Addressing the determinants of non-communicable diseases (NCDs) is challenged by aggressive market promotion by tobacco, alcohol and unhealthy food industries in emerging countries with fast economic development; and interference by these industries in government policies aimed at containing consumption of unhealthy products. This editorial reviews market promotion and industry interference and classifies them into four groups of tactics: (a) interfering with the legislative process; (b) using front groups to act on their behalf; (c) questioning the evidence of tobacco harm and the effectiveness of harm-reduction interventions; and (d) appearing responsible in the eyes of the public, journalists and policy-makers. Despite active implementation of the Framework Convention on Tobacco Control (FCTC), the tobacco, alcohol and unhealthy food industries use similar tactics to aggressively interfere in policies, with the tobacco industry being the most aggressive. Policy interference by industries are effective in the context of poor governance, rampant corruption, conflict of interest among political and government actors, and regulatory capture in all levels of countries from low- to high-income. In addressing these interferences, government requires the practice of good governance, effective mechanisms to counteract conflict of interests among political and policy actors, and prevention of regulatory capture. The World Health Organization (WHO) Framework of Engagement with non-State Actors can be applied to the country context when engaging private entities in the prevention and control of NCDs.
Commentaries Published on this Paper
“Big” Food, Tobacco, and Alcohol: Reducing Industry Influence on Noncommunicable Disease Prevention Laws and Policies; Comment on “Addressing NCDs: Challenges From Industry Market Promotion and Interferences”
Addressing NCDs: Penetration of the Producers of Hazardous Products into Global Health Environment Requires a Strong Response; Comment on “Addressing NCDs: Challenges From Industry Market Promotion and Interferences”
Shaffer ER, Brenner JE. International trade agreements: hazards to health? Int J Health Serv. 2004;34(3):467-481. doi:10.2190/fb79-g25u-dwgk-c3qk
World Health Assembly 2006. World Health Assembly Resolution WHA59.26 International trade and health. https://bit.ly/2B4rq1C. Accessed November 17, 2018.
World Health Organization (WHO). International trade and health, Report by the Secretariat. https://bit.ly/2mcOGCh. Accessed July 10, 2018. Published 2005.
Alcohol use and burden for 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2018;392(10152):1015-1035. doi:10.1016/s0140-6736(18)31310-2
World Health Organization (WHO). Tackling NCDs: 'best buys' and other recommended interventions for the prevention and control of noncommunicable diseases. WHO; 2017.
Noar SM, Francis DB, Bridges C, Sontag JM, Brewer NT, Ribisl KM. Effects of Strengthening Cigarette Pack Warnings on Attention and Message Processing: A Systematic Review. Journal Mass Commun Q. 2017;94(2):416-442. doi:10.1177/1077699016674188
Fong GT, Hammond D, Hitchman SC. The impact of pictures on the effectiveness of tobacco warnings. Bull World Health Organ. 2009;87(8):640-643. doi:10.2471/BLT.09.069575
de Ruyter JC, Olthof MR, Seidell JC, Katan MB. A trial of sugar-free or sugar-sweetened beverages and body weight in children. N Engl J Med. 2012;367(15):1397-1406. doi:10.1056/NEJMoa1203034
Cabrera Escobar MA, Veerman JL, Tollman SM, Bertram MY, Hofman KJ. Evidence that a tax on sugar sweetened beverages reduces the obesity rate: a meta-analysis. BMC Public Health. 2013;13:1072. doi:10.1186/1471-2458-13-1072
Lal A, Mantilla-Herrera AM, Veerman L, et al. Modelled health benefits of a sugar-sweetened beverage tax across different socioeconomic groups in Australia: A cost-effectiveness and equity analysis. PLoS Med. 2017;14(6):e1002326. doi:10.1371/journal.pmed.1002326
Silver LD, Ng SW, Ryan-Ibarra S, et al. Changes in prices, sales, consumer spending, and beverage consumption one year after a tax on sugar-sweetened beverages in Berkeley, California, US: A before-and-after study. PLoS Med. 2017;14(4):e1002283. doi:10.1371/journal.pmed.1002283
Gortmaker SL, Wang YC, Long MW, et al. Three Interventions That Reduce Childhood Obesity Are Projected To Save More Than They Cost To Implement. Health Aff (Millwood). 2015;34(11):1932-1939. doi:10.1377/hlthaff.2015.0631
The Statistic Portal. Cigarette market share worldwide as of 2017, by company. https://bit.ly/2QHuJ4f. Accessed November 17, 2018. Published 2018.
British American Tobacco. The global market, trends affecting our industry. https://bit.ly/2wlye6p. Accessed November 17, 2018. Published 2018.
Allied Market Research. Alcoholic Beverages Market Overview. https://bit.ly/2K4sXY6. Accessed November 17, 2018. Published 2017.
Prescient & Strategic Intelligence. Global Alcoholic Drinks Market (Size of $1,199 Billion in 2014) to Witness 3% CAGR during 2015 – 2020. 2015. https://bit.ly/2B4wPpo. Accessed November 17, 2018.
Canadean. Global Beverage Forecasts, March 2016: Comprehensive Topline Analysis of All Commercial Beverages Trends and Forecasts. Statistics on Alcohol Market in Asia. London: Canadean; 2016.
Jiang H, Xiang X, Waleewong O, Room R. Alcohol marketing and youth drinking in Asia. Addiction. 2017;112(8):1508-1509. doi:10.1111/add.13835
Jernigan D, Noel J, Landon J, Thornton N, Lobstein T. Alcohol marketing and youth alcohol consumption: a systematic review of longitudinal studies published since 2008. Addiction. 2017;112 Suppl 1:7-20. doi:10.1111/add.13591
Market Research Report. Carbonated Soft Drinks Market Size, Share & Trends Analysis Report by Distribution Channel, Competitive Landscape, By Region, And Segment Forecasts, 2018 – 2025. https://bit.ly/2FmlEN1. Accessed November 17, 2018. Published 2018.
Malik VS, Schulze MB, Hu FB. Intake of sugar-sweetened beverages and weight gain: a systematic review. Am J Clin Nutr. 2006;84(2):274-288. doi:10.1093/ajcn/84.1.274
Papandreou D, Andreou E, Heraclides A, Rousso I. Is beverage intake related to overweight and obesity in school children? Hippokratia. 2013;17(1):42-46.
Uzunov I. Top consumer trends in Asia’s emerging markets. Bluenotes website. https://bit.ly/2qP9fqJ. Accessed November 17, 2018. Published February 20, 2018.
O'Dowd A. Spending on junk food advertising is nearly 30 times what government spends on promoting healthy eating. BMJ. 2017;359:j4677. doi:10.1136/bmj.j4677
Baker P, Smith J, Salmon L, et al. Global trends and patterns of commercial milk-based formula sales: is an unprecedented infant and young child feeding transition underway? Public Health Nutr. 2016;19(14):2540-2550. doi:10.1017/s1368980016001117
Rollins NC, Bhandari N, Hajeebhoy N, et al. Why invest, and what it will take to improve breastfeeding practices? Lancet. 2016;387(10017):491-504. doi:10.1016/s0140-6736(15)01044-2
Saloojee Y, Dagli E. Tobacco industry tactics for resisting public policy on health. Bull World Health Organ. 2000;78(7):902-910.
Rosenberg NJ, Siegel M. Use of corporate sponsorship as a tobacco marketing tool: a review of tobacco industry sponsorship in the USA, 1995-99. Tob Control. 2001;10(3):239-246.
Chapman S, Carter SM. "Avoid health warnings on all tobacco products for just as long as we can": a history of Australian tobacco industry efforts to avoid, delay and dilute health warnings on cigarettes. Tob Control. 2003;12 Suppl 3:iii13-iii22.
Martino FP, Miller PG, Coomber K, Hancock L, Kypri K. Analysis of Alcohol Industry Submissions against Marketing Regulation. PLoS One. 2017;12(1):e0170366. doi:10.1371/journal.pone.0170366
Mialon M, Swinburn B, Wate J, Tukana I, Sacks G. Analysis of the corporate political activity of major food industry actors in Fiji. Global Health. 2016;12(1):18. doi:10.1186/s12992-016-0158-8
Tobacco industry challenges Thai government. DW. October 14, 2013. https://bit.ly/2LjVtVe. Accessed June 1, 2018.
Cooper C. Tobacco companies file lawsuits against UK Government over plain packaging laws. Independent. May 22, 2015. https://Ind.Pn/2j7qilh. Accessed June 1, 2018.
Smith CN, Kraemer JD, Johnson AC, Mays D. Plain packaging of cigarettes: do we have sufficient evidence? Risk Manag Healthc Policy. 2015;8:21-30. doi:10.2147/rmhp.s63042
Boseley S. Threats, bullying, lawsuits: tobacco industry's dirty war for the African market. The GuardianWeekly. 2017. https://bit.ly/2uh1T2U. Accessed July 9, 2018.
Stead M, Eadie D, Purves RI, Moodie C, Haw S. Tobacco companies' use of retailer incentives after a ban on point-of-sale tobacco displays in Scotland. Tob Control. 2018;27(4):414-419. doi:10.1136/tobaccocontrol-2017-053724
Framework Convention Alliance. COP8 Policy Briefing: Participation of Public and Media at Sessions of the FCTC COP. Framework Convention Alliance website. https://bit.ly/2z8kmiP. Accessed November 17, 2018. Published 2018.
World Health Organization (WHO). Guidelines for implementation of article 6 of the WHO FCTC; price and tax measures to reduce the demand for tobacco. Geneva: WHO; 2014. https://bit.ly/2DEQw9H. Accessed November 17, 2018.
NIH to end funding for Moderate Alcohol and Cardiovascular Health trial. National Institutes of Health (NIH) website. https://bit.ly/2lhBo77. Accessed November 17, 2018. Published June 15, 2018.
McCambridge J, Mialon M, Hawkins B. Alcohol industry involvement in policymaking: a systematic review. Addiction. 2018. doi:10.1111/add.14216
McCambridge J, Hawkins B, Holden C. Industry use of evidence to influence alcohol policy: a case study of submissions to the 2008 Scottish government consultation. PLoS Med. 2013;10(4):e1001431. doi:10.1371/journal.pmed.1001431
McCambridge J, Mialon M. Alcohol industry involvement in science: A systematic review of the perspectives of the alcohol research community. Drug Alcohol Rev. 2018;37(5):565-579. doi:10.1111/dar.12826
Jernigan DH. Global alcohol producers, science, and policy: the case of the International Center for Alcohol Policies. Am J Public Health. 2012;102(1):80-89. doi:10.2105/ajph.2011.300269
USDA Foreign Agriculture Service. Thai Excise Department Implements New Sugar Tax on Beverages. Global Agricultural Information Network; 2017. https://bit.ly/2zCbFfz. Accessed July 10, 2018.
The Nation. Thailand one of many countries waging war on sugar via a tax on sweetened soft drinks. Nation Newspaper. 2016. https://bit.ly/2uuBaOe. Accessed July 10, 2018.
Szabo L. Soda industry steals page from tobacco to combat taxes on sugary drinks. NBC News. November 6, 2018. https://nbcnews.to/2Dcx1V1. Accessed November 17, 2018.
Granheim SI, Engelhardt K, Rundall P, Bialous S, Iellamo A, Margetts B. Interference in public health policy: examples of how the baby food industry uses tobacco industry tactics. World Nutrition. 2017;8(2):288-310. doi:10.26596/wn.201782288-310
World Health Organization (WHO). Tobacco industry interference in the WHO European Region. Copenhagen: WHO European Regional Office; 2012.
American Public Health Association (APHA). Ensuring That Trade Agreements Promote Public Health (Policy Number: 201512). https://bit.ly/2dMd6yX. Accessed July 10, 2018. Published 2015.
Millstone E, Lang T. Risking regulatory capture at the UK's Food Standards Agency? Lancet. 2008;372(9633):94-95. doi:10.1016/s0140-6736(08)61012-0
Hatchard JL, Fooks GJ, Gilmore AB. Standardised tobacco packaging: a health policy case study of corporate conflict expansion and adaptation. BMJ Open. 2016;6(10):e012634. doi:10.1136/bmjopen-2016-012634
Diethelm PA, Farley TM. Re-analysing tobacco industry funded research on the effect of plain packaging on minors in Australia: Same data but different results. Tob Prev Cessat. 2017;3:130. doi:10.18332/tpc/78508
Egilman DS, Presler AH, Valentin CS. Avoiding the regulatory capture of the Food and Drug Administration. Arch Intern Med. 2007;167(7):732-733. doi:10.1001/archinte.167.7.732-b
Tangcharoensathien, V., Chandrasiri, O., Kunpeuk, W., Markchang, K., & Pangkariya, N. (2019). Addressing NCDs: Challenges From Industry Market Promotion and Interferences. International Journal of Health Policy and Management, 8(5), 256-260. doi: 10.15171/ijhpm.2019.02
Viroj Tangcharoensathien; Orana Chandrasiri; Watinee Kunpeuk; Kamolphat Markchang; Nattanicha Pangkariya. "Addressing NCDs: Challenges From Industry Market Promotion and Interferences". International Journal of Health Policy and Management, 8, 5, 2019, 256-260. doi: 10.15171/ijhpm.2019.02
Tangcharoensathien, V., Chandrasiri, O., Kunpeuk, W., Markchang, K., Pangkariya, N. (2019). 'Addressing NCDs: Challenges From Industry Market Promotion and Interferences', International Journal of Health Policy and Management, 8(5), pp. 256-260. doi: 10.15171/ijhpm.2019.02
Tangcharoensathien, V., Chandrasiri, O., Kunpeuk, W., Markchang, K., Pangkariya, N. Addressing NCDs: Challenges From Industry Market Promotion and Interferences. International Journal of Health Policy and Management, 2019; 8(5): 256-260. doi: 10.15171/ijhpm.2019.02