A brief history of tobacco industry interference in global public health efforts towards smoking prevention and cessation.
Tobacco industry interference in global public health efforts stretches back for over a century.
From denying the health risks of smoking in the 1950s to promoting e-cigarettes and HTPs as part of a ‘harm reduction’ strategy today, the industry has consistently aimed to alter public perception and policy. Key figures and organisations, like the WHO, whistleblowers and public health advocates, have played a vital role in exposing these tactics. But the battle between public health and tobacco industry interests goes on.
This summary traces the evolution of tobacco industry interference, highlighting key events, strategies and people, and bringing us to the present day.
Early 20th Century
Industrial and technological advances in the late 1800s included the Bonsack Machine, an invention capable of rolling 210 cigarettes a minute. Quickly adopted by the American Tobacco Company, this innovation triggered mass production and a sharp rise in sales.
This rise was further fuelled by aggressive marketing strategies, targeting first men, then women. A defining moment came in 1928 with the 2012 ‘Torches of Freedom’ campaign, devised by Edward ‘The Father of Modern PR’ Bernays. Linking the act of smoking to women’s liberation, the campaign upended the social taboo of women smoking in public, and secured the female market.
1950s
By the 1950s, scientific research connecting smoking to lung cancer and heart disease had begun to emerge. In 1953, U.S. tobacco company CEOs formed the Tobacco Industry Research Committee, orchestrated by a PR firm to cast doubt on these findings and delay regulation.
In 1958, the creation of the Tobacco Institute further embedded this strategy. The Institute claimed that smoking wasn’t necessarily to blame for these illnesses. Instead, it pointed to pollution, food additives, and personality traits. Creating doubt was the core tactic at this time.
1960s
In 1964, the U.S. Surgeon General’s landmark report on Smoking and Health, officially declared smoking a cause of lung cancer and other diseases.
This was a turning point for public health: despite smoking reaching its peak in the USA - with over half of men and over a third of women smoking - public opinion began to shift. The industry persisted in undermining scientific evidence - but the public health message continued to gather strength.
1970s
The Public Health Cigarette Smoking Act of 1971 banned cigarette advertising on TV and radio, forcing the industry to change tack. It ramped up product innovation under the guise of ‘harm reduction,’ introducing ‘light’ cigarettes and filters - despite internal knowledge that these offered little to no benefit.
Brands also experimented with messaging. From masculinity and glamour to health and personal freedom, they engaged values and aspirations to counter both regulations and the growing public awareness of second-hand smoke and nicotine addiction.
1980s
As more tobacco-related deaths and industry tactics came to light, lawsuits from families of victims increased alongside public health efforts across the world. In 1987, the WHO established World No Tobacco Day - an annual reminder of the impact of tobacco on global health that continues to this day.
To address the impact on sales, tobacco companies worked to improve their image through Corporate Social Responsibility (CSR) campaigns, while expanding into low- and middle-income countries (LMICs) where regulation was weaker and public awareness of the harms was much lower.
1990s
The 1990s was a defining decade. Mounting lawsuits forced the disclosure of internal industry documents, revealing tactics to discredit science and spread disinformation. Whistleblower Dr. Jeffrey Wigand - portrayed in the 1999 film The Insider - exposed how companies deliberately manipulated nicotine levels to increase addiction.
These revelations led to the historic 1998 Master Settlement Agreement, in which the four largest U.S. tobacco companies agreed to pay billions in healthcare costs and curtail advertising, in exchange for certain legal protections.
2000s
Global momentum for tobacco control accelerated. In 2003, under the leadership of Dr. Gro Harlem Brundtland, the WHO adopted the Framework Convention on Tobacco Control (WHO FCTC) - the world’s first international public health treaty aimed at reducing tobacco use.
In response, the industry lobbied powerfully against the treaty’s implementation, often via front groups and trade organisations.
2010s
As smoking rates declined globally, new measures emerged. In 2012, Australia became the first country to introduce plain cigarette packaging - stripping brands of logos, colours, and fonts, and replacing them with standardised designs and graphic health warnings. This innovation directly threatened tobacco companies’ marketing strategies. As Tobacco Journal International noted in 2011: “The power of the brand… would be severely damaged without the colours and the design recognised by millions.”
With the increasing regulation in high-income countries, the tobacco industry redoubled its efforts in LMICs and developed new strategies. Companies expanded their portfolios of so-called ‘smoke-free alternatives’, promoted as ‘safer’ options - despite limited evidence -
and positioned to appeal to both policymakers and consumers within the frame of ‘harm reduction’.
2020s
During the COVID-19 pandemic, tobacco companies launched CSR campaigns as ‘public health allies’, donating medical supplies and funding vaccine development. However, such activities were seen as violations of Article 5.3 of the WHO FCTC, which prohibits partnerships between governments and the tobacco industry.
Meanwhile, youth-targeted marketing of so-called ‘smoke-free alternatives’ - through enticing flavours, social media campaigns and sleek product designs - continues to surge. This has led to new regulatory discussions aiming to thwart the tobacco industry’s cultivation of a new generation of addicts from whom to secure a lifetime of profits, under the guise of innovation.
Looking ahead
From the outset, the tobacco industry has used the same playbook: deny, distract, delay, and evade. Whether through scientific disinformation and aggressive lobbying, or positioning itself as an ‘innovator’ and ‘public health ally’, its overarching goal remains the same - secure profits at the expense of public health.
Despite major victories by public health advocates, the industry continues to adapt. Foresight and vigilance remains critical for public health professionals moving forward.
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Carra Santos is a strategic thinking and communication specialist with over 15 years' experience at the intersection of creativity, innovation and behavioural insights. She explores what enables - and what inhibits - more sustainable ways of working and living, so we can navigate more effectively towards them.