"Fighting a hurricane": tobacco industry efforts to counter the perceived threat of Islam

Defining and conceptualising the commercial determinants of health

Although commercial entities can contribute positively to health and society there is growing evidence that the products and practices of some commercial actors-notably the largest transnational corporations-are responsible for escalating rates of avoidable ill health, planetary damage, and social and health inequity; these problems are increasingly referred to as the commercial determinants of health. The climate emergency, the non-communicable disease epidemic, and that just four industry sectors (ie, tobacco, ultra-processed food, fossil fuel, and alcohol) already account for at least a third of global deaths illustrate the scale and huge economic cost of the problem. This paper, the first in a Series on the commercial determinants of health, explains how the shift towards market fundamentalism and increasingly powerful transnational corporations has created a pathological system in which commercial actors are increasingly enabled to cause harm and externalise the costs of doing so. Consequently, as harms to human and planetary health increase, commercial sector wealth and power increase, whereas the countervailing forces having to meet these costs (notably individuals, governments, and civil society organisations) become correspondingly impoverished and disempowered or captured by commercial interests. This power imbalance leads to policy inertia; although many policy solutions are available, they are not being implemented. Health harms are escalating, leaving health-care systems increasingly unable to cope. Governments can and must act to improve, rather than continue to threaten, the wellbeing of future generations, development, and economic growth.

Islam and Motivation to Quit Smoking: Public Health Policy Implications

In the WHO Eastern Mediterranean Regional Office some 14 years ago, a 'religiously inspired approach' was proposed to combat tobacco use. This promoted a useful debate in the region. The purpose of this paper is to argue the need to identify the role which Islamic beliefs and teachings play (1) in influencing individual motivation to quit smoking and (2) in gaining support for public policies to reduce smoking. Ramadan and Hajj are taken as key points. These, it is argued, are times when Muslim religious motivation to abstain from smoking is strongest. This paper concludes that there is an insufficient evidence base on which to adopt a religiously inspired approach. All of civil society, including religious Muslim authorities, should rather supplement the efforts of health professionals to encourage smoking cessation.

The Effectiveness of Cigarette Pack Health Warning Labels with Religious Messages in an Urban Setting in Indonesia: A Cross-Sectional Study

This study sought to assess the effectiveness of religious cigarette health warning labels (HWLs) in Indonesia, a country with a high public health burden from tobacco use. The study tested different religious and nonreligious messages related to suicide, secondhand smoke (SHS) and gangrene. Participants were smokers and non-smokers from Surabaya, Indonesia (n = 817). Participants rated each HWL for its effectiveness on a scale of 1 to 10 (1 = “not at all”, 10 = “extremely”) with respect to 10 items. Nonreligious HWLs were marginally superior for SHS and suicide while religious HWLs were marginally superior for gangrene. Given the close rating scores between religious and nonreligious HWLs, they were functionally equal in effectiveness. With proper assessment of potential unintended consequences, the implementation of religious HWLs could be considered for a proportion of HWLs.

The 500-year Cultural & Economic Trajectory of Tobacco: A Circle Complete

Who smokes, and why do they do it? What factors discourage and otherwise reward or incentivize smoking? Tobacco use has been accompanied by controversy from the moment of its entry into European culture, and conflicting opinions regarding its potentially adverse influence on health have coexisted for hundreds of years. Its use in all forms represents the world's single greatest cause of preventable disease and death. Tobacco was introduced to Europe by Christopher Columbus, who in October 1492 discovered the crop in Cuba. While the next four centuries would see tobacco as the most highly traded economic commodity, by 1900, the now familiar cigarette remained obscure and accounted for only 2% of total tobacco sales. Global tobacco consumption rose sharply after 1914 and became especially prevalent following World War II, particularly among men. Indeed, overall tobacco sales increased by more than 60% by the mid-20th century, and cigarettes were a critical driver of this growth. Cigarettes dominated the tobacco market by 1950, by then accounting for more than 80% of all tobacco purchases. In the absence of clinical and scientific evidence against tobacco, moral and religious arguments dominated opposition voices against tobacco consumption in the 1800s. However, by the mid-20th century, advancements in medical research supported enhanced government and voluntary actions against tobacco advertising and also raised awareness of the dangers associated with passive tobacco smoke exposure. Solid epidemiological work connecting tobacco use with "the shortening of life span" began to appear in the medical literature in the 1950s, linking smoking with lung cancer and related conditions. In subsequent years, these developments led to significant curtailment of tobacco use. This monograph explores aspects of the intersection of tobacco with themes of behavioral incentives, religion, culture, literature, economics, and government over the past five centuries.

Tobacco industry globalization and global health governance: towards an interdisciplinary research agenda

Shifting patterns of tobacco production and consumption, and the resultant disease burden worldwide since the late twentieth century, prompted efforts to strengthen global health governance through adoption of the Framework Convention on Tobacco Control. While the treaty is rightfully considered an important achievement, to address a neglected public health issue through collective action, evidence suggests that tobacco industry globalization continues apace. In this article, we provide a systematic review of the public health literature and reveal definitional and measurement imprecision, ahistorical timeframes, transnational tobacco companies and the state as the primary units and levels of analysis, and a strong emphasis on agency as opposed to structural power. Drawing on the study of globalization in international political economy and business studies, we identify opportunities to expand analysis along each of these dimensions. We conclude that this expanded and interdisciplinary research agenda provides the potential for fuller understanding of the dual and dynamic relationship between the tobacco industry and globalization. Deeper analysis of how the industry has adapted to globalization over time, as well as how the industry has influenced the nature and trajectory of globalization, is essential for building effective global governance responses. This article is published as part of a thematic collection dedicated to global governance.