Making trade work for public health

Credit: Graur Codrin and

Tobacco use is the leading preventable cause of death in the world today. Developing countries are now the top tobacco-consuming nations, where men and women are addicted to tobacco at higher rates than in developed countries, and have less success stopping.

Nations have responded in domestic law by implementing warning labels and anti-teen smoking measures, and in international law through the World Health Organization’s Framework Convention on Tobacco Control.

But international law may actually be hurting as much or more than it’s helping.

Earlier this year, the World Trade Organization (WTO) ruled against US efforts to reduce teen smoking. Elsewhere, tobacco multinational Philip Morris is using international investment treaties to target so-called plain-packing laws in Australia and Uruguay. Philip Morris has also been supportive of three pending challenges of the Australian legislation at the WTO.

In this month’s Transnational Dispute Management journal, I explore the first dispute, over the 2009 Family Smoking Prevention and Tobacco Control Act. Congress saw this as a hard-won political compromise. On the one hand, it took aggressive action to reduce smoking by teens by prohibiting the sale of sweet-flavoured cigarettes. (These cigarettes are particularly appealing to people in their teenage years – the so-called window of initiation that strongly influences future tobacco addiction.) On the other hand, it took seriously the warnings made consistently by the US Supreme Court, police organisations, and economists that banning cigarettes used by adults in large numbers could have serious adverse consequences for crime. A key part of this political compromise was exempting menthol from the flavoured cigarettes ban. Health researchers have shown that menthol smokers have less elastic demand, and that many would keep smoking the products even if illegal.

The WTO ruled against the US because one of the 13 banned flavors – clove – was primarily imported from Indonesia, while menthol was regulated by other means. While equity certainly requires that developing country cigarette workers be given some consideration, the WTO appellate body (staffed by trade lawyers, not health experts) made the interests of tobacco producers the only consideration that counted. As such, they went against smart, incremental policy, and sensible cost-and-benefit weighing. Indeed, if the US wants to try to comply with the ruling without reducing the number of flavours subject to the ban, it would have to ban menthol cigarettes – something that is not feasible politically or administratively.

The implications for this ruling extend far beyond the US. The World Health Organization’s framework calls for, among other things, national prohibitions on sweet tobacco products that are appealing to teens. Over 75 countries report making progress on this front. The WTO ruling could be cited to pressure other countries’ to weaken their bans on sweet products.

The Australia and Uruguay cases are also worrying. Philip Morris is arguing that warning labels go against international law and expropriate their brand value. If successful, citizens in these countries might be faced to pay the company massive compensation – all for the privilege of regulating in ways that their own legislatures and courts have approved.

How do we get international law on the right track?

In the short run, nations will understandably focus energy on winning the cases, or limiting the extent of losses. Uruguay is mounting a vigorous defence with the assistance of the Bloomberg Foundation. We can also sidestep the international law problem by lowering demand for cigarettes, as Gates Foundation grantees are doing in China, India and Africa.

But it is untenable to have international law like the health framework conflict with international trade law. WTO and investment treaty decisions with a bearing on public health could be appealed to panels with more expertise in such matters. This would create incentives to pay closer attention the regulatory logic that every country has to sort out in addressing addiction in a way that makes sense on the ground.

Better yet, costly litigation could be avoided in the first place by having trade negotiators carve out tobacco and other health matters from trade deals. This type of firewall could go a long way towards keeping kids from lighting up.

*Todd Tucker [2012] is doing a PhD in Developmental Studies. For more on his studies, click here.


Reducing wrongful convictions

Close your eyes and tell me what you are wearing today. What is the person next to you wearing? Our memory is capable of incredible things; however, it does not work like a tape recorder, neither when memorising an event, nor when attempting to recall it. In court, eyewitness evidence is regarded to be among the most incriminating type of evidence. However, it is not always accurate and can lead to miscarriages of justice. To date, over 330 wrongfully convicted people have been exonerated in the US by DNA testing, including 18 people who had been sentenced to death. On average, these people had served 13 years each in prison before they were exonerated and released. In the US over 75% of known wrongful convictions, many of them in rape cases, are at least in part due to mistaken eyewitness identification, making it the single greatest cause of wrongful convictions.

Although witness memory is indisputably fallible, it is heavily relied on. And although a wealth of literature exists on eyewitness issues in general, relatively little is known about older witnesses. This is especially concerning as the proportion of the world population that is 60 years or older will rise from 11 per cent in 2011 to 22 per cent in 2050, reaching a total of two billion. Taken with the fact that older adults are found to live healthier and more actively to older ages, this rapid population ageing will likely lead to an increase in older adults being witnesses of crimes and generally being involved in the Criminal Justice System. Bearing in mind older adults’ declining sensory systems and memory, it is most important to get further insights into strategies that can enhance their witness performance.

Person identification decisions are subject to mistakes in general. However, older adults are found to perform even worse in eyewitness situations than young adults, both regarding testimony and person identification. Attempts that have been made to improve witness performance in general have had limited success. Specific interviewing techniques, for instance, are often training-intense and time-consuming. An easy-to-apply and effective method to aid older eyewitnesses could, however, come through a consideration of the witness’ individual circadian rhythm. Circadian rhythms reflect roughly 24-hour cycles in biological and physiological processes, which impact, among other things, on attention processes and memory. These show regular peaks and declines across the day and people who perform at their optimal time of day, i.e. according to their circadian rhythm, are at their peak of cognitive functioning.

Applied to eyewitness research, my PhD supervisor Katrin Mueller-Johnson was able to show that taking elderly witnesses’ optimal time of the day into account substantially improved the quality and quantity of their testimony. To pursue this further, I examined the impact of circadian rhythm on performance in an eyewitness identification task. Again, preliminary results were very promising. In a first study, the overall odds of performing correctly in a line-up were roughly seven times higher if participants were tested at their optimal time of day (80% correct) than at their non-optimal time (37% correct), an effect that was highly significant. This becomes even more interesting when looking only at line-ups in which the perpetrator was not present, which is the research equivalent to situations in which the police have arrested the wrong suspect. Here, the odds of correctly indicating that the perpetrator is not there were eight times higher if participants were tested at their optimal time (33% falsely identified someone) as opposed to their non-optimal time (80% of participants falsely identified someone from the line-up).

Although these are just preliminary studies and there are, of course, limitations to this research, it nevertheless constitutes an important step in the investigation of possible improvements of the person identification process for older eyewitnesses. It shows the importance of studying what influences eyewitness testimony and reveals a promising approach to improving older adults’ person identification. In due course this could lead to more effective police investigations, better access to justice and more successful prosecutions and ultimately to a reduction in the number of wrongful convictions.

*Katrin Pfeil [2012] is doing a PhD in Criminology. Picture credit: renjith krishnan and

Does crime run in families?

The apple doesn’t fall far from the tree’, ‘Like father like son’, ‘chip off the old block’. Many people agree with these idioms and even more people have ideas as to why crime runs in families: bad upbringing, growing up in bad neighbourhoods, and ‘it’s in the genes’ among them. To some extent these explanations are supported by empirical research and in my dissertation I examine some of these mechanisms. Something people do not generally think about, however, is whether criminal justice policies might nourish this cycle of intergenerational crime.

One way in which the criminal justice system might increase intergenerational transmission is through imprisonment of the parents (see earlier news post and the Gates Scholar Magazine). A less extensively investigated mechanism, however, is official bias. Official bias means that the police and other agents in the justice system such as judges focus their attention on a certain group of people, such as children of criminal parents. This mechanism suggests that such children are seen as ‘usual suspects’ and will get caught more often, get convicted more easily, and appear in criminal records more often. This would then explain why we find a relationship between parental and offspring convictions.

Using English data we investigated whether sons of convicted parents had an increased risk of conviction compared to sons of unconvicted parents. Not only did we have information about their criminal records, but over the years these sons were asked to report whether they had taken part in delinquent behaviour. We grouped sons with similar levels of self-reported offending and found that sons with a convicted parent had an increased risk of having a conviction compared to sons of unconvicted parents. This supports the idea of official bias.

Moreover, we know that a criminal conviction increases criminal behaviour. This process is called ‘labelling’. When people are labelled ‘criminal’, this label or stigma might influence someone’s self-perception; people will act in accordance with the label attached to them by society. Furthermore, the criminal label might block conventional and non-criminal pathways and thereby pushes people into a criminal lifestyle. This label could be a crucial event leading to a more persistent delinquent life course.

These are disturbing results, because it seems that the criminal justice system accomplishes exactly the opposite of what it aims to do: reduce crime. However, it is not surprising that justice agencies focus their attention on what they think will be the usual suspects. Prejudice and stereotypes help us to perceive the world around us, a world with often too much information to readily handle. These stereotypes work, because children from criminal parents do have a higher risk to commit crime. However, it is undesirable that criminal justice policies increase crime. Therefore, it is vital to make criminal justice agents aware of this bias and the impact on future offending. Second, we know that other mechanisms such as growing up in a poor environment also impact on intergenerational transmission of criminal behaviour. Instead of increasing criminal behaviour among children of criminal parents, it would be preferable to try and prevent the development of this behaviour in the first place. Energy and resources would be better spent on family-based prevention programmes, such as parent education and parent management training. Such programmes have been shown effective in reducing offspring offending. If special attention were focused on children of criminal parents, this could be a more positive and effective means of preventing criminal behaviour.

*Sytske Besemer [2008] investigated intergenerational transmission of criminal and violent behaviour at the Institute of Criminology. She has recently been awarded a Rubicon fellowship from NWO, the Netherlands Organisation for Scientific Research, and is now doing a post-doc at UC Berkeley in California. This blog is based on part of Sytske Besemer’s dissertation which is shortly being published by Sidestone Press. Picture credit: sakhorn38 and

Women at the centre of US elections

The upcoming US presidential election is making news all over the world. As a Canadian living between the United Kingdom and South America, the debates are of enormous interest to me – despite the fact whoever wins the election won’t be my president.  They are captivating for a great number of reasons, not least of which being that I am a woman.

The election revolves heavily around ‘social’ issues and the corresponding public policies that will directly impact women (and make no mistake about it – men as well). These include equal access to employment and rights to equal pay; access to quality, affordable healthcare; the regulation of women’s bodies, reproductive health, and freedom of choice in relation to contraceptives and abortion – even what constitutes rape. ‘Women’ are everywhere in the debates.  We are featured alongside the why’s and what-now’s of the ailing economy and over and above the war in Afghanistan.

I’m captivated even as I struggle to understand the reasons why this is the case-  didn’t ‘developed’ nations figure out long ago that social and economic equality and right to healthcare and decision-making over reproductive issues were key to prosperous, healthy, sustainable communities?

Women’s issues are treated as a subset of ‘social issues,’ and are scoffed at by those who assert they are a distraction from more important and serious debates around the economy, job creation, and high unemployment. This view is erroneous. Women’s reproductive freedom, right to equal pay for equal work, and access to quality healthcare are very much economic issues, and are directly related to what it means to be a developed country.

Women in the US are tuned into the debates as well. By now we’ve all heard about the ‘gender gap’ in pre-election polls – more women seem to favour the Democratic platform of President Obama over that of Republican candidate Mitt Romney – and in considerable numbers.  Let’s be clear about something – this isn’t about the old colour-of-the-tie psychology theory.  What is interesting is what these numbers can tell us, particularly when they are broken down. For example, among the female democratic supporters are women of colour, immigrant women, single mothers, and low-income women.  So what is the story behind the numbers?

Women know what they need. There are 46.2 million women, or 15.1% of the population, living in poverty in the United States (notably, there are 4 million more poor women than men). Social services such as those provided by Planned Parenthood (access to birth control, non-judgemental abortion, and gynecological exams), food stamp programmes, and state assistance in caring for children and the disabled (work that women overwhelmingly do) are imperative for women and their families living in poverty. In part, President Obama’s numbers are boosted by those women lacking equal access to employment and who are  directly impacted by the fact that women still only make 77 cents to every dollar (and women of colour 61 cents to every dollar) that men make. Women’s issues are as much economic as they are social. Any woman wanting to limit the number of children she bears, that struggles to feed her family, or is unable to make ends meet in a low-paying job can tell you that.

A great deal of women clearly know what is at stake on a personal level in this election. The gender gap in the polls makes a lots of sense to me – it’s the impetus behind the debates that does not. Have the big guys in power suits forgotten what being a developed country involves?

There is no one universal or concrete definition for a developed country. What constitutes ‘developed’ is highly contested, and definitions vary according to the weight placed on different social, economic and political indicators.  While it lags behind in some indicators, gender equality being one of them, the US is considered a developed country – and indeed one that invests in promoting development in other countries. Considering the differing perspectives and definitions, I think it is safe to look to the UN Millenium Development Goals for guidance on some of the characteristics of a developed country. These would indicate one that is free from poverty and hunger, and with universal access to education, for a start. It would also have gender equality, excellent child and maternal health, and would have universal healthcare provision. Countries where women have particularly low status and little access to social, economic and reproductive rights often fall into the ‘developing’ or ‘less developed’ category.

Public policies that work towards sustainable development would support women’s access to reproductive health services, such as information on family planning, safe contraceptives and abortions, and pre- and post-natal care. They would also ensure universal access to healthcare regardless of your position as a CEO, a student, or a janitor. They would promote women receiving the same pay that men did for the same work, and also the same access to employment – which might include provision of childcare services so that single or low-income mothers could engage in paid employment outside of the house. Women suffer, as do their families and communities, when they are not supported via inclusive policies. One need only look at international statistics on maternal mortality, domestic violence, and female illiteracy – as well as what happens when women’s rights are upheld – to understand this.

Considering that these are the types of policies that have immediate relevance for low-income women, and within this group a disproportionate number of women of colour, single mothers, and immigrant women, it’s no wonder that female support is markedly greater for one party’s platform than that of the other. Feminists have insisted that ‘the personal is political’  since the 1960s and 70s – a statement with continued relevance today. Women are engaged in these elections because the outcome will have direct, tangible, every-day impacts on their lives. My fascination with the US presidential election stems partly from a morbid curiosity – I just can’t wrap my head around why a ‘developed’ country would retract the policies that helped propel it towards that coveted status in the first place. The election will show whether a majority of American women feel the same.

*Tara Cookson [2011] is doing a PhD in Geography on the effects of the more recent post-neoliberal policy shifts on women’s lives as carers within the Latin American region, focusing specifically on those policies that seek to ’empower’ women and alleviate poverty. Picture credit: Claus Simonsen and Creative Commons. This article was first published on Sense and Sustainability.