Industry-sponsored antismoking advertisements in low-income countries
Authors: Onyema Greg Chido-Amajuoyi, Israel Agaku, Chinemerem Onwuliri, Sanjay Shete
Journal: The Lancet Global Health (2020)

Beginning in November, 2017, for the first time in history, the USA's biggest tobacco companies sponsored antismoking advertising campaigns that ran in the USA for an entire year. This unprecedented event was the result of a landmark ruling by US district judge Gladys Kessler, who—having found the tobacco industry guilty of intentionally misleading the general public about the dangers of tobacco—instructed the industry to make corrective statements via widespread advertising campaigns.1District US Court for the District of ColumbiaUnited states and intervenors vs Philip Morris USA, Inc., et al. US district court for the District of Columbia. 2018.https://www.tobaccofreekids.org/assets/content/what_we_do/industry_watch/doj/FinalOpinion.pdfDate accessed: December 12, 2018Google Scholar Despite intensive lobbying efforts by the tobacco industry to sway legislative agenda, Judge Kessler's verdict and the subsequent execution of antismoking advertising campaigns represents further substantial progress in tobacco control in the USA. However, this progress is in vast contrast to other regions of the world, especially low-income and middle-income countries, where about 80% of the worldwide smoking population live. In an assessment of the penetration of the tobacco-industry-sponsored advertising campaign, a study found that only 40% of the US adult population was reached.2Chido-Amajuoyi OG Yu RK Agaku I Shete S Exposure to court-ordered tobacco industry antismoking advertisements among US adults.JAMA Netw Open. 2019; 2: e196935Crossref PubMed Scopus (10) Google Scholar This coverage was considered suboptimal; however, in the poorest countries in the world, with a total absence of antismoking campaigns, 40% corrective advertising coverage would be meaningful. Most low-income countries have consistently failed to implement Article 12 of the WHO Framework Convention on Tobacco Control (FCTC), which encourages member states to "promote and strengthen public awareness of tobacco control issues".3WHOWHO framework convention on tobacco control. 2002.https://www.who.int/tobacco/framework/WHO_FCTC_english.pdfDate accessed: February 5, 2020Google Scholar The 2019 WHO Report on the Global Tobacco Epidemic showed that most countries in Africa were non-compliant with Article 12 of the FCTC, with about 70% of African countries reporting "no national antismoking media campaign conducted in the past 2 years".4WHOWHO report on the global tobacco epidemic, 2019: offer help to quit tobacco use. 2019.https://apps.who.int/iris/bitstream/handle/10665/326043/9789241516204-eng.pdf?ua=1Date accessed: January 6, 2020Google Scholar This finding greatly corresponds to findings of a study in this journal that ranked tobacco mass media among the least implemented WHO non-communicable disease policies globally, with countries in sub-Saharan Africa scoring the lowest implementation scores.5Allen LN Nicholson BD Yeung BYT Goiana-da-Silva F Implementation of non-communicable disease policies: a geopolitical analysis of 151 countries.Lancet Glob Health. 2020; 8: e50-e58Summary Full Text Full Text PDF PubMed Scopus (50) Google Scholar Although Judge Kessler's ruling is arguably one of the finest moments in US tobacco control history, its potential to establish similar precedents in other region is great and carries immense implications for global tobacco control. Even though the tobacco industry's illicit practices have been applied globally, and sometimes even more aggressively in low-income countries, Judge Kessler's ruling has no jurisdiction beyond the shores of the USA. Yet, in light of the industry's guilty verdict in the USA, admittance to wrongdoing, and execution of resultant court-ordered corrective advertising campaigns in the USA, the question is: would the tobacco industry take the initiative to scale similar corrective advertisements in all countries where they operate, particularly in low-income countries that continue to struggle to fund antismoking campaigns? The tobacco industry purports to be invested in the wellbeing of developing countries. In fact, the industry has been involved in several projects that show corporate social responsibility. In September, 2017, Phillip Morris made a commitment to become a key player in the realm of public and global health.6Koh HK Geller AC The Philip Morris International–Funded foundation for a smoke-free world.JAMA. 2018; 320: 131-132Crossref PubMed Scopus (7) Google Scholar By implementing advertisements in low-income countries similar to the US court-ordered corrective advertisements, the tobacco industry could help reduce global disparities in tobacco control and tobacco-related disease burden, as well as abate the financial burden associated with funding such campaigns. As it pertains to low-income countries, the industry should adopt a proactive approach and not wait for local litigations to be a driving factor for corrective action. However, cues from historical practices of the industry should prompt countries to follow the example of judicial actors in the USA. In conclusion, tobacco companies should self-initiate corrective advertisements in low-income countries; however, in light of the industry's unpredictability, bilateral steps must be taken to empower the judiciary in developing nations. The judiciary in all countries must realise its oversight authority over practices of companies within their jurisdiction. This responsibility includes guarding public health from influential entities. Interventions centred on education (eg, adding public health law courses to the curricula of law schools across Africa or creating fellowship programmes for members of African judiciary to learn directly from their counterparts in nations that have been successful at holding the industry accountable) should also be adopted to ensure lower rates of smoking worldwide. We declare no competing interests. Implementation of non-communicable disease policies: a geopolitical analysis of 151 countriesImplementation of WHO-recommended NCD policies is increasing over time. On average, countries implemented just under half of the NCD policies recommended by WHO in 2017. Nutrition-related policies saw gains, while those related to alcohol and physical activity were the most likely to have been dropped. Aggregate implementation scores tended to be highest in high-income countries that invest in health care and education. Full-Text PDF Open Access