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Crosbie E, Tran B, Albuquerque de Figueiredo B, Severini L, Severini G, Sebrié EM. Tobacco industry strategies to influence the regulation of new and emerging tobacco and nicotine products in Latin America and the Caribbean. Rev Panam Salud Publica 2024; 48:e43. [PMID: 38859810 PMCID: PMC11164239 DOI: 10.26633/rpsp.2024.43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 01/02/2024] [Indexed: 06/12/2024] Open
Abstract
Objective To document tobacco industry strategies to influence regulation of new and emerging tobacco and nicotine products (NETNPs) in Latin America and the Caribbean. Methods We analyzed industry websites, advocacy reports, news media and government documents related to NETNPs, focusing on electronic cigarettes and heated tobacco products. We also conducted a survey of leading health advocates. We applied the policy dystopia model to analyze industry action and argument-based strategies on NETNP regulations. Results Industry actors engaged in four instrumental strategies to influence NETNP regulation - coalition management, information management, direct involvement in and access to the policy process, and litigation. Their actions included: lobbying key policy-makers, academics and vaping associations; providing grants to media groups to disseminate favorable NETNP information; participating in public consultations; presenting at public hearings; inserting industry-inspired language into draft NETNP legislation; and filing lawsuits to challenge NETNP bans. The industry disseminated its so-called harm reduction argument through large/influential countries (e.g., Argentina, Brazil, and Mexico). Industry discursive strategies claimed NETNPs were less harmful, provided safer alternatives, and should be regulated as so-called harm reduction products or have fewer restrictions on their sale and use than those currently in place. Conclusion Our analysis provides a better understanding of industry strategies to undermine tobacco and nicotine control. To help counter industry efforts, health advocates should proactively strengthen government capacities and alert policy-makers to industry attempts to create new regulatory categories (so-called reduced-risk products), provide misleading information of government authorizations of NETNPs, and co-opt so-called harm-reduction messages that serve the industry's agenda.
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Affiliation(s)
- Eric Crosbie
- School of Public HealthUniversity of Nevada RenoRenoNVUnited States of AmericaSchool of Public Health, University of Nevada Reno, Reno, NV, United States of America.
| | - Brian Tran
- School of Public HealthUniversity of Nevada RenoRenoNVUnited States of AmericaSchool of Public Health, University of Nevada Reno, Reno, NV, United States of America.
| | - Beatriz Albuquerque de Figueiredo
- Campaign for Tobacco-Free KidsWashington, D.C.United States of AmericaCampaign for Tobacco-Free Kids, Washington, D.C., United States of America.
| | - Luciana Severini
- Pan American Health OrganizationWashington, D.C.United States of AmericaPan American Health Organization, Washington, D.C., United States of America.
| | - Gianella Severini
- Campaign for Tobacco-Free KidsWashington, D.C.United States of AmericaCampaign for Tobacco-Free Kids, Washington, D.C., United States of America.
| | - Ernesto M. Sebrié
- Campaign for Tobacco-Free KidsWashington, D.C.United States of AmericaCampaign for Tobacco-Free Kids, Washington, D.C., United States of America.
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Sánchez-Romero LM, Li Y, Zavala-Arciniega L, Gallegos-Carrillo K, Thrasher JF, Meza R, Levy DT. The potential impact of removing a ban on electronic nicotine delivery systems using the Mexico smoking and vaping model (SAVM). MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.04.28.24306511. [PMID: 38746147 PMCID: PMC11092684 DOI: 10.1101/2024.04.28.24306511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Objective To develop the Mexico Smoking and Vaping Model (Mexico SAVM) to estimate cigarette and electronic nicotine delivery systems (ENDS) prevalence and the public health impact of legalizing ENDS use. Methods SAVM, a cohort-based discrete-time simulation model, compares two scenarios. The ENDS-Restricted Scenario estimates smoking prevalence and associated mortality outcomes under the current policy of an ENDS ban, using Mexico-specific population projections, death rates, life expectancy, and smoking and e-cigarette prevalence. The ENDS-Unrestricted Scenario projects smoking and vaping prevalence under a hypothetical scenario where ENDS use is allowed. The impact of legalizing ENDS use is estimated as the difference in smoking- and vaping-attributable deaths (SVADs) and life-years lost (LYLs) between the ENDS-Restricted and Unrestricted scenarios. Results Compared to a national ENDS ban, The Mexico SAVM projects that legalizing ENDS use could decrease smoking prevalence by 40.1% in males and 30.9% in females by 2049 compared to continuing the national ENDS ban. This reduction in prevalence would save 2.9 (2.5 males and 0.4 females) million life-years and avert almost 106 (91.0 males and 15.5 females) thousand deaths between 2025 and 2049. Public health gains decline by 43% to 59,748 SVADs averted when the switching rate is reduced by half and by 24.3% (92,806 SVADs averted) with a 25% ENDS risk level from that of cigarettes but increased by 24.3% (121,375 SVADs averted) with the 5% ENDS risk. Conclusions Mexico SAVM suggests that greater access to ENDS and a more permissive ENDS regulation, simultaneous with strong cigarette policies, would reduce smoking prevalence and decrease smoking-related mortality. The unanticipated effects of an ENDS ban merit closer scrutiny, with further consideration of how specific ENDS restrictions may maximize public health benefits.
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Affiliation(s)
- Luz María Sánchez-Romero
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC. United States of America
| | - Yameng Li
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC. United States of America
| | - Luis Zavala-Arciniega
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Katia Gallegos-Carrillo
- Epidemiology and Health Services Research Unit, Morelos, Mexican Institute of Social Security, Mexico
- Evaluation and Surveys Research Center, National Institute of Public Health, Cuernavaca, Mexico
| | - James F Thrasher
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, United States of America
| | - Rafael Meza
- Department of Integrative Oncology, BC Cancer Research Institute, British Columbia, Canada
- School of Population and Public Health, University of British Columbia, Canada
| | - David T Levy
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC. United States of America
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Sheikh ZD, Branston JR, Llorente BA, Maldonado N, Gilmore AB. Tobacco industry pricing strategies for single cigarettes and multistick packs after excise tax increases in Colombia. Tob Control 2023; 33:59-66. [PMID: 35641118 PMCID: PMC10803973 DOI: 10.1136/tobaccocontrol-2022-057333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 05/10/2022] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Taxes on tobacco products are an efficient way of reducing consumption. However, they are only effective if passed on to consumers with higher prices. This study aims to examine tobacco industry (TI) pricing strategies in response to tax increases, and whether they differ by price segments or presentation (packs or individual sticks) in Colombia. This is the first such academic study in Latin America and the first anywhere to include the market for single sticks. METHODS Using data on cigarette pricing/taxation from a survey of smokers (2016-2017) and official government data on pricing (2007-2019), the TI's pricing strategies were examined, split by brand, price segments, different sized packs and single cigarettes. RESULTS The TI employed targeted pricing strategies in Colombia: differentially shifting taxes; and launching new brands/brand variants. The industry overshifted taxes when increases were smaller and predictable, but used undershifting more when there was a larger increase in 2017, after which it mostly overshifted on budget and premium (but undershifted mid-priced) brands. The prices for single sticks increased more than the tax increase in 2017 when their consumption also increased. CONCLUSION The pricing strategies identified suggest excise taxes can be increased further, particularly the specific component, to reduce the price gap between brand segments. Brands should be restricted to a single variant along with prohibitions on launching new brands/brand variants. Lastly, since the pricing of single sticks does not match the pattern of packs, more monitoring of their sales and distribution is required, especially since they promote consumption and hinder effective implementation of tobacco tax policies.
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Affiliation(s)
- Zaineb Danish Sheikh
- Tobacco Control Research Group, Department of Health, University of Bath, Bath, UK
| | - J Robert Branston
- Tobacco Control Research Group, Department of Health, University of Bath, Bath, UK
- School of Management, University of Bath, Bath, UK
| | | | - Norman Maldonado
- PROESA - Research Center on Health Economics and Social Protection, Department of Economics, Universidad Icesi, Cali, Colombia
| | - Anna B Gilmore
- Tobacco Control Research Group, Department of Health, University of Bath, Bath, UK
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Perucic AM, Sandoval RC, Malik S, Morales-Zamora G. Taxation of novel and emerging nicotine and tobacco products (HTPs, ENDS, and ENNDS) globally and in Latin America. Rev Panam Salud Publica 2022; 46:e175. [PMID: 36267147 PMCID: PMC9559335 DOI: 10.26633/rpsp.2022.175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 05/23/2022] [Indexed: 11/24/2022] Open
Abstract
This article provides a snapshot of the market structure and regulatory approaches around novel and emerging tobacco and nicotine products, both globally and in Latin America, with a focus on excise taxation. Using data from leading market research companies, the WHO Report on the Global Tobacco Epidemic 2021, and country laws and decrees, the article analyses the evolution and market structure of heated tobacco products (HTPs), electronic nicotine delivery systems (ENDS), and electronic non-nicotine delivery systems (ENNDS). This is followed by a summary review of regulatory approaches adopted by countries toward these products, with a particular focus on excise tax policies currently implemented. Based on the well-established knowledge about tobacco taxation best practices and on WHO’s recent recommendations on the taxation of novel and emerging tobacco and nicotine products, the authors then discuss possible elements of a good tax policy approach for countries to consider.
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Affiliation(s)
| | | | - Sehr Malik
- Pan American Health Organization, Washington, D.C., United States of America
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Severini G, Sandoval RC, Sóñora G, Sosa P, Gutkowski P, Severini L, Valdivia V, Sebrié EM. Towards a smoke-free world? South America became the first 100% smoke-free subregion in the Americas. Rev Panam Salud Publica 2022; 46:e103. [PMID: 36211249 PMCID: PMC9534353 DOI: 10.26633/rpsp.2022.103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 03/14/2022] [Indexed: 11/24/2022] Open
Abstract
Almost 20 years after the launching by the Pan American Health Organization of its “Smoke-Free Americas” initiative in 2001, in December 2020, South America became the first subregion in the Americas to accomplish 100% smoke-free environments in line with Article 8 of the World Health Organization Framework Convention on Tobacco Control (FCTC). Some of these countries adopted legal measures that are more robust than others, including in their laws specific outdoor places in the smoking ban (like Argentina and Uruguay) and/or novel nicotine and tobacco products under their scope (like Ecuador and Paraguay). The 10 countries took different paths to adopt this public health measure, either through executive or legislative measures or a combination of both. A few countries, like Argentina, Brazil, and Venezuela, started at the subnational level and then moved on to the national level, similar to the rest of the countries. For achieving this milestone, an adequate context was crucial: the broad ratification of the FCTC and the relevance given to the human right to health, civil society efforts, commitments made by intergovernmental bodies, media and communication strategies, and the development of scientific evidence. Countries faced obstacles, including the well-known interference of the tobacco industry, which among other strategies used litigation; however, courts and judges upheld comprehensive legal measures on smoke-free environments. The process by which South America achieved this milestone represents a role model for other subregions of the Americas and the world.
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Affiliation(s)
- Gianella Severini
- Campaign for Tobacco-Free Kids, Washington, D.C., United States of America
| | | | - Gustavo Sóñora
- International Union Against Tuberculosis and Lung Disease, Paris, France
| | - Patricia Sosa
- Campaign for Tobacco-Free Kids, Washington, D.C., United States of America
| | - Patricia Gutkowski
- Campaign for Tobacco-Free Kids, Washington, D.C., United States of America
| | - Luciana Severini
- Pan American Health Organization, Washington, D.C., United States of America
| | - Víctor Valdivia
- International Union Against Tuberculosis and Lung Disease, Paris, France
| | - Ernesto M. Sebrié
- Campaign for Tobacco-Free Kids, Washington, D.C., United States of America
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Patay D, Schram A, Collin J, Sell S, Friel S. Authority in tobacco control in Pacific Small Island Developing States: a qualitative study of multisectoral tobacco governance in Fiji and Vanuatu. Tob Control 2022:tobaccocontrol-2022-057404. [PMID: 35882520 DOI: 10.1136/tc-2022-057404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 07/16/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Small Island Developing States (SIDS) struggle with implementing multisectoral tobacco control measures, and health sector actors often lack capacity to forge multisectoral commitment. This study aims to explore the sources and dynamics of authority that can enable multisectoral collaboration despite the divergence of policy agendas in tobacco control. METHODS We applied a qualitative, explorative case study design, with data collection and analysis guided by an analytical framework that identifies sources and dynamics of authority. Seventy interviews were conducted in Fiji and Vanuatu between 2018 and 2019. RESULTS The key features shaping multisectoral coordination for tobacco control in Fiji and Vanuatu are the expert, institutional, capacity-based and legal authority that state and non-state actors have in tobacco governance. The amount of authority actors can secure from these sources was shown to be influenced by their performance (perceived or real), the discourse around tobacco control, the existing legal tools and their strategic alliances. SIDS vulnerabilities, arising from small size, isolation and developing economies, facilitate an economic growth discourse that reduces health sector actors' authority and empowers protobacco actors to drive tobacco governance. CONCLUSIONS Our results highlight the need for terms of engagement with the tobacco industry to enable governments to implement multisectoral tobacco control measures. Expanding assistance on tobacco control among government and civil society actors and increasing messaging about the impact of economic, trade and agricultural practices on health are essential to help SIDS implement the Framework Convention on Tobacco Control.
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Affiliation(s)
- Dori Patay
- Menzies Centre for Health Governance, School of Regulation and Global Governance, The Australian National University, Canberra, Australian Capital Territory, Australia
- Public Health Advocacy and Policy Impact team, Food Policy Division, The George Institute for Global Health, Sydney, New South Wales, Australia
| | - Ashley Schram
- Menzies Centre for Health Governance, School of Regulation and Global Governance, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Jeff Collin
- Global Health Policy Unit, University of Edinburgh, Edinburgh, UK
| | - Susan Sell
- Menzies Centre for Health Governance, School of Regulation and Global Governance, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Sharon Friel
- Menzies Centre for Health Governance, School of Regulation and Global Governance, The Australian National University, Canberra, Australian Capital Territory, Australia
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