Where there’s smoke there’s money:

1. Where there’s smoke there’s money: Campaign contributions and U.S. government efforts to derail the Global Tobacco Treaty Martin Donohoe

3. Tobacco – Weapon of Mass Destruction • 1.3 billion smokers • 84% in developing countries • 5.7 trillion cigarettes smoked/yr worldwide • 5.4 million deaths/yr worldwide (1/10 deaths) • Estimated 10 million by 2030

4. Tobacco – Weapon of Mass Destruction • Leading cause of death in U.S. • 450,000 deaths/yr • 50,000 from environmental tobacco smoke (ETS)

5. Tobacco – Weapon of Mass Destruction • Numerous health consequences • Heavily pesticide-dependent crop • Tobacco industry has lobbied to weaken environmental regulations

6. Tobacco – Weapon of Mass Destruction • Direct medical costs = $75 billion/yr • Medical care and lost productivity due to tobacco use costs each U.S. citizen $550/yr • vs. $770/U.S.citizen/yr., based on $200 billion cost, for Iraq/Afghanistan War • Society saves $3 in medical costs for every $1 spent to prevent smoking

8. Smokescreen • Cigarettes most marketed products in the world • $2 billion/year in the U.S. • 3 largest companies have combined annual revenues exceding $121 billion (2007) • U.S. leading exporter of cigarettes • U.S. tax money used to assist corporations in their marketing efforts overseas

9. WHO Framework Convention on Tobacco Control Treaty • Finalized 2/27/05 • Ratified by 160 nations (as of 11/08) • Including Russia, Canada, Australia, Mexico, and the UK • Another 8 have signed but not yet ratified/approved

10. WHO Framework Convention on Tobacco Control Treaty • Exempts tobacco control from free trade challenges • Limits tobacco advertising • Cracks down on tobacco smuggling • Bans tobacco sales to and by minors

11. WHO Framework Convention on Tobacco Control Treaty • Promotes agricultural diversification and alternative livelihoods for tobacco farmers • Standardizes packaging • Bans deceptive terms such as “light” and “mild” • Improves warning labels

12. U.S. Efforts to Undermine the Treaty • Despite overwhelming U.S. and international public support for the goals of the treaty… • U.S. government attempted to scuttle the treaty in the name of free trade and free speech • Tobacco industry documents show attempt to create alternative through Project Cerberus

13. U.S. Efforts to Undermine the Treaty • Original U.S. negotiator Thomas Novotny resigned after the Bush administration pressured him to lobby for the deletion of 10 of 11 treaty provisions, as outlined in a Phillip Morris memo

14. Phillip Morris and Altria • Phillip Morris = world’s largest tobacco company • Parent company = Altria (also owns 85% of Kraft Foods and 28 % of Miller Brewing) • 2008: Phillip Morris International becomes independent company, separates from Phillip Morris USA and Altria

15. U.S. Efforts to Undermine the Treaty • U.S. Belatedly signed on 5/3/05 • Senate must ratify AND President must sign • Administration has not submitted treaty to Congress – “studying it”

16. Bush Administration Ties to the Tobacco Industry • Karl Rove (Deputy Chief of Staff and Senior Advisor) – lobbyist/strategist for PM • Kirk Blalock (White House liaison to the business community) – PM public relations official

17. Bush Administration Ties to the Tobacco Industry • Charles Black (informal advisor to Bush during 2000 campaign) – PM lobbyist • Daniel Troy (former FDA Chief Counsel) – represented tobacco industry when it sued the FDA over tobacco ad regulation

18. Bush Administration Ties to the Tobacco Industry • Tommy Thompson (HHS Secretary) • received $72,000 in campaign contributions from PM executives when he was governor of Wisconsin • advisor for the primary tobacco lobbying firm in D.C. • Rejected his own advisory panel’s recommendation to increase federal tobacco tax

19. Bush Administration Ties to the Tobacco Industry • British American Tobacco PLC’s Brown and Williamson unit and RJ Reynolds Tobacco Holdings, Inc. represented by Barbour, Griffith and Rogers • Lobbying firm stocked with Republican operatives, including: • Haley Barbour – former GOP Chairman, MS governor • Lanny Griffith – White House aide to GHW Bush

20. Campaign Contributions • $3.5 million (through individual contributions and PACs) in 2004 • 74% to Republicans • $20 million to Republican candidates for federal office since 1997 • PM – leading overall campaign contributor to Republicans since 1989

21. U.S. Non-Cooperation on International Treaties • Failure to sign or approve: • Kyoto Protocol on Climate Change • Convention on the Prohibition of Anti-Personnel Land Mines • Comprehensive Nuclear Test Ban Treaty • Convention on the Rights of the Child • Convention on the Elimination of Discrimination Against Women

22. U.S. Non-Cooperation on International Treaties • Failure to sign or approve: • Convention on Economic, Social and Cultural Rights • Convention for the Suppression of Traffic in Persons • Failure to pay full U.N. dues • Opposition to International Criminal Court

23. Health Care Organizations and Medical Schools • As of 1999: insurers (including some of the largest owners of HMOs) and mutual funds heavily invested in tobacco stocks • Cigna - $42.7 million; MetLife – $62.1 million; Prudential - $892 million. • TIAA-CREF (whose mutual funds are owned by many health professionals) - $732 million Phillip Morris stock.

24. Health Care Organizations and Medical Schools • 1996-1998: PM and Cigna collaborated to censor accurate information on the harms of smoking and ETS from health newsletters • Tobacco companies sponsored “research” to refute links between tobacco and disease

25. Health Care Organizations and Medical Schools • Tobacco industry has “white-coated” itself since the 1940s • Borrowing from medicine’s prestige and public esteem in ads featuring smoking doctors

26. Health Care Organizations and Medical Schools • As of late 2004, despite a decade’s old plea from the AMA for medical schools to divest their tobacco holdings, some of the nation’s leading medical schools had failed to do so: • Cornell, Duke, Washington University, Yale, and possibly Penn (refused to answer requests) • Columbia is said to have divested, but could not provide details to confirm

27. Conclusions • U.S. resistance to / attempts to scuttle global tobacco treaty squanders opportunity for U.S. to take lead on important international public health issue • Represents callous disregard for human health and world economy

28. Conclusions • Some health care organizations and medical schools have failed to provide ethical and moral leadership in anti-tobacco crusade • Government / health care community’s obstructionism and failure to lead likely due to influence of campaign contributions / research funding

29. Recommendations • President should send Treaty to U.S. Senate, which should immediately ratify, and President sign • Campaign finance reform • Medical schools and health care organizations should immediately divest all tobacco holdings

30. Recommendations • Media should more aggressively expose tobacco industry machinations • Health care professionals should lobby their institutions and legislators to take the lead in the war on tobacco • Ban tobacco sales in pharmacies

31. Family Smoking Prevention and Tobacco Control Act(Currently before Congress) • Tobacco companies must provide ingredients to govt.; govt. would regulate harmful ingredients • Govt. could not ban cigarettes, reduce nicotine content to zero, set underage limit of more than 18, control where tobacco products sold/amount of menthol • New, larger set of warning labels

32. Family Smoking Prevention and Tobacco Control Act(Currently before Congress) • Supported by Phillip Morris • Possibly to solidify its dominant market position • Might be weakened by industry lobbying • Could mitigate the legal liabilities of tobacco companies

33. For references, see: Donohoe MT. Cigarettes: The other weapons of mass destruction. Medscape Ob/Gyn and Women’s Health 2005;10(1): posted 4/5/05. Available at http://www.medscape.com/viewarticle/501586

34. Contact Information Public Health and Social Justice Website http://www.phsj.org martindonohoe@phsj.org