Search results: tobacco

Hennessey quotes from a speech by Steven Parrish, of the Steve Parrish Consulting Group describing parallels between tobacco and food litigation.

From the first lawsuit filed against [tobacco] industry member in 1953 to mid-1990s, the industry never lost or settled a smoking and health product liability suit. In the mid ‘90s the eggs hit the fan because the industry for all those decades had smugly thought it had a legal problem. But over time, it came to realize it had a society problem. Litigation was a symptom of the disease, not the disease itself.

…When it came time to resolve the litigation, we couldn’t just sit in a room and say, ‘how much money do you want?…A lot had nothing to do with money. It had to do with reining the industry in…We spent so much time early on talking to ourselves about greedy trial lawyers, out-of-touch regulators, media-addicted elected officials and public health people who didn’t know how to run a business. At the end of the day, it didn’t matter. We would have been much better off recognizing these people had legitimate agendas.”

… Maybe there are some parallels, but I urge people not to succumb to the temptation to say, ‘cigarettes kill you, cigarettes are addictive. But mac and cheese, coffee, and Oscar Meyers wieners don’t. That may be true, but there are still risks for the industry.

There’s this idea, which has picked up steam in the media, that large food companies are manipulating ingredients to hook people on food. It hasn’t been manifest in litigation yet, but we’re seeing it with legislative initiatives, like Mayor Bloomberg in New York City saying sugar hooks people and causes diabetes. We’ve seen some with GMOs, though most of that legislation is about consumers’ right to know. But there’s this overarching concept that Big Food is somehow manipulating our food supply and as a result, giving us non-food.

Sounds like the message is getting across loud and clear.

Thoughts?

Anti-tobacco advocates have been worried for years that concerns about obesity would draw funding away from anti-smoking initiatives (see previous posts).  Their fears are justified, as described in today’s New York Times and in a recent editorial in the New England Journal of Medicine.

Years of experience have taught anti-smoking advocates that countering the marketing efforts of cigarette companies required constant vigilance.  It also taught them that cigarette companies take immediate advantage of any weakening of resistance to their efforts.

Cigarettes remain the leading cause of preventable deaths among Americans.  Cigarette marketing aimed at children remains a national—and international—public health scandal.

Health should not be a zero-sum game.  Anti-obesity advocates have much to learn from anti-smoking advocates.  How about joining forces to improve the health of Americans?

I’ve just read an enlightening paper in the July issue of the American Journal of Public Health (see Note below) about the tobacco industry’s role in and funding of “We Card,” a program ostensibly aimed at discouraging smoking among young people by encouraging retail cigarette sellers to “card” underage buyers.

The paper is an analysis of internal food company discussions about this program in cigarette company documents released as part of the 1998 Master Settlement Agreement.  These documents are now publicly available on the University of  California San Francisco (UCSF) website.

This analysis demonstrates that the actual purpose of tobacco industry support for the program was to make the industry look good (public relations) and to convince legislators and health officials that regulation would be unnecessary.

The industry effectively recruited astonishing numbers of private business, retail, and trade groups (expected) and state health, legal, and police agencies (which should have known better) as partners in this program.  The paper lists these groups in tables that take up nearly five pages.

As the paper explains:

Economic theory predicts that industry self-regulation will achieve social benefits far smaller than those gained from government regulation, although governments increasingly view self-regulation as a means to achieve public goals without public spending. However, industries and governments may have competing agendas, suggesting that public health advocates should be wary of self-regulation strategies…. This program’s success in reaching tobacco retailers and attracting independent allies has made We Card one of the tobacco industry’s major public relations achievements. However, despite industry claims that the program is effective, internal industry evidence suggests that We Card has not reduced tobacco sales to minors and that it was not designed to do so. Instead, We Card was explicitly structured to improve the industry’s public image and to thwart regulation and law enforcement activity.

The authors’ conclusion: “Policymakers should be cautious about accepting industry self-regulation at face value, both because it redounds to the industry’s benefit and because it is ineffective.”

Proponents of food industry self-regulation and of partnerships and alliances with food companies should read this study carefully.

Note: Only the Abstract is available to non-subscribers.  The reference is Apollonio DE, Malone RE, The “We Card” Program: Tobacco Industry “Youth Smoking Prevention” as Industry Self Preservation.. Am J Public Health 2010;100:1188-1201.

The Rudd Center at Yale is devoted to establishing a firm research basis for obesity interventions.  Its latest contribution is a paper in the Milbank Quarterly from its director, Kelly Brownell, and co-author Kenneth Warner, an equally distinguished anti-smoking researcher from the University of Michigan.  Its provocative title: The perils of ignoring history: Big Tobacco played dirty and millions died.  How similar is Big Food?

The paper is getting much attention.  A spokesman for the American Dietetic Association, a group well known for its close ties to food companies, emphasizes that food is not tobacco.  Of course it’s not.  But food companies often behave like tobacco companies, and not always in the public interest.  The Milbank paper provides plenty of documentation to back up the similarity.  Worth a look, no?

April 3 update: Evidently, FoodNavigator.com thinks so.  It is asking readers to file 100 word comments on issues raised by the paper by April 8.   And here are the comments.

Politico reports: White House invites 46 farm, food groups to discuss MAHA report

The MAHA report, as I’ve written, could have enormous implications for food system businesses.  The problems it describes with the health of America’s children call for policies that could reduce profits for companies that, for example, produce seed oils, food products with color additives, and ultra-processed foods in general.

The secretaries of HHS and USDA have promised to soon issue dietary guidelines to reduce intake of such foods.

Food companies making products targeted by such views are unlikely to be happy with the report.  If past history is any indication, they will lobby for exceptions, exemptions, and delays, and will insist that the proposed measures have no scientific basis (which some indeed do not), violate the First Amendment, and will cost jobs—the playbook that worked for such a long time for the tobacco industry.

The Politico report is behind a paywall, but Helena Bottemiller Evich obtained a list of who has been invited and writes the details in FoodFix: White House holds flurry of industry meetings in wake of MAHA drama. 

Her list shows separate meetings for fruit and vegetable producers and trade groups, and those for meat and dairy, restaurants, grocers, beverage companies (Big Soda), commodity groups, and Big Ag.

Oh to be a fly on those walls.

It’s hard for me to believe that this administration will do anything to reduce business interests, and early indications are that RFK Jr is merely calling for companies to take voluntary actions, and individuals to take personal responsibility—neither of which is likely to have any chance of Making America Healthy Again.

I look forward to seeing what they do with the dietary guidelines and the next MAHA Commission report on policy—both expected by the end of the summer, apparently.  Stay tuned.

 

The MAHA Commission released its report last week: The MAHA Report: Make Our Children Healthy Again.  Assessment.

This is one impressive report, forcefully written and tightly documented (it cites my work, among that of many others).

Overall, it paints a devastating portrait of how our society has failed our children.

It begins by stating that “The health of American children is in crisis” due to:

• Poor diet
• Aggregation of environmental chemicals
• Lack of physical activity and chronic stress
• Overmedicalization

The result: high rates of obesity, type 2 diabetes, neurodevelopmental disorders, cancer, allergies  and mental health problems among kids.

Here are some selected items I particularly appreciated in the report.  The bullet points are direct quotes.

On poor diet

• Most American children’s diets are dominated by ultra – processed foods (UPFs ) high in added sugars , chemical additives , and saturated fats, while lacking sufficient intakes of fruits and vegetables.
• Pesticides , microplastics , and dioxins are commonly found in the blood and urine of American children and pregnant women— some at alarming levels.
• Children are exposed to numerous chemicals , such as heavy metals , PFAS , pesticides , and phthalates, via their diet, textiles, indoor air pollutants, and consumer products.
• To get into schools , many food companies have reformulated their products with minor ingredient adjustments to qualify for the federal Smart Snack program by meeting the school nutrition standards, which children can purchase separate from school meals.

The driving factors for poor diets

• Consolidation of the food system
• Distorted nutrition research and marketing
• Compromised dietary guidelines

On the dietary guidelines  

They maintain problematic reductionist recommendations, such as:

• Advising people to “reduce saturated fat” or “limit sodium” instead of focusing on minimizing ultra-processed foods.
• Treating all calories similarly, rather than distinguishing between nutrient-dense foods and ultra-processed products.
• Remain largely agnostic to how foods are produced or processed: There is little distinction between industrially processed foods and home-cooked or whole foods if their nutrient profiles look similar.
• Added sugars, saturated fats and sodium are treated as proxies for ultra-processed foods. For instance, a cup of whole-grain ready to eat fortified breakfast cereal and a cup of oatmeal with fruit might both count as “whole grain servings,” and the guidelines do not weigh in on differences in processing.

They also,

• Do not explicitly address UPFs.
• Have a history of being unduly influenced by corporate interests .

On food systems

• The greatest step the United States can take to reverse childhood chronic disease is to put whole foods produced by American farmers and ranchers at the center of healthcare.
• Traditional Field Crops vs. Specialty Crops : Historically, federal crop insurance programs have primarily covered traditional field crops like wheat , corn , and soybeans, while providing much less support for specialty crops such as fruits, vegetables, tree nuts, and nursery plants.

On Corporate Capture 

• Although the U.S. health system has produced remarkable breakthroughs, we must face the troubling reality that the threats to American childhood have been exacerbated by perverse incentives that have captured the regulatory bodies and federal agencies tasked with overseeing them .
• Limited comparisons between industry-funded research versus non- industry studies have raised concerns over potential biases in industry-funded research…Additionally, some industry leaders have engaged in promoting ghostwriting and sponsored reviews to influence the scientific literature.
• Notably, this ghostwriting strategy mirrors tactics used by the tobacco industry to distort scientific consensus is largely propelled by “corporate capture,” in which industry interests dominate and distort scientific literature, legislative actions, academic institutions, regulatory agencies, medical journals, physician organizations, clinical guidelines, and the news media.
• The pharmaceutical industry, with its vast resources and influence, is a primary driver of this capture, though similar dynamics pervade the food and chemical industries.

Research recommendations

• GRAS Oversight Reform: Fund independent studies evaluating the health impact of self-affirmed GRAS food ingredients, prioritizing risks to children and informing transparent FDA rulemaking.
• Nutrition Trials: NIH should fund long-term trials comparing whole-food, reduced-carb, and low-UPF diets in children to assess effects on obesity and insulin resistance.
• Large-scale Lifestyle Interventions: Launch a coordinated national lifestyle-medicine initiative that embeds real-world randomized trials-covering integrated interventions in movement, diet, light exposure, and sleep timing-within existing cohorts and EHR networks.

Comment

The report has been criticized for not getting some of the science right.  The agriculture industry is particularly concerned about the attack on the chemicals it uses.  It is said to be outraged by the report.  The report did throw Big Ag this bone: “Today, American farmers feed the world, American companies lead the world, and American energy powers the world.”

But the report raises one Big Question:  What policies will this administration come up with to deal with these problems?  These, presumably, will be in the next report, due in about 80 days.

This is an extraordinary report, a breath of fresh air in many ways, and I would love to know who wrote it.

But to fix the problems it raises will require taking on not only Big Ag, but also Big Food, Big Pharma, Big Chemical, and other industries affected by these and its other recommendations (the report also says a lot about drugs and mental health).  Big Ag has already weighed in.  Others are sure to follow.

Oh.  And it’s hard to know how policies can be implemented, given the destructive cuts to FDA, CDC, and NIH personnel and budget.

I will be watching this one.  Stay tuned.

Resources

• The press release: MAHA Commission Unveils Landmark Report Exposing Root Causes of Childhood Chronic Disease Crisis
• The Executive Order establishing the MAHA Commission
• The Commission report: Make Our Children Healthy Again Assessment

Additional resource

• Errol Schweizer sent me his analysis on Medium, well worth reading.

 

If you are going to do advocacy (or be an activist, if you prefer), it’s likely to be far more effective if done right.  The steps begin with identifying the problem you want solved, deciding what you want to do to solve it, and figuring out who or what you have to convince to solve the problem.

Note: the best thing I’ve ever read about how to do this is the Midwest Academy’s how-to manual for activists, Organizing for Social Change.

Research is a crucial component of effective policy advocacy; it’s the basis of convincing change agents to agree to make the change.

The Global Health Advocacy Incubator (“Changing Policies to Change Lives”) and the Campaign for Tobacco-Free Kids have  just published Research for Advocacy Action Guide: Five Stretegies to Use Research in a Policy Change campaign.

This tells you what to look for, how to find it, what to highlight, and how to present it. Download the Guide.

The research piece extends the information in these groups’ Advocacy Action Guide, a shorter version of the information from the Midwest Academy.

Advocacy done “by the book” has a much better chance of success than what might seem intuitive.  These guides are well worth reading.

Advocacy, by the way, is one of the words on the government’s new forbidden list.  This alone is why we need it more than ever.  Get to work!

 

If you have any doubts about the value of the concept of ultra-processed, the breadth and extent of industry pushback against the idea is excellent evidence.  The concept is an existential threat to the processed food industry, and it is fighting back.  The Italian food industry is especially concerned because it also has the Nutri-Score front-of-pack labeling system to contend with; the letter grades on ultra-processed products tend to be C’s, D’s, and E’s—as bad as they come.

Here’s an example of the pushback.

The opinion piece: Visioli, F., Del Rio, D., Fogliano, V., Marangoni F, Ricci C, Poli A.  Ultra-processed foods and health: are we correctly interpreting the available evidence?. Eur J Clin Nutr 79, 177–180 (2025). https://doi.org/10.1038/s41430-024-01515-8

Competing interests: AP and FM are the Chairman and Scientific Director, respectively, of NFI—Nutrition Foundation of Italy, a non-profit organisation partially supported by Italian and non-Italian Food Companies. All other authors declare no conflict of interest associated with this publication.

Comment: The senior (last) author and one other run the Italian Nutrition Foundation, an organization sponsored by food companies, Italan and international.  This makes the Foundation an industry front group, pretending to be independent, but not.  Its job is to further the commercial interests of its corporate sponsors, which is what it is doing here.  It is using the tobacco industry playbook: cast doubt on the research, suggest alternatives, argue against regulation.  The foundation’s authors are joined by academic and government authors, who have their own, not necessarily commercial, reasons for unhappiness with the UPF concept, which focuses on degree of processing, not nutrient content.  Yes, nutrients matter, but there are better ways of getting them than through UPFs.