Heide Weishaar

“Working the System”—British American Tobacco's Influence on the European Union Treaty and Its Implications for Policy: An Analysis of Internal Tobacco Industry Documents

Katherine Smith and colleagues investigate the ways in which British American Tobacco influenced the European Union Treaty so that new EU policies advance the interests of major corporations, including those that produce products damaging to health.

Is the increasing policy use of Impact Assessment in Europe likely to undermine efforts to achieve healthy public policy

European policymakers have recently become increasingly committed to using Impact Assessment (IA) to inform policy decisions. Welcoming this development, the public health community has not yet paid sufficient attention to conceptual concerns about IA or to corporate efforts to shape the way in which IA is used. This essay is a thematic analysis of literature concerning IA and associated tools and a related assessment of the European Unions (EU) new ‘integrated’ IA tool. Eight key concerns regarding IA are identified from the literature, many of which relate to the potential for undue corporate influence. Assessment of the EUs IA tool suggests that many of these concerns are valid. The findings raise crucial questions about the role of IA in public policy. By focusing mainly on the impact on the economy and business environment, the EUs current approach to IA may undermine healthy public policy. Those interested in public health need to acknowledge and respond to the problems associated with IA and evaluate the effects of ‘integrated’ IA tools on policy decisions affecting public health.

Consequences of international migration: a qualitative study on stress among Polish migrant workers in Scotland.

OBJECTIVES This article aims to gain a greater understanding of the personal experiences of Polish migrant workers who work in manual and low-skilled jobs in Scotland, and to explore the experiences of stress and its impact on physical and psychological health and well-being. STUDY DESIGN Qualitative in-depth interviews and subsequent focus groups. METHODS Eight in-depth interviews and two focus groups were conducted in Spring 2007. Data were analysed thematically using Nvivo computer software. RESULTS The following stress factors were identified: difficulties with communication, unfamiliarity with the new environment and culture, work-related stress, practical stress, and social stress. Several respondents gave accounts of decreased health, particularly psychological and psychosomatic distress, and attributed this to the variety of stressors and demands on their physical, sociocultural and psychological adaptation abilities. CONCLUSIONS Cross-border migration is a time of transition and demands adjustment by the individual migrant as well as the country of settlement. Due to high acculturative demands and increased vulnerability, migrant workers need to be recognized as a specific target group for health promotion and health services.

Global Health Governance and the Commercial Sector: A Documentary Analysis of Tobacco Company Strategies to Influence the WHO Framework Convention on Tobacco Control

Heide Weishaar and colleagues did an analysis of internal tobacco industry documents together with other data and describe the industrys strategic response to the proposed World Health Organization Framework Convention on Tobacco Control.

Tobacco industry attempts to undermine Article 5.3 and the “good governance” trap

The Framework Convention on Tobacco Control1 (FCTC), which has now been ratified by 166 countries, is the first global public health treaty to be developed by the World Health Organization and represents a crucial milestone for tobacco control. In recognition of systematic, often covert tobacco industry efforts to undermine tobacco control policy, Article 5.3 of the FCTC specifically requires that, “in setting and implementing their public health policies with respect to tobacco control, Parties shall act to protect these policies from commercial and other vested interests of the tobacco industry in accordance with national law”.1 The impact of Article 5.3 depends on governments’ commitment to implementing the guidelines agreed in Durban, in November 2008.2 Given that tobacco industry success in undermining tobacco control to date has relied on its ability to influence policy,3 it is perhaps unsurprising that tobacco companies lobbied hard against the Article 5.3 guidelines and are now trying to undermine their implementation by claiming that they contravene existing commitments to “better regulation” and “good governance”.4 5 6 7 What the companies fail to acknowledge is that at least one major tobacco company, British American Tobacco (BAT), had a lead role in promoting these concepts. In the European Union and the United Kingdom the strategy being employed by major tobacco companies (both before and after the agreement of the Article 5.3 guidelines) is to claim that Article 5.3 contravenes existing official standards on consultation because it requires complete exclusion of the tobacco industry from policy discussions (in fact, it merely requires that consultation should be limited to that which is strictly necessary and should be transparent and accountable). Such claims are frequently framed within broader policy commitments to “better regulation” or “good governance”, as table 1 illustrates. View this table: Table 1 Tobacco industry attempts to undermine Article …

Tobacco industry attempts to influence and use the German government to undermine the WHO Framework Convention on Tobacco Control

Background Germany has been identified as one of a few high-income countries that opposed a strong Framework Convention on Tobacco Control (FCTC), the WHOs first global public health treaty. This paper examines whether the tobacco industry had influenced the German position on the FCTC. Methods Analysis of previously confidential tobacco industry documents. Results The tobacco industry has identified Germany as a key target within its global strategy against the FCTC. Building on an already supportive base, the industry appears to have successfully lobbied the German government, influencing Germanys position and argumentation on key aspects of the FCTC. It then used Germany in its efforts to weaken the FCTC. The evidence suggests that the industry enjoyed success in undermining the Federal Health Ministrys position and using Germany to limit the European Union negotiating mandate. The tactics used by the tobacco industry included the creation of controversy between the financial, trade and other ministries on one side and the health ministry on the other side, the use of business associations and other front groups to lobby on the industrys behalf and securing industry access to the FCTC negotiations via the International Standardization Organization. Conclusion The evidence suggests that Germany played a major role in the tobacco industrys efforts to undermine the FCTC. Germanys position consistently served to protect industry interests and was used to influence and constrain other countries. Germany thus contributed significantly to attempts to weaken an international treaty and, in doing so, failed in its responsibility to advance global health.

“You have to be flexible”—Coping among polish migrant workers in Scotland

Migrants after international relocation are confronted with various stressors that can challenge their adjustment capacities and lead to decreased health. Based on the analysis of qualitative interviews and focus groups, this article is the first to explore successful coping strategies of Polish migrants in Edinburgh, thereby providing insight into the coping process after economic migration across the European Union. The study reveals that Polish migrants are very resourceful in dealing with the stressors they face. It confirms the employment of various types of coping including problem-solving, emotion-regulating and appraisal-oriented strategies. Social support and appraisal emerge as important variables and are perceived to considerably influence the subsequent stages of the adjustment process. Based on the assumption that coping is likely to affect the health of migrant populations, a better understanding of coping followed by tailored support for international migrants might have a positive influence on public health, particularly in societies where international mobility and large migrant populations are common phenomena.

E-cigarettes, a safer alternative for teenagers? A UK focus group study of teenagers' views

Objective Concerns exist that e-cigarettes may be a gateway to traditional cigarettes and/or (re)normalise teenage smoking. This qualitative study explores how teenagers in the UK currently perceive e-cigarettes and how and why they do or do not use them. Design 16 focus groups were conducted across the UK between November 2014 and February 2015, with 83 teenagers aged 14–17. All discussions were digitally recorded, transcribed verbatim, imported into NVivo 10 and thematically analysed. Results Teenagers generally agreed that e-cigarettes are useful products for smokers, including teenage smokers, to quit or reduce traditional cigarette use. Concerns were expressed about lack of information on their precise ingredients and any unknown risks for users and bystanders. However, teenagers typically viewed e-cigarettes as substantially less harmful than traditional cigarettes. They perceived e-cigarettes as attractive, with products described as ‘fun’ and having ‘great flavourings’. Seeing websites or social media featuring e-cigarettes, especially YouTube ‘vaping tricks’, prompted some experimentation and imitation. E-cigarettes were used in a variety of situations, including at parties or when they could not smoke traditional cigarettes. A very few participants suggested covert use was a possibility and that e-cigarettes might help maintain a fledgling nicotine habit. Conclusions Teenagers support the use of e-cigarettes as smoking cessation aids for established adult smokers. However, they engage with these products differently from adults, with the novel hypothesis that covert use could potentially reinforce traditional cigarette smoking requiring further investigation. Policy responses should more clearly meet the needs of young people, as well as helping established adult smokers.

Capturing complexity: mixing methods in the analysis of a European tobacco control policy network

Social network analysis (SNA), a method which can be used to explore networks in various contexts, has received increasing attention. Drawing on the development of European smoke-free policy, this paper explores how a mixed-method approach to SNA can be utilised to investigate a complex policy network. Textual data from public documents, consultation submissions and websites were extracted, converted and analysed using plagiarism detection software and quantitative network analysis and qualitative data from public documents and 35 interviews were thematically analysed. While the quantitative analysis enabled understanding of the network’s structure and components, the qualitative analysis provided in-depth information about specific actors’ positions, relationships and interactions. The paper establishes that SNA is suited to empirically testing and analysing networks in EU policy-making. It contributes to methodological debates about the antagonism between qualitative and quantitative approaches and demonstrates that qualitative and quantitative network analysis can offer a powerful tool for policy analysis.

Why media representations of corporations matter for public health policy: a scoping review.

BackgroundMedia representations play a crucial role in informing public and policy opinions about the causes of, and solutions to, ill-health. This paper reviews studies analysing media coverage of non-communicable disease (NCD) debates, focusing on how the industries marketing commodities that increase NCD risk are represented.MethodsA scoping review identified 61 studies providing information on media representations of NCD risks, NCD policies and tobacco, alcohol, processed food and soft drinks industries. The data were narratively synthesized to describe the sample, media depictions of industries, and corporate and public health attempts to frame the media debates.ResultsThe findings indicate that: (i) the limited research that has been undertaken is dominated by a focus on tobacco; (ii) comparative research across industries/risk-factors is particularly lacking; and (iii) coverage tends to be dominated by two contrasting frames and focuses either on individual responsibilities (‘market justice’ frames, often promoted by commercial stakeholders) or on the need for population-level interventions (‘social justice’ frames, frequently advanced by public health advocates).ConclusionsEstablishing the underlying frameworks is crucial for the analysis of media representation of corporations, as they reflect the strategies that respective actors use to influence public health debates and decision making. The potential utility of media research lies in the insights that it can provide for public health policy advocates about successful framing of public health messages and strategies to counter frames that undermine public health goals. A better understanding of current media debates is of paramount importance to improving global health.