Hostage to fortune: an empirical study of the tobacco industry’s business strategies since the advent of e-cigarettes

The tobacco market has been transformed by the arrival of e-cigarettes and array of alternative nicotine delivery systems (ANDS). Public health has struggled to cope with these changes and clear divisions are apparent, but less is known about the tobacco industry (TI) response. This first empirical study to examine TI and independent ANDS companies’ business strategies fills this gap. Primary data were collected through 28 elite interviews with senior/influential TI and independent stakeholders, triangulated with a documentary analysis of company reports, investor analyses, market research, and consultation responses (1022 documents). A deliberately emic analysis shows that tobacco multinationals were initially disconcerted by ANDS, but logic provided by the fiduciary imperative is enabling them to turn a potential threat into profitable opportunities. Interviewees argue market changes played to their strengths: customer links, expertise in nicotine, and enormous financial resources. This enabled portfolio diversification in which combustible and ANDS coexist; providing potential to develop robust scientific and regulatory positions and hope of retrieving corporate reputations. The principal threat for major tobacco players comes from the independent sector, which is prepared and able to satisfy bespoke consumer needs. Multinationals by contrast need to turn ANDS into a genuinely mass-market product appealing to its global customers. They are making progress. Given the continued buoyancy of the combustibles market, they have extensive resources to continue their efforts. Disruptive innovations are not unique to tobacco control. Equivalent technological solutions – with concomitant business opportunities − are emerging in obesity and alcohol fields with implications for public health

PSYCHOTHERAPY, RELIGION AND MENTAL HEALTH

Many researchers studied matters of correlation between psychotherapy and religion in their works: С.G. Jung, R. May, E. Fromm, V.E. Frankl etc. Psychotherapy must be applied to all patients (believers or non-believers) by any psychotherapist regardless of his world-outlook

Emotion in the ANDS (alternative nicotine delivery systems) market: Practice-theoretical insight into a volatile market

PurposeThe alternative nicotine delivery systems (ANDS) market is complex, with a range of multi-national and multi-sector stakeholders competing for market share but also clashing ideologically as the evidence about the impact and side-effects of ANDS emerges. This empirical study examines the beliefs, goals and emotions at the heart of the practices performed by actors within the organisations behind the controversial commercial explosion of ANDS. Design/methodology/approachThe study was designed to explore business strategies from the viewpoints of ANDS business stakeholders. A purposive, snowball sampling strategy was used to recruit ANDS stakeholders and gatekeepers among UK tobacco multinational and independent companies (n = 28). Data were then analysed using a market-as-practices theoretical framework which specifically frames market activities as practices, governed by teleoaffective structures, which seek to establish market procedures and rules, and which contribute to the taste regimes of a consumer practice. Findings Analysis has indicated that the ANDS market is highly contested and volatile, interwoven with competition, emotion and conflicting beliefs. In this context, there are commercial practices routinely undertaken in an attempt to align stakeholdrs' beliefs, which is seen as a core part of the corporate activities required within the marketplace. A key driver of these alignment activities is the profit end-goal, but this is in tension with beliefs, such as about doing 'right' and the objectivity of 'science'. Beliefs across this emergent market vary and are strongly held, and they lead to emotional positions, tying back to why aligning stakeholders is difficult. Analysis illuminates how the projects, end goals, emotions and beliefs which comprise the teleoaffective structures of various corporate practices in the ANDS market might inform the rules and norms of the markey, shaping a taste regime experienced by consumers. LimitationsThe data and analysis cannot account for the beliefs and emotions of public health bodies, researches, the media, policymakers and other stakeholders, but seek to illuminate how teleoaffectivity is a key part of market practices. Furthermore, the taste regimes of ANDS consumers cannot be observed in the data due to the focus on ANDS commercial actors. Finally, it is possible that conscious or unconscious biases in the interviewing style may have driven interviewees' responses and influenced data interpretation. ImplicationsTobacco control is one of the greatest success stories of public health; smoking prevalence has been driven down with a combination of popular empowerment and corporate containment. All this depended on a coherent and accepted evidence base. As this evidence base has fractured during the evolution of the ANDS market, so the stories have proliferated and progress has become less certain. The high emotion in the ANDS market indicates a tougher task for behaviour change activity targeting corporate actors. ContributionThis paper speaks to the multiple calls in the behaviour change literature to tackle the intractable problems of the day through upstream measures including the restriction of corporate activity. The value is in the unique dataset and in the ambition of the project to unravel behind-the-scenes activities in the ANDS market. A practice-theoretical framework, although conceptually complex, is deployed to capture the complex intertwining of multiple practices and thus attempt to grasp the full significance of teleoaffectivity in the marketplace

Selective Silencing of Disease-Associated B Lymphocytes from Hashimoto’s Thyroiditis Patients by Chimeric Protein Molecules

Hashimoto’s thyroiditis is one of the most common endocrine disorders, affecting up to 20% of the adult population. No treatment or prevention exists except hormonal substitution for hypothyroidism. We hypothesize that it may be possible to selectively suppress anti-thyroglobulin (Tg) IgG antibody-producing B lymphocytes from HT patients by a chimeric protein molecule containing a monoclonal antibody specific for the human inhibitory receptor CR1, coupled to peptide epitopes derived from Tg protein. We expect that this treatment will down-regulate B-cell autoreactivity by delivering a strong inhibitory signal. Three peptides—two epitope-predicted ones derived from Tg and another irrelevant peptide—were synthesized and then coupled with monoclonal anti-human CR1 antibody to construct three chimeric molecules. The binding to CD35 on human B cells and the effects of the chimeric constructs on PBMC and TMC from patients with HT were tested using flow cytometry, ELISpot assay, and immunoenzyme methods. We found that after the chemical conjugation, all chimeras retained their receptor-binding capacity, and the Tg epitopes could be recognized by anti-Tg autoantibodies in the patients’ sera. This treatment downregulated B-cell autoreactivity and cell proliferation, inhibited Tg-specific B-cell differentiation to plasmablasts and promoted apoptosis to the targeted cells. The treatment of PBMCs from HT patients with Tg-epitope-carrying chimeric molecules affects the activity of Tg-specific autoreactive B lymphocytes, delivering to them a strong suppressive signal