Recruitment and interview feasibility
Five out of the first six officials who were approached agreed to be interviewed. The one who declined was on extended leave. Of the first six politicians approached, three declined immediately, and one declined after three failed attempts to keep an appointment, leaving two interviewees at that stage.
A further group of six politicians were approached and three agreed to participate (giving an overall response rate for politicians of 5/12 or 42%). For the others, one politician's secretary thought the inquiry should go no further, and two declined and recommended other members of their caucuses whom they thought more knowledgeable about the tobacco industry. The two who were recommended were also on the list, and had already agreed to take part.
The ten participants consisted of politicians from five different political parties (out of the eight represented in the 2006 Parliament), and managers or senior advisors from the three Ministries of Health, Education and Social Development. Persistence was needed to ensure access to interview the politicians. It was necessary to be flexible with their appointment times, as they could be called urgently to government business, or be late because of extended caucus meetings.
Interviewees were willing to answer questions fully and frankly about their knowledge and views of the tobacco industry. The time and effort spent on establishing rapport and trust appeared to be successful in obtaining frank and open answers and comments. Participants often showed genuine surprise or shock, and were willing to make statements that might not be in keeping with their political party or organisational policy. As far as the interviewer could judge, and as could be heard from the audio recording, any reticence appeared to be due to lack of knowledge about the topic in question.
Contact with the industry
Participants were asked if they had had any contact with tobacco industry personnel. For four of the participants (three politicians and one official), industry contact was regular, and they saw it as part of their job. One politician described their role as being the 'contact person for the ...party'. A second official described the experience of being approached by a 'salesperson' from the tobacco industry, who wanted the official's support for a community project being funded by his tobacco company. Five other participants had had one significant contact, but it was not on-going, and one official stated he never had contact.
Politicians and officials appeared to view contact with the industry in different ways. On being asked whether contact with tobacco industry personnel would be any different from that with other agencies or industries, the politicians in the study stated that their contact would be no different. In contrast, most of the officials were very clear that their contact would be different, for reasons such as:
'I view them as producers of a hazardous substance, so I would have different mind set.'
'Because most of the other agencies I deal with are either government agencies or non-government organisations, charitable organisations and so on. The similar organisation [to the tobacco industry] would be with the food industry and I do have contact with the food industry. But I think the tobacco industry is slightly different to the food industry, and I think my relationships would be quite different.'
Knowledge of the tobacco industry and its associations
The interviewees' knowledge of the investment in tobacco industries by New Zealand government agencies [30] was low or absent. All except three did not know of, and were surprised to hear of, the investment. Of the three, one had no firm knowledge of details, and two only showed any knowledge after denials and prompts.
When the politicians were asked about their party's policy on accepting money from tobacco companies, only one said that their party had a formal policy to not accept money from tobacco companies. According to three politicians from other parties, those parties appeared to have informal policies that such funding had not and would not happen. The remaining politician said he thought his party would not accept money from tobacco companies, but would now check on this.
The three participants closest to the tobacco policy process (based on their statement of tobacco policymaking being an important part of their job) agreed that they needed to have up-to-date knowledge about the actions and nature of the tobacco industry, when making policy decisions. This included:
'Evidence from overseas on the way that they operate ...and all the efforts around the world to legislate the tobacco industry.'
Attitudes to public relations initiatives by tobacco companies
For most (but not all) interviewees, the general subject of tobacco company public relations activity provoked stronger reactions than any other area of questioning. Seven of the participants were more forceful in addressing this subject than when answering any other question. They were sceptical of the motives of the tobacco companies in any activity relating to health outcomes (such as the tobacco company support of the Life Education Trust in New Zealand, an organisation that seeks to provide drug education in schools). For instance:
'No business is going to invest its money in activities that go against its own interests.'
'They wouldn't be doing it if there was not some spin-off for their product ... I find it remarkable that the industry can come out with statements like being "socially responsible." '
'I think there are conflicting messages...it is good that they are doing those things, but you would need to follow the logic of that through ...one can't on the one hand promote a health message and on the other hand market a product which is responsible a considerable amount of ill health in the community.'
'They are putting on some nice clothes, so they can't be seen for what they are.'
However, one interviewee suggested that a tobacco company donation to a nominally health-focused charity was:
'given in good faith ... When I spoke to people I had contact with in the tobacco industry about that, they were very clear in their minds that they were doing good work and that that was a positive.'
Attitudes on associations with the tobacco industry
Interviewees were asked what risks there might be to the government, when it and or its agencies were associated in any way with the tobacco industry. Seven of the participants, including three politicians, thought that if such contact extended to co-operation, it would be inconsistent with present government policy. They made clear statements on this, such as:
'I think that there is a risk of influence, in terms of the tobacco industry promoting their products, which is inconsistent with the smoke free policies, but also with the health of New Zealanders.'
'If you are talking about a healthy and safe environment for all New Zealanders, and then you are deliberately involved in practices that undermine that, then you are not putting your money where your mouth is ... you've got conflict going on.'
'Some companies you don't want to be in partnership with.'
Knowledge and attitudes around tobacco company marketing
The interviewees showed little knowledge about the detail of tobacco marketing. Only one was able to volunteer any knowledge of tactics for marketing to women or particular ethnic groups. However, across all the interviews, their answers did suggest some underlying understanding of what might be happening in tobacco marketing. When asked whether they thought that tobacco companies in New Zealand promoted tobacco to children under 16 years of age, only one participant stated that they did not believe that there was any kind of promotion. The sale of tobacco products to those under the age of 18 is illegal, and one purpose of the Smoke-free Environments Act is:
'to reduce the social approval of tobacco use, particularly among young people, by – (i) imposing controls on the marketing, advertising, or promotion of tobacco products and their association with other products and events' [31].
Nine of the participants considered that there was tobacco promotion to under-16 s, even though this appeared to be against the general aims of New Zealand government policy. They also were aware of what they regarded of the subtleties of such promotion. The consistency and depth of their attitudes on this is suggested by such statements as:
'I don't think they do go out and specifically target under-16 s, but ... I think it is actually very difficult to not ... cross the line'.
'I think they do it through subtle marketing and peer pressure, and through availability... and I think little shops still market to children. Big shops, by which I mean supermarkets, I think, are less likely to display and market to children, although cigarettes are still on display.'
'I think they don't do it as [much as] they certainly once did, but I'd be in no doubt that they'd be not too unhappy with any under-16 year old who starts smoking either.
'I am sure there will be, deep down, perhaps a strategy on how they get their next generation of customers. But whether that's targeted to them or not, I don't know. There have certainly been incidents of products sold with cigarettes that would indicate that they are targeting younger people...and we've stopped that.'
'Obviously there's subtle marketing efforts, and the industry are using them'.
'Talking to the people from BAT [British American Tobacco], I don't think they would consciously do that, but if you are going to [market] vigorously, obviously it can't escape people under 16'.
In answering this question, four officials expanded on their attitudes on tobacco marketing, suggesting the power of video, television and movies to influence tobacco use by young people. The comments included:
'One thing that I feel strongly about [tobacco marketing]. That is the influence of movies. ... it sort of promotes the view that smoking is OK and acceptable.'
'There are still films made with people smoking as a social norm, and that has a significant influence.'
'Have we got tobacco role modelling going on particularly in television and the movies? And the answer is yes ...and does that influence youth behaviour? The answer is yes. Are tobacco companies tied up in product placement? I understand they are.'
Attitudes on tobacco industry efforts to counter health protection activities
The participants were asked if they thought that tobacco companies deliberately set out to counteract government efforts to reduce the harm from smoking, through legal or official processes. All ten participants believed that the tobacco companies would use many different tactics to promote their own interests that were contrary to the health promotion and protection aims of the government. In answer to the question, comments from the politicians included:
'Yes. Their mission is to sell tobacco.'
'I am sure they look for other avenues, as do accountants when we change tax law, as we change regulations on any industry, they will always be those who wish to push the boundaries. Yes, I guess they have challenged government in terms of the process and as does any organisation. They will use the law and the legal process to promote their company objective, and that's increased profits and returns to shareholders.'
'I remember one of the South American doctors, employed by BAT, that came out and lectured all around the place and minimized the harm caused by tobacco... I think that they sprinkle a variety of medical professionals who have basically been captured ... paid off...absolutely.'
The officials in the group were also explicit in their attitudes on this:
'They have been reasonably vigorous lobbyists against, for example, smokefree legislation. They have been fairly vigorous over time in terms of trying to combat medical evidence, with respect to say, the illness that is caused by smoking.'... 'I think they would certainly put pressure on groups who oppose them.'
'It's just business isn't it ... it is surviving and in business you are trying to make a profit and trying to make the best money possible and you'll do what it takes to do that.'
'They use a variety of approaches ...both questioning research, doing their own researching [on] regulatory measures, challenging regulatory measures, challenging government processes.'
'At times they have been successful in challenging [the official] process, and that further delays [the process] and that means we've got to concentrate on very good process ...or we get challenged at any possible slip-up in process. And that [level of] challenge wouldn't normally occur in most other [health policy areas].'
General attitudes to the tobacco industry
A more open question, asking interviewees more generally about their attitudes to tobacco companies, produced answers from all the interviewees. These contained both uncritical and critical aspects. For instance, one politician's comment appeared to assume that the industry was within the limits of 'normal' business, and that it showed some social responsibility.
'They are like everybody else. They have a job to do ... they sell tobacco. ... they do have that element of social responsibility there.'
Seven responses were wholly critical, and these ranged from mildly so, through to extremely forceful. Criticism came from both politicians and officials:
'At one level I don't regard them as doing anything of great value, but then I regard the advertising industry in the same category'.
'They are huge multinationals, and operate as such in an area of high profit, high taxation, high levels of regulation, but ultimately one that is still sanctioned by the vast majority of governments. [An industry] that we have become increasingly aware of, [which] produces harm for societies through direct and indirect utilization of the product, and... the only product that used as recommended will harm you.'
'I think they should all just shut up shop really ... [laughter]...and get into some other industry that's actually constructive and helpful ... I don't know how people can bear to work in them, I mean to be honest ... how could you?'
'Their product is harmful ... and whether they are good at being harmful or bad at being harmful ... they are harmful.'
'Their business is death. It is the sale of death, and for that reason I would like them out of the country and I believe that by so doing we will set an example that many other countries will follow.'
'Well, they are a scourge really ... they are the worst extreme example of global corporitisation.'
One interviewee felt that one word could fully describe tobacco companies:
'Pariahs'.