The 13th World Conference on Tobacco OR Health

Objective: The notion that tobacco companies need to be constrained in marketing tobacco to consumers is universally accepted. Debate continues as to whether sufficient controls can be exercised using conventional regulatory constraints, or whether more fundamental changes are required. I have published a proposal for taking the control of marketing of tobacco products away from for-profit corporations (Borland, 2003, Tobacco Control). Others have come up with similar proposals. The aim of this paper is to review these ideas, and complement my plenary presentation.

Methods: Conceptual analysis

Results: The main criticisms of the proposals are: that conventional regulation could do the job just as well, concern over whether governments would ultimately be prepared to take responsibility for something that kills over half of its long term users, making it politically too hard to achieve. I argue that there are things that conventional regulation cannot do, and it is a far less responsive tool than changing the pattern of incentives. We need to understand that governments are ultimately responsible for everything they allow, so allowing for-profit entities to actively market tobacco, thus undermining public policy is a major failure of government. The difficulty of implementing the change is mainly because it will be contested by those with competing interests, most notably tobacco companies. I discuss the proposition that no responsible government with a commitment to the health of its citizens can continue to allow the tobacco market to operate as it does today.