Recent findings from Action on Smoking & Health (ASH) indicate an increasing sway of the tobacco sector over public health policy in the United States.

In its Tobacco Industry Interference Index 2025, initially shared with The Hill, ASH revealed that the U.S. received a score of 89 out of a possible 100 on the Global Tobacco Industry Interference Index. This evaluation assesses governmental responses to influence from the tobacco industry.

Among 100 countries evaluated, the U.S. ranked 98th.

“The evaluation hinges on 20 critical indicators derived from Article 5.3 of the World Health Organization’s Framework Convention on Tobacco Control,” explained Nichelle Gray-Lkhagvadorj, ASH’s manager of engagement and special programs, and the principal author of the report. This article underscores the necessity of shielding public health from tobacco industry interests.

The survey investigates several domains, including transparency, conflicts of interest, government-industry interactions, and awareness.

“Eighty-nine is a pretty terrible score, because it’s 89 out of 100 and, you know, the US is set to be one of the worst countries again this year in our reporting,” Gray-Lkhagvadorj added.

This score is notable as the U.S. is not particularly notable in terms of its tobacco use, ranking only 52 globally according to the CIA. This places it behind countries like China, Spain and Russia.

Where the U.S. scores poorly is transparency, receiving a four out of five in this category.

“The government does not publicly disclose meetings/ interactions with the tobacco industry in cases where such interactions are strictly necessary for regulation,” noted the report.

Chris Bostic, ASH policy director of action, noted that the tobacco industry’s involvement in the federal government probably doesn’t differ significant when compared to other industries, but said the industry’s core product is what sets it apart.

“Countries ought to treat the tobacco industry differently because their product kills when used as intended. It shouldn’t be treated as just a normal industry,” Bostic told The Hill.

In the past year, there has been a 24 percent jump in lobbying registrations by the tobacco industry. According to Bostic, this is likely being spurred by anti-tobacco legislative actions.

“This fear for the other tobacco industry is the growing number of jurisdictions that are passing tobacco end game laws, and these are laws that are phasing out the sale of commercial tobacco entirely,” Bostic said. “From zero a few years ago, we’re up to 23 jurisdictions that have done that in the U.S. And so that’s a that’s a death sentence for the tobacco industry.”

To combat the growing interference, ASH recommended raising awareness of the WHO’s Framework Convention on Tobacco Control, increasing the number of years executive branch appointees before working as lobbyists and that more employees be included in this category.

“Ever since they signed it in 2004 HHS has said that we’re in full compliance with the FCTC, and that’s just demonstrably false,” said Bostic. “And I’m not blaming any single administration. Every administration has said it, and they’ve all been wrong about that. And it’s a terrible shame because it’s the things that are in the FCTC are the blueprint for reducing death and disease from from tobacco.”