Suchergebnisse

Objective: To highlight revelations from internal tobacco industry documents about the conduct of the industry in the Philippines since the 1960s. Areas explored include political corruption, health, employment of consultants, resisting pack labelling, and marketing and advertising.

EXECUTIVE SUMMARY Argentina accounts for 15% of total tobacco consumption in Latin America and has made the epidemiological transition to an advanced stage in the tobacco epidemic. The Southern Cone region of the Americas leads the hemisphere in tobacco attributable mortality. Argentina is a developing country with economic interests in tobacco growing and rapidly increasing tobacco use in urban areas. In 2000, smoking prevalence was 40.4% among adults- 46.8% of men and 34% of women- and Buenos Aires urban youth (13 to 15 years old) had a 30.2% 30-day smoking prevalence (27.8% male; 31.8% female) compared to 17.7% (17.8% male; 17.7% female) in the United States. Argentina also has a high smoking prevalence among health professionals (30.3% of physicians, and 36.3% of nurses currently smoke). Given the limited smoking restrictions in indoor environments the general population is highly exposed to secondhand smoke both in public and private places. In 2000, the percentage of young people aged 13 to 15 years exposed to secondhand smoke in Buenos Aires was 69.6% at home, 87.6%, in public places, and 27.6% from their friends. A multi-country study carried out in seven Latin American cities in 2004 showed that the city of Buenos Aires had the highest airborne nicotine levels inside hospitals, schools, government buildings, airports, and restaurants observed. According to the National Program on Tobacco Control of the Ministry of Health and Environment of Argentina, tobacco use causes 40,000 deaths per year, including 6,000 due to secondhand smoke. The cost of the treatment of tobacco-related diseases is more than 4,330 million pesos per year, which represents 15.5 % of the total public expenditure on health care. Meanwhile, the tobacco excise taxes collected by the government are only 3,500 million pesos per year. The transnational tobacco companies working through their local affiliates dominate production and marketing of cigarettes in Argentina. Philip Morris International and British American Tobacco, as well as other transnational tobacco companies such as Liggett, Reemtsma, Lorillard, and RJ Reynolds International- through their local subsidiaries Massalín-Particulares and Nobleza-Piccardo- have been actively influencing public health policy-making in Argentina since the early 1970s. These transnational tobacco companies have used the same strategies in Argentina as in the United States to block meaningful tobacco control. Methods This report uses three main sources to describe the interference of the tobacco industry in tobacco control efforts in Argentina. First, we examined the tobacco industry documents in the University of California San Francisco Legacy Tobacco Documents Library (http://legacy.library.ucsf.edu) and British American Tobacco Documents Archive (http://bat.library.ucsf.edu) and in Tobacco Documents Online (www.tobaccodocuments.org). We also used internet resources, major Argentinean newspapers (Clarín, La Nación, Página 12, La Prensa), local magazines (Muy Interesante, Revista 23, Somos, Humor, VEA), and the Argentinean National Congress Library for complete texts of the laws, bills and other tobacco control measures. Finally, we conducted face-to-face interviews with congressmen, public health officials, and tobacco control advocates in Buenos Aires during December 2003. Results • In 1966, the first bill on tobacco regulation was introduced in the Argentinean Congress to adopt a mandatory warning label on cigarette packs, but did not pass. In 1970 the government promulgated Law 18.604 that ended cigarette advertising on radio, television, and in movie theaters, and established fines for violators. This law was in effect only for one year. • In 1973 and 1974, two bills were introduced that would have placed a health warning label on tobacco products and advertisements, but these bills were not approved due to the intervention of the Cámara de la Industria del Tabaco (Chamber of Tobacco Industry), the tobacco industry's national manufacturers' association. • In 1977, as in the USA and other countries, the Chamber of Tobacco Industry created a weak and ineffective voluntary self-regulating code to avoid strong legislated restrictions on cigarette advertising. • In 1976 and 1979, the Ministry of Social Welfare drafted two bills to regulate the content of tobacco and alcohol advertisements and to require a warning label on cigarette packages. Tobacco Industry representatives lobbied government officials claiming that the established voluntary industry code was adequate and both bills died. • In the early 1980s, the Chamber of Tobacco Industry created the "Smoking Controversy Department" to counteract and undermine potential legislation. This department organized "Information Seminars" intended for selective community groups to promote the industry's position that the causal links between smoking and disease had not been proven. Seminars were aimed at the managers of tobacco production associations, agricultural technicians, physicians, scientists, journalists, tobacco advertising agencies, tobacco products distributors, elected officials, and Ministers of Health. The Smoking Controversy Department also produced and promoted literature arguing the industry's position. • During the 1980s, efforts to pass comprehensive tobacco control legislation intensified. These attempts were neutralized by a much better-organized tobacco industry that implemented a public campaign to lobby health authorities and convince journalists and the public that there was a "controversy" about the links between smoking and disease. • In 1986, the National Congress passed Law 23.344 that essentially codified the tobacco industry's ineffective voluntary advertising code and placed the weak health warning label "Fumar es perjudicial para la Salud" (Smoking is harmful to health) print on cigarette packs. Industry representatives had meetings with selected influential federal and provincial ministers, governors, and federal senators to water down the original proposal introduced by Representative Lorenzo Pepe in 1984. • In 1992, the 8th World Conference on Tobacco or Health was held in Buenos Aires. Local tobacco control advocates tried to push for the approval of a new comprehensive tobacco control bill in the Congress introduced by Representative Aldo Neri in 1990. At the same time, Philip Morris International and British American Tobacco worked together to divert the attention of the conference by organizing briefings with friendly journalists to create controversy about secondhand smoke. • In September 1992, the Neri Bill was approved in the Congress. The tobacco industry rapidly organized and orchestrated a major lobbying and public relations campaign to defeat it with the help of front groups (e.g., the International Advertising Association, the Inter-American Press Association, the Inter-American Society for Freedom of Commercial Speech, and the Argentine Association of Advertising Agencies), "scientific" consultants secretly hired and managed by industry lawyers based in the US, and Congressmen from the tobacco growing provinces. Ten days later, on October 10, President Carlos Menem vetoed the law. • Between 1992 and 2000, the tobacco industry supported alternative legislation to write the industry's ineffective voluntary marketing code into law. Even though they were not approved, these bills distracted political and public attention so that all efforts at meaningful tobacco control legislation were neutralized. • Since the mid-1990s, the tobacco industry has been promoting its "accommodation" program "La Cortesía de Elegir" (The Courtesy of Choice), to avoid legislation to end secondhand smoke exposure in restaurants and bars and to maintain the social acceptability of smoking. • Since 1997, the tobacco industry has been promoting ineffective "youth smoking prevention" programs (such as "Yo Tengo P.O.D.E.R." [I Have Power] and "Yo NO Vendo Cigarrillos a Menores de 18 Años" [I DO NOT Sell Cigarettes to Minors under 18]) to preempt meaningful anti-tobacco education by the government and to shift the focus away from the industry's responsibility for increasing youth smoking through its advertising and marketing. • In 2003, the Lower House Public Health Committee drafted a version that consolidated 18 tobacco control bills (including one from Representative Neri) but again, the tobacco industry succeeded in burying the bills. • In September 2003, President Néstor Kirchner signed the Framework Convention on Tobacco Control, the first international public health treaty negotiated by the 192 countries under the auspices of the World Health Organization. The ratification process in the Argentinean Senate remained bogged down as of September 2005, with limited efforts to ratify it. It appears that the industry is effectively lobbying Argentinean legislators not to ratify the treaty. • In August 2005, the Ministry of Health and Environment introduced in the Senate a new comprehensive tobacco control bill that follows the minimum standards required by the Framework Convention on Tobacco Control, including the creation of smokefree public places (including bars and restaurants) and workplaces, the end of all types of tobacco advertising (except point-of-sale) and sponsorship, and the placement of rotating health warning labels and images in cigarette packages. It also bans misleading descriptors (such as "light") and requires the placement of maximum levels of nicotine and tar print on packages. Recommendations 1. The journalists from print and electronic media, public health advocates, politicians and institutional leaders need to become more aware of how the transnational tobacco industry has manipulated and influenced policy making in Argentina, which affects the health of the public, and report this information to the public. 2. The national government, through the Ministry of Health and Environment, should implement a comprehensive educational campaign to enhance awareness about the health dangers of secondhand smoke and to promote the enactment of city-wide, provincial and national ordinances that prohibit indoor exposure to secondhand smoke. 3. Argentina should implement the principal provisions of the Framework Convention such as increased taxes, a complete advertising ban, and graphic pictorial warning labels on cigarette packages. 4. The federal government and health care industry need to support effective smoking cessation services, such as quit-lines, at minimal cost to all smokers. RESUMEN Argentina representa el 15% del consumo total de tabaco en América Latina y se encuentra en una fase avanzada de la transición epidemiológica en la epidemia del tabaquismo. La región del Cono Sur de las Américas lidera el hemisferio en mortalidad atribuible por tabaco. Argentina es un país en desarrollo con intereses económicos en el cultivo de tabaco y un alto consumo de tabaco en áreas urbanas. En 2000, la prevalencia del consumo de tabaco en adultos fue del 40.4% (46.8% en varones; 34% en mujeres). El mismo año, la prevalencia del consumo de tabaco en los últimos 30 días, en jóvenes de 13 a 15 años de la ciudad de Buenos Aires, fue del 30.2% (27.8 % en varones; 31.8% en mujeres) comparada con 17.7% (17.8% en varones; 17.7% en mujeres) en los Estados Unidos. Argentina posee también una alta prevalencia de consumo de tabaco entre los profesionales de la salud (30% de los médicos y 36.6% de los enfermeros actualmente fuman). Debido a las escasas restricciones al consumo de tabaco en ambientes cerrados, la población general está altamente expuesta al huno de tabaco ajeno, tanto en lugares públicos como en privados. En 2000, el porcentaje de jóvenes de 13 a 15 años expuestos al humo de tabaco ajeno en Buenos Aires, fue del 69,6% en sus casas, 87,6% en lugares públicos y 27,6% de sus amigos. Un estudio multicéntrico llevado a cabo en siete ciudades latinoamericanas en 2004, mostró que la ciudad de Buenos Aires tenía la mayor concentración de nicotina ambiental en hospitales, escuelas, edificios gubernamentales, aeropuertos y restaurantes observados. De acuerdo al Programa Nacional de Control del Tabaco del Ministerio de Salud y Ambiente de la Argentina, el uso de tabaco causa 40.000 muertes anuales, incluyendo 6.000 debido a la exposición al humo de tabaco ajeno. El costo del tratamiento de la enfermedades relacionadas al tabaco es de más de 4.330 millones de pesos por año, el cual representa el 15,5% del gasto público total en salud. Mientras tanto, los impuestos al tabaco recaudados por el gobierno son sólo 3.500 millones de pesos al año. Las compañías transnacionales de tabaco, trabajando a través de sus filiales locales, dominan la producción y la comercialización de los cigarrillos en la Argentina. Philip Morris International y British American Tobacco, así como otras compañías transnacionales de tabaco tales como Liggett, Reemtsma, Lorillard y RJ Reynolds International, a través de sus subsidiarias locales Massalín-Particulares y Nobleza-Piccardo, han influenciando activamente las políticas de salud pública en Argentina desde comienzo de los años 1970s. Estas compañías transnacionales de tabaco han utilizado las mismas estrategias en Argentina que en Estados Unidos para bloquear políticas de control del tabaco significativas. Métodos El siguiente reporte utiliza tres fuentes principales para describir la interferencia de la industria del tabaco en los esfuerzos por controlar el tabaco en Argentina. Primero, examinamos los documentos de la industria del tabaco que se encuentran disponibles en la internet en las bibliotecas Legacy Tobacco Documents Library (http://legacy.library.ucsf.edu) y British American Tobacco Documents Archive (http://bat.library.ucsf.edu) de la Universidad de California en San Francisco, y en Tobacco Documents Online (www.tobaccodocuments.org). También utilizamos otras fuentes de información de la internet, los principales periódicos argentinos (Clarín, La Nación, Página 12, La Prensa), revistas locales (Muy Interesante, Revista 23, Somos, Humor, VEA), y la Biblioteca del Congreso de la Nación de la Argentina para ubicar y analizar los textos completos de leyes, proyectos de ley, y otras medidas de control del tabaco. Finalmente, en diciembre de 2003, realizamos entrevistas cara a cara en la ciudad de Buenos Aires, con legisladores, funcionarios de salud pública y activistas para el control del tabaco. Resultados • En 1966 fue introducido en el Congreso Nacional argentino el primer proyecto de ley para la regulación del tabaco. El proyecto, que no fue aprobado, requería la colocación obligatoria de una etiqueta de advertencia sanitaria en todos los paquetes de cigarrillos. En 1970, el gobierno promulgó la Ley 18.604 que ponía fin a la publicidad de los cigarrillos en la radio, la televisión y los cines, y establecía multas para los infractores. Sin embargo, esta ley estuvo en vigencia sólo durante un año. • En 1973 y 1974 dos proyectos de ley ingresados en el Congreso Nacional requerían la colocación de una etiqueta de advertencia sanitaria en los envases de los productos de tabaco y en su publicidad. Sin embargo, estos proyectos no fueron aprobados debido a la intervención de la Cámara de la Industria del Tabaco, la asociación nacional de productores de la industria del tabaco. • En 1977, de la misma manera que en los Estados Unidos y otros países del mundo, la Cámara de la Industria del Tabaco creó voluntariamente un Código de Autorregulación Publicitaria débil e inefectivo para evitar la aprobación de legislación que contemplara fuertes restricciones a la publicidad del tabaco. • En 1976 y 1979 el Ministerio de Bienestar Social de la Nación preparó dos proyectos de ley para regular el contenido de la publicidad del tabaco y el alcohol y para requerir una etiqueta de advertencia sanitaria en los paquetes de cigarrillos. Representantes de la industria del tabaco ejercieron presión política sobre funcionarios del gobierno reclamando que el ya voluntariamente establecido Código de Autorregulación Publicitaria de la industria era suficiente. Finalmente, ambos proyectos fueron archivados. • A principios de los años 1980s la Cámara de la Industria del Tabaco creó el "Departamento sobre la Controversia del Tabaco" como una herramienta para contrarrestar y menoscabar una posible futura legislación anti-tabaco. Este departmento organizó "Seminarios de Información" dirigidos a grupos específicos de la comunidad para promocionar la posición de la industria por la cual la relación causal entre tabaco y enfermedad no estaba comprobada. Los seminarios estuvieron dirigidos a gerentes de asociaciones de productores de tabaco, técnicos agricultures, médicos, científicos, periodistas, agencias de publicidad del tabaco, distribuidores de productos del tabaco, Ministros de Salud y otros funcionarios gubernamentales. El "Departamento sobre la Controversia del Tabaco" también editó y promocionó publicaciones exponiendo la posición de la industria del tabaco. • Durante los años 1980s se intensificaron los esfuerzos para aprobar una legislación amplia para el control del tabaco. Estos intentos fueron neutralizados por una industria del tabaco mucho mejor organizada que orquestó una campaña pública para ejercer presión sobre las autoridades de salud, y convencer a periodistas y al público en general sobre lo que la industria llamó la "controversia" sobre tabaco y salud. • En 1986 el Congreso Nacional aprobó la Ley 23.344 que esencialmente codificó el inefectivo y voluntario Código de Autorregulación Publicitaria de la industria del tabaco y requirió la colocación de la débil etiqueta de advertencia sanitaria "Fumar es perjudicial para la Salud" en los paquetes de cigarrillos. Representantes de la industria del tabaco tuvieron reuniones con influyentes ministros nacionales y provinciales, gobernadores y senadores nacionales para "suavizar" el proyecto de ley original introducido en 1984 por el Diputado Nacional Lorenzo Pepe. • En 1992 la 8va Conferencia Mundial sobre Tabaco o Salud se llevó a cabo en la ciudad de Buenos Aires. Activistas locales para el control del tabaco intentaron presionar para la aprobación en el Congreso de una ley amplia la cual había sido introducida en 1990 por el Diputado Nacional Aldo Neri. Al mismo tiempo, Philip Morris International y British American Tobacco trabajaron juntas para desviar la atención de la conferencia, organizando sesiones informativas con periodistas "amigos" para crear controversia sobre los efectos de la exposición pasiva al humo de tabaco. • El 30 de septiembre de 1992, la Ley Neri fue aprobada en el Congreso Nacional. Sin embargo, la industria del tabaco rápidamente organizó y orquestó un exitoso plan para derrotarla con la ayuda de grupos de fachada (por ej. la Asociación Internacional de Publicidad, la Asociación de Prensa InterAmericana, la Sociedad InterAmericana para la Libertad de Expresión Comercial, y la Asociación Argentina de Agencias de Publicidad), consultores "científicos" contratados y orientados por la industria y legisladores de las provincias tabacaleras, y montó una gran campaña de relaciones públicas y de presión política. Diez días más tarde, el 10 de octubre, la ley fue vetada por el Presidente Carlos Menem. • Entre 1992 y 2000, la industria del tabaco apoyó proyectos de ley "alternativos" que estaban en consonancia con su Código de Autorregulación Publicitaria. A pesar de no haber sido aprobados, estos proyectos sirvieron para distraer la atención política y pública y de esa manera, todos los esfuerzos para el control del tabaco fueron neutralizados. • Desde mediados de los años 1990s la industria del tabaco ha estado promoviendo su programa de "acomodación" conocido como "La Cortesía de Elegir" o "Convivencia en Armonía", para evitar legislación que ponga fin a la exposición pasiva al humo de tabaco ajeno en restaurantes y bares, y para mantener la aceptación social del consumo de tabaco. • Desde 1997 la industria del tabaco ha estado promoviendo programas de "prevención del uso de tabaco en jóvenes" inefectivos (tales como "Yo Tengo P.O.D.E.R." y "Yo NO Vendo Cigarrillos a Menores de 18 Años") para evitar campañas educativas anti-tabaco por parte del gobierno y para desplazar el foco de atanción por la responsabilidad que la industria tiene, a través de la publicidad y comercialización de sus productos, en el incremento del uso de tabaco entre los jóvenes. • En 2003, la Comisión de Acción Social y Salud Pública de la Cámara de Diputados de la Nación escribió un Dictamen Final que consolidaba 18 proyectos de ley para el control del tabaco (uno de ellos del Diputado Aldo Neri) pero una vez más, la industria del tabaco tuvo éxito en cajonear los mismos. • En septiembre de 2003, el Presidente Néstor Kirchner firmó el Convenio Marco para el Control del Tabaco, el primer tratado internacional sobre salud pública negociado por 192 países bajo los auspicios de la Organización Mundial de la Salud. Al mes de septiembre de 2005, el proceso de ratificación en el Senado argentino permanece estancado con pocos esfuerzos para ratificarlo. En vista de los acontecimientos pasados parecería que la industria ha estado ejerciendo presión exitosamente sobre los lesgisladores argentinos para que no ratifiquen el convenio. • En agosto de 2005, el Ministerio de Salud y Medio Ambiente introdujo en el Senado de la Nación un nuevo proyecto de ley amplio para el control del tabaco que está en sintonía con los estándares mínimos requeridos por el Convenio Marco para el Control del Tabaco. El proyecto contempla la creación de ambientes públicos y lugares de trabajo libres de humo de tabaco (incluyendo bares y restaurantes), la prohibición de la publicidad (excepto en los lugares de venta) y el patrocinio y la colocación de etiquetas de advertencias sanitarias rotatorias con imágenes, en los paquetes de cigarrillos. También prohibe la colocación de descriptores engañosos (tales como "suaves") y requiere los niveles máximos de nicotina y alquitrán impresos en los en los envases de tabaco. Recomendaciones 1. Periodistas tanto de los medios gráficos como electrónicos, activistas de la salud pública y líderes institucionales, deberían tomar conocimiento sobre como las compañías transnacionales del tabaco han manipulado e influenciado las políticas de control del tabaco en la Argentina lo cual afecta la salud de la población, y comunicar esta infomación a la población general. 2. El gobierno nacional, a través del Ministerio de Salud y Ambiente, debería implementar una amplia campaña educativa para aumentar la conciencia sobre los daños a la salud provocados por la exposicion pasiva al humo de tabaco ajeno, y promover la aprobación de legislación local, provincial y nacional que impida la exposicion pasiva al humo de tabaco ajeno en lugares cerrados. 3. Argentina debería implementar los estándares principales del Convenio Marco para el Control del Tabaco, tales como el aumento de los impuestos al tabaco, la prohibición total de la publicidad, y la colocación de etiquetas de advertencia sanitarias con imágenes en los paquetes de cigarrillos. 4. El gobierno nacional y el sector privado de la atención de la salud deben apoyar servicios de cesación tabáquica efectivos, tales como las líneas telefónicas de ayuda para dejar de fumar, a un bajo costo para todos los fumadores.

AbstractIn recent years, tobacco research has become an increasingly politicized field, with 'legitimate' research on this topic expected to further the goals of tobacco control. This paper presents an overview of the state of field of social science studies on tobacco and critiques the growing polarity evident in scholarship on this topic. Moving beyond mainstream public health perspectives, I outline a body of research that challenges dominant understandings of tobacco use and tobacco control. This research can be classified into three main categories: studies that interrogate conceptions of why people smoke, those that examine the impacts of tobacco control policy on smokers, and studies embracing intellectual and philosophical perspectives (especially phenomenology and social constructionism) that place them outside of a public health frame. I end with a broader discussion of the growing instrumentalization of social science research and the need to resist prescriptions that seek to dictate the appropriate form and content of scholarly work.

For centuries before Europeans came to the New World, tobacco had an important role in the religious and social life of the early peoples of Kentucky. W.F. Axton describes the various forms in which tobacco has been used, its quick adoption by the Old World, and its gradual development into the forms common today, especially the blended cigarette. Little has been written about the place occupied by Burley leaf in the economic life of the Commonwealth, where tobacco is still the most important crop. Tobacco in Kentucky is accompanied by charts and maps illustrating the many aspects of tobacco

The tobacco industry successfully blocked or displaced strong tobacco control legislation in Costa Rica for nearly 40 years using similar strategies used in the U.S. and the rest of the world, until the country successfully passed a strong tobacco control law in March 2012. During the 1970s and 1980s, the tobacco companies displaced strong tobacco control legislation on tobacco advertising by endorsing weaker executive decrees. In response to increased tobacco control pressure, the industry successfully weakened the 1995 law by secretly hiring scientific consultants to counter the SHS threat and using the hospitality industry to rollout the Courtesy of Choice program in Costa Rica (then Latin America). Tobacco companies then used Costa Rica as a model to rollout industry youth smoking prevention programs and corporate social responsibility campaigns throughout Latin America and the Caribbean. The industry continued its dominance in Costa Rica during the 2000s by developing a cooperative relationship with the Ministry of Health. Although theNational Anti-Tobacco Network(RENATA), a new coalition ofgovernmental health institutions and nongovernmental tobacco control associationsformed in 2007, generated enough public pressure on Legislative Assembly to ratify the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) in 2008 and secure Bill 17.371's introduction in 2009 to implement the treaty, the industry once again worked through the Ministry of Health to delay the bill's passage. However, RENATA's abilityto alert the media and mobilize a coalition of international health advocates to effectivelyinform lawmakers on the importance of the FCTCbetween 2010 and 2012 helped pass a strong tobacco control law in March 2012.

The high levels of smoking in Ireland require a more concerted effort to support the continued development of a tobacco free society where people can live longer and healthier lives free from the detrimental effects of tobacco. The direction given in this policy report seeks to de-normalise tobacco within Irish society, reduce initiation rates, assist smokers to quit, protect non-smokers, especially children, from the effects of second-hand smoke, by building on a stable policy and legislative framework. These measures will be achieved within existing resources. Click here to download Tobacco Free Ireland PDF 911KB

Legislation to control tobacco use in developing countries has lagged behind the dramatic rise in tobacco consumption. India, the third largest grower of tobacco in the world, amassed 1.7 million disability-adjusted life years (DALYs) in 1990 due to disease and injury attributable to tobacco use in a population where 65% of the men and 38% of the women consume tobacco. India's anti-tobacco legislation, first passed at the national level in 1975, was largely limited to health warnings and proved to be insufficient. In the last decade state legislation has increasingly been used but has lacked uniformity and the multipronged strategies necessary to control demand. A new piece of national legislation, proposed in 2001, represents an advance. It includes the following key demand reduction measures: outlawing smoking in public places; forbidding sale of tobacco to minors; requiring more prominent health warning labels; and banning advertising at sports and cultural events. Despite these measures, the new legislation will not be enough to control the demand for tobacco products in India. The Indian Government must also introduce policies to raise taxes, control smuggling, close advertising loopholes, and create adequate provisions for the enforcement of tobacco control laws.

This report examines the proposed global standards for tobacco marketing and assesses whether it will lead to the responsible marketing of tobacco products. It concludes that the proposed measures will not lead to any substantive changes in current tobacco advertising practices and will not protect children from tobacco marketing. The report recommends that governments should reject the industry's overtures, and instead rapidly implement past World Health Assembly resolutions on tobacco marketing and ensure that the Framework Convention on Tobacco Control (FCTC) incorporates scientifically sound measures based on international best practice to protect the health of all – young and old, smokers and non-smokers.

Sri Lanka ratified the Framework Convention on Tobacco Control in 2003 and implemented some comprehensive tobacco control policies. From June 1, 2015, health warnings on cigarette packages in Sri Lanka have to cover 80 percent of the large sides. In 2005-2006, about 38.0 percent of men and less than 1 percent of women were current tobacco smokers in Sri Lanka. The prevalence smoking among men was about 40 percent in 2005-2006 and decreased to about 32 percent in 2009-2014. The volumes of cigarette production in Sri Lanka were fairly steady at the level of 5.2 billion sticks in the late 1990s, and then the production gradually decreased to about 4 billion cigarettes in 2013-2016. The government has the power to change excise tax rates several times a year. The taxation system used for cigarettes is 5-tier specific. In 2005-2015, excise rates for most tiers were increased by more than 300 percent; however, the inflation rate for those eleven years combined was 260 percent; so, real cigarette prices did not change much. In late 2014, the VAT liability on cigarettes was temporarily removed. For two years, excise was the only tax levied on cigarettes in Sri Lanka. While the excise rates were increased in 2014, the overall tax burden almost did not change. Such a shift between VAT and excise tax was the main factor of the excise revenue increase by 40 percent in 2015 as excise revenue mainly replaced VAT revenue. The largest changes in cigarette taxation in Sri Lanka took place in October-November 2016: (1) Excise rates were increased by 26-28 percent for two higher tiers, by 37-40 percent for two middle ties, and by 67 percent for the lowest tier; (2) The VAT rate was increased from 12 percent to 15 percent, and cigarettes were again made liable for VAT. However, after the increase in cigarette tax burden in late 2016, in the first four months of 2017, the excise revenue from cigarettes and tobacco products declined by 17 percent, and cigarette production decreased by 31 percent. The VAT-excise reverse shift was the main factor of excise revenue reduction in early 2017. The VAT revenue increased, and its increase was larger than the reduction in the excise revenue. Another factor of revenue decline in early 2017 was forestalling: tobacco industry overproduced cigarettes to pay taxes before tax increases. Another factor behind cigarette sales reduction in Sri Lanka was the pricing policy of the tobacco industry.