketing Report, Bates No. 621054744, at http://legacy.library.ucsf.edu/cgi/getdoc?tid=ltp21f00&fmt=pdf&ref=results (accessed 10 July 2006), quoted on pp. 3, 9.

(12) "Cigarette logos abound despite ad bans abroad," USA Today, 12 September 2000, p. 1B, at http://lists.essential.org/pipermail/intl-tobacco/2000q3/000282.html (accessed 10 July 2006).

(13) Thomas E. Novotny and D. Carlin, "Ethical and legal aspects of global tobacco control," Tobacco Control 14 (2005), pp. 26-30; Heather Wipfli, Frances Stillman, Stephen A. Tamplin, Vera Luiza da Costa e Silva, Derek Yach, and Jonathan Samet, "Achieving the Framework Convention on Tobacco Control's potential by investing in national capacity," Tobacco Control 13 (2004), pp. 433-37.

(14) "Mariboro Classics moves into Spain," 20 May 2002, at http://www.fashionunited.co.uk/ business/media/marlboro.htm (accessed 10 July 2006); Paul Nuki, "Tobacco Firms Brew up Coffee to Beat the Ban," Sunday Times, 18 January 1998.

(15) Mary Assunta and Simon Chapman, "The tobacco industry's accounts of refining indirect tobacco advertising in Malaysia," Tobacco Control 13 (2004), pp. 11630-1170.

(16) Timothy Dewhirst, "Smoke and ashes: tobacco sponsorship of sports and regulatory issues in Canada," in Lynn R. Kahle and Chris Riley, eds., Sports Marketing and the Psychology of Marketing Communication (Mahwah, NJ: Lawrence Erlbaum Associates, Inc., 2004), pp. 32752; T. Bettina Cornwell, "The use of sponsorship-linked marketing by tobacco firms: international public policy issues," Journal of Consumer Affairs 31, no. 2 (1997), pp. 238-54; and Cunningham, Smoke and Mirrors.

(17) R. Don Brown, "Temporary Royalty Rate Reduction," memo sent to Ulrich Herter, British American Tobacco Industries, 3 June 1993. Bates No. 500028145, at http://tdo.roswellpark.org/health_canada/50002812.pdf (accessed 10 July 2006), quoted on p. 4.

(18) South America PARC, 1993 Plan and Estimated Budget, British American Tobacco, 30 October 1992. Strategic Plan, Guildford Depository, Bates No. 503860118 at http'//tdo.roswell park.org/batco/503860115-0119.pdf (accessed 10 July 2006).

(19) Ernest M. Sebrie, Joaquin Barnoya, Eliseo J. Petez-Stable, and Stanton A. Glantz, "Tobacco industry successfully prevented tobacco control legislation in Argentina," Tobacco Control 14 (2005), p. e2.

(20) Ibid.

(21) Philip Morris, "Veto Of Anti-Tobacco Law Case Analysis: Argentina," 1993, at http:// www.pmdocs.com/PDF/2023333155_31600.PDF (accessed 10 July 2006), quoted on p. 6.

(22) Brendan Brady to Dick Hartley, 30 June 1993, "PARG Meeting--Mauritius 23-25 June 1993," (Mayo: British American Tobacco), Tobacco Documents, Bates No. 300565569, at http:// tdo.roswellpark.org/mayo_clinic/81002437.pdf (accessed 10 July 2006), quoted on p. 10.

(23) Ibid.

(24) Robert D. Tollison, "World Health and the World Health Organization: Assessment and Recommendations," October 1992, BATCO Documents, at http://www.library.ucsf.edu/ tobacco/batco/html/15500/15597/otherpages/allpages.html (accessed 10 July 2006).

(25) Stanton A. Glantz, John Slade, Lisa A. Bero, Peter Hanauer, and Deborah E. Barnes, eds., The Cigarette Papers (Berkeley: University of California Press, 1996); US Centers for Disease Control, "Surgeon General Report: Reducing the Health Consequences of Smoking," Smoking and Health Report of the Advisory Committee to the Surgeon General of the Public Health Service, 1964, at http://www.cdc.gov/Tobacco/sgr/sgr_1964/ sgr64.htm (accessed 10 July 2006).

(26) Tobacco Industry Research Committee, "A Frank Statement to Cigarette Smokers," Advertisement, 4 January 1954, at http://tobaccodocuments.org / pro/2015002376.pdf (accessed 10 July 2006).

(27) Roper Organization, "A Study of Public Attitudes Toward Cigarette Smoking and the Tobacco Industry," Roper Reports 1 (May 1978), p. 50007-0014, at http://legacy.library.ucsf. edu/cgi/getdoc?tid=qra99d00&fmt=pdf&ref=results (accessed 10 July 2006), quoted on p. 6.

(28) Covington and Burling, "Regional Public Affairs Plan and Budget for 1993 Central and South America ETS Consultant Project," 1992, Philip Morris USA, at http://www.pmdocs. com/PDF/2023591418_1425_0.PDF (accessed 7 July 2006), quoted at pp. 1, 2.

(29) Philip Morris, "Note on A Special Meeting of the UK Industry on Environmental Tobacco Smoke," London, 17 February 1988, at http://tobaccodocuments.org / landman/20637911821187.html (accessed 10 July 2006), quoted on p. 3.

(30) Lisa A. Bero, "Tobacco industry manipulation of research," Public Health Reports 120, no. 2 (March/April 2005), pp. 200-8.

(31) Judith Mackay and Michael P. Eriksen, The Tobacco Atlas (Geneva: World Health Organization, 2002).

(32) British American Tobacco Company, "Talk to TMDP--Chelwood," July 24 1990, at http:// outside.cdc.gov:8085/BASIS/ncctld/web/mnimages/DDW?W=DE TAILS1D=657&M=3 (accessed 10 July 2006), quoted on p. 3.

(33) Belinda O'Sullivan and Simon Chapman, "Eyes on the prize: transnational tobacco companies in China 1976-1997," Tobacco Control 9 (2000), pp. 292-302.

(34) Clive Bates and Andy Rowell, "Tobacco Explained ... The truth about the tobacco industry ... in its own words." World Health Organization, Tobacco Control Reports on Industry Activity, Paper [WHO.sub.4], 1999, at http://repositories.cdlib.org/context/tc/article/1104/type/pdf/ viewcontent/(accessed 10 July 2006).

(35) World Health Organization, "Framework Convention on Tobacco Control" (Geneva: World Health Organization, 2003), at http://www.who.int/tobacco/framework/fctc_bookletenglish.pdf (accessed 10 July 2006), quoted on p. 5.

(36) Filip Palda, "The History of Tobacco Regulation: Forward to the Past," Fraser Institute Occasional Paper 8, No. 40 (2000), at http://www.fraserinstitute.ca/admin/books/files/HistTbccReg.pdf (accessed 10 July 2006); Robert G. Wyckham, "Regulating the marketing of tobacco products and controlling smoking in Canada," Canadian Journal of Administrative Sciences 14 (1997), pp. 141-65.

(37) Health Canada, Federal Tobacco Control Strategy: A Framework for Action (Ottawa: Her Majesty the Queen in Right of Canada, 2001), at http://www.hc-sc.gc.ca/hl-vs/alt_formats/hecssesc/pdf/pubs/tobac-tabac/ ffc-/ffa-ca_e.pdf(accessed 10 July 2006).

(38) Health Canada, New Directions for Tobacco Control in Canada, at http://www.hc-sc.gc.ca/ahcasc/media/nr- cp/2002/2002_58bk3_e.html (accessed 10 July 2006).

(39) David Hammond, Geoffrey T. Fong, Paul W. McDonald, K. Stephen Brown, and Roy Cameron, "Graphic Canadian cigarette warning labels and adverse outcomes: evidence from Canadian smokers," American Journal of Public Health 94, no. 8 (August 2004), pp. 1442-45.

(40) Health Canada, A Regulatory Proposal to Include Warnings in Tobacco Advertisements, Consultation Paper, 17 November 2004, Health Canada, at http://www.hc-sc.gc.ca/hl-vs/alt_formats/hecs-sesc/pdf/pubs/tobac- tabac/rpiwta-prirsfept/rpiwtacp-primgptdc-e.pdf (accessed 10 July 2006).

(41) Non-Smokers' Rights Association, "Compendium of 100% Smoke-free Public Place Municipal By-laws," January 2005, at http://66.51.169.163/cms/file/pdf/compendium_April_ 2006.pdf (accessed 10 July 2006).

(42) Barbara Sibbald, "Landmark Global Tobacco Treaty Coming into Effect," Canadian Medical Association Journal 172, no. 4 (15 February 2005), p. 457.

(43) Andrew Pipe, "'Light' and 'Mild' cigarettes: let's end the confusion now," Canadian Journal of Public Health 96, no. 3 (May/June 2005), pp. 165-67; Canadian Coalition for Action on Tobacco, to Minister of Health Anne McLellan, 15 November 2002, at http://www.cqct.qc. ca/Communiques_docs/2002/MAIL_02_10_16_OpenLetterMinisterOnDenormalizat.PDF (accessed 10 July 2006).

(44) Atul Kapur, "Global solidarity against globalized tobacco: the world's first modern health treaty tackles tobacco," Canadian Medical Association Journal 168, no. 10 (13 May 2003), pp. 1263-64.

(45) Derek Yach and Douglas Bettcher, "Globalisation of tobacco industry influence and new global responses," Tobacco Control 9 (2000), pp. 206-16.

Anne M. Lavack is professor at the Faculty of Business Administration, University of Regina. Gina Clark received her Master of Public Administration degree from the University of Regina, and currently works for the Canadian public service in Ottawa.
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