Did Big Tobacco Help Water Down United Nations Tax Recommendations?

The world is at a critical juncture in the fight against noncommunicable diseases (NCDs), and Big Tobacco may be trying to stymy progress.

On September 25, Heads of State and Government from United Nations Member States will gather at the Fourth UN General Assembly High-Level Meeting (HLM4) on NCDs and mental health. The goal of the meeting: Finalize a Political Declaration that lays out key targets in NCD reduction and actionable measures to achieve them.

This meeting is timely. NCDs, such as heart disease, cancer, chronic respiratory diseases, diabetes, kidney and liver disease, mental health conditions and others, have become the leading cause of death globally, and could be costing the world economy more than US $2 trillion every year. The NCD Alliance estimates that three out of every four deaths worldwide are due to NCDs.

It also estimates that up to 80% of these deaths are preventable.

The Political Declaration, currently in its fourth draft, rightly targets key areas of prevention including substantially reducing tobacco use, which is a leading cause of NCDs and kills more than 7 million people every year. The measures it recommends to achieve this reduction, however, have been watered down since the first draft—potentially due to pressure from Big Tobacco and other vested commercial interests.

The deterioration of the Declaration

In its first iteration, known as the zero draft, the Declaration included a target of at least 80% of countries implementing or increasing taxes on tobacco, alcohol and sugar-sweetened beverages in line with World Health Organization (WHO) recommendations. For tobacco, WHO recommends raising taxes so they represent at least 75% of the retail price of tobacco products.

WHO considers tobacco taxes a “best buy” intervention. They are a powerful tool that is cost-effective to implement and leads to reduced tobacco use and more revenue for governments. If 80% of Member States raised taxes by WHO’s recommended level, the UN could reach its goal of 150 million fewer people using tobacco by 2030.

Analysis of the zero draft by the WHO Civil Society Working Group on NCDs urged the Declaration to go even further in its commitments. Instead, it appears to have gone backward.

By the fourth iteration, that language had been replaced with the vague and passive: “Consider introducing or increasing taxes on tobacco and alcohol to support health objectives, in line with national circumstances.”

Big Tobacco’s lobbying could be to blame

Tobacco taxes are a win for public health, but a loss for tobacco industry profits. That is why the tobacco industry uses a playbook of tactics to fight taxes all over the world and neutralize their positive effects on public health.

The industry commonly threatens that higher taxes will lead to increased illicit trade—though independent research has shown that countries with higher tobacco taxes tend to have relatively smaller illicit markets and vice versa—and claims that reduced tobacco use will lead to reduced tobacco tax revenues for governments.

The industry also lobbies, a lot. The Global Tobacco Industry Interference Index, which ranks countries on how well they defend their policies against Big Tobacco’s influence, cites example after example of the industry lobbying policymakers to either reduce, delay or not increase tobacco taxes.

The industry also has a history of trying to influence the UNGA. That may be why the Director of Policy and Advocacy at the NCD Alliance, Alison Cox, easily recognized and called out this potential involvement, saying, “It looks like health harming industry fingerprints are all over this.”

She said in a media briefing leading up to the HLM4: “We’ve heard from early this year that representatives of these [health harming] companies were seeking meetings with governments in their capitals and with their missions in New York, and it’s very frustrating because these interactions are often not documented and they’re not transparent, yet we can see these interests represented in the outcome of this negotiation process.”

In countries that have not fully implemented the WHO Framework Convention on Tobacco Control (FCTC), which calls for governments to not interact with the tobacco industry except when strictly necessary, such as for regulation, and to document all interactions with the industry, tobacco lobbyists can work behind closed doors. Without this needed transparency, the industry is able to influence policies in its commercial favor without leaving an evidence trail.

Governments must recognize industry influence—and rise above it

The economic and health burdens of NCDs are unsustainable. There is an urgent need for governments around the world to take action to reduce these burdens. This includes protecting policies from the influence of industries that profit from products that cause NCDs. While the Political Declaration to be discussed at the HLM4 contains worthy goals and beneficial actions governments can take, more must be done.

Governments can and should reach further than the recommendations laid out in the Declaration when it comes to reducing tobacco use. The FCTC, for example, provides detailed, proven measures governments can implement to reduce tobacco use and protect its policies from harmful tobacco industry interference. Another useful tool, WHO’s MPOWER measures can help with country-level implementation of FCTC interventions.

To truly tackle the large and complex issue of NCDs, governments must keep the industry out of policymaking and enact strong and specific measures, like those outlined in the FCTC.