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Foundation for a Smoke-Free World and healthy Indigenous futures: an oxymoron?
  1. Andrew Waa1,2,
  2. Bridget Robson3,4,
  3. Heather Gifford5,6,
  4. Janet Smylie7,8,9,
  5. Jeff Reading10,11,
  6. Jeffrey A Henderson12,13,
  7. Patricia Nez Henderson13,14,
  8. Raglan Maddox8,15,16,
  9. Raymond Lovett17,18,
  10. Sandra Eades19,20,
  11. Summer Finlay21,22,23,24,
  12. Tom Calma25,26
  13. Hāpai Te Hauora Māori Public Health
  1. 1 Ngati Hine/Ngapuhi
  2. 2 Eru Pomare Māori Health Research Unit, Department of Public Health, University of Otago, Wellington, New Zealand
  3. 3 Ngāti Raukawa
  4. 4 Department of Public Health, University of Otago, Wellington, Wellington, New Zealand
  5. 5 Ngāti Hauiti
  6. 6 Whakauae Maori Health Research and Development, Auckland, New Zealand
  7. 7 Métis, Métis Nation
  8. 8 Well Living House, Centre for Urban Health Solutions, St. Michael’s Hospital, Toronto, Ontario, Canada
  9. 9 University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada
  10. 10 Tyendinega Mohawk First Nation, Haudenosaunee (Iroquois) Confederacy
  11. 11 I-HEART Centre St. Paul’s Hospital, Providence Health Care, British Columbia First Nations Health Authority Chair in Heart Health and Wellness, West Vancouver, British Columbia, Canada
  12. 12 Cheyenne River Sioux Tribe (Lakota)
  13. 13 Black Hills Center for American Indian Health, Rapid City, South Dakota, USA
  14. 14 Navajo Nation (Diné)
  15. 15 Modewa Clan
  16. 16 Centre for Research and Action in Public Health, University of Canberra, Canberra, Australian Capital Territory, Australia
  17. 17 Ngiyamppa, (Wongaibon)
  18. 18 National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
  19. 19 Noongar
  20. 20 Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
  21. 21 Yorta Yorta
  22. 22 Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute and School of Health Sciences, University of South Australia Division of Health Sciences, Adelaide, South Australia, Australia
  23. 23 Vice President (Aboriginal and Torres Strait Islander)—Public Health Association of Australia, Canberra, Australian Capital Territory, Australia
  24. 24 Co-Vice Chair, Indigenous WorkingGroup, World Federation of Public Health Associations
  25. 25 Elder, Kungarakan tribal group and a member of the Iwaidja tribal group
  26. 26 Consultant to the Commonwealth Department of Health, Indigenous tobacco control advocate, Canberra, Australian Capital Territory, Australia
  1. Correspondence to Dr Raglan Maddox, Centre for Research and Action in Public Health, University of Canberra, Canberra, ACT 2617, Australia; raglan.maddox{at}

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Indigenous peoples represent a diversity of cultures, perspectives and experiences that brings tremendous vibrancy to our world. Within this diversity, many Indigenous peoples share a common history of colonisation that continues today.1 We humbly acknowledge and respect that Indigenous people are diverse and constitute many nations, language groups and cultures. For the purposes of this commentary, Indigenous peoples include self-identified individuals and communities who have historical continuity with pre-colonial/pre-settler societies; are strongly linked to their natural environments; and often maintain their own distinct language(s), belief and social systems.

In 2017, Philip Morris International (PMI) provided US$1 billion funding for 12 years to establish the Foundation for a Smoke-Free World (the Foundation). The stated purpose of the Foundation is to help achieve a ‘smoke free world’.2 According to the Foundation’s Strategic Plan, ‘ending smoking’ means eliminating use of the cigarette and other forms of combustible tobacco, while ensuring populations affected by this transformation are supported to find sustainable alternative activities and products.3 The research agenda includes a focus on an alternative nicotine product version of ‘harm reduction’. In August 2018, the Foundation provided a US$1 million grant that created a New Zealand-based Centre for Research Excellence: Indigenous Sovereignty and Smoking (the Centre) whose stated aim is to focus on reducing smoking-related harms among Indigenous peoples.4 5

Are the interests of Indigenous peoples truly being served by promoting the research agenda of a tobacco industry-funded Foundation? We do not think so, for several reasons. While improving help for people to cease commercial tobacco use does have potential to reduce the harm from smoked tobacco use, evidence suggests that individually targeted interventions that are essentially palliative and require a significant level of individual agency do not actually address the root cause of the problem.6 7 As such, they …

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