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Exploring the impact of foreign direct investment on tobacco consumption in the former
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     ABSTRACT

    Background: Tobacco is the single largest cause of morbidity and mortality in the

    developed world; in the former socialist bloc tobacco kills twice as many men as in the

    west. Although evidence shows that liberalisation of the cigarette trade through the

    elimination of import barriers leads to significant increases in consumption, far less is

    known about the impact of foreign direct investment on cigarette consumption. This paper

    seeks to explore the impact that the substantial transnational tobacco company investments

    have had on patterns of tobacco trade and consumption in the former Soviet Union.

    Design: Routine data were used to explore trends in cigarette trade and consumption in

    the 15 countries of the former Soviet Union from the 1960s to the present day. Comparisons

    were made between trends in countries that have received substantial investment from the

    tobacco transnationals and countries that have not.

    Results: Between 1991 and 2000 cigarette production increased by 96% in countries

    receiving industry investment and by 11% in countries that did not. Over the same period

    cigarette consumption increased by 40%; the increase was concentrated in countries

    receiving investments. Despite these investments, cigarette imports still outweigh exports

    and no trade surplus has yet to result.

    Conclusions: The findings suggest that liberalisation of inward investment has a

    significant and positive impact on cigarette consumption and that without appropriate

    safeguards, market liberalisation may have long term negative impacts on health. Specific

    trade rules are needed to govern trade and investment in this uniquely harmful product.

    Implementation of effective tobacco control policies should precede tobacco industry

    privatisation. International financial organisations pressing for privatisation should

    ensure this occurs.

    Abbreviations: FAO, United Nations Food and Agriculture Organization; FDI, foreign

    direct investment; FSU, former Soviet Union; GATT, General Agreement on Tariffs and Trade;

    IMF, International Monetary Fund; TTCs, transnational tobacco companies; USDA FAS, US

    Department of Agriculture, Foreign Agricultural Service

    Keywords: former Soviet Union; tobacco consumption; trade liberalisation

    The unprecedented political, economic, and social changes that followed the collapse of

    the former Soviet Union (FSU) in 1991 and the creation of 15 independent states have had a

    huge short term impact on health.1 The immediate decline in life expectancy has been

    largely attributed to the rapid increase in cardiovascular deaths and injuries

    predominantly affecting young and middle aged men.2–4 There has, however, been much less

    attention paid to the longer term impact of these changes.

    Market reforms, in particular the rapid and large scale privatisation recommended by

    the global financial institutions, have had mixed but, to date, largely negative

    consequences in the FSU.5,6 Market liberalisation has improved access to a variety of

    products. Some—for example fruit, vegetables, and vegetable oils—should improve health,7

    but others, including fast food and tobacco, will be detrimental. The transnational tobacco

    companies (TTCs) entry to and substantial investments8 in a region with already high rates

    of tobacco related disease, and male tobacco related mortality rate twice that seen in the

    west,9 is therefore of particular concern.

    Previous studies show that the TTCs forced entry to the Asian markets in Taiwan, Korea,

    Thailand, and Japan under the threat of US trade sanctions10 led to an increase in per

    capita consumption of about 10%.11 Other econometric studies show that greater trade

    openness (measured using total trade as a share of gross domestic product and import

    penetration) has a significant and positive impact on tobacco consumption that is greatest

    in low income countries.12,13 Such findings are consistent with economic theory which

    suggests that reducing trade barriers increases tobacco consumption through an increase in

    both supply and demand, the latter driven by and through competition, which reduces prices

    and increases advertising expenditure.13 The TTCs entry to new markets and the surge in

    global trade of tobacco products since the 1980s has been enabled by trade liberalisation,

    driven by bilateral, regional, and multilateral agreements that have reduced both tariff

    and non-tariff barriers.12 Pursuant to the 1994 General Agreement on Tariffs and Trade

    (GATT), for example, a 42% rise in global cigarette exports was seen between 1993 and

    1996.12

    However, in addition to exporting to a foreign market, companies can access new markets

    by establishing or acquiring the facilities to produce in-country and sell directly to the

    domestic market. Over the last decade such foreign direct investment (FDI) has grown

    considerably faster than trade, leading some to argue that "globalisation of production"

    now outweighs "globalisation through trade" in economic importance.14 It offers TTCs the

    advantage of accessing cheaper labour, avoiding developed world regulations on disposal of

    cigarette production waste,15 and lower transport costs. Yet to our knowledge only one

    attempt has been made to explore the impact of FDI on tobacco consumption.13 It suggested

    that an increase in exchange rate distortions (used to indicate a disincentive to

    investment) led to a decline in cigarette consumption, leading to the tentative conclusion

    that FDI should lead to higher levels of cigarette consumption. Certainly the theoretical

    impact of FDI, in terms of its consequences for supply and demand, is likely to be similar

    to that of trade liberalisation. In addition FDI gives the transnationals additional

    economic and political leverage within the country concerned.16

    Between 1992 and 2000 the TTCs invested over $2.7 billion in the tobacco industries of

    10 of the 15 FSU states, accounting for between 1% and over 31% of the total FDI in these

    countries.8 This led to major changes including the introduction of branding and

    advertising which were previously unknown.8,17 Unlike the industry’s entry to Asia, there

    was little opposition to the TTC’s entry. The newly created countries were in the process

    of developing their own constitutions with new legislative and taxation systems, so none

    had in place, nor was able to rapidly enact, tobacco control laws. Nor did they have

    established tobacco control or civil society groups to oppose industry pressure.8,17 As

    elsewhere, the TTCs used smuggling as a major market entry technique17 and in countries

    where they have not yet invested, smuggling rates remain high.8,18

    Despite the scale of these changes, little is known about their impacts. This paper

    therefore seeks to explore the impact that foreign direct investment has had on patterns of

    cigarette trade and, in turn, on cigarette consumption in the FSU. In so doing it aims to

    add to the growing body of evidence on the impact that trade liberalisation and transition

    from a socialist to a market economy has on health. Given evidence that the International

    Monetary Fund (IMF) is pressuring countries to privatise their tobacco industries and

    making privatisation a prerequisite for loans,19,20 it is becoming increasingly important

    to understand what impact privatisation might have. The economic turmoil accompanying

    transition, periods of rapid inflation, and the introduction of new currencies and

    redenomination of old ones, makes interpretation of financial data, including cigarette

    prices, across these 15 countries extremely difficult, so this paper takes a descriptive

    rather than an econometric approach.

    METHODS

    Three main data sources were used, the United Nations Food and Agriculture Organization

    (FAO) database which provides data from 1961 onwards,21 the United Nations Commodity

    Statistics Yearbooks which provide cigarette production data from 1963, and the US

    Department of Agriculture, Foreign Agricultural Service (USDA FAS) data which are available

    from 1960.22 The accuracy and completeness of the data were compared with each other and

    with other sources in order to identify the most appropriate source for each measure of

    interest (table 1).

    All data are presented for the region as a whole, the USSR until transition, and the

    FSU as a whole post-transition. The demise of the FSU does not present problems when

    examining production or consumption data over time, with data simply aggregated where

    necessary. It does, however, lead to potential difficulty when comparing import and export

    data as products traded between different parts of the USSR did not, until the collapse of

    the USSR, contribute to international trade figures. The FAO database allows for this

    transfer by providing trade figures for the old boundaries (that is, for the USSR) up until

    1995 and for the new boundaries from 1992 to 1999, giving a four year period of overlap. By

    contrast USDA simply provides data for the old boundaries up to 1991 and for the new

    boundaries from 1992 (Arnella Trent, USDA, personal communication). For trade figures we

    therefore present both sets of data up to 1995 to examine the impact that these

    configuration changes had.

    Where not already provided, cigarette consumption was calculated from USDA data using

    the formula: production + imports – exports. Consumption per capita was calculated for the

    population as a whole using mid year population estimates from the United Nations

    Demographic Yearbooks for the years to 199023–25 and the World Health Organization Health

    for All database (which uses data from the United Nations Population Division) for the

    years 1990 onwards.26 Whole population data were used rather than the population aged 15

    and over as accurate data on the latter were not available across the whole time period.

    For the period 1991 onwards we examined consumption per capita using the population aged 15

    years plus.

    The newly independent states can be split into two groups, those without direct

    industry investments (Belarus, Georgia, Moldova, Tajikistan, and Turkmenistan) and those

    with substantial investment from the tobacco transnationals in the early to mid 1990s

    (Latvia, Lithuania, Estonia, Russia, Ukraine, Kazakhstan, and Uzbekistan).8 Trends in

    tobacco leaf imports, and cigarette production and consumption, were compared in these two

    groups of countries. Kyrgyzstan, Armenia, and Azerbaijan were excluded from these analyses

    because although they have now received investments from the tobacco industry this only

    occurred after 1997, considerably later than the other countries, and it was felt that

    insufficient time had elapsed for these investments to have had an observable impact.

    RESULTS

    Tobacco leaf production

    Agricultural production of tobacco has varied greatly over time, with a drop in the late

    1970s and early 1980s, a peak in the mid 1980s, followed by a notable decline until the mid

    1990s (fig 1). This recent decline is consistent with reported shortfalls in tobacco during

    this period. It appears to reflect a number of factors27 including policies to discourage

    production as part of Gorbachev’s health campaign in the 1980s, droughts and wars, and the

    demise of Soviet subsidies for agricultural production.28 Gorbachev’s health campaign

    focused largely (and effectively) on reducing alcohol consumption,29 but some believe it

    also aimed to reduce cigarette consumption through reducing supply of leaf and manufactured

    cigarettes. Others, however, have suggested that the campaign really only served to hide

    the underlying economic difficulties that were driving down production.

    In the mid 1990s production stabilised and now appears to be increasing. The

    traditional tobacco producing areas of Moldova, Azerbaijan, and Kyrgyzstan30 are all

    recovering from slumps in production post-transition, although little increase in

    production has yet been seen in Azerbaijan.31 Interestingly, production has also increased

    in countries that have not traditionally been major tobacco producers, notably Uzbekistan

    and Kazakhstan, reflecting foreign investment by British American Tobacco (BAT) and Philip

    Morris respectively in their leaf growing industries32–34 (fig 2).

    Cigarette production

    Cigarette production fluctuated from 1960 with a slow, overall upward trend that peaked

    in 1986 (fig 3). The rapid decline then seen has been attributed variously to obsolete

    manufacturing equipment, shortages of raw materials (tobacco leaf, paper, and filters) and,

    once again, Gorbachev’s health campaign. Since the mid 1990s cigarette production has

    increased almost exponentially and has now reached higher levels than ever previously seen,

    with a 76% increase between 1991 and 2000. Production in countries receiving foreign

    investment increased by 96% during this period, compared with only 11% in countries not

    receiving investment (fig 3).

    Imports and exports

    Imports of cigarettes fluctuated, albeit with an overall upward trend between 1960 and

    1984 (fig 4). A rapid decline then occurred through the rest of the 1980s. In 1990 and 1991

    imports suddenly rose due to the airlift into the USSR of a reported 34 billion

    manufactured cigarettes by Philip Morris and RJ Reynolds.35 USDA data suggest that imports

    then increased steadily between 1993 and 1995, declining rapidly thereafter. Importantly,

    this temporary increase was seen only in those countries where the transnationals had

    invested. These patterns are consistent with the production data described above,

    suggesting that imports increased until local production picked up from 1995 onwards.

    Before transition tobacco leaf imports fluctuated over time (fig 5). It appears that

    shortfalls in local leaf production (fig 1) were covered by increasing imports. Since 1990,

    leaf imports have increased steadily, with the increase seen almost exclusively in

    countries with transnational tobacco investments.

    Tobacco leaf and cigarette exports from the USSR varied between 1961 and 1990 with no

    clear trend but were always small, at under 5000 metric tonnes and 5 billion units (one

    unit = 1 cigarette), respectively. A sudden increase in cigarette exports occurred in the

    mid 1990s (fig 6), a trend that appears to have continued. In contrast leaf exports have

    not increased overall since transition (data not shown).

    Cigarette consumption

    Per capita cigarette consumption increased between 1960 and the mid 1970s but then

    stabilised for a decade until the shortfalls in production and imports led to a rapid

    decline until the mid-1990s (fig 7). Since then consumption has increased almost

    exponentially and now totals almost 575 billion cigarettes per year, considerably higher

    than the previous peak. Over the period 1991 to 2000 per capita consumption among those

    aged 15+ increased by 40% in all countries combined, 51% in countries that had received

    tobacco industry investments compared with a 3% fall in countries that had not, with

    similar figures seen for the period 1991 to 2001 (table 2).

    These data suggest that the transition to a market economy with its accompanying

    liberalisation of trade and investment, which permitted entry of the tobacco

    transnationals, has had a major impact on tobacco trade and consumption in the FSU.

    Cigarette consumption has increased almost exponentially in line with the rapid increase in

    cigarette production. Moreover, these large increases in consumption have been concentrated

    in countries receiving tobacco industry investment. Tobacco leaf production declined,

    largely due to the disruption of transition, but has now started to increase, not only in

    traditional producing areas but also in Uzbekistan and Kazakhstan, following British

    American Tobacco and Philip Morris investments. Cigarette imports increased only

    temporarily and in countries receiving industry investments, seemingly until output from

    the updated local production facilities had reached a sufficient level, while exports have

    seen a continued but smaller rise insufficient to result in a trade surplus.

    Before considering the results in any detail, it is necessary to consider data

    accuracy. There are three main concerns in this area: data collection systems, smuggling,

    and illegal production. With independence, each country had to establish new data

    collection systems and this caused difficulties, particularly in the early 1990s. Thus,

    while the Statistical Committee of the Commonwealth of Independent States publish trade

    statistics, they do not cover all years or all countries, and the definitions of tobacco

    related categories are inconsistent.36 Similarly, the United Nations Statistical Division

    Comtrade database37 does not contain data for some countries in the region such as

    Uzbekistan.

    Problems with data appear to have mainly affected the smaller central Asian states

    which contribute less to the regional total. In addition, the gaps are predominantly in

    export data for the early 1990s which, given the small scale of exports relative to

    production or imports, will have relatively little impact on final consumption figures.

    However, in some other countries, at particular times, there are some contradictions

    between data sources that cannot be reconciled. The USDA has attempted to overcome these

    problems by using a variety of sources to generate best estimates in the absence of

    credible data and, while it cannot be considered perfect, we believe it is the most

    comprehensive and consistent source of data available at present.

    Import and export data include only officially traded cigarettes and are therefore

    problematic given that smuggling was and is a major issue in the region.17,18 As much of

    the smuggling, particularly in more recent years, is likely to occur between countries

    within the region, this problem is overcome to some extent by considering the FSU as a

    whole. Based on the fact that cigarette exports far outweigh imports, it is estimated that

    approximately one third of global cigarette exports are smuggled.38 Our data show the

    opposite occurring in this region. Nevertheless, the most likely impact of smuggling on the

    data presented in this paper is to underestimate imports to and hence consumption in

    countries without substantial TTC investments, while also perhaps underestimating exports

    from countries that have received investments. This will exaggerate the different scale of

    increases in consumption between countries with and without tobacco industry investments

    and may account for part of these differences. Overall, the three issues are likely to

    underestimate consumption in the immediate post-transition period when data problems,

    illegal production, and smuggling (used as an industry market entry strategy) were

    greatest.39

    While not wishing to overlook these serious concerns, the data presented here are the

    most comprehensive available and, despite their weaknesses, allow a preliminary assessment

    of an important issue. Although data sources often overlap, wherever possible, data from at

    least two sources were obtained and compared. FAO data were used for tobacco leaf

    production as they were more consistent with industry data on production levels in the

    post-transition period,28,40 and because the trade data have the advantage of being

    presented in metric tons across the whole time period. UN and USDA data on imports,

    exports, and production differed somewhat more in the post-transition period, particularly

    in the early 1990s, although overall trends were similar. USDA data were more complete and

    believed to be more accurate for consumption (and for the underlying import, export, and

    production data). They were, for example, more consistent with the publication World

    Tobacco Trends41 and with ERC data42 and had the additional advantage of being more up to

    date. Other sources, including the World Tobacco File,43 did not have data for all

    countries in the region and could not therefore be used.

    Attempts to validate our findings also suggest they are reasonably robust. For most

    countries, our estimates of cigarette consumption per capita were very similar to those

    provided by ERC which also found that between 1990 and 2000 consumption increased by 57.3%

    in Russia.42 In addition, survey data suggests that smoking prevalence has been rising

    particularly among young women.44–46 Production figures were consistent with our previous

    assessment of production capacity.8 We estimated that in 10 countries receiving investments

    before 2001, production capacity in factories with transnational investments totalled 416

    billion cigarettes. Such factories are thought to account for between 80–90% of

    production39,47 consistent with the data presented here that in 2000, production in these

    countries totalled 459 billion, the extra 43 billion presumably accounted for by factories

    without TTC investments.

    This current level of consumption (2529 cigarettes per capita in 2001) is high by

    international standards although similar to levels seen in much of central and eastern

    Europe.26 The increase in consumption has been far greater in countries that have received

    major tobacco industry investments (56%) than in countries that have not (–1%). While some

    of the overall increase is caused by the artificially low consumption levels seen around

    independence, and some of the differential increase in countries receiving investments is

    due to undocumented smuggling from these countries in the latter half of the decade (or

    smuggling to these countries in the first half), it is clear that consumption has now

    increased well above its previous peak in the mid 1980s. The increase in consumption is

    particularly notable for two reasons. Firstly, the tobacco epidemic in the FSU, at least

    among men, has been established for some time. Although historical data on smoking habits

    are scarce, contemporary studies asking about ever smoking, combined with data on lung

    cancer mortality,9,48 suggest that male smoking must have become widespread during the

    first half of the 20th century, probably contemporaneously with the establishment of the

    habit in the USA or UK. In addition, the region’s first cigarette factories and brands

    were established in the 1850s and 1860s.34,49 Although Soviet women did not smoke in large

    numbers until recently, the classic description of the progress of the tobacco epidemic

    would suggest that consumption should now be steady or declining as appeared to be the case

    in the 1970s to 1980s, not increasing to the extent indicated here. Second, after

    independence, most countries experienced sustained economic recessions, with pronounced

    increases in poverty, which would be expected to reduce rather than increase consumption.

    As noted earlier, trade liberalisation can work in several ways to increase

    consumption. Although elucidating the precise mechanisms in this instance is impossible

    because of the absence of detailed data on, for example, price, compounded by the extreme

    financial volatility during this period, it appears that many factors seen elsewhere were

    also in operation here, albeit with some minor differences. An increased supply of

    cigarettes was seen but occurred through increased production rather than imports. Even

    where companies planned to or successfully established monopolies8,50 and then exerted

    pressure on governments to close the market to outside competition through both tariff and

    non-tariff barriers,51,52 competition was more intense than in the Soviet era. Moreover,

    industry documents suggest that, in terms of marketing, such markets would be treated as

    though they were competitive.50 Thus advertising increased virtually everywhere, even where

    the TTCs had manufacturing monopolies. The TTCs were soon identified as the largest

    advertisers on Russian television and radio and in at least four of the former Soviet

    states the tobacco transnationals ranked among the top three advertisers.53,54 With the

    advent of television advertising bans (in Russia, for example) industry spend shifted to

    other media—tobacco is now the product most heavily advertised outdoors with three major

    transnationals ranked as first, second, and third heaviest advertisers.55 An almost

    identical pattern is seen in Ukraine and Belarus.55 Tobacco industry documents indicate

    that young people, women, opinion leaders, and urban residents were specifically targeted

    and the allure of western products was used to attract smokers.17,50,56–58 This targeted

    advertising combined with the increased production of filter brands, and the introduction

    of milder brands and brands targeted specifically to women to a market previously dominated

    by coarse filterless or papirossy cigarettes, must have encouraged new smokers

    (particularly women) to take up the habit as the TTCs predicted.50 Indeed our studies in

    several countries have found smoking among women to be far higher in cities, where

    advertising has been concentrated.45,59,60

    But why then was the increase in consumption in the FSU (approximately 40%) so much

    greater than in Asia (10–20%)? One factor is data artefact, in particular the artificially

    low consumption level at the end of the 1980s. Another is the absence of effective tobacco

    control policies, or even organised tobacco control groups that might have counterbalanced

    industry pressure. However, it is argued here that a major factor was the enormous economic

    and political leverage of the tobacco industry on account of their major contribution to

    FDI in the recipient countries.8 It is also likely that efforts to stimulate demand

    succeeded because of the vulnerability of the population in a time of rapid transition and

    great uncertainty. Our research on factors influencing smoking behaviour in Ukraine

    highlighted the role of deterioration in social position (a proxy for of the stress of

    changes associated with transition), as well as unemployment and poverty as important

    determinants of current smoking.45

    Over the period 1991 to 2000, annual cigarette production increased by over 200

    billion, a 76% increase. Yet, despite the increase in production, exports have only

    increased by a fraction of this amount to a total of just over 20 billion for the region.

    Meanwhile, imports, which rose initially, have declined to approximately 50–60 billion.

    Overall, therefore, despite significant investment in the region’s tobacco industry, the

    overall trade balance in cigarettes remains negative. Moreover the rapid increase in

    tobacco leaf imports by countries receiving tobacco industry investment may further

    increase their trade deficit. The shift in consumer preferences towards new blended

    cigarette varieties, coupled with the increase in consumption, has led to a decline in the

    proportion of tobacco imported from former Soviet republics in favour of imports from, for

    example, India, Greece, Turkey, Italy, Spain, Zimbabwe, and Brazil.61,62

    Ideally, further work would be useful to verify these findings on a country by country

    basis using more detailed econometric analysis to control for changes in incomes, price,

    and advertising over this period. Researchers studying other parts of the world have

    examined this issue by undertaking such analyses and we considered doing so here, but it

    rapidly became clear that many factors (not only affecting data on tobacco) that arose as

    countries struggled to establish data systems, tackle the informal economy, introduce new

    currencies, deal with hyperinflation, build state structures and, in some cases, define

    national frontiers following the outbreak of hostilities, made it impossible to obtain

    sufficient valid and meaningful data in which one could be confident. Nevertheless, we

    conclude tentatively that similar to trade liberalisation, liberalisation of inward

    investment leads to an increase in cigarette consumption. Although liberalisation has led

    to the investment of much needed capital, no other benefits have accrued from tobacco

    industry investments. Trade deficits initially increased and, although now stabilised, have

    yet to decline and leaf deficits are likely to increase. Profits from tobacco sales will

    accrue to investors outside the region, while the considerable costs of long term health

    consequences will be borne by host countries with already high premature mortality rates.

    What this paper adds

    This paper shows that liberalisation of inward investment has had a significant and

    positive impact on cigarette consumption in the countries of the former Soviet Union. It

    highlights the need for appropriate safeguards to govern trade and investment in this

    uniquely harmful product.

    The World Bank plays a major role in global tobacco control and since 1991 has not

    loaned for or invested in the tobacco industry.63 Despite the growing body of evidence on

    the impact of trade liberalisation on tobacco consumption, the World Bank suggests trade

    restrictions would be potentially counterproductive, and recommends restricting supply side

    measures to the control of smuggling.63 Others, however, argue that international treaties

    that have liberalised trade should develop specific rules to govern tobacco as they have

    done other uniquely harmful products such as weapons and hazardous waste—products that

    kill far fewer people.9,64 In the meanwhile, a basic first step would be to protect markets

    before their opening through ensuring the presence of comprehensive tobacco control

    programmes with comprehensive advertising bans and effective taxation policies as absolute

    prerequisites (although the Thai experience suggests that this may be insufficient). The

    IMF which may exert pressure for industry privatisation (as it did, for example, in

    Moldova19,20) and the World Bank have a particular responsibility in this regard. Unlike

    the World Bank, which recognises the economic consequences of tobacco use and poor health,

    this may require a major volte-face by the IMF. In addition, the case can be made for

    requiring health impact assessments of the short and long term health and economic impacts

    of tobacco industry privatisation where further privatisations are recommended.

    FOOTNOTES

    Funding: This work was supported in part by the National Cancer Institute, US National

    Institutes of Health, grant number 1 R01 CA91021-01.

    Conflict of interest: AG is board member of ASH-UK (unpaid)

    The opinions are those of the authors alone.

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