How Big Tobacco uses disruptive tactics to deny child rights to be tobacco-free.

The denial of children's rights is at the heart of the tobacco industry's interference in health policies. Big Tobacco (composed of the five largest tobacco companies) controls 80% of the global market, and mergers and acquisitions have solidified interference on an industrial scale. Driven by shareholder demand for profits, the industry needs children to replace the sick, the dying and those that have stopped smoking. With no apparent intention of ending their marketing of addictive, lethal products, which kill 8 million people a year, the industry is aggressively releasing new products and using front groups, corporate social responsibility (CSR) and philanthropy to disrupt tobacco control. The industry presents itself as caring about children and positions itself as part of the solution, not the problem. While the interference tactics of Big Tobacco are well documented, their misleading concerns about children (while simultaneously denying their rights) demands a more strategic response, with integrated use of treaties and frameworks to protect children. For this review, searches were conducted between 2015 and 2019 for articles in English referring to tobacco industry tactics that harm child health rights. A narrative synthesis was used to combine the evidence and author's experience in industry reporting. The analysis reveals that the tobacco industry delays interventions to protect children by expanding its use of allied front groups, flooding markets with novel products and disrupting tobacco control policies. To combat this approach, stakeholders in health need to reclaim the child health agenda. A variety of existing mechanisms can be used to develop more integrated and policy coherent reporting processes for protecting current and future generations of children.