Tobacco (59) Q3. What is the role of the tobacco industry? (5)

15 March, 2023

Dear HIFA colleagues,

This paper highlights how tobacco companies are increasingly targeting their nefarious messaging to people online, including through social media and 'social influencers'. Citation, extracts and a comment from me below. Full text:

CITATION: Importance of online exposures to pro-tobacco messaging

Brittney Keller-Hamilton, Amy K Ferketich

Lancet Global Health COMMENT| VOLUME 11, ISSUE 4, E491-E492, APRIL 2023

Published:April, 2023 DOI:

'Globally, a high proportion of young people recalled past 30-day exposure to pro-tobacco messaging [but] do not assess exposure to pro-tobacco messaging online...

In several countries, a substantial proportion of young people report recent exposure to pro-tobacco messaging online, both from the tobacco industry and from their peers. Exposure to pro-tobacco messages online, including on social media, has consistently been associated with increased risk of tobacco use among young people...

Beyond the negative effects of online pro-tobacco messaging exposures on youth overall, tobacco companies deftly use online advertising to target specific audience segments, including lesbian, gay, bisexual, and transgender (LGBT) populations and youth with lower socioeconomic status...

Although paid advertisements for tobacco products are prohibited on most social media sites, social media influencers promoting tobacco products are often permitted. These influencers, part of a broad international network with ties to hundreds of tobacco brands, skirt governments’ and social media sites’ policies against targeting youth with pro-tobacco messaging...

Implementation of counter-marketing campaigns targeted to young people—deployed online and via other media sources—could dampen the effects of pro-tobacco messaging exposures in this vulnerable population.'

COMMENT (NPW): This is of course just one example of the abhorrent and manipulative behaviour of tobacco companies. Which brings me to a question: To what extent have the tobacco control community been successful in communicating to people, especially youth, the true nature of tobacco companies' communications. Is there perhaps a minority of people who 'get it' in the sense of understanding this true nature? How can they be leveraged to spread the word? And what are the most effective short videos or other tools that expose tobacco companies for what they are?

HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: