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The Hindu
4 days ago
- Health
- The Hindu
Can mHealth and AI amp up tobacco cessation efforts?
If we compare the GATS 1 (Global Adult Tobacco Survey) with the GATS 2, all parameters related to tobacco cessation show a downward trend. While the sustained efforts by the government through implementation of national programs such as NTCP, COTPA, and NOHP; ratification of strategic frameworks such as WHO's MPOWER or FCTC; or multilateral collaboration with global health organisations, NGOs, and other stakeholders, the efforts fall short in responding to the tobacco scourge prevalent in the country. 28.6 % of the people aged 15 and above use tobacco in India, the use of smokeless forms being double that of smoked forms. This can be attributed to the social acceptability of smokeless tobacco (SLT), especially among women in old times. Tobacco continues to hold cultural value in local traditions, where it is offered to guests and gods with equal reverence. The second largest consumer—and third largest producer—of tobacco, India is home to 72.7 million smokers. It is responsible for 13.5 lakh deaths, 1.5 lakh cancers, 4.2 million heart diseases, and 3.7 million lung diseases every year. With a 20 % share of the global burden load, India is touted as the oral cancer capital of the world. Also Read | From tea stalls to tumours, tobacco affordability fuelling cancer epidemic in India Secondhand smoking (SHS), caused by the inhalation of toxic fumes when somebody is smoking in the vicinity, compounds the problem further. It contributes to 14% of total tobacco deaths, with the brunt falling squarely on the most vulnerable—women, children, and older people. Almost half of the non-smoking women and over one-third of pregnant women are exposed to tobacco smoke in India and Bangladesh. According to GATS 2, despite 85.6% of people being aware of the detrimental effects of SHS, 38.7% of people working at home and 30.2% working indoors were exposed to smoking. A 2023 report by WHO on global tobacco epidemic believes that physical distancing—whether it be designated smoke rooms (DSRs) or ventilation—fails to protect from the exposure of SHS. The smoke residues from 7000 chemicals, including over 70 carcinogenic substances, cling to physical surfaces long after a cigarette is stubbed out. Through case studies of popular smoke ban laws in Atlanta and Finland, WHO FCTC's Section 8 advocates for strict legislation for a smoke-free environment to protect our basic right to breathe in clean air. Also Read | Two decades after India's public smoking ban, challenges persist in tobacco control Dependency on tobacco Multiple studies have shown that dependence on tobacco and bidis significantly impairs individuals' ability to quit. The wide availability of locally-produced tobacco brands in India further complicates regulation of nicotine content. Moreover, Big Tobacco is frequently accused of deliberately maintaining high nicotine levels to promote addiction. Furthermore, the tobacco industry lobbying has actively obscured critical information and deflected public discourse from the health risks linked to tobacco use. This has resulted in manufacturing of narratives, such as conflating the harms of tobacco smoking with air pollution. What harm will one cigarette cause when the level of pollution amounts to breathing 20 cigarettes a day!? (While air pollution demands urgent action, the harm caused by cigarette smoke is 2 to 2.5 times greater, according to a Chinese study.) In the 1996 issue of Time Magazine, the president and CEO of Philip Morris was quoted saying that cigarettes are no more addictive than coffee or gummy bears. This impact on teenagers by Big Tobacco propaganda is concerning. 8.5% of young adolescents (between 13 and 15 years) consume tobacco in some form in India. With stylish names, flashy packaging, fancy brand ambassadors, and fun flavours, the tobacco industry preys on the young to initiate tobacco use as well as continue it. A WHO report highlighted the addition of sweetening agents, flavorings, bronchodilators, and additives such as levulinic acid and menthol to tobacco products—measures intended to reduce the harshness of nicotine and create a cooling effect in the throat. These modifications in taste, smell, and sensory appeal, experts believe, hype the demand of these products among the youth. Kicking the habit The GATS 2 survey revealed that out of the total people who wanted to quit, 70% had to do it alone, and most couldn't sustain it beyond a month. We must also realize that cessation is not a one-off thing but a continuum—the counselling must always be ongoing and adaptive. Pranav Ish, a pulmonologist at VMMC and Safdarjung Hospitals said even 2-3 minutes of reinforcement has worked wonders in his patients. GATS 2, however, reveals a dismal picture when it comes to the attitude of healthcare providers: only 31.7% of healthcare providers advised their patients to quit in the last month, and 48.8% in the last year. Aninda Debnath, assistant professor, Community Medicine, MAMC, Delhi, says that while a lot of programs related to tobacco cessation are in place, a critical look at their functioning and utilisation is important. The COTPA Act prohibits advertising of tobacco in any form; however, a study by Vital Strategies found 75 % of online surrogate marketing of tobacco on Meta platforms. Vikrant Mohanty, HoD and Project Head, National Resource Centre for Oral Health and Tobacco Cessation, MAIDS, Delhi, said: 'While the government is doing its bit through cessation services at primary level, dedicated counsellors in NCD clinics, dentist training under NOHP, a comprehensive approach with integration of stakeholders at various levels is the need of the hour. The dropout from follow-up still remains huge, and faith in the treatment low.' Also Read | Smokeless tobacco products contribute to over 50% of oral cancer cases in India, study finds AI to the rescue Traditional forms of counseling are, for one, not equitable—the social desirability bias kicks in when hospitals expect the patient to come back. Plus, affordability and accessibility to TCCs is an issue for most who come from lower to lower-middle classes and work in informal sectors or as daily wage workers. Researchers have found that the results of tobacco cessation have stagnated, or at times gone down, for people with social disadvantage. While mCessation in the form of encouraging text messages or telephonic counselling through NTQLS has been an innovative solution (as part of WHO's Be He@lthy, Be mobile), limited success has been observed. Some of the gaps in successful implementation of mHealth include voice recognition inaccuracies, network connectivity issues, poor digital literacy, shoddy interface, absence of personal connection, poor long-term engagement, and high attrition rates. Integrating mHealth with innovative solutions such as PSD (Persuasive Systems Design) or just-in-time-adaptive-intervention (JITAI) that deliver an intervention in moments of elevated need or receptivity has shown great promise. This is where AI can give us a leg up. Mohanty adds that large language models can bridge the gap of delivery, provide personalized healthcare systematically, capture data, and use them in improving the outcomes.' AI can be harnessed not only through chatbots but also indirectly to train healthcare professionals so they can assess, advise and follow-up with the patients rigorously. Dr. Debanath emphasised the importance of refresher training—a component often neglected—which can be made significantly more accessible and efficient with the help of AI.' Monika Arora, Vice President of Research and Health Promotion at PHFI, believes, 'Chatbots and virtual assistants powered by AI can provide round-the-clock support, track and monitor tobacco use behavior, offer evidence-based information, and deliver personalized motivational messages. AI can also utilize predictive analytics to identify individuals at higher risk of relapse and tailor interventions accordingly.' However, this can't happen in isolation. All the interviewees believed that AI should not be thought of as an alternative but as an adjunct to traditional strategies. Dr. Arora and others are working on an AI-based model under Project CARE, where the focus is on 'co-development with users and healthcare providers' who can come up with innovative and contextually relevant solutions. Also Read | The tobacco epidemic in India Digital literacy challenge However, all is not rosy with mHealth and AI. While mobile penetration in the country is good, the lack of digital literacy might act as a massive deterrent. Debnath shared a personal anecdote: 'My mother has a smartphone, but she uses it only for calling and WhatsApp.' Moreover, in this age of digital revolution, when we are always bombarded with text messages and the ubiquitous 'ting' of notifications, the impact of one more message needs to be looked at with a fair bit of skepticism. These newer innovations should be complemented with other time-tested strategies. Plain packaging, which was initiated by Australia for the first time in 2012—and was followed by a wave of countries—should be considered as the next step to challenge the growing empire of tobacco corporations. Stronger warnings, higher taxes, increasing the size of graphic warnings, banning e-cigarettes, and hiring brand ambassadors cam aid our efforts. Emerging approaches such as adaptive counseling, designed to provide stepped care that addresses patients' unmet needs and parallels chronic disease management, can also be considered. Dr. Ish added: 'It feels rewarding that a patient who could earlier smoke three cigarettes had to contend with only one due to high costs.' India has garnered international attention for its tobacco cessation program, but the sheer burden of tobacco warrants that we not only explore newer strategies while also ensuring rigorous implementation of the existing ones. (Kinshuk Gupta is a writer, journalist, and public health physician. His debut book is Yeh Dil Hai Ki Chor Darwaja. kinshuksameer@
Cision Canada
4 days ago
- Health
- Cision Canada
WORLD NO TOBACCO DAY: Some twenty Quebec groups call for major investment in prevention drawn from provincial tobacco-settlement windfall Français
MONTREAL, May 31, 2025 /CNW/ - On this World No Tobacco Day, close to twenty Quebec health groups are calling on the Quebec government to take a small proportion of the financial benefits it will draw from the settlement ending all litigation faced by the three largest cigarette manufacturers (including Quebec's claim), and to invest that amount in the tobacco control budget. More specifically, the groups are asking that 2.7% of the $6.6 billion that the province will collect – the equivalent of $30 million – be invested in government initiatives aimed at accelerating the fight against smoking, improving support for smokers who want to quit, reverse the youth vaping crisis, and better combat the illegal sale of vaping products, as specified in this recent letter to the Quebec government, signed by five provincial anti-smoking groups. According to Flory Doucas, co-director and spokesperson for the Quebec Coalition for Tobacco Control, " the fight against smoking is far from over, and unless this battle is accelerated, smoking will continue to monopolize a huge proportion of Quebec healthcare resources. Tobacco kills over 36 Quebec smokers every day, as smoking remains the leading cause of preventable illness and death in the province. Meanwhile, public health workers, schools officials and government inspectors are overwhelmed by the vaping phenomenon, with new cohorts of young people continuously falling into the nicotine addiction trap. "Despite the financial compensation for victims and the injection of substantial funds into provincial coffers, the settlement negotiated and approved by Quebec and the other creditors has significant shortcomings, as it fails to include a single measure to force the industry to change its ways." In fact, the settlement endorsed by Quebec and the other provinces grants Big Tobacco total and complete immunity for their decades of dishonest and irresponsible marketing of tobacco products – in exchange for payments spread out over the next two or three decades. It even prevents the new ' Cy-près ' foundation (with assets of one billion dollars) from funding smoking prevention or cessation interventions, stating that these "fall within the purview of the Provinces and Territories" [ 9.3 1 ]. "Given that payments to provinces, including Quebec, will come from current and future smokers, the agreement raises a potential conflict between the government's desire for revenue and its primary responsibility to protect the public. By investing part of the funds to fight the use of these harmful products, the government would counter the appearance or existence of such a conflict," explains David Raynaud, Senior Manager, Quebec - Public Interest Advocacy at the Canadian Cancer Society. "The agreement doesn't include any measures to prevent or minimise further harm. It even stipulates that the industry must maintain its usual commercial operations, which includes recruiting new consumers of tobacco and vaping products, resulting in new victims and new healthcare costs. It would be immoral for the government to collect these billions without dedicating a substantial amount to prevent additional harm and costs," he adds. The settlement protects the vaping market The settlement exempts revenues from the sale of vaping and heated tobacco products from all financial obligations. "This extraordinary exemption allows for the continued aggressive expansion of the recreational nicotine market, inevitably leading to new consumers becoming addicted to nicotine and exposing them to new health risks," adds Marc-André Parenteau, Senior Advisor, Government Affairs and Advocacy at Heart & Stroke. "In our view, the government's primary responsibility is to do everything in its power to stop the suffering and loss of life caused by harmful and unnecessary products from a profit-driven industry. Without new investments to better protect the public from the nicotine industry, the popularity of its traditional and novel products will continue to harm the health and well-being of Quebecers while generating additional healthcare costs," concludes Ms. Doucas. SOURCE Quebec Coalition for Tobacco Control Information: Flory Doucas, Spokesperson, Quebec Coalition for Tobacco Control, 514-515-6780; Fatou Thiam, Communications Manager for Quebec and Francophone Canada, Canadian Cancer Society, 514-229-0671; Maryse Bégin, Cœur & Stroke, [email protected]. 514 669-6297
Yahoo
28-05-2025
- General
- Yahoo
Clinton, Franklin, Essex Reality Check youth take action against tobacco at national conference
PLATTSBURGH — Clinton Franklin Essex Reality Check youth traveled to Washington, D.C. last week to stand up to Big Tobacco as part of the 2025 Mobilize Against Tobacco Lies conference. Reality Check is a youth-led program that empowers teens to fight back against tobacco marketing and work toward a healthier, tobacco-free future for their generation. The event took place from May 14 to May 15 and brought together young advocates from across the country to call out tobacco industry deception and demand change. The two-day event began with intensive training led by national public health organizations such as the Campaign for Tobacco-Free Kids and Counter Tools. These sessions covered rally planning, media engagement and current nicotine trends equipping students with the tools to make their voices heard. The conference culminated in a powerful demonstration outside the Washington, D.C. lobbyist office of Altria Group, which was holding its annual virtual shareholder meeting. Just steps from the U.S. Capitol, youth delivered a bold message: 'Don't Get Caught in Altria's Web of Lies.' 'Being there in person and seeing the effect we had on shareholders and the general public was really impactful,' Ada Burgess, a local Reality Check participant, said. 'Even negative reactions showed they noticed us and were affected by what we were saying. It's powerful to realize we can actually make a difference.' Reality Check participants and national youth leaders also made their voices heard inside the virtual shareholder meeting by using Altria stock to submit tough questions to company executives during the Q&A session. These powerful contributions challenged the company's narrative and brought youth concerns directly to the forefront. McKenna McGrath, another Reality Check advocate, said 'it was a really powerful and valuable experience.' After the demonstration, the group gathered with peers and mentors to reflect on the day's actions, share insights, and plan how to bring the momentum back to their local communities. Alice Elizabeth Ladue, Reality Check Coordinator for Clinton Franklin Essex, praised the students. 'These young people are fierce, informed, and fearless,' Ladue said. 'They're taking on one of the most powerful industries in the world and they're already making a real impact.'
Yahoo
28-05-2025
- Business
- Yahoo
Opinion: Health Canada should thank business for great smoking news
By Ian Irvine In Ode to a Nightingale, John Keats described how 'but to think is to be full of sorrow/And leaden-eyed despairs.' Such pervasive, perpetual gloominess sounds exactly like Canadian health officials contemplating the latest statistics on smoking, which are in fact spectacularly good news. Smoking has not yet been fully extinguished, but millions or smokers have quit and switched to lower-risk products. Yet 'woe is us!' groan the officials. To be precise, Statistics Canada surveys indicate that between 2017 and 2022 the smoking rate fell by just over four percentage points of the population while the vaping rate increased by three. About a million Canadians changed their nicotine status in a mere four years. Daily smoking among teens is now less than one per cent. That is not a typo: yes, less than one per cent. In all likelihood, the number of smokers is down another couple of hundred thousand since 2022, which means smokers now out-number vapers by less than two to one — and falling. Let's raise our glass to that, if the alcohol ascetics will permit. This rapid and unprecedented decline in smoking has brought no joy to anti-nicotine purists. Ottawa's medium-term goal is at most a five per cent smoking rate by 2035, but self-styled health groups want to obliterate all nicotine use, not just cigarettes, regardless of the relative harm associated with each product. Until nicotine is banished the purists will continue in 'leaden-eyed despair.' Driven by these interests, Ottawa and the provincial capitals have done their utmost to prevent the substitution of low-risk nicotine products for cigarettes. Primarily, it is the private sector that continues the fight for consumer and citizen sovereignty. A handful of e-juice producers and importers and a thousand-plus vape shops, most run by small entrepreneurs, have given the Canadian public what it wanted: nicotine in a non-lethal, non-combusted format. This sector of the economy is responsible for one of the great improvements in health in the modern era. The decline in smoking brought about in the past few years should reduce tobacco-related deaths by several thousand persons per year down the road. Even Big Tobacco has come to the party, with vapes, heated tobacco products and pouches. JUUL, a true innovator in the vape space, foundered on stupidity. But VUSE, STLTH and VEEV vapes are available in gas stations and convenience stores, giving smokers an alternative. The leading heat-not-burn product, IQOS, is enjoying major success worldwide. In several European cities it accounts for a third of the nicotine market, and in Japan its introduction coincided with a decline in cigarette sales of about 50 per cent over an eight-year period. Oral nicotine pouches are also on the market now, the most well-known being Zonnic — a tobaccoless product made from synthetic nicotine and vegetable matter. Unfortunately, it was launched ham-handedly: its ads showed young adults having a fun time on nicotine, which gave the federal health minister at the time all he needed to consign pouches to pharmacies. Our lowest toxin nicotine product is now the hardest to access. Thank your federal government for that. In response to the hugely positive downward trend of tobacco use, the Brahmins in Ottawa have decreed that under the Tobacco and Vaping Products Act implementation a vendor can be prosecuted for telling a buyer what the U.K.'s Royal College of Physicians has said for a decade: that vapes carry about five per cent of the risk of combustibles. They have also decreed that buyers may purchase only low-nicotine vapes and that low-risk products must be in plain packaging and out of sight lest smokers see them. At the same time, just about every medical group in Canada continues to wage war on the greatest quitting device ever invented. The provinces are no better. Most disfavour reduced-harm products, some avidly so. The most strident are British Columbia and Quebec, whose restrictions run to volumes. Of course, these two provinces also have the highest rate of alcohol-use in Canada. The oenophiles in Quebec City and West Van elect governments that are high on alcohol, but low on harm reduction from tobacco. The contradiction isn't a mystery. Smoking is a lower-class thing for the stressed, the mentally ill and others who seldom are members of wine-tasting groups in Outremont. William Watson: The throne speech should be short, sweet and backward-looking Opinion: The embassy murders — some stakeholders are more equal than others So let us celebrate the private sector. It has stepped up and continues to fight on difficult terrain, while governments and the privileged slouch only grudgingly and reluctantly to a new and better reality. Ian Irvine, an economics professor at Concordia University, has worked as a consultant to both the private sector and the federal government on alcohol and tobacco. Some of his recent research has been funded by Global Action to End Smoking. 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Yahoo
21-05-2025
- Health
- Yahoo
Big Food's Big Tobacco moment: Arianna Huffington
We are entering Big Food's Big Tobacco moment. The fight to hold tobacco companies responsible for the deadly health effects and associated health-care costs of their products took decades, culminating in the 1998 $206 billion settlement with 46 states and reforms like a ban on marketing cigarettes to young people. In the '60s, when free sampler packs of cigarettes were given out to high schoolers, 42% of American adults smoked. Today that number is 12%. Is that where Big Food is headed with ultra-processed foods, artificial dyes, and sugary beverages? We're actually further along in that process than many might think. Forces for change are converging across the political, legal, and cultural landscape—and we have the example of the fight against Big Tobacco to draw on. In December, a landmark, first-of-its-kind lawsuit was filed in Philadelphia on behalf of a teenager alleging that consuming ultra-processed foods led to him developing fatty liver disease and Type 2 diabetes. Among the 11 companies named in the lawsuit are General Mills, Kraft Heinz, PepsiCo, Coca-Cola, and Kellogg's. Ultra-processed foods 'are alien to prior human experience,' the 148-page complaint reads. 'They are inventions of modern industrial technology and contain little to no whole food…The explosion and ensuing rise in UPFs in the 1980s was accompanied by an explosion in obesity, diabetes, and other life-changing chronic illnesses.' The lawsuit goes on to make an explicit tie between Big Food and the rise of UPFs and Big Tobacco, arguing that food manufacturers are 'using the same master playbook.' The connection is more than metaphorical. In the 1980s, tobacco companies Philip Morris and R.J. Reynolds bought Kraft, General Foods, and Nabisco. In the early 2000s, the food companies were spun off, 'but not before leaving a lasting legacy on the foods that we eat,' as Anahad O'Connor put it in The Washington Post. That's because, as the complaint notes, 'UPF formulation strategies were guided by the same tobacco company scientists and the same kind of brain research on sensory perceptions, physiological psychology, and chemical senses that were used to increase the addictiveness of cigarettes.' This was confirmed by a 2023 study published in the journal Addiction, which found that the decades when Big Tobacco owned Big Food corresponded to the rise of 'hyper-palatable' foods, which are ultra-processed foods engineered to have a combination of fat, sugar, sodium, and carbohydrates that trigger the brain to encourage excessive eating. In the study, foods from tobacco-controlled brands were 80% more likely to contain powerful combinations of sodium and carbs that made them hyper-palatable and 29% more likely to have similar combinations of sodium and fat. The study notes that by 2018, the differences between food from the tobacco-owned brands and foods from other companies had disappeared—not because any of the foods became less unhealthy, but because other companies saw that ultra-processed foods sold well and simply copied them. 'Every addictive substance is something that we take from nature and we alter it, process it, and refine it in a way that makes it more rewarding—and that is very clearly what happened with these hyper-palatable food substances,' said Ashley Gearhardt, a professor of psychology at the University of Michigan who studies food addiction. 'We treat these foods like they come from nature. Instead, they're foods that come from Big Tobacco.' In fact, Big Tobacco's use of the same master playbook for cigarettes as for food goes back decades earlier. In the '60s, R.J. Reynolds conducted market research on children for the development of sugary drinks. As Reynolds' manager of biochemical research put it in a 1962 internal memo, 'It is easy to characterise R.J. Reynolds merely as a tobacco company. In a broader and much less restricting sense, however, R.J. Reynolds is in the flavour business.' The manager also noted that 'many flavourants for tobacco would be useful in food, beverage and other products,' producing 'large financial returns.' And it turns out, the negative consequences from the 'flavour business' were strikingly similar for ultra-processed foods and tobacco. Research being presented this month at the American College of Cardiology's annual scientific meeting found that consuming an additional 3.5 ounces a day of ultra-processed food was associated with a 14.5% increased risk for hypertension, a 5.9% increased risk for cardiovascular events, and a 19.5% increased risk for digestive diseases, as well as heightened risk for obesity, metabolic syndromes, diabetes, and depression or anxiety. Last year, in the world's largest review of its kind, a comprehensive study found that consumption of ultra-processed foods is linked to a higher risk of at least 32 different health problems, including heart disease, cancer, Type 2 diabetes, mental health disorders, and early death. The term ultra-processed foods was coined by Carlos Monteiro of the University of São Paulo. He also developed the NOVA food classification system that categorizes foods based on their level of industrial processing. As Monteiro put it, 'no reason exists to believe that humans can fully adapt to these products.' Or at least adapt to them any better than the dinosaurs did to asteroids. And avoiding ultra-processed foods is actually harder now than avoiding cigarettes was even in the '60s. Nearly three-quarters of America's food supply is now made up of ultra-processed foods. A huge part of the problem are sugary beverages, which are the single largest source of added sugars consumed by Americans. According to the American Heart Association, having one more sugary drink each day can increase a person's risk of hypertension by 8% and risk of heart disease by 17%. And a January study in Nature Medicine found that these drinks contribute to 2.2 million new cases of Type 2 diabetes, 1.2 million cases of cardiovascular disease, and 340,000 deaths globally each year. 'This is a public health crisis, requiring urgent action,' said study author Dr. Dariush Mozaffarian, a cardiologist and director of the Food is Medicine Institute at Tufts University. And the playbook by the two industries to stave off reform is the same. As more science comes in, so do the efforts to prevent that science from making its way into policy and regulation. Part of that involves lobbying. According to an analysis by the Financial Times, food and beverage companies spent $106 million on lobbying in 2023, nearly twice as much as tobacco and alcohol companies combined. And that was an increase of over 20% from the year before, largely due to 'lobbying relating to food processing as well as sugar.' Next in the playbook? Discredit the science. 'The strategy I see the food industry using is deny, denounce, and delay,' says Barry Smith, professor at the University of London. Right on cue, here was the response by Sarah Gallo, of the Consumer Brands Association, which represents the food industry, to the study in the American Journal of Preventive Medicine finding an increased risk of dying early from consuming UPFs: 'Demonizing convenient, affordable and shelf ready food and beverage products could limit access to and cause avoidance of nutrient dense foods, resulting in decreased diet quality, increased risk of food-borne illness and exacerbated health disparities.' And here is Gallo's response to the lawsuit filed in December: 'Attempting to classify foods as unhealthy simply because they are processed, or demonizing food by ignoring its full nutrient content, misleads consumers and exacerbates health disparities.' The final step in the playbook, of course, is to fight back in court. The Financial Times notes that in Mexico, food companies, including Nestlé and Kellogg, have sued the government to stop front-of-package warning labels and other restrictions like forbidding the use of children's characters in marketing. And all of that can work. Until it doesn't. The fight against Big Tobacco went the same way Hemingway described bankruptcy happening: 'Gradually, then suddenly.' What it shows is that, yes, the road is long, and there are many bumps and reversals and dead ends. And then, suddenly, the momentum changes, the zeitgeist changes, and what seemed impossible for decades swiftly becomes the obvious and consensus position. As far back as 1950, two scientists, Ernst Wyndner and Evarts Graham, published a study that found that 96.5% of lung-cancer patients were moderate to heavy smokers. Two years later, the counter-science began, when the tobacco company Liggett promoted a study, by a 'competent medical specialist,' that found that smoking Chesterfields had no adverse effects. In 1954, the first lawsuit against tobacco was brought by Eva Cooper, whose husband had died of lung cancer. Cooper lost that suit, but in the next four decades, over 800 lawsuits were filed by smokers or their families. Until the '90s, only two of those were successful and both were overturned on appeal. In the '90s, a third wave of lawsuits began. The breakthrough was that state attorneys general were seeking to recover health-care costs associated with tobacco. In 1994, the first of those suits was filed by Mississippi seeking $940 million in Medicaid costs the state spent treating smokers. As Mississippi's then-Attorney General Mike Moore put it, 'The lawsuit is premised on a simple notion: you caused the health crisis; you pay for it. The free ride is over.' And après Moore, the deluge. By the end of that year, three more states filed suits. By 1997, 39 states were suing. At the same time, there were major class-action suits being filed, including one, known as the Castano suit, by a group of 60 law firms across the country on behalf of 'all nicotine-dependent persons in the United States.' Another was brought on behalf of 60,000 flight attendants. A tipping point had been reached, and in 1998, the $206 billion 'Master Settlement Agreement'—the largest civil settlement in U.S. history—was agreed upon. 1998 wasn't that long ago, but the pre-Master Agreement world of tobacco acceptance now seems incomprehensible. And now we're down a similar road. In 2009, Kelly Brownell, a Yale nutrition expert, wrote a paper entitled 'The Perils of Ignoring History: Big Tobacco Played Dirty and Millions Died. How Similar is Big Food?' In explaining why he wrote the paper, Brownell said, 'We simply didn't want the food industry to be able to get away with some of those same tactics.' The food industry, he said, is at a crossroads: 'They can behave as tobacco did, which is lie about the science, distort the truth, and buy up the scientists. Or they can come face-to-face with the reality that some of their products are helping people and some are hurting, and we need to shift the balance.' That would mean food companies would stop marketing to children and overstating health claims. But most of all, said Brownell, 'they should reformulate their products and market the healthier versions as aggressively as possible.' At the time, there weren't a lot of voices in that chorus. But in the years since, more have joined. In 2012, lawyers pitched state attorneys general in 16 states with the idea of suing companies to make them pay for the soaring costs of obesity and diet-related health-care costs. Politico called it a 'radical' idea and 'a move straight from the playbook of the Big Tobacco takedown of the 1990s.' Paul McDonald, a lawyer who led the effort, said the aim wasn't to cast the food industry as villains, but 'to lighten the economic burden of obesity on states and taxpayers and to negotiate broader public health policy objectives.' On the legal front, according to the law firm Perkins Coie, 256 class action lawsuits were filed against the food and beverage industry last year, a 58% increase from 2023. While many of those are about truth in label and health claims, an increasing number are about ultra-processed foods. The food industry may win these lawsuits today. But for how long? The culture is changing, the science is becoming more and more clear, too many people are suffering, and too many lives are being lost. In the last few years, there is evidence that Big Food has seen the writing on the menu, trying to get ahead of the reckoning by buying up smaller companies focused on healthier food to diversify their product lines. In 2023, Mars, Inc. bought Kevin's Natural Foods, which makes healthy prepared meals and sauces. In January of this year, PepsiCo acquired Siete Foods, known for better-for-you Mexican-American inspired foods. In March, PepsiCo bought the prebiotic soda brand Poppi. This was on the heels of Coca-Cola launching its own prebiotic soda Simply Pop. In April, Hershey bought the better-for-you snack brand LesserEvil. In the meantime, the lawsuits continue. As the saying goes, first they ignore you, then they laugh at you, then they fight you, then you win. That's what happened with tobacco: 'When we filed the tobacco lawsuits, our peers—good lawyers and great lawyers—laughed at us,' said Wayne Reaud, one of the lawyers representing Texas in its lawsuit against the tobacco companies in the '90s. 'They told us there was no way we were ever going to win.' But they did win. Which is to say, all of us won. Now we need another win. And the good news? We already know how. The opinions expressed in commentary pieces are solely the views of their authors and do not necessarily reflect the opinions and beliefs of Fortune. This story was originally featured on
