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Tobacco: a deadly business – about this series

This series is focused on the damage caused by the tobacco industry, which continues to endanger the lives of millions of the world’s most vulnerable people

This content is funded by support provided, in part, by Vital Strategies with funding by Bloomberg Philanthropies. Content is editorially independent and its purpose is to shine a light on both the tobacco industry and the world’s most vulnerable populations, who disproportionately bear the brunt of the global health crisis resulting from tobacco consumption.

Although tobacco consumption remains one of the world’s greatest health threats, media coverage has decreased as the sense of urgency to address the issue has waned. This investigative reporting series seeks to renew the focus on tobacco consumption and deaths worldwide, contextualised through the duel lenses of global inequality and health.

All our journalism follows GNM’s published editorial code. The Guardian is committed to open journalism, recognising that the best understanding of the world is achieved when we collaborate, share knowledge, encourage debate, welcome challenge and harness the expertise of specialists and their communities.

Unless otherwise stated, all statements and materials posted on the website, including any statements regarding specific legislation, reflect the views of the individual contributors and not those of Vital Strategies and/or Bloomberg Philanthropies.

Action against on-screen smoking

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.

Talking with … An anti-tobacco crusader

Name: Stanton Glantz

Age: 69

City: San Francisco

Position: Professor of medicine at UCSF, director of Center for Tobacco Control, Research and Education

Stanton Glantz

J.: It’s been a few years since the fight against big tobacco was a big news item. Where does that fight stand now?

Stanton Glantz: We haven’t solved the problem but we’ve made dramatic progress. Here in California, for example, we’ve dramatically cut the smoking rate down to 11 or 12 percent, and most smokers are relatively light smokers. But there are still millions of smokers. And the tobacco companies have become more active in the state Legislature. California has the 33rd lowest cigarette tax rate in the country. Jerry Brown is the first governor in decades to take tobacco campaign money.

I was surprised to find that you’re not an M.D. Your education was in engineering, including your undergrad, master’s and Ph.D. studies. How did you first get into anti-tobacco work?

I started out as a rocket scientist. I worked in several different areas at NASA, but I spent the largest amount of my time working in the mission planning and analysis divisions where we actually design the missions. I got interested in a project to use the same kind of methods that are used to control spacecraft to control anesthesia, which turns out to be a harder problem. That led to a dissertation on how the heart muscle works. Then I spent the first chunk of my career as an academic doing bioengineering, applying engineering concepts to how the heart and cardiovascular system work. And then the tobacco stuff was sort of a hobby that I got interested in in the late ’70s. It’s become a big part of my life, but I still do cardiovascular research and publish in those journals.

One of your projects is called SmokeFreeMovies, which has a website where people can see which current movies include smoking. What’s the goal of that campaign and what kind of success have you had with it?

Smoking in the movies is the major reason kids start smoking. I realized that we weren’t going to solve this talking with studios in the backrooms because tobacco has been putting money into Hollywood going back a long time. So we started this public campaign to get smoking out of movies. The six major studios now have policies discouraging smoking in their youth-rated movies. The amount of smoking in movies in 2015 was about half what it once was. The big goal for the next year is to get rid of the remaining half.

There’s a lot of new research on e-cigarettes. What is their impact and what do people need to know?

It’s true that heating up a [nicotine] solution does not create as many cancer-causing chemicals — but most people who are using e-cigarettes are not abandoning regular cigarettes, but using the two together. The odds of quitting smoking are 28 percent lower in smokers who use e-cigarettes compared to smokers who don’t. More kids are starting nicotine addictions through e-cigarettes, and those who do are more likely to go on to smoke regular cigarettes. San Francisco has integrated e-cigarettes into its indoor clean air law, but Alameda County just refused to.

The tobacco industry has twice sued the University of California over your work. What can you tell me about that?

On May 12, 1994, I got a box of purloined industry documents sent to me anonymously. The tobacco companies sued the university, trying to prevent us from releasing them, and we beat them. The second time, the tobacco industry claimed indoor smoking laws would destroy restaurant revenue, but our research found that to be false. So they sued the university on that, and it was dismissed because they didn’t have a case. But the tobacco companies are bullies with infinite money so they appealed it all the way up the Supreme Court. They lost.

Do Jewish ethics play a role in your work?

They play a big role. Historically, Jews have been on the edge, and we’re willing to take some risks that some others might not. Underlying attitudes built into Jewish culture have certainly been an element in why I am who I am and why I do what I do. My wife and I are members of Congregation Beth Sholom in San Francisco, and my wife is very active. We do Shabbos every week and always have, but I’m more into the ethical and prophetic part of the Jewish tradition, rather than ritualistic stuff.

Did limits on payments for tobacco placements in US movies affect how movies are made?

Download (PDF, 334KB)

China Shames Excessive Smoking in Latest Films

May 14, 2015

Kiki Liu

China’s New Year blockbuster “Gone With The Bullets” was given an award of shame for excessive smoking as part of the country’s latest anti-tobacco campaign.

The Chinese Association on Tobacco Control announced the “Dirty Ashtray Award” as it disclosed the results for an annual smoking scene review of films and television series.

The film by director Jiang Wen has 45 smoking scenes, the highest of all other films, showing one every 3.1 minutes. It contended with 30 of the most popular films over the past year, said Xu Guihua, deputy director of the association. Nine films and television series were given “No Smoking Scene Awards”.

The association has been monitoring smoking scenes in popular films and television series in China since 2007 to encourage celebrities to take more social responsibilities not to expose too many smoking scenes in their works to prevent the minors from mimicking.

As the world’s largest tobacco maker and consumer, China has more than 300 million smokers, almost the size of the U.S. population, and another 740 million people are exposed to second-hand smoke each year.

According to official data, over one million Chinese people die from smoking-related diseases annually.

The country is adopting its strictest measures in the latest tobacco-control efforts.

Apart from shame awards, China’s top legislature in April adopted an amendment to the Advertisement Law, banning tobacco advertising on mass media, in public places, public vehicles and outdoors.

The consumption tax on cigarettes at the wholesale level was raised on May 10, a move expected to cut cigarette consumption by four to five percent and add 100 billion yuan to annual tax revenue.

Meanwhile, Beijing will pilot the country’s toughest smoking ban starting June 1, prohibiting smoking in all indoor public places, workplaces, and on public transportation.

But despite multiple efforts, experts say challenges are still in the way.

Wang Chaocai, an official of the Ministry of Finance, said prices of the cigarettes are determined by the market. Whether the tax raise will entirely be passed on to retail prices is still unknown.

A shop owner at the Communication University of China in Beijing, said, cigarette prices in his shop have grown by one yuan per package on average after the price hike. “The sales have not been affected yet. Most of my customers are nearby residents and college students. It seems that they would not pay much attention to the slight rise of cigarette prices.”

Liu Rongjun, a 21-years-old student at the university, said, “The price of the cigarette I used to buy has grown by over one yuan per package, but the prices for some brands have remained unchanged. I would choose some cheaper ones after the price rise.”

Zhang Guodong, columnist of economic news portal, said rising retail price of cigarettes will have a limited deterring effect on chain smokers.

Despite rising cigarette tax and price, it is even more important for the local governments to cut the scale of the tobacco industry and reduce their dependence on tobacco companies for revenue.

Additionally, doubts about the feasibility of Beijing’s new smoking ban have been climbing as smokers are still seen puffing away in restaurants, schools and other public spaces in the city, regardless of previous smoking bans.

Liu said, “I don’t think the ban will have much to do with me. Mostly I smoke in entertainment venues, bars for example. It will be hard to actually implement the ban in such places which usually lack effective supervision.”

Xu said, “We have made secret investigations in some bars and found that the managers are unaware of the new regulations. More publicity and promotions about the ban are needed.

“After the ban takes effect, the city’s law enforcement still needs to work out ways to implement the regulations to the letter and make the smokers who defy the ban get due punishment.”

Wu Yiqun, executive vice director of ThinkTank, a Beijing-based anti-smoking advocacy group, said, effective implementation of the regulations should be based on solid public support.

It is important for the government to heighten public awareness of the harm of smoking and invite the public to supervise the law enforcement activities, he said.

(Source: Xinhua)

Health experts optimistic over anti-smoking law

26 November, 2014

Zhuang Pinghui

Public health experts are optimistic that the mainland’s draft tobacco-control regulation has a good chance of curbing smoking if properly implemented.

The draft regulation, published by the Legislative Affairs Office of the State Council, proposes banning smoking in all indoor public areas – and certain outdoor ones, near hospitals and kindergartens, for example.

It also calls for all tobacco advertising, promotion and sponsorship to be banned, while graphic and verbal health warnings must take up at least half the outside of a cigarette pack.

The draft details specific government agencies that will handle offences in different areas and lists penalties for offenders.

Individuals smoking in forbidden areas will be fined between 50 yuan (HK$63) and 500 yuan and businesses face fines of up to 30,000 yuan or even the revocation of their business licences.

Smoking will not be permitted to be shown in movies or television shows, and scenes of actors lighting up could also attract 30,000 yuan fines.

“We can safely say the draft has thoroughly adopted the most important articles of the World Health Organisation’s Framework Convention on Tobacco Control,” said Yang Jie, a researcher at the office of tobacco control at the Centres for Disease Control and Prevention.

China ratified the convention in 2005 but has failed to introduce a complete smoking ban in indoor public areas, as required.

The issue now is whether the mainland will water down the rules in the final law, and how well it will be implemented.

The lobbying power of the state-owned tobacco monopoly is significant – tobacco sales contributed between 7 per cent and 10 per cent of the country’s tax revenue over the past decade.

“There are some articles in the law that the tobacco companies might oppose during the consultation period. We will send our opinions. We expect there will be some wrangling with the industry,” Yang said.

“As for implementation, the best chance of making it effective is to involve multiple government agencies.”

Smoking is common across the mainland, even in hospitals and government offices. The former health ministry issued its own ban on smoking in indoor public areas but it was poorly implemented. Several cities have introduced their own smoking bans, with some enforced by a dozen or more agencies while others are policed by only a few.

Yang researched 10 cities and found that regulations involving multiple agencies had the best chance of working as long as they had to report to a central office.

Shenzhen, for example, did not hand out a single fine under previous smoking rules, yet had issued more than 300,000 yuan in fines since March when a tougher regulation came into effect.

Wu Yiqun, deputy director of the think tank Research Centre for Health Development, said the law’s articles included details of implementation and accountability. “I am very optimistic,” he said. Both Yang and Wu agreed the State Council’s proposed regulations would help control tobacco use even without a more senior law passed by the NPC, which could take years.

David Cameron urged to probe claim that aide had £6m tobacco deal

David Cameron urged to probe claim that aide had £6m tobacco deal

Lynton Crosby comes under renewed fire over Philip Morris links as row over cigarette packaging rages on

Lynton Crosby

Lynton Crosby signed the contract with Philip Morris. Photograph: Stuart Clarke / Rex Features

Labour has urged David Cameron to investigate claims that a contract that his electoral strategist, Lynton Crosby, signed to provide the cigarette firm Philip Morris International (PMI) with lobbying services could be worth as much as £6m.

As the row over Crosby’s role in a government U-turn on plain cigarette packaging continues, an informed source claimed that the PMI contract was signed personally by Crosby last November after another lobbying firm, Luther Pendragon, severed its ties with the company following criticism from leading health organisations.

The source said a figure “of around £6m” was discussed, although the agreed amount and the duration of the contract are not known.

In a letter to Cameron, Labour’s shadow health secretary, Andy Burnham, states: “It has been alleged to me that last November, after his appointment as your electoral strategy adviser, Lynton Crosby personally signed a contract between Philip Morris International and Crosby Textor for lobbying work in the UK, including on standardised packaging of tobacco. It is claimed that the contract was in the region of £6m.” Burnham also asks Cameron to clarify what discussions, if any, he had with Crosby on plain packs.

“In various interviews, you refused to say whether you had discussed the issue of standardised packaging with Mr Crosby, leaving the clear impression that a conversation has indeed taken place,” he writes. “It is essential that you address this point directly and clear this matter up.”

The contract with Crosby’s company, Crosby Textor Fullbrook (CTF), was signed following close discusssions with Livio Vanghetti, PMI’s vice-president of corporate affairs, European Union region, and Brett Cooper, its director of corporate affairs, UK and Ireland.

PMI said in response to a series of questions put to it by the Observer that the claims were “factually incorrect” and “completely inaccurate”. It declined to comment further. A CTF spokesman said that the “allegations are without foundation and categorically untrue”. It declined to comment on the value of its contract with PMI.

Crosby’s relationship with the prime minister has been under intense scrutiny since the government abandoned plans for cigarettes to be sold in plain packs. Cameron is expected to repeat on the Andrew Marr Show on Sunday his assertion that he has never been lobbied by Crosby on the issue of cigarette packaging and add that there has been no other “intervention” by the Australian on the matter.

There has been speculation that the rise of Ukip, which promotes the rights of smokers, and concerns that plain packaging would lead to a rise in tobacco smuggling were two reasons why Cameron decided to abandon the plan after Crosby reputedly encouraged him to prioritise the Tories’ goals ahead of the 2015 general election.

“Nobody cares about the latest hair-splitting evasion Mr Cameron dreams up to obscure whether he and Mr Crosby spoke about standard packaging,” said Deborah Arnott, chief executive of health charity Ash. “But they do care that over 200,000 children still start to smoke in this country every year, and that many will go on to terrible illnesses and early deaths as a result.”

In January PMI shared a report with Department of Health officials that it had commissioned from an independent expert that was scathing about the arguments made for plain packaging.

The report was written by Rupert Darwall, who worked with Crosby on the 2005 Tory election campaign and was offered an associate directorship at one of the lobbyist’s companies.

A spokesman for the Conservative party said: “The PM has already been absolutely clear that he was not lobbied by Lynton Crosby on this, or anything else, and that the decision was his and the health secretary’s without reference to any other outside bodies.”

No 10 faces questions over ‘tobacco lobby links’

No 10 faces questions over ‘tobacco lobby links’

Lynton Crosby was appointed to construct the next Tory election campaign

Times photographer Tom Pilston

  • Lynton Crosby

Lynton Crosby was appointed to construct the next Tory election campaign Times photographer Tom Pilston

Alex Ralph and Francis Elliott

Last updated at 12:01AM, July 13 2013

A lobbying consultancy run by David Cameron’s election guru helped the world’s biggest tobacco company to avoid moves to make cigarettes less attractive to young people.

Ministers effectively abandoned yesterday efforts to introduce plain packaging for tobacco products. But hours later it emerged that Lynton Crosby’s company, CTF, had been advising Philip Morris Ltd in Britain since November.

The Australian-born Mr Crosby was appointed as a strategy adviser to the Conservative Party late last year, based on his reputation for securing election victories for the former Australian Prime Minister John Howard, and Boris Johnson, the Mayor of London.

The U-turn

Study examines placement of tobacco and alcohol brands in movies rated for youth audiences

Contact: Robin Dutcher
603-653-9056 begin_of_the_skype_highlighting 603-653-9056 FREE  end_of_the_skype_highlighting
The JAMA Network Journals

Study examines placement of tobacco and alcohol brands in movies rated for youth audiences

An analysis of top box-office movies released in the United States indicated tobacco brand producer placements in movies have declined since implementation of the Master Settlement Agreement (MSA), but alcohol placements, which are subject only to industry self-regulation, have increased in movies rated acceptable for youth audiences, according to a study published Online First by JAMA Pediatrics, a JAMA Network publication.

There is growing evidence that movies influence substance use behaviors during adolescence. Children’s exposure to movie imagery of tobacco and alcohol has been associated with not only smoking but also early onset of drinking, heavier drinking and abuse of alcohol, according to the study background.

Elaina Bergamini, M.S., of the Geisel School of Medicine at Dartmouth University, New Hampshire, and colleagues examined recent trends for tobacco and alcohol use in movies. The study analyzed the top 100 box-office movie hits released in the United States from 1996 through 2009 (N=1400).

After implementation of the MSA in 1998, tobacco brand product appearances decreased by 7 percent each year, then held at a level of 22 per year after 2006. The MSA also resulted in a decrease in tobacco screen time for youth and adult rated movies (42.3 percent and 85.4 percent, respectively). Alcohol brand product appearances in youth-rated movies trended upward during the period from 80 to 145 per year, an increase of 5.2 appearances per year.

“In summary, this study found dramatic declines in brand appearances for tobacco after such placements were prohibited by an externally monitored and enforced regulatory structure, even though such activity had already been prohibited in the self-regulatory structure a decade before. During the same period, alcohol brand placements, subject only to self-regulation, increased significantly in movies rated acceptable for youth audiences, a trend that could have implications for teen drinking,” the study concludes.


(JAMA Pediatr. Published online May 27, 2013. doi:10.1001/jamapediatrics.2013.393. Available pre-embargo to the media at

Editor’s Note: The study was supported by grants from the National Institutes of Health. Please see article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.


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