In terms of human misery, tobacco is a giant. One of the world's leading causes of mortality and ill-health, it is a manufactured epidemic which enriches a few at the expense of millions. From cultivation to consumption, the negative effects of the tobacco industry outweigh the positive at all steps in the production process. Yet, like a reviled, disgraced but wealthy relative at a wedding, it continues to be politely tolerated - even welcomed - by otherwise respectable organisations willing to benefit financially from its malevolent noblesse oblige. 'Social responsibility' and reputation management initiatives are essential proxy advertising for an industry which regularly features in consumer survey 'worst reputation' lists. In this issue we examine two such initiatives: an industry announcement of an intention to adhere to (already well-established) legal standards regarding child labour, and acceptance by one of the USA's largest humanitarian charities of tobacco company donations. The cognitive dissonance inherent in praise and endorsement of these initiatives is striking, given the extent to which the industry profits from youth smoking, as well as the enormous annual death toll from its products - far in excess of any other natural or human-caused disaster.
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