Q&A with Researcher Tera Fazzino: What we can learn about the global food supply today by examining Big Tobacco’s past
In the 1980s, as U.S. tobacco companies faced increasing scrutiny and restrictions on cigarette products, the tobacco firms also invested heavily in food and beverage companies. As they expanded their footprint in this consumer market, the same tactics they developed to keep people smoking encouraged people to purchase and over consume types of highly processed, packaged foods and drinks. Many of these products are what we now call ultra-processed foods.
Tera Fazzino, associate director of the Cofrin Logan Center for Addiction Research and Treatment at the KU Life Span Institute, has published research about tobacco companies and their legacy of influence on the global food supply, years after the companies divested from food manufacturing and marketing. The research was published in June in the the American Journal of Public Health.
Fazzino discussed these findings and implications of her research in the following Q&A:
Q: What did your study find about the relationship between tobacco companies and the global food supply?
Tera Fazzino: The way the tobacco companies approached their food companies was effectively using the same strategies that they used to expand their tobacco businesses internationally.
The design of our food system, and the way these foods have been pushed internationally is pretty much based on a model for maximizing the sales of cigarettes. That includes the aggressively purchasing smaller, local food stores; building and synthesizing distribution and sales channels for food and tobacco; and using tobacco-influenced food product design strategies.
Q: Through the research, what similarities did you see between cigarette marketing and food marketing?
TF: The discourse that we saw from tobacco companies was that they intended to make many products to retain consumers, like they did with their cigarettes. It was explicit. "Leave them wanting more” is a direct quote from tobacco companies about the beverages and the food they manufactured.
In the U.S., if you're going on a diet or you're trying to restrict your intake, the amount of high flavor, low- “fill-in-the-blank" — low-fat, sugar, or whatever — products that exist is absurd.
It's the framework of still being able to eat the foods that you want, right? And having it taste almost exactly the same. But our “low” in something is a concept from the tobacco companies, from when they tried to market cigarettes to health-conscious consumers.
With cigarettes, they were marketing them as lower tar, lower nicotine, and healthier and slim, to retain their customers who might otherwise stop smoking. But cigarettes were still highly addictive. The entire premise is so skewed, and that premise comes from the tobacco companies.
Q: You've studied obesity and addiction for years. How did you become interested in the idea that some foods may have addictive qualities?
TF: It honestly took me a while to make the connection because I did not go in as someone who was like, "Oh yeah, I bet food addiction is a thing.” I did a postdoc in obesity treatment research after my PhD in addiction science. And I was interested, because I knew there were similarities, but also differences.
Then eventually I was reading a couple of papers from Ashley Gearhart, professor of psychology at the University of Michigan, from her earlier years, about why some foods could be addictive. And then I'd also read some animal studies about food and addiction that really convinced me.
Q: What are ultra-processed foods and hyper-palatable foods? Are they the same thing?
TF: Ultra-processed is an umbrella term. Ultra-processed foods are industrially processed and contain little to no whole foods. You wouldn't be able to produce ultra processed food from cooking in your home because you don't use high fructose corn syrup when you make cookies, right? The industrialized processes that are used, like emulsification, are techniques that are used for product texture and feel, but no one could do that at home.
The definition for hyper-palatability is separate from food processing; it just focuses on nutrients and their combinations, specifically, that don’t occur in nature (e.g., high fat and sodium, and high fat and sugar). Hyper-palatable foods are difficult to stop eating, and people probably are going to eat more than they intend to.
In our research, we found that, especially in the U.S. food system, the majority of foods that you would categorize as ultra-processed are also hyper palatable.
Q: How is the U.S. food supply different from what you observed in other countries?
TF: We know most ultra processed foods in the U.S. are now also designed to be hyper palatable. However, if you look more globally, they're not as directly overlapping. What we found was that the degree to which the foods were identified as ultra processed, hyper palatable or both, ranged widely.
In the U.S., it was most of the foods. But in many other countries, there was much more distinction. Some foods were ultra processed, some were hyper palatable, and the overlap between the two was far lower.
Also, one aspect of the ultra-processed foods is that they've got a lot of additives. They have chemical processes that people from abroad may not be used to.
Q: Why do you think discussions about personal responsibility and food can miss part of the picture?
TF: The tobacco companies for decades pushed the blame on the individual. They denied their cigarette products were addictive. They said it was a personal choice. People could stop if they wanted to.
And it's totally unfair to put it on the individual, especially if a product is addictive and society has very little, if any, structural protections. Some people are inherently vulnerable, for various reasons, to addictive substances. To put them in an environment where smoking is everywhere, there's no restrictions, they can't get away from it: Now, that sounds ridiculous, in a sense, right?
So, telling people in a food context that it's basically on them, when we have growing evidence to indicate that these foods have elevated addictive qualities, is completely unfair. Combine that with the structure of the U.S. food system, which is saturated with these foods. It's a losing battle.
Q: If policymakers want to improve public health, where should they start?
TF: We really need a country-level or intra-country level approach to address this.
In any kind of effective policy, it really needs to be a comprehensive approach with multiple policies bundled to really make a major impact within a public health domain.
At the federal level, we also need to shift our focus from subsidizing the crops (e.g., corn, wheat) that are being used in ultra-processed foods and making the population sick, to subsidizing the crops that will make us healthy, such as fruit and vegetable crops. That would reduce the cost if we have subsidies for it, but it would also increase the availability, which would also likely lower cost, eventually.
I want to research further to find out about the possibility of requiring companies to reduce some of the addictive nutrients in their products, because then at least we retain foods in the food supply. We don't exacerbate hunger.
If they drop sodium below a certain threshold, and it's no longer hyper palatable, then people won't be driven to overeat them. I think there's a lot of ways that we need to consider, but it's also very dependent on what the characteristics of the current food supply are.
Q: Are there examples of countries already taking action?
TF: In South America, some of those countries have done a phenomenal job of getting out ahead of it, pushing back on the entry of the multinational, ultra-processed food industry, and their attempts to get a foothold in various countries’ food supplies. They've been able to use a lot of the prior tobacco strategies for restrictions on marketing and taxation.
Q: What does healthy eating look like in your own household?
TF: I benefit from the fact that my husband cooks a lot of whole and fresh foods. He takes over most of the shopping and the food prep. I'm grateful because he's a great cook, and so we tend to lean not on the ultra-processed stuff because he says, “That's not food.”
My travels to Europe over the years also provided a starting point for this research as well, because I had such an explicit and drastic comparison, on a regular basis, with the U.S. food system and that of European countries.
This conversation has been lightly edited for clarity.