Sri Lanka: Protecting children and youth, the policymakers’ responsibility

Worldwide, tobacco products kill over 8,000,000 people every year.

Tobacco use creates a significant economic burden on society at large. Higher direct health costs associated with tobacco-related disease, and higher indirect costs associated with premature loss of life, disability due to tobacco-related disease and productivity losses create significant negative externalities of tobacco use.

Tobacco use devastates not only the smoker, but also non-smoking bystanders  who are exposed to tobacco smokers’ exhaled  tobacco smoke; this is called ‘passive smoke’ or  ‘secondhand smoke’. The groups often exposed to and affected by the harms of secondhand smoke are  women and children. Worldwide, approximately one third of women are exposed to secondhand smoke. (The Lancet 2017)  A 2016 study across 68 low and middle income countries estimates around 56% of youth (age 12-15) are exposed to secondhand smoke in any place. (The Lancet Global Health 2016)

Of the eight million deaths caused by tobacco, about 1.2 million deaths are due to secondhand smoke exposure.(WHO Factsheet May 2019)

 How do youth become addicted to tobacco products?

The avenues of targeting youth and children by the tobacco industry (TI)  are many – viz.   on social media, internet sales, display of tobacco products at Points of Sale  (supermarkets, grocery, mobile vendors, billboards) at sports events and through strategic sponsorships. TI’s Corporate Social Responsibility (CSR) activities are varied and subtle. CSR campaigns focus on  different sectors in the society. Like all advertising, CSR is sophisticated in how it targets and conveys messages so that it appears simply “goodwill” action. But a committed and experienced tobacco control advocate understands how to monitor and expose how CSR is a form of tobacco advertising and serves to undermine tobacco control.

Why does the tobacco industry  target young people?

The industry has even called children “replacement smokers” for those killed by tobacco use. (February 29,1984 RJR report, “Young Adult Smokers: Strategies and Opportunities”. Bates No. 501928462-8550) In Sri Lanka 60 people die of tobacco- related diseases each day. Thus the TI  needs to lure new users to replace those who die of tobacco – related diseases like heart disease, lung cancer, respiratory diseases, and more).

Children and youth  are more susceptible to cigarette advertising and marketing than adults. Most smokers initiate tobacco use during adolescence and early adulthood. A US report found that 46% of smokers become daily smokers before the age 18, and 80% before 21. In other words, if large numbers of kids did not try smoking and go on to become regular users, the tobacco companies eventually would not have enough adult customers to make staying in business worthwhile.

Investigations around the world have revealed disturbing patterns of four key tobacco companies, using marketing tactics to target youth: In 40 countries, data collected at points of sale almost exclusively near primary and secondary schools found tobacco product displays at the eye level of a child (one metre high), special advertising and promotions, tobacco products and e-cigarettes designed to appeal to youth (like flavoured tobacco), and tobacco products and e-cigarettes positioned near products, such candy and sweets.

The TI is subverting tobacco advertising laws, flying under the radar of government regulators and abusing the policies of social media platforms to market tobacco products and e-cigarettes to youth.

*          TI  and their marketing firms engage popular social media influencers to help promote cigarettes and other tobacco products to their social media communities. The influencers’ posts are designed to appear authentic, but are actually carefully composed to advertise cigarettes. Most recently, tobacco and e-cigarette companies have been found promoting their products as branded pages on Facebook and Instagram.

*           TI also host trendy cigarette themed parties all over the world. When party-goers post photos from the events on social media, big tobacco’s digital footprint expands exponentially. The parties are designed to promote cigarette brands and generate significant social media content to ensure maximum visibility for brands like Marlboro and Lucky Strike.

*           TI sponsor events (sports events) and activities to promote the use of tobacco to their target customers/consumers. When sponsorship is not included in tobacco advertising bans, the industry uses sponsorships to advertise their products often without the requirement of accompanying health warnings.

We must protect our children and youth  from Big Tobacco’s efforts luring youngsters into a lifetime of addiction and disease.

The Government can protect the next generation by enacting and enforcing policies mandated by the World Health Organization’s Framework Convention on Tobacco Control  (FCTC) to protect children and youth  from the aggressive marketing tactics of TI.

The National Authority on Tobacco and Alcohol (NATA) being the focal point for tobacco control has an utmost responsibility and duty to persuade the government to implement important regulations and protect youth from tobacco  use.

Recommendations

* Policymakers should exclude the TI and tobacco funded or linked research from policy discussions on tobacco control and alternative products.

* Advocates and the public health community can continue to hold the industry accountable.

* Consumers should not support a business that builds a portfolio of addictive, deadly products while fighting efforts to reduce smoking.

* Journalists should challenge the discrepancy between industry claims and its actual behaviour.

* Government should facilitate more media coverages that promote tobacco control, at least through government owned media. (right now there is no positive contribution or support from government newspapers.)

TI’s marketing plan in attracting  youth

TI cannot stay in business unless children and youth get hooked – therefore we must protect the next generation from TI’s efforts to lure them into a lifetime of addiction and disease.

NATA along with other stakeholders engaged in tobacco control work should monitor how TI is engaged in addicting the next generation by launching their marketing plan.

Across the globe, TI uses a combination of marketing tactics to reach youth at Points of Sale (POS), on social media, via sponsored parties, sports events, and other sponsored activities.

Recommendation – Though Sri Lanka has banned Article 13 of the FCTC of WHO – still we observe tobacco products are displayed at POS, hence this regulation is not comprehensive. The government should support NATA in amending the law.

Social media

“A 2018 report, Where there’s smoke, documented the tobacco industry’s aggressive marketing of cigarettes and other tobacco products to young people on social media through attractive young brand ambassadors, elaborate parties, contests, and more.”  – there’s something behind the cigarettes you see on social media – a deceptive strategy from TI to addict the next generation of smokers.

Do you know?

Tobacco industry is secretly paying social media stars to flood your newsfeed with images of their cigarette brands.

They are subverting tobacco advertising laws and  abusing government regulators and the policies of social media platforms to market cigarettes to youth.

Who are they  using ?

Young social media stars are paid to make smoking look cool.

The tobacco industry and its marketing firms engage popular social media influencers to help promote cigarettes and other tobacco products to social media communities. The influencers’ posts are designed to appear authentic, but are actually carefully composed to advertise cigarettes.

Young popular influencers are recruited based on their youthful appearance and number of followers. The reason for this is the TI targets a super young profile… The people they select are always young. They look for young people that have large groups of friends so that the social media promotional message gets expanded more and more.

Recommendation: The Government should support NATA in amending the existing law to stop social media promotions of tobacco and nicotine products.

Tobacco industry social media marketing undermines tobacco control policies. TI does not tell influencers to include “#ad or # sponsored “ in their posts, which avoids being caught by social media platforms’ official ad systems. The posts use subtle campaign hashtags, such as #likeus or #nighthunters which fly under the radar but are actually campaigns by TI.

The posts include tobacco products in the images, which are often hard to differentiate from an influencer’s own everyday content. Facebook, Twitter and Instagram can play a critical role in stopping online tobacco advertising if they enforce their policies to block tobacco advertising in influencer content.

Around the world, governments have banned or restricted tobacco advertising. In fact (WHO FCTC Parties to the Framework Convention on Tobacco Control, updated May 2020. Available at: https://www.who.int/fctc/cop/en/), the  Parties are already obligated to ban all tobacco advertising including internet advertising – under a global treaty called the WHO Framework Convention on Tobacco Control. But still TI is undermining those efforts.

Recommendation: Therefore, government regulations on tobacco advertising and promotion must include TI influencing through social media.

Single cigarettes are more attractive and available to youth

Studies and evidence indicate that youth can and do access single cigarettes more easily, that single sticks facilitate smoking among regular youth users, and may encourage youth non-users to experiment with smoking.

*   Single cigarettes are sold at a price point that allows vulnerable populations, such as youth, to buy cigarettes without paying the price of a whole pack. The lower price point undermines efforts to decrease the affordability of tobacco products through tax and price increases

*  Single sticks are often displayed, sold, and consumed without consumers ever having been exposed to warning labels placed on the pack. This is concerning because health warning labels are effective in reducing intentions to smoke among non-smokers, including youth.

* Single stick cigarette sales can  facilitate experimentation among youth who have not yet become regular smokers. The sale of single sticks also undermines effective tobacco control policies by limiting a person’s exposure to health warning labels and lessening the impact of tobacco tax increases on cigarette packs. Where single sticks cigarette sales are prohibited, such sales constitute a form of illicit trade.Lastly, single stick sales can undermine smokers’ efforts to quit by not only making the product easily accessible but also by serving as a cue for smoking, promoting relapse.

Single stick sales can be more profitable for retailers than selling whole packs. One study found that retailers can “markup” or charge more for single sticks than what the stick would cost if sold in a pack. The absence of laws regarding cigarette sales and/or the lack of enforcement of laws banning single stick sales in some countries make it easier for retailers to sell them.

The availability of single sticks allows those with few resources, such as youth, to buy tobacco products. In addition, the fact that single sticks are widely available and promoted underscores the concern that they are considered a common item available for sale, and that single stick sales normalize smoking which is a dangerous addictive behaviour that can result in death. It is important to note that BAT and PMI supply free promotional materials to tobacco retailers in order to create brand recognition and encourage individuals to buy their products.

Recommendations:

The WHO Framework Convention on Tobacco Control (FCTC) is the world’s first and only public health treaty. Ratified by 182 Parties, the Treaty identifies evidence-based measures to prevent and reduce tobacco use, especially to protect children and youth.

* In line with Article 16 of the FCTC, Parties should ensure that the sale of single sticks or small packs of tobacco products is prohibited by passing and enforcing appropriate legislation. 

* In line with Article 13 of the FCTC, Parties should comprehensively ban all forms of tobacco advertising, promotion and sponsorship and this should include any advertising or promotional materials related to single sticks.

In line with Article 15 of the FCTC, Parties should consider additional provisions such as licensing of retail vendors of tobacco products to control the sale of single sticks. Failure to obey the law could result in a range of sanctions; from fines and penalties to license suspension or revocation.

How effective is tobacco taxation to protect children and youth from smoking?

Tobacco-related death and disease can cause a significant economic burden on society, due to lost productivity and health care costs associated with early death. Effective tobacco taxes not only reduce these burdens through reducing consumption and prevalence, but also contribute to the reduction of governments’ expenditures for the health care costs associated with tobacco consumption.

 Tax and price policies are widely recognised to be one of the most effective means of influencing the demand for and thus the consumption of tobacco products. Consequently, implementation of Article 6 of the WHO FCTC is an essential element of tobacco-control policies and thereby efforts to improve public health. Tobacco taxes should be implemented as part of a comprehensive tobacco-control strategy in line with other articles of the WHO FCTC.

Increasing tobacco taxes is particularly important for protecting young people from initiating or continuing tobacco consumption.

Effective taxes on tobacco products that lead to higher real consumer prices (inflation-adjusted) are desirable because they lower consumption and prevalence, and thereby in turn reduce mortality and morbidity and improve the health of the population.Effective tobacco taxes also are an important source of revenue and they contribute significantly to State budgets. Increasing tobacco taxes generally further increases government revenues, as the increase in tax normally outweighs the decline in consumption of tobacco products. 

Tobacco taxes reduce health inequalities and are generally considered to be economically efficient as they apply to a product with inelastic demand. Low- and middle-income population groups are more responsive to tax and price increases; therefore consumption and prevalence are reduced in these groups by greater magnitudes than in higher-income groups, resulting in a reduction in health inequalities and tobacco-related poverty.

Recommendations:

The Government should support NATA in making the Article 6 of the FCTC implemented in order to protect potential users being the children and youth in this country, at its earliest.

The policymakers should not forget that the world’s largest tobacco companies, belonging to the entire tobacco industry (TI) are targeting children and youth using their vicious and many strategies to recruit youth as their future customers. The government should help NATA prevent 60 premature deaths being caused in a day due to tobacco smoke related deaths.

This is more than Covid-19 deaths, but unnoticed completely.

Source: SUNDAY OBSERVER