To bypass the provisions of the WHO-FCTC, the tobacco industry established a public health foundation.
As the four students of Whitesands College, Lekki, posed for the camera after emerging winners of the 2018 Conrad Challenge, the name of an entity screamed from a roll-up banner behind them: Foundation for a Smoke-Free World.
The Junior Secondary School Two (JSS2) students had won the Smoke-Free World category of the Conrad Foundation Spirit of Innovation challenge held at the Kennedy Space Centre, USA.
With the World Health Organisation Framework for Tobacco Control (WHO-FCTC) urging Parties to ban or restrict all forms of tobacco advertising, promotion, and sponsorship, particularly ones targeting youth populations, the companies found a subtle way.
The FCTC is a legally binding treaty that requires countries bound by the treaty — or Parties — to implement evidence-based measures to reduce tobacco use and exposure to tobacco smoke. There are 182 Parties to the FCTC as of May 2020.
The Foundation for a Smoke-Free World, the sponsors of the challenge, is a foundation funded by Philip Morris International (PMI), one of the biggest tobacco manufacturing companies in the world.
Bypassing an obstacle
Tobacco kills more than eight million people each year, with more than seven million of the deaths due to direct tobacco use, according to the World Health Organisation. About 1.2 million of the deaths are the result of non-smokers being exposed to second-hand smoke.
To check the interference of the tobacco industry in countries’ public health policies, the WHO-FCTC in Article 5.3 stated that, “In setting and implementing their public health policies with respect to tobacco control, Parties shall act to protect these policies from commercial and other vested interests of the tobacco industry in accordance with national law.”
To bypass this provision, PMI established, in September 2017, the Foundation for a Smoke-Free World (FSFW), a not-for-profit organisation with a mission to “solving the global health crisis and ending smoking in this generation.” PMI initially pledged to, starting from 2018, support the Foundation with $80 million annually over 12 years.
Two weeks after its launch, the WHO issued a statement saying there are a number of clear conflicts of interest involved with a tobacco company funding a purported health foundation.
“WHO will not partner with the Foundation. Governments should not partner with the Foundation and the public health community should follow the lead,” the UN agency stated.
Several other renowned public health bodies, including the John Hopkins Bloomberg School of Public Health, also distanced themselves from any proposed partnership with FSFW. In January 2019, 279 global health organisations and public health leaders urged the WHO to reject any affiliation with the Foundation.
With millions of dollars in its coffers and the chances of partnership with notable public health organisations becoming a mirage by the day, FSFW found another way: give money to a foundation involved with young people. Enter the Conrad Foundation, which holds the annual Conrad Challenge, an innovation and entrepreneurship competition that encourages “young adults to participate in designing the future through purpose-driven education,” according to information on its website. Other sponsors of the challenge include Dell Technologies, Bezos Family Foundation, and Kennedy Space Centre, among others.
But it is the involvement of the Foundation for a Smoke-free World that had raised eyebrows among tobacco-control advocates and other public health professionals.
“There is generally a difference between the provisions of the FCTC and the ways in which parties are legally obligated to adhere to those provisions,” said Michél Legendre, Associate Campaign Director at Corporate Accountability.
“But there is no doubt that groups like the Conrad Foundation, which are affiliated with the industry, can be considered as advertising and promotion. This is clearly laid out in Article 5.3. More broadly, the FCTC seeks to protect children and adolescents, so any targeting of these groups by industry affiliates like the Conrad Foundation is in violation of the treaty.”
The FSFW’s 2019 tax return shows that PMI has continued to be the sole funder for its activities. An analysis of the tax return by Tobacco Tactics reveals that the grants and contributions for the year 2019 are not primarily focused on funding scientific research but appear to be in line with the Foundation’s public relations and advocacy strategies.
“Only one in six of the grantees listed in this tax return (seven out of a total of 45) appear to be based within academic institutions.”
Since it was introduced in Nigeria two years ago, 248 secondary school students have participated in the Conrad Challenge across four categories comprising aerospace and aviation, cyber technology and security, energy and environment, and food and nutrition. For the 2020-21 challenge, the Foundation for a Smoke-Free World has introduced a new ‘special category’ named ‘Repurposed Farmlands and Tobacco Crops.’
“A reduced demand of tobacco could bring devastating consequences to smallholder tobacco farmers who are economically dependent on tobacco crops for their livelihood,” the Conrad Foundation said in a statement. “We challenge you to develop 21st-century agricultural technology solutions to increase smallholder agriculture efficiency and productivity to either repurpose tobacco farmlands for a different crop, or utilise farmlands for a different crop, or utilise the tobacco plant for a different purpose.”
When contacted, the Conrad Challenge Nigeria denied any links with the tobacco industry.
“Conrad Challenge in Nigeria is currently only sponsored by the Conrad Foundation and through scholarships from Clarkson University New York,” the foundation said in an e-mailed response.
In a follow-up email from the Conrad Foundation, the organisation said its funder, the FSFW, is independent of the tobacco industry.
“This is a misrepresentation of the Foundation for a Smoke-Free World (FSFW), which is an independent, nonprofit, private foundation committed to reducing deaths and diseases caused by smoking.
“For three years, FSFW has sponsored Conrad Challenge categories through grants that were aimed at eliminating and reducing e-cigarette usage and waste, as well as helping smallholder tobacco farmers who are seeking alternative livelihoods.”
Prior to beginning the Conrad Foundation’s relationship with FSFW, the organisation continued, the Conrad Foundation carefully examined FSFW’s organizational documents to ensure its independence from any influence by the tobacco industry.
“Confirming FSFW’s independence was vital to the Conrad Foundation’s decision to accept FSFW funding.”
After its initial funding promise, PMI amended its agreement with FSFW this year by adjusting its pledge thus: $80 million for 2018 and 2019; $45 million in 2020; $40 million in 2021; and $35 million from 2022 to 2029.
A FSFW spokesperson said the Foundation supports the full implementation of the FCTC and had authored and published papers that cite the need to fill gaps in its implementation.
“However, the Foundation does not agree with a biased interpretation of Article 5.3, which focuses on the governments who are the FCTC signatories and is not meant for nonprofit organisations like the Foundation,” the organisation said in an e-mailed statement.
The statement reiterated that FSFW is independent of PMI and operates in a manner that ensures its independence from the influence of any commercial entity.
Drafting government’s policy
The 2020 edition of Global State of Tobacco Harm Reduction, published by the Foundation for a Smoke-Free World-funded Knowledge Action Change, called for Tobacco Harm Reduction (THR) to be regarded as complementary, rather than inimical to reducing the global death and disease from smoking.
Although it noted that “there is no such thing as absolute safety,” the report stated that the newer Safer Nicotine Products (SNP) have been in circulation for more than a decade, with evidence that they are much less risky than combustibles.
The report accused tobacco-control advocates of making misleading claims about the SNP which has led to an increase in the number of smokers who now believe that SNP are no safer or may even be more dangerous than cigarettes. This action, it stated, has allowed “activist NGOs” and academics to attract substantial funding from billionaire Michael Bloomberg, through Bloomberg Philanthropies. These NGOs, the report continued, had done nothing but spread bad science and misinformation, undermining the promise of THR products by putting governments under pressure to ban their use.
More than 16,000 people are killed by tobacco-caused diseases in Nigeria every year, according to the Tobacco Atlas.
Last July, the Nigeria Tobacco Control Alliance (NTCA) petitioned the Industry, Trade and Investment ministry accusing the tobacco industry of using agencies of government to draft a ‘Policy on Conventional Tobacco and Non-Combusted Alternatives to Cigarette Smoking’ in clear contravention of the National Tobacco Control (NTC) Act, 2015, its regulations; and the WHO-FCTC which Nigeria ratified in 2015.
The 19-page draft document listed the benefits from the tobacco sector to include employment creation, a significant contribution to Nigeria’s GDP, and a significant increase in government revenue.
It also noted that there would be more than one billion smokers globally by 2025 and “it makes sense to offer less harmful, yet satisfying non-combusted alternatives for those smokers who would otherwise continue to smoke.” It encouraged the switch to alternative products that do not combust tobacco but produce aerosol with potential to present less risk of harm compared to those found in cigarette smoke. Some of these alternatives include Electrically Heated Tobacco, Carbon Heated Tobacco Product, and E-Vapour Products.
“Epidemiologically, it has been clearly established that smoking increases the risk of developing a smoking-related disease. It has equally been demonstrated that if a smoker quits, the risk of developing a smoking-related disease decreases.
“So, it is wise to make available these alternatives to cigarettes for adult smokers who would otherwise continue to smoke.”
PREMIUM TIMES learnt that the draft document was sponsored by PMI and sent to the ministry of industry, trade and investment. Both PMI and the ministry did not respond to requests for comments.
It was not the first time the tobacco industry in Nigeria had attempted to flout the provisions of the WHO-FCTC. In 2014, the British American Tobacco Nigeria organised a training for police officers in Lagos on the enforcement of the then newly-passed tobacco control legislation in the state.
In its petition, the NTCA said such “outdated ploys” have been used by the tobacco industry in low- and middle-income countries like Nigeria to undermine their tobacco control policies and open up the market to “unproven safer alternatives.” The group advocated that every novel tobacco product, including heated tobacco products and e-cigarettes, be banned in Nigeria while every new product be subjected to thorough regulatory scrutiny.
“Many countries have seen the gimmick [of the tobacco industry] and have taken strict measures against all kinds of tobacco products in the interest of public health and safety,” said Akinbode Oluwafemi, who signed the petition on behalf of the NTCA, a network of frontline civil society organisations, NGOs, and professional groups working on tobacco control, public health and cancer control in Nigeria.
One of the most recent gimmicks by the tobacco industry was the action by Philip Morris, in July, after the U.S Food and Drug Administration (FDA) published the outcome of PMI’s 2016 application to market its flagship heated tobacco product, IQOS, as a “modified risk tobacco risk product” in the U.S. In its ruling, the FDA noted that although the data submitted by PMI showed that IQOS may reduce exposure to harmful substances, it does not reduce the risk of disease and death when compared to cigarette smoking.
PMI immediately responded to the ruling, describing it as a “historic public health milestone.” The company’s managing director. sub-Saharan Africa, Bahman Safakish, told Nigerian journalists that providing smokers with science-based less harmful alternatives is a “commonsense solution to improve public health.”
Anna Gilmore, a Professor of Public Health, described Philip Morris action in the aftermath of the FDA ruling as “worrying,” and noted that, ultimately, the company is focused on profitability and not the well-being of tobacco users.
“There is a couple of things that might be worth flagging, one is that it’s not just that Philip Morris is misrepresenting this decision but that, actually, in doing that, they try to push governments down a room for tobacco control that is not the most effective.”
IQOS – which contains both tobacco and nicotine – was launched in South Africa in 2017, and plans are underfoot to extend the product to other African countries as soon as possible, Mr Safakish told the Nigerian Tribune in an interview last August.
Ms Gilmore, who is also the Director of the Tobacco Control Research Group at the University of Bath, UK, said while independent research on IQOS showed that exposure to some chemicals was reduced, there was an increased exposure to other chemicals.
“And the critics also looked at the risk issue and showed that there really is no evidence that the risk of diseases is reduced and disease markers, if you like, are not reduced.”