Intended for healthcare professionals


Tobacco industry involvement in children’s sugary drinks market

BMJ 2019; 364 doi: (Published 14 March 2019) Cite this as: BMJ 2019;364:l736
  1. Kim H Nguyen, research scientist1,
  2. Stanton A Glantz, professor2 3 4,
  3. Casey N Palmer, research analyst1,
  4. Laura A Schmidt, professor15 6 7
  1. 1Philip R Lee Institute for Health Policy Studies, University of California, San Francisco, CA 94148, USA
  2. 2Department of Medicine, University of California, San Francisco, USA
  3. 3Center for Tobacco Control Research and Education, San Francisco, California, USA
  4. 4Cardiovascular Research Institute, San Francisco, California, USA
  5. 5Global Health Sciences, San Francisco, California, USA
  6. 6Clinical and Translational Science Institute, San Francisco, California, USA
  7. 7Department of Anthropology, History, and Social Medicine, University of California, San Francisco, USA
  1. Correspondence to: L A Schmidt{at}

Kim H Nguyen and colleagues examine how tobacco companies applied their knowledge of flavours, colours, and child focused marketing to develop leading children’s sugar sweetened drink brands. These techniques continue to be used by drinks companies despite industry agreement not to promote unhealthy products in this way

Sugar sweetened beverages are a risk factor for obesity and cardiometabolic disease.1234 Young children are particularly susceptible to the persuasive influence of adverts for sugary drinks,567 and the World Health Organization has urged governments to tighten food and drink marketing restrictions to protect children.8

Marketing of sugary drinks to children by multinational corporations, and the need to regulate it, have been public concerns since the 1970s.910111213 In 1974 the Better Business Bureau created the Children’s Advertising Review Unit to promote “responsible” children’s advertising through industry self policing. In 2006, in response to calls for government regulation, industry created its Children’s Food and Beverage Advertising Initiative (CFBAI).14 CFBAI members pledge “to shift the mix of advertising primarily directed to children (‘child-directed advertising’) to encourage healthier dietary choices,” to “devote 100% of their child-directed advertising to better-for-you foods, or to not engage in such advertising,” and to “limit the use of third-party licensed characters, celebrities and movie tie-ins.”15

Comparisons have been made between the tobacco and soft drink industries, 1617 including similarities in aggressive activities to oppose taxation and marketing restrictions, leading some to ask, “Is sugar the new tobacco?”1819 Internal tobacco industry documents show that many of today’s leading children’s drink brands were once owned and developed by tobacco companies (table 1; see supplementary data on for document sources and research methods).

View this table:
Table 1

Ownership of large brands of children’s sugary drinks

R J Reynolds and Philip Morris, the …

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