Search results: tobacco

At the end of December, I received an email from Paula Johns, director of ACT Health Promotion in Brazil.

Today we are celebrating the approval of the tax reform in Brazil. This Tuesday, Dec 17th, the text was approved by the National Congress!!

The tax reform is a historic achievement for Brazil and we celebrate the fact that products harmful to health, such as tobacco, alcohol and sugary drinks, are included in the selective tax. We followed each stage of the discussion and saw the intense lobbying by the economic sector that profits from these products to weaken the selective tax proposal, but it was finally approved, as well as the tax-exempt basic food basket, with healthier products in accordance with the Brazilian Food Guidelines.

…Important to highlight that our National Congress is one of the worst we’ve ever had! To beat The Coca-Cola lobby there is quite an achievement! Wanted to celebrate with you. The inclusion of carbonated drinks in the selective tax now opens the door for a broader discussion about other categories of ultraprocessed foods in the revision that will happen in five years from now.

I also received a press announcement: “Historic Public Health Victory”: Vital Strategies Applauds Brazil’s Approval of Selective Tax on Tobacco, Soft Drinks, and Alcohol

The newly approved legislation includes annual tax adjustments for tobacco, soft drinks and alcohol in line with inflation. Additionally, it establishes an innovative basic food basket of healthy, sustainable products exempt from taxation. The tax reform also grants a 60% reduction in tax rates for horticultural and minimally processed products, nuts, oils, flours, and items from Brazil’s rich socio-biodiversity.  These measures will help ensure better access to nutritious food while discouraging consumption of unhealthy commodities.

…The specific tax rates for tobacco, alcohol, and soft drinks will be determined in 2025. To fully realize the public health benefits of this new tax structure, the levels of tax must be sufficient to reduce consumption. Vital Strategies, Brazil, will collaborate closely with partners to advocate for tax rates that prioritize public health. Setting these rates at levels that significantly reduce consumption of harmful products will protect communities from preventable diseases.

I tried to find more details, and hit upon Covington ‘s Brazil’s historic tax reform: a primer.  This lays out what will have to happen before implementation.  It says almost nothing about the public health taxes except this:

Key Change: the Selective Tax
In addition to the dual VAT (CBS/IBS), the reform establishes a new Selective Tax (IS) to regulate goods and services it characterizes as having significant negative health and environmental externalities. The IS will be charged on production, extraction, sale, or importation of these goods and services.

This will be interesting to watch.  Stay tuned!

The Dietary Guidelines Advisory Committee may not think there is much to ultra-processed foods (UPF), but companies making them have just been served with a lawuit.

I learned about this from a tweet (x) from Carlos Monteiro, the Brazilian public health professor who coined the UPF term.

CMonteiro_USP (@Carlos A. Monteiro) posted: A first-of-its-kind lawsuit against 11 UPF industries alleging they engineer their UPF products to be addictive with details on the actions taken to target children including internal memos, meetings & the research conducted to create addictive substances.

The lawsuit, filed by several law firms, is aimed at Big Food: Kraft, Mondelez, Post, Coca-Cola, PepsiCo, General Mills, Nestle, Kellanova, WK Kellogg, Mars, and Conagra.

The suit charges that these firms, through their deliberate marketing, are making people sick.

Due to Defendants’ conduct, Plaintiff regularly, frequently, and chronically ingested their UPF, which caused him to contract Type 2 Diabetes and Non-Alcoholic Fatty Liver Disease Plaintiff is now suffering from these devastating diseases, and will continue to suffer for the rest of his life.

The suit makes interesting reading.

Some examples:

• Big Tobacco companies intentionally designed UPF to hack the physiological structures of our brains.  These formulation strategies were quickly adopted throughout the UPF industry, with the goal of driving consumption, and defendants’ profits, at all costs.
• The same MRI machines used by scientific researchers to study potential cures for addiction are used by UPF companies to engineer their products to be ever more addictive.
• Big Tobacco repurposed marketing strategies designed to sell cigarettes to children and minorities, and aggressively marketed UPF to these groups.
• The UPF industry now spends about $2 billion each year marketing UPF to children.
• UPF increase the risks of disease because they are ultra-processed, not because of how many grams of certain nutrients they contain or how much weight gain they cause. Therefore, even attempts to eat healthfully are undermined by the ultra-processed nature of UPF. One cannot evade the risks caused by UPF simply by selecting UPF with lower calories, fat, salt, sugar, carbohydrates, or other nutrients.
• The UPF industry is well aware of the harms they are causing and has known it for decades. But they continue to inflict massive harm on society in a reckless pursuit of profits.

Can’t wait to see what happens with this one.  Stay tuned.

Resources

Consumer Federation of America: “Ultra-processed Foods: Why They Matter and What to Do About It.”

With government officials reluctant to issue advice on ultra-processed foods (UPFs), Consumer Federation of America aims to raise awareness about research on UPFs, explain the leading theories of how they harm health, and build support for public policies to reduce harms from UPFs in our diet.

The report pushes back on arguments that researchers have not consistently defined UPFs, or that the categorization lacks scientific rigor. In fact, researchers have operationalized the “Nova classification” system behind UPFs in a largely consistent manner, defining foods based on whether they contain ingredients that are “industrial formulations” or “rarely used in home kitchens,” with little serious disagreement about which ingredients should be considered “ultra processed.” Consumers can take CFA’s online quiz to test their knowledge of which ingredients are markers of “ultra processing.”

New research: Trends in Adults’ Intake of Un-processed/Minimally Processed, and Ultra-processed foods at Home and Away from Home in the United States from 2003–2018.  J Nutr 2024, https://doi.org/10.1016/j.tjnut.2024.10.048.  The data show that 50% or more of calories are consumed from UPF at home, away from home, and by pretty much everyone.

New research: Hagerman CJ, Hong AE, Jennings E, Butryn ML. A Pilot Study of a Novel Dietary Intervention Targeting Ultra-Processed Food Intake. Obes Sci Pract. 2024 Dec 8;10(6):e70029. doi: 10.1002/osp4.70029.  Behavioral interventions to reduce UPF intake cut calories by about 600 calories per day.

My post summarizing the three studies demonstrating that diets high in UPF induce intake of an excess of 500, 800, and 1000 calories per day.

This is a report from the WHO Regional Office for Europe: Commercial determinants of noncommunicable diseases in the WHO European Region.  

This report describes how i”7500 deaths per day in the Region are attributed to commercial determinants, such as tobacco, alcohol, processed food, fossil fuels and occupational practices. These commercial products and practices contribute to 25% of all deaths in the Region.

These industries, says WHO, “glamourize and normalize the use of harmful products, including harmful ones often targeting children and socioeconomically disadvantaged groups and others.”

Overall, it documents how these industries use their market power to:

• Maintain monopolistic positions, extend product lines into new sectors, and manipulate pricing
• Engage in political practices to prevent, weaken, and delay public health regulations
• Influence scientific research and public understanding of health issues to favour their commercial interests
• Use CSR [corporate social responsibility] initiatives to improve their public image and gain influence
• Avoid taxes, shift profits to tax havens
• Use financial strategies to deprive governments of revenues needed to fund public health.
• Use laws to oppose policies aimed at addressing the NCD burden
• exploit crises and emergencies to advance their commercial interests

In other words, this report describes how industries use the “playbook” to advance their interests.

While specific to Europe, its findings and recommendations are widely generalizable.

And the report gives plenty of references for everything it reports and recommends.

I received an e-mailed press release from the Senate Committee on Health, Education, Labor, and Pensions (HELP), chaired by Sen. Bernie Sanders (I-VT):  NEWS: Sanders and Booker Take on Food and Beverage Industry with New Legislation to Address Childhood Diabetes and Obesity Epidemics.

Sen. Sanders, along with Sens. Cory Booker (D-NJ) and Peter Welch (D-VT), have introduced legislation to

Take on the greed of the food and beverage industry and address the growing diabetes and obesity epidemics negatively impacting millions of American children and families across the country. The Childhood Diabetes Reduction Act establishes a first-of-its-kind federal ban on junk food advertising targeted to children in the United States, requires the Food and Drug Administration (FDA) to implement strong health and nutrient warning labeling, directs the National Institutes of Health (NIH) to investigate the dangers posed by ultra-processed foods, and develops a national education campaign for children and caregivers through the Centers for Disease Control and Prevention (CDC).

The press release quotes Sen. Sanders:

“Let’s be clear: The twin crises of type 2 diabetes and obesity in America are being fueled by the food and beverage industry that, for decades, has been making massive profits by enticing children to consume unhealthy products purposely designed to be overeaten…We cannot continue to allow large corporations in the food and beverage industry to put their profits over the health and well-being of our children.

Nearly 30 years ago, Congress had the courage to take on the tobacco industry, whose products killed more than 400,000 Americans every year. Now is the time for Congress to act with the same sense of urgency to combat these diabetes and obesity epidemics. That means banning junk food ads targeted to kids and putting strong warning labels on food and beverages with unacceptably high levels of sugar, salt, and saturated fat.”

Resources:

• Senate hearing:  What is Fueling the Diabetes Epidemic?
• Sanders’ letter  to the FDA to require warning labels on unhealthful food products
• The bill, section-by-section, is here.
• The bill text is here.

At long last, congressional representatives are trying to do something to prevent childhood obesity.  Let’s urge our representatives to sign on to this bill.

The UN’s World Health Organization (WHO) has long led efforts to tax unhealthy products, starting with tobacco.

WHO describes its health tax efforts here.

It recently issued Global report on the use of sugar-sweetened beverage taxes, 2023.

The report finds that 108 countries have some kind of tax on sugar-sweetened beverages.

But, it finds

Less than a quarter of countries surveyed account for sugar content when they impose taxes on these non-alcoholic beverage products. Countries with a sufficiently strong tax administrative capacity are encouraged to tax beverages based on sugar content, as it can encourage consumers to substitute with alternatives that have lower sugar content as well as incentivize the industry to reformulate beverages to contain less sugar.

One of its major overall findings:

Among its conclusions are these:

• Existing taxes on SSBs could be further leveraged to decrease affordability and thereby reduce consumption. While other perspectives and competing factors have to be accounted for when designing taxation policies, the protection of health should be a key consideration, particularly considering the health and economic burden associated with obesity and diet-related NCDs.
• This report concludes that excise taxes on SSBs are not currently being used to their fullest potential. Improving tax policy and increasing taxes so that SSBs become less affordable should be pursued more systematically by countries in order to effectively reduce consumption and prevent and control diet-related NCDs, including obesity and dental caries.

Here’s the evidence.  Get to work!

Resoures

• More about WHO’s work on health taxes
• Global report on the use of alcohol taxes, 2023
• WHO technical manual on alcohol tax policy and administration
• Health taxes database

I’m just getting around to reading this report from three groups in the UK: Action on Smoking and Health (ASH), the Obesity Health Alliance (OHA) and the Alcohol Health Alliance (AHA): Holding us back: tobacco, alcohol and unhealthy food and drink.

I learned about it from an article in The Guardian:

The report gives the health statistics: 13% of adults in England smoke, 21% drink above the recommended drinking guidelines, and 64% are overweight or living with obesity,.

NOTE: this report—unlike so many others—examines the political and economic causes of poor health.  It says practically nothing about personal choice or responsibility.  Instead, it focuses on industry profits and the costs of industry profiteering to society.

Big businesses are currently profiting from ill-health caused by smoking, drinking alcohol and eating unhealthy foods, while the public pay the price in poor health, higher taxes and an under-performing economy.

The wage penalty, unemployment and economic inactivity caused by tobacco, alcohol and obesity costs the UK economy an eye-watering £31bn and has led to an estimated 459,000 people out of work.

Meanwhile each year, the industries which sell these products make an estimated £53bn of combined industry revenue from sales at levels harmful to health.

The press release emphasizes the need to curb industry practices: More needs to be done to tackle the unhealthy products driving nearly half a million people out of work.

It recommends, among other things:

• The Government should take a coherent policy approach to tobacco, alcohol and high fat, salt and/or sugar foods, with a focus on primary prevention.
• Public health policymaking must be protected from the vested interest of health-harming industry stakeholders.

To do this, it suggests these actions to decrease sales of harmful products (my summary):

• Restrict advertising
• Set age limits  for purchase.
• Do not allow prominent placement in shops.
• Raise prices; tax.
• Educate the public about risks (the one place where personal responsibility is considered).

For years now I have been posting on Mondays something about conflicts of interest in nutrition research and practice on this site .

My goal in doing so is to raise awareness of practices that give the nutrition profession the appearance of undue food industry influence at the expense of public health.

Occasionally someone involved with something I post requests a correction or clarification.

Most recently, I heard from Gunter Kuhnle, a researcher in the UK whom I do not know personally.   He wrote:

In your blog (https://www.foodpolitics.com/2023/11/chocolate-an-update-on-the-food-politics-thereof/), you comment about my article in “The Conversation” on flavanols. This comment concludes with a statement that could be interpreted as if I was paid to write this piece. I would like to make clear that I was not paid to write this article – it was conceived and written in order to address a number of misunderstandings in the reporting of various studies concerning flavanols.  I would appreciate if you could correct this.

Since that was not at all my intention, I clarified the post immediately.

But I also requested his permission to reprint his note so I could do some more explaining about why this issue so concerns me.

I want to start by emphasizing that I do not see this as a personal matter.  My original post did not mention the author’s name and in general I try to avoid mentioning names of authors of industry-funded research unless they report financial ties to companies with vested interests in the outcome of that research.

I see this as a systemic issue.

But to summarize the arguments—and the research—I make and summarize in my book, Unsavory Truth: How Food Companies Skew the Science of What We Eat:

An enormous body of evidence, most of it derived from studies of tobacco, chemical, or pharmaceutical drug industry-sponsored research, consistently shows:

• Industry-funded research generally yields results that favor the sponsor’s interests.
• Industry funding of research influences its outcome.
• The influence of industry funding usually shows up in the framing of the research question or in the interpretation of results.
• Recipients of industry funding do not recognize the influence, do not intend to be influenced, and deny the influence (“science is science”).
• Denial of influence contradicts an enormous body of evidence to the contrary.
• Disclosure of funding source or relationships is necessary but not sufficient; considerable evidence exists to show that the statement “the sponsor had nothing to do with the design, conduct, or publication of the study” is often misleading or false.
• Exceptions do exist, but they are rare.

That researchers do not recognize the risks of industry funding is disturbing.  At the very least, when nutrition researchers accept funding from food companies, they give the appearance of conflict of interest.

And that is all it takes to reduce public trust in nutrition research, nutrition professionals, and nutrition professional societies.

I think there is something seriously wrong when I can look at the title of a nutrition research article and make a good guess about what company or industry trade association funded it.

I think there is something seriously wrong when I can look at the funder of a study and guess what the outcome is.

One more point: an argument I hear often is that all nutrition researchers are biased because they have dietary or ideological preferences.  There is research on this point too.  It argues that all researchers have personal or ideological biases—that’s what motivates them to do studies to test their hypotheses.  Personal biases, therefore, are universal and do not cause conflicts of interest.

Industry funding introduces a quite different motive: proving the health benefits or safety of a food product for commercial—not scientific—purposes.

Unsavory Truth provides references for all of this.

Also see Science in the Private Interest:  Has the Lure of Profits Corrupted Biomedical Research? by the late Sheldon Krimsky (I miss him terribly).

Professor Kuhnle, I thank you for writing and for the opportunity to respond.

Jerry Mande, a co-founder of Nourish Science wrote me to urge support for a national action plan to reduce obesity—and the chronic diseases for which it raises risks. (Note: he also has an op-ed in The Hill on NIH research and leadership needs).

Here is what we should do. It’s time for a new federal nutrition goal. For decades it’s been some variation of “access to healthier options and nutrition information.” Jim Jones [the new head of food and nutrition at FDA] used that last week in his vision for the new human foods program. It’s in USDA FNS’s mission too. The WaPo reporting on life expectancy, fatty liver disease, & Lunchables in school meals reveals that goal has failed and needs to be replaced.

The goal should be updated to: ensuring that every child reaches age 18 at a healthy weight and in good metabolic health. Cory Booker proposed making it the U.S. goal in his attached letter to Susan Rice on the WHC [White House Conference]. It’s part of the Nourish Science vision.

It’s doable.  USDA has the necessary power, reach, and resources. Over half of infants are on WIC, 1/3 of children in CACFP [Child and Adult Care Feeding Program], virtually all in school meals, and almost ½ of SNAP recipients are under 18. If we leveraged those programs to achieve the new goal and with FDA’s & CDC’s help, we could make substantial progress. For example, USDA was able to raise school meal HEI [Healthy Eating Index] scores from failing U.S. average of 58 to an acceptable 82 in just three years.

We have a successful blueprint in FDA regulation of tobacco. When we began our FDA investigation in 1993 1/3 of adults and ¼ of kids smoked cigarettes. Today we have a $700M FDA tobacco center and 11% of adults and only 2% of high school students smoke cigarettes.

We should set the new goal in the upcoming Farm Bill. We should change USDA’s name to the U.S. Department of Food and Agriculture and state the new goal.

The only needed ingredient to make this happen is an effective federal nutrition champion. That’s how tobacco happened.

I’m optimistic. We can do this.

I like the vision.  I’m glad he’s optimistic.  Plenty of work to do to get this on the agenda.

Some background

• The CDC on how nearly 70% of American adults are overweight or have obesity.
• My report on the White House Conference, a year ago
• Politico (Helena Bottemiller Evich, now at Food Fix)  on how diet- and obesity-related diseases are a huge public health problem, especially for COVID-19, but no government program exists to prevent them.
• Politico (Catherine Boudreau and Helena Bottemiller Evich) on how federal research on prevention of diet- and obesity-related diseases hardly exists.