Smoking remains the leading preventable cause of death, accounting for one-third of all cancers and nearly two-thirds of heart disease among people under 55. Reducing tobacco-induced disease requires understanding how the tobacco industry maintains a social and policy environment favorable to smoking. To understand a microbe, one might study its genome; the tobacco industry's genome is its written record of research and decision making in the form of over 83 million pages of previously secret internal tobacco industry documents. We will use this growing collection of industry documents, triangulated with data from other sources, to pursue four Specific Aims: (1) Analyze tobacco industry internal research to gain a better understanding of how and why the tobacco companies promote some metrics of tobacco product toxicity and avoid others in the context of regulation of tobacco products and assessment of reduced harm and nicotine replacement products; (2) Use the tobacco industry's internal research to gain a better understanding of how packaging elements, including color, font, and other aspects of packaging influence consumers' perceptions of the cigarettes contained in the packages, (3) Understand tobacco industry analyses of marketing and development of other non-cigarette tobacco products (e.g. little cigars/cigarillos, hookah, roll your own cigarettes), nicotine replacement, and nicotine delivery devices such as e-cigarettes, including the impact of their use on cigarette use; and (4) Analyze evolving tobacco industry strategies to oppose tobacco control policies at the local, state, national, and international level, including efforts to undermine implementation of the World Health Organization Framework Convention on Tobacco Control. While this research makes systematic use of digitized tobacco industry documents as the primary data source, we will also triangulate with other sources (including government records, advertising archives, media coverage of issues discussed in the documents, the academic literature, and interviews with key informants) to confirm whether plans described in the documents were actually implemented and to assess their effect. The research questions we propose are innovative because they address the latest activities of tobacco companies in the rapidly evolving policy and regulatory framework for tobacco products. Results of this research will inform the development of more effective tobacco control strategies, which will help reduce tobacco use and its associated burden of cancer and other tobacco-caused disease and death.

Public Health Relevance

Smoking is the leading preventable cause of death, accounting for 1/3 of all cancers and nearly 2/3 of heart disease among people under 55. Reducing this burden of disease requires understanding how the tobacco industry maintains a favorable social and policy environment to promote smoking so that public health professionals can develop and implement effective programs to prevent smoking and promote cessation.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Research Project (R01)
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Community Influences on Health Behavior (CIHB)
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Kaufman, Annette R
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University of California San Francisco
Internal Medicine/Medicine
Schools of Medicine
San Francisco
United States
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Hiilamo, Heikki; Glantz, Stanton (2018) Limited implementation of the framework convention on tobacco control's tobacco tax provision: global comparison. BMJ Open 8:e021340
Apollonio, Dorie E; Glantz, Stanton A (2018) Marketing with tobacco pack onserts: a qualitative analysis of tobacco industry documents. Tob Control :
Elias, Jesse; Hendlin, Yogi Hale; Ling, Pamela M (2018) Public versus internal conceptions of addiction: An analysis of internal Philip Morris documents. PLoS Med 15:e1002562
Elias, Jesse; Ling, Pamela M (2018) Origins of tobacco harm reduction in the UK: the 'Product Modification Programme' (1972-1991). Tob Control 27:e12-e18
van der Eijk, Yvette; McDaniel, Patricia A; Glantz, Stanton A et al. (2018) United Nations Global Compact: an 'Inroad' into the UN and reputation boost for the tobacco industry. Tob Control 27:e66-e69
Velicer, Clayton; St Helen, Gideon; Glantz, Stanton A (2018) Tobacco papers and tobacco industry ties in regulatory toxicology and pharmacology. J Public Health Policy 39:34-48
Elias, Jesse; Ling, Pamela M (2018) Invisible smoke: third-party endorsement and the resurrection of heat-not-burn tobacco products. Tob Control 27:s96-s101
Egbe, Catherine O; Bialous, Stella A; Glantz, Stanton (2018) Role of stakeholders in Nigeria's tobacco control journey after the FCTC: lessons for tobacco control advocacy in low-income and middle-income countries. Tob Control :
Lempert, Lauren K; Glantz, Stanton A (2018) Tobacco Industry Promotional Strategies Targeting American Indians/Alaska Natives and Exploiting Tribal Sovereignty. Nicotine Tob Res :
Crosbie, Eric; Sosa, Particia; Glantz, Stanton A (2018) Defending strong tobacco packaging and labelling regulations in Uruguay: transnational tobacco control network versus Philip Morris International. Tob Control 27:185-194

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