Big Battle, Big Tobacco, Big Deal in The Global South [GIN Therapy Part 3]

In wrapping up my three-part GIN Therapy series, I turn to Tobacco – and its marketing in the Global South.

Only recently, I published an article “Cutting Loose or Losing (Tobacco) Control over Loosies,” in Woxsen Insights – the in-house magazine/ newsletter/ blogsite of the Woxsen University Hyderabad (India) – where I opined that the term “loosies” in this case study specifically refers to single cigarettes sold individually and outside of standard packaging – often as a means to sidestep tax laws and regulations. Interestingly, the term also carries other meanings, such as non-album musical tracks released individually by artists, or more colloquially, any single loose cigarette sold at retail level.

This practice is not unique to Africa – loosies permeate markets in the Global South and the GIN (Ghana, India, Nigeria) discussed illustrate only part of the bigger picture. Oceania, for example, leads the pack (in percentage terms) in tobacco consumption, but African countries probably trumps that when it comes to the headcount (due to having larger populations).

Starting with Ghana, although the has ratified the WHO Framework Convention on Tobacco Control (FCTC) and became a party to the Protocol to Eliminate Illicit Trade in Tobacco Products in 2021, there is a need to fully implement these international commitments, especially the protocol on illicit trade. In a recent article “The trade of illicit cigarettes in Ghana,” published in Tobacco Prevention & Cessation, it was pointed out that “Ghana has made important strides in tobacco control: the implementation of an early advertising ban (1982), the passage of the Tobacco Control Act (in 2012), the prohibition of single-stick sales (2017), the implementation of graphic health warnings (2018), provision of tax stamps on tobacco products (2018), and, more recently, the ratification of the ITP (2021) and a review of tobacco taxes”. The study went on to highlight that single stick sales continue to be rampant in Ghana, and cigarettes remain accessible and inexpensive (< US$1 per pack), with total excise taxes on tobacco products in Ghana accounting for only 31.8% of the average retail price.

An earlier study, “Landscape of tobacco control in sub-Saharan Africa,” mentions that Ghana’s tobacco regulation includes the Public Health Act of 2012 and the 2017 Tobacco Control Regulations, which prohibit smoking in public places, ban tobacco advertising, promotion, and sponsorship (TAPS), and mandate graphic health warnings on packaging. With all the regulations including the Public Health Act 2012 and the prohibition on the sale of single sticks and a ban on sales to minors, challenges remain due to issues like inadequate resources for enforcement, the prevalence of illicit trade, and the continued sale of individual cigarettes. Three ‘i’s stood out – Inconsistent enforcement, Industry interference, and Illicit trade – leading to a fourth “i” – implementation challenges.

In terms of inconsistent enforcement, regulations like the ban on single-stick sales are not consistently enforced, and designated smoking areas are still common in public spaces. When it comes to industry interference, there is concern about the tobacco industry’s interference in policy development, as the code of conduct to protect public health policy from industry influence has not been issued. Finally, the illicit trade of tobacco remains a significant problem, exacerbated by porous borders and a lack of effective enforcement.

Moving on to India, loosies are also common, with single sticks priced between ?15 ($0.17) and ?25 ($0.28). Besides the prevalence of loosies – there’s another uphill battle that still requires a fix (literally speaking) – paan masala – It’s complicated as “paan masala may or may not contain tobacco,” but when it does, it is considered a tobacco product. While pure pan masala is a mixture of ingredients like areca nut, lime, and spices, many versions also include a complimentary pouch of chewing tobacco, and products like “gutkha” are a blend of pan masala with tobacco. Tobacco-containing pan masala is a harmful and potentially carcinogenic smokeless tobacco product. As the following article  “Social Determinants and the Prevalence of Paan Masala Use among Adults in India” from the  2016-17 PubMed Central (PMC) “Global Adult Tobacco Survey” reveals, the battle is hardly won against Big Tobacco.

As for Nigeria, this context was captured in my article “Loosies”! Has Africa Lost the War on Big Tobacco?, and an earlier wider 2-part study examining the regulatory hurdles and public policy implications of ongoing regulatory breaches by “Big Tobacco” in Africa – from the ‘outright sale’ of single cigarettes (“loosies”) to ‘outright bans’ on smoking in public places, advertising regulations to plain packaging initiatives.

In the first study “Consumer Protection in Sub-Saharan Africa: An Exploration of “Big Tobacco” Marketing Practices in 2016, I explored how tobacco marketers used Sub-Saharan Africa as a testbed for “guerrilla marketing” strategies, exploiting weak consumer protection laws that were already well established elsewhere. In my follow-on study three years later in 2019, “Regulatory Challenges in Sub-Saharan Africa and Marketing Malpractices of “Big” Tobacco,” I went a step further to review regulatory practices in Nigeria alongside other African countries – Malawi and Mauritius. That study revealed that while policies to protect vulnerable groups from harmful products exist, enforcement had been – and is still – inconsistent at best. For example, although selling single cigarettes is illegal in much of the world, the practice remains widespread across African markets, particularly in the three countries examined.

In that article, I also highlighted how tobacco companies frequently partnered with governments in joint marketing initiatives – from publicity and sponsorship efforts that not only glamorized smoking, but also projected it as “cool.” Evidently the economic stakes further complicate matters – In Malawi, for example, tobacco contributes about 50 percent of the country’s total foreign currency earnings and 15 percent of GDP – making it politically and economically – difficult to penalize “Big Tobacco” for regulatory breaches.

Let’s face it, Tobacco Regulation in the Global South is not just a public health and social issue, but also one of marketing – social, strategic or sustainable marketing – that requires further research interrogation especially where there are real or perceived power asymmetry – “Global North” versus “Global South”, and between tobacco production and consumption.

This article ultimately speaks to both SDG3 (good health and wellbeing) and SDG12 (sustainable production and consumption) – it is all going up in smoke it seems.