Intended for healthcare professionals

Editorials

Tobacco giant wants to eliminate smoking . . .

BMJ 2017; 358 doi: https://doi.org/10.1136/bmj.j4443 (Published 26 September 2017) Cite this as: BMJ 2017;358:j4443
  1. Simon Chapman, emeritus professor
  1. School of Public Health, University of Sydney, Australia
  1. simon.chapman{at}sydney.edu.au

. . . and pigs might fly

The Foundation for a Smoke-Free World, an “independent” research funding body fully funded by Philip Morris, launched on 13 September.1 It will provide $960m (£711m; €808m) over 12 years to help “eliminate smoking worldwide.” No benchmarks for this modest task have apparently yet been announced. This largesse is a mere $80m a year from a company with global revenue in 2016 of $26.7bn2 and a marketing budget (in 2012) of $7bn intended overwhelmingly to promote smoking.3

Harm reduction

The long, deceptive, and failed history of tobacco harm reduction has seen filters (including crocidolite asbestos); misleading “reduced carcinogen” brands; and a wide range of breathlessly announced innovations.4 Each of these had their academic touts. None reduced harms from smoking, and the “lights” and “milds” reduced risk fiasco5 arguably kept many smoking who may have otherwise quit. Electronic vaporisers, with their growing consumer acceptability, may turn out to be the real deal. But with less than a decade of widespread use, any verdict on their status as much less dangerous may be decades premature.

The vaporised nicotine industry, including Big Tobacco, is now focused on how it can break down potent regulatory controls on vaporised products and assure consumers about safety.

“Buying scientists”

In the past, Philip Morris has publicised seductive research funding and courted prominent scientists, including US epidemiologist Ernst Wynder, the first proponent of tobacco harm reduction.6 The new foundation’s director, Derek Yach, former leader of the World Health Organization’s tobacco control programme, is acutely aware of why it does this, having written powerfully in 2001 about the industry “buying scientists” to serve commercial objectives and help thwart effective tobacco control.7

Will this be a modern Faustian tale, as many expect, or will Yach have the success with Philip Morris that he heroically failed to experience in trying to turn Pepsi into a health oriented company for six of his post-WHO years?8 Doubtless he will have a predictable coterie of supplicants for the foundation’s money. But the breathtaking arrogance of Philip Morris and Yach shunning WHO’s article 5.3 on industry interference in the Framework Convention on Tobacco Control9 supported by 180 nations will surely steel the resolve of thousands of researchers to continue to shun money obtained from tobacco sales with its unavoidable ethical problems. Nearly 120 health organisations have now called on the company instead to simply stop selling cigarettes,10 what Philip Morris (USA)’s website describes as its “core product.” This is, of course, thoroughly naive, because shareholders would prevent any serious attack on the company’s profitability to which cigarettes are central. Euromonitor estimates that the 2016 global market for combustible tobacco was $736bn while that for e-cigarettes was $12bn.11

If Philip Morris really wanted smoking rates to decline it could announce tomorrow that it will voluntarily introduce large graphic health warnings and plain packaging on all its tobacco products. We know, from countries where it has been forced to do this, that this could happen within 12 months.12 Knowing the impact of price on sales, it could massively increase its wholesale prices to retailers. It could stop all its tobacco advertising and sales promotions.

But Philip Morris and other tobacco companies have done nothing voluntary to embrace any policy that would accelerate the decline in smoking in populations. So they will do none of this and instead continue to reward staff who increase tobacco sales.

Importantly, Philip Morris has legally attacked potent tobacco control policies like graphic health warnings and plain packaging.13 The tobacco industry has armies of lobbyists whose goals are to defeat, dilute, and delay any policy or initiative that threatens its cash cow.

“Useful idiots”?

So will Yach actively join the world tobacco control community in attacking such activities or will he be historically numbered among prominent “useful idiots,” as Lenin might have called them,14 formerly working in tobacco control, who now attend global tobacco industry meetings to cheer on their tobacco host’s “game changing” while doing nothing about this industrial vector’s daily efforts to promote smoking?

Disturbingly, the main task for tobacco control is now increasingly framed by such quislings as convincing smokers to switch to vaporised products, not preventing and quitting smoking. Some even talk of vaping by children as being “protective” against future smoking.15

Just as car manufacturers now producing electric motor vehicles have not abandoned the production and sales promotion of fossil fuel powered cars, no tobacco company would do the equivalent with its combustible tobacco products. But progressive governments like France, Germany, India, and Norway have set dates after which the sales of new fossil fuel powered vehicles will be banned. Many more will follow.

Over many decades, governments have acted to ban a huge range of unsafe, deadly products (thalidomide, asbestos, chlorofluorocarbons, countless unsafe consumer goods), and exploitative practices (slavery, people trafficking, child labour). With tobacco companies now embracing the rhetoric of the end of smoking, it is time for governments to take the industry at its word and set those dates when combustible tobacco products will be banned.

Footnotes

  • Provenance: Commissioned, not peer reviewed.

  • Competing interests: None declared.

References

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