We are entering Big Food’s Big Tobacco moment. The fight to hold tobacco companies responsible for the deadly health effects and associated health-care costs of their products took decades, culminating in the 1998$206 billion settlement with 46 states and reforms like a ban on marketing cigarettes to young people. In the ’60s, when free sampler packs of cigarettes were given out to high schoolers, 42% of American adults smoked. Today that number is 12%.
Is that where Big Food is headed with ultra-processed foods, artificial dyes, and sugary beverages? We’re actually further along in that process than many might think. Forces for change are converging across the political, legal, and cultural landscape—and we have the example of the fight against Big Tobacco to draw on.
In December, a landmark, first-of-its-kind lawsuit was filed in Philadelphia on behalf of a teenager alleging that consuming ultra-processed foods led to him developing fatty liver disease and Type 2 diabetes. Among the 11 companies named in the lawsuit are General Mills, Kraft Heinz, PepsiCo, Coca-Cola, and Kellogg’s. Ultra-processed foods “are alien to prior human experience,” the 148-page complaint reads. “They are inventions of modern industrial technology and contain little to no whole food…The explosion and ensuing rise in UPFs in the 1980s was accompanied by an explosion in obesity, diabetes, and other life-changing chronic illnesses.”
The lawsuit goes on to make an explicit tie between Big Food and the rise of UPFs and Big Tobacco, arguing that food manufacturers are “using the same master playbook.”
The connection is more than metaphorical. In the 1980s, tobacco companies Philip Morris and R.J. Reynolds bought Kraft, General Foods, and Nabisco. In the early 2000s, the food companies were spun off, “but not before leaving a lasting legacy on the foods that we eat,” as Anahad O’Connor put it in The Washington Post.
That’s because, as the complaint notes, “UPF formulation strategies were guided by the same tobacco company scientists and the same kind of brain research on sensory perceptions, physiological psychology, and chemical senses that were used to increase the addictiveness of cigarettes.”
This was confirmed by a 2023 study published in the journal Addiction, which found that the decades when Big Tobacco owned Big Food corresponded to the rise of “hyper-palatable” foods, which are ultra-processed foods engineered to have a combination of fat, sugar, sodium, and carbohydrates that trigger the brain to encourage excessive eating. In the study, foods from tobacco-controlled brands were 80% more likely to contain powerful combinations of sodium and carbs that made them hyper-palatable and 29% more likely to have similar combinations of sodium and fat.
The study notes that by 2018, the differences between food from the tobacco-owned brands and foods from other companies had disappeared—not because any of the foods became less unhealthy, but because other companies saw that ultra-processed foods sold well and simply copied them.
“Every addictive substance is something that we take from nature and we alter it, process it, and refine it in a way that makes it more rewarding—and that is very clearly what happened with these hyper-palatable food substances,” said Ashley Gearhardt, a professor of psychology at the University of Michigan who studies food addiction. “We treat these foods like they come from nature. Instead, they’re foods that come from Big Tobacco.”
In fact, Big Tobacco’s use of the same master playbook for cigarettes as for food goes back decades earlier. In the ’60s, R.J. Reynolds conducted market research on children for the development of sugary drinks. As Reynolds’ manager of biochemical research put it in a 1962 internal memo, “It is easy to characterise R.J. Reynolds merely as a tobacco company. In a broader and much less restricting sense, however, R.J. Reynolds is in the flavour business.” The manager also noted that “many flavourants for tobacco would be useful in food, beverage and other products,” producing “large financial returns.”
And it turns out, the negative consequences from the “flavour business” were strikingly similar for ultra-processed foods and tobacco. Research being presented this month at the American College of Cardiology’s annual scientific meeting found that consuming an additional 3.5 ounces a day of ultra-processed food was associated with a 14.5% increased risk for hypertension, a 5.9% increased risk for cardiovascular events, and a 19.5% increased risk for digestive diseases, as well as heightened risk for obesity, metabolic syndromes, diabetes, and depression or anxiety.
Last year, in the world’s largest review of its kind, a comprehensive study found that consumption of ultra-processed foods is linked to a higher risk of at least 32 different health problems, including heart disease, cancer, Type 2 diabetes, mental health disorders, and early death.
The term ultra-processed foods was coined by Carlos Monteiro of the University of São Paulo. He also developed the NOVA food classification system that categorizes foods based on their level of industrial processing. As Monteiro put it, “no reason exists to believe that humans can fully adapt to these products.” Or at least adapt to them any better than the dinosaurs did to asteroids. And avoiding ultra-processed foods is actually harder now than avoiding cigarettes was even in the ’60s. Nearly three-quarters of America’s food supply is now made up of ultra-processed foods.
A huge part of the problem are sugary beverages, which are the single largest source of added sugars consumed by Americans. According to the American Heart Association, having one more sugary drink each day can increase a person’s risk of hypertension by 8% and risk of heart disease by 17%. And aJanuary study in Nature Medicine found that these drinks contribute to 2.2 million new cases of Type 2 diabetes, 1.2 million cases of cardiovascular disease, and 340,000 deaths globally each year. “This is a public health crisis, requiring urgent action,” said study author Dr. Dariush Mozaffarian, a cardiologist and director of the Food is Medicine Institute at Tufts University.
And the playbook by the two industries to stave off reformis the same. As more science comes in, so do the effortsto prevent that science from making its way into policy and regulation. Part of that involves lobbying. According to an analysis by the Financial Times, food and beverage companies spent $106 million on lobbying in 2023, nearly twice as much as tobacco and alcohol companies combined. And that was an increase of over 20% from the year before, largely due to “lobbying relating to food processing as well as sugar.”
Next in the playbook? Discredit the science. “The strategy I see the food industry using is deny, denounce, and delay,” says Barry Smith, professor at the University of London.
Right on cue, here was the response by Sarah Gallo, of the Consumer Brands Association, which represents the food industry, to the study in the American Journal of Preventive Medicine finding an increased risk of dying early from consuming UPFs: “Demonizing convenient, affordable and shelf ready food and beverage products could limit access to and cause avoidance of nutrient dense foods, resulting in decreased diet quality, increased risk of food-borne illness and exacerbated health disparities.”
And here is Gallo’s response to the lawsuit filed in December: “Attempting to classify foods as unhealthy simply because they are processed, or demonizing food by ignoring its full nutrient content, misleads consumers and exacerbates health disparities.”
The final step in the playbook of course, is to fight back in court. The Financial Times notes that in Mexico, food companies, including Nestlé and Kellogg, have sued the government to stop front-of-package warning labels and other restrictions like forbidding the use of children’s characters in marketing.
And all of that can work. Until it doesn’t. The fight against Big Tobacco went the same way Hemingway described bankruptcy happening: “Gradually, then suddenly.” What it shows is that, yes, the road is long, and there are many bumps and reversals and dead ends. And then, suddenly, the momentum changes, the zeitgeist changes, and what seemed impossible for decades swiftly becomes the obvious and consensus position.
As far back as 1950, two scientists, Ernst Wyndner and Evarts Graham, published a study that found that 96.5% of lung-cancer patients were moderate to heavy smokers. Two years later, the counter-science began, when the tobacco company Liggett promoted a study, by a “competent medical specialist,” that found that smoking Chesterfields had no adverse effects. In 1954, the first lawsuit against tobacco was brought by Eva Cooper, whose husband had died of lung cancer. Cooper lost that suit, but in the next four decades, over 800 lawsuits were filed by smokers or their families. Until the ’90s, only two of those were successful and both were overturned on appeal.
In the ’90s, a third wave of lawsuits began. The breakthrough was that state attorneys general were seeking to recover health-care costs associated with tobacco. In 1994, the first of those suits was filed by Mississippi seeking $940 million in Medicaid costs the state spent treating smokers. As Mississippi’s then-Attorney General Mike Moore put it, “The lawsuit is premised on a simple notion: you caused the health crisis; you pay for it. The free ride is over.”
And apres Moore, the deluge. By the end of that year, three more states filed suits. By 1997, 39 states were suing. At the same time, there were major class-action suits being filed, including one, known as the Castano suit, by a group of 60 law firms across the country on behalf of “all nicotine-dependent persons in the United States.” Another was brought on behalf of 60,000 flight attendants. A tipping point had been reached, and in 1998, the $206 billion “Master Settlement Agreement”—the largest civil settlement in U.S. history—was agreed upon.
1998 wasn’t that long ago, but the pre-Master Agreement world of tobacco acceptance now seems incomprehensible. And now we’re down a similar road. In 2009, Kelly Brownell, a Yalenutrition expert, wrote a paper entitled “The Perils of Ignoring History: Big Tobacco Played Dirty and Millions Died. How Similar is Big Food?” In explaining why he wrote the paper, Brownell said, “We simply didn’t want the food industry to be able to get away with some of those same tactics.” The food industry, he said, is at a crossroads: “They can behave as tobacco did, which is lie about the science, distort the truth, and buy up the scientists. Or they can come face-to-face with the reality that some of their products are helping people and some are hurting, and we need to shift the balance.”
That would mean food companies would stop marketing to children and overstating health claims. But most of all, said Brownell, “they should reformulate their products and market the healthier versions as aggressively as possible.”
At the time, there weren’t a lot of voices in that chorus. But in the years since, more have joined. In 2012, lawyers pitched state attorneys general in 16 states with the idea of suing companies to make them pay for the soaring costs of obesity and diet-related health-care costs. Politico called it a “radical” idea and “a move straight from the playbook of the Big Tobacco takedown of the 1990s.”
Paul McDonald, a lawyer who led the effort, said the aim wasn’t to cast the food industry as villains, but “to lighten the economic burden of obesity on states and taxpayers and to negotiate broader public health policy objectives.”
On the legal front, according to the law firm Perkins Coie, 256 class action lawsuits were filed against the food and beverage industry last year, a 58% increase from 2023. While many of those are about truth in label and health claims, an increasing number are about ultra-processed foods.
The food industry may win these lawsuits today. But for how long? The culture is changing, the science is becoming more and more clear, too many people are suffering, and too many lives are being lost.
In the last few years, there is evidence that Big Food has seen the writing on the menu, trying to get ahead of the reckoning by buying up smaller companies focused on healthier food to diversify their product lines. In 2023, Mars, Inc. bought Kevin’s Natural Foods, which makes healthy prepared meals and sauces. In January of this year, PepsiCo acquired Siete Foods, known for better-for-you Mexican-American inspired foods. In March, PepsiCo bought the prebiotic soda brand Poppi. This was on the heels of Coca-Cola launching its own prebiotic soda Simply Pop. In April, Hershey bought the better-for-you snack brand LesserEvil.
In the meantime, the lawsuits continue. As the saying goes, first they ignore you, then they laugh at you, then they fight you, then you win. That’s what happened with tobacco: “When we filed the tobacco lawsuits, our peers—good lawyers and great lawyers—laughed at us,” said Wayne Reaud, one of the lawyers representing Texas in its lawsuit against the tobacco companies in the ’90s. “They told us there was no way we were ever going to win.”
But they did win. Which is to say, all of us won. Now we need another win. And the good news? We already know how.
The opinions expressed in Fortune.com commentary pieces are solely the views of their authors and do not necessarily reflect the opinions and beliefs of Fortune.
This story was originally featured on Fortune.com
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