Research

Abstract:

Objective: There is a growing need to expand research on the alcohol industry's corporate social responsibility activities in low- and middle-income countries within the commercial health determinants framework. This study aims to examine how the alcohol industry frames its corporate social responsibility in the Philippines post-pandemic and its implications for public health policies.

Methods: Using the READ approach, data was extracted from the research literature, market research, alcohol companies’ annual and corporate social responsibility reports, media coverage, editorials or commentaries, and media statements from policy actors from 2022 to 2023. A reflexive thematic analysis of the data is integrated into a narrative synthesis based on discursive power.

Results: The alcohol industry in the Philippines has framed corporate social responsibility through two lenses: those that form its intrinsic corporate interests and those socially constructed norms it has chosen to co-opt. Based on corporate interests, the alcohol industry frames corporate social responsibility as a public relations tool to manage reputation, risks, and negative impact, as well as an investment strategy. Based on co-opted norms, the alcohol industry frames corporate social responsibility as contribution to development, nation-building and public service. Based on an analysis of the statements about corporate social responsibility in the public discourse, policy actors that support the institutionalization of corporate social responsibility use similar frames. Policy actors who opposed the institutionalization of corporate social responsibility perceive it as an evasive strategy: a discursive tool to deter demands for corporate accountability.

Conclusion: The study reveals that the alcohol industry in the Philippines follows the lead of transnational alcohol corporations in using corporate social responsibility as a marketing tool and a discursive tactic. Policymakers must consider regulating the marketing of alcohol corporate social responsibility initiatives. This will help to mitigate and manage conflicts of interest and safeguard policies from industry influence.

Recommended citation: 

Amul GGH. (2025). Corporate social responsibility as a commercial determinant of health: A case study of the alcohol industry in the Philippines. Social science & medicine (1982), 380, 118169. Advance online publication. https://doi.org/10.1016/j.socscimed.2025.118169   

Abstract:

In line with recommendations of Article 11 of the WHO Framework Convention on Tobacco Control, the Philippines has implemented graphic health warnings (GHWs) on cigarette packs. While the Graphic Health Warnings Law was passed in 2014, it was only implemented in 2016. Using a commercial determinants of health framework, this study aims to contribute evidence on Filipinos’ perceptions of GHWs and the potential plain packaging of tobacco products in the Philippines.

We used a dataset based on open-ended questions in online and nationwide household surveys from 2021. Data collectors showed mock-up sets of cigarette packs based on the Philippines' law on GHWs and Thailand's and Singapore's plain packaging to respondents to gather their comments on each pack's features and its GHW. We conducted a thematic analysis to extract themes in respondents' perceptions.

We gathered 3,723 responses from online and household surveys. Most respondents commented on the Philippine packs' ineffectiveness and lauded GHWs from Singapore and Thailand for their characteristics and the information in the warnings, remarking that valuable features of Singapore and Thailand's plain packs for making current cigarette packaging more effective were larger GHWs, less brand visibility, and quitline availability.

The study supports recent literature assessing local GHWs. Current GHWs are seen as ineffective, highlighting the need for policy reform. Policymakers should consider prohibiting single-stick cigarette sales, adopting plain packaging with larger GHWs to decrease brand visibility, and increasing the visibility and accessibility of quitlines to motivate smokers to quit and discourage Filipinos from smoking.

Recommended citation: 

Amul, G. G. H., Mallari, E. U., Arda, J. R. Y., & Santiago, A. J. A. (2024). Cigarette packaging as a commercial determinant of smoking: A thematic analysis of Filipinos’ perception of graphic health warnings and plain packaging in the Philippines. Social Science & Medicine, 365, 117616. https://doi.org/10.1016/j.socscimed.2024.117616 

Abstract:

Background: Historically, tobacco companies have used flavored tobacco products to enhance the appeal of tobacco consumption, encourage initiation and experimentation of tobacco use, and contribute to sustained tobacco use. While flavored tobacco products are regulated in several countries, there is no existing regulation on flavored tobacco products in the Philippines, specifically for cigarettes and cigars. This study aims to update evidence on the flavored tobacco product landscape in the Philippines by assessing both the flavor descriptors and flavor imagery featured on cigarette and cigar packaging. 

Results: We collected 106 cigarette and cigar products from four major cities in the National Capital Region, Balanced Luzon, Visayas, and Mindanao. Of these 106 cigarette and cigar products, 62 (58.49%) had flavor descriptors. Three crushable capsule products did not feature any flavor descriptor but were included for flavor imagery examination. We identified five categories of flavor descriptors: menthol, concept descriptors, tobacco, beverages, and other flavors. Out of 62 packs, ten featured more than one flavor descriptor on the packaging. Menthol flavor descriptors comprised the majority of flavor descriptors. Imagery and other graphic elements closely resonate with and enhance the flavor descriptors found on these packs. 

Conclusions: This study aimed to update the evidence on the flavored tobacco product landscape in the Philippines and address their absence of regulation. Regulating flavored tobacco products requires a comprehensive policy approach complemented by complete enforcement. Flavor substances, flavor descriptors, and flavor imagery must be regulated altogether; however, it is ideal to enforce a ban on flavored tobacco products in compliance with the WHO FCTC, to which the Philippines is a signatory. Policymakers should consider plain packaging as an intervention to eliminate the appeals associated with flavored tobacco products. 

Recommended citation: 

Ackary, S.J., Cabrera, P.J.D., Santiago, A.J.A., Amul, G.G.H. (2024). An analysis of flavor descriptors on tobacco products in the Philippines: Regulatory implications and lessons for low- and middle-income countries. Global Health 20 (67), https://doi.org/10.1186/s12992-024-01072-6. 

Abstract:

Aims: Transnational alcohol and tobacco corporations are expanding operations in Southeast Asia. This study has two objectives: to examine the power of the tobacco and alcohol industries in shaping tobacco and alcohol policies in the Philippines and Singapore and to identify key lessons and challenges for alcohol and tobacco control.

Methods:  We developed a conceptual framework from the literature on power and political, commercial, and legal determinants of health. We conducted a literature review and content analysis of official government documents, corporate documents, and news articles on the tactics of the alcohol and tobacco industries. To triangulate findings, we also conducted a thematic analysis of 30 interviews that we conducted in the Philippines and Singapore.

Findings:   Transnational and national alcohol and tobacco corporations used various tactics to influence the policy process for alcohol and tobacco control in the Philippines and Singapore. These industries utilised lobbying, litigation or threat of litigation, revolving doors,  and marketing to exercise their instrumental power.  They exercised their structural power by exploiting their market dominance and promoting public-private partnerships and alcohol marketing self-regulation. In the Philippines, the tobacco industry benefitted from regulatory capture.  Both industries tapped framing tactics,  corporate social responsibility,  and public-private partnerships to exert their discursive power.

Conclusions: Our study detailed how the alcohol and tobacco industries have exercised their instrumental,  structural,  and discursive power to influence and interfere in alcohol and tobacco control policies in the Philippines and Singapore. Less regulated, the alcohol industry retains an advantage over the tobacco industry in both countries.

Recommended citation: 

Amul, G. G. H., and Etter, J-F. (2023). Examining the power of the alcohol and tobacco industries in policymaking: Lessons and challenges for the Philippines and Singapore. International Journal of Alcohol and Drug Research, https://doi.org/10.7895/ijadr.417 

Abstract:

Objective: To provide a comparative analysis of current tobacco and alcohol control laws and policies in the Philippines and Singapore

Methods: We used a public health law framework that incorporates a systems approach using a scorecard to assess the progress of the Philippines and Singapore in tobacco and alcohol control according to SDG indicators, the WHO Framework Convention on Tobacco Control and the WHO Global Strategy to Reduce Harmful Use of Alcohol. We collected data from the scientific literature and government documents.

Results: Despite health system differences, both the Philippines (73.5) and Singapore (86.5) scored high for tobacco control, but both countries received weak and moderate scores for alcohol control: the Philippines (34) and Singapore (52.5). Both countries have policy avenues to reinforce restrictions on marketing, improve corporate social responsibility programs, protect policies from the influence of the industry, and reinforce tobacco cessation and preventive measures against alcohol harms.

Conclusion: Using a health system-based scorecard for policy surveillance in alcohol and tobacco control helped set policy benchmarks, showed the gaps and opportunities in these two countries, and identified avenues for strengthening current policies.

Recommended citation: 

Amul, G. G. H., and Etter, J-F. (2022). Comparing Tobacco and Alcohol Policies From a Health Systems Perspective: The Cases of the Philippines and Singapore. International Journal of Public Health, Published online, 13 October 2022. https://doi.org/10.3389/ijph.2022.1605050 

Abstract:

After a public consultation in 2018, Singapore implemented standardized tobacco packaging as part of its portfolio of tobacco control policies in 2020, in compliance with Article 11 guidelines for implementing the World Health Organization Framework Convention on Tobacco Control. This study analyzed policy actors in opposition to standardized packaging in Singapore and their submissions to the public consultation. Policy actors were profiled, and their arguments were then coded and compared across submissions. Descriptive results were then summarized in a narrative synthesis. In total, 79 submissions were considered for final analysis that opposed plain packaging in Singapore. Thematic analysis shows that transnational tobacco companies and their subsidiaries in Singapore, along with a variety of policy actors opposed to the standardized packaging policy, have significant similarities in arguments, often with identical statements. Industry tactics included framing tobacco as a trade and investment issue; utilizing trade barriers, intellectual property, and investment rights; pursuing litigation or threat of litigation; mobilizing third-party support and citing policy failure. This study provides evidence that further contributes to the growing literature on commercial determinants of health, particularly industry tactics and, in this case, where the tobacco industry and its local and global allies utilize to counter evidence-based tobacco control measures.

Recommended citation: 

Amul, G. G. H., (2022). The 2018 public consultation on standardized packaging in Singapore: Analysis of policy actors' submissions. Frontiers in Political Science 4:943120 https://doi.org/10.3389/fpos.2022.943120 

Abstract:

Background: Transnational tobacco companies (TTCs) have a well-established presence in Southeast Asia and are now targeting other low- and middle-income countries (LMICs), especially Africa. While the tobacco industry’s tactics in Southeast Asia are well documented, no study has systematically reviewed these tactics to inform tobacco control policies and movements in Africa, where the tobacco epidemic is spreading.

Methods: We conducted a systematic literature review of articles that describe tobacco industry tactics in Southeast Asia, which includes Singapore, Indonesia, Malaysia, the Philippines, Myanmar, East Timor, Thailand, Cambodia, Vietnam, Laos, and Brunei. After screening 512 articles, we gathered and analysed data from 134 articles which met our final inclusion criteria.

Results: Tobacco transnationals gained dominance in Southeast Asian markets by positioning themselves as good corporate citizens with corporate social responsibility (CSR) initiatives, promoting the industry as a pillar of, and partner for, economic growth. Tobacco transnationals also formed strategic sectoral alliances and reinforced their political ties to delay the implementation of regulations and lobby for weaker tobacco control. Where governments resisted the transnationals’ attempts to enter a market, they used litigation and deceptive tactics including smuggling to pressure governments to open markets, and tarnished the reputation of public health organizations. The tobacco industry undermined tobacco advertising, promotion and sponsorship (TAPS) regulations through a broad range of direct and indirect marketing tactics.

Conclusion: The experience of Southeast Asia with tobacco transnationals show that, beyond highlighting the public health benefits, underscoring the economic benefits of tobacco control might be a more compelling argument for governments in LMICs to prioritise tobacco control. Given the tobacco industry’s widespread use of litigation, LMICs need more legal support and resources to counter industry litigations. LMICs should also prioritize measures to protect health policy from the vested interests of the tobacco industry, and to close regulatory loopholes in tobacco marketing restrictions.

Recommended citation: 

Amul, G. G. H., Tan, G. P. P., & van der Eijk, Y. (2021). A Systematic Review of Tobacco Industry Tactics in Southeast Asia: Lessons for Other Low- And Middle-Income Regions. International journal of health policy and management, 10(6), 324–337. https://doi.org/10.34172/ijhpm.2020.97 

Abstract:

Objective: The expansion of transnational alcohol corporations (TACs) in Southeast Asia has been suggested as a possible contributor to increased alcohol advertising, promotion, and sponsorship (AAPS), which in turn may have contributed to increasing rates of alcohol consumption and alcohol-related problems. The aim of this scoping review is to document the growth of TACs in the region and to critically evaluate the development of alcohol policies to regulate AAPS in 10 Southeast Asian nations.

Method: National policies related to AAPS were reviewed using data from the Global Information System on Alcohol and Health, following the framework of the WHO Global Strategy to reduce the harmful use of alcohol. The policy review was supplemented with data from corporate annual reports, press releases, four databases of academic literature, market research from Euromonitor International, and news articles.

Results: Four TACs—Carlsberg, Diageo, Heineken, and San Miguel—have been expanding operations in Southeast Asia by setting up new breweries, acquiring local alcohol companies as subsidiaries, and entering into joint ventures. In contrast, policies for regulating AAPS vary across Southeast Asia and range from nonexistent to strong control of AAPS. There is strong control of AAPS in countries with existing legislation ranging from a complete ban (Brunei) to almost comprehensive bans (Indonesia, Myanmar, Laos) and partial bans (Thailand). Nonexistent to weak control of AAPS is observed in the Philippines, Singapore, Cambodia, Malaysia, and Vietnam, which mostly rely on voluntary regulation.

Conclusions: The study’s findings point to the growing power of TACs in the region and call for the need for stronger measures based on scientific evidence of effectiveness that are implemented without interference from commercial interests.

Recommended citation: 

Amul, G. G. H. (2020).  Alcohol Advertising, Promotion, and Sponsorship: A Review of Regulatory Policies in the Association of Southeast Asian Nations. Journal of Studies on Alcohol and Drugs, 81(6), 697–709. https://doi.org/10.15288/jsad.2020.81.697  

Abstract:

Using a tobacco control framework that combines demand-reduction and selected supply-reduction measures according to a health system's building blocks, this article aims to assess the state of Framework Convention on Tobacco Control implementation in ASEAN countries from a health systems perspective. Results show that more ASEAN member states are showing leadership in adopting effective policies in the MPOWER suite of interventions, such as raising taxes on tobacco, establishing smoke-free areas and implementing graphic health warnings. However, effective enforcement of these policies is hampered by the lack of policies to protect public health measures from tobacco industry interference. ASEAN faces three challenges to control and reduce tobacco use: tackling the increasing burden of disease from tobacco use, tobacco industry interference and the need for better governance based on stronger political will and commitment. ASEAN member states need to further invest and innovate on tobacco control and promoting healthy lifestyles in order to achieve the SDG target on tobacco control.

Recommended citation: 

Amul, G. G. H and Pang, T. (2018). The State of Tobacco Control in ASEAN: Framing the Implementation of the FCTC from a Health Systems Perspective. Asia & the Pacific Policy Studies, 5(1), 47-64. https://doi.org/10.1002/app5.218  

Abstract:

Singapore has implemented tobacco control policies since the 1970s, more than three decades before it became party to the World Health Organization (WHO) Framework Convention on Tobacco Control—the first evidence-based global health treaty in 2005. The country's stringent policies have resulted in a 13 per cent adult smoking prevalence rate, one of the lowest in the world. This article reviews how a mix of demand- and supply-reduction measures with extensive regulation and stringent enforcement has contributed to Singapore's reputation as the ‘most hostile environment’ for tobacco companies. Its tobacco control policies can offer lessons for more effective tobacco control among its neighbouring countries.

Recommended citation: 

Amul, G. G. H and Pang, T. (2018). Progress in Tobacco Control in Singapore: Lessons and Challenges in the Implementation of the Framework Convention on Tobacco Control. Asia & the Pacific Policy Studies, 5(1), 102-121. https://doi.org/10.1002/app5.222