Ruth E. Malone, Simon Chapman, Prakash C. Gupta, Rima Nakkash, Tih Ntiabang, Eduardo Bianco, Yussuf Saloojee, Prakit Vathesatogkit, Laurent Huber, Chris Bostic, Pascal Diethelm, Cynthia Callard, Neil Collishaw, Anna B. Gilmore
The surprise announcement by the former head of the World Health Organization’s Tobacco Free Initiative, Derek Yach, that he would head a newly-established organization called the “Foundation for a Smoke-free World” to “accelerate the end of smoking” was met with gut-punched disappointment by those who have worked for decades to achieve that goal. Unmoved by a soft-focus video featuring Yach looking pensively off into the distance from a high-level balcony while smokers at ground level stubbed out Marlboros and discussed how hard it was to quit, leading tobacco control organizations were shocked to hear that the new organization was funded with a $1 billion, twelve-year commitment from tobacco company Philip Morris International (PMI). PMI, which has been working for decades to rebrand itself as a “socially responsible” company while continuing to promote sales of its top-branded Marlboro cigarettes and oppose policies that would genuinely reduce their use, clearly believes this investment will further its “harm reduction” agenda, led by its new heat-not-burn product, IQOS. But don’t worry, the Foundation assures everyone that “PMI and the tobacco industry are precluded from having any influence over how the Foundation spends its funds or focuses its activities.”
Except that is what a broad range of industry front groups, sometimes headed by respected and even well-intentioned leaders, have been saying since the “Frank Statement” of 1954. The long and sordid history of the industry’s funding of “research,” a major part of the mission of this new foundation, is replete with exactly this sort of blithe reassurance, as Yach himself pointed out in an earlier time. In reality, nothing has changed. The “research” really isn’t the point anyway. The mere fact of having landed Yach is a major public relations coup for PMI that will be used to do more of what the industry always does: create doubt, contribute further to existing disputes within the global tobacco control movement, shore up its own competitive position, and go on pushing its cigarettes as long as it possibly can.
In the video, Yach invites “everyone” to join the “movement” this new organization is starting – implicitly dismissing the past 40 years of tobacco control activism and advocacy and 60 years of tobacco industry lies and duplicity. Leaders of active existing civil society coalitions like the Framework Convention Alliance and the Noncommunicable Disease Alliance were blindsided. Contrary to the video’s claim, there is no shortage of “fresh thinking” in the already-vibrant, already-existing global movement to end the tobacco epidemic. There are many great “endgame”-furthering ideas now being actively debated, studied, and tried out: the primary obstacle to implementing them is the tobacco industry.
PMI hasn’t stopped opposing the policies that would reduce tobacco use, has it? No: recently leaked documents show that PMI continues to actively oppose any policy that could genuinely reduce tobacco use. Countries around the world identify the tobacco industry as the single biggest barrier to progress in implementing such tobacco control policies. This “new” initiative is just more of the same lipstick on the industry pig, but in a way it’s far worse this time: by using a formerly high profile WHO leader as a spokesperson, PMI can also accelerate its longstanding ambition to splinter the tobacco control movement.
It’s also not true, as the video suggests, that tobacco control efforts have “plateaued.” Cigarette consumption is declining and since 2003, more than 180 countries have become parties to the World Health Organization Framework Convention on Tobacco Control (FCTC), committing themselves to implement effective policy measures and building public support for ending the epidemic. PMI knows this, hence its ongoing, covert and overt efforts to stymie the FCTC. For example, at the last Conference of the Parties, the meetings where implementation of the treaty is discussed, tobacco farmers organized by PMI demonstrated outside the venue and PMI representatives met secretly with delegates to the meeting.
The company hasn’t announced it is going to stop promoting cigarettes to kids in Africa and Asia, has it? No: in fact, it’s developing “stronger” products for some markets, and continuing to aggressively promote Marlboro cigarettes to the young through campaigns like “Be Marlboro”(see also here and here). Despite decades of developing and then abandoning so-called “reduced harm” products, cigarettes remain PMI’s biggest moneymaker, dwarfing anything else. Only the profoundly naïve will believe that PMI is not solely promoting its self-interest in supporting this new “foundation”.
In fact, the announcement came the day after a huge win for tobacco control: the exclusion of tobacco companies (as well as makers of cluster bombs and some other unsavory actors) from membership in the United Nations Global Compact, due to their incompatibility with responsible business principles. Tobacco control leaders across the globe are convincing governments to protect health policymaking from tobacco industry influence, in line with Article 5.3 of the FCTC. PMI’s response is a new industry sponsored entity, eager to work with governments. From its inception, this organization will constitute a challenge for Article 5.3 implementation.
The timing of the announcement was interesting in another way: just the day before, a new global health initiative led by former US Centers for Disease Control head Tom Frieden was announced, with $225 million in funding from Bloomberg Philanthropies, the Chan Zuckerberg Initiative and the Bill & Melinda Gates Foundation. While this initiative does not focus solely on tobacco, these funders know how much tobacco contributes to disease and death worldwide. They are also funders who have unequivocally taken positions supporting the strong policy measures that work.
What is required to end smoking isn’t helping the world’s leading cigarette manufacturer in its ongoing image makeover while it continues to try to derail the significant public health progress made to date. What is required is leaders who have the humility to work with the movement and policymakers with the backbones of steel needed to stand up to the industry to enact and implement strong tobacco control measures, including high taxes, smokefree laws, effective media campaigns to denormalize both smoking and tobacco companies, and marketing, packaging and retailing regulations to make these deadly products less ubiquitous. The global movement public health activists built over decades of toiling in the trenches must stand together and not allow PMI to buy more time by executing a 21st century version of the “Frank Statement.”
The authors would like to thank Elizabeth Smith and Patricia McDaniel for their input to this article.