On April 14, 2021, Le Monde published “Philip Morris’s Secret War on WHO and Tobacco Control Experts.” Therein, author Stèphane Horel makes several false and misleading statements about the Foundation for a Smoke-Free World (FSFW). Specifically, Horel attempts to cast doubt on the Foundation’s independence and its motives—without any evidence to support her claims. Moreover, the piece fails to communicate the Foundation’s goals and its accomplishments, choosing instead to highlight the unwarranted assertions of our detractors. In doing so, the piece ironically promotes tobacco control infighting, while also bemoaning this phenomenon.
FSFW was formed to reinvigorate the fight against smoking and, ultimately, to reduce the eight million annual deaths from combustible cigarettes. We are fully transparent about our funding on our website and elsewhere: the Foundation receives funding from PMI Global Services Inc. (PMI). Our independence is affirmed in the Pledge Agreement between the Foundation and PMI, as well as in the Foundation’s bylaws and other documents. Additionally, our annual 990PF tax filing documents are publicly available on the financials page of the website and they include the amount awarded for each grant, as well as project overviews.
Foundation grants have allowed more than 100 international researchers to advance their smoking cessation and harm-reduction work. This support also has enabled multi-year research programs that have already yielded important outputs, including: a series of reports that will critically inform policy and regulations to accelerate an end to smoking; establishment of research centers in priority countries; a Centre for Agricultural Transformation in Malawi that is leading the country out of its century-long dependence on tobacco; and development of the Tobacco Transformation Index, which tracks the behavior of the tobacco industry and acknowledges companies that are making strides toward ending combustible sales.
Yet, regardless of how laudable our goals, how factual our arguments, or how successful our efforts, the Foundation’s detractors—some of whom are heavily funded by Bloomberg Philanthropies—refuse to accept FSFW as a valuable contributor to the field of tobacco control. Trapped in an ideological quagmire where science and innovation are ignored, many of our critics seem to take issue with the fact that the Foundation dares to depart from tobacco control orthodoxy.
Horel quotes a paper in which I state that the Framework Convention on Tobacco Control is “frozen in time,” requiring “modernization.” I appreciate her highlighting this point that I stand by. It is this very stance—this deviation from the status quo—that appears to rile our detractors. In particular, many critiques stem from our support for harm reduction research. Yet, the Foundation is hardly unique in this position. Gradually, harm reduction is becoming part of the mainstream in tobacco control.
Snus and heated tobacco products have now been authorized by the US FDA as reduced harm and risk products compared to combustibles; and the UK Cochrane Center has released several reports showing that e-cigarettes are more effective cessation aids than traditional nicotine replacement therapy (e.g., gums or patches). In fact, 100 million people who previously smoked now use harm reduction products. Well-known cigarette brands are being cannibalized by reduced risk alternatives, leading to the closures of cigarette factories. This is what real transformation looks like.
Still, work remains to be done if we hope to continue reducing death and disease caused by tobacco. Though smoking rates are declining in most high-income countries, they remain quite high in France. According to the WHO, 26% of women and 32% of men in the country still smoke. Rates are also alarmingly high in low- and middle-income countries, where the majority of the world’s smokers live. Reducing smoking prevalence in these countries will require input from diverse stakeholders and consideration of all relevant scientific evidence—even when it’s unpopular.
We remain hopeful that our detractors will join us in our efforts to help those billion smokers and to reduce the devastation caused by cigarette smoking.