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 philanthropic organization, 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 is also to address 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). Dr. Yach 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 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 regarding government regulations that 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 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—as a matter of fact, the words “science” and “harm reduction” are not even mentioned in the last progress report of the FCTC—we will address these elements. In fact, the Foundation takes one of the broadest approaches to tobacco control. Our work will focus 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 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 aims to fund 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 will fill these gaps, by supporting research also in low- and middle-income countries, where 80% of the global smoking population resides. We will help them build their tobacco research capacity and implement effective interventions to end smoking.

We plan to combine 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 a smoke-free world, 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
The Foundation is currently funded by Philip Morris International (PMI) through a binding pledge agreement for 12 years. The Foundation’s commitment to its funding sources is to operate and spend financial resources in line with its purpose, which is to improve global health by ending smoking in this generation. The Foundation’s Board of Directors and independent external auditors hired by the Board ensure compliance. The Foundation will diversify its financial sources by seeking funding from other entities. Three important factors have compelled us to accept funding from PMI, while adhering to criteria laid forth by Cohen et al., particularly relevant to transparency and independence, as well as the establishment of an independent research agenda, when we accepted funding from PMI:
  • The Foundation’s ensured independence. The Foundation guaranteed its independence through its Certificate of Incorporation and Bylaws. The Foundation’s independence is described in detail in the answer to Frequently Asked Question 5.
  • 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 product. 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 20 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.
The Foundation’s Certificate of Incorporation states that the Foundation is to “support independent scientific research free from the influence of any commercial entity that may be affected by the research outcome.” This certificate, in addition to articles in the Foundation’s Bylaws, precludes any influence from Philip Morris International (PMI) or any other tobacco company on the Foundation’s activities or funded research.
No third party, including Philip Morris International (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.
    • All 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)
  • Summary reports of meetings of the:
    • Agriculture & Livelihoods and Industry Transformation Advisory Boards
    • Health, Science, and Technology Advisory Committee
  • Annual reports

The Foundation has also created an internal review panel to assess the status of innovative projects and the research the Foundation is funding. This panel is composed of experts who acknowledge status quo–disrupting technologies.

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. You can access the list of Foundation grants here.

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, will provide quantifiable evidence over time of what steps the largest tobacco companies are taking toward achieving a smoke-free world and any actions they take to undermine that progress. Specifically, the Tobacco Transformation Index® will annually evaluate 15 of the largest tobacco companies in the world. The Foundation for a Smoke-Free World announced consultancy agreements with global market research company Euromonitor International and leading consulting firm and think tank SustainAbility for the creation of the Tobacco Transformation Index®, which will be published in June 2020, with annual updates thereafter. Using an objective methodology, the Tobacco Transformation Index® endeavors to measure the nature of the tobacco companies’ allocation of capital, research and development, marketing, product sales, regional variations, production decisions, violations, and more. The aim 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 will also review 35 countries to determine how they are or are not contributing to a smoke-free world, through indicators including tax structure on combustible cigarettes, regulatory policy on reduced-risk products, and other metrics. We believe investors have considerable influence on corporate management decision-making. The Index will provide 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 a smoke-free world and to meet consumer demand for reduced-harm nicotine delivery products worldwide.
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 the following reports:

Worldwide State of Smoking Survey:

The global State of Smoking Survey 2018 enrolled more than 17,000 participants in 2017 to determine smokers’ behavioral patterns, their perceptions of addictiveness and risks related to tobacco harm reduction products versus conventional cigarettes, and barriers to quitting.

Some of the key findings of the survey revealed that smoking is intricately linked to pleasurable rituals such as drinking coffee, as reported by the smokers. 60% to 91% of smokers consider themselves addicted to cigarettes, and 25% to 78% plan to quit. The highest rate of smokers who used e-cigarettes or other vaping devices to try to quit was 24%. There were notable discrepancies among countries regarding product harm perceptions. For example, a higher proportion of smokers in low- and middle-income countries (e.g., India) versus high-income countries (e.g., Japan) misperceive e-cigarettes as being more harmful than cigarettes. Additionally, a high proportion (up to 58%) of smokers wrongly believe that nicotine in e-cigarettes causes cancer.

Global State of Tobacco Harm Reduction (Gsthr) 2018 Report

The report highlighted for the first time the availability and use, at global, regional, and national levels, of reduced harm nicotine products relative to combustible tobacco. Such products include, but are not limited to, e-cigarettes, heat-not-burn devices, and smokeless snus, and are referred to as “safer nicotine products (SNPs) in the report. The report also shed light on the regulatory responses to harm reduction products, and the potential public health benefit of tobacco harm reduction. “‘Quit or Die’ is no longer the only option for those who cannot give up nicotine.” The cost of harm reduction interventions and strategies to governments is stated to be insignificant compared to other public health interventions.

Smoking Cessation Products and Services – Global Landscape Analysis

The project aimed to catalog the variety of products and services offered to smokers who want to quit. A total of 89 distinct smoking cessation products and services were identified, in addition to 12 smoking alternatives that are not indicated specifically for smoking cessation. Prescription drugs and nicotine replacement therapies were noted to have a 12-month abstinence efficacy rate of up to 23%, as opposed to behavioral interventions, which had an estimated efficacy rate of 13%. The analysis also highlighted the limited clinical evaluation of the growing number of technology solutions, notably self-guided smoking cessation applications on mobile devices. Additionally, the number of pharmaceutical and medical device candidates in the development pipeline was limited, suggesting no breakthrough treatments are to be expected within the next 5 to 10 years.

Global Trends in Nicotine

This report identifies the major players in nicotine delivery, outlines their product organizations and geographic focus, and quantifies their output. The reports highlights the following: An estimated USD $785 billion were attributed to global retail sales associated with the nicotine ecosystem in 2017; the retail volume in terms of cigarette stick equivalents was estimated at 6.1 trillion in 2017, with an additional trillion when illicit trade and locally manufactured combustible tobacco products were included; China National Tobacco Corporation is the largest producer at 38% retail volume share, followed by the five publicly traded tobacco companies headquartered in Europe, Japan, and the United States.

Business Transformation: an Analysis of Case Studies Relevant to Achieving a Smoke-free World

This report presents six cases studies of companies (DSM, Waste Management, IBM, GE, Interface, and Ford) that undertook business transformations. As the tobacco industry is also undergoing a transformation toward “cleaner” products, the key takeaways from this report may be relevant to the tobacco industry: Successful companies understand the reality of the high possibility of their “fall” and shift their footing to prevent the “fall”; companies implement strategies that satisfy their customers⎯current ones—and plan to satisfy future ones; adequate communication about the transformation is crucial during the process; transformation could be a lengthy and gradual process, although some cases may warrant immediate action; investment in new adventures is key despite any threats they may cause to the core business; and, finally, business transformation is not without risk and success is not guaranteed.

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