The global tobacco control conference opens for the first time on African soil today in Cape Town, but South African-born Dr Derek Yach, a former World Health Organization (WHO) official, has been forbidden to attend because of his links to Marlboro.
Dr Yach was Executive Director for Noncommunicable Diseases at the WHO, and one of the architects of a global tobacco control convention that is now supported by 180 countries.
Offices on 5th Avenue
Today, the South African-born doctor is a pariah in the tobacco control world, after his appointment in September 2017 to head a multimillion rand venture, the Foundation for a Smoke Free World, which is being bankrolled by Philip Morris International (PMI), the manufacturer of Marlboro cigarettes.
Philip Morris is channelling $80-million a year for the next 12 years – a massive $1-billion – into the foundation, which has set up offices on 5th Avenue, New York.
The foundation says it will fund research into “smoking cessation and harm reduction” including supporting “better products and services” aimed at helping people to stop smoking and assist tobacco farmers to transition to other crops.
Dr Yach’s appointment shocked his former colleagues in the tobacco control sector who worked alongside him to develop the Framework Convention on Tobacco Control (FCTC), which has become the public health world’s game plan for fighting the effects of tobacco, including “sin” taxes and the regulation of tobacco products, their packaging and marketing.
Finding new users
The attendance section of the 17th World Conference of “Tobacco or Health” website expressly forbids access to anyone associated with the new foundation or any tobacco company.
In addition, today Bloomberg Philanthropies will launch STOP, a global tobacco watchdog to monitor and expose tobacco industry interference in public health policy.
“Tobacco control measures have saved nearly 35 million lives around the world, but as more cities and countries take action, the tobacco industry is pushing to find new users, particularly among young people," said Michael Bloomberg, the billionaire former mayor of New York who has donated $1-billion to curbing tobacco use, and is attending the Cape Town conference.
“We cannot stand by as the industry misleads the public in an effort to get more people hooked on its products – and this global watchdog will help us fight back,” added Bloomberg, who is also the WHO Ambassador for Noncommunicable Diseases.
The WHO has condemned the new foundation, saying that if PMI was truly committed to a smoke-free world, it would support evidence-based policies outlined in the Convention, including “tobacco taxes, graphic warning labels, comprehensive bans on advertising, promotion and sponsorship, and offering help to quit tobacco use”.
“Instead, PMI engages in large-scale lobbying and prolonged and expensive litigation against evidence-based tobacco control policies,” said the WHO. It referred to a six-year arbitration process in Uruguay that Philip Morris lost recently, in which it “spent approximately $24-million to oppose large graphic health warnings and a ban on misleading packaging in a country with fewer than four million inhabitants”.
The International Union against Tuberculosis and Lung Disease dismissed the foundation as a “billion-dollar bribe the tobacco company hopes will secure it a seat at the table with public health policymakers around the world”.
“Philip Morris International makes huge profits each year off the back of people who are sick, impoverished and dying as a result of its cigarettes. Tobacco kills half of its users. And nearly 80% of smokers live in the world’s poorest countries.”
As awareness of the dangers of smoking – which is associated with 23 different cancers and a host of other health problems – has become more widely known, cigarette companies have started to promote electronic cigarettes that deliver nicotine-based vapour to users and heat-not-burn devices, that heat up tobacco.
Dr Stanton Glantz, director of the University of California San Francisco’s Center for Tobacco Research, Control and Education, sees the new foundation as part of Philip Morris’s “efforts to promote its new heat-not-burn IQOS product”.
Vaping less harmful
Unlike e-cigarettes that heat up liquid that usually contains nicotine until it releases a vapour, the IQOS actually heats up tobacco – but doesn’t burn it, and Philip Morris claims that this makes it much less harmful.
Writing in the Lancet last October, Dr Yach said that millions of people now used e-cigarettes and heat-not-burn products and that “there is emerging evidence of the health benefits relative to continued smoking”.
“For e-cigarettes (vaping) in particular, there is emerging evidence from the UK and the USA that increases in use are helping some smokers to switch and to quit, and that these products are not directly associated with daily cigarette smoking among youth,” argued Dr Yach.
While there is little doubt that vaping is less harmful than smoking, electronic devices are not simply being used to wean people off cigarettes, according to the University of California San Francisco (UCSF).
“Studies are increasingly documenting that, instead of prompting smokers to switch from conventional cigarettes to e-cigarettes or quitting altogether as some scientists and policymakers had hoped, e-cigarettes are reducing the likelihood that people will quit smoking, while also expanding the nicotine market by attracting more youth to start,” said the UCSF.
Last month, the UCSF released results of a study of almost 70 000 which found that daily use of electronic cigarettes nearly doubles a person’s risk of a heart attack.
“E-cigarettes are widely promoted as a smoking cessation aid, but for most people, they actually make it harder to quit smoking, so most people end up as so-called ‘dual users’ who keep smoking while using e-cigarettes,” according to Dr Glantz, who co-authored the study.
Dr Ramla Benmaamar, Director of Global Scientific Communications for the Foundation for a Smoke-Free World confirmed that Dr Yach would be in Cape Town at the time of the conference but would not attend “due to a ban that has been implemented on the Foundation and its associates”.
“Although Dr Yach has supported and led smoking cessation research and policy development and has been a strong proponent of harm-reduction policies, calling for a greater emphasis on harm reduction as early as 2005, the conference organisers have not taken into account the benefit his attendance would have provided the community with,” said Benmaamar. – Health-e.
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