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Confronting the Vector of Tobacco-Related Disease

Published online by Cambridge University Press:  06 January 2021

Matthew Allen
Matthew Allen*
Affiliation:
Allen and Clarke Policy and Regulatory Specialists Limited, New Zealand. Email: mallen@allenandclarke.co.nz
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Extract

It has been estimated that the use of tobacco kills nearly 6 million people each year, with most deaths occurring in low- and middle-income countries. This disparity is expected to increase over the next few decades. On the basis of current trends, tobacco use will kill more than 8 million people worldwide per annum by 2030, with eighty percent of those premature deaths occurring in low- and middle-income countries. The significant burden of morbidity and mortality associated with tobacco use is well documented and proven and will not be repeated here.

The evidence base for addressing the tobacco epidemic domestically, regionally, and globally has developed in a systematic fashion over the past five decades. Effective measures for tobacco control are now well known and have been canvassed widely in the published literature.

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Article
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American Journal of Law & Medicine , Volume 39 , Issue 2-3 , June 2013 , pp. 308 - 331
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Copyright © American Society of Law, Medicine and Ethics and Boston University 2013

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References

1 WORLD HEALTH ORGANIZATION [WHO], WHO REPORT ON THE GLOBAL TOBACCO EPIDEMIC, 2011: WARNING ABOUT THE DANGERS OF TOBACCO 7 (2011) [hereinafter TOBACCO EPIDEMIC], available at http://whqlibdoc.who.int/publications/2011/9789240687813_eng.pdf.

2 Id.

3 Id.

4 Id.

5 See WORLD BANK, CURBING THE EPIDEMIC, GOVERNMENTS AND THE ECONOMICS OF TOBACCO CONTROL 37 (Prabhat Jha & Frank Chaloupka, eds., 1999), available at http://transition.usaid.gov/policy/ads/200/tobacco.pdf. See generally TOBACCO CONTROL IN DEVELOPING COUNTRIES (Prabhat Jha & Frank Chaloupka, eds., 2000), available at http://go.worldbank.org/HWHXKJJ050; WHO, GUIDELINES FOR CONTROLLING AND MONITORING THE TOBACCO EPIDEMIC (1998).

6 See, e.g, TOBACCO EPIDEMIC, supra note 1, at 66.

7 Id.

8 Id.

9 See id. at 66-73.

10 MATHEW J. ALLEN, OVERSEAS DEVELOPMENT ASSISTANCE PROGRAMMES FOR TOBACCO CONTROL: A FRAMEWORK FOR EFFECTIVE ACTION 4 (2012).

11 Id.

12 See id. at 18-19; TOBACCO EPIDEMIC, supra note 1, at 70.

13 See generally COMM. OF EXPERTS ON TOBACCO INDUS. DOCUMENTS, TOBACCO INDUSTRY STRATEGIES TO UNDERMINE TOBACCO CONTROL ACTIVITIES AT THE WORLD HEALTH ORGANIZATION (2000), available at http://www.who.int/tobacco/en/who_inquiry.pdf; CORPORATE ACCOUNTABILITY INT’L, PROTECTING AGAINST TOBACCO INDUSTRY INTERFERENCE: 2010 GLOBAL TOBACCO TREATY ACTION GUIDE (2008), available at http://stivoro.nl/wp-content/uploads/2012/docs/tabaksindustrie/2010%20global%20tobacco%20treaty%20action%20guide.pdf; WHO, BUILDING BLOCKS FOR TOBACCO CONTROL: A HANDBOOK (2002) [hereinafter WHO BUILDING BLOCKS], available at http://whqlibdoc.who.int/publications/2004/9241546581_eng.pdf; WHO, TOBACCO INDUSTRY INTERFERENCE WITH TOBACCO CONTROL (2008) [hereinafter INDUSTRY INTERFERENCE], available at http://www.who.int/tobacco/resources/publications/tob_ind_int_cover_150/en/index.html; Brandt, Allan M., Investing Conflicts of Interest: A History of Tobacco Industry Tactics, 102 AM. J. PUB. HEALTH 63 (2010).

14 See INDUSTRY INTERFERENCE, supra note 13, at 5.

15 See CORPORATE ACCOUNTABILITY INT’L, supra note 13, at 21.

16 Early resolutions on tobacco control included those of the Executive Board and the World Health Assembly itself. See, e.g., World Health Assembly [WHA], 24th sess., May 4-20, 1971; WHO Doc. WHA24.48 (May 20, 1971); WHA, 23d sess., May 5-22, 1970, WHO Doc. WHA23.32 (May 19, 1970); WHA, Ex. Bd., 53d sess., Jan. 15-25, 1974, WHO Doc. EB53.R31 (Jan. 1974); WHA, Ex. Bd.., 47th sess., Jan. 19-29, 1971, WHO Doc. EB47.R42 (Jan. 1971); WHA, Ex. Bd., 45th sess., Jan. 20-29, 1970, WHO Doc. EB45.R9 (Jan. 1970); all of which concerned the health hazards of tobacco smoking and WHO's role in limiting this “harmful habit.”

17 These resolutions call for implementation of comprehensive, multisectoral, long-term tobacco control strategies. See, e.g., WHA, 29th sess., May 3-21, 1976, WHO Doc. WHA29.55 (May 1976); WHA, 31st sess., May 8-24, 1978, WHO Doc. WHA31.56 (May 24, 1978); WHA, 33d sess., May 5-23, 1980, WHO Doc. WHA33.35 (May 23, 1980); WHA, 39th Sess., May 5-16, 1986, WHO Doc. WHA39.14 (May 15, 1986); WHA, 43d sess., May 7-17, 1990, WHO Doc. WHA43.16 (May 17, 1990); WHA, 45th sess., May 4-14, 1992, WHO Doc. WHA45.20 (May 13, 1992).

18 See WHA, 48th sess., May 1-12, 1995, WHO Doc. WHA48.11 (May 12, 1995), (requesting WHO to prepare a feasibility study on options for international instruments to control tobacco); WHA, 49th sess., May 20-25, 1996, WHO Doc. WHA49. 17 (May 25, 1996) (requesting WHO to initiate a framework convention on tobacco control).

19 See WHA, 49th sess., May 20-25, 1996, WHO Doc. WHA49.17 (May 25, 1996).

20 WHA, 53d sess., May 15-21, 2000, WHO Doc. WHA54.18 (May 21, 2000), available at http://www.who.int/tobacco/framework/wha_eb/wha54_18/en/index.html.

21 Id.

22 Id.

23 WHO, HISTORY OF THE WHO FRAMEWORK ON TOBACCO CONTROL 40 (2009), available at http://whqlibdoc.who.int/publications/2009/9789241563925_eng.pdf.

24 Id.

25 Parties to the WHO Framework Convention on Tobacco Control, WHO FRAMEWORK CONVENTION ON TOBACCO CONTROL (2012), http://www.who.int/fctc/signatories_parties/en/index.html.

26 WHO, WHO FRAMEWORK CONVENTION ON TOBACCO CONTROL 2 (2003) [hereinafter WHO FCTC], available at http://whqlibdoc.who.int/publications/2003/9241591013.pdf.

27 Id. at 7.

28 WHO, GUIDELINES FOR IMPLEMENTATION OF ARTICLE 5.3 OF THE WHO FRAMEWORK CONVENTION ON TOBACCO CONTROL 9 (2008) [hereinafter 2008 WHO GUIDELINES], available at http://www.who.int/fctc/guidelines/article_5_3.pdf.

29 WHO FCTC, supra note 26, at 11.

30 2008 WHO GUIDELINES, supra note 28.

31 Id. at 2.

32 Id. at 3.

33 Id.

34 Id.

35 Id.

36 Id. at 9.

37 Matthew Allen, Implementing the FCTC Article 5.3 Guidelines: Scoping Paper and Action Plan on Curbing the Influence of the Tobacco Industry (Int’l Union Against Tuberculosis and Lung Disease, May 2012) (unpublished manuscript) (on file with author).

38 Id. at 5-6.

39 WHO FCTC, PHASE 2 (GROUP 2 QUESTIONS) OF THE REPORTING INSTRUMENT UNDER THE WHO FRAMEWORK CONVENTION ON TOBACCO CONTROL (2010), available at http://www.who.int/fctc/reporting/India_5y_report_final.pdf

40 K. Alechnowicz & S. Chapman, The Philippine Tobacco Industry: “The Strongest Tobacco Lobby in Asia,” 13 TOBACCO CONTROL ii71, ii76 (2004), available at http://tobaccocontrol.bmj.com/content/13/suppl_2/ii71.full.pdf+html.

41 See generally SOUTHEAST ASIA TOBACCO CONTROL ALLIANCE [SEATCA], TOBACCO INDUSTRY FRONT GROUPS & ACTIVITIES (2012), http://seatca.org/dmdocuments/TI%20front%20groups%20fact%20sheet.pdf.

42 See Allen, supra note 37, at 20; see also CORPORATE ACCOUNTABILITY INT’L, supra note 13.

43 See Allen, supra note 37, at 20.

44 See Allen, supra note 37, at 8.

45 For a timeline and description of tobacco industry efforts in opposition to plain packaging of tobacco products, see ASH Action: Plain Packaging of Tobacco, ACTION ON SMOKING AND HEALTH: AUSTRALIA (2013), http://www.ashaust.org.au/lv3/action_plainpack.htm#TOBACCO INDUSTRY's “PLAIN PACK ATTACK”.

46 See PHILIP MORRIS LTD., COMMODITISING TOBACCO PRODUCTS THROUGH PLAIN PACKAGING WILL HARM PUBLIC HEALTH, VIOLATE TREATIES, AND DOES NOT MEET THE TEST OF “EVIDENCE-BASED POLICY” 1 (2011), available at http://www.yourhealth.gov.au/internet/yourhealth/publishing.nsf/Content/8E244C9A4FC7011ECA2579540005F690/$File/Philip%20Morris.pdf.

47 See McGrady, Benn & Jones, Alexandra, Tobacco Control and Beyond: The Broader Implications of United States—Clove Cigarettes for Non-Communicable Diseases, 39 AM. J.L. & MED. 265, 266 (2013)Google Scholar.

48 See AGREEDISAGREE, http://www.agreedisagree.co.nz (last visited Mar. 6, 2012).

49 Id.

50 Id.

51 Id.

52 Id.

53 See Local Submissions on the Plain Packaging of Tobacco Products Consultation, MINISTRY OF HEALTH NZ (Feb. 21, 2013), http://www.health.govt.nz/about-ministry/legislation-and-regulation/regulatory-impact-statements/plain-packaging-tobacco-products/local-submissions-plain-packaging-tobacco-products-consultation; Overseas Submissions on the Plain Packaging of Tobacco Products Consultation, MINISTRY OF HEALTH NZ (Feb. 21, 2013), http://www.health.govt.nz/about-ministry/legislation-and-regulation/regulatory-impact-statements/plain-packaging-tobacco-products/overseas-submissions-plain-packaging-tobacco-products-consultation.

54 See, e.g., CRAWFORD MOODIE ET AL., PUB. HEALTH RESEARCH CONSORTIUM, PLAIN TOBACCO PACKAGING: A SYSTEMATIC REVIEW 46-47 (2012), available at http://eppi.ioe.ac.uk/cms/LinkClick.aspx?fileticket=j54fXGDr5Ps%3d&tabid=3327.

55 See, e.g., AGREEDISAGREE, supra note 48.

56 Cancer Society of New Zealand, Campaigns, Plain Packaging, CANTOBACCO, http://www.cantobacco.org.nz/campaigns/plain-packaging (last visited Feb. 26, 2013).

57 See Allen, supra note 37, at 12-24 (listing the key strategies used by the tobacco industry to interfere with tobacco control).

58 Eric Crosbie & Stanton A. Glantz, Tobacco Industry Argues Domestic Trademark Laws and International Treaties Preclude Cigarette Health Warning Labels, Despite Consistent Legal Advice that the Argument is Invalid, TOBACCO CONTROL ONLINE FIRST (Nov. 24, 2012), http://tobaccocontrol.bmj.com/content/early/2012/11/23/tobaccocontrol-2012-050569.full.pdf+html.

59 Id.

60 Id.

61 Id.

62 Allen, supra note 37, at 27.

63 See Action Against Corruption, G.A. Res. 51/59, U.N. Doc. A/RES/51/59 (Jan. 28, 1997), available at http://unpan1.un.org/intradoc/groups/public/documents/un/unpan010930.pdf; U.N. Secretary-General, Secretary-General's Bulletin: Financial Disclosure and Declaration of Interest Statements, U.N. Doc. ST/SGB/2006/6 (Apr. 10, 2006), http://www.un.org/sg/files/staff_fd_form.pdf; ORG. FOR ECON. COOPERATION & DEV., GLOBAL FORUM ON PUBLIC GOVERNANCE: TOWARDS A SOUND INTEGRITY FRAMEWORK: INSTRUMENTS, PROCESSES, STRUCTURES AND CONDITIONS FOR IMPLEMENTATION, available at http://www.oecd.org/officialdocuments/displaydocumentpdf/?cote=GOV/PGC/GF(2009)1&doclanguage=en (last accessed Dec. 18, 2012); ORG. FOR ECON. COOPERATION & DEV., MANAGING CONFLICT IN THE PUBLIC SECTOR: A TOOLKIT, available at http://www.oecd.org/dataoecd/5/48/49107986.pdf?Contentid=49107987 (last accessed Dec. 18, 2012); ORG. FOR ECON. COOPERATION & DEV., RECOMMENDATION OF THE COUNCIL ON GUIDELINES FOR MANAGING CONFLICT OF INTEREST IN THE PUBLIC SECTOR, available at http://www.oecd.org/dataoecd/13/22/2957360.pdf (last accessed Dec. 18, 2012); ORG. FOR ECON. COOPERATION & DEV., RECOMMENDATION OF THE COUNCIL ON IMPROVING ETHICAL CONDUCT IN THE PUBLIC SERVICE INCLUDING PRINCIPLES FOR MANAGING ETHICS IN THE PUBLIC SERVICE, available at http://www.oecd.org/document/32/0,3343,en_2649_34135_2516085_1_1_1_1,00.html (last visited Dec. 18, 2012); ORG. FOR ECON. COOPERATION & DEV., RECOMMENDATION OF THE COUNCIL ON PRINCIPLES FOR TRANSPARENCY AND INTEGRITY IN LOBBYING, available at http://acts.oecd.org/Instruments/ShowInstrumentView.aspx?InstrumentID=256&InstrumentPID=250&Lang=en&Book=False (last accessed Dec. 18, 2012); ORG. FOR ECON. COOPERATION AND DEV., 10 PRINCIPLES FOR TRANSPARENCY AND INTEGRITY IN LOBBYING, available at http://www.oecd.org/dataoecd/42/35/49051351.pdf (last visited Dec. 18, 2012).

64 See sources cited supra note 63.

65 See id.

66 See, e.g., ORG. FOR ECON. COOPERATION & DEV., RECOMMENDATION OF THE COUNCIL ON PRINCIPLES FOR TRANSPARENCY AND INTEGRITY IN LOBBYING, supra note 63.

67 Id.

68 See 2008 WHO GUIDELINES, supra note 28, at 2.

69 OXFORD MEDICAL COMPANION 908 (John Walton et al. eds., 1994).

70 Tobacco, WHO (May 2012), http://www.who.int/mediacentre/factsheets/fs339/en/index.html.

71 Smoking & Tobacco Use – Fast Facts, CTR. FOR DISEASE CONTROL & PREVENTION, http://www.cdc.gov/tobacco/data_statistics/fact_sheets/fast_facts/ (last visited Dec. 20, 2012).

72 See Allen, supra note 37, at 10.

73 Id.

74 Id. at 10 n.2; see Master Settlement Agreement (MSA) Collections, LEGACY TOBACCO DOCUMENTS LIBRARY, http://legacy.library.ucsf.edu/about/about_collections.jsp;jsessionid=71DDA356FDFD63E7F8AEE0F4F53A6BA3.tobacco03(last visited Feb. 28, 2013).

75 See Allen, supra note 37, at 10.

76 Id. at 10-11 & n.3-7.

77 Allen, supra note 37, at 11.

78 Allen, supra note 37, at 11.

79 Id.

80 See generally WHO FCTC, GUIDELINES FOR IMPLEMENTATION ARTICLE 5.3; ARTICLE 8; ARTICLE 11; ARTICLE 13 (2009), available at http://whqlibdoc.who.int/publications/2009/9789241598224_eng.pdf.

81 Id. at 7.

82 Id.

83 Id.

84 Id. at 6.

85 See id.

86 Id. at 7.

87 Id. at 8.

88 Id. at 9-10.

89 Id. at 10.

90 Id. at 11.

91 Id. at 12.

92 Id. at 4.

93 Id.

94 Id.

95 Id.

96 See generally Allen, supra note 37.

97 Id.

98 See Public Notification of Meetings Between the Australian Department of Health and Ageing and the Tobacco Industry, DEP't OF HEALTH & AGEING, http://www.health.gov.au/internet/main/publishing.nsf/Content/tobacco-conv-public (last updated Feb.12, 2013).

99 See Meetings with Tobacco Industry Representatives: 2011-Present, MINISTRY OF HEALTH NZ, http://www.health.govt.nz/our-work/regulation-health-and-disability-system/tobacco-control/framework-convention-tobacco-control-fctc (last updated Feb. 19, 2013).

100 See Allen, supra note 37, at 38-40, 42-43.

101 SEATCA & HEALTH JUSTICE, INC., TOOLKIT FOR POLICY MAKERS AND ADVOCATES: PREVENTING TOBACCO INDUSTRY INTERFERENCE 20 (2010), available at http://seatca.org/dmdocuments/Article%205.3%20Toolkit%20Oct%202010.pdf.

102 Id.

103 Id.

104 See Allen, supra note 37, at 22 n.84 (citing Memorandum from Office of the Secretary, Phil. Dep't of Health, Protection of the Department of Health, Including All of its Agencies, Regional Offices, Bureaus or Specialized/Attached Offices/Units, Against Tobacco Industry Interference (May 6, 2010), available at http://www.healthjustice.ph/uploads/DOH%20Memo%20on%20Art%205.3%20DM%202010-0126.pdf); Joint Memorandum from Phil. Civil Serv. Comm’n & Phil. Dep't of Health, Protection of the Bureaucracy Against Tobacco Industry Interference, (Jun. 29, 2010), available at http://www.tobaccocontrollaws.org/files/live/Philippines/Philippines%20-%20DOLE%20Memo%20-%20national.pdf).

105 See Macon R. Araneta, Pro-Sin Tax Pols Warned of Backlash, MANILA STANDARD TODAY, Dec. 10, 2012 http://www.scribd.com/doc/116118246/Manila-Standard-Today-Monday-December-10-2012-issue.

106 Id.

107 See WHO, TECHNICAL RESOURCE FOR COUNTRY IMPLEMENTATION OF WHO FRAMEWORK CONVENTION ON TOBACCO CONTROL ARTICLE 5.3 (2012), http://whqlibdoc.who.int/publications/2012/9789241503730_eng.pdf; Tobacco Free Initiative, WHO, http://www.who.int/tobacco/industry/en/ (last visited Feb. 28, 2013).

108 See SEATCA & HEALTH JUSTICE, INC., supra note 101.

109 See Industry Interference, CORP. ACCOUNTABILITY INT’L, http://www.stopcorporateabuse.org/industry-interference (last visited Mar. 3. 2013).

110 See Industry Watch, CAMPAIGN FOR TOBACCO-FREE KIDS, http://global.tobaccofreekids.org/en/industry_watch/ (last visited Feb. 28, 2013).

111 See World No Tobacco Day 2012, Tobacco Free Initiative, WHO, http://www.who.int/tobacco/wntd/2012/announcement/en/ (last visited Feb. 28, 2013).

112 See Allen, supra note 37.

113 INT’L UNION AGAINST TUBERCULOSIS & LUNG DISEASE, FCTC ARTICLE 5.3 TOOLKIT (2012), http://www.tobaccofreeunion.org/assets/FCTC%20Article%205_3%20Toolkit/Factsheets%20set.pdf [hereinafter THE UNION TOOLKIT].

114 Id.

115 See INT’L UNION AGAINST TUBERCULOSIS & LUNG DISEASE, Factsheet 5: The Union Template for Assessing Parties’ Compliance with Guidelines for the Implementation of Article 5.3 of the WHO Framework Convention on Tobacco Control, in THE UNION TOOLKIT, supra note 113.

116 See INT’L UNION AGAINST TUBERCULOSIS & LUNG DISEASE, Factsheet 6: Model Government Directive on Implementation of Steps to Prevent Interference by the Tobacco Industry, in THE UNION TOOLKIT, supra note 113.

117 See INT’L UNION AGAINST TUBERCULOSIS & LUNG DISEASE, Factsheet 7: Model Process Guidelines for Interaction with the Tobacco Industry, in THE UNION TOOLKIT, supra note 113.

118 See INT’L UNION AGAINST TUBERCULOSIS & LUNG DISEASE, Factsheet 8: Guidance on Legislation to Give Effect to the FCTC Article 5.3 Guidelines – Guidance on Tobacco Control Legislation, in THE UNION TOOLKIT, supra note 115.

119 See INT’L UNION AGAINST TUBERCULOSIS & LUNG DISEASE, Factsheet 9: Model Code of Conduct Provisions and Conflict of Interest Protocols in Relation to the Tobacco Industry, in THE UNION TOOLKIT, supra note 113.

120 See THE UNION TOOLKIT, supra note 113.

121 INT’L UNION AGAINST TUBERCULOSIS & LUNG DISEASE, supra note 116, at 1.

122 Id. at 4.

123 Id. at 3-4.

124 Id. at 4.

125 Id. at 6.

126 Id. at 7.

127 Id.

128 Id.

129 Id. at 8.

130 Id. at 7.

131 See INT’L UNION AGAINST TUBERCULOSIS & LUNG DISEASE, supra note 117.

132 Id.

133 Id. at 2-4.

134 See INT’L UNION AGAINST TUBERCULOSIS & LUNG DISEASE, supra note 116, at 8.

135 Id. at 8.

136 Id. at 9.

137 Id.

138 Id. at 10.

139 Id.

140 Id. at 11.

141 Id.

142 Id.

143 INT’L UNION AGAINST TUBERCULOSIS & LUNG DISEASE, supra note 118.

144 Id. at 2 fig.1.

145 Id.

146 Id. (emphasis added).

147 Id. (emphasis added).

148 Id. (emphasis added).

149 See INT’L UNION AGAINST TUBERCULOSIS & LUNG DISEASE, supra note 118.

150 Id. at 3-8.

151 Id. at 6.

152 Id. at 7.

153 Id.

154 Id.

155 Id. at 4.

156 “SPC is an international organisation that works in public health, geoscience, agriculture, forestry, water resources, disaster management, fisheries, education (community, TVET, quality and standards for all school levels), statistics, transport, energy, ICT, media, human rights, gender, youth and culture to help Pacific Island people achieve sustainable development.” Welcome to SPC, SPC: SECRETARIAT OF THE PACIFIC COMMUNITY, http://www.spc.int/en/about-spc.html (last visited Mar. 3, 2013).

157 About the Bloomberg Initiative, TOBACCO CONTROL GRANTS, http://www.tobaccocontrolgrants.org/Pages/44/About-the-Bloomberg-Initiative (last visited Mar. 3, 2013).

158 World No Tobacco Day Takes on “Big Tobacco,” SPC (May 31, 2012), http://www.spc.int/en/component/content/article/216-about-spc-news/943-world-no-tobacco-day-takes-on-big-tobacco.html.

159 Id.

160 “The FCA is a civil society alliance whose mission is to help develop and implement the FCTC as the basis for effective global tobacco control. It is made up of over 350 organizations from more than 100 countries working on the development, ratification and implementation of the international treaty, the World Health Organization's (WHO) Framework Convention on Tobacco Control (FCTC).” About Us: What is the Framework Convention Alliance?, FRAMEWORK CONVENTION ALLIANCE, http://www.fctc.org/index.php?option=com_content&view=article&id=2&Itemid=277 (last visited Mar. 3, 2013).

161 See World No Tobacco Day Takes on “Big Tobacco,” supra note 158.

162 UK: Tobacco Products Control Bill, 2004 (Solom. Is.) (unenacted draft) (on file with author).

163 Interview with PNG Department of Health Officials, in Papua New Guinea (Oct. 2012). During the course of this interview, the author observed the memorandum of understanding.

164 Interview with Solomon Island Department of Health Officials, in Solomon Islands (Sept. 2012). During the course of this interview, the author observed the memorandum of understanding.

165 Papua New Guinea Health Minister Fights BAT, FRAMEWORK CONVENTION ALLIANCE (Nov. 29, 2011), http://www.fctc.org/index.php?option=com_content&view=article&id=626:papua-new-guinea-health-minister-%E2%80%A61/3.

166 Interview with PNG Seventh Day Adventist Church Personnel, in Papua New Guinea (Oct. 2012).

167 Interview with PNG Department of Health Officials, in Papua New Guinea (Oct. 2012).

168 Id.

169 These reflect my personal observations.

170 K. E. Smith et al., Tobacco Industry Attempts to Undermine Article 5.3 and the “Good Governance” Trap, 18 TOBACCO CONTROL 509, 509 (2009), available at http://www.socialpolicy.ed.ac.uk/__data/assets/pdf_file/0020/59024/We_request_UK_Govt_promotes_stakeholder_consultation_2009.pdf.

171 Id.

172 Id. at 510.

173 Kelsey, Jane, The Trans-Pacific Partnership Agreement: A Gold-Plated Gift to the Global Tobacco Industry?, 39 AM. J.L. & MED. 237 (2013)Google Scholar.

174 Id.

175 Id.

176 A COP Too Far? What's Next: The Tobacco Industry after CoP5, TOBACCO REPORTER, Jan. 2013, at 28-29.

177 See Memorandum from Office of the Secretary, Phil. Dep't of Health, supra note 104.

178 See supra Part VII.

179 See, e.g., Allen, supra note 37; see also THE UNION TOOLKIT, supra note 113.

180 See WHO FCTC, supra note 26, at 4.

181 See, e.g., Tobacco Industry Watch, ACTION ON SMOKING AND HEALTH AUSTRALIA, http://www.ashaust.org.au/lv3/action_accountability.htm (last updated Feb. 5, 2013).