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Chronic diseases including cancer, diabetes, neurocognitive disorders and infertility are rising globally, with health-harming products such as fossil fuels, tobacco, ultra‑processed foods, toxic chemicals, plastics and alcohol being major contributors, say the authors of a new paper published in New England Journal of Medicine (NEJM).

The authors include proposed solutions, including policy safeguards and a stronger research focus on the risks to health connected with corporate activity.

This is the first time the NEJM has published a paper which recognises corporations that manufacture and market health-harming products as primary vectors of non-communicable disease.

Corporate drivers of chronic disease

“The global increase in certain chronic diseases is startling,” said lead author Dr Nicholas Chartres, researcher from ������’s Faculty of Medicine and Health and scientific lead to the Center to End Corporate Harm at the UC San Francisco.

“Increases in health-harming products mirror the rise in certain chronic diseases to a disturbing extent. Chronic diseases now account for 74 percent of deaths around the world.”

Globally, five commercial products are key factors in 31 percent of all deaths each year:

• Fossil fuels contribute to 8.1 million deaths
• Tobacco contributes to 7.2 million deaths
• Ultra-processed foods contribute to 2.3 million deaths
• Chemicals (manufactured chemicals used in commerce and pesticides) contribute to 1.8 million deaths
• Alcohol contributes to 1.8 million deaths

“To protect our health, it is critical to analyse and understand these corporate drivers of disease and how to curb their influence,” Dr Chartres said.

Lessons from tobacco industry reform

Industry documents have shown that tobacco-company executives knew for decades that smoking caused cancer and that nicotine was addictive yet concealed this information from the public.

“�����𲹰�������on the tobacco industry provides a blueprint for identifying and counteracting other corporate influences on health,” said Dr Chartres.

“In the United States, tobacco research led to sweeping policy changes including local tobacco bans, national and state tax increases, state and local smoke-free policies, and a federal investigation of the industry.

“A significant drop in smoking occurred in high-income countries once the tobacco industry's lies about the safety of their products was exposed, alongside the rollout of major anti-smoking campaigns. It is estimated that more than 37 million lives have been saved to date. 

“Clinicians, the public, media and policymakers need to understand that these health harming industries all apply the same set of tactics used by ‘Big Tobacco’ to create uncertainty about the harms of their products, delay regulation and therefore continue to profit from their sale - while we increasingly become sick from consuming them and ultimately pay the price with our health. 

“We must regulate these products like we have with tobacco,” he said.

Co-author of the paper Tracey J. Woodruff, co-founder of the Center to End Corporate Harm, said: “A clear solution to corporate drivers of disease is to enact similar restrictions on policy influence for all health-harming industries.”

Proposed solutions

Dr Chartres added: “In the paper we propose solutions to safeguard policy from corporate influence, such as rules that prohibit health-harming industries from engaging in policy via a global treaty, which would be similar to the tobacco treaty; databases that track and expose industry payments to scientists and policymakers; and governments prohibiting financial ties between industry and researchers.

“We believe that the medical and health fields should prioritise research on, and communication about, risks to health associated with corporate activity.”

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Chartres, N. et al, ‘Corporations as Vectors of Noncommunicable Disease: Using Internal Industry Documents to Identify Preventive Strategies’ (NEJM, 2026)

DOI: 10.1056/NEJMms2507028