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Conflicts of Interest

Towards a smoke-free world? Philip Morris International’s new Foundation is not credible

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Tobacco control: a Foundation too far?

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Commentary on the launch of the Foundation for a Smoke-Free World

September 2017 saw the launch of the Foundation for a Smoke-Free World, which describes itself as “an independent, non-profit organization created to accelerate global efforts to reduce health impacts and deaths from smoking, with the goal of ultimately eliminating smoking worldwide”.

http://blogs.bmj.com/tc/2017/10/13/commentary-on-the-launch-of-the-foundation-for-a-smoke-free-world/

The creation of such an organization would usually be a matter for celebration among the tobacco control community and especially for the WHO Framework Convention on Tobacco Control (WHO FCTC), the United Nations tobacco control treaty, whose Secretariat I lead.

And yet this is not good news. The Foundation is currently 100% funded by Philip Morris International (PMI). The company has already pledged around US$1 billion for the period of 12 years or around US$80 million a year. To put that in context, this is more than eight times greater than the entire WHO FCTC annual budget.

The Foundation claims that its funding source doesn’t matter, since its bylaws prohibit tobacco industry interference, and safeguard against conflicts of interest, thereby guaranteeing its independence. We are asked to believe that this industry-funded organization will simply ignore the commercial interests of its paymaster. We are asked to believe this where the organization is established to work on specific issues of interest to PMI, where that work may promote other products that contain nicotine and have the ability to sustain addiction, and where the paymaster can decide not to continue funding the organization from one year to another. How can masters of this Foundation that claim to be independent be unaware of PMI’s lobbying strategies, and ensure that their Foundation is not inadvertently supporting bad public health policy?

The establishment of the Foundation ties into a broader PMI strategy to ensure that there is little or no regulation on new tobacco products PMI is producing. It also fits into the tobacco industry’s corporate social responsibility schemes. Such projects are designed to mislead or confuse public opinion. They are the anti-truth.

How do we know? Reams of research and legal documents on tobacco industry behaviour confirm that the Foundation’s public statements fit seamlessly into the tobacco industry’s strategy, which is to sell new products while continuing to sell cigarettes. Over decades, tobacco industry dollars have funded influence buying, covert activities and scientific misrepresentation. Industry money has never advanced the cause of public health, as is made clear in excruciating detail by the millions of tobacco industry documents. These reveal, for example, that firms have “sought to influence debate by buying up scientists on a spectacular scale.”

PMI recently rejected an appeal from 120 Organisations asking it to halt the production of cigarettes. To make it plain, if the company were serious about making the world smoke-free they should immediately stop fighting, in several countries, tobacco control measures to implement the Framework Convention.

This Foundation fits within a broader strategy of PMI attempting to present itself as a “stakeholder” in tobacco control. Some examples of these initiatives include PMI Impact,which claims to counter the illicit trade in tobacco products but in fact serves to slow and disrupt the entry into force of the Protocol to Eliminate Illicit Trade in Tobacco Products. Another tobacco industry initiative, which PMI co-funds, is the Eliminating Child Labour in Tobacco Growing Foundation (ECLT). With little impact on reducing child labour on tobacco in low and middle income countries, this Foundation detracts from implementation of Article 17 of the WHO FCTC, which calls upon governments to support tobacco workers and growers to switch to alternative sustainable livelihoods.

Taken as a whole, the tobacco industry’s corporate social responsibility programmes are an abomination, which seek to give the impression of action on important issues, while boosting its own profits and hiding its own role in creating problems.

Parties to the WHO FCTC have pledged, through Article 5.3 of the treaty, to resist tobacco industry interference. In a 2016 ruling against the tobacco industry, a senior English judge accurately summarised this key Article and its Guidelines : “[T]he tobacco industry should be treated as having adopted a deliberate policy of subverting public health policy through, inter alia, the deployment of its substantial capital and organisational resources to generate evidence designed to contradict the established policy consensus… that this evidence is unreliable, i.e. false.”

WHO FCTC Parties should therefore adopt legislation or rules to implement Article 5.3 and ensure they do not promote, participate in or endorse tobacco industry involvement, directly or through these “foundations”, in initiatives related to tobacco control. No government and no reputable academic, research or public health organisation should partner with PMI’s new foundation.

It is already clear that this tobacco industry-funded Foundation fits a long-established and sinister pattern of corporate chicanery. The industry’s aim, after all, is not to help its customers but to profit from them.

The tobacco industry’s new “partnerships” with supposedly independent organizations do constitute a serious threat, but we have a response to hand.

It’s called the WHO FCTC, and it’s the true foundation for a smoke-free world.

Dr Da Costa e Silva is the Head of the WHO FCTC Secretariat.

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WHO Statement on Philip Morris funded Foundation for a Smoke-Free World

WHO statement http://www.who.int/mediacentre/news/statements/2017/philip-morris-foundation/en/

28 September 2017

On 13 September 2017, tobacco company Philip Morris International (PMI) announced its support for the establishment of a new entity – the Foundation for a Smoke-Free World. PMI indicated that it expects to support the Foundation by contributing approximately USD 80 million annually over the next 12 years.

The UN General Assembly has recognized a “fundamental conflict of interest between the tobacco industry and public health.” (1) WHO Member States have stated that “WHO does not engage with the tobacco industry or non-State actors that work to further the interests of the tobacco industry”, (2) the Organization will therefore not engage with this new Foundation.

Article 5.3 of the WHO Framework Convention on Tobacco Control (WHO FCTC) obliges Parties to act to protect public health policies from commercial and other vested interests of the tobacco industry in accordance with national law. Guidelines for implementation of Article 5.3 state clearly that governments should limit interactions with the tobacco industry and avoid partnership. These Guidelines are also explicit that Governments should not accept financial or other contributions from the tobacco industry or those working to further its interests, such as this Foundation.

Strengthening implementation of the WHO FCTC for all tobacco products remains the most effective approach to tobacco control. Policies such as tobacco taxes, graphic warning labels, comprehensive bans on advertising, promotion and sponsorship, and offering help to quit tobacco use have been proven to reduce demand for tobacco products. These policies focus not just on helping existing users to quit, but on preventing initiation.

If PMI were truly committed to a smoke-free world, the company would support these policies. Instead, PMI opposes them. PMI engages in large scale lobbying and prolonged and expensive litigation against evidence-based tobacco control policies such as those found in the WHO FCTC and WHO’s MPOWER tobacco control, which assists in implementation of the WHO FCTC. For example, just last year PMI lost a six year investment treaty arbitration with Uruguay, in which the company spent approximately US$ 24 million to oppose large graphic health warnings and a ban on misleading packaging in a country with fewer than four million inhabitants.

There are many unanswered questions about tobacco harm reduction (3), but the research needed to answer these questions should not be funded by tobacco companies.

The tobacco industry and its front groups have misled the public about the risks associated with other tobacco products. This includes promoting so-called light and mild tobacco products as an alternative to quitting, while being fully aware that those products were not less harmful to health. Such misleading conduct continues today with companies, including PMI, marketing tobacco products in ways that misleadingly suggest that some tobacco products are less harmful than others.

This decades-long history means that research and advocacy funded by tobacco companies and their front groups cannot be accepted at face value. When it comes to the Foundation for a Smoke-Free World, there are a number of clear conflicts of interest involved with a tobacco company funding a purported health foundation, particularly if it promotes sale of tobacco and other products found in that company’s brand portfolio. WHO will not partner with the Foundation. Governments should not partner with the Foundation and the public health community should follow this lead.

WHO tells governments to reject Philip Morris-funded smoking foundation

The World Health Organization told governments on Thursday not to get involved in a foundation funded by tobacco firm Philip Morris International to look at ways of reducing the harm from smoking.

http://www.reuters.com/article/us-health-tobacco/who-tells-governments-to-reject-philip-morris-funded-smoking-foundation-idUSKCN1C31X4

The U.N. health body said there was a conflict of interest in a tobacco firm funding such research – drawing a sharp rebuke from the Foundation’s head who said his work was independent.

Philip Morris International said this month it wanted to help set up a body called the Foundation for a Smoke-Free World and planned to give it about $80 million a year for 12 years to keep it running.

The company did not immediately respond to a request for a comment on the WHO’s statement.

The U.N. body said on Thursday there were already proven techniques to tackle smoking – including tobacco taxes, graphic warning labels and advertising bans – which the tobacco industry had opposed in the past.

“WHO will not partner with the Foundation. Governments should not partner with the Foundation and the public health community should follow this lead,” it said.

The foundation’s founder and president-designate, Derek Yach, a former senior official at the WHO, said more collaboration, not less, was needed to win the war on smoking.

“I am deeply disappointed, therefore, by WHO’s complete mischaracterisation of the nature, structure and intent of the Foundation in its recent statements – and especially by its admonition to others not to work together.”

He said the foundation was a non-profit organization with strict rules to insulate it from the influence of the tobacco industry, and its research agenda would be subject to peer review.

Reporting by Tom Miles; Editing by Toby Chopra and Andrew Heavens

Tobacco giant wants to eliminate smoking . . .

. . . and pigs might fly

http://www.bmj.com/content/358/bmj.j4443

The Foundation for a Smoke-Free World, an “independent” research funding body fully funded by Philip Morris, launched on 13 September.1 It will provide $960m (£711m; €808m) over 12 years to help “eliminate smoking worldwide.” No benchmarks for this modest task have apparently yet been announced. This largesse is a mere $80m a year from a company with global revenue in 2016 of $26.7bn2 and a marketing budget (in 2012) of $7bn intended overwhelmingly to promote smoking.3

Harm reduction

The long, deceptive, and failed history of tobacco harm reduction has seen filters (including crocidolite asbestos); misleading “reduced carcinogen” brands; and a wide range of breathlessly announced innovations.4 Each of these had their academic touts. None reduced harms from smoking, and the “lights” and “milds” reduced risk fiasco5 arguably kept many smoking who may have otherwise quit. Electronic vaporisers, with their growing consumer acceptability, may turn out to be the real deal. But with less than a decade of widespread use, any verdict on their status as much less dangerous may be decades premature.

The vaporised nicotine industry, including Big Tobacco, is now focused on how it can break down potent regulatory controls on vaporised products and assure consumers about safety.

“Buying scientists”

In the past, Philip Morris has publicised seductive research funding and courted prominent scientists, including US epidemiologist Ernst Wynder, the first proponent of tobacco harm reduction.6 The new foundation’s director, Derek Yach, former leader of the World Health Organization’s tobacco control programme, is acutely aware of why it does this, having written powerfully in 2001 about the industry “buying scientists” to serve commercial objectives and help thwart effective tobacco control.7

Will this be a modern Faustian tale, as many expect, or will Yach have the success with Philip Morris that he heroically failed to experience in trying to turn Pepsi into a health oriented company for six of his post-WHO years?8 Doubtless he will have a predictable coterie of supplicants for the foundation’s money. But the breathtaking arrogance of Philip Morris and Yach shunning WHO’s article 5.3 on industry interference in the Framework Convention on Tobacco Control9 supported by 180 nations will surely steel the resolve of thousands of researchers to continue to shun money obtained from tobacco sales with its unavoidable ethical problems. Nearly 120 health organisations have now called on the company instead to simply stop selling cigarettes,10 what Philip Morris (USA)’s website describes as its “core product.” This is, of course, thoroughly naive, because shareholders would prevent any serious attack on the company’s profitability to which cigarettes are central. Euromonitor estimates that the 2016 global market for combustible tobacco was $736bn while that for e-cigarettes was $12bn.11

If Philip Morris really wanted smoking rates to decline it could announce tomorrow that it will voluntarily introduce large graphic health warnings and plain packaging on all its tobacco products. We know, from countries where it has been forced to do this, that this could happen within 12 months.12 Knowing the impact of price on sales, it could massively increase its wholesale prices to retailers. It could stop all its tobacco advertising and sales promotions.

But Philip Morris and other tobacco companies have done nothing voluntary to embrace any policy that would accelerate the decline in smoking in populations. So they will do none of this and instead continue to reward staff who increase tobacco sales.

Importantly, Philip Morris has legally attacked potent tobacco control policies like graphic health warnings and plain packaging.13 The tobacco industry has armies of lobbyists whose goals are to defeat, dilute, and delay any policy or initiative that threatens its cash cow.

“Useful idiots”?

So will Yach actively join the world tobacco control community in attacking such activities or will he be historically numbered among prominent “useful idiots,” as Lenin might have called them,14 formerly working in tobacco control, who now attend global tobacco industry meetings to cheer on their tobacco host’s “game changing” while doing nothing about this industrial vector’s daily efforts to promote smoking?

Disturbingly, the main task for tobacco control is now increasingly framed by such quislings as convincing smokers to switch to vaporised products, not preventing and quitting smoking. Some even talk of vaping by children as being “protective” against future smoking.15

Just as car manufacturers now producing electric motor vehicles have not abandoned the production and sales promotion of fossil fuel powered cars, no tobacco company would do the equivalent with its combustible tobacco products. But progressive governments like France, Germany, India, and Norway have set dates after which the sales of new fossil fuel powered vehicles will be banned. Many more will follow.

Over many decades, governments have acted to ban a huge range of unsafe, deadly products (thalidomide, asbestos, chlorofluorocarbons, countless unsafe consumer goods), and exploitative practices (slavery, people trafficking, child labour). With tobacco companies now embracing the rhetoric of the end of smoking, it is time for governments to take the industry at its word and set those dates when combustible tobacco products will be banned.

Footnotes

• Provenance: Commissioned, not peer reviewed.
• Competing interests: None declared.
References
1. ↵
Foundation for a Smoke-Free World. Global foundation launched to accelerate an end to smoking. 13 September 2017. www.smoke-freeworld.org/newsroom/global-foundation-launches-accelerate-end-smoking.
2. ↵
Philip Morris International. Dear shareholder. 2017. http://media.corporate-ir.net/media_files/IROL/14/146476/AR_2017/index.html#letter.
3. ↵
Corporate Accountability International. New report: Philip Morris International global marketing campaign targets teens, violating the law. 2014. www.stopcorporateabuse.org/press-release/new-report-philip-morris-international-global-marketing-campaign-targets-teens.
4. ↵
Parascandola M. Lessons from the history of tobacco harm reduction: The National Cancer Institute’s Smoking and Health Program and the “less hazardous cigarette”. Nicotine Tob Res2005;358:779-89. doi:10.1080/14622200500262584 pmid:16191749.
5. ↵
Wilson N, Weerasekera D, Peace J, Edwards R, Thomson G, Devlin M. Misperceptions of “light” cigarettes abound: national survey data. BMC Public Health2009;358:126. doi:10.1186/1471-2458-9-126 pmid:19426502.
6. ↵
Fields N, Chapman S. Chasing Ernst L Wynder: 40 years of Philip Morris’ efforts to influence a leading scientist. J Epidemiol Community Health2003;358:571-8. doi:10.1136/jech.57.8.571 pmid:12883059.
7. ↵
Yach D, Bialous SA. Junking science to promote tobacco. Am J Public Health2001;358:1745-8. doi:10.2105/AJPH.91.11.1745 pmid:11684592.
8. ↵
Charles D. How one man tried to slim down Big Soda from the inside. National Public Radio 2013. www.npr.org/sections/thesalt/2013/01/28/169733003/how-one-man-tried-to-slim-down-big-soda-from-the-inside.
9. ↵
Bialous S, Chapman S, Freeman B, Shatenstein S. Tobacco industry interference with tobacco control. World Health Organization. WHO Tobacco Free Initiative. Conference of the Parties to the WHO Framework Convention on Tobacco Control, 2008. www.who.int/tobacco/resources/publications/Tobacco%20Industry%20Interference-FINAL.pdf.
10. ↵
Unfairtobacco. Open letter from 115 groups to PMI. 2017. www.unfairtobacco.org/en/open-letter-quitpmi.
11. ↵
He E, Felstead A. Big Tobacco has a death wish. Bloomberg Gadfly. 2017. www.bloomberg.com/gadfly/articles/2017-09-20/philip-morris-and-the-slow-death-of-smoking.
12. ↵
Chapman S, Freeman B. Removing the emperor’s clothes. Plain tobacco packaging in Australia. Sydney. Sydney University Press 2016 p92. https://ses.library.usyd.edu.au//bitstream/2123/12257/7/9781743324295_Chapman_RemovingtheEmperorsClothes_FT.pdf.
13. ↵
Gartrell A. Philip Morris ordered to pay millions in costs for plain packaging case. Sydney Morning Herald. 2017; July 9. www.smh.com.au/federal-politics/political-news/philip-morris-ordered-to-pay-australia-millions-in-costs-for-plain-packaging-case-20170709-gx7mv5.html.
14. ↵
Wikipedia. Useful idiot. https://en.wikipedia.org/wiki/Useful_idiot.
15. ↵
Current opinions on teen vaping run the gamut from harmful to protective. http://youthandsocialissues.com/e-cigarette-use-as-a-predictor-of-cigarette-smoking.