This position paper was commissioned by PETRA to look at how the health-harming industries use international trade and investment law. The authors look in particular at the Investor-State Dispute System (ISDS) as well as the emergence of regulatory cooperation which allows the monitoring of domestic legislation when it is proposed rather than after its adoption. Such provisions enable tobacco and alcohol companies to either veto or dilute proposed health measures. The authors also consider the potential impact of the change in the international trade system as a result of the 2020 US elections.