The health case for a fossil fuel advertising ban

What are the health harms of using fossil fuels?

The burning of fossil fuels directly results in air pollution, which has been associated with many health consequences, particularly cardiovascular and respiratory disease exacerbations.8 Air pollution from fossil fuels is responsible for an estimated 1 in 7 premature deaths each year in Canada.1 Climate change, which is primarily caused by the burning of fossil fuels, contributes to further morbidity and mortality through food insecurity, infectious disease, and extreme weather events, disproportionately harming communities that have contributed the least to fossil fuel pollution.2^–4

The use of fossil fuels today, moreover, drives climate change both now and in the future, systematically contributing to cardiovascular, respiratory, infectious, and heat-related health burdens and mortality for future generations who have not consented to or participated in the use of fossil fuels, and cannot act to protect themselves against the harm.9

How do advertising and marketing promote the use of fossil fuels?

Companies that extract and sell fossil fuels have historically used advertising, public relations strategies, and the manufacturing of evidence to entrench the use of their products, influence scientific consensus, and hamper the implementation of health-protective policies that would curb the use of fossil fuels. Investigations have revealed that major oil companies were aware of climate change at least since the 1970s, with internal reports accurately predicting the scale and timing of global warming. Instead of disclosing this information, companies funded think tanks, public relations campaigns, and industry associations to cast doubt on climate science and emphasize uncertainty with the explicit goal of delaying regulatory action.10 Industry documents have revealed the explicit adoption of tactics that were used by tobacco companies to hamper policy-making, even hiring the same public relations firms and pursuing the strategic goal to reposition global warming as theory rather than fact.11^,12

The commercial determinants of health framework, defined as “systems, practices, and pathways through which commercial actors drive health and equity,” provides a critical lens for understanding how such corporate practices shape health outcomes and impede regulatory efforts.5^,13

Fossil fuel corporate practices operate through multiple channels: direct product promotion that shapes consumer preferences toward carbon-intensive choices, and through political messaging that determines whether health-protective climate policy is enacted.

For example, gas industry campaigns directly promote cooking with gas appliances while omitting evidence of increased asthma risk from indoor gas use.14^–16 Car advertisements associate high-emission vehicles with social status while ignoring the health impacts of emissions.

Industry advertising campaigns also explicitly target climate policy discussions, using sophisticated messaging to undermine public support for carbon pricing and regulatory frameworks. For example, one study found that the Pathways Alliance, a coalition of Canadian oil sands companies, used advertising to undermine climate pricing policies in Canada.17 Evidence also exists that spending on fossil fuel advertising spikes ahead of elections and major policy debates, mirroring tobacco industry tactics for legislative manipulation.18 Such campaigns operate through democratic discourse rather than consumer markets, suggesting that advertising restrictions should be evaluated for their political influence in addition to their commercial effects.19

What precedents exist for action to ban the advertising of harmful products?

What might bans on fossil fuel advertising look like?

Proposed bans on fossil fuel advertising vary considerably in scope and may target different industry segments. Company-level restrictions can target fossil fuel producers (oil, gas, and coal companies) by prohibiting advertising that promotes fossil fuel consumption — such as product advertising for gas utilities — as well as institutional corporate messaging. Restrictions on institutional or advocacy advertising aim to address industry political interference and greenwashing campaigns that distort public discourse about climate policy. Greenwashing refers to communication that misleads people into forming overly positive beliefs about an organization’s environmental practices.31

Product-level restrictions extend to high-carbon products, including gas-powered vehicles, aviation, and fossil fuel–burning appliances.32^,33 These product-focused restrictions more closely resemble tobacco advertising bans in their consumer-facing approach and may produce more direct consumption effects, particularly where genuine alternatives exist and consumer choice meaningfully influences demand patterns.

Is drawing parallels between bans on tobacco and fossil fuel advertising useful?

Fundamental differences between tobacco and fossil fuels exist that are noteworthy and may limit the ability to draw direct parallels. Unlike tobacco, fossil fuels are not directly addictive in a pharmacological sense. Tobacco is a product that nobody needs for survival, whereas fossil fuels are currently used to supply energy for transportation, heating, and electricity in many communities globally.

Targeting tobacco cessation by curtailing marketing is an intervention that may have immediate personal health benefits for individual users.20^,21 Fossil fuel consumption is shaped not only by individual choice but by structural systems, including energy grids, public infrastructure, and government subsidies, making individual demand less malleable through advertising restrictions alone. Public health messaging that ignores these distinctions risks undermining credibility and must acknowledge the complex role of fossil fuels in society today.

The temporal and geographic displacement of health impacts and intergenerational harm of fossil fuels is also unprecedented in contexts of tobacco control. Policies that promote the burning of fossil fuels for energy primarily endanger others rather than fossil fuel users, mirroring the distributive justice implications of the marketing of firearms and heightening the moral imperative for action.

Despite these differences, instructive similarities remain between the tobacco and fossil fuel industries. Both have invested heavily in public relations messaging strategies designed to undermine science and policy and to shape public perception and delay health-protective regulation.12 Both have knowingly contributed to preventable disease and death through their health-harming products. Both sectors deploy commercial strategies that prioritize profit over population health through systematic interference with scientific discourse and policy development.34

Which jurisdictions have already instituted bans on fossil fuel advertising?

France has implemented comprehensive restrictions on coal, oil, and gas advertising,35 and more than 40 cities worldwide, including Amsterdam and The Hague in the Netherlands and Edinburgh in Scotland, have policies banning advertising for fossil fuel products, as well as other high-emission products, such as vehicles and aircraft. 36 These emerging policy precedents demonstrate legal and practical feasibility.37 Courts in The Hague upheld municipal bans on fossil fuel advertising on the grounds that they protect public health and democratic discourse from corporate interference.38

Other jurisdictions are looking to follow these examples. The Spanish government’s new sustainable consumption law proposed banning advertising for both fuels and gas-powered vehicles, and the UK parliament recently debated such a ban.39 In Canada, an Act Respecting Fossil Fuel Advertising (Bill C-372) was tabled as a private member’s bill in 2024 with more than 30 health organizations representing half a million health workers in support.40 Montréal’s transit network, Toronto, and Ottawa have all considered or put in place restrictions on fossil fuel advertising.41

Could eliminating fossil fuel advertising lead to health gains?

Direct evidence linking restrictions on fossil fuel advertising to population health outcomes is not yet available. Evaluation frameworks will be essential and should include intermediate outcomes (e.g., advertising exposure, product sales and uptake, patterns of energy use, and policy outcomes) as well as longer-term health indicators. Restrictions on fossil fuel advertising may plausibly improve health through 2 pathways: (1) shorter-term demand-mediated effects that reduce fossil fuel combustion; and (2) longer-term, potentially transformative effects via norm change and reduced industry political interference. The latter are more difficult to estimate or model using conventional epidemiologic approaches.

What are the challenges to consider?

Despite potential benefits, restrictions on fossil fuel marketing face important challenges. As with the tobacco industry, it may be difficult to enforce advertising bans online, and industries often adapt through indirect marketing channels, sponsorships, and the funding of third-party advocacy groups, all of which may limit effectiveness of advertising bans.

Most critically, advertising restrictions cannot address the fundamental infrastructure and economic factors that drive fossil fuel consumption. Energy system transitions require massive capital investments, regulatory frameworks, and technological developments that operate independently of advertising influences. Advertising bans may contribute to political conditions necessary for such transitions but cannot substitute for comprehensive energy and climate policies.

Despite these challenges, restrictions on fossil fuel advertising merit serious consideration as part of comprehensive climate policy that can affect human health. Norm-shaping represents a legitimate health intervention when harmful social norms impede policy implementation necessary for the protection of population health. Research indicates that approximately 60% of emission reductions needed to limit warming to 1.5°C could come from demand-side measures,48 including behavioural shifts enabled by changes to social norms and supportive policy environments.

How can health care professionals help?

Health professionals have historically played important roles in campaigns to regulate advertising for tobacco, alcohol, and unhealthy foods. Physicians for a Smoke-Free Canada led the call for comprehensive tobacco control, first calling for a tobacco advertising ban in a CMAJ editorial in 1991.49 The credibility of health professionals as trusted communicators positions them uniquely to support restrictions on fossil fuel advertising as population health measures.50 The commercial determinants of health framework legitimizes this engagement by recognizing how fossil fuel companies influence both consumer behaviour and political decisions affecting health at scale.5

Effective engagement can take many forms: clinical leadership within health systems to reduce fossil fuel industry sponsorship and promotion, public education and media engagement to raise awareness about fossil fuel health impacts,51^–53 and advocacy through professional associations to support policy development.54^,55

Crucially, health professionals should know and communicate the many health co-benefits of reduced fossil fuel use and, by extension, the potential impacts of restrictions on fossil fuel advertising: improved air quality, reduced disease burden, and greater health equity.56^,57 This framing aligns with regulatory precedents in jurisdictions where advertising restrictions already exist for tobacco, alcohol, infant formula, cannabis, gambling, and unhealthy food products, positioning restrictions on fossil fuel advertising within established public health frameworks.

Acknowledgements

The authors acknowledge the contributions of Nabha Shetty and Valerie Palda.

Footnotes

• Competing interests: Samantha Green reports honoraria from The Ottawa Hospital and Ontario College of Family Physicians, and is a board member for the Canadian Association of Physicians for the Environment (CAPE). Leah Temper is an employee of CAPE; as director of the Health and Economic Policy Program, Dr. Temper leads the Fossil Fuel Ads Make Us Sick campaign. No other competing interests were declared.

• This article has been peer reviewed.

• Contributors: Samantha Green and Leah Temper contributed to the conception and drafting of the manuscript, gave final approval of the version to be published, and agreed to be accountable for all aspects of the work.

• Generative AI disclosure: During the preparation of this work, the authors used the AI tool Claude for copyediting. After using this tool, the authors reviewed and edited the content as needed and take full responsibility for the content of the publication.

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY-NC-ND 4.0) licence, which permits use, distribution and reproduction in any medium, provided that the original publication is properly cited, the use is noncommercial (i.e., research or educational use), and no modifications or adaptations are made. See: https://creativecommons.org/licenses/by-nc-nd/4.0/