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f MEMBERS OF WORKING PARTY ON SOCIAL ACCEPTABILITY ISSUE :

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7Members of Working Party Letter of Transmittal ~ ti.~'.~;~sr •'a'-~,. .a~;. , -..r_. T. ' : ,Tab1e of Contents _Reader's Guide to This Repor t., t .SECTION I Introduction to Country-by-Country Analyses ~'~'S..'$+ ~ .~AR~. r r *.>_~ + 3fra9a~s..`t,.~. 'r}~' ~. . `.• SECTION III 31• ~i~~-Y~~~..-t:«~~~~i.'i!-1L` Sumnarv Findin4s'and Conclusions'on Current Levels, Country-by-Coun C y~ 'S r . ~ F.r 7' `r ? .~' ,y-~ +-gy~ .y''~' ~ f~'S~, !" r ~.~~y"~; !t•'.A,~~'e.~~}~}'"'~'~''"- { ~~ r }' ' .~ J.~+~r~' . . . T , ..'.X'h' 'YY-.+tiirt"'btrJ'h~Z~k~~ti.,.:~,~'C ' i - l~: ~~~~:".": SECTION IV i ~ +r 3 ~ ,r ~~r ~ ~'~ i - tSummary. Findings and Conclusions on Influencing Factorsl; . _.~ . ~,. SECTION . V_-~:

~~ `~- i"45 r w':~'~1 ' ? 5- This ;reportcovers the first three of the "terms of the Working Party in the ICOSI statement of June iii~`S4* 9 # - a ", ..~.. r '. r a~ • t i ~P . . F.(= , . ~ - ` ' 2) To identify the factors which have affected this. 3) To examine such countermeasures as have been used. . ~ ~` : n . . . . For theseI activities, the Working Party followedICOSI's suggestion and incorporated "country-by country" anaiyses into their work and this report. • . . . , : ~ ~~ t, ~ r~~rr : .:'2"~,u''f1rL"~'3 r.. 5`3..., k•`..-Y ~ -"^~. 'r'4-f.[ r4t -~+~~ ;~ ~,`Li .~ t ,, tt x _ .°fr}~~- ' ~ ~ .n. . . z -"wa".t;' _ , . _. ~~ ;: } 'f ~6°s ~ Additionally; this report includes the Working Party's proposals for carrying out .the final two of IGUSi's five assi9nments::~~~ '° P,f~ .-r:~~j ~~y ~.;;~~'"~)'>•F': . .`:'~fY ry ^: ~ " To recommend the countermeas "To recommend a mechanism for.monitoring and measur~ng future_changes; ~'~'x:'r.: ~. •r, { 3 ! 'a .we^. i i `s' ti'1 + ~f k i'StL:`»6eG±~ ~•.s~!Fn.a;r°_:.w~...- i,ar......-.,ict:•;{5t~~$" .si~T~TS?'t?~=.~,~r,5 ....:;..,,r.. ~. .>,n..N .n~N.:.•~•-..+-Rir,r,,~a.t ...~. . ,...-.,r~, ~;:, :..,w....,, .,..... .. .., .- ..,,;..,.-.~~ .;•,.-:a~,.._...:...+ The Working Party is prepared to start on its second{round of research and reporting, d i w ewe . has rev ICOSI ill get underway after and cover these two additional tasksIt ~ ` this present report and has given their green llght to proceed.°`a ~~AQW ~.. ? fi ~' Mp.i~~~r,i -~i..ro ~i:4'~~' ~'e~. • r'vy . ~""r3 " ~ ' . i ,~ ~ ,. , . . - .,. . . ~ c ~ ~~~3.f~-,J; n compiling this first-report; the Working Party faced problems in compressing large volumes of study data into a workable volume.' There were also needs to draw general conclusions from many specifics.'. Our report format is designed to surmoun " "' ' k&.&*;,U-a tAulWs< :w~* ' f ~ ' d h orwar way :, t the problems and meet the needs in a straig .F;~~ nf all_~rn,t eur eiaht rt~st imaortant aeneral conclusions sii Tt:Mx ,r~ . r.~ i~y - • - . ~ ~ immediately following this "Guide ' ~;}( id P t " - r 4~r ,~1 rM 4~ , ~~ ~~~~~~-/ ns II Additional conclusions about country-by country findings are found in Sectio .IV; and Vs'~ These can be read independently, but they take on more meaning if they ;'~ ~are_read in the light of the perspectives set forth in Section II.F.x;6ackup materials from Working Party members are listed in Appendix A. A much larger collection of .ti .-. '`"' * materi al s produced by the Working Party has been suppl i ed to each member. • ' ` eitt.'~! ilul:q 2Yts k•+; .1 t ' ~'.~ sn ~~~i~ r .f x-°rt+. ......,.. InSection VI, wey set out "observations" of the Working Party on.issues of sociaT` acceptability "-We believe these."observations" are both valid and valuable insights nto the issue: `~ However, at this stage of the work, the Working Party could not .~ t l t d " " " conc usions se ou findings an as readily as the support these'"observations .~ .. . . . , ~~n earl ier sections."'., '~.'tiA.~` ~~~ ' "~t ~)2~ ' 1 ': F` ~ ~^~-.k'PN ' ` ~•~.1 k ' ~ R ~/~ ~{~~ ~ ~ s~ ~ ; a '. { ,y .} . ~: f ,.. Y I f ~ : ; .. - rS . .~ K lt'~` °. ~~~i~~' AjS ~~ .: .*l'Y.?s~ ~~:~'IYP'~~~~ :..,;Section VII °concludes the main body of~th3e*Vreport. It'sets forth the Working Party's ~- ~~proposal sfor _carryi ng out the final two items assigned to the group by :; 1) To assess the current level of the social acceptability. 7~'2 ~~ ' ~ ~:~~a~a

1v~' d 1 `~:.The8asic `Smokinand Health Issue Smoking Affects Smokers) is a root- .cause of Social Acceptability Issues .,: Smokin Affects Others in Society). However, the two issues can and must be divided for purposes of effective industry response. Clearly, if realw rogress is made toward resolving f questions•concerning smoking and health, much of.the pressure agains smoki ng i n asoci social sense wi l l be - ~eased. ^~:The Working Party emphasizes therefpre;"that it,is essential to spare no effort in continually pur='" suing conclusive answers to smoking` ; and health questions..' ,, •'S. .",C~ -._ However,:the Working Party's terms of reference aresuch..that, having made g,'" X this point,''it concentrated its efforts on tackling issues of..th ;..e ~ 7~~.social acceptability of smoking. O~ ~~'~ e~ ocial acceptabilityIssues arise on SUMMARY OF GENERAL CONCLUSIONS ~ i k ~~~~' . r~~s:~~.~.i w.~>.h.:... #a .. ..a_, ..,n. '~'~` .l '%d•..ifCP.. '. ' '_ '.~!~ I ~ This section presents the ~Jorking(Party s\Sconclusions of highest priority Here at the outset of the report they are highlighted and placed before ICOSI . .. . a < •4e'N'^ ;;xvyl•3 k•f 3' {.l`... f ,~r P '},~ eSYn ~,~, ,: -{ . • ';,..- Until society believes that smoking does not harm the health y of nearby nonsmokers ;'`the i ndustry .~ `will continue to run grave ris ks~ "of further reverses'`on socialj ~~ acceptability issues For example; rthe industry.'s critical "freedom ' of choi ce";, posi ti on cannot be maintained if people`believe tfiey: are harmed simply by being near.a: Psmoker. ~Y e.! '1'-~-'~i S3 ° ' ~' • .The courtesy level--smoking allege to be socially unacceptable because it is annoying to others who happen ._~ ,,to be in the presence of smokers ;Approaches.to.the , courtesy F- ~ l evel can be compati bl e and V, ~parallel with those'addressing ~~'the passive smoker level.~ -Vol, . The social cost level--smoking is asserted to be socially unacceptable because it allegedly raises society's insurance and ; heal th care cost. " Smokers ~~ .,~~~ .. _.: are asserted to be sick more often, require more medical treatment,''._ :and die earlier. '`:;They alle~edly_ .:require others in society to pay '.higher taxes and insurance pre-~ ,miums to "subsidize" the social costs/expenses supposedly generated by smokers. `Social acceptability issues concern the smoker as well as the non-smoker.'- OFponents of smoking try to create an intimidating atmosphere which, if successful, can lead to smokers' feeling socially uncomfortable about their behavior, even among famiiy and friends. R F ~~:~~ S L•A4 X'~ J:~ ~+'~ ~.4. In dealing with issues of social . acceptability, there is spread throu4hout the world a body of 'unorganized facts and data that be co a e wi gaps and needs to 4xthree bas i c l evel s~~;r._~AV The passive smoker level--smoking is asserted to be socially unaccept- able because it allegedly is damaging to the health of others who happen to be in the presence of smokers., When considering actions on social acceptability issues the Working Party feels the greatest immediate needs for industry action are at this passive smoker level. Available research indicates that smoking does not harm the health of others who are nearby. This must be sustained and firmly established as "fact" in all public discussion of the issue. .The "courtesy" and "social cost" -:levels of the social acceptability rissue are also important, and deserv- r;ing of careful -industry attention ~~ . Still, the highest priority is P~ .= assigned to the passive smokerlevel. , )~. ~'.r'~A'~7~~r ,. ~ ° ~t.`• fy,y'- + ~~5 ~~'w ~,~ $, ,.i~.~~.~~%.1 : n,i ~, ~ P .~.,<•" ,,~y+~. N~

, i: ~ iiSr F 'Y': - x'y'.: ~`'~".t"~• ~~,~' ,( FY H' ~ a } '. i -' 1 r Y "" . •:..'t7•cPxi I f~^~-~ `~f •r ;~5~ ~•~41..itf~'I.r_" ~ ~ .. i ` k h'f~ n• _+ 't "~"+'~ *~~.°. • -3. i Y~ _ !"~. ~j ; ~; i ri s ~ k , • ,q..-e, ~,g,,....- ~ .l ~ ~ : : » ~ <.•;,+.~.......i._. - ~ i-t~:i• t~s. ,:ina f ~SF. ~6 The Working Party found distinct correlation b etween : the extent of government actions s:agai nst smoking and the i ntens i f ` l i ~ o e ti st/consumeri st/ci vi c; ii act v st pressures to castigate _ smoking as socially unacceptable ~..'+~fK_ ,.~•h.~4 I. ~ behavior. Judicial decisions and bureaucratic rul i ngs tend to r`.;V ,,,,.... further dramatize and di gni fy smoki ng efforts in the eyes of the ,~~,~; publ i c. +'' ~•* a ~ ., ~ii"~c" '' '~'~ ~:.. ~a ,~ , , ..~ Data on countermeasures indicates'"~~, =°that only in a few countries has -the cigarette industry commenced ~ r any organized and systematic a-~~ ..,,. efforts to~improve the climate of ~~ ,. social acceptabi l i ty ;4 , fiN~ ~-~~~ ~ . jxf($k'c. ' } ~ ~•R~--•4 •l y;:-~ lq~ ; 'f:`~ti ~~ l~~ k•e ~ ~: ~ ~ ~'' ' ', .. { y l ,' .. Y .: .. . t ++~ r ` , Anti-smoking efforts are internationaT=:: ized, with common strategies and tactics implemented through the.}j~_'"r worldwide networks of unified ~A*" , organizations such as the World ,sY :< ~ Health Organization, Cancer Societies, _; professional medical and heal th 4 associations, and religious ,?K_ ts organizations) :.In the face of. ~~ ' this, the industry s inability .:-.organize a cohesive strategy limits :~. z., the effectiveness of its counter- measures. 6 , , , " y } t e: ' !`' . C~` 2 . . `~'"~~ ~'.:1` h"4c~F.~"d- ,vs~i, ~ K."h~'. ~4'`~^t .~F.s'L • ' te~s~+"i-'~.z".'',~:%' ~ ~'..~. ± .. ; F .?~ ?'+:7t • ti;k1r. ~'. l r••:s r:d' yi ... ~-. .:: :. '"~~•3•=

Xne- ^1-*.v.r~~r s•- ~p;, ~c i4.. .~ '~`. { . . SECTION I ` ~.' . _ . . .INTRODUCT.ION TO COUNTRY-BY-COUNTRY ANALYSES ~''K ~Y'w4 .. ' ~ 't«~ r n- -~5.~' c . ~a 7~`~' efr s .c +C.. ~~&.n ~- ~'~t-"'.~?: a j ~. . 5 ~. , ',~ A ~....~'•'" 4-....IS'... ~{w.~., ~ ~, i~ S~ . ~"qr ~ G-Ej~,3.-i'.. __ ...~.....'~ , f ... _w', S . . ~~.< ~ ~~AM ~ y; . . . ._.. . . ... .. - - . _ . . .. The Working Party's assignment from ICOSI calls for analyses of social acceptabilit ; factors on a country-by-country basis. In selecting the countries to be used for = their study, the Working Party considered the following factors ~~ ~ ~ f ', r ~ a t ' ~'•~ ~ _ -.. . 1.,- Government Monopolies--countries 5 Data Availability--in selecting ;where the sale of cigarettes is countries and assigning them to in the hands of a government mono-. individual members, the Working poly were excluded from the study Party took into account the likelyl At ltt itayavailability of data and the member sampe. aaer sage m, ~ss to it through his company'-`+ become necessary to include some acce A. of them because of their i nfl uence channel sq on neighboring countries and theiril itit 6 Sity of Competitive Data the impact on internatonansu.ecur tions (WHO, Council of Europe, etc Working Party's selection of Mtic ~ C ~ . - 4 u countries excluded any nation where, ;.L r _.. : " .... ::'. , , .. "`^ r ..t.-•f ~ , .ir j~. . -x Markets Where Total Bans on•Adver- development of the data needed for this study wouTd lead to b~~F*~ , <- tising Already Exist--no attention, at this stage,was devoted by thedisclosure of confidential or . J;_ Working Party to markets where proprietary information about any ~~. ~ governments have already taken the individual company. ultimate measures to stigmatize res -~~¢~• the count i smoking as socially unacceptable behavior Applying these factors, selected and assigned to individual task force members were as follows d and polarize public attitudes against smoking (e.g:, Norway, .. Finland, Italy, Singapore, Icelan , etc )': It is fel t, however, that .. when relevant information becomes available, consideration should be given to "reopeni ng"„ the social ; acceptabi 1 i ty i ssues -i n some of. these countries. Size/Makeuof Markets--countries with oth smal - and large-size 2%:volume cigarette markets were in- s~'~ ~=T7 cluded, as were countries with T+ - f ~ differing social customs and political systems. fw -~ . . ~"~~-:{ ?rZy~t~r e'Y^`}v: ,::.:•... Intensity of the Social Acceptability :.:-.Issue--The Working Party concentrated its sample in Western Europe and North America where the issue of social acceptability is apparently most intense. It is assumed that develop- lu. ments in these regions set the basic patterns and trends for later publ i c ~,~{fy< and private approaches to social acceptability issues in -other regions *Subsequent to the assignment,it proved M`= to be impossible to get up-to-date,; accurate information from Argentina. . y:...-

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P Where negative attitudes of the government and public are aqains Laws, restraints, and pressures against ~, cigarette smoking, the greater__i the marketing and smoking of cigarettes the taxation of cigarettes.;,For are not severe. example, in the United States during the period 1964-1976, when the'"~~ negative attitudes toward smoking developed broadly among the masses;~ the average weighted state cigarette tax more than doubled, from 5.6t -:~ ~ to 12.4~ per package.

y,~ .3s _ - .. . ";~:• ,.~Siar . _. . . . . . . + , . 0' ~~. fn~.. ~~~~~~ ~~-~T;, •-~~,~a~~.-, ,..-~ ;, ''' acceptability re~ Influencing factors on the levels of social flect country-by- country differences of social circumstances, institutions, public policies $ , and cultural outlooks.'~'Thus,-in terms of detail, the factors influencing 'each country's level form a unique pattern. .Yet,"-the Working Party finds ~ ~that there are-23 general factors that deserve consideration on a worldwide basis as primary influences on the social acceptability levelsin every A~ h , .'•~'~.~a~'~~~~~ ..`F . K,'".~__ .C! h rr,- ~~~ s~~~~^~~ 'l"' ~•• sie~eS1~'LL ~ ~ ] ~ '~~k~~~E~'7 ~ . ~ ~ fi ~. i-. SECTION IV t i` A~n >~ x k ,j< .,..:,.5::. .. r•'~ ."'.~ • ~. _ ~-_.`• ~'..~..~ x. . ~~- y . .,-.^ V ;, . SUMMARY FINDINGS AND CONCLUSIONS ON "INFLUENCING FACTORS" ~ ^ { ~ 3 SA a"-.5r.`,n~_ ~~~P `,'~ Y~k" .... Y ~ 4S •~• 5~: <vt, c~ *"~ ~ 7~ ... ^Y'_'i..i.i ''.r+.\ ~wb ~~` ~ ~ y ~•.:~~~ k~- These possible ~nfluences are 1~sted on the following table :~~.~ ~ r-. +try;~;:.. ~~"~'h4!"."~~a~~i~~.,t'~~ra.~:~~2~~~~~'~a.~dS~~i`. ~~,~ •~}cNs~•`.,~: '~''~';p^.' l.. . Each of ,the general factors was considered for each sample country• The ten most'important factors were selected for thosecountries where the social ~~'_ acceptab;ltyissue has been exploited most. In three countries where the controversy has not yetrdeveloped into a"public issue,"it was not possible -~ fl ifi t i b i i uences. n gn can ng s e to identify as many as ten factors as , ._. ~.._.. MIM. The results of t matrix' table.-- ~r. •a ' t yF y ~x='~: P~. t ~ Es.~ k ",T z ~r r r . •-" 1 " ^ : ~ ~ ~ Sa2 y ~ e country-by country rankings are also shown on the following , V4W W' .~AVk 1'3'~~~~'~ h ( • . X Y ~ ~9d~~.7.~ii ~.:,~..., ~'~ X• 4t-- a~'` TI~,.x ~ s.4;yi/.~•4~ •q~~ ,~~~~'_'~~~'Pa .3y a To prepare this table, the members of each Working Party who is_most familiar;;- with each sample country scored the relative importance of.the ten top factors..,-~ W. influencing factor judged to be most important is given a score of 1110°, with other scores scal i ng down to 11111 in decreasing order of importance ~.~ hA n~t' ..o,..,,~;:~rE d`s x a,•. • t h!t.r ,:`i.~ ~" y ~. Z,..i"~•c rr :3•.v, X's`' ~. r y~, + o t"r i Us f c~ti''~ `-~~'i ~lr .-: ?.sqn e,c~`~~n~~''~'~t'xa"~~~~X-""`~x ~.-t-4 "`~ 1'.`Y- ,a• ..-._ r. .=_ t . Y+YSCr~', ~. •d. x.Y~~~w i •f';{ 'K._ `~',<.~ ~yna=.f.'~'~" :'~ '~c~'.it Before summarizing the_findings and conclusions of this analysis, it is important A to stress that this is an exercise in judgment. '::It deals with "infiuences," ~~ not with precise "causes".and "effects." ..This type of analysis does not show - 'how the various influences operate together within each country.=Also, there .is difficulty in analytically separating basic health issues (smoking affects smokers) from social acceptability issues (smoking affects society) x,*9- ?tx~ ~ Q,;y ~ r~~ ~ ~ ~4 '~''r 't"~' . r ..' .r nar ,,~:~•'+y, ~~.~%-•1`'. )` ~' #h{, 7,ti'.;:•l.t ,v~:.+.'!, ? : ,..`i, .~ . On balance, however' , the Working Party believes that this analysis presents a . ~ ~_fair estimate of the relative importance of social acceptability influencing .factors. More importantly, it shows how certain types of influences cluster ,~on a worldwide basis. Based on this matrix analysis and subsequent group ~ discussion, the Working Party reached the following findings and conclusions .~..; . . ~ -+.~. { ,~,~~ ~:_+ ,,y~, y y1 j. ~.yi'•~t.y'N t~~~ J~ 1-Y~F ~ ~ f~,y' +.~ j ., ~f~ 1~ Y~ry~;y '~yJti`~~.:t~v -•.S`~1'g~~TF_ ,...j~"'°R -,~-Y f . ~'t~. _ ~. ..$ .t,`: ._ =.' S R'Y":. 1f'C"•wi.v Ta f.7, .~.? y~ ~{~ :~. ' Basic health issues are main root based Were it not for basic . . smoking and health issues, the By far, the most important basic :influence on social acceptability Working Party concludes that there j-<,issues are related to the well- would be no serious social acce ta- bility issues•':•(The Appendix p~ ~~ publicized alleged statistical associ 71 ~4.;ation between smoking and alleged ~'contains a short essay that attempts ~ damage to the health of the smoker. I to link these two issues in the = ~ .•Z . r ,-., . % ~~ r United States.) F ~ , • Tt ~"" . S-+1-+•~~,. ~"'n-0`rt1~ T ~. . •.'. . ' Y 2 Social acce tabilit ti i ~ ed to basr ~ ; ~~~ ealth issues in public attitudes. ~~ t r 3. --Ur e continued basic health researchl- us, t e Working Party finds that ^s•' ~< hus, there is a clear conc usTon t at basic smoking and health issues the industry must continue sponsoring; 3"::form the major cornerstone on which research efforts desiqned to resolve social acceptability issues are basic health issues. - _ ~ ~• !+ ~ ~~~~..~(• i~ti:p'~i' -.~°~j`r}~`~`,.<' Jry #:~ !~It caa A-11- ,:~