A seasoned litigator against major tobacco companies and a tobacco stocks investment manager have warned regulators and law makers that the ‘demonisation of big tobacco’ is a counterproductive strategy that will cost – not save – more lives, writes Chris Bateman for MedicalBrief.
Public health activist David Sweanor, Adjunct Professor at the Faculty of Law, University of Ottawa, and tobacco stocks investment management company executive Jonathan Fell were addressing the Global Forum on Nicotine 2021 – the eighth of the GFN conferences – cyber-broadcast from Liverpool in the United Kingdom from 17-18 June.
More than 2,000 people from 100 countries registered for the diverse forum. The pair were addressing a session entitled, “Investment in Nicotine Innovation: Risks and rewards for public health”.
Use tobacco’s billions to help
Jonathan Fell said the tobacco industry – dominated by Philip Morris International (market value US$144 billion), the Altria Group (market value US$96.9 billion) and British American Tobacco (market value US$91.6 billion) – took a huge hit as smoking became less socially acceptable.
However, the industry quickly adapted, mimicking smaller companies producing harm-reducing heated tobacco products, e-cigarettes and snus to produce quality alternative nicotine-delivery systems, which now make up over 30% of their portfolios.
He said global and country regulators, including the World Health Organisation (WHO) and European anti-tobacco agencies, insisted on demonising ‘big tobacco’ when they should rather be working with them in an already highly – but unsuitably – regulated environment.
Globally there are 100 million users of safer nicotine products and 1.1 billion cigarette smokers – the latter a number unchanged for 20 years, because population growth has offset decreases in the proportions of people who smoke.
A full 80% of the world’s smokers live in low- to middle-income countries, while seven million people die from a smoking related disease annually – more than the combined toll of malaria, HIV-AIDS and tuberculosis.
Two thirds of the worlds’ population have no access to smoking cessation services, the weakest and most expensive part of a shaky and ineffective WHO anti-tobacco policy.
“We have proof from many countries that tobacco harm reduction works. The obstacles are wealthy foundations with a myopic view of tobacco control and international organisations wedded to a narrow view of what can be done,” said Fell.
Alternative products not the enemy
Too often the war on tobacco has become a war on the people who use tobacco or nicotine, instead of understanding addiction and how damaging combustible tobacco is, he added. The discourse over ‘big tobacco’ with its portrayal as a cartoon villain is also undermining the cause of tobacco harm reduction.
“There’s a perverse perception of the industry from nearly 30 years ago and relating to even prior events – and it’s very United States-centric. It obscures the lines between legacy tobacco and the new nicotine business – they’ve become blurred and create a barrier to dialogue,” Fell said.
This evoked the several decades old, well known misbehaviours of big tobacco companies that emerged in leaked class action court documents, plus the CEOs of tobacco companies being paraded before US congress hearings in 1994.
A vastly more effective, agile approach in today’s new context would be to work with big tobacco companies by encouraging harm reduction approaches and products in the interests of improved global health.
“Today even the largest tobacco companies pursue different strategies – one of our largest public health problems is that this demonising short circuits critical thinking on why people use these products and paints the companies as some breed of evil geniuses,” Fell said.
Tobacco executives could be prosecuted or lose their jobs if they misled investors, he added, advising harm reduction lobbyists and activists to “use investors to get your case across and press for progress. It’s irresponsible for a tobacco company investor to say, ‘just sell tobacco’, and wash their hands of it. That’s a very dissatisfying approach.”
Fell estimated the market capitalisation of the world’s major tobacco companies at US$536 billion at the end of May 2021, saying that “while this sounds a lot”, it represents only about a quarter of Apple’s worth, while tobacco’s weight in the global equity index is just 0.6%.
“The development of reduced harm products with some major contributions from small firms has blurred the lines of what’s good and what’s bad – tobacco is not controlled by some secret cabal, but by those who own the rest of the stock market. It boils down to a broad swathe of society,” he emphasised.
Wake up and smell the tobacco
David Sweanor asked whether the tobacco industry was “uniquely toxic as an industry – even compared to oil and gas? Don’t we want them to shift their focus to tobacco harm reduction?”
The health impact of their products was an overwhelming concern. “Investors need help in how to think about that – to say that engagement is futile doesn’t really help,” he added.
“Ultimately, if you want to win in regulation, politics and courtroom litigation you need a realistic view of your opponent. This cartoonish caricature of the industry can be fun to have. It’s used in war to recruit people to fight an enemy, but it’s not very effective in changing policy.
“The share price in big tobacco has declined by over half. Their whole business model came under long term danger similar to the telecommunications industry – new tech destroys the business model of existing companies.
“At the same time, much of tobacco control thought that vaping was a plot by big tobacco and felt they had to attack them. That was a failure to grasp the reality of what was going on and what’s happening in nicotine delivery. It’s pretty simple from a business standpoint, the science is there; can we deliver a less hazardous way?” he said.
Sweanor warned that big tobacco companies could go private, “losing us this tremendous flow of public information they have to divulge by law. Unlike the WHO, if you mislead investors or the security exchange commission, really bad things can happen to you.”
He asked: “How did we transform other industries? From automobiles to sanitary food, from snake oil remedies to science-based products. What are the lessons? What’s the difference between those selling tobacco products and those selling harm reduction products?”
Ultimately, tobacco businesses would continue to seek to grow the proportion of their revenues that came from non-combustible products and were already aiming to increase this to 50% of their portfolio.
“Is being hostile to reduced harm products and who makes them much different to opponents to harm reduction framing big tobacco involvement as a reason to dismiss it?” he asked.
Answering questions from the global audience, Sweanor said the easiest way to get innovative companies to do more for public health in low- to middle-income countries was to stop banning alternative products to tobacco combustion.
“If anybody thinks new technology cannot be accepted in low- to middle-income countries, just look at smart phones,” he added.
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