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Antismoking Coalition Gives Big Tobacco a Fight in Indonesia

http://www.nytimes.com/2016/05/01/world/asia/antismoking-coalition-gives-big-tobacco-a-fight-in-indonesia.html?_r=0

The densely packed houses along Yogyakarta’s Kali Code River went from drab to a riot of reds, blues, yellows and whites.

Residents did not know who had paid for the elaborate painting job last year. The Yogyakarta press speculated that an unknown company had painted the houses so they would resemble the colorful favelas of Rio de Janeiro.

It turns out the village’s benefactor was Philip Morris International and its “Show Your Colors” advertising campaign. On the side of the Gondolayu bridge that overlooks the settlements sits a giant picture frame, with tag lines hung above it reading, “Create your own story” and “Go ahead.”

The village had been transformed into a giant advertisement for a brand owned by the tobacco company.

The ads were another aggressive marketing attempt by an international tobacco company to gain market share in Indonesia. The country is the second-largest cigarette market in Asia after China, and had the highest male smoking rate in the world — 67 percent, according to a 2011 survey — thanks in part to the popularity of pungent clove cigarettes.

Over the last decade, it has become a last Eden for tobacco companies facing declining smoking rates at home. As late as 2004, international tobacco companies had a marginal presence in the Indonesian market. Today, led by Philip Morris International, they control around 45 percent.

Yet that push has been met by an increasingly potent coalition of mayors, health officials and antismoking groups that has scored some important victories.

In one prominent example, huge cigarette billboards that dominated the highways of Jakarta, the capital, were taken down in 2015, as part of a move to ban outdoor tobacco advertisements by mayors around the country.

Many of the lobbying efforts that led to local regulations, including in Jakarta, were substantially financed by the Bloomberg Initiative to Reduce Tobacco Use, the $600 million fund founded by Michael R. Bloomberg, the former New York mayor.

The Bloomberg Initiative has designated Indonesia one of its five priority countries, and has donated more than $10 million since 2007. The initiative is largely focused on establishing local and regional tobacco control laws in a nation with a highly decentralized government structure.

“It’s a battle — like a war,” Yayi Prabandari, a professor of public health at Gadjah Mada University in Yogyakarta, said of the clash between tobacco companies and tobacco control organizations.

Before the Bloomberg Initiative became active in the country nearly 10 years ago, fewer than 10 cities had laws that restricted smoking in public areas, according to the Campaign for Tobacco-Free Kids, which jointly administers the Bloomberg Initiative’s grant programs in Indonesia. Since then, the group says, more than 170 cities have passed laws heavily restricting smoking in public spaces.

Yet tobacco growing has deep roots here. Indonesia is one of the few countries in Asia that has not signed the World Health Organization’s Framework Convention on Tobacco Control, which mandates strict limits on tobacco advertising and sponsorship.

The Bloomberg Initiative has also created a backlash from smokers’ rights groups, who portray Mr. Bloomberg as a foreign oligarch determined to stamp out Indonesia’s proud tobacco tradition.

“People who smoke today are stigmatized — we’re discriminated against,” said Alfa Gumilang, the chain-smoking secretary general of Komunitas Kretek, a smokers’ rights group that accepts funds from the tobacco industry.

The Indonesian government relies on the tobacco industry for around 10 percent of state tax revenue. Although tobacco is not nationalized, the government issues growth targets; in 2015, the Industry Ministry released a “road map” for the industry calling for expanded cigarette production.

In October, President Joko Widodo visited the United States to promote American investment in Indonesia. While he was there, Philip Morris announced a $1.9 billion expansion of its tobacco factories in the country — the second-largest investment that Mr. Joko secured from an American corporation during his visit.

Philip Morris’s success — it controls 35 percent of Indonesia’s tobacco market through its local subsidiary, Sampoerna — ushered in a new age of foreign expansion. In 2009, British American Tobacco purchased Bentoel, a local tobacco company that is now Indonesia’s fourth largest, with around 7.5 percent market share.

According to Health Ministry officials, Indonesia’s fragmented government ministries often work at cross purposes when tackling the issue.

Because of the difficulty of making sweeping changes to tobacco control laws nationally, Indonesia tobacco control advocates are increasingly pushing for changes at the local and regional levels, where money from the Bloomberg Initiative comes in handy.

Dr. Theresia Sandra, a specialist in chronic lung disease at the Health Ministry, credits the Bloomberg Initiative with helping local governments counter the influence of big tobacco. The group “builds organizations to balance against the strength of industry and opens local governments to the necessity of protecting their communities,” Dr. Sandra said.

In one national success, the Indonesian government, with help from the Bloomberg Initiative, passed a law in 2014 requiring manufacturers to put warning labels on cigarette packaging.

The tobacco fight in Indonesia, the world’s most populous Muslim nation, even extends to the country’s most powerful Muslim organizations, and shows just how central the issue is for society and the economy.

Muhammadiyah, Indonesia’s second-largest Muslim organization, became the first major Muslim group in the country to issue an edict declaring that smoking is forbidden in all circumstances, citing smoking’s devastating consequences to public health.

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The 2010 decision was significant: Muhammadiyah operates thousands of schools, universities and hospitals around the country. Almost overnight, those places became smoke-free zones.

But the Indonesian media quickly pounced on a funding detail. Posted on the Bloomberg Initiative’s website was a $393,000 grant to Muhammadiyah in 2009. According to Bloomberg’s website at the time, the grant sought “the issuance and dissemination of religious advice on the dangers of tobacco use among Muhammadiyah/Islamic institutions.”

Critics accused Muhammadiyah of seeking to unite Muslim opinion against tobacco in return for the grant money.

Dr. Sudibyo Markus, who led Muhammadiyah’s health department at the time, said there had never been any quid pro quo.

Meanwhile, religious leaders affiliated with Nahdlatul Ulama, Muhammadiyah’s main rival, criticized Muhammadiyah for supposedly bowing to Bloomberg’s money. But Nahdlatul Ulama, which does not view smoking as forbidden in most circumstances, receives funding from the foundation wing of Djarum, Indonesia’s third-largest tobacco company.

The group’s vice chairman, Maksum Mahfudh, said there was “no relationship whatsoever” between the funding and its decision that it would not forbid smoking. He added that moving “drastically” against tobacco would impoverish the farmers and sellers who are “grass-roots people of N.U.”

For now, the two sides appear to have fought to a draw. After steadily rising for a decade, the smoking rate has plateaued, according to the Indonesian Family Life Survey, funded by the United States National Institutes of Health, that was released in April.

Still, Philip Morris International remains optimistic about Indonesia. In a February conference call with investors, André Calantzopoulos, the chief executive officer, said Indonesia remained a good bet.

“We remain optimistic about the profit growth opportunities in this key market thanks to its growing adult population and rising income levels,” he told them

Cigarette sales get a boost from TV commercials for e-cigs, says study

http://www.campaignlive.com/article/cigarette-sales-boost-tv-commercials-e-cigs-says-study/1392249

It’s been nearly 50 years since Congress banned cigarette commercials from the airwaves. But a new study suggests the rapid proliferation of e-cigarette commercials may be lifting the sales of cigarettes, too, offering an unexpected path back to TV for the tobacco industry.

According to the study, Advertising, Habit Formation and U.S. Tobacco Product Demand, funded by the U.S. Food and Drug Administration, TV advertisements for e-cigarettes create a “spillover effect” that also increases demand for cigarettes. “If you increase e-cigarette advertisement, then cigarette demand is going to increase slightly,” said Yuqing Zheng, an agricultural economist the University of Kentucky and lead author of the study.

Researchers compared advertising data from Kantar Media with point-of-sale data at outlets that sold five different kinds of tobacco or nicotine products between 2009 and 2013. What they found was that for every increase in e-cigarette advertising on television, there was an accompanying lift — however small — of cigarette sales.

That rise in cigarette sales is small but statistically significant: one-one hundredth of 1% whenever e-cigarette advertising doubles. But e-cigarette advertising increased 17-fold between 2011 and 2014, so it could be contributing to tens of millions of dollars in cigarette sales.

Though the FDA has petitioned for regulatory control of the e-cigarette market, there are currently no restrictions on e-cigarette advertising, the bulk of which take the form of TV commercials. The findings of the study, which was published in the American Journal of Agricultural Economics, could renew calls for e-such oversight, said the authors. “Such results may lend support to those who advocate that more regulations on e-cigarette marketing are needed,” they wrote.

The study found that the spillover effect was restricted to TV. E-cigarette magazine ads did not have the same positive effect on cigarette sales. “We consistently find that TV advertising is the most effective way to enhance demand,” said Zheng.

Why e-cigarette ads increase cigarette demand is unclear, though Zheng speculated there could be an “umbrella” effect at work. “A lot of the cigarette and e-cigarette brands belong to the same parent company, so when you do advertise for e-cigarettes, it’s probably going to enhance the image of the parent company which owns the cigarette brand, so that might stimulate some cigarette smoking as well,” he said. Intentionally or not, cigarette manufacturers may have found a way to boost sales by advertising a different product in their inventories.

These could be problematic numbers for e-cigarette manufacturers, who have been resisting calls for the regulation of either their products or their advertising. If further research supports the study’s finding that e-cigarette advertising increases cigarette sales, then continuing to allow unregulated e-cigarette advertising “might undermine the efforts to reduce cigarette smoking,” the study said. “If a new policy were to prohibit e-cigarette television ads, similar to what is imposed for cigarettes, the model predicts a small drop in consumer demand for e-cigarettes, and a minor decrease in cigarette demand.”

Whether the prospect of that minor decrease helps anti-smoking advocates win regulatory controls for e-cigarettes and their ads remains to be seen.

Judge, Big Three tobacco manufacturers reach deal on corrective statements – Winston-Salem Journal: Local Business

http://www.journalnow.com/business/business_news/local/judge-big-three-tobacco-manufacturers-reach-deal-on-corrective-statements/article_82ff0b0d-c941-5f6a-9911-b03dad623827.html?mode=print

A federal judge and the Big Three tobacco manufacturers have reached an agreement on five “here is the truth” corrective statements for cigarette marketing.

Judge Gladys Kessler ruled in November 2012 that cigarette marketing should carry the overarching preamble: “A federal court has ruled that the defendant tobacco companies deliberately deceived the American public about the health effects of smoking, and has ordered those companies to make this statement.”

In May 2015, a U.S. Appeals Court ruling found that Kessler’s preamble exceeded, in part, the District Court’s authority, saying the preamble “reveals nothing about cigarettes. Instead, they disclose defendants’ prior deceptive conduct.”

“After all … the statute reads ‘prevent and restrain,’ not ‘prevent, restrain and discourage.’”

The consent order, approved Tuesday, strips that preamble and replaces it with “a federal court has ordered Altria, R.J. Reynolds Tobacco, Lorillard and Philip Morris USA to make this statement about the addictiveness of smoking and nicotine.” The ruling affects ITG Brands LLC, the successor to Lorillard Inc.

The compromise did not include a “trigger date” for when the ads would start. Altria Group Inc. spokesman Brian May said Friday that the trigger date is the date on which all appeals are exhausted.

The manufacturers filed their latest appeal with the U.S. Appeals Court for the District of Columbia on April 8.

“We continue to object to the content of the corrective communications, including the language in the preamble, and intend to pursue the appeal, May said.

Kessler said the order “is the complete agreement of the parties as to corrective statements and supersedes any prior negotiations, agreements or understandings of the parties.”

Kessler ordered the corrective statements appear on company websites, cigarette packages, prime-time network television ads and in newspaper ads in the front section of Sunday editions. The ad will not appear in the Winston-Salem Journal, but it will in The Charlotte Observer. Each newspaper ad will feature one of the five corrective statements. The 260 TV spots will run over a 52-week period

The manufacturers filed a joint appeal of Kessler’s ruling in January 2013. They have tried to persuade Kessler to reject the statements, calling them “forced public confessions” in legal filings.

The compromise does not include Reynolds’ complaint that it should not have to run additional ads related to its 2004 purchase of Brown and Williamson Tobacco Corp.

The manufacturers have said the 2009 Tobacco Control Act eliminated any reasonable likelihood the companies would commit future violations, thus making the need for corrective statements moot.

Responding to the May 2015 appellate ruling, Kessler said the federal government has agreed to remove “deliberately deceived the American public” from the preamble. But Kessler said the phrase “Here is the truth” remains appropriate to begin each corrective statement.

The U.S. government filed a lawsuit in 1999 against the nation’s largest tobacco manufacturers.

The initial ban on labels — such as “low tar,” “light” and “mild” — was part of Kessler’s landmark 2006 ruling that found the manufacturers guilty of racketeering and fraud for deceiving the public about the dangers of smoking, in particular whether certain products were marketed with an expressed or implied lower-risk health message or descriptor.

Kessler ruled that cigarettes marketed as low tar, light and mild have been found to be no safer than others.

In May 2009, a U.S. Court of Appeals panel unanimously upheld requirements that manufacturers change the way they market cigarettes. The Food and Drug Administration banned the use of the labels in June 2010.

Corrective statements

The order from federal Judge Gladys Kessler specifies “truth” statements for five categories:

* Adverse health effects of smoking, such as “more people die every year from smoking than from murder, AIDS, suicide, drugs, car crashes and alcohol combined; ”
* Addictiveness of smoking and nicotine;
* Lack of significant health benefit from smoking low-tar, light, ultra-light, mild and natural cigarettes;
* Manipulation of cigarette design and composition to ensure optimum nicotine delivery, such as “when you smoke, the nicotine actually changes the brain – that’s why quitting is so hard; ” and,
* Adverse health effects of exposure to secondhand smoke, such as “secondhand smoke kills over 3,000 Americans each year.”

Retailer licensing and tobacco display compliance

Are some retailers more likely to flout regulations?

http://tobaccocontrol.bmj.com/content/early/2016/04/08/tobaccocontrol-2015-052767.short?g=w_tobaccocontrol_ahead_tab

Abstract

Objectives

To assess retailer compliance with a licensing scheme requiring tobacco retailers to list their business details with the government, to examine whether listed retailers are more likely to comply with a point-of-sale (POS) display ban and other in-store retailing laws and to explore variations in compliance between different retailer types and locations.

Method

An audit of 1739 retailers in New South Wales, Australia, was used to assess compliance with tobacco retailing legislation. Auditors actively searched for and audited unlisted retailers and all listed retailers in 122 metropolitan and regional postcodes. Multivariate generalised linear regression models were used to examine associations between compliance and retailer type, remoteness and demographic characteristics (socioeconomic level, proportion of population under 18 years and proportion born in Australia).

Results

One unlisted tobacco retailer was identified for every 12.6 listed tobacco retailers. Unlisted retailers were significantly more likely than listed retailers to breach in-store retailing laws (p<0.001). Compliance with the POS display ban was observed in 91.3% of tobacco retailers, but compliance with all retailing laws was only 73.4%. Retailers in socioeconomically disadvantaged areas had lower compliance than those in high socioeconomic areas.

Conclusions

Some tobacco retailers did not list their business details with the government as required, even though there was no financial cost to do so. Unlisted retailers were more likely to violate in-store regulations. The results suggest licensing schemes can be useful for providing a list of retailers, thus facilitating enforcement, but require a system to search for, and respond to, unlisted/unlicensed retailers.

Tobacco point-of-sale advertising in downtown Buenos Aires, Argentina and compliance with the new tobacco advertising restrictions

http://tobaccocontrol.bmj.com/content/early/2016/03/30/tobaccocontrol-2015-052870.short?g=w_tobaccocontrol_ahead_tab

Background

Despite increased awareness of the health threat posed by tobacco use, Latin America continues to experience high smoking rates. Argentina is no exception, where an estimated 22.1% of adults were smokers in 2012.1 Prior to 2011, few limitations were placed on the advertisement of tobacco products in Argentina, and any restrictions were largely self-imposed by the tobacco companies.2

On 14 June 2011, Argentina enacted the ‘National Law of Tobacco Control: Law 26.687’. This law provides 42 articles that address tobacco advertising, packaging, product composition, sale/distribution, secondhand smoke, and preventive education. Notably, it largely prohibits all forms of tobacco advertisements except for those indoors at the point of sale (PoS) (table 1).3 Unfortunately it is unclear how many convenience stores are compliant with its provisions.

Methods

To investigate the compliance with the new restrictions, we surveyed all convenience stores (n=137) found in an 8 by 7 block area of Buenos Aires from July to August of 2014. This area was selected due …

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Ban on display of tobacco products from 2017

http://www.straitstimes.com/singapore/ban-on-display-of-tobacco-products-from-2017

Retailers will have to keep tobacco products out of sight from next year, following changes to the law approved by Parliament yesterday.

These products include cigarettes, cigars, beedies and “ang hoon”, or loose tobacco leaves.

The ban on the display of such products is intended to prevent impulse buys, especially among young people who have not yet picked up smoking.

However, specialist tobacco shops, such as those that sell cigars, simply need to make sure that their products cannot be seen from outside the shop.

Duty-free shops at Changi Airport will be exempt from the ban for now, while those at seaports will be subject to rules similar to those for specialist tobacco sellers.

Tighter rules on online tobacco advertisements – such as banning ads from Singapore even if they do not target Singaporeans – were also introduced.

Tobacco Companies’ Public Relations Efforts: Corporate Sponsorship and Advertising

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Tobacco Company Marketing to Children

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Action against on-screen smoking

http://nation.lk/online/2016/02/20/action-against-on-scree-smoking.html

Cinema is a core element in mass media approaches to normalizing smoking, states the World Health Organization. Since smoking in films is not perceived as advertising, it does not draw the skepticism that advertising engenders. Tobacco industry has funded film producers to feature specific tobacco brands and launched advertising campaigns through latest films using top stars.

The British Medical Association, the US National Cancer Institute, the US Centers for Disease Control and Prevention all cite several reasons why smoking in films should be addressed as a public health problem. Films reach every corner of the globe effectively promoting smoking, in the absence of public health scrutiny until now.

However, public health researchers and institutions are increasingly paying close attention to this important exposure. The tobacco industry knows that motion pictures are one of humanity’s most common entertainment experiences. Half of world’s households now have Internet access, including nearly one third of households in developing countries.

Worldwide, one in three individuals now has a mobile-broadband, which is five times more than in 2008. The rapid spread of multiple media platforms for viewing films outside of cinemas, across cultures and economies, means that exposure to film content is vastly underestimated by cinema attendance alone.

Films offer not only para-social relationships with world famous stars, but also an imagined view of life; insofar as adolescents hope to take part in the glamorous and exciting lifestyles depicted in films, they may adopt the behaviour they see in them. Tobacco industry has been able to covert a deadly product into a status symbol or token of independence through films.

Hollywood and Bollywood films provide powerful information about the “benefits” of smoking, instead of traditional advertising. Young people imitate, not only “positive” characters, but also the villain who smokes can have even more influence on them than the hero. The USA National Cancer Institute in 2008 and the USA Surgeon General in 2012 concluded that smoking in films causes adolescent smoking.

There are strong theoretical grounds about the mechanisms by film smoking influencing adolescent smoking. Population based scientific surveys and indirect scientific surveys on exposure to smoking in films show links that adolescent smoking in a range of socio-cultural contexts. Trend studies show that prevalence of smoking, both generally and among adolescents, tend to parallel trends in film smoking.

A brain imaging study shows how seeing on-screen smoking stimulates smoking and generates pleasurable feelings. WHO-FCTC Article 13 guidelines obligate Parties to enact comprehensive bans on banning tobacco advertising, promotion and sponsorship within five years of ratification. It clearly states that depiction of tobacco in entertainment media, such as films, theatre and games, is a form of tobacco advertising and promotion.

It also calls specifically for a ban on cross-border advertising to prevent the entry of banning advertising and promotion into their territories. This regulation applies to all forms of commercial communication including print, television, radio, internet, mobile phones and other new technologies, recommendation or action and all forms of contribution to any event, activity or individual with the aim, effect or likely effect of promoting a tobacco product, brand names or tobacco use either directly or indirectly.

The WHO-FCTC asserts that implementation of a comprehensive ban on tobacco advertising, promotion and sponsorship should not prevent legitimate expression. The presentation of smoking on screen is, however, rarely realistic, generally showing images more consistent with cigarette advertising than with authentic representations of the dire health consequences of tobacco use.

Some people raise concern on free expression of measures limiting smoking in films. Most of the concern is based on distorted accounts of the policies actually proposed to reduce tobacco imagery in films.

On-screen smoking increases the initiation of smoking by young people. Therefore, measures to limit film smoking should be there to establish a comprehensive tobacco control strategy. Policy-makers must also take into account the rapid evolution of the media and the emergence of new platforms in order to provide “future-proof” solutions.

One way to counteract the effect of film smoking on smoking attitudes might be to show an anti-smoking spot before any film with smoking. Well-designed, evidence-based public health policy will improve population health both nationally and globally.