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Abstract According to the Centers for Disease Control and Prevention, about 45 million Americans continue to smoke, even after one of the most intense public health campaigns in history, now over 40 years old. Each year some 438,000 smokers die from smoking-related diseases, including lung and other cancers, cardiovascular disorders and pulmonary diseases. Many smokers are unable – or at least unwilling – to achieve cessation through complete nicotine and tobacco abstinence; they continue smoking despite the very real and obvious adverse health consequences. Conventional smoking cessation policies and programs generally present smokers with two unpleasant alternatives: quit, or die. A third approach to smoking cessation, tobacco harm reduction, involves the use of alternative sources of nicotine, including modern smokeless tobacco products. A substantial body of research, much of it produced over the past decade, establishes the scientific and medical foundation for tobacco harm reduction using smokeless tobacco products. This report provides a description of traditional and modern smokeless tobacco products, and of the prevalence of their use in the United States and Sweden. It reviews the epidemiologic evidence for low health risks associated with smokeless use, both in absolute terms and in comparison to the much higher risks of smoking. The report also describes evidence that smokeless tobacco has served as an effective substitute for cigarettes among Swedish men, who consequently have among the lowest smoking-related mortality rates in the developed world. The report documents the fact that extensive misinformation about ST products is widely available from ostensibly reputable sources, including governmental health agencies and major health organizations. The American Council on Science and Health believes that strong support of tobacco harm reduction is fully consistent with its mission to promote sound science in regulation and in public policy, and to assist consumers in distinguishing real health threats from spurious health claims. As this report documents, there is a strong scientific and medical foundation for tobacco harm reduction, and it shows great potential as a public health strategy to help millions of smokers.

AbstractBackground Sponsorship of Formula One (F1) motor racing, which has been used as an indirect medium of tobacco advertising for several decades, was prohibited by the 2005 European Union Tobacco Advertising Directive. Most F1 tobacco sponsorship of motor racing in the EU has since ceased, with the exception of the Scuderia Ferrari team, which continues to be funded by Philip Morris. In 2007, the Marlboro logo on Ferrari cars and other race regalia was replaced by an evolving 'barcode' design, which Ferrari later claimed was part of the livery of the car, and not a Marlboro advertisement.Objective To determine whether the 'barcode' graphics used by Ferrari represent 'alibi' Marlboro advertising.Methods Academic and grey literature, and online tobacco industry document archives, were searched using terms relevant to tobacco marketing and motorsport.Results Tobacco sponsorship of F1 motor racing began in 1968, and Philip Morris has sponsored F1 teams since 1972. Phillip Morris first used a 'barcode' design, comprising red vertical parallel lines below the word Marlboro on the British Racing Motors F1 car in 1972. Vertical or horizontal 'barcode' designs have been used in this way, latterly without the word Marlboro, ever since. The modern 'barcode' logos occupied the same position on cars and drivers' clothing as conventional Marlboro logos in the past. The shared use of red colour by Marlboro and Ferrari is also recognised by Philip Morris as a means of promoting brand association between Marlboro and Ferrari.Conclusion The Ferrari 'barcode' designs are alibi Marlboro logos and hence constitute advertising prohibited by the 2005 EU Tobacco Advertising Directive.

The study estimates the economic issues related to tobacco. Cigarette and bidi production in Bangladesh have been increasing since 1980. Imports and exports have fluctuated, but there is a persistent negative trade balance in tobacco and tobacco products. Recent prevalence trends are not clear, but remain over 40% among men. National statistics put smoking among women at 4-5%, but tobacco chewing is common among women, and undocumented. Prevalence is much higher for men with lower incomes and education. Policies to reduce tobacco use are summarized, they have been relatively weak, but would be greatly enhanced if proposed legislation is enacted. Money spent on tobacco products by poor people could do much to reduce malnutrition if it were spent on food instead. Real prices of cigarettes have fallen, and incomes have risen, stimulating consumption. Real price increases would help reduce demand, by 3% for every 10 real price increase. Taxes are relatively low (even for the highest priced, most taxed brands, only 55% of the retail price, plus a 15% value-added tax). Higher taxes would increase total revenues, already 7% of total government revenues. Inadequate data exist to estimate the health care costs attributable to tobacco use in Bangladesh.

ABSTRACTThis paper contributes to the very limited literature examining the factors determining tobacco companies' advertising strategies. The paper explores whether firms in the UK tobacco market significantly changed their advertising expenditure in the face of proposed changes to the UK and European Commission tobacco advertising legislation. The results suggest that changes in legislation have little impact on firms' advertising strategies for existing brands, but that legislative changes impact upon product launch dates. Our results also offer some information on the nature of firm interdependencies in the UK tobacco industry.

In 1998, the Australian Government announced a major reform of Australia's overall tax system. The previous system was characterized as out of date (it included a range of historically justified but now anachronistic taxes), unfair, discouraging of exports and investment, ineffective and complex. The proposed reforms included the introduction of a Goods and Services Tax (GST) and the abolition of a raft of state taxes and charges. The aim was to bring the service economy into the tax net, provide sustainable funding to the states and lower corporate and individual tax rates. Tobacco control advocates felt that it was essential to ensure that this did not adversely affect tobacco taxation levels. Higher tobacco taxes significantly reduce cigarette smoking and other tobacco use. However, for a specific tax increase to have maximum effect on reducing consumption there are a number of criteria that must be considered. Firstly, it must be a real, sustained increase, that is, greater than the rate of inflation. Ad valorem taxes such as the GST will increase with actual prices. Secondly, the impact of the tobacco tax will depend on the magnitude of the price increase. Thirdly, it must be understood that smokers exhibit compensating behaviour, for example, substituting with higher tar and nicotine cigarettes. And finally, smuggling can reduce the effect on consumption of a tax increase (Chaloupka, 1998), as can other means of excise avoidance.

Although governments have imposed controls on tobacco company behaviour, they have not yet aligned tobacco industry goals to public health objectives. As a result, tobacco companies have delayed or diminished the impact of imposed public health measures and have not contributed to curbing the epidemic of tobacco use. Over the past decade, several regulatory innovations have been proposed as ways to better align industry actions with public health needs, but none have been put in place. These policy suggestions share the goal of providing a supply-side complement to conventional demand reduction strategies, but they differ in the assumptions they make and in the regulatory and governance approaches they take. Similarly, differing views on ideology and political context within the tobacco control community and between governments may hinder the establishment of a global consensus on the ideal supply-side intervention. A government willing to implement innovative supply-side strategies as part of a tobacco control endgame may not require such consensus if factors specific to their national public health systems or political contexts are supportive.

Background The tobacco industry claims that illicit cigarette trade in South Africa is high and rising. This is often used as an argument not to increase the tobacco excise tax. Objectives To determine how the industry's estimates of the size of the illicit market have changed over time. Methods Published media articles on illicit trade were obtained from South African Press Cuttings, and published and unpublished articles and statements were sourced from the internet. Results 419 relevant articles and media statements were found. Of these, 80 emphasised the industry's perspective, 40 emanated primarily from the tobacco control community, and 299 reported on action taken against illicit activity. For each for the years between 2006 and early 2011, the Tobacco Institute of Southern Africa reported that South Africa's illicit market share was 20%, increasing to 25% in late 2011 and to 30% in 2012. In a 2012 presentation to Treasury the illicit market share in 2008 was shown as 7.9%, compared to claims in 2008 that the illicit market share was 20%. There was a large spike in reported seizures of illicit cigarettes in 2010 and 2011, but a 60% decrease in 2012. Conclusions The tobacco industry has adjusted previous estimates of the illicit trade share downwards in order to create the impression that illicit trade is high and rising. If previous estimates by the tobacco industry were incorrect by their own admission, the credibility of current estimates should be questioned, especially by government officials. ; We would like to acknowledge the Bill and Melinda Gates Foundation, through the American Cancer Society, for funding this research. Economics of Tobacco Control Project, Southern Africa Labour and Development Research Unit, School of Economics, University of Cape Town, South Africa

Purpose. To review published state tobacco control plans (STCPs) to determine the extent to which the needs of the states' populations are being addressed. Design. A qualitative cross-sectional comparison of states' strategic plans for tobacco control as of March 2010. Setting. Online searches. Participants. The 50 states and the District of Columbia. Method. Internet-based searches were completed using tobacco and other keywords (control, prevention, strategies, comprehensive/strategic plan) to obtain all publicly available STCPs; telephone follow-up was conducted to ensure that all publicly available plans were captured. Each plan was coded by two researchers using a standardized protocol to assess provisions made for addressing disparate populations as defined by the states. Results. A total of 43 states addressed disparate populations. Thirty-six states addressed these populations within published STCPs, six states had separate stand-alone tobacco disparities plans, and one addressed it within their cancer plan. Specific populations addressed included racial and ethnic minorities, blue-collar employees, pregnant women, children under the age of 18, and college students. There were also several STCPs that cited the general goal of eliminating tobacco use disparities. Conclusion. More work is needed to address tobacco disparities, including additional planning efforts in some states and effective implementation and evaluation among states with plans. States can look to the experiences of other states to help guide tobacco control planning for their own populations.

Numerous employers in over 20 U.S. states currently discriminate legally against smokers in their hiring policies. We analyze the cost of being a smoker, measured in annual hospital days, and compare this with the cost of being a former smoker, the cost of being obese, and the cost of a variety of other medical conditions, relative to the cost of being a never smoker, using three large recent surveys each having in excess of one hundred thousand observations. The paper also explores the cost of former smokers as determined by the number of years since quitting. Smokers as a whole are not found to be the most costly employees. Furthermore, health costs vary dramatically among smokers of different duration and intensity. As a consequence, our results question the efficiency of such discrimination. (JEL I10, I18, J71, J7)

The 1998 Master Settlement Agreement resolved the unprecedented litigation in which the states sought to recoup the cigarette-related Medicaid costs. The litigation was settled through a combination of negotiated regulatory requirements and financial payments of about $250 billion over 25 years. Settlement payments received by states are strongly related to smoking-related medical costs but are also related to political factors. The payments largely took the form of an excise tax equivalent, raising potential antitrust concerns. The regulatory restrictions imposed by the agreement also raised antitrust concerns. However, there has been no evident shift in industry concentration. The increase in advertising and marketing expenses has largely taken the form of price discounts. The settlement sidestepped the usual procedures pertaining to the imposition of taxes and the promulgation of new regulations.

The 1998 Master Settlement Agreement (MSA) resolved litigation between forty-six states and the major U.S. cigarette manufacturers. In total, the defendants agreed to pay more than $246 billion over twenty-five years to compensate the states for costs incurred in treating smoking-related diseases. This article explores the political and economic determinants of the monies to be distributed to the states under the MSA. Consistent with a damage model, the evidence suggests that the tobacco settlement payments are positively correlated with states' smoking-attributable health care expenditures. However, the authors also find that politics influenced the amounts individual states are scheduled to receive from the tobacco companies: the four states that did not participate in the MSA, big-government states, and those with greater numbers of medical professionals and health-related organizations will collect significantly larger sums over time than the damage model predicts.