October, 2017:
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.
As Part Of ‘Tobacco Nation,’ Indiana Has A Smoking Rate On Par With Developing Countries
A group of 12 contiguous U.S. states in the Midwest and South has the highest rate of adult tobacco use in the nation. If taken as a country, this group would rank among those with the highest smoking rates in the world.
https://www.wfyi.org/news/articles/as-part-of-tobacco-nation-indiana-has-a-smoking-rate-on-par-with-developing-countries
According to a report released by Truth Initiative last week, Indiana is one of these 12 states, along with neighboring Ohio, Michigan, West Virginia, Kentucky, Tennessee, Alabama, Mississippi, Louisiana, Arkansas, Oklahoma and Missouri.
The Washington-based tobacco control nonprofit has termed this group, “tobacco nation.”
Three non-contiguous states ‒ South Carolina, Maine and North Dakota ‒ have also have high adult tobacco use.
According to the report, if these 12 contiguous states made up a “nation,” it would rank fifth among the countries with the highest smoking rates, behind Indonesia, Ukraine, China and the Philippines ‒ “countries with a fraction of our financial, scientific and healthcare resources,” said Truth Initiative CEO Robin Koval.
For instance, in the Philippines, 23 percent of adults use tobacco. In the “tobacco nation,” 22 percent of adults do. The U.S. national average is 15 percent.
In Indiana, smoking is still the leading cause of preventable death, causing a host of illnesses including cancer, heart disease and stroke. The Centers for Disease Control and Prevention ranks Indiana’s adult smoking rate the 10th highest in the country.
Richard M. Fairbanks School of Public Health Dean Paul Halverson was not surprised to see Indiana highlighted in the report.
“We are horrible when it comes to funding public health,” he said. “We’re ranked 49th in 50 states in our per capita investment in public health.”
Furthermore, while the CDC recommends a state the size of Indiana should spend $70 million a year in tobacco control and prevention. Halverson said Indiana only invests $7 million annually.
Beside their proclivity for smoking, the twelve states have other characteristics in common, too.
One is poverty. Compared with the other 38 states, “tobacco nation” earns nearly 21 percent less per year, the report said.
Additionally, this region has weak smoke-free laws and tobacco control policies.
In April, Indiana lawmakers proposed increasing the tax levied on a pack of cigarettes, but it failed to pass. The state’s cigarette tax is around a dollar, one of the lowest in the county, and well below the national average, $1.71.
Indiana also has a preemptive law, common in the other “tobacco nation” states, that restricts tobacco control efforts at a local level.
For instance, even if local governments wanted to raise the minimum age for purchasing cigarettes to 21, the preemptive law would prevent them from passing policies more stringent than state law.
While the U.S. smoking rate has declined in recent years, it remains high in rural communities.
“In fact, in some of our areas, it has actually increased,” said Alana Knudson, co-director of the Walsh Center for Rural Health Analysis.
“Many of the counties in ‘tobacco nation’ are rural, and when you look at the public health infrastructure in our rural communities, it has greatly diminished,” Knudson said.
She said not enough federal funding flows into smaller communities.
“We already know 70 percent of smokers want to quit,” said Corinne Graffunder, director of CDC’s Office on Smoking and Health.
However, she said those who live below the poverty line have the hardest time quitting.
Dr. Kasisomayajula Viswanath, who teaches behavioral sciences at Harvard’s T.H Chan School of Public Health, said it’s important to study tobacco use within “the context of class, place and race.”
While the data show high rates of poverty in this region, Viswanath said researchers should take into context what compels people to smoke.
In many of these states the manufacturing industry has disappeared, said Viswanath. The threat of losing work demoralizes residents.
“It is a challenge of micro-humiliations where they’re constantly under stress,” he said “One part of it is mental health, but the other part is just not mental. It’s the stress associated with navigating and maneuvering through life.”
This story was produced by Side Effects Public Media, a reporting collaborative focused on public health.