Everyone knows that cigarette smoking and the use of tobacco products remain a leading and truly avoidable cause of preventable, premature death worldwide. Public health and other researchers have developed a robust and irrefutable body of evidence on the risks of tobacco products and strategies for reducing use.
Guided by this evidence, great progress has been made in reducing smoking, and as smoking has declined, there have been parallel decreases in deaths from several major diseases caused by smoking.
Take away the tobacco industry and the gains would be immediate and extend across much of the 21st century. However, the tobacco industry is not going out of business.
Now agglomerated into a few very large multinational companies along with China National Tobacco, Big Tobacco is developing strategies for maintaining a market of nicotine-addicted people. These emerging strategies are based around new products that provide nicotine, but without the burning of tobacco. Electronic cigarettes and related devices have entered the U.S. market over the last 10 years and Philip Morris International now has a “heat-not-burn” product that delivers a nicotine-containing vapor. In comparison with the known lethality of conventional cigarettes, these products are intended to be marketed with claims of harm reduction. Another element of the Philip Morris strategy is the recently announced Foundation for a Smoke-Free World, funded by Philip Morris at $80 million annually with a 12-year commitment. The Foundation has already solicited proposals for research.
Should public health researchers accept funding from the Philip Morris foundation or eschew it?
History offers a lesson. In 1954, as evidence on smoking and lung cancer began to indicate a possible causal relationship, the tobacco industry colluded and began its campaign of discrediting scientific evidence and fraudulently misleading the public on the risks of smoking. One element of that strategy was the Tobacco Industry Research Committee, which provided research funding to the academic community. Its underlying agenda was to fund research to undermine the emerging evidence on smoking and disease causation. In the 1990s, the Center for Indoor Air Research was launched by the tobacco industry; it similarly funded academic and non-academic researchers to carry out studies with the underlying purpose of diverting attention from secondhand smoke as a public health threat. Now, because of this history, many academic institutions will not accept funding from the tobacco industry, either directly or indirectly.
Viewed in this historical context, Philip Morris’s new foundation is concerning, coming from an industry with a long record of documented misdeeds around science. Consequently, the Colorado School of Public Health has joined with 16 other public health schools to announce that we will not accept funds from the Philip Morris foundation. Our message is clear — we consider funding from the Foundation for a Smoke-Free World to be equivalent to funding from the tobacco industry.
Additional events of the last few weeks further speak to the need for the credible research and policy analyses carried out by schools of public health. On Jan. 23, the National Academy of Medicine released a comprehensive report on electronic cigarettes. Not surprisingly, major gaps in evidence were identified, given the limited span over which research has been carried out. Compared to the “gold standard” of toxicity — the conventional cigarette — the report found electronic cigarette vapors to be less toxic. Of concern, the report also concluded that e-cigarettes were linked to future risk of cigarette smoking in adolescents and young adults. Then, on Jan. 25, the FDA’s Tobacco Products Scientific Advisory Committee delivered a negative vote on the Philip Morris application to designate the heat-not-burn product as harm reducing.
Given the FDA’s new strategy for tobacco control which includes lowering nicotine in cigarettes and pushing smokers towards lower-risk products, research on harm reduction products and strategies is needed, but with the scientific community in the driver’s seat — not the tobacco industry.
Jonathan Samet, the first chair of the FDA’s Tobacco Products Scientific Advisory Committee, is the dean of the Colorado School of Public Health, a collaborative school with students, faculty and staff at the University of Colorado Anschutz Medical Campus, Colorado State University and the University of Northern Colorado.
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