10.23 Public attitudes to the tobacco industry
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There is no doubt that the tobacco companies in Australia and in many other parts of the world have suffered devastating blows to their public image in recent decades. In the wake of litigation cases during the 1990s that revealed duplicitous industry conspiracies to mislead and reassure smokers about the effects of tobacco use,166 to encourage children to start smoking175 and to undermine public health policy,253, 320 the companies have embarked upon a multifaceted public relations offensive designed to persuade the general public that they have turned over a new corporate leaf.
Several studies have examined Australian attitudes to tobacco companies. One of the earliest was undertaken in Western Australia in 1988, at a time when the tobacco companies were still publicly denying that smoking caused disease, were challenging the mounting evidence on second-hand smoke, and contending with an increased demand for tobacco control measures from a growing number of Australian health concerns. This research found that on the basis of public credibility, 75% of respondents felt that tobacco industry representatives were 'not at all believable,' rating them lower than used car salesmen (69%).334
Industry attempts to resuscitate their image appear not to have been of much influence. South Australian research in the late 1990s found that 80% of respondents (and 74% of smokers) thought that tobacco companies mostly did not, or never, told the truth about smoking and health;335 and Victorian research undertaken in 2004 reported similar findings.336 International research studying opinions in Canada, the USA, the UK and Australia shows that overall, 80% of smokers do not believe that tobacco companies can be trusted to tell the truth.337 Distrusting the tobacco industry is associated with an increased likelihood of cessation behaviours among smokers,337 and negative attitudes to the industry have been harnessed by tobacco control advocates as a way of encouraging quitting.
Other research has investigated just how far people believe that the tobacco industry may reasonably be regulated. A survey of Australian smokers in 2004 showed that 69% of respondents felt that tobacco products should be more tightly regulated, and 49% agreed that tobacco companies should take responsibility for the harms caused by tobacco.338 Interestingly, 77% of smokers surveyed also believed the government does not really care about reducing the prevalence of smoking because of the revenue it receives from tobacco taxes. The authors of this study conclude that 'stronger government action to control tobacco products and the tobacco industry is likely to be supported by the majority of Australian smokers and that failure of governments to act is associated with cynicism about in whose interests governments operate.'338 p 169
10.23.1 'Denormalisation' of tobacco use and the tobacco industry
The changing public attitudes to the tobacco industry are a marker of the growing 'denormalisation' of tobacco use. Denormalisation refers to the transition in status of smoking from a widely practiced and socially acceptable behaviour to one which is increasingly typified as destructive, dirty and anti-social. Denormalisation does not only apply to smoking. It has increasingly applied to the tobacco industry, which (as shown in the preceding section) has not enjoyed a particularly positive public profile in recent years. Public recognition that the industry has for many decades lied to smokers and the wider community about the health effects of tobacco use has been heightened by high-profile legal cases and the public release of previously confidential industry documents. The industry has been cast as the villain in popular culture (such as John Grisham's novel The Runaway Jury and movies The Insider339 and Thank you for Smoking). The industry's adoption of corporate social responsibility programs has been a major public relations campaign to regain corporate credibility (see Section 10.11 above).
Chapman and Freeman detail many markers of denormalisation of smoking in Australia that demonstrate just how marginalised smoking—and its champion, the tobacco industry—has become.339 These include prevailing attitudes in the community, as evidenced through an array of media reports, environmental and health campaigns and advertising for items such as insurance, accommodation and cessation aids.
Increasing limits on where smoking may occur means that smokers are for the most part defined as a group whose unwelcome behaviour entails segregation. Provision of smoking accessories such as cigarette lighters and ashtrays is no longer standard in cars of Australian manufacture and some imported European vehicles; once elegant tobacco packets are now disfigured by graphic health warnings.339
In that denormalisation of smoking contributes to continued downward pressure on smoking rates by encouraging quitting and discouraging uptake of smoking, it can be seen as a marker of progress. However it is important to consider whether the denormalisation of smoking might lead to the marginalisation of those people who continue to smoke. There is a risk that as smoking becomes more concentrated among populations which are already disadvantaged (such as lower SES groups and the mentally ill), these individuals may have less motivation to quit or access to programs which might assist them.340 Stigmatisation of smokers could also lead to discrimination (for example in the workplace) and 'victim blaming' if smokers are regarded as responsible for their own illness.339
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