Passed a Policy? The Tobacco Industry May Still Try to Interfere

Summary

• The tobacco industry is known to try to interfere in health policy still in development. New research shows the industry also tries to interfere in policy implementation, after the policy has been adopted.
• Researchers identified five key tactics the industry uses to try to interfere in policy implementation: using transition periods to preemptively adapt, disregarding policies, engaging in token implementation, finding work-arounds and using intermediaries to gain influence.
• Examples from around the world suggest the industry may be implementing these tactics to get around smoke-free policies in Pakistan and tobacco advertising, promotion and sponsorship regulations in Viet Nam.

The past two decades have seen enormous progress in tobacco control. Thanks to strong health policies, global tobacco use declined from 33% in 2000 to under 20% in 2024.

These advancements are especially remarkable because they’ve been made despite the tobacco industry’s efforts to sustain the tobacco epidemic.

The industry’s attempts to delay, weaken or block health policy still in development are well documented. Now, evidence is showing that industry efforts to undermine policy continue even after the policy has been adopted.

Here is what researchers found, plus real-world examples collected by Vital Strategies’ Global Implementation Program, which supports governments in effectively implementing and enforcing tobacco control policies.

The tobacco industry tries to derail policy implementation and enforcement

Researchers at the Tobacco Control Research Group at the University of Bath examined industry attempts to influence policy post-adoption. They identified five key tactics:

• Tobacco companies use transition periods to preemptively adapt. For example, they may use the time between a regulation passing and coming into force as an opportunity to stockpile products that are not compliant with the new rules.
• Tobacco companies disregard the policy. They may act as if it were non-binding and may continue as before.
• They engage in token implementation. Companies may take superficial actions, such as adding a graphic health warning as a removable sticker to signal adherence while undermining its effectiveness.
• They find work-arounds. Tobacco companies may change product or package designs or move to less-regulated spaces to circumvent regulations.
• They try to influence implementation through intermediaries. Tobacco companies may provide incentives or industry-favorable interpretations of regulations to retailers, hospitality workers, enforcers or other relevant authorities.

The researchers examined how the industry used these tactics to fight a range of tobacco control measures, including smoke-free policies and bans on tobacco advertising, promotion and sponsorship (TAPS), among others.

The tobacco industry’s efforts to undermine smoke-free policies

Smoke-free policies can result in almost immediate health benefits for a community, and can increase the number of people who quit smoking and reduce the number of people who start.

The researchers found that intermediary-focused interventions were particularly prominent in the literature on smoke-free policies. In other words, the industry tried to influence how others implemented and enforced smoke-free policies. Researchers also noted product-based circumvention, such as promoting the use of heated tobacco products (HTPs) or e-cigarettes in smoke-free areas.

Example from the field

In Pakistan, schools, hospitals, restaurants and many other public places are smoke-free.

The industry’s promotion of HTPs as alternatives to cigarettes, and the industry’s framing of HTPs as “smoke-free” (which is contested among researchers), is an example of product-based circumvention. This tactic risks confusing implementers about whether HTPs are included in smoke-free policies, and thus whether they can be used in smoke-free places. A 2024 study found that 38% of general public survey respondents were unsure about the legality of HTP use.

How the industry tries to skirt marketing bans after adoption

Bans on TAPS—from digital ads to sports sponsorship to point-of-sale marketing and more—protect people from exposure to targeted industry marketing and reduce tobacco use. When implemented effectively, TAPS bans may reduce the odds of smoking by up to 20% and were linked to a 37% reduced risk of people starting to smoke.

The researchers identified channel-based circumvention as a prominent documented tactic in response to TAPS bans. When one advertising avenue closed, the industry would open another. They also found numerous cases of TAPS regulations being disregarded altogether.

Example from the field

In Viet Nam, to limit the scale of point-of-sale tobacco advertising, retailers are allowed to display only one pack, carton or box for any cigarette brand they sell.

However, evidence shows that many tobacco retailers have disregarded this regulation. Research from 2024 showed a high rate of non-compliance, with 40% violating the one-pack/carton/box display limit, increasing the scale of this point-of-sale marketing tactic. Of the surveyed sellers, only 38% knew about the TAPS regulation.

The industry has been documented around the world providing advertisements, displays or guidance that help retailers work around TAPS regulations, and may incentivize them to do so. The high rate of non-compliance around this regulation in Viet Nam raises questions about the industry’s potential influence.

What policymakers can learn from these cases

It is important for those who design, implement and enforce health policies to anticipate tobacco industry interference at all stages of policymaking, including post-adoption. The researchers highlight five ways governments can help protect policies:

1. Clearly define all components of a new policy, to reduce opportunities for tobacco companies to re-interpret or misrepresent its details.
2. Identify and plan for alternative paths the industry may take to achieve its original objective.
3. Account for the time in between passage of the policy and its entry into force, during which the industry may take actions to undermine or reduce the policy’s intended effect.
4. Communicate policies clearly and directly to enforcement bodies and other implementers, such as those in retail and hospitality, to reduce the risk of the industry misrepresenting the policies and how they must be implemented.
5. Stay abreast of industry activity and identify new trends in interference.

The passage of a health policy doesn’t necessarily mean it’s safe from industry interference. These recommendations can help governments anticipate and respond to interference, strengthening policy implementation and effectiveness.