Tobacco Control editor won't share panel with tobacco industry

Ruth Malone, editor of Tobacco Control, writes an open letter to the FDA declining an invitation to discuss tobacco industry research on a panel including delegates from the tobacco industry.

The FDA is a body I know very little about. The little I know suggests that it falls under the undue influence of the very powerful. However I take issue with some of Malone's reasoning.

First, involving the tobacco companies as “stakeholders” on a panel with the public health community in this way suggests that all parties share a common or at least congruent goal.

Is it? Is that the basis on which talks took place in Northern Ireland? I would have thought the opposite was the case. There is a common agenda, one that recognises tobacco industry research as something worth talking about, but it wouldn't be worth talking about if everyone had the same view of it.

Second, any such discussion among “stakeholders” would require a minimal level of mutual understanding about the nature and purpose of science.

This is also an absolute requirement. Tobacco is legal according to specific guidelines, and it is vital that the parties reach a common understanding on this issue.

While the companies may have an interest in reducing the numbers who die prematurely from using their products (so that they will live to purchase more of them), they have never indicated any willingness to pull from the market the products that kill half their longtime users and continue to be sold. Absent such willingness, the practical goals of public health and the tobacco industry are in direct conflict. No “dialogue” will change that.

Unless the tobacco companies commit harikari, consigning to the black market a product used by billions worldwide, on which countless people depend for their livelihoods, there can be no common ground. Is this outlook – the fantasy that a recreational product will simply cease to exist – really consistent with sound public health goals?

As the Kessler decision found, the tobacco industry engaged in a conspiracy to cover up and distort the evidence of their products’ harmfulness, and they have a long track record of egregious manipulation of science.

No industry associated with health ever behaves like that!

From Malone's third point:

As we demonstrated in our papers examining Philip Morris’s support for FDA regulation of tobacco products [1]and its development of Project Sunrise, which sought to create and exploit divisions within tobacco control, [2]engagement with public health organizations allows tobacco companies to position themselves as reasonable and responsible, and position those who refuse to engage as extremists.

My issue with Tobacco Control is their obsession with tobacco as a public health issue in spite of ample evidence of other potential environmental hazards created by other powerful industries. Public health should identify environmental health hazards and seek to minimise them, but its current approach is judgemental and self-righteous. It is scarcely believeable that no one working for tobacco companies has any concern about the health consequences of their product, any more than it is believeable that everyone who works for GlaxoSmithKlein is a crook. Public health needs to do away with its self-righteous attitude and simply attempt to influence matters in such a way as to limit harm. Refusing to engage with industry because it causes harm is a bizarre approach. (Does any other industry than tobacco get singled out in this way?)

Ruth's Malone's summary shows up how far I disagree with her argument:

Fourth, tobacco industry denormalization is a key part of successful tobacco control efforts. Convening a meeting of this sort undermines those critically important efforts by creating a forum for re-legitimation through association with respected public health agencies and leaders. Lending the FDA imprimatur to a public meeting featuring tobacco company speakers suggests that something has indeed changed and the industry is no longer harming people through its promotion of deadly products.

On the contrary, engaging with the tobacco companies is only necessary because the product is recognized as a hazard to health. Where did this cosy attitude come from, that government is a matter of engaging only with those whose goals are alike?

The FDA may be required to interact with the industry for the purposes of discussing proposed regulation of tobacco products and what tobacco companies must do to comply. The FDA is not, however, required to “facilitate” dialogue as though it were acting as a neutral mediator between two parties with equally valid but divergent interests. In positioning itself as some sort of neutral party, FDA is unwittingly acting as an agent for the tobacco industry’s public relations initiatives and undermining a strong tobacco control strategy.

This would naturally work against her goal of denormalization. As far as she is concerned, the tobacco companies are required to turn up at the FDA offices just to be told what orders to follow. Anything else is giving the tobacco companies ideas above their station.

Tobacco is a huge market and the best that public health can hope for is that the companies' corporate reponsibility is strong and checks are in place to ensure that standards are reached and maintained. Public health also needs to recognise that although its contribution is important it does not trump everyone else's, and does not entitle it to tell the FDA how to engage with stakeholders (although it is entitled to an opinion, of course).

Those who refer to engage are extremists? As if!!

Malawi tobacco and child labour

The Guardian has produced a video about child labour on Malawi's tobacco plantations (the Bill and Melinda Gates Foundation is also linked on the page). Although it points out that child labour is not unique to tobacco plantations, a serious and erudite looking gent near the end of the video reminds us that we can't trust the tobacco industry whatever efforts they make to eliminate child labour because they are the tobacco industry and really one has to control them and not trust them.

The video points out that tobacco farmers don't get paid until after the tobacco plantations have deducted costs from the income of each harvest. That is tenant farming in any commodity that does not offer advance payments to farmers. These are the conditions that persist for millions throughout the world. Featuring tobacco farming as an educational snapshot of the issue teaches us more about global conditions for tenant farmers than it does about the tobacco industry.

Malawi's tobacco accounts for a high proportion of its export earnings. It is absurd to state that no one employed in the management of this industry has any sense of responsibility for children. Proposals to ban the employment of children do very little to solve the problem that children can't learn on an empty stomach. The video mentions the Malawi tobacco industry's campaign against child labour, and even says that those involved seem genuinely committed to the issue – although we are still reminded at the end that the tobacco companies are only in it for profit.

Malawi tobacco has also hit the spotlight because of the plan of the WHO Framework Convention on Tobacco Control (recently discussed at COP-4 in Uruguay) to ban additives that improve the flavour of tobacco. This could significantly affect the market value of tobacco in Malawi, and is likely to worsen the conditions for families employed on plantations. Malawi is not a member of the FCTC, and an organisation known as Smoke-Free Malawi has recommended that Malawi should join in order to allow representation in discussions like COP-4 (however it would also have to implement other articles further restricting tobacco use and the influence of tobacco companies). It also recommends that Malawi face the reality that global markets in tobacco will decline in future because of the health threat from tobacco, and seek alternative sources of revenue.

At least some of those involved in making the Guardian video wish to represent the tobacco industry as the big demon in Malawi, the cause of child labour in Malawi, the cause of bonded labour conditions. Child labour, claims UNICEF, is rife throughout the world involving up to 1 in 6 children (its introductory page on child labour does not even mention tobacco). Does this focus on Malawi originate from Malawi's non-membership of the FCTC, in order to generate further pressure on it to join this anti-democratic organ of world governance? Or is it just another excuse to score points off the tobacco industry as a whole?

Workplace Hazards

I've decided to include the Hazards Magazine in the links to this blog. The smoking ban was brought in on the pretext that it was a health hazard after all. So the concerns of this profession are quite important to us.

This is a publication that campaigns for better health and safety at work. It is critical of the agencies that are meant to enforce health and safety legislation. I haven't yet found an equivalent publication that (critically) covers Scottish workplaces.

In the popular imagination, 'Elf and Safety' is getting more powerful. In truth it is getting less powerful. Its enforcement activities are low and getting lower, meaning that employers are less likely to be pursued for negligence in the workplace. This article, entitled A Neutered Watchdog, states chillingly that 'only a third of amputations are now investigated by the Health and Safety Executive'.

Co-authors Dave Whyte and Steve Tombs, in a separate interview, opine that the HSE has effected a 'surrender to the anti-regulation rhetoric of successive Labour governments'. Well ... see, we were being lied to. Few people would accuse Labour of a light touch when it came to regulations, but clearly they were ready to take it easy when safety at work was at stake ... but let's investigate further before making any allegations. It isn't expected that the Con-Dem Coalition will do anything to tighten the regulatory framework.

Warning: The Hazards Magazine has documented its suspicion of the tobacco industry, equating it with any industry bogeyman who invests in studies claiming the noxious chemicals he requires people to work with to be safe. Their claim that the expression 'manufacturing scientific uncertainty' originates with the tobacco industry may have substance. In their eyes, corporate money is evil and exploitative whether in the hands of tobacco or any other nasty employer.

It shouldn't really come as a surprise that a smoking ban at work was not really a decision taken on safety grounds, although we knew that it didn't come from the government's health and safety agency. What I didn't know was that in areas where workers were crying out for intervention (and this does come from Scotland), they were being told there was no danger, or that the government had decided that a light touch was in order.
Whatever.

Light touch indeed. The smoking ban has been anything but.