Harmful industries still exert their influence over health professionals, academia, and health systems; robust change is required, write Chris van Tulleken, Nigel Rollins, and Rebecca Coombes In the 1950s, smoking was proven beyond doubt to cause cancer and yet efforts to curb this pandemic were stalled over the next half century by a network of individuals and institutions with competing interests. The industry paid doctors, academics, charities, and policy makers to dilute and distort the science and public health messaging.1 By the 1980s, the largest tobacco companies bought the largest food companies2 and used the same methods to create a food environment where poor diet has overtaken tobacco as the leading cause of early death globally.3 Food and tobacco are just two of the industries that use their economic power to evade effective regulation; food, alcohol, pharmaceuticals, gambling, and fossil fuels, among others, have the same commercial incentives and obligations as the tobacco industry and directly impact human and planetary health. The World Health Organization (WHO) has defined these commercial determinants of health as “…private sector activities that affect people’s health, directly or indirectly, positively or negatively”. To varying degrees, all these industries fund and partner with those that would regulate them. From de facto regulators, including charities, press offices, health professional associations, academic departments, doctors, and influencers, to formal …

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利益冲突：迈向零容忍


有害行业仍然对卫生专业人员、学术界和卫生系统施加影响;克里斯·范·图勒肯 （Chris van Tulleken）、奈杰尔·罗林斯 （Nigel Rollins） 和丽贝卡·库姆斯 （Rebecca Coombes） 写道，需要强有力的变革在 1950 年代，吸烟被证明会致癌，但在接下来的半个世纪里，遏制这种大流行的努力被利益竞争的个人和机构网络停滞不前。该行业向医生、学者、慈善机构和政策制定者付费，以淡化和扭曲科学和公共卫生信息。到 1980 年代，最大的烟草公司收购了最大的食品公司2，并使用相同的方法创造了一个食品环境，使不良饮食已经超过烟草成为全球早期死亡的主要原因。食品和烟草只是利用其经济实力逃避有效监管的两个行业;食品、酒精、制药、赌博和化石燃料等与烟草业具有相同的商业激励和义务，并直接影响人类和地球的健康。世界卫生组织 （WHO） 将这些健康的商业决定因素定义为“......直接或间接、积极或消极地影响人们健康的私营部门活动”。所有这些行业都在不同程度上为那些监管它们的人提供资金和合作。从事实上的监管机构，包括慈善机构、新闻办公室、卫生专业协会、学术部门、医生和影响者，到正式的......