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Foundation for a Smoke-Free World and the mindless mob behaviour of tobacco control

An update from the World Conference on Tobacco or Health, Cape Town

This is an update to an earlier post about the PMI-funded Foundation for a Smoke-Free World (FSFW). My main argument in that post can be summarised as:

The FSFW is a good thing with sound and important objectives that are valuable to public health It has sufficient irreversible funding commitment and independence from the funder’s competing interests to do useful work that can be trusted That the criticism and position-taking of many in tobacco control was premature and an unthinking ugly reflex in advance of knowing the foundation’s financing system, legal structures and governance That it is unethical to prefer $1 billion allocated for public health research to be wasted and to work towards wasting it, rather than trying to make it work That the opposition is built on anti-corporate “tobacco warrior” mindset or dislike of anything that challenges an “abstinence-only” agenda that would be mocked in any other field of public health Its critics need to grow up and rethink

My views have not changed much, but I wanted to provide a quick update from the World Conference on Tobacco or Health (twitter:#WCTOH2018) in Cape Town, where the subject of the FSFW is a hot talking point.  And not in a good way…

The ignorance and strategy failure of tobacco control

The bloodlust of the critics of the Foundation on display here is vile – an unethical and mindless reflex response to innovation.  The tobacco warriors are now explicitly defining their mission as a war on Big Tobacco, and not a war on disease.  While these may have been one and the same some years ago (it was never the case for smokeless tobacco), now is exactly the wrong time to double down on a war with Big Tobacco (see David Sweanor’s post: Tobacco control and the tobacco industry – a failure of understanding and imagination).

Haven’t they noticed that there is an emergent major technology disruption? Can they not see that a move to non-combustible tobacco products has a fundamental technology driver (the improving energy and power density of batteries) that will revolutionise this industry, both in terms of its technology and its impacts on health?

Can anyone explain what bad things are supposed to emerge from a foundation with these objectives (“to accelerate global efforts to reduce health impacts and deaths from smoking, with the goal of ultimately eliminating smoking worldwide”)? How this leadership and the degree of independence it has secured could lead to bad outcomes? What, exactly, is the threat to health behind all this vitriolic opposition?

Opportunity lost

I keep hearing good people say “if only we had money to do this survey” or “we need to know more about dual use” or “what causes smokers to take up or reject low-risk products and what could change that?” or “why hasn’t someone developed standard testing protocols?” or “how could harm reduction work in poorer countries?”or “if only we could work out what is going on in Japan”… the list is endless. But that is exactly what this foundation is for. And it meets a real need.

The established funders, notably FDA/NIH do not fund this kind of thoughtful inquiry – they are mainly looking for reasons to intervene and to regulate. It is another failure of imagination to be unable to see what good can come of this. But it is deliberate. The Campaign For Tobacco-Free Kids has forgotten what it is supposed to do and is focussed on its plan to ‘isolate’ the tobacco industry.

Visual aid from CTFK presentation: Breaking the Grip of Big Tobacco

Isolation, it seems, is more important than the conduct of valuable public health research. They would rather a billion dollars for public health was wasted or returned to PMI shareholders than allow the possibility that a tobacco company is doing a good thing. A tobacco company doing a good thing just cannot be allowed to happen in their world-view narrative and strategy (as above). And for that reason, the FSFW must be defined, a priori, as a bad thing… whatever the reality.

My reaction

So how am I feeling about this …? Appalled, basically…

at the bullying and hounding of Derek Yach (branded a pariah) and his team: people trying to do the right thing with an innovative approach; by the chilling effect on researchers and potential staff and board members that the bullying culture rife in tobacco control has created – this is deliberate McCarthyism; that the interests of those who are at greatest risk, that is smokers, have been disregarded and their views ignored; by the unthinking rush to judgement and condemnation of the foundation well before the financial, legal and governance machinery was in place; by the primacy given to ‘industry denormalisation’ over public health; by the righteous ‘useful idiots’ who are trying to block any product or research innovation in the tobacco field and are doing their bit to protect the cigarette trade; that the FSFW was excluded from the conference and in particular that it was barred from representing itself in a conference session devoted to the foundation itself. What sort of discussion is that? by the lack of open-minded and relentless curiosity in ‘tobacco control’, which I think is a professional duty given the life and death consequences involved by the astonishing stupidity of trying to ensure $1 billion allocated for public health is wasted.

Disclosure: other than counting Derek Yach as a friend since we both worked on the gestation and birth of the WHO FCTC from 1999, I have no connection with the foundation and I have no plans at present to apply to be on its staff or board or to apply for grant funding. However, I wish the initiative well.

Original author: Clive Bates
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