The tobacco industry’s influence on public health policy making in the US is increasing, according to the latest report from anti-smoking organization Action on Smoking and Health (ASH).
ASH’s Tobacco Industry Intervention Index 2025, first provided to The Hill, found that the U.S. scored 89 out of 100 on the Global Tobacco Industry Intervention Index, a survey used to measure how governments respond to interference by the tobacco industry.
America’s score is 98th out of 100 countries included in the survey.
“The scoring is based on 20 key indicators around Article 5.3 [of the World Health Organization’s Framework Convention on Tobacco Control] This is the article that basically states that, you know, public health needs to be protected from the vested interests of the tobacco industry,” said Nichelle Gray-Lakhgwadorg, manager of engagement and special programs at ASH and lead author of the report.
The survey covered categories including transparency; conflicts of interest; negotiations between the government and the tobacco industry; And awareness.
“Eighty-eight is a pretty terrible score, because it’s 89 out of 100 and, you know, the U.S. will again be one of the worst countries in our reporting this year,” Gray-Lakhgwadzorge said.
This score is notable because the US is not particularly notable in terms of its tobacco use, ranking only 52nd globally according to the CIA. This places it behind countries like China, Spain and Russia.
While the US scores poorly on transparency, it scores four out of five in this category.
“The government does not publicly disclose meetings/negotiations with the tobacco industry in cases where such negotiations are strictly required by regulation,” the report said.
ASH Policy Action Director Chris Bostick said the tobacco industry’s involvement in the federal government may not be significant compared to other industries, but he said the industry’s core product is what sets it apart.
“Countries should treat the tobacco industry differently because their product becomes deadly when used not as intended. It should not be viewed as just a normal industry,” Bostic told The Hill.
Lobbying registrations by the tobacco industry have jumped 24 percent in the past year. According to Bostick, this is likely being driven by anti-tobacco legislative actions.
“The other tobacco industry fear is the increasing number of jurisdictions that are passing end-game tobacco laws, and these are laws that are shutting down commercial tobacco sales altogether,” Bostic said. “From zero a few years ago, we’ve gone up to 23 jurisdictions that have done this in the US and so it’s a death sentence for the tobacco industry.”
To counter increasing interference, ASH recommended increasing awareness of the WHO Framework Convention on Tobacco Control, increasing the number of appointments to the executive branch for years prior to working as lobbyists, and including more staff in this category.
“HHS has said since they signed it in 2004 that we are in full compliance with the FCTC, and that is absolutely false,” Bostic said. “And I’m not blaming any one administration. Every administration has said this, and they’ve all been wrong about it. And it’s a terrible shame because the things that are in the FCTC are a blueprint for reducing tobacco-related death and disease.”
