North American public health schools decline funding from tobacco funded foundation

The deans of 19 schools of public health from prominent universities in the US and Canada have signed a joint statement1 declining offers of research funding from the Foundation for a Smoke-Free World (FSFW), an organisation set up with money from tobacco giant Philip Morris International.

The deans wrote that “both the tobacco industry and Philip Morris International have a long history of funding ‘research’ in ways meant to purposely confuse the public and advance their own interests, aggressively market cigarettes globally, including to children, and persist in their relentless opposition to evidence based tobacco control interventions.”

The World Health Organization has declined to work with FSFW, the deans noted, and they cite the WHO Framework Convention on Tobacco Control, the world’s first public health treaty, which says: “There is a fundamental and irreconcilable conflict between the tobacco industry’s interests and public health policy interests.”

They added: “If Philip Morris really wished to establish a ‘smoke free world’ they would stop legal challenges to local and national tobacco control efforts, and cease advertising and manufacturing cigarettes.”

Deans of the schools of public health from Harvard, Johns Hopkins, Ohio State, Rutgers, Tulane, and the universities of Alberta, Illinois, and Maryland were among the signatories.

Derek Yach, the foundation’s president, said: “It is disappointing, and a loss for smokers, that deans of some institutions have opted not to work with the foundation in its efforts to end smoking. We share the same goals: to improve public health and urgently advocate for more funding and better science to help millions of smokers reduce their risk of death and disease.

“The deans’ principal concern—that because we have received funding from a tobacco company, we somehow cannot operate independently—has been comprehensively dealt with.”

Philip Morris, Yach said, “is legally bound to fund the foundation,” giving $80m (£56.3m; €64.1m) a year for 12 years, “yet is legally prohibited from having any influence over it.”

Yach, a former WHO staff member who once worked on the framework convention, added: “My hope is that, upon proper reflection, these deans will work with us to eliminate smoking worldwide, as others in the public health, medicine, and science communities have already begun to do.” The prevention of nicotine addiction, he said, would “absolutely” be considered as part of a strategy to end smoking.

The last point touches on the essence of the deans’ suspicions about the foundation—that it is a vehicle for promoting e-cigarettes and other smokeless alternatives which would allow the tobacco industry to continue to profit from nicotine addiction.

It is an approach that has been newly adopted by the US Food and Drug Administration (FDA), which has unveiled a plan to phase almost all nicotine out of cigarettes, while allowing a range of smokeless nicotine delivery systems.

The deans alluded to this new FDA policy in their statement, saying it “holds tremendous potential, as well as potential risks, for public health.” The research on which it rests must be “untainted by the interests of the tobacco industry,” they said.

Philip Morris’ own flagship smoke free product, the IQOS tobacco heating device that is sold in Britain and many other countries, suffered a setback in the US this week when an FDA expert panel voted against letting the maker claim that it reduced risks to health compared with smoking.

Philip Morris has been criticised for funding the foundation while refusing to commit to a date for stopping the sale of cigarettes. A spokesman told The BMJ: “Our minimum ambition is that by 2025, at least 40 million men and women, or about 30% of our current cigarette consumers, will have switched from cigarettes to one of our smoke free products.”