The FCTC, MPOWER, and FSFW: Holistic Tobacco Control
The World Health Organization’s 2017 report on the global tobacco epidemic focuses on exciting progress made under the MPOWER strategy, funded by Bloomberg Philanthropies. It indicates nearly two thirds of the world’s population, about 4.7 billion people, is now protected by at least one best-practice tobacco control measure. That’s real progress over nearly ten years.
As a member of the tobacco control community who worked on the Bloomberg Initiative Grants Program (which helped fund policy development and implementation of MPOWER elements), I remember how MPOWER was almost blocked at the outset – ironically, by critics from the tobacco control community.
When WHO first developed the MPOWER strategy, some criticized it for giving in to funding pressures by accepting foundation support, and for being out of sync with the Framework Convention on Tobacco Control (FCTC) arguing that focus of MPOWER was too limited and that it neglected the holistic approach required for effective tobacco control efforts. At the time, even the FCTC secretariat expressed that WHO was “turning its back” on the FCTC. WHO, to its credit, persisted, and attracted funding from Bloomberg Philanthropies and others not only for itself but also for organizations across the globe including governments and civil society organizations.
Instead of embracing MPOWER as a vital new approach and potential key ally in the global battle to end smoking, skeptics viewed it as a threat, and chose to try to undermine the entire effort rather than embrace its aims. That knee-jerk reaction was unjustified and misplaced, as seen by the progress reported in the 2017 report on the global tobacco epidemic.
Nearly ten years later, the launch of the Foundation for a Smoke-Free World elicited a similar reaction from some. Though the Foundation is led by an original architect of the FCTC, and supported by many others like me, who have long advocated for tobacco control and fought the industry's efforts to block progress, the Foundation was quickly shouted down by critics.
Why? Because the Foundation, like some other anti-tobacco initiatives, received initial funding from a tobacco company. The grant of nearly US$1 billion will sustain a decade’s worth of important research that will hopefully help millions quit smoking. Independence is assured by ironclad provisions written into the Foundation’s funding agreement, certificate of incorporation and bylaws. But, rather than examine the facts and see what good the Foundation could do, some chose to immediately and unjustifiably characterize the Foundation as a threat and label those of us who dare to inject new ideas into tobacco control as sell-outs.
But just like those who developed MPOWER, we will persevere.
The Foundation for a Smoke-Free World will complement MPOWER and will support the FCTC by filling the gaps in the FCTC that have received inadequate attention or funding. Progress in areas like taxation, indoor smoking bans and packaging regulation is well underway. So, rather than repeating the work of others, the Foundation will focus on gaps that include scientific research on cessation, encouraging the cooperative exchange of information, and supporting economically viable alternatives for tobacco farmers. All this will be done following the rigorous independence criteria set forth by Cohen, Zeller, et al. and with an open dialogue with members of the public health community.
As with other innovative areas in public health, we know that trust must be earned. The Foundation is a new entity, barely a few months old, but our work is conducted with full transparency. So before skeptics pass judgement, we encourage them to take a close look at the many ways which the Foundation will support and complement the FCTC and MPOWER to help provide the world with a holistic approach to tobacco control.