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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.

Global tobacco giant Philip Morris commits to a ‘smoke-free’ future in Australia

TOBACCO giant Philip Morris will on Thursday commit to a “smoke-free” Australia in a push to legalise reduced-risk alternatives to replace cigarettes.

http://www.heraldsun.com.au/news/global-tobacco-giant-philip-morris-commits-to-a-smokefree-future-in-australia/news-story/110c8a659e56980e5b6aa16c9c9fe19c

The company will tell a federal parliamentary inquiry on electronic cigarettes that technology has rapidly transformed its business away from cigarettes in favour of smoke-free alternatives.

E-cigarettes containing nicotine are not regulated as therapeutic goods in Australia and cannot be legally imported for personal use.

Australian medicines regulator the Therapeutic Goods Administration does not support the use of electronic cigarettes.

Philip Morris scientific affairs fellow Maurice Smith said every level of the global company was committed to “transitioning away” from cigarettes “as soon as possible” — a process it has already begun in 30 countries.

Mr Smith will tell the hearing in Melbourne that more than three million smokers worldwide — and more than 8000 smokers a day — had switched to Philip Morris’s IQOS, which heats tobacco rather than burning it.

He said the rapid consumer acceptance had made it possible for cigarette smoking to become obsolete.

The product has already captured 10 per cent of its worldwide market.

“Ironically, although many share our vision of a smoke-free Australia, the law in Australia, unique in the world, requires that all tobacco products must be smoked,” Mr Smith said.

While the Council of Australia has conceded e-cigarettes are “probably less harmful to health” than traditional cigarettes, it says and the short- and long-term health effects are not yet known.

It says claims e-cigarettes can help people quit smoking are “unsubstantiated” and unfair to consumers.

Chairman of the parliamentary Standing Committee for Health, Aged Care and Sport Trent Zimmerman, said it was important for politicians to query the implications of the growing body of research on the health impacts of e-cigarettes.

Phillip Morris has pledged $US80 million a year until 2030 to develop alternative measures to reduce the harm caused by smoking.

The research is headed by former World Health Organisation cabinet director, Dr Derek Yach.

rob.harris@news.com.au

Big tobacco’s push to legalise e-cigarettes needs to be quashed immediately

If Philip Morris truly believed it’s push to legalise e-cigarettes containing nicotine in this country had merit it would be making its case publicly and under its own name.

http://www.canberratimes.com.au/comment/ct-editorial/big-tobaccos-push-to-legalise-ecigarettes-needs-to-be-quashed-immediately-20170713-gxaow8.html

The fact the tobacco giant is using its catspaw smokers’ rights lobby group “I Deserve To Be Heard” to lend the argument the dubious legitimacy of contrived popular support is, in itself, a good reason for the Federal Government to refuse to give this matter any oxygen.

Another is that in the almost 500 years since Spanish merchants introduced tobacco to Europe from the New World big tobacco’s track record of advocating anything in the public interest has been appalling.

It’s a pretty good bet, just on the historical record, that if Philip Morris thinks it would benefit from the legalisation of e-cigarettes there’s likely some sort of downside for the broader society.

Despite the handsome revenues governments rake in from the taxes, levies and charges imposed on what is arguably the most deadly mass consumption product available for public sale, the industry, and its users, always come out ahead.

The costs to other taxpayers from picking up the burden of additional healthcare and lost productivity arising from the chronic illnesses and early deaths caused by consumption on tobacco products far outweigh the revenues that come in.

An estimated 15,000 Australians die of smoking related causes each year at a cost to the community, in terms of health expenditure and economic costs, of $31.5 billion a year. This is almost three times the roughly $12 billion spent on tobacco products in Australia in 2015.

This is not a message big tobacco is keen to spread. Instead, by enlisting proxies from the nicotine-using and “vaping” communities, it is trying to play this as a “free speech” and “freedom of choice” issue.

That is not the case. Public health was, is and must always be, the core issue in the smoking debate. Everything else, as was demonstrated by the industry’s failed bid to overturn plain packaging, is a side show.

Health concerns were behind the many initiatives, including increased prices, that have seen Australian smoking rates fall to less than 13 per cent compared to 1945 when 72 per cent of males and 26 per cent of females smoked.

Today’s battle is not so much to wean the last hard core smokers off the habit as it is to stop young people from taking it up.

This is why e-cigarettes, which could be touted as a “reduced risk” and potentially “cool” way to imbibe must stay banned.

If legalised they would simply serve as yet another gateway towards the use of the traditional product.

Exposed: big tobacco’s behind-the-scenes ‘astroturf’ campaign to change vaping laws

Tobacco giant Philip Morris is running an under-the-radar campaign to convince federal politicians to legalise e-cigarettes containing nicotine, with anti-smoking campaigners accusing the company of using the same “astroturf” tactics it used in its fight against plain packaging.

http://www.smh.com.au/federal-politics/political-news/exposed-big-tobaccos-behindthescenes-astroturf-campaign-to-change-vaping-laws-20170712-gx9lsl.html

The multinational has been using its offshoot smokers’ rights lobby group – dubbed “I Deserve To Be Heard” – to contact Australian smokers and vapers and urge them to make submissions to a parliamentary probe into the use and marketing of e-cigarettes.

The company’s campaign – along with a coordinated push from Australia’s online vaping community – has seen the inquiry inundated with submissions from people who say vaping has helped them quit smoking and dramatically improved their health.

While health groups in Australia and across the globe continue to warn about the potential risks of nicotine vaping, 107 of the 108 submissions so far loaded on the inquiry’s website are strongly pro-vaping – and the vast majority follow a similar “personal story” template.

World renowned tobacco control expert Simon Chapman, an emeritus professor at the University of Sydney, said Philip Morris and other interest groups were “astroturfing” – trying to create the illusion of a big grass-roots pro-vaping movement that does not really exist.

“They’ve been actively recruiting people to put in submissions,” Professor Chapmen told Fairfax Media. “These are exactly the same tactics they used for plain packaging. They have dusted off the same software, the same template and just changed the content.”

E-cigarettes are a multi-billion-dollar business overseas but the sale and personal possession of nicotine e-cigarettes is illegal in Australia. Health groups fear that if the government relaxes the rules it could lead to a wave of seductive advertising that would lure young people into taking up the habit – and possibly serve as a gateway drug to other forms of smoking.

Philip Morris’s new campaign comes after it was ordered to pay the Australian government millions in legal costs over its failed bid to kill off world-first plain packaging laws.

The company used I Deserve To Be Heard in its plain packaging efforts but it has been largely sitting dormant in recent years. It fired back into life late last month with an email blast to members calling on them to “make their voices heard”, as the company intensifies its push into the increasingly lucrative international e-cigarette market.

“Australia’s laws on vaping are ridiculous. While the UK, USA, EU, Canada and New Zealand have all legalised or are legalising e-cigarettes, Australia completely lags behind. There’s no reason why e-cigarettes with nicotine shouldn’t be legal in Australia,” it said.

Company spokesman Patrick Muttart told Fairfax Media that Philip Morris was committed “to converting the world’s one billion plus smokers to smoke-free alternatives”. I Deserve to be Heard members had demonstrated a strong interest in the legalisation of smoke-free products, he said: “As such we wrote once to our membership, informed them of the inquiry and encouraged those interested to consider submitting.”

The submissions are also being coordinated by senior members of Vaper Cafe Australia, an online forum.

On June 7, a senior member of the forum identified as a 52-year-old man from Western Sydney urged users to “inundate” the inquiry with submissions. He offered a step-by-step guide on writing a submission.

Many of the 108 published submissions closely follow the template, in which people are urged to include “your age and gender, when you started smoking, how long you smoked for, how much you smoked and if you suffered any side effects from smoking”.

Australian Medical Association president Michael Gannon said the tobacco industry was aggressively pursuing the potential of e-cigarettes because it had given them the opportunity to “rebrand” themselves as part of the effort to reduce smoking – even there is no evidence e-cigarettes work as a deterrent.

“We must not allow e-cigarettes to become a socially acceptable alternative to smoking,” he said. “E-cigarettes essentially mimic or normalise the act of smoking. They can result in some smokers delaying their decision to quit, and they can send signals to children and young people that it is okay to smoke.”

But Dr Colin Mendelsohn, a tobacco treatment specialist in Sydney who advocates for e-cigarettes as a healthier alternative to smokes, said the AMA’s submission was “disgraceful” and accused it of using misleading data and ignoring international evidence that could save lives.

He defended the submissions despite the coordination: “These are still genuine stories, many of whom have had their lives saved by vaping.”

The National Health and Medical Research Council says ‘there is currently insufficient evidence to support claims that e-cigarettes are safe”.

Big tobacco’s big profits

Why are tobacco companies’ profits still booming – despite government regulation and declining smoking rates?

http://www.aljazeera.com/programmes/countingthecost/2017/06/big-tobacco-big-profits-170603092904305.html

Smoking kills. So if you’re in an industry where your product is known to be damaging the health of people who buy it, then you should, in theory, go out of business.

But shares in companies listed in the Bloomberg tobacco producers index have risen 351 percent since 2009, making it one of the best investments of the past decade.

Graphic warning labels and taxes seem to have some effect on reducing the number of smokers but less so on industry profits which keep rising. And investors can’t quit buying the stocks because operating profits continue to go up.

Although some pension funds and life insurers have turned their back on the sector, it’s still not enough to hit big tobacco where it hurts.

Different tax regimes around the world mostly account for the difference in price of cigarettes. But governments are not as hooked as the consumers who buy cigarettes.

Consumers cough up for higher prices because they crave the drug in tobacco – nicotine. Without nicotine addiction, there would be no tobacco industry.

The tobacco industry knows this and has diversified to develop other nicotine products like E-cigarettes. The electronic cigarette market has grown from just $50m in 2005 to an estimated $7.5bn last year, according to Euromonitor. It’s all part of the unique economy of addiction.

New evidence suggests the dangers of cigarettes in the United States have increased despite the fall of smoking rates in recent years. A new study has found that so-called “light” cigarettes may be behind a spike in lung cancer cases, as Heidi Zhou-Castro reports.

Jeremias Paul from the World Health Organization joins Counting the Cost from Geneva to discuss the unique dynamics of the nicotine economy.

Paul thinks the tobacco industry should pay more taxes because they’re making a profit out of people’s addiction.

“If they cause death, they should be taxed to death. In the latest global adult tobacco survey, there was a reduction in tobacco use of about 20 percent, which essentially proves increasing taxes regenerates a lot of revenues but at the same time reduces consumption.”

PMI test marketing ‘flat coil’ e-liquid technology

Philip Morris International is test marketing a product employing new technology described by PMI as a mesh patch to heat e-liquids that eliminates manual assembly of wick-and-coil designs that are the industry standard.

http://www.tobaccojournal.com/PMI_test_marketing_%C3%82%E2%80%98flat_coil%C3%82%E2%80%99_e-liquid_technology.54255.0.html

PMI’s technology allows full automation in contrast to nearly all e-cigarette products that require wicks to be hand-threaded through heating coils, the company said in its latest Scientific Update for Smoke-free Products. A flat-coil product has been undergoing test marketing under the MESH brand in Birmingham, UK, since late last year, PMI said.

“The trick was to design a flat alternative to the original coil-and-wick technology that provided a comparable user experience to traditional e-cigarette products,” PMI said. “By designing a flat coil, a machine could place a flat wick on top of it, inject e-liquid into an adjacent cavity, and neatly seal it all in a self-contained cartridge.”

How e-cigarette ads might sway teens to try tobacco products

When non-smoking teens see ads for e-cigarettes, and are curious about the products advertised, perhaps even identifying with a favorite brand, they might also be more susceptible to taking up cigarettes, a new study finds.

http://www.businessinsider.com/r-how-e-cigarette-ads-might-sway-teens-to-try-tobacco-products-2017-5?IR=T

For the study, researchers showed a nationally representative sample of 10,751 U.S. teens advertisements for a wide variety of tobacco products including traditional cigarettes, cigars, chewing tobacco and e-cigarettes. Overall, the teens were more receptive to ads for e-cigarettes than other products and television ads were most likely to prompt brand recall.

“The imagery used by tobacco companies focuses on the aspirations of young people including having fun, being independent, sophisticated, socially accepted, popular, etc.,” said lead study author John Pierce of the University of California, San Diego.

“Those who have an emotive response to these aspirational images are more likely to see use of the product as a way to achieve their aspirations,” Pierce said by email. “It is hypothesized that in adolescents who are committed never smokers, recall of tobacco product advertising will be associated with first movement toward product use within a one-year time frame.”

Big U.S. tobacco companies are all developing e-cigarettes, battery-powered gadgets with a heating element that turns liquid nicotine and flavorings into a cloud of vapor that users inhale.

For the past decade, public health experts have debated whether the devices might help with smoking cessation or at least be a safer alternative to smoking traditional combustible cigarettes, or whether they might lure a new generation into nicotine addiction.

Fewer teens smoke today than a generation ago, but declines in traditional cigarette use have stalled and e-cigarettes have become increasingly popular in recent years. As of 2015, an estimated 16 percent of U.S. high school students used e-cigarettes, compared with about 9 percent for traditional cigarettes, according to the U.S. Centers for Disease Control and Prevention.

While television ads for traditional cigarettes have been illegal in the U.S. for decades, e-cigarette ads are currently allowed on TV, researchers note in Pediatrics.

In the study, Pierce and his colleagues examined how receptive or curious non-smoking teens were about different tobacco products and whether they had a favorite image or advertisement. They also looked at how susceptible the adolescents might be to trying tobacco products based on their ability to recall specific brands they saw in the ads.

The researchers showed each study participant a random selection of five ads each for cigarettes, e-cigarettes smokeless tobacco and cigars based on 959 different promotions that had recently been used to advertise these products.

Overall, 41 percent of the younger teens in the study and half of older adolescents were receptive to at least one tobacco advertisement, the study found.

Across each age group, teens were most receptive to ads for e-cigarettes, followed by traditional cigarettes and smokeless tobacco.

E-cigarette ads shown on television had the highest recall.

Compared to teens in the study who were not at all receptive to the ads, youth who had the highest level of engagement with the promotions were more than six times more likely to be susceptible to trying tobacco products, the study found.

The study isn’t a controlled experiment designed to prove whether or how ads may directly influence tobacco use.

Another limitation is that researchers didn’t have data to show whether or not teens actually used tobacco products after viewing these ads, the authors note.

Even so, the findings suggest that non-cigarette ads for tobacco-related products may be damaging for adolescent health, Rebecca Collins of Rand Corporation in Santa Monica, California, writes in an accompanying editorial.

“This study provides some very provocative data suggesting that the marketing of e-cigarettes, which is not regulated, might be leading to cigarette smoking among teens,” Collins said by email.

Big Tobacco Attacks Sensible F.D.A. Rules on Vaping

As smokers turned to electronic cigarettes to reduce the health risks of smoking, big tobacco companies started buying e-cigarette makers and producing and selling their own. Now those companies are lobbying Congress to prevent the Food and Drug Administration from regulating electronic cigarettes and cigars, as it does conventional cigarettes. If they succeed, they will be able to sell and market addictive nicotine products to young people with few restrictions.

https://www.nytimes.com/2017/04/19/opinion/big-tobacco-attacks-sensible-fda-rules-on-vaping.html?_r=1

While promoters of e-cigarettes and e-cigars, which provide nicotine in vapor form, say they can help people quit conventional tobacco products containing harmful tar, there is not a lot of evidence for that claim. In addition, the devices are dangerous to young people because the nicotine they provide “can cause addiction and can harm the developing adolescent brain,” according to a 2016 report by the surgeon general, Vivek Murthy. Health experts also say that the vapor those devices produce can contain carcinogens and metal particles.

Another government report found that 16 percent of high-school students said they had used e-cigarettes in 2015, up from just 1.5 percent in 2011. The industry sells these products in a broad array of flavors, like gummy bear and cotton candy, designed to appeal to young people when they are more susceptible to becoming dependent or addicted to nicotine.

After years of deliberation, the F.D.A. said last May that it would begin regulating the manufacturing, sale, packaging and advertising of e-cigarettes, and all tobacco products, under a 2009 federal law that authorized it to do so. Specifically, the agency said it would begin reviewing the health risks of e-cigarettes introduced since early 2007, and potentially ban specific flavors and products that it deemed harmful. The tobacco lobby wants Republicans to amend a vital appropriations bill to exempt products that were introduced before May 2016 from F.D.A. review.

The push to undermine the F.D.A.’s authority began even before the agency had finished its rule. One Republican lawmaker, Representative Tom Cole of Oklahoma, introduced a bill in 2015 that was identical to a draft circulated by the Altria Group, the country’s biggest tobacco company and a marketer of vaping products. In addition to its legislative effort, the industry has also filed several lawsuits in federal courts challenging the rule.

Tobacco companies complain that the F.D.A.’s rule amounts to “retroactive” regulation because many of the e-cigarettes and e-cigars it will regulate have been on the market for years. But the industry has known for years that government officials were developing this rule. Large bipartisan majorities in Congress voted in 2009 to hand the agency the authority to evaluate and approve new tobacco products introduced on or after Feb. 15, 2007. The F.D.A. is simply doing its job by protecting public health.

When Public Health and Big Tobacco Align

Nobody trusts the tobacco industry, and it’s easy to understand why. For decades, industry executives knew that smoking caused cancer and heart disease yet publicly denied the dangers of cigarettes. It relentlessly attacked its critics. Documents that emerged in the 1990s showed that the industry targeted teenagers, knowing that the earlier someone became addicted to cigarettes, the more likely they would be lifelong smokers. And so on.

https://www.bloomberg.com/view/articles/2017-03-09/when-public-health-and-big-tobacco-align

In the 1980s and 1990s, the public health community went to war with the tobacco industry. Though the war largely ended in 1998 with Big Tobacco agreeing to a multi-billion-dollar settlement with the states, it remains a powerful memory for public health.

To this day, most tobacco-control advocates view the cigarette companies as being every bit as duplicitous and evil as they were in the bad old days. Some years ago, I asked Stanton Glantz, perhaps the leading anti-tobacco scientist in the U.S., what his ultimate goal was. He didn’t say it was to eliminate the scourge of smoking. He said: “To destroy the tobacco industry.”

What brings this to mind is an excellent cover story in the upcoming issue of Bloomberg Businessweek about the efforts of the tobacco industry to devise and market so-called reduced risk products like electronic cigarettes — products that give users their nicotine fix without most of the attendant carcinogens that come with combustible tobacco.

Although the tobacco companies have done decades of R&D on smokeless products, the business was dominated early on by startups like NJOY, which is today the largest independent e-cigarette company in America. From the start NJOY has said that a big part of its mission was “to end smoking-related death and disease.” And from the start, messages like that have been scorned by the public health community.

Ingesting nicotine in some smokeless fashion is vastly safer than smoking a combustible cigarette. (In the words of the late South African tobacco scientist Michael Russell, “People smoke for the nicotine but die from the tar.”) Last year, the Royal College of Medicine issued a report saying that e-cigarettes were some 95 percent safer than cigarettes.

Even so, the public health community in the U.S., led by the Centers for Disease Control and Prevention, has done everything it can to demonize smokeless products. Some of this has been with good reason: to try to keep kids from picking up an addictive habit. But this effort has also helped to create the impression that smokeless products are as dangerous as cigarettes. One result, sadly, is that many long time smokers have refused to try them, even though they could save their lives.

My sense in talking to tobacco-control officials over the years is that too many of them simply don’t believe in a reduced-harm approach. We give heroin addicts methadone not because methadone is good but because it is better than heroin. With cigarettes, however, the public health mindset appears to be all or nothing — that the only “right” thing for smokers to do is to go cold turkey.

But the lingering distrust of the tobacco industry has also had a lot to do with public health’s unwillingness to acknowledge the potential benefits of alternative products. Matt Myers, the president of the Campaign for Tobacco Free Kids, has often complained, for instance, about the marketing of e-cigarettes, saying that companies are using the same tactics to hook teenagers that Big Tobacco once used.

With the e-cigarette market clearly established, the four big tobacco companies — BAT, Reynolds American, Altria (formerly Philip Morris) and Philip Morris International (spun off from Altria) — have proclaimed themselves all in.

Philip Morris International is an especially interesting case: Not only does it have an array of e-cigarettes and other smokeless products, but as the Bloomberg Businessweek story points out, it has publicly proclaimed that its goal is to lead the world into “a smoke-free future.” The home page of its website asks, “How long will the world’s leading cigarette company be in the cigarette business?”

As astonishing as it is that a company with $26 billion in tobacco revenue last year would be calling for the end of cigarettes, I believe Philip Morris is sincere. It has spent around $3 billion in research. Its new flagship product, called IQOS, heats tobacco but doesn’t burn it — which the company believes will be more satisfying to smokers than vaping. IQOS already has 7 percent of the tobacco market in Japan, and is being rolled out in other countries.

Philip Morris recently asked the British government that tobacco products “be taxed according to their risk profile.” In other words, it wants the government to impose higher taxes on cigarettes to encourage smokers to move to reduced-risk products. What tobacco company has ever done that before?

In the U.S., Philip Morris has done something extraordinary: It has made a submission to the Food and Drug Administration to get the right to market IQOS as a reduced risk product. The expensive submission consumed 2.3 million pages and is backed by a great deal of research, including several clinical trials. So far, none of the U.S. e-cigarette companies have attempted to get such a designation, and it is a big problem. How do you sell a reduced risk product when you can’t tell anybody it reduces risk?

The business case for diving into this market is that it’s a product category that’s growing, while the cigarette market is shrinking. Philip Morris doesn’t want to be left behind. But there is no particular need for the company to set out such a transformative agenda, at least not yet. The small smokeless companies are not much of a threat. NJOY filed for bankruptcy last fall. And under a 2009 law, every company in the e-cigarette industry will have to file something called a premarket tobacco application with the FDA by August 2018. The submissions will cost, on average, over $450,000, and the companies will have to show that their products have some public health benefit. There is a legitimate chance that some small companies won’t be able to clear the hurdle.

No, Philip Morris is pushing as hard as it is, I believe, because it wants to get on the right side of the issue, finally — to be viewed as a good corporate citizen. When I spoke to Glantz the other day about the company’s new anti-smoking agenda, he said, “I don’t believe them.” (He added, “If they were serious, they would stop marketing cigarettes right now.”)

No doubt many others in the tobacco-control community feel the same way. They still loathe Big Tobacco, and view Philip Morris’s new strategy as just another deception. But the truth is, if there is ever going to be a serious move from cigarettes to less dangerous products, it will have to come from Big Tobacco. They have the R&D resources, they have the marketing apparatus — and, it appears, they have the will.

Public-health advocates don’t have to trust Philip Morris, or any other tobacco company. They don’t have to believe what I believe in order to arrive at the same conclusion: that the advocates should be rooting for the companies’ innovations — pushing them, double-checking their data, making sure regulations are in place to prevent their products from being marketed to kids. The advocates should also be spreading the word that there is an alternative to cigarettes. Who really cares whether it’s Big Tobacco or some other entity that reduces smoking deaths? What matters is that it happens.

The tobacco wars are long over. Continuing to fight the cigarette companies may bring a certain satisfaction to the veterans on the public-health side. But joining forces is the way to save lives.

This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.

To contact the author of this story:
Joe Nocera at jnocera3@bloomberg.net

To contact the editor responsible for this story:
Philip Gray at philipgray@bloomberg.net