Category: Harm Reduction

WHO Criticized for ‘Backward-Looking’ Approach

Tom Miller | Photo: David Parker
Marking World No Tobacco Day, an international group of independent experts has criticized the World Health Organization (WHO) for its “backward-looking” approach to innovation and new technology, such as vaping products.
The experts say they are exasperated by the WHO’s “dogmatic hostility” towards new technology and fear the U.N. health agency will squander the opportunity to avoid millions of premature deaths that will be caused by smoking.
Iowa State attorney general Tom Miller said the WHO has lost its sense of mission and purpose. “It’s as if the WHO has forgotten what it is there to do—to save lives and reduce disease,” Miller said.
“We can do that by helping and encouraging consumers to switch from cigarettes to lower-risk products. This means being honest about the much lower risks and by using smarter regulation to make switching more attractive.”
The group of experts criticizing the WHO include David Abrams of the School of Global Public Health, New York University; Tikki Pangestu, visiting professor, Lee Kuan Yew School of Public Policy, National University of Singapore; John Britton, professor of epidemiology at the University of Nottingham; Rajesh Sharan, of North-Eastern Hill University, Shillong, India; David Sweanor, Centre for Health Law, Policy and Ethics, University of Ottawa; and Clive Bates, director of Counterfactual Consulting.
June 1, 2020
Consumer Group Urges Liberal Tobacco Policies

Illustration: The Consumer Choice Center
The liberalization of vaping has considerable potential to help millions of people switch from traditional tobacco smoking to vaping, according to the Consumer Choice Center (CCC). Vaping is widely believed to be a less harmful way of consuming nicotine than smoking.
The CCC examined 61 countries and assessed how “smart” tobacco harm reduction policies could make the switch easier.
Fred Roeder
“We looked at 61 countries (including the U.K.) around the world and compared the current rate of daily and occasional vapers,” said Fred Roeder, health economist and managing director of the CCC. “We used the United Kingdom’s progressive tobacco harm reduction policies as a reference point and estimated how many current smokers could be helped to switch to vaping by having a more permissive vaping framework.”
“More liberal rules on advertising to smokers, displaying products at the point of sale for cigarettes, lower taxation, and public health bodies endorsing the evidence of vaping being at least 95 percent less harmful than traditional smoking can help smokers to switch to vaping.”
The CCC estimates that nearly 200 million adults in the analyzed 60 countries could switch to vaping and urges public health bodies and regulators to endorse tobacco harm reduction
June 1, 2020
Rehumanize Yourself – The WHO’s Backward Priorities
In the fights against smoking, the World Health Organization appears to measure success in bureaucratic rather than human terms.
By George Gay

As I get older, I have a growing problem whereby my thought processes move into circular orbits around my head. For instance, I have been reading the 2019 World Health Organization’s (WHO) tobacco report and, while you might expect it to contain much food for thought, just about the only question that is doing the rounds in my mind is: Why does the report contain so many pictures of children (and to be clear, I’m talking about preteen children)? There are so many such pictures that I gave up counting less than halfway through the 200-page online version of the WHO report on the global tobacco epidemic 2019, by which time I had totted up 50 smiling children.
Don’t get me wrong, such pictures, with their air of joy and hope, can brighten the darkest days even for an old cynic. But there is a time and a place, and I thought that mixing such pictures with tobacco was a no-no, unless overwhelming evidence could be presented to support the idea that such juxtapositions would have a significant positive outcome for children in general.
So, perhaps I wouldn’t have questioned the placement of the pictures if the underlying theme of the report had been the prevention of smoking initiation among children, but it wasn’t, and the use of the pictures seemed gratuitous. The theme was “offer help to quit tobacco use,” a seemingly tortuous effort to justify the ‘O’ in ‘MPOWER,’ which was said in a foreword by WHO Director General Tedros Adhanom Ghebreyesus to encompass six measures to help implement the WHO’s Framework Convention on Tobacco Control (FCTC) using “effective interventions that are proven to reduce demand for tobacco.”
To my mind, this foreword is a strange piece in which “success” seems to be measured in bureaucratic terms—in respect of how many countries have been encouraged to implement MPOWER measures—rather than in human terms—the number of people who quit smoking, which doesn’t get a mention.
It seems a strange thing to say, but the FCTC doesn’t seem to do humanity. Rather than try to get to the bottom of why people smoke and help address the issues they have, it encourages governments to threaten them with graphic images of diseases and tax them until they bleed through the eyes. It seems not to be on the side of the smoker but on the side of some greater calling. It seems to be on the side of tobacco manufacturers, through its Protocol to Eliminate the Illicit Trade in Tobacco, and on the side of governments and their revenues, which many spend not on programs to prevent tobacco initiation among smiling children but on armaments, some of which end up blowing the limbs off those children. I suppose you can’t smoke if you don’t have any fingers.
As usual, the United Nations is protecting us from things we can protect ourselves from, but leaving us exposed to those that we cannot
The closest the director general comes to talking about getting smokers to quit their habit is when he suggests that due in part to countries implementing MPOWER measures, “many tobacco users now want to quit, and we know how to help them.” To my mind, the lack of urgency and ambition in this statement beggars belief. But then I guess it’s easy to get used to failure. Part of the summary of the report has this to say: “Unfortunately, only 13 new countries have started providing comprehensive cessation programs since 2007. There are now 23 countries protected by this measure, up from 10 countries in 2007.” At this point, you start to wonder whether the children are pictured because this report is meant to be read by them—or, more likely, only by the very youngest among them. After all, I assume that adults and most children would not need to be told that if a number has increased from 13 to 23, the original number was 10.
The forewords by Michael R. Bloomberg, WHO global ambassador for noncommunicable diseases and injuries and founder of Bloomberg Philanthropies, and Vera Luiza da Costa e Silva, head of the WHO FCTC Secretariat, also seem to measure success in getting countries to implement FCTC policies, and the nearest they get to talking about the numbers of people who have quit—or who would have quit if only—is when the latter says, “If tobacco cessation measures had been adopted at the highest level of achievement in 14 countries between 2007 and 2014, 1.5 million lives could have been saved.” I’m sure that if they could speak, those 1.5 million people would want to thank da Costa e Silva for her encouraging words.
The three forewords run to about 1,750 words, and, despite the number of pictures of children in the report, the word “children” occurs only once in those forewords when da Costa e Silva claims the tobacco industry doesn’t want anything to change, but “for the sake of public health, and in the interests of our children and future generations, things must change.”
Ah, change; it’s all very well, but you do have to be careful what you wish for. In his foreword, Bloomberg highlights some of the WHO’s most important gains, one of which has occurred in Brazil, which “is now the second country [after Turkey] … that has passed all MPOWER policies at the highest level.” It’s true. Policies in Brazil do seem to have changed to ensure that fewer of its children will die of tobacco-related diseases, but mainly, I would suggest, because they will firstly fall victim to the effects of climate change-induced environmental disasters, in which, in fairness, many other countries will be complicit.
As usual, the United Nations is protecting us from things we can protect ourselves from, but leaving us exposed to those that we cannot: climate change, environmental breakdown, pollution, poverty, globalized viruses and those endless bombs sold, according to the logic of the market economy, to any lunatic group with the money to buy them. There is little sense that we should be in preventative rather than reactive mode. When I see the pictures of the WHO’s smiling children, I cannot get out of my mind the faces of children I see in my newspaper: terrified, dirty faces above malnourished, shabbily clothed bodies wandering among rubble-strewn streets a million miles and years from a school, an inspiring teacher and the prospects of a better life. But at least they’re too poor to be using tobacco.
Success in South America
This is not to say that children should not be protected from tobacco and any other products deemed to be suitable only for adults. And Brazil has seemingly done a good job in bringing in measures said by the WHO to encourage people not to start smoking or to quit if they have already done so, starting, according to the WHO report, from 1981 when the Ministry of Health set up the Commission for the Study of the Consequences of Tobacco. In 1999, Brazil also set up the National Commission on Tobacco Control to support the country’s role in negotiating the FCTC, which it signed in 2003 and ratified in 2005. And in 2018, Brazil also ratified the Protocol to Eliminate Illicit Trade in Tobacco Products.
Since 1989, Brazil has taken increasingly stringent steps against tobacco advertising and promotion and introduced bans on smoking in enclosed public places. The country has introduced increasingly graphic health warnings on tobacco packs and integrated cessation treatments into its public health system. And, of course, it has increased tobacco taxes, which, as of 2018, were said to represent 82.97 percent of the retail price of the most popular brand.
One of the more amazing—and rounded, it has to be said—figures to come out of Brazil’s efforts appears outside the special section on the country where, it is said, “when Brazil became the first large country to include its national quit line number in graphic health warnings on cigarette packaging, the quit line received unprecedented call volumes—reaching up to 6 million calls in the first year, and more than all other quit lines globally at that time.” Given that we live in a time of fake news, I should point out that “up to 6 million” could legitimately mean one. Just saying.
Whether due to these measures wholly or in part, adult smoking prevalence in Brazil was said by WHO to have declined from 35 percent in 1989 to 18.5 percent in 2008, the year the MPOWER measures were introduced, and to 14.7 percent in 2013. Adult cigarette smoking was said to have decreased in capital cities from 15.6 percent in 2007 to 10.1 percent in 2017.
But the smiling children didn’t do so well. “Despite declining smoking rates among adults, smoking prevalence among youth remains stable at around five percent, with 19 percent of boys and 17 percent of girls experimenting with smoking during their school years, according to PENSE [National Adolescent School-based Health Survey] 2015,” the report said.
Rather than try to get to the bottom of why people smoke and help address the issues they have, the FCTC encourages governments to threaten them with graphic images of diseases and tax them until they bleed through the eyes.
Brazil is not the only country of South America featured prominently in the report. There is a piece on Colombia that describes how, from 2016 to 2017, tobacco taxes there have been increased hugely. But again, success is measured not against how many people quit smoking because of these increases but on the grounds that civil society groups were able to counteract the tobacco industry’s argument that tax increases would create an unmanageable surge in illicit trade and because Colombia managed “the highest level of achievement under the raise taxes on tobacco MPOWER measure.”
There was also a piece on Ecuador that focused on its integration of tobacco cessation strategies into its health system. But here, at least, we get a glimpse of what should be the focus of the WHO’s efforts: people quitting smoking. “From mid-March to mid-November 2018, 3,916 tobacco users were identified and given advice on quitting,” the report said. “Among the 2,069 patients who completed a follow-up at four months, the seven-day self-reported abstinence rate was 57.2 percent, and of the 968 who completed a six-month follow-up assessment, the self-reported abstinence rate was 48.9 percent.” So, my interpretation of these interventions suggests that just over 470 people are believed to have not smoked for a while. What can you possibly say? It’s a start?
Of course, it is impossible not to set Brazil’s success against the fact that the country is the biggest exporter of leaf tobacco. While Brazil is praised by the WHO for its MPOWERing, it is a major contributor to fueling what the WHO characterizes as the “global tobacco epidemic.” And this raises a number of questions.
Older readers will remember the arguments put forward in the past that EU farm subsidies should not go to supporting leaf tobacco growing, some of which had merit. But some cleaved to the ludicrous claim that if you stopped leaf production in the EU, you would stop smoking there, seemingly forgetting that the EU was a relatively small player in tobacco production and a major leaf importer. Brazil is not the EU, however. If Brazil stopped leaf production overnight, it would MPOWER the WHO’s activities like nothing else. And, of course, it would impoverish a lot of people, especially those in Brazil.
I would not advise such a course of action. As one reformed supporter of globalization once said, the basic responsibility of governments is to maximize the welfare of its citizens not to pursue some abstract concept of the global good.
But what is the WHO’s view? In its eyes, is impoverishment an acceptable side effect of curing the tobacco epidemic? Of course, I cannot know the answer to that question, but something tells me that it would be “yes.” If you look closely at the children whose pictures were chosen for publication by the WHO, most of them seem to be living in or close to poverty. I can assume only that, from the lofty heights of Geneva, Switzerland, poverty seems quite quaint.
George Gay is Tobacco Reporter’s European editor, but his territory spans the globe. Based in London, George has covered the tobacco industry since 1982, initially for a U.K.-based publication and since 2004 for Tobacco Reporter. George’s understanding of industry issues, combined with his keen sense of observation and dry wit, have earned him a loyal following among Tobacco Reporter’s readers.

June 1, 2020
The Global Forum on Nicotine 2020 Moves Online

Photo: Rudy and Peter Skitterians from Pixabay
The Global Forum on Nicotine (GFN) will take place online June 11-12, 2020, following the cancellation of the face-to-face event in Warsaw due to Covid-19.
The conference is free of charge and open to everyone with an interest in nicotine science and policy.
During the conference, experts will discuss advances in nicotine science, the ethical arguments in favor of tobacco harm reduction and the human rights issues for all those who advocate for the right to health will be explored.
“As always, and perhaps even more so in this critical year, GFN is open to everyone with an interest in nicotine science and policy,” said Paddy Costall, co-director of the conference.
“It is open to everyone who wants to reduce the toll of tobacco-related death and disease worldwide. And it is open to everyone who recognizes that global tobacco control will fail without the strategic addition of tobacco harm reduction, in the form of widespread access to safer nicotine products. We look forward to welcoming you on the 11 and 12 June—and hope to see many of you in Warsaw, where we plan to meet again in June 2021.”
Participants can register now.
May 29, 2020
‘Harm Reduction Is Human Right’

Photo: Horst Winkler from Pixabay
The European Tobacco Harm Reduction Advocates (ETHRA) is calling on policymakers to recognize the benefits of tobacco harm reduction in advance of World No Tobacco Day on May 31.
According to ETHRA, reduced-risk products such as e-cigarettes and snus are providing a gateway out of smoking for millions of Europeans, yet across the continent, consumer access to these products is being denied or is under threat.
Today, the organization launched a manifesto to promote appropriate regulation of innovative solutions for people who wish to continue using nicotine in far safer forms than smoking tobacco, as well as on behalf of the many smokers who may be able to quit through switching to these products in the future.
Among other things, the manifesto calls for access to harm reduction, including tobacco harm reduction, to be recognized as a human right; for consumers of safer nicotine products to be recognized as essential stakeholders in discussions of policy; and for the regulation for safer nicotine products to reflect the risks relative to the risks from smoking.
What’s more, regulators must recognize that having a wide choice of products and flavors is key to the success of safer nicotine products in enabling people to stop smoking, according to the manifesto. Regulation must consider the harm to adults when considering bans intended to protect youth, and tax policy must consider that high taxation of safer nicotine products increases rates of smoking.
Comprising 21 consumer associations in 16 European countries, the ETHRA was created to increase understanding about the benefits of “new” risk-reduced nicotine products and to promote recognition of long-term recreational use of nicotine as an incentive for smoking cessation.
May 26, 2020
Foundation Debates Covid-19 Crisis’ Impact on Harm Reduction

Sally Satel during the 2019 GTNF in Washington DC | Photo David Parker
The Reason Foundation will host a webinar on May 19, 2020, at 12:30 p.m. Eastern time to discuss how Covid-19 is affecting tobacco harm reduction and policymaking.
Guy Bentley, director of consumer freedom research for the Reason Foundation, will host the webinar. Other speakers will include Sally Satel, resident scholar at the American Enterprise Institute, Michelle Minton, senior fellow at the Competitive Enterprise Institute, and Tim Andrews, executive director for the Taxpayers Protection Alliance.
The webinar is open to the public.
May 6, 2020
Beyond Tobacco

Photos: BAT
British American Tobacco prepares for a radically different future.
By Stefanie Rossel
Less than a year after taking over as British American Tobacco’s (BAT) new CEO, Jack Bowles has already left a distinctive mark on the company. In September, the maker of Lucky Strike and Camel cigarettes unveiled a comprehensive restructuring program that included the layoff of 2,300 of its 55,000 employees. A fifth of the job cuts were senior roles. Savings delivered by the measure were to be reinvested in the company’s new categories, such as vapor, tobacco-heating products and oral tobacco, BAT said. The goal is to make BAT a more efficient and agile company and to facilitate business processes.
On the occasion of its capital markets update in mid-March, the company appeared to have reinvented itself: Gone was the tobacco leaf in its logo, replaced by a double swoosh and accompanied by the slogan, “A better tomorrow.” BAT appears to be redefining itself as a consumer goods company.
“Our strategy puts the consumer first, focusing on understanding adult consumer choice and enjoyment,” explained Kingsley Wheaton, BAT’s chief marketing officer. “We will capture lost consumer moments with a portfolio in tobacco, nicotine and beyond. This will enable sustainable, long-term growth with a clear focus on foresights, innovation, brands, activation, teams and technology. We will become a business that defines itself not by the products it sells but by the consumer needs it meets.”

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“The redesigned logo, replacing one that hadn’t altered since the late 1990s, helps to emphasize that an increasing part of BAT’s future is likely to be in noncombustible nicotine products such as smokeless tobacco, vapes and tobacco-heating [products],” says Jonathan Fell, principal at Ash Park. “With ‘beyond nicotine,’ it is also raising the prospect of going into areas such as caffeine or cannabidiol/tetrahydrocannabinol products once the appropriate legal and regulatory framework is in place and the company’s scientists have fully substantiated their safety and efficacy.”
BAT experienced a 4.7 percent reduction in traditional cigarette volume in 2019, according to its most recent annual report. The company’s revenue growth of 5.7 percent to £25.88 billion ($32.26 billion) in 2019 was driven by pricing across the cigarette portfolio and an increase in revenue from traditional oral tobacco and next-generation products (NGPs).
In light of continuously declining global cigarette sales, tobacco companies have increasingly felt the pressure to adapt their business models to the changing environment. Philip Morris and Japan Tobacco International announced similar restructuring and rationalizing measures in the last quarter of 2019.

Jack Bowles aims to make BAT a more efficient and agile company
Faster and more responsive
Upon taking the helm at BAT, Bowles set out three priorities: driving value from combustibles, improving the performance of new categories and simplifying the business. During the capital markets event, Bowles substantiated forthcoming goals. BAT aims to reduce the health impact of its business by offering a greater choice of better and less risky products with the ambition to have 50 million noncombustible product consumers by 2030. By extending its Quantum project, a business simplification program initiated in 2004, the company aims to generate £1 billion over the next three years—money it intends to utilize to accelerate the revenue growth of its “new category” (NC) business. Next to vapor products, NC includes heated-tobacco products (HTPs) and modern oral products, a category comprising white, tobacco-free nicotine pouches, such as Epok, Lyft and Velo. The company will support its strategy by establishing innovation hubs in London, San Francisco, Shenzhen and Tel Aviv in addition to its R&D centers in Winston-Salem, North Carolina, USA, and Southampton, U.K.
While acknowledging that the coronavirus crisis was likely to make NC growth in the first half of 2020 difficult with the company having postponed product launches, Bowles nevertheless expected to make further progress this year toward BAT’s aim to produce revenues of £5 billion through novel products by 2023–2024.

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Consolidating brand properties
In 2019, BAT increased its NC revenue to £1.3 billion, which represents 37 percent growth compared to the previous year and more than double the revenue from two years ago. BAT sold 226 billion vapor units and 9 billion HTP units in 2019, up 19 percent and 32 percent, respectively, over the previous year. With a plus of 188 percent, modern oral products saw extraordinary growth. The company sold 1,194 million pouches in 2019.
In November, BAT began to streamline its NGP portfolio to further accelerate the growth of its NC business, thereby creating three global brands. Vapor products will be branded as Vuse and HTPs will continue to be branded as Glo whereas modern oral products will be marketed under the Velo brand. The brand consolidation, taking place in phases, is set to be completed by the end of 2020.
BAT’s flagship Vype brand will also be migrated to Vuse, currently a brand manufactured by R.J. Reynolds Vapor Co., a subsidiary of Reynolds American Inc. (RAI), which BAT acquired in 2017. Launched in 2013, Vuse once was the U.S.’ most popular e-cigarette, reaching a market share of 33 percent in 2015 before Juul overtook it in 2017. In 2019, Vuse recovered some of the lost territory, claiming a market share of 14 percent. Growth was driven by the launch of Vuse Alto, a pod-mod type vaporizer. In October 2019, RAI submitted a premarket tobacco product application (PMTA) to the U.S. Food and Drug Administration (FDA) seeking market authorization for a range of Vuse flavors. At the time of writing, the FDA’s court-ordered May 12 PMTA deadline was likely to be extended by 120 days because of the coronavirus pandemic.
Fell is confident that BAT will be able to pursue its growth strategy in the U.S. despite the nationwide restrictions on e-cigarette flavors that took effect in February. The ban applies to mint and fruit flavors that are offered in cartridge-based e-cigarettes, such as the pods sold by Juul Labs. Menthol and tobacco flavors continue to be allowed as well as fruit flavors delivered by disposable vapes, vapor devices with an open-tank system and their respective e-liquids. “BAT has been gaining share of the U.S. vaping market, helped by the success of its Vuse Alto device and also because, relative to major competitors, a smaller proportion of its portfolio has been hit by the flavor ban,” says Fell. “In the short term, the growth of the overall vaping category could be impacted by the challenges and ongoing uncertainty posed by the May 2020 PMTA deadline, which may now be extended due to the Covid-19 outbreak. But in the long term, BAT should be in a very strong position to compete energetically in the U.S. vape market and certainly has the resources to meet the increasing regulatory demands.”

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Jonathan Fell
Pushing forward
BAT’s Glo has been sold in Japan and South Korea—the world’s leading HTP markets—along with Eastern Europe, Russia and Canada, among other markets. To support the expansion of Glo across Europe, the company in 2018 started a €800 million ($875 million) five-year investment program in its Romanian factory.
With around 70 percent of global industry volume, Japan is by far the largest market for HTPs. The segment in that country is currently led by Philip Morris International (PMI), which debuted the category in 2014 with the launch of IQOS and holds a 71.8 percent share. BAT launched Glo in Japan in 2016, and the product held a 20.1 percent category share in 2018, according to Reuters. To narrow the gap with IQOS, BAT in 2019 launched three new Glo variants in Japan: Sens, Pro and Nano. A fourth version was supposed to be introduced around press time.
“I think we will see increased efforts in this category, starting with the launch of Glo Hyper—with larger tobacco sticks and a device which uses induction heating—in April,” says Fell. “Rather than stressing it wants to be a leader in HTP specifically, BAT is very committed to its multi-category approach,” he adds. “It is well ahead of PMI in vaping and smokeless and will offer a choice of modern oral tobacco, vapes or tobacco-heating [products] that [are] relevant to consumer needs in individual markets. Hence, BAT says it wants to go ‘from a distant number two to a very strong number two’ in HTP.”
Stefanie Rossel is Tobacco Reporter’s editorial contributor. An experienced trade journalist, she combines sharp reporting skills with in-depth knowledge of the tobacco and vapor industries. Prior to joining Tobacco Reporter, Stefanie was editor-in-chief at Tobacco Journal International, where she worked for a decade. Fluent in English, German and French, Stefanie covers tobacco news around the world. She is based in Germany.

May 1, 2020
Comments Deadline Set for 22nd Century’s Modified-Risk Application

Photo: Eduin Escobar | PixaBay
The U.S. Food and Drug Administration (FDA) has set May 18, 2020, as the deadline for the submission of public comments on 22nd Century Group’s Modified Risk Tobacco Product (MRTP) application.
The application seeks authorization from the FDA to allow 22nd Century to market its reduced nicotine content cigarettes under the brand name VLN, with packs and advertising stating that the product contains 95 percent less nicotine than conventional tobacco cigarettes, as well as related claims regarding reduced nicotine exposure.
“We are very pleased with the progress our team continues to make towards receiving FDA authorization to market our VLN reduced nicotine content cigarettes,” said Michael Zercher, president and chief operating officer of 22nd Century Group. “With the imminent closing of the public comment period, we are hopeful that we will receive a positive decision from FDA allowing us to introduce our reduced nicotine content cigarettes to adult smokers looking to reduce their exposure to nicotine.”
22nd Century’s reduced nicotine content cigarettes enable adult smokers to experience the same taste and smell as conventional cigarettes but with minimal exposure to nicotine. Numerous independent scientific studies funded by the National Institutes of Health and other U.S. federal government agencies using the company’s reduced nicotine content cigarettes studies show that smokers who use 22nd Century’s reduced nicotine content cigarettes reduce their nicotine exposure and dependence, smoke fewer cigarettes per day, experience reduced withdrawal symptoms, increase their number of smoke-free days, and double their quit attempts.
The company believes that bringing its reduced nicotine content cigarettes to market will be an important step towards the implementation of the FDA’s proposed plan to require all cigarettes sold in the U.S. to be made “minimally or non-addictive.”
By limiting the nicotine content of all combustible cigarettes to just 0.5 milligrams of nicotine per gram of tobacco, a level already achieved in VLN, FDA projects that 5 million adult smokers would quit one year after implementation and more than 8 million American lives would be saved by the end of the century.
April 17, 2020
Encouraging Transformation

Photo: Hans Benn
An index that ranks tobacco companies aims to hasten the demise of combustible cigarettes.
By Stefanie Rossel
In the end, it will be about the money—that’s one expectation driving the Foundation for a Smoke-Free World’s (FSFW) most recent initiative. To accelerate the reduction of harm caused by smoking, the foundation plans to introduce an index designed to incentivize tobacco manufacturers to develop and market less hazardous products. A good score on the index could help tobacco companies attract new investors.
The Tobacco Transformation Index (TTI) is designed to provide quantifiable evidence over time of what steps the world’s 15 largest tobacco manufacturers—which account for around 85 percent of global cigarette volume—are taking toward achieving a world free of combustible cigarettes and other high-risk tobacco products as well as any actions they take to impede that progress. Cigarette makers have invested millions of dollars into the development of reduced-risk products (RRP) over the past few years, but they have been criticized for targeting high-income countries with their novel products while continuing to market combustible cigarettes in low-income and middle-income countries. The new index intends to foster faster change in these regions, too, by detailing tobacco manufacturers’ activities in 36 countries, which represent about 85 percent of the world’s current combustible tobacco sales and consumption.
“Of the more than 5 trillion cigarettes consumed globally each year, about 80 percent are consumed in low-[income] and middle-income countries,” explains David Janazzo, the FSFW’s chief financial officer and vice president of industry transformation. “Around 87 percent of global nicotine consumption is derived from cigarettes, another 7 percent from other forms of combustible tobacco, about 2 percent from various forms of smokeless tobacco, and the balance from RRPs, including e-cigarettes, heated tobacco products [HTP] and nicotine replacement therapies. Currently, combustibles drive the vast majority of consumption. The foundation’s mission is to end smoking in this generation and, importantly, to reduce the deaths and diseases caused by smoking.”
The index will be published every two years. Using an objective methodology that is presently under development, the TTI will measure various parameters, including companies’ allocation of capital, research and development; volume sales by product type—that is, combustible cigarettes versus RRPs—and violations. In addition, the index will review factual indicators associated with the countries it covers to demonstrate their policies and actions in contributing to a world free of high-risk nicotine products through measures such as tax structure, regulatory policy on RRPs and other metrics.
“The index strives to make patterns and trends visible over time that show the changing distribution of combustible cigarettes versus less-hazardous products,” says Janazzo. “It will give the foundation and all stakeholders a window not only into what companies are saying but also into what they are doing. How will they invest their money in R&D? Will it be directed into more or less harmful products? How serious is their commitment to tobacco harm reduction? We will also monitor companies’ transparency and their commitment to reduction of harm.”

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Countering tobacco divestment
David Janozzo
The index is designed to stimulate competition among tobacco companies to deliver the required business transformation. It also seeks to enhance awareness and engagement among investors, policymakers and others. “We believe investors have a significant influence on corporate management decision-making,” says Janazzo. “The index will provide them and their advisors with quantifiable evidence of how companies are addressing industry transformation, on both an absolute and a relative basis, as an additional tool with which to wield influence and promote change. By creating a direct relationship between a company’s transformation and shareholder value—while quantifying transformation through clear and transparent metrics—we envision a market-driven approach that incentivizes sustainable change.”
The index targets investors who remain committed to tobacco. In recent years, a growing number of investors have divested their tobacco holdings. In September 2018, the United Nations launched their “Tobacco-Free Finance” pledge, which aims to eliminate investment in tobacco. Among its goals are raising awareness of the role financial institutions can play in tobacco control. At press time, the pledge had 151 signatories, among them well-known investors such as Allianz and Zurich Insurance Group, which together represent more than $10 trillion in assets under management, corporate loan books and gross premiums.
Other investors, including the U.K. National Employment Savings Trust, have announced the exclusion of tobacco from their portfolios, arguing that the tobacco sector is a dying industry facing stricter regulation, increasingly aggressive legal action and falling smoking rates.
Exposing their operations in an index by agreeing to release comprehensive and perhaps sensitive data may hence become an economic necessity for tobacco companies. “The Tobacco Transformation Index will rely as much as possible on public and independently sourced information,” says Janazzo. “But some of the necessary data will be nonpublic, accessed through nondisclosure agreement and protected accordingly. The companies will be encouraged to make all such data public, and transparency will in some form be encompassed by the index scoring methodology.” The Index will score and rank the companies, regardless of their participation level.

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From bad to less bad
Janazzo is convinced that the approach will work despite the tobacco industry’s historic reputation of secrecy. “What we have seen in other industries is the power of technological innovation, combined with other influences, to drive change: Coal companies are shifting to renewable energy, waste management companies are shifting from dumping to recycling and reusing and automobile manufacturers are developing electric and hybrid cars, shifting away from reliance on the combustion engine,” says Janazzo. “This transformation can also occur in the tobacco industry. Companies compete with one another and are therefore interested in the actions of their peers.
By actively encouraging and monitoring this transition, the index will over time incentivize industry players to act more quickly and more responsibly than they otherwise would, according to the FSFW. “Conversely, players that do not make the necessary transition will be exposed,” says Janazzo. “As a result, stakeholders such as investors and public health professionals will be better informed and able to demand necessary action.”
Janazzo stresses that the index will not be an effort to spruce up the image of the tobacco industry. “The tobacco industry created a global health crisis and then tried for decades to cover it up. Its poor reputation is well-deserved, and stakeholders have every right to be distrustful,” he says. “But those facts alone will not lead to the end of the smoking epidemic. Indeed, to the extent we allow the tobacco companies to be responsible for changing themselves without external influence, we become responsible for maintaining the status quo.”
The objective of the index, he adds, is to highlight the journey from “bad” to “less bad”—not to reward the sale of deadly products. The index is intended to complement tobacco control efforts, such as the World Health Organization’s (WHO) Framework Convention on Tobacco Control (FCTC) guidelines, governmental implementation of which is currently the primary method to tackle smoking-related diseases and deaths, according to the FSFW. “These efforts should and will continue,” says Janazzo. “However, more than a billion people still smoke, most of whom live in low-[income] and middle-income countries. Seven million smokers die prematurely every year. The bottom line is: Change isn’t happening fast enough.”
In its 2017 sustainability report, Philip Morris International (PMI) calculated that if the WHO’s projected pace of the decline in smoking prevalence continued at 0.21 percentage points per year while global population kept growing at 70 million people per year, it would take almost 100 years for the world to be smoke-free.

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Independent
To set up the TTI, the FSFW studied two other ranking systems as models. The Access to Medicine Index, established in 2008, ranks the world’s 20 largest pharmaceutical companies according to their ability to make their pharmaceutical drugs more available, affordable, accessible and acceptable in 106 low-income and middle-income countries. The Access to Nutrition Index, launched in 2013, evaluates the largest food and beverage manufacturers’ policies and performances related to the world’s most pressing nutrition challenges: obesity and undernutrition.
Both indexes are financially and organizationally independent of their respective industries. While the FSFW was set up in 2017 with PMI as its sole supporter—the company pledged almost $1 billion of funding for 12 years—the foundation’s independence is guaranteed by provisions in its bylaws.
For the TTI, the foundation has developed a management and governance structure that supports its impartiality. Foundation personnel are kept out of the index-making process completely. To work out the design of the index, the Foundation in May 2019 sponsored a series of listening seminars and consultations around the world with more than 100 participants from multiple disciplines, including representatives from academia, the investor community, NGOs and tobacco associations as well as agricultural groups. Among other things, they discussed the index’s theory of change and identified and prioritized specific topics the system should address.
“The concern about independence was raised at each and every one of the stakeholder dialogue sessions,” says Janazzo. “The index will be funded by the foundation and will operate independently, allowing for findings that are critical of the tobacco industry. Transparency is key. Therefore, a steady flow of information concerning the structure, design and methodology will be disclosed before the first index is published.”
For development and implementation of the TTI, the FSFW appointed two companies: market intelligence provider Euromonitor and SustainAbility, a think tank and advisory firm. While Euromonitor is responsible for process design, index research, analysis and reporting, SustainAbility oversees stakeholder engagement and seminars as well as program oversight and project review.
The two will represent the official “index team” and will be guided by an advisory panel that is in the process of being established. Composed of experts with knowledge of business and investment, corporate behavior and public health, the panel’s task will be to provide strategic advice on governance, development and promulgation of the index.
The panel will operate independently from the foundation, Janazzo says, and will adhere to a charter that forbids industry involvement. “The advisory panel, consisting of members from various areas of expertise, will provide guidance [on] how the index can evolve over time as it is not a one-report initiative.” None of the panel members will be from the tobacco industry.
In data collection and verification, however, interaction with the industry cannot be avoided. It will be the index team’s job to document and report on the nature of interactions with the industry during the index development and data collection process. Before being incorporated into the index, all information provided by tobacco companies will be independently reviewed by the Euromonitor team.
The first report is scheduled for release this September.
Stefanie Rossel is Tobacco Reporter’s editorial contributor. An experienced trade journalist, she combines sharp reporting skills with in-depth knowledge of the tobacco and vapor industries. Prior to joining Tobacco Reporter, Stefanie was editor-in-chief at Tobacco Journal International, where she worked for a decade. Fluent in English, German and French, Stefanie covers tobacco news around the world. She is based in Germany.

March 31, 2020
VApril Moves Online

VApril, an annual campaign to help U.K. smokers transition to vaping, will launch on April 1 and is going digital following the coronavirus outbreak.
Now in its third year, VApril is the world’s largest vaping consumer education campaign. This year, the campaign will harness digital platforms to reach out to U.K. smokers and vapers during the coronavirus lockdown and continue to provide specialist advice for those trying to quit smoking.
VApril follows the latest Vaping Evidence Review published by Public Health England (PHE) in March, which indicated that misinformation has led to false fears about vaping, preventing more smokers from make the switch.
“Normally during VApril, our members’ retail stores host expert classes across the country to educate smokers on everything to do with vaping, but this year, we’ve had to change tact to safeguard the welfare of smokers and vapers during the month, and therefore we will be engaging audiences through digital media,” said John Dunne, a director of the U.K. Vaping Industry Association (UKVIA), which organizes and coordinates VApril.
“Our VApril campaign aims to address the misinformation out there and give smokers all the evidence-backed advice and information that they need to make informed decisions about vaping and to give them peace of mind.”
An online hub is now live to support the campaign, where smokers can access information and expert advice covering vapor devices, flavors and nicotine levels.
Smokers can download a special “Switch on to Vaping” guide and pose questions online to an industry expert panel. A number of vapers also share their positive life-changing experiences of making the switch from smoking to vaping, and there is a vaper’s guide to coronavirus.
Vaping companies and associations in the U.K. and internationally can contact UKVIA to gain free access to all the campaign’s materials.
March 30, 2020