Funding “independent” research is a long-standing tobacco industry strategy used to sow doubt, offer ineffective “solutions” to industry-caused problems, and legitimize industry efforts to engage in public health policymaking. [1-3] This research is often funded via third-parties, deliberately established to obscure tobacco industry involvement. [4] Results are then used to obstruct effective public health policy adoption and implementation, prevent or defend against litigation, and maximize tobacco consumption (and thereby increase industry profits). [5] These underhand tactics contribute to large-scale tobacco-caused death and disease that are entirely preventable.
Litigation against the tobacco industry in the US identified the malign influence of these efforts, forced the dissolution of major tobacco industry third-party funders of research and precluded participating companies from reconstituting similar industry wide organisations. [4] This, however, left a loophole for companies not directly involved in the litigation. Given the history of the tobacco industry utilizing “independent” research to undermine public health, Cohen et al. proposed criteria that would need to be met for a tobacco company to support research in a manner that might be acceptable to the research community; those criteria included transparency and an independent research agenda. [6]
For technical reasons Philip Morris International (PMI) was not party to that US litigation (although its parent company was), and in 2017 was therefore able to establish the Foundation for a Smoke-Free World (‘the Foundation’) with a stated goal of funding and conducting scientific research. [4] The Foundation’s President claimed that its Certificate of Incorporation and Bylaws embody Cohen et al’s. criteria and stated the Foundation was fully independent from its corporate sponsor. [7] However, public health experts including Cohen herself did not agree. [8]
Since then, mounting evidence has accumulated supporting the view that the Foundation has become even less independent and free from tobacco industry influence, but instead serves a key public relations (PR) function for PMI. [1]
In late September 2020, the pledge agreement between PMI and the Foundation was altered in a way that increases the opportunity for tobacco company involvement. The original agreement avowed the Foundation would be free from the “influence, whether direct or indirect, from or by: (a) Pledgor [PMI] or any of its affiliates, employees or agents.” In contrast, the updated agreement indicates the Foundation will be free from the “improper influence” [emphasis added] from these same parties. A new subsection added: “Nothing in this Section or elsewhere in this Pledge Agreement or Foundation’s Bylaws shall be interpreted to prohibit the Foundation from exchanging information or interacting with any third-party, including but not limited to the Pledgor [PMI], or other donors, in order to advance the Foundation’s Purpose.”
This updated agreement makes clear the Foundation is not independent. This lack of independence is supported further by other evidence including the apparent synchronisation of the Foundation and PMI’s lobbying activities. [9]
Now a lawsuit from a former employee alleges the Foundation is coordinating with the industry and “engaging in activities designed to increase the profits of and do the bidding of … the tobacco industry, namely Philip Morris International… and its former parent company, Altria Group, Inc.” Court documents also allege that the Foundation performs a PR role for the tobacco industry by promoting youth vaping. These allegations are consistent with existing evidence; the Foundation’s 2019 tax return revealed it spent almost one third of its $80 million budget on salaries, PR and legal fees. Of the grants it did make, many were for PR or advocacy, rather than scientific research. [10]
In response to these allegations, the Foundation filed a motion to dismiss on 5 May 2021. The Foundation alleges that the Plaintiff failed to state a viable claim under any of the laws she has relied on in her complaint. The case was settled out of court on 25 June 2021.
Allegations in the lawsuit add to the other evidence that the Foundation does not meet the Cohen et al. criteria, including the recent changes to the Foundation’s constitutive documents. Thus, the Foundation still does not represent a tobacco industry-supported funding model that should be acceptable to the research community.
While we cannot stop a tobacco company from setting up a foundation, we can choose not to enable it. The scientific and public health communities should reject funding from and any relationship with the Foundation for a Smoke-Free World. The evidence summarized above serves as an unambiguous call to join the hundreds of others who already have rejected PMI’s Foundation. [11] Not doing so opens the door for complicity with the tobacco industry and the suffering it perpetrates.
Joanna E. Cohen is director of the Institute for Global Tobacco Control (IGTC) in the Department of Health, Behavior and Society at the Johns Hopkins Bloomberg School of Public Health (JHSPH); she has written about the relationships between the tobacco industry and academia for over two decades.
Anna B Gilmore directs the Tobacco Control Research Group (TCRG) in the Department for Health at the University of Bath;
Tess Legg is a PhD student with the Tobacco Control Research Group (TCRG) in the Department for Health at the University of Bath
Louis Laurence is a researcher the Tobacco Control Research Group (TCRG) in the Department for Health at the University of Bath.
Thomas Eissenberg directs the Center for the Study of Tobacco Products in the Department of Health Psychology at Virginia Commonwealth University; his primary area of research is the behavioral pharmacology of drugs of abuse, focusing primarily on nicotine/tobacco.
Lauren Czaplicki is a faculty member of JHSPH based at IGTC; her research focusses on corporate influence on population health outcomes and the health policy development process
Connie Hoe is a faculty member in the Department of International Health at JHSPH; her work focuses on social determinants, including corporate influences, of noncommunicable diseases and injuries.
Competing interests: Anna Gilmore and her team have a particular interest in the commercial determinants of health including corporate influence on science and run the knowledge exchange platform www.tobaccotactics.org, which reports on the strategies and tactics the tobacco industry uses to undermine public health. Thomas Eissenberg is a paid consultant in litigation against the tobacco industry and also the electronic cigarette industry and is named on one patent for a device that measures the puffing behavior of electronic cigarette users and on another patent for a smartphone app that determines electronic cigarette device and liquid characteristics.
Funding: Joanna Cohen, Connie Hoe and Lauren Czaplicki are funded by a grant from Bloomberg Philanthropies’ Bloomberg Initiative to Reduce Tobacco Use. Tess Legg is funded by the South West Doctoral Training Partnership (SWDTP). Anna Gilmore and Louis Laurence acknowledge the support of Bloomberg Philanthropies’ Stopping Tobacco Organizations and Products funding (www.bloomberg.org).
The opinions expressed are those of the authors’ alone. Thomas Eissenberg’s research is supported by grant number U54DA036105 from the National Institute on Drug Abuse of the National Institutes of Health and the Center for Tobacco Products of the U.S. Food and Drug Administration. The funders had no role in the analysis, decision to publish, preparation or review of the manuscript. The content is solely the responsibility of the authors and does not necessarily represent the views of the funders.
References:
- Evans-Reeves K. Addiction at Any Cost. Philip Morris International Uncovered 2020 [Available from: https://exposetobacco.org/wp-content/uploads/STOP_Report_Addiction-At-Any-Cost.pdf.)
- Hoe C, Cohen JE, Weiger C. Industry interference: A proposed conceptual framework. Poster presentation at the Society for Research on Nicotine & Tobacco Annual Meeting. San Francisco, CA. February 20-23, 2019.
- Parascandola M. Hazardous effects of tobacco industry funding. J Epidemiol Comm Health 2003;57:548–9.
- Legg T, Legendre M, Gilmore AB. Paying lip service to publication ethics: scientific publishing practices and the Foundation for a Smoke-Free World. Tobacco Control [in press]
- Ulucanlar S, Fooks G, Gilmore A. The Policy Dystopia Model: An interpretive nalysis of tobacco industry political activity. PLoS Medicine 2016;13(9):e1002125.
- Cohen JE, Zeller M, Eissenberg T, Parascandola M, O’Keefe R, Planinac L, Leischow S. Criteria for evaluating tobacco control research funding programs and their application to models that include financial support from the tobacco industry. Tobacco Control 2009; 18(3):228-234.
- Yach D. Foundation for a Smoke-Free World. Lancet 2017;390:1807-10.
- Cohen JE, Eissenbeg T. Criteria Not Met for Tobacco Industry-Supported Foundation. December 17, 2009. https://www.jhsph.edu/research/centers-and-institutes/institute-for-global-tobacco-control/news-and-media/Releases/lancet-letter/
- Foundation for a Smoke-Free World. https://tobaccotactics.org/wiki/foundation-for-a-smoke-free-world/
- Stopping Tobacco Organizations and Products (STOP) 10 takeaways from the Foundation for a Smoke-Free World’s 2019 tax return https://exposetobacco.org/wp-content/uploads/FSFW_2019_Tax_Return.pdf
- https://www.jhsph.edu/about/dean-mackenzie/news-headlines/smoke-free-world.html; and, https://ggtc.world/wp-content/uploads/2019/12/List-of-organizations-rejecting-FSFW-funds_ff2_12182019-converted-1.pdf