Frequently Asked Questions | Foundation for a Smoke-Free World

FREQUENTLY ASKED QUESTIONS

Since our founding in September 2017, we’ve received and responded individually to a number of important questions. The FAQs below are designed to provide clarity for all interested parties on the most commonly asked questions regarding the Foundation’s history, governance, focus, and position on issues of importance in tobacco control.

The Foundation, a nonprofit private foundation, was formed to help the world’s more than 1 billion smokers quit and reduce their risks from smoking, which remains the leading cause of preventable disease and premature death. The purpose of the Foundation is to improve global health by ending smoking in this generation. Our mission also includes addressing the impacts of a reduced demand for tobacco on smallholder tobacco farmers, and to help them transition to alternative crops and livelihoods.

The Foundation was founded and is led by President Dr. Derek Yach, a renowned global health expert and anti-smoking advocate for more than 30 years. Dr. Yach is a former Executive Director for Non-Communicable Diseases and Mental Health at the World Health Organization (WHO). He served as Cabinet Director at the WHO, where he was instrumental in the development of the WHO Framework Convention on Tobacco Control (FCTC). In this work, and throughout his career, Dr. Yach has emphasized the urgent need to implement tobacco control measures globally. He authored an important review article that outlined the origins and strategies that were used to forge the WHO FCTC. Dr. Yach also has identified the need to accelerate global tobacco control efforts and to identify new and emerging approaches to drive and accelerate progress toward achieving a smoke-free world.

Other organizations focus mainly on tobacco control measures implemented by government regulations and do not include tobacco harm reduction in their efforts to reduce tobacco-related diseases and death. Many of them are funded by Bloomberg Philanthropies, the Bill & Melinda Gates Foundation, or by governments. On the other hand, the Foundation’s work supports a full array of tobacco control measures, as proposed by the Framework Convention on Tobacco Control (FCTC). While other organizations neglect certain FCTC-agreed elements, such as harm reduction (which is an integral part of the definition of tobacco control in Article 1 of the main FCTC text), science and innovation, and alternatives to tobacco—we address these elements. In fact, the Foundation takes one of the broadest approaches to tobacco control. Our work focuses on those elements that have been relatively underfunded and/or neglected (e.g., tobacco harm reduction, science, research, innovation, and implementation of tobacco control measures in vulnerable populations).

While most funding for research on smoking cessation and tobacco harm reduction, for example, is concentrated in the United States and the United Kingdom (with some important work underway in Europe), the Foundation funds research globally. Countries where tobacco control progress has been slower and smoking-related impacts greater, often lack the resources and research capacity to investigate effective tobacco control initiatives. Low-income countries received merely 0.3% of direct grants for health research in 2015. The Foundation is working to fill these gaps, by supporting research also in low- and middle-income countries, where 80% of the global smoking population resides. We are helping them build their tobacco research capacity and implement effective interventions to end smoking.

We are combining our innovative approaches with proven best practices in the areas of smoking cessation, tobacco harm reduction, behavior economics, policy, and taxation.

Furthermore, the Foundation is seeking to address a critical need for crop diversification by helping tobacco farmers in countries that are economically over-reliant on tobacco diversify their crops and livelihoods. As the demand for tobacco declines worldwide, crop diversification is becoming increasingly crucial.

The Foundation’s mission is to accelerate progress toward ending smoking through three key pillars of focus: (1) health, science, and technology, for smoking cessation and tobacco harm reduction tools that complement progress achieved by FCTC efforts; (2) agricultural transformation, for crop diversification and alternative livelihoods in tobacco-dependent countries, with an initial focus on Malawi; and, (3) tobacco industry transformation, for transformation of the global tobacco industry and nicotine ecosystem in a manner that is compatible with the United Nations Sustainable Development Goals (SDGs) framework.

The Foundation’s efforts to achieve its mission are being realized by:

  • Funding health, science, and technology research to provide insights and solutions that fill the gaps in the existing smoking cessation and tobacco harm reduction knowledge
  • Supporting product development and innovations that explore new and emerging approaches to assist smokers in their journey to quit or to reduce their risks
  • Supporting collaborative programs in the agricultural sector to assist tobacco farmers, particularly smallholder farmers, with the viable and sustainable alternatives and livelihoods in countries with tobacco-dependent economies
  • Critically evaluating industry progress and assessing actions taken that undermine progress toward tobacco harm reduction in the form of the Tobacco Transformation Index.
  • Driving mission-critical smoking cessation and tobacco harm reduction conversations among key opinion leaders and the public.

At its inception, the Foundation entered into a Pledge Agreement in which it agreed to accept charitable gifts from PMI each year for the period 2018 through 2029 to fund Foundation’s mission of solving the global health crisis and ending smoking in this generation. Recently, that agreement was revised, and PMI’s annual charitable gifts have been reduced. 

While the Foundation is aware that there are challenges associated with accepting any funding from the tobacco industry, given the urgency of the problem – 1.1 billion smokers, more than 8 million dying each year, and a trajectory toward a billion deaths this century, the Foundation was compelled to help save lives, and took the bold step of accepting funding from PMI. The Foundation operates with integrity, as we abide all legal requirements, and holds itself to the highest ethical and scientific standards. Indeed, independence and transparency are core principles of the Foundation. To that end, Foundation adheres to the criteria laid forth by Cohen et al., particularly those relevant to transparency and independence, and has established an independent research agenda.

A revised agreement between PMI Global Services Inc. and the Foundation for a Smoke-Free World provides that the Foundation’s annual funding will be reduced. The Foundation reviewed the text of its Bylaws and Pledge Agreement and considered its three years of operations. The changes to the Bylaws reflect a renewed commitment to research focused on areas where there are scientific and regulatory gaps, and areas otherwise in furtherance of the Foundation’s purposes. The other changes to the Pledge Agreement and Bylaws reflect our learning about the importance of furthering our mission through dialogue with stakeholders.

No. The Foundation’s mission and purposes are unchanged. The Foundation’s “Purpose” includes the entirety of Article Third of the Foundation’s Certificate of Incorporation, which specifies use of assets or income toward seven sets of activities. The Bylaws articulate the “Independent Research Agenda,” which remains as it was before, “to promote and support significant scientific research that advances the field of tobacco harm reduction and reduce the public health burden of smoking-related diseases.” The change to the Bylaws relating to our research agenda highlights our intent to focus on non-duplicative and novel areas.

The Foundation’s Certificate of Incorporation states that the Foundation was formed to, among other things, “support independent scientific research free from the influence of any commercial entity that may be affected by the research outcome.” Consistently, the Foundation’s Bylaws state that the Foundation shall not take into account the potential impact of its research on the image of the tobacco industry or any other industry or commercial entity. The Bylaws also contain a rigorous conflict of interest policy.  Finally, in the Pledge Agreement that the Foundation entered into with PMI, both parties agreed that  the Foundation shall maintain full independence, and shall make all its decisions on its own, free from the control, interim instructions, or improper influence, from or by PMI or any other third parties. These statements are not just written on paper, but they are the lived experience of the organization.

No. Indeed, the independence language in the Pledge Agreement remains clear that the Foundation “shall maintain full independence” from PMI. The Foundation is governed by an independent Board that oversees our work.

As the largest funder of research and capacity building in tobacco harm reduction and smoking cessation globally, we are adapting our programs to enhance performance and continue the work toward ending smoking in this generation. Our work will be even more focused on research that is closing scientific and regulatory gaps.

Yes. The Foundation provided the documents required by Pledge Agreement Section 3.4 by the required date. These included the unanimous attestation of its Board of Directors and a report from its independent auditors.

PMI Global Services Inc. and the Foundation both are parties to the Pledge Agreement.

As such, both parties agreed to the changes to the document. In addition, material changes to the Foundation’s organizational documents, including its Bylaws, require notice to PMI.

PMI receives a report from the Foundation’s independent auditor and an attestation from its Board of Directors. Under the Pledge Agreement, PMI must rely on these documents to determine funding.

The Foundation has taken several steps:

  • Eliminated staff positions by about one-third across all levels
  • Reviewed grants portfolio for performance, alignment with the purpose, and contribution toward the mission. As a result, we have shared the extent of our cuts with current grantees and will adjust future grants.
  • Reduced consulting expenses

Yes. The Foundation will continue reductions in these areas that have been underway for 18 months. 

The goal is to accelerate and maximize the impact of Foundation resources on smallholder tobacco farmers in Malawi. Programs are under evaluation for performance, alignment with the purpose, and contribution toward the mission.

The team in Malawi working with the Agriculture Transformation Initiative (ATI) will be taking on major responsibilities on the ground, building relationships with the local stakeholders and leading our work there.

The executive leadership team has been restructured to best serve the Foundation with its sharper focus.

In addition to filling the urgent need, and saving the lives and reducing the risks for the 1.1 billion smokers in the world, the existence of the Foundation is timely now because of:

  • The opportunity for technological disruption.

The Foundation seized this timely opportunity as technological advances in software, devices, vaping, and tobacco use have been creating the potential to improve the effectiveness of smoking cessation tools and reduce the risks associated with tobacco products. Technological disruption is an integral part of the Fourth Industrial Revolution.

  • The scarcity of funding for smoking cessation and tobacco harm reduction research.

Financial support for international tobacco control is very low. Of the $31.4 billion USD in development assistance for global health in 2011, only $68 million were spent on international tobacco control. Funding for health research remains insignificant (0.3% of direct health research grants) in countries where most smokers live, i.e., in low- and middle-income countries.

More than 30 years ago, Dr. Yach emphasized the importance of tobacco control research in reflecting a “planned, sustained, and comprehensive surveillance strategy” to track tobacco use with the goal of reducing tobacco-related diseases and death. His role in defining global research priorities set the stage for NIH Fogarty’s International Tobacco and Health Research and Capacity Building Program.

No third party, including PMI Global Services Inc. (PMI), can influence decisions on the research programs that the Foundation decides to fund, research conducted by the Foundation’s grantees, or the publication of their research findings. Article IX, sections A, C, and F of the Foundation’s Bylaws provide for independence in research, transparency and independence, and ownership of data and freedom to publish, including grantees making their raw data available for secondary analyses, respectively.

The Foundation makes and will make available the following:

  • The three-year strategic plan
  • Requests for proposals (RFPs)
    • Program proposals, which are aligned with our three-year strategic plan and with the United Nation’s sustainable development goals (SDGs), are solicited directly or via RFPs by members of our executive leadership team, who have research backgrounds and are instrumental in issuing program proposals, grant reviews, and grantee selections.
  • Grant decisions and grantees (will be announced as grants are awarded)
    • We ensure oversight and review of grants, grant applications, and grantee selection, as indicated in our grant policies and procedures.
    • Our decisions to fund programs are aligned with the Cochrane mission.
    • Decisions regarding funding of programs and grant selection require independent peer review, as outlined on page 19 of our Bylaws.
  • Research findings (will be accessible when they are communicated by the grantees)
  • Annual reports

The Foundation supports research that addresses our three core pillars: Health, Science, & Technology; Agriculture & Livelihoods; and Industry Transformation. We provide grants to support work that is being conducted by independent research organizations, academic institutions and centers, and organizations in the private sector. All current and past requests for proposals (RFPs) that the Foundation supports are featured on the website.

Yes, absolutely. The UN’s Sustainable Development Goals (SDGs) and the Foundation’s strategic plan for action intersect in many ways and are an invaluable framework for alignment. The Foundation’s SDG map and the legend that supports it identify relevant SDG goals, their specific targets, and associated indicators that the Foundation aims to materially impact. The UN’s SDGs are grounded in improving people’s lives and the planet across economic, social, and environmental dimensions, and providing “a better and more sustainable future for all.” The Foundation embraces these priorities through our mission to end smoking in this generation. Smoking is a major behavioral risk factor for noncommunicable diseases, and the approaches of the SDGs to prevent and control noncommunicable diseases align with the Foundation’s purpose to improve global health by ending smoking worldwide in this generation. The Foundation is also committed to mitigating the collateral negative effects of ending smoking and of the global decline of tobacco demand on tobacco farmers and tobacco-dependent economies.

Yes, unequivocally. Our President, Dr. Derek Yach, is a leader who contributed significantly to the development of the FCTC. The Foundation is supportive of the progress that has been achieved in implementing key provisions of the FCTC and seeks to complement such progress and accelerate efforts to achieve a smoke-free world.

In support of its mission, the Foundation’s Industry Transformation efforts focus on attaining change within the global tobacco industry and nicotine ecosystem. The Tobacco Transformation Index, which is the first action of the Foundation’s Industry Transformation initiative, aims to accelerate the reduction of harm caused by tobacco use. Specifically, the Tobacco Transformation Index evaluates 15 of the largest tobacco companies in the world on their relative progress, or lack thereof, toward harm reduction. This ranking and supporting analyses help stimulate innovation and competition among the companies and equip stakeholders with valuable information to drive change. 

 

The first Tobacco Transformation Index was released in September 2020 and found that most of the 15 largest tobacco companies are not making substantive progress in phasing out cigarettes and other high-risk tobacco products and transitioning smokers to reduced-risk alternatives. A small group of companies have made public commitments to harm reduction and backed them with significant investments. 

 

The aim of the Index is to incentivize scientific research and development for the advancement of product innovations to benefit public health and potentially millions of adult smokers, particularly in developing countries. The Index provides investors, among all stakeholders, with quantifiable evidence of how companies are addressing industry transformation, on both an absolute and a relative basis, as an additional tool with which to wield influence and promote change. By creating a direct relationship between a company’s transformation and shareholder value, while quantifying transformation through clear and transparent metrics, we envision using a market-driven approach to incentivize sustainable change toward accelerating tobacco harm reduction and to meet consumer demand for reduced-harm nicotine delivery products worldwide.

 

The Foundation believes that the forces of competition, differentiation, and constructive engagement are part of the solution, in addition to policy prescriptions. The record shows that implementation of policy strategies alone is not achieving the degree and speed in the reduction of the prevalence of cigarette smoking that is desired.

 

The Tobacco Transformation Index’s key premise is that by actively encouraging and monitoring the transformation, it will over time incentivize the tobacco companies to act more quickly and more responsibly than they otherwise would. Conversely, players that do not make the necessary transition rapidly enough will be exposed. As a result, stakeholders will be better informed and able to demand necessary action.

Careful engagement with tobacco companies increases awareness and impact of the Index program. None of this has any effect on our independence.

The Index relies on extensive engagement with non-industry stakeholders. Through a separate process, the Index approached the companies to ensure they are informed about the Index program, consider their feedback on proposed indicators, and invite them to share data to be evaluated by the Index.

Company participation is voluntary. However, companies that elect not to engage are scored using publicly available data and included in the final ranking. 

The nature and content of interactions with tobacco companies is available for public review in the Industry Consultation Summary report via the Tobacco Transformation Index ™ website.

The Index objectively evaluates the depth of how the top 15 tobacco companies deploy their capital, including PMI. The methodology for the Index includes the review of quantitative and qualitative evidence of how the companies are addressing harm reduction, which is a verifiable means of assessing progress that goes well beyond the qualitative way STOP, WHO and others report on “tobacco industry interference.” Further, the Index includes companies who account for 90% of worldwide cigarette sales versus STOP/WHO reports that focus mainly on 4 or 5 multinationals. Their limited scope means that the companies whose progress is slow or nonexistent are not a part of the analysis, leading to an inaccurate evaluation of the landscape.

The Index is not an all-encompassing tool intended to supplant other measures, but it is designed to complement them. These include WHO-FCTC, SASB, Global Tobacco Interference Index, and more. It adds the perspective of accelerating the reduction of harm caused by tobacco use which is largely ignored by others.

The Foundation strongly condemns vaping among youth and teens, just as we condemn smoking among youth and teens. We believe that regulations, public policies, and corporate actions must prevent minors from having access to vape devices, e-cigarettes, or any tobacco-related product.

Tobacco companies must cease all marketing of their products to minors, such as on social media and through advertising. Such a commitment, paired with enforcement and education on the potential health effects of nicotine on children and teens, is imperative.

The Foundation has supported/commissioned a number of surveys and reports that are featured in the following Research and Reports Library on the site:

 

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