COVID-19

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Background

The COVID-19 pandemic is of particular relevance to the tobacco industry due to the nature of the disease. It is a viral infection of the lungs that can be severe and fatal. A host of tobacco-related conditions have been identified as associated risk factors for a severe form of the disease including respiratory and cardiovascular diseases.1 Tobacco products and their associated health risks have therefore received increasing negative attention.2

In addition to the disease itself, the resulting changes in global society, with lockdowns and social distancing imposed across much of the globe, have had cascading economic effects for many industries. As Philip Morris International (PMI) told investors:

“The COVID-19 pandemic has created significant societal and economic disruption, and resulted in closures of stores, factories and offices, and restrictions on manufacturing, distribution and travel, all of which will adversely impact our business, results of operations, cash flows and financial position during the continuation of the pandemic. Although we have business continuity plans and other safeguards in place, there is no assurance that such plans and safeguards will be effective”.3

Attempts to confuse the science linking smoking to COVID-19

Influencing the scientific debate has been a deliberate tobacco industry tactic through which the industry seeks to achieve several interrelated goals:

  • to influence the research agenda;
  • to create doubt about evidence, by publicly denying the relationship between smoking and cancer and the addictiveness of nicotine; and
  • to divert the issue away from the causal link between smoking and various non-communicable diseases and promote diversionary issues such as hereditary disease, healthy cigarettes or indoor climate.

A key aim in influencing science is the creation of doubt around a given topic, be it the impact of second-hand smoke, links to diseases or newly arising public health issues such as COVID-19. Calls that ‘more research is needed’ prevent the timely implementation of regulation, draw out the debate and confuses the policymakers and the public. The tactic has been employed since its suggestion by PR firm Hill and Knowlton in 1953.

Doubt creation is enabled by the commission and funding of research that fits the preferred industry narrative. Industry-funded research either carried out directly or through surrogate scientists or organisations such as the Tobacco Industry Research Committee (TIRC), often seek alternative explanations for health risks associated with smoking e.g. Medical research points to many possible causes of cancer.4

The industry also exerts influence over science by ghost writing articles and research and covertly funding scientists, as was the case with PMI’s White Coat Project, which sought to “restore social acceptability of smoking”.5 Indirect influence is achieved by funding independent research6 in areas that benefit the industry and that distract from the harm caused by cigarettes, e.g. next generation products (NGPs).

Ultimately, by influencing science the tobacco industry aims to shape the evidence-base  upon which decision makers set policy. And by creating uncertainty around the smoking and health debate, it simultaneously attempts to reduce public support for regulatory action.

Documents released though litigation show the industry’s long history with using science to further its corporate objectives.7 For more information on the tobacco industry’s attempts to influence research, see our page Influencing Science.

Many of these tactics have quickly become apparent as the industry responds to COVID-19:

  • Peer reviewed studies have highlighted an increase in COVID-19 severity in smokers.8 However the industry and its allies appear to favour the promotion of non-peer reviewed studies9 that conclude smoking is not an associated risk factor or suggest that media coverage has been unbalanced and lacking nuance.10
  • A non-peer reviewed study11 conducted by Dr. Konstantinos Farsalinos and others “to examine the prevalence of current e-cigarette use and current smoking among hospitalized patients with COVID-19 in China”. It concludes that a below average number of smokers are being hospitalised with COVID-19 and suggests that it may be down to the role of ACE-2 receptors and a “protective effect” of nicotine. Farsalinos has previously received e-cigarette sponsorship but he explicitly says he does not take tobacco industry money and there is no evidence of such funding. This paper was reported as ‘Nicotine Stops COVID-19’ in the popular UK newspaper The Daily Mail12 and elsewhere. David Hockney has been a prominent voice championing this research. He has links to the tobacco industry-funded Forest group and regularly speaks out against tobacco control.
  • There has been concern about the risk of increased COVID-19 transmission13 (touching mouth, blowing vapour) and severity14 (unknown lung damage) when using next generation products, though the science is uncertain. Riccardo Polosa, who has received funding from the Foundation for a Smoke-Free World (FSFW), has challenged claims that vaping poses a risk during COVID-19. Separately, Dr Farsalinos has posited the potential anti-viral benefits of nicotine and propylene glycol inhalation.15 There is no evidence that either of these comments are industry sponsored or that the research itself is flawed. However they have been widely reported by industry supporters and industry-linked groups such as the Reason Foundation16 and FSFW.10
  • The industry and its allies have highlighted17 several studies that report an under-representation of smokers among COVID-19 patients18 and hypothesise a therapeutic role for nicotine in patients with COVID-19.19 There is no evidence that the industry was involved in these studies.

Tobacco industry participation in vaccine development

The industry has investments in biotechnology companies and pharmaceuticals and these have become involved in vaccine development for COVID-19. These investments are  part of the tobacco industry’s business strategy as well as  making tobacco companies appear “part of the solution”20 and gives them a respectable voice in the scientific debate.

  • Kentucky BioProcessing is a fully owned subsidiary of British American Tobacco (BAT). It has a history of drug development. The firm was bought initially by R J Reynolds in January 2014 and came to public attention later that year with its ZMapp Ebola drug.21 However the drug is not yet a viable treatment. The company is now attempting to produce a vaccine using tobacco plants.22
  • PMI owns a 40% stake in Medicago and it is also attempting to produce a COVID-19 vaccine using tobacco plant relatives.23

Targeted donations and corporate social responsibility

The tobacco industry has long used “corporate social responsibility” (CSR), which refers to the practice of corporations using voluntary social performance standards and investments, as a strategy to gain legitimacy, increase public trust and advance its business interests. Tobacco companies invest in wide range of causes, including sustainability and environmental and human rights NGOs, universities and art institutions. The WHO denounces tobacco industry CSR involvement as “an inherent contradiction”. Article 5.3 of the WHO Framework Convention on Tobacco Control (FCTC) explicitly bans such activity and its promotion.24

CSR is also used as a strategy by tobacco companies to facilitate access to policymakers, break down opposition and promote voluntary regulation.25

The tobacco industry makes a point of announcing donations made in the wake of disasters around the world. Between 2018 and 2020, Philip Morris International (PMI) and Japan Tobacco International (JTI) included donations for disaster relief to more than 18 countries in their corporate reporting.26272829 Targeted donations such as these have been critiqued as “crisis-washing” (similar to “greenwashing”) the actions of corporations, like tobacco companies, whose business actively produces social and health harms.30 The outbreak of COVID-19 is no exception to the tobacco industry’s historic attempts to take advantage of disasters to promote its own CSR agenda and products.

  • PMI came under fire for donating 50 ventilators to a Greek hospital.31
  • A major problem during the pandemic has been shortages of Personal Protective Equipment (PPE) and hand sanitiser. This is a particular issue in developing countries and the tobacco industry has donated ventilators, PPE and hand sanitiser in Bangladesh,32 Nigeria,33 the Philippines34 and a growing list of other countries.35

Policy interference and delayed regulation

As governments have looked to introduce different regulations on tobacco products to reduce smoking prevalence, so the tobacco industry has fought to delay or derail such initiatives. If regulations are proposed then the industry will use a variety of arguments to argue that they are not necessary, will cost jobs, will be counter-productive or are illegal. The fall-back position is often that such regulations should be voluntary and written in conjunction with the industry, even though that is in violation of Article 5.3.

Once the regulations have been introduced then the industry will look to undermine their effectiveness by questioning what benefits they bring, seek legal challenges or use the legislative process to amend them.36 A good example of this are the regulations on plain packaging introduced by a number of countries.

The industry has deployed the same tactics in the context of the global COVID-19 pandemic.

Challenging classifications of “essential” businesses

  • Riccardo Polosa successfully lobbied for vape shops to remain open in Italy during the lockdown, with a statement on the Foundation for a Smoke Free World-funded CoEHAR website.37
  • In Pakistan, where the health system was already under strain from smoking-related disease,38 PMI successfully lobbied to reopen its factory, despite evidence of black-market tax avoidance and an initial restriction on tobacco sales.39
  • PMI maintained cigarette production in Brazil (Santa Cruz do Sol), to avoid “compromising the business”, despite a decree banning non-essential industrial manufacture.40
  • In South Africa, BAT lobbied the government to reverse a decision to ban cigarette sales while a industry association threatened legal action.41

Delaying major tobacco control measures

  • In America, The National Association of Tobacco Outlets and Altria successfully lobbied the Food and Drug Administration (FDA) for an eight-week deadline extension (previously 12 May 2020) to apply for authorisation to sell certain tobacco products. Currently some NGP’s are sold pending FDA authorisation.42
  • In New Zealand, the government went ahead with legislation to regulate vaping despite vaping advocacy groups attempting to extend the consultation period due to COVID-19.43

Criticism of tobacco control organisations and advocates

  • Industry funding has been linked to pro-vaping pandemic response,44 with particular criticism from the industry and its allies levelled at New York City Mayor Bill de Blasio and Professor Stanton Glantz of the Center for Tobacco Research Control & Education at UCSF.45
  • The WHO has in turn cautioned governments against working with Big Tobacco.46

Relevant TT resources

STOP resources

From the Global Center for Good Governance in Tobacco Control

COVID-19 and Tobacco Industry monitoring resources

References

  1. R.E. Jordan, P. Adab & K.K. Cheng, Covid-19: risk factors for severe disease and death, BMJ, 2020;368:m1198
  2. M. Hefler & C.E. Gartner, The tobacco industry in the time of COVID-19: time to shut it down?, Tobacco Control, 2020;29:245-246
  3. Philip Morris, 2020 First-Quarter Results, April 2020, accessed April 2020
  4. A.M. Brandt, Inventing conflicts of interest: a history of tobacco industry tactics. American journal of public health, 102(1), 63–71, https://doi.org/10.2105/AJPH.2011.300292
  5. Philip Morris, Proposal for the Organisation of the Whitecoat Project, Truth Tobacco Industry Documents, 25 June 2002, kynp0183
  6. M. Enserink, Big tobacco’s offer: $1 billion for research. Should scientists take it?, February 2018, accessed April 2020
  7. Truth Tobacco Industry Documents website, UC San Francisco
  8. C.I. Vardavas & K. Nikitara. COVID-19 and smoking: A systematic review of the evidence, Tobacco Induced Diseases, 2020;18(20), doi:10.18332/tid/119324
  9. C.M. Petrilli, S.A. Jones, J. Yang, H. Rajagopalan, L.F. O’Donnell, Y. Chernyak, K. Tobin, R.J. Cerfolio, F. Francois, L.I. Horwitz, Factors associated with hospitalization and critical illness among 4,103 patients with COVID-19 disease in New York City, medRxiv, 8 A April 2020, accessed April 2020
  10. abC. Gardner, COVID-19 And Lung Health: Smoking And Vaping, Foundation for a Smoke Free World, FSFW blog, April 2020, accessed April 2020
  11. K. Farsalinos, A. Barbouni, R. Niaura, Smoking, vaping and hospitalization for COVID-19, qeios.com, 4 April 2020, doi:10.32388/Z69O8A.13
  12. S. Blanchard, Does smoking PROTECT against coronavirus?, Daily Mail, April 2020, accessed April 2020
  13. T. Yoshida, Smoking may spread coronavirus easily, make symptoms worse: Tokyo doctor, The Mainichi, March 2020, accessed April 2020
  14. N. Layne, Smoking or vaping increases risks for those with coronavirus: NYC mayor, Reuters, March 2020, accessed April 2020
  15. S. Marar, No, vapers are not at greater risk of catching Covid-19, Spiked, April 2020, accessed April 2020
  16. G. Bentley, Does Vaping Increase Your Risk of Getting Coronavirus?, Reason Foundation, March 2020, accessed April 2020
  17. E. N. Brown, Can Nicotine Treat COVID-19? French Researchers Think So, Reason Foundation, April 2020, accessed April 2020
  18. M. Miyara et al., Low incidence of daily active tobacco smoking in patients with symptomatic COVID-19, qeios.com, 21 April 2020, accessed April 2020
  19. J. Changeux et al., A nicotinic hypothesis for Covid-19 with preventive and therapeutic implications, qeios.com, 21 April 2020, accessed April 2020
  20. A. Ralph, WHO warns on tobacco industry role in vaccine, The Australian, April 2020, accessed April 2020
  21. NBC News, Ebola treatment: how big tobacco and the military came together, August 5, 2014, accessed April 2020
  22. H. Ziady, This is no April Fool’s. British American Tobacco is trying to make a coronavirus vaccine, CNN Business, April 2020, accessed April 2020
  23. C. Gertler, Coronavirus Vaccine Race Gets Unlikely Partner: Big Tobacco, Bloomberg, April 2020, accessed April 2020
  24. World Health Organisation, Guidelines for implementation of Article 5.3 of the WHO Framework Convention on Tobacco Control: on the protection of public health policies with respect to tobacco control from commercial and other vested interests of the tobacco industry, point 3, 2008, accessed April 2020
  25. G. Fooks, A. Gilmore, J. Collin et al., The limits of corporate social responsibility: techniques of neutraliztion, stakeholder management and political CSR, J Bus Ethics, 2013;112(2):283-299, doi: 10.1007/s10551-012-1250-5
  26. Japan Tobacco International, Sustainability Report 2018, JTI website, 2019, accessed March 2020
  27. Japan Tobacco Inc., Integrated Report 2019, JT Group websiste, March 2020, accessed March 2020
  28. Philip Morris International, Sustainability Report 2018, PMI website, 2019, accessed March 2020
  29. Philip Morris International, Charitable contributions PMI 2014-2018, PMI website, undated, accessed March 2020
  30. R. Hicks, The corporate world is helping to combat coronavirus – but mind the virus-washing, Eco Business, 2 April 2020, accessed April 2020
  31. I. Togoh, Big Tobacco Criticized For Donating Ventilators To Greek Hospitals Amid Coronavirus Crisis, Forbes, 30 March 2020, accessed April 2020
  32. Professional bodies, NGOs donate PPE for public hospitals, Bangladesh Post, 31 March 2020, accessed April 2020
  33. COVID-19: Kwara shuts borders, fumigate markets, Sun News Online, 31 March 2020, accessed April 2020
  34. LT Group clarifies donation of face masks to Cavite hospital, The Mindanao Daily Mirror, 2 April 2020, accessed April 2020
  35. Global Centre for Good Governance in Tobacco Control, Tobacco industry’s Covid donations vs economic cost of tobacco, April 23 2020, accessed April 2020
  36. S. Ulucanlar, G.J. Fooks, A.B. Gilmore, The Policy Dystopia Model: An Interpretive Analysis of Tobacco Industry Political ActivityPLOS Medicine, 2016;13(9): e1002125
  37. Italy: Riccardo Polosa talks about smoking, vaping and COVID-19, CoEHAR, March 2020, accessed April 2020
  38. Pakistan’s tobacco epidemic leaves it in no state to fight the coronavirus, Qrius, 31 March 2020, accessed April 2020
  39. A. Ahmed, Companies begin resumption of operations in Pakistan, Business Recorder, 6 April 2020, accessed April 2020
  40. T. Dias, CORONAVIRUS: PHILIP MORRIS INCREASES CIGARETTE PRODUCTION AMID DEATHS FROM RESPIRATORY FAILURE, April 2020, accessed April 2020
  41. ATCA press statement, Africa must mobilise to stop the tobacco industry from using Covid-19 to grow its business, April 20, 2020, accessed April 2020
  42. A. LaVito, Altria Asks FDA to Delay Regulatory Deadline Due to Coronavirus, Bloomberg Law, March 2020, accessed April 2020
  43. Rushed Vaping Bill During Covid-19, Grossly Unfair, Scoop Politics, March 2020, accessed April 2020
  44. T. Kary, Philip Morris Money Is Funding Pro-Vaping Virus Spin, Bloomberg, April 2020, accessed April 2020
  45. S. Marar, No, vapers are not at greater risk of catching Covid-19, Spiked, April 2020, accessed April 2020
  46. A. Ralph, Be wary of working with Big Tobacco, says WHO, The Times, April 2020, accessed April 2020