Foundation backed by Philip Morris funds schoolchildren’s global science contestBMJ 2019; 366 doi: https://doi.org/10.1136/bmj.l5366 (Published 19 September 2019) Cite this as: BMJ 2019;366:l5366
All rapid responses
Ms. Bhuyan’s article shames the U.S. Conrad Challenge. Its “Smoke Free World Challenge”—children competing for ideas to combat smoking in India, Malawi, and the US—is solely funded by Philip Morris International, disguised under its “Foundation for a Smoke Free World” (FSFW). Yet, she commended the India’s health ministry for specifically asking the state governments not to “partner with FSFW” and for its supposedly long-term stance against exposing children to tobacco. (1)
Currently, India is the world’s 2nd largest producer of tobacco, the 3rd largest for Flue-Cured Virginia (FCV); 60% is exported. The government supports tobacco industry growth—and always has. In 1947, it set up the Tobacco Board to increase exports. In 1965, it created the Central Tobacco Research Institute, under the aegis of the Indian Council of Agricultural Research, to provide consultancies. Accordingly to experts, “The performance of FCV tobacco has been impressive, particularly in terms of export and farmer earnings.”(Table 1). (https://www.tiionline.org/facts-sheets/tobacco-production/)
In India, from 1998 to 2010, smoking doubled in men for ages 15-69 years and increased fourfold for ages 15-29. (http://www.dnaindia.com/health/report-since-1998-number-of-indian-male-s...). Prevalence among Indian females was 3% in 2012, an ironic benefit of their position in society.
A BMJ Rapid Response (https://www.bmj.com/content/361/bmj.k1162/rr) questioned why in 2016, WHO held its seventh Conference on the Framework Convention on Tobacco Control in India as the government is openly declaring its commitment to “the smooth functioning of a vibrant farming system, fair and remunerative prices to tobacco growers and export promotion.” This policy obviously and deliberately breaches the Convention’s mission (http://tobaccoboard.com/).
In 2014, Ng and colleagues showed that between 1980 and 2004, the decrease in the prevalence of daily smoking worldwide was on a fast track, reaching 2% per year in 2004 (the year of the Convention. But since then progress had levelled off. By 2012, further improvements were non-existent.(2) In 2019, the BMJ confirmed “no evidence that global progress in reducing cigarette consumption has been accelerated by the Framework Convention on Tobacco Control.”(3) The Convention is reduced to a smokescreen, adding to the long record of WHO’s bureaucracy.(4,5) Indeed, no government wants to close the tobacco gold mine.(8)
Smokers pay large amount of taxes (roughly 80% of cigarettes prices in rich countries). And as one out two smokers will die prematurely from a tobacco-related disease (a smoker dies an average 10 years earlier than a non-smoker); it yields major cost savings in pension payments. Barnett et al. calculated that “tobacco cessation pharmacotherapy has an incremental cost-effectiveness ratio of $4705 per quit.”(7)
The so-called Big Tobacco, being a low-income worker, is a perfect scapegoat. The Big Boss is the Secretary of the Treasury! That is why no government has banned menthol or reduced nicotine content in cigarettes, dead consumers must be replaced and young people are the target as nicotine plus favours is the best gateway to addiction.
Table 1. Performance of FCV tobacco in India (https://www.tiionline.org/facts-sheets/tobacco-production/)
FCV Tobacco 2001-02 2013-14 Change
Production (106 kg) 167.97 315.92 88%
Average Price (Rs/kg) 34.80 122.60 252%
Gross Returns (107 Rs) 584.55 3873.19 563%
Exports (107 Rs) 483 4086 746%
1 Bhuyan A. Foundation backed by Philip Morris funds schoolchildren's global science contest. BMJ 2019;366:l5366.
2 Ng M, Freeman MK, Fleming TD et al . Smoking prevalence and cigarette consumption in 187 countries, 1980-2012. JAMA 2014;311:183e92.
3 Hoffman SJ, Mammone J, Rogers Van Katwyk S et al. Cigarette consumption estimates for 71 countries from 1970 to 2015: systematic collection of comparable data to facilitate quasi-experimental evaluations of national and global tobacco control interventions. BMJ 2019;365:l2231
4 Braillon A. The Framework Convention on Tobacco Control. Lancet 2016;387:1907.
5 Braillon A. Global health challenges facing bureaucracy: democratization or revolution? Public Health 2014;128:1134-5.
6 Braillon A. Smoking-attributable medical expenditures: Time biases and smokers' social role. Prev Med 2015;81:294.
7 Barnett PG, Ignacio RV, Kim HM et al. Cost-effectiveness of real-world administration of tobacco pharmacotherapy in the United States Veterans Health Administration. Addiction 2019;114:1436-1445.
Competing interests: No competing interests