Author: Franklin Apfel [including interview transcript from Derek Yach] January 18 2018 – This blog, one of four, is part of series in which Apfel analyses and McKee comments on Yach’s interview responses on the tobacco industry and his involvement in the Foundation for a Smoke-Free World. The series is intended to identify new ways in which the industry is attempting to (re)frame conversations on tobacco and health and tobacco industry behaviours as demonstrated by their adherence to or circumvention of article 5.3 of the WHO Framework Convention on Tobacco Control (FCTC). Article 5.3 of the WHO Framework Convention on Tobacco Control states: "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." 

 

 A four part interview and commentary series 

Interviewer: Franklin Apfel, World Health Communication Associates (WHCA)

Interviewee:  Derek Yach, Founder and Director Phillip Morris International (PMI) Foundation for a Smoke- Free World

Commentary: Professor Martin McKee, London School of Hygiene and Tropical Medicine (LSHTM)

Background notes 

In September, 2017 PMI [Phillip Morris International] announced the establishment of a new 1 billion dollar (80million/a year for 12 years) Foundation for a Smoke Free World. Derek Yach, a former WHO [World Health Organization] director of the Tobacco Free Initiative (TFI) and NCDs [non-communicable diseases], was named director. Along with WHO and other public health voices, I expressed my concerns and suggestions for corrective action in blogs published by TheNewsMinute and The Communication Initiative. Following the appearance of those blogs, Derek Yach called me and asked to talk as he “wanted to explain his actions.”  I suggested that I interview him, and he agreed to have the interview recorded. The text attributed to Derek Yach (DY) that follows is drawn from taped transcripts and his subsequent edits. As I reviewed the conversation, I realised that underlying his responses were some new Tobacco Industry communication framing strategies that needed to be exposed and countered as they, I believe, pose clear threats to public health.

Framing is emphasising some aspects or attributes of a perceived reality and making them more visible and attractive as a way of shaping/creating/catalysing a particular problem definition, causal interpretation, moral evaluation and/or [action] recommendation. Many say that those who control the frame control the debate. The Tobacco industry, or rather their paid marketing and advertising strategists, like Ogilvy, who now represents the Foundation, were very successful in framing tobacco debates for decades around the smoker’s right to smoke. This “individual rights” frame shifted discussion away from public health impacts. Key to the success of the Framework Convention on Tobacco Control (FCTC) was the ability of the public health community to reframe the debate around ”Tobacco kills - don’t be duped”… “by an industry that lies, hides and manipulates evidence, etc.” 

In this interview, I believe that Yach reveals several new, what I would call toxic frames, - frames that aim to redirect current public health policies, attitudes and behaviours away from current FCTC priority actions to new cooperative research and policy actions funded by the tobacco industry.

This blog series aims to shed some light on four of these new frames; called here:

1. 50 shades of gray frame;

2. Stalled FCTC policy frame; 

3. The harm reduction frame; and 

4. The public health research incompetence frame.

To further stimulate public health debate on these frames I have asked Martin McKee to comment on the Yach interview. [We encourage comment from the public – simply register with The CI and comment at the close of the blogs.]

50 shades of gray frame:

Apfel: In this frame, a case is made to start perceiving tobacco companies differently. Currently, the FCTC, WHO, and most peer review journals consider any funding by or relationship with any tobacco company as representing a public health conflict of interest and recommend no cooperation or publication. Yach challenges this approach and starts to make the case that some companies, like PMI, which he believes are actively working to get out of the addictive and deadly “burn” tobacco business and into the addictive and, according to Yach, less deadly “heated” tobacco and nicotine businesses are better intentioned. In this frame, he makes the case for distinguishing the “less bad” companies and aims to open the door to funding from and cooperation with the less bad. 

Q. Philip Morris International tobacco industry consistently opposes measures such as advertising brands, tax increases, strong health warnings and smoke-free measures. Do you agree or disagree with that?

DY. I would say in most parts of the world that is still correct; there have been a few examples recently where they've gone the other way. For example, in the UK they have called for increased excise taxes on cigarettes and have withdrawn from challenges to plain packaging so I think it's a work in progress...

Q. Is the Foundation for a smoke-free world a public relations program that aims, to ‘greenwash’ ‘astroturf’ and/or clean-up perceptions of Philip Morris International and help them circumvent article 5.3 of the WHO Framework Convention on Tobacco Control (FCTC)?

DY. The Foundation is set up as an independent foundation. It is not a public relations exercise and if it is used for public relations it will fall foul of US law. So what Philip Morris's intent is you have to speak to them about. I would assume it's primarily to advance science around accelerating the end of smoking, whether people agree or disagree. That [I believe] is the[ir] intention and that's been [the focus of] the [Foundation’s] discussions with them.

As to 5.3 (part of the WHO FCTC which I played a key role in shaping) I remain convinced most have never read it carefully... If they had they would see that … it calls for transparency and the avoidance of conflict of interest in working with tobacco companies; it doesn't say zero contact, zero interaction, or that you would be penalized if you interact with them. That has become part of the folklore that some in WHO (who should know better) and particularly the NGO community have propagated If it did really mean no interaction, many of the largest countries in the world, starting with China would have great difficulty given the fact that they are the home to the largest state monopoly producing 40% of the world cigarettes. The same albeit at a smaller level applies to Thailand, Indonesia and range of other countries.

Q. What areas of research do you foresee the Foundation working on? 

DY. Our mandate is very clear, it is to end smoking and in the process of doing that we obviously have to look at all issues around access to cessation and new-products...[this will be] one of our main areas of research. We also have to deal with the behavior of tobacco companies with respect to thwarting the most effective and main provisions of the framework convention. 

Q.  How do you deal with the ‘paradox’ that at the same time that PMI is pursuing what you perceive as a very positive thing they are also actively pushing the ‘deadlier’ product they are trying to replace? 

DY.  Yeah, and frankly I wish that the world was perfect. When I was at PepsiCo I learned the harsh reality that transformation of a portfolio in a company is not as easy as it may look on the books of WHO. The companies have to stay profitable and stay afloat while they are changing the company and that means negative activities will continue probably in some parts of the world while the transition is happening. You can think about the motor vehicle industry, General Motors recently announced it's going to make sure all of their cars are electric at some time in future. Well I haven’t heard activists say “Well, then stop selling your gas guzzling cars because they are destroying the environment today and just go on with those.” Most knowledgeable people know they won’t get to a world of an electric car being the major product if they don't continue to make the profits out of these polluting cars today. 

Q. What do you feel about the statements that point to the fact that this is a sort of PR exercise that is really aiming to divert attention from the harmful products? That PR companies like Ogelvy, which is actually representing the Foundation as well as many tobacco companies, and that notoriously brought us the 'sick building syndrome', frame and spin on environmental tobacco smoke in the past, are going to utilize this as a diversionary tactic and that if no profits are realized PMI will reverse its course.

DY. There is no going back with this. This is the final transformation in cigarettes, the[se] changes in products , and I'm willing to bet whatever credibility [some] of you think I might have, [that] this is the end of the cigarette as we know. For 100 years we've lived with a product that has not changed all that much. Now with very large investments in science technology, the demand of consumers and many other things the separation of nicotine from the rest of the cigarette is a reality - it's not perfect but it's a reality. What does that mean? It means that the tobacco companies of the future will mainly be selling things closer to pharmaceutical nicotine devices rather than the gungie dirty stuff they’re selling today...

Q. Some would say that the Tobacco industry’s continued interference with public health, continued marketing to young people, persistent and growing expansion into developing markets overwhelms any trust or interest in  'innovative' research like you are describing. Isn’t this just too difficult a pill to swallow?

DY. Absolutely, it is a difficult pill for me to swallow!  But what many don’t know is… that I didn't jump into this one day to the next. I went through my decision making process very deliberatively and over the course of 18 months went through the PMI research facilities twice: once alone, once with some top systems biologists. I did my due diligence on how serious this is as a corporate-wide transformation which left me no doubt that this was the only plan they have, they transform or they go under. Is this actually a big subterfuge? If so, it's got to be a subterfuge of a magnitude that we have never seen before to pull off this level of investment in R&D and actually demonstrate the transition in many countries around the world. To start closing down factories, I don’t know how many factories, but I know that 3 or 4 major Marlboro factories have been shifted to actually transition to reduce risk products and all this is already having an impact on the demand for leaf tobacco in parts of the world. This isn’t theory; this is actually putting tobacco farmers livelihoods on the line faster than we ever suspected which is great news for ending smoking but not great news for tobacco farmers. You tell me it's a subterfuge. I really think that the problem with many folk in tobacco control is that they don't want to actually look at the hard evidence or go and talk to people whom normally they have never spoken to. If they did they will find out the same facts I've seen. I have many colleagues around the world that have seen and [believe in] this as well. What none of us like is the pace of change -  that it is still not fast enough – and we [definitely] don’t  like the fact that they are still carrying out dirty tactics around the world; that doesn't negate the fact that the transition is happening and it's happening potentially faster than anything we would've seen in public health.

Q.  Some, including myself in a recent blog have called for some more visible repentance from the tobacco industry to develop some more sense of trustworthiness in this process. What’s your thought about repentance on the part of the tobacco industry for the major harms they have caused over these decades?

DY.  My view is that the best form of repentance is to accelerate their investment in getting these harm reduced products to market to displace the ones that are already killing people and in the process to stop the dirty tactical lobbying…[I would like to]  see the nature of the product the nature of the marketing the nature of the lobbying changing fundamentally.

Q. What would be your drop-dead demand on the industry in terms of your continued willingness to work for them?

DY. In the sustainability report and the letter by the CEO of Philip Morris, he alludes to key performance indicators which are going to spell out transition in terms of actual capital expenditure towards reduced risk products away from traditional products.  We should see marketing, sales and all the other investments towards them. I think that if they fail to actually make progress on those, they’ll be held to account by the investment community as not doing what they know to believe is the best way for a tobacco company to accelerate the increased transition to reduce risk products. What will I do?  Well I am the director of an independent foundation. We will report it honestly and truly and be very clear about the lack or the positive aspects of progress of PMI or any other company.

Commentary - Professor Martin McKee

In the above interview, Derek Yach seeks to respond to the virtually universal criticism among the global public health community of the newly created Philip Morris Foundation. After it was announced, I and two Australian colleagues argued, in a commentary in the medical journal The Lancet, that the claims made for the new Foundation simply were not credible. Similar views were expressed in the British Medical Journal and elsewhere. The World Health Organisation and leading public health groups, such as the European Public Health Association, of which I am immediate past president, have made clear that they will have nothing to do with it. As the Secretariat of the Framework Convention on Tobacco Control (FCTC) has argued, this is "a clear attempt to breach the WHO FCTC by interfering in public policy" and "a deeply alarming development aimed at damaging the treaty’s implementation...". Yach clearly takes a different view but it stretches credulity that so many public health groups, including the Secretariat of the Convention, can all be wrong...

So has Derek Yach told me anything that will lead me to change my mind? No. Those with long memories recall earlier attempts by the tobacco industry to rehabilitate itself. It didn’t work then and, from what we have seen so far, it won’t work now.

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