Fossil fuels are the new tobacco. The health sector must take action

The news out of COP27 – the UN’s annual conference on climate change – was grim. “We are in the fight of our lives. And we are losing,” United Nations Secretary General Antonio Guterres said in his opening remarks.

“Greenhouse gas emissions keep growing. Global temperatures keep rising,” he continued. “And our planet is fast approaching tipping points that will make climate chaos irreversible. We are on a highway to climate hell with our foot still on the accelerator. Humanity has a choice:  cooperate or perish. It is either a Climate Solidarity Pact – or a Collective Suicide Pact.”

The Sixth Assessment Report (AR6) of the Intergovernmental Panel on Climate Change (IPCC), released in September, just ahead of COP27, is clear. In the Working Group II report, paragraph D.5.3, it states: “The cumulative scientific evidence is unequivocal: Climate change is a threat to human well-being and planetary health.”

Of course, this should not be news to the health sector. After all, the World Health Organization (WHO) has maintained since 2008 that “climate change is the single biggest health threat facing humanity.” In its analysis of the evidence on health outlined in AR6, the WHO concludes: “Impacts to health are increasing. Climate risks are appearing faster and will become more severe sooner than previously expected, and it will be harder to adapt with increased global heating.”

But while the fact of climate change and its health impacts is well known by now, it is another aspect of this major health challenge we want to draw attention to, one that should have a particular resonance with the health sector: As we note below, the fossil fuel industry is the new tobacco. And like the tobacco industry – with which it has disturbing links – it both represents a massive threat to health and has indulged in unethical behaviours to suppress and distort evidence.

For this reason, the health sector should treat the fossil-fuel industry as it has treated the tobacco industry – by revealing its health impacts, divesting from the industry, refusing funding and support from the industry, severing all financial and commercial links as soon as possible, and urging others to do the same.

Fossil fuels are the new tobacco

In what The Guardian called a “blistering attack” on the fossil fuel industry in June, Guterres, noted: “For decades, the fossil fuel industry has invested heavily in pseudoscience and public relations – with a false narrative to minimize their responsibility for climate change and undermine ambitious climate policies.”

The Guardian reported that for the first time, Guterres “compared fossil-fuel companies to the tobacco companies that continued to push their addictive products while concealing or attacking health advice that showed clear links between smoking and cancer.”

Specifically, Guterres stated the industry has “exploited precisely the same scandalous tactics as big tobacco decades before. Like tobacco interests, fossil-fuel interests and their financial accomplices must not escape responsibility.”

This may be the first time Guterres made this comparison, but it is certainly not the first time it has been noted.

Among other examples, the International Federation of Medical Students’ Associations, representing more than 1 million students in 119 countries, published an open letter on this issue in April 2015. Titled “Fossil fuels are the new tobacco when it comes to health risk,” the letter demanded that the Bill and Melinda Gates Foundation and the Wellcome Trust divest from fossil fuels, noting: “The arguments that led the health sector to divest from tobacco provide a still more compelling mandate for divestment from fossil fuels.”

That argument is strengthened – if it needs strengthening – by a report titled “Smoke and Fumes” from the Centre for International Environmental Law (CIEL): “Our research in more than 14 million documents of the Tobacco Industry Archives reveals compelling evidence that the relationship between these two industries is neither coincidental nor casual. Beyond a doubt, the oil companies have benefitted from the tobacco playbook in their fight against climate science.”

Beyond a doubt, the oil companies have benefitted from the tobacco playbook in their fight against climate science.

The report notes there is a “a robust alignment of interests” between the two industries, with gas stations important retail outlets for tobacco and tobacco forming a significant part of their sales; not surprisingly, there has been “extensive joint marketing and cross-promotion campaigns” dating back to at least the 1950s. Other commercial ties included testing air and products for toxic chemicals, and the development of cigarette filters by the oil industry.

Learning from tobacco control measures

A 2019 report from the Winnipeg-based International Institute for Sustainable Development (IISD) and the NCD Alliance links the tobacco and fossil-fuel industries in another way. In “Burning Problems, Inspiring Solutions,” the authors note both that tobacco and fossil-fuel related air pollution have similar and very large health impacts and – more importantly – that governments can learn from tobacco control measures how to better control the fossil fuel industry.

With respect to health costs, the IISD reports that “tobacco smoking and air pollution are leading causes of death worldwide, causing 8 million and 7 million deaths per year, respectively,” with total costs for both in the trillions of dollars.

When it comes to learning from tobacco, the first step the IISD recommends is naming fossil fuels as an unhealthy commodity (like tobacco). This, they note, is not the same as naming the problem as greenhouse gas emissions, which are just downstream consequences (rather like tobacco smoke). Yet, the report notes, “fossil fuels are not even mentioned in the Paris Agreement and many other documents related to climate and air pollution.”

They also recommend creating new social norms by restricting advertising and sponsorship of these products or by divesting from the producers of these products. Specifically, the report states: “Health professionals, by acting as respected health commissioners, can also be crucial actors in raising awareness against air pollution and creating new attitudes against the burning of fossil fuels.”

A third important strategy, the report suggests, is to support those affected. This includes both the workers in the industry who will be affected by the transition away from fossil fuels and vulnerable groups – mainly those living on low incomes – who might be adversely affected by increased taxes, price increases or loss of subsidies.

The report also recommends using “every tool in the box,” a multi-faceted, multi-level approach as was used in the fight against tobacco. The authors suggest it is better to “act now and be a first mover” and to “be patient and persevere.” But as with tobacco, they suggest: “When change reaches a tipping point, it rapidly accelerates and becomes irreversible.”

What does this mean for the health sector?

  • First, we have to name the problem, to proclaim not only that climate change is a health threat but that fossil fuels – the main drivers of climate change – are a health threat, one that is on a par with tobacco.
  • Second, we must speak out against fossil fuels, and specifically against fossil fuel expansion.
  • Third, just as a health-sector organization would not take money or other forms of support from the tobacco industry, so too it should not take money or support from the fossil-fuel industry.
  • Fourth, just as health-sector pension and investment funds should be divested from tobacco, so too should they now divest from the fossil-fuel industry.
  • Fifth, we must advocate that the sort of regulatory controls and other mechanisms that were used by government against the tobacco industry now be applied to the fossil-fuel industry, as the IISD report recommends.

But while governments often have had cozy relationships with the tobacco industry over the years – the industry was, after all, a major source of revenue and provided sponsorship for the arts, sports and other social benefits – they have a far more harmful relationship with the fossil-fuel industry. Not only do the governments provide direct subsidies and supports, they are still actively promoting the expansion of the industry, both here in Canada and abroad. They are joined in this by the banks; Canadian banks are among the largest funders of the fossil-fuel industry in the world.

This raises the need for the health sector to actively campaign against the further expansion of the fossil-fuel industry and against public and private sector efforts to support the industry. After all, the health sector would never have condoned public or private sector support for expansion of the tobacco industry, so why would it accept it in the case of the equally harmful fossil fuel industry?

We will address the issue of the health sector’s role with respect to fossil-fuel expansion and the banking and insurance industries in a later article.

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1 Comment
  • Darren says:

    How do we reduce using fossil fuels? Our entire economy depends on fossil fuels and there are no viable alternatives. The comparison to smoking doesn’t make sense because smoking doesn’t serve an essential purpose.


We are a grassroots group of activist physicians working with our communities to grow an intersectional, decolonial and anti-racist movement on the climate and ecologic emergency. We use a long-term approach to address the complex interconnected issues and structural problems contributing to this emergency, and stand in solidarity with Indigenous land and water protectors. We use our health lens and evidence-informed approach to bring light to structural injustices that impact the earth we share.

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