Big Tobacco is Increasingly Targeting the Most Vulnerable to Boost Profits

This is simply exploitation of the vulnerable for profit, using arguably the most dangerous consumer products (cigarettes) ever made no less.

The sixth edition of The Tobacco Atlas and its companion website finds the tobacco industry is increasingly targeting vulnerable populations in emerging markets, such as Africa, Asia, and the Middle East, where people are not protected by strong tobacco control regulations. The report was released at the 17th World Congress on Tobacco OR Health in Cape Town, South Africa.

The Atlas, which is co-authored by American Cancer Society (ACS) and Vital Strategies, graphically details the scale of the tobacco epidemic around the globe. It shows where progress has been made in tobacco control, and describes the latest products and tactics being deployed by the tobacco industry to grow its profits and delay or derail tobacco control efforts. In response to an evolving tobacco control landscape, the Sixth Edition includes new chapters on regulating novel products, partnerships, tobacco industry tactics and countering the industry.

In 2016 alone, tobacco use caused over 7.1 million deaths worldwide (5.1 million in men, 2.0 million in women). Most of these deaths were attributable to cigarette smoking, while 884,000 were related to secondhand smoke. The increase in tobacco-related disease and death has been outpaced by the increase in industry profits. The combined profits of the world’s biggest tobacco companies exceeded US $62.27 billion in 2015, the last year on record for all the major companies. This is equivalent to US $9,730 for the death of each smoker, an increase of 39% since the last Atlas was published, when the figure stood at US$7,000.

“Every death from tobacco is preventable, and every government has the power reduce the human and economic toll of the tobacco epidemic,” said Jeffrey Drope, PhD, co-editor and author of The Atlas and Vice President, Economic and Health Policy Research at the American Cancer Society. “It starts by resisting the influence of the industry and implementing proven tobacco control policies. The Atlas shows that progress is possible in every region of the world. African countries in particular are at a critical point — both because they are targets of the industry but also because many have opportunity to strengthen policies and act before smoking is at epidemic levels.”

“Tobacco causes harm at every stage of its life cycle, from cultivation to disposal,” said Dr. Neil Schluger, Vital Strategies’ Senior Advisor for Science and co-editor and author of The Atlas. “It is linked to an ever-increasing list of diseases, burdens health systems, and exacerbates poverty, especially when a breadwinner falls ill and dies from tobacco use. At a conservative estimate, there are more than 7 million tobacco-related deaths and global economic costs of two trillion dollars (PPP) each year, not including costs such as those caused by second-hand smoke and the environmental and health damages of tobacco farming. The only way to avert this harm is for all governments to vigorously implement the Framework Convention on Tobacco Control and to enforce the proven strategies that reduce tobacco use.”

Tobacco use and exposure to secondhand smoke costs the global economy more than two trillion dollars (PPP) every year — equivalent to almost 2% of the world’s total economic output. More than 1.1 billion people are current smokers, while 360 million people use smokeless tobacco. Low and middle income countries represent over 80% of tobacco users and tobacco-related deaths, placing an increased share of tobacco-related costs on those who can least afford it. A growing proportion of that burden will fall on countries across Africa in the future, if governments do not implement tobacco control policies now to prevent it.


“The ultimate path to improved tobacco control is political will,” said José Luis Castro, President and CEO, Vital Strategies. “Strong tobacco control policies deliver a significant return on investment, and The Tobacco Atlas offers the best and most recent data on the tobacco epidemic as a resource for governments to pursue effective strategies. The answer does not lie with the industry: as The Atlas makes clear, there is a complete disconnect between the tobacco industry’s claims about harm reduction and its actual work to grow tobacco use among vulnerable populations. Governments must be accountable to their citizens in reducing tobacco use and improving health. They must prepare to rebuff the tobacco industry’s challenges to legislation, seek the appropriate assistance to build capacity, and be transparent about the industry’s inevitable approaches. We urge governments, advocates, organizations and people who care about health, the environment and development to stand together to reduce this man-made epidemic in pursuit of a healthier planet.”

Comprehensive Study of E-Cigarettes

While e-cigarettes sometimes helping people quit smoking (which is one of the leading causes of preventable death) is beneficial, a lot of them do contain chemicals that are clearly toxic. These chemicals are probably less harmful than the chemicals in other cigarettes, but the supposition that e-cigarettes aren’t harmful (periodically found among misinformed youth) shouldn’t be perpetuated.

A new congressionally mandated report from the National Academies of Sciences, Engineering, and Medicine takes a comprehensive look at evidence on the human health effects of e-cigarettes. Although the research base is limited given the relatively short time e-cigarettes have been used, the committee that conducted the study identified and examined over 800 peer-reviewed scientific studies, reaching dozens of conclusions about a range of health impacts.

Evidence suggests that while e-cigarettes are not without health risks, they are likely to be far less harmful than conventional cigarettes, the report says. They contain fewer numbers and lower levels of toxic substances than conventional cigarettes, and using e-cigarettes may help adults who smoke conventional cigarettes quit smoking. However, their long-term health effects are not yet clear. Among youth — who use e-cigarettes at higher rates than adults do — there is substantial evidence that e-cigarette use increases the risk of transitioning to smoking conventional cigarettes.

E-cigarettes are a diverse group of products containing a heating element that produces an aerosol from a liquid that users can inhale via a mouthpiece, and include a range of devices such as “cig-a-likes,” vape tank systems, and vape mods. Millions of Americans use e-cigarettes, and e-cigarette use is generally greatest among young adults and decreases with age. Use varies substantially across demographic groups, including age, gender, race, and ethnicity. For example, among youth and adults, use is typically greater among males than females.

Whether e-cigarettes have an overall positive or negative impact on public health is currently unknown, the report says. More and better research on e-cigarettes’ short- and long-term effects on health and on their relationship to conventional smoking is needed to answer that question with clarity.

“E-cigarettes cannot be simply categorized as either beneficial or harmful,” said David Eaton, chair of the committee that wrote the report, and dean and vice provost of the Graduate School of the University of Washington, Seattle. “In some circumstances, such as their use by non-smoking adolescents and young adults, their adverse effects clearly warrant concern. In other cases, such as when adult smokers use them to quit smoking, they offer an opportunity to reduce smoking-related illness.”

The report offers conclusions about e-cigarette use and a range of health impacts, including the following, and it notes the strength of the evidence for each conclusion.

Exposure to nicotine

  • There is conclusive evidence that exposure to nicotine from e-cigarettes is highly variable and depends on the characteristics of the device and the e-liquid, as well as on how the device is operated.
  • There is substantial evidence that nicotine intake from e-cigarettes among experienced adult e-cigarette users can be comparable to that from conventional cigarettes.

Exposure to toxic substances

  • There is conclusive evidence that in addition to nicotine, most e-cigarettes contain and emit numerous potentially toxic substances.
  • There is substantial evidence that except for nicotine, exposure to potentially toxic substances from e-cigarettes (under typical conditions of use) is significantly lower compared with conventional cigarettes.


Analysis Finds 60% People Who Try a Cigarette Become Daily Smokers

The addictive power of cigarettes shouldn’t be underestimated. The damage to health that cigarettes do shouldn’t be estimated either, and that’s probably why wise cigarette smokers simply tell others to not start smoking to begin with.

At least 61 per cent of people who try their first cigarette become, at least temporarily, daily smokers, suggests an analysis of survey data by Queen Mary University of London.

The findings, from over 215,000 survey respondents and published in the journal Nicotine & Tobacco Research, provides strong support for prioritising efforts to reduce cigarette experimentation among adolescents.

Lead researcher Professor Peter Hajek from Queen Mary said: “This is the first time that the remarkable hold that cigarettes can establish after a single experience has been documented from such a large set of data.

“In the development of any addictive behaviour, the move from experimentation to daily practice is an important landmark, as it implies that a recreational activity is turning into a compulsive need. We’ve found that the conversion rate from ‘first time smoker’ to ‘daily smoker’ is surprisingly high, which helps confirm the importance of preventing cigarette experimentation in the first place.

“The UK is seeing a dramatic reduction in smoking at the moment and this tallies with recent findings that only 19 per cent of 11-15 year olds have ever tried a cigarette, so the good news is that we are on the right track.”

The researchers searched the Global Health Data Exchange for relevant surveys that included questions about ever trying a cigarette and ever smoking daily. Datasets from eight surveys were found from the UK, USA, Australia and New Zealand, and the survey methods were found to be on par with best practice. Data were analysed to calculate the conversion rate from ever trying a cigarette to ever smoking daily.

The team calculated that 60.3 per cent of respondents had said they had ever tried a cigarette, and among those, an estimated 68.9 per cent said they had progressed to daily smoking.

The different surveys used different methodologies and yielded different results, so the estimated 68.9 per cent ‘conversion rate’ from experimentation to daily smoking has a margin of error (between 60.9 and 76.9 per cent).

Given the high conversion rate found in all existing surveys, the researchers suggest that at least some of the reduction in smoking prevalence observed over the past 20 years is likely due to reduced experimentation with cigarettes among adolescents.

Professor Peter Hajek added: “Concerns were expressed that e-cigarettes could be as addictive as conventional cigarettes, but this has not been the case. It is striking that very few non-smokers who try e-cigarettes become daily vapers, while such a large proportion on non-smokers who try conventional cigarettes become daily smokers. The presence of nicotine is clearly not the whole story.”