Paradise at risk: recommendations to control tobacco and alcohol industry interference in Pacific Island Countries and Territories

This post was written by Matthew Catanzariti, Jessica Heaney and Oscar Loughnan

Tobacco and alcohol represent significant threats to public health. The businesses that manufacture, distribute, and market these products to the public have irreconcilable interests to those that attempt to improve and protect public health. These businesses use coercive techniques, such as lobbying, tactical use of litigation, and re-shaping their public image, to advance their interests. The impact of tobacco and alcohol industry interference on policy-making is a significant challenge within Pacific Island Countries and Territories (PICTs).

Recently, Sydney Health Law, Sydney Law School’s health law centre, hosted three interns to research and advise on good practices for protecting public health policies in PICTs from inappropriate influence and interference from commercial and other vested interests of the tobacco, nicotine and alcohol industries.

The interns completed a desktop review of scholarly literature and existing legislation to identify the kinds of risks that arise, the importance and benefits of resisting industry interference, and the scope of regulatory measures available. This research informed nine recommendations provided to the Public Health Division of the Pacific Community (SPC) on how to best reduce the influence of the tobacco, nicotine and alcohol industries on policymaking in PICTs. The recommendations included a description of key legislative provisions that might be appropriately integrated within the Pacific Legislative Framework for Non-Communicable Diseases, which represents the next-generation public health legislation for PICTs.

Summary of recommendations

The recommendations were categorised into short-term, medium-term, and long-term strategies.

• Short-term recommendations focused on grassroots education, intrastate consultations, and developing a PICT-wide code of conduct to resist industry influence and build community support.
• Medium-term recommendations emphasized regional collaboration, enhancing the MANA Dashboard, and establishing twinning partnerships to foster multilateral knowledge sharing. 
• Long-term recommendations focused on strengthening the model provisions on industry interference in the Pacific Legislative Framework and encouraging political commitment within PICTs to implement national legislation addressing tobacco and alcohol industry interference, supported by public awareness campaigns and the creation of an independent oversight body to enforce these provisions.

The recommendations highlight the importance of community empowerment, capacity building, and national legislation to mitigate industry interference. Taken together, the recommendations offer a range of options for consideration by SPC and PICTs to achieve robust public health protections while advancing the broader development goals of the region.

Short-term recommendations

Community-based education about tobacco and alcohol industry interference

Educating the community about the pervasive nature of tobacco and alcohol industry interference will assist in identifying public health advocates and champions and empower community members to demand more from their governments to appropriately address tobacco and alcohol industry interference. SPC has already led a number of initiatives designed to encourage community engagement, such as an SPC-led regional poetry competition, a photography competition, or the creation of media for showing at the Pacific Human Rights Film Festival.

Building community-driven support for policy evolution in PICTs

Building on community education, establishing anti-corporate interference as a social movement is critical to the success of the report’s recommendations. The case for a grassroots coalition to resist harmful industry interference lies in its capacity to reinforce social norms against industry interference, to establish a stable foundation from which advocacy can take place, and to facilitate change at the local and national level. Such consultation is often a precursor to law and policy reform at a national level.

A Regional Code of Conduct on tobacco and alcohol industry interference

To build on the local support generated by the first two recommendations, SPC could support the creation of a regional code of conduct. This code would govern conflicts of interest between government officials and industry actors or affiliates. Consultation should be used to identify the content of the code, with input from development partners (eg, WHO WPRO), regional health NGOs, and suitable civil society partners. The content of the code could also be informed by the Guidelines for Implementation of Article 5.3 of the WHO FCTC.

Medium-term recommendations

Regional consultation on implementation of norms to address tobacco and alcohol industry interference

Once the content of the code has been determined, SPC could convene a regional consultation to assess how the code could be implemented within PICTs. This stage of consultation should involve identifying how similar regulatory frameworks have been introduced in the past. Again, a broad range of development partners and other stakeholders should be included.

Integrating anti-interference policy indicators into the MANA Dashboard

The MANA Dashboard is an important framework through which PICTs can monitor their progress in implementing priority interventions for non-communicable diseases. However, it could be amended in three key ways. First, the definition of tobacco should be expanded to include vaping. Second, higher levels of achievement should be reflected in a more structured way. Finally, the MANA Dashboard should adopt an indicator for monitoring interference from the alcohol industry, as it has for tobacco interference.

Encouraging knowledge sharing with twinning partnerships

Due to the pernicious nature of tobacco interference, it is recommended that collaborative initiatives between countries should be established to enhance knowledge sharing and capacity building. PICTs, supported by SPC, should adapt twinning programs to support knowledge sharing between PICTs seeking to resist tobacco and alcohol industry interference. This could be achieved by broadening engagement between health professionals in different PICTs to include others working at the intersections of tobacco control initiatives, for example, experts in communications, policy development, education and youth leaders. 

Long-term recommendations

Strengthening model provisions on industry interference in the Pacific Legislative Framework

We recommend a number of specific amendments to the Pacific Legislative Framework, which build on the provisions dealing with tobacco industry interference in Chapter 2. These suggested amendments include: broadening the scope of the anti-interference provisions to include the alcohol industry, clarifying and expanding the scope of several conflict of interest provisions, and introducing several transitional provisions. These recommendations took inspiration from sections 54–58 of the Tobacco Control Act 2018 (Niue), which we believe to be the current gold-standard for the region.

Encouraging commitment in PICTs to the passage of national legislation addressing tobacco and alcohol industry interference

Any law reform process will directly challenge existing links between the tobacco and alcohol industries and government ministers and officials (and the perceived benefits they bring). Resistance from these industries, and their proxies, can be expected. Given the limitations on SPC’s political role, any strategy will likely need to be sensitive to the actions that are appropriate for SPC, and for civil society partners. Actions could include: using the Tobacco Industry Interference Index to foster discussions on seven indicators of industry interference, providing assistance for those implementing legislation as to how it should operate in practice (eg, provision of best practice guidelines/templates), and implementing the MANA Dashboard amendments (see above).

Establishing an independent anti-interference oversight body

In common with other anti-corruption measures, lobbying regulations require independent accountability mechanisms to work. Therefore, we recommend that PICTs establish an independent, statutory body to enforce statutory obligations, enhance corporate transparency, and to reduce alcohol and tobacco industry influence.

Conclusion

PICTs are at different stages in their response to tobacco and alcohol industry interference. The recommendations developed by Sydney Health Law interns encompassed three stages: short-term, medium-term, and long-term recommendations, while acknowledging that these stages do not necessarily represent a chronological process, and that not all PICTs would necessarily begin with the first stage.

Future areas of research, to support these recommendations, could include investigating the applicability of a “sinking lid” policy in PICTs which places quotas on the trade of tobacco and/or alcohol, and evaluating the impact of corporate interference from harmful industries within PICTs.

Addressing tobacco and alcohol interference within PICTs will strengthen public health policies and legislation and help to promote SPC’s development goals of a ‘unified, safe, just, equitable and resilient Blue Pacific’.