How a debate over vaping might derail the war on tobacco

Cliff Douglas fought the tobacco industry for decades. As a lawyer, activist, and executive at nonprofit organizations, he sued cigarette makers, cultivated whistleblowers, and led the campaign to ban smoking on airlines.

Which is why allies in the anti-smoking movement were surprised when in October he became CEO of the Foundation for a Smoke-Free World, a nonprofit created and entirely funded by Philip Morris International, one of the world’s largest tobacco companies.

Douglas, who previously worked for the American Cancer Society and the American Lung Association, sees his new job as the continuation of his anti-smoking work. He joined the foundation only after its board agreed to make a clean break from Philip Morris. He wants to bring together foundations, nonprofits, public health experts, elected officials, regulators, and academics in a renewed effort to curb death and disease caused by smoking.

It won’t be easy. Because anti-smoking groups aren’t just fighting the tobacco companies these days. They’re fighting, sometimes bitterly, among themselves.

“I’m under no illusions about the challenges,” Douglas says.

The stakes are high. Smoking remains the leading cause of preventable death in the United States, killing about 480,000 people a year, according to the Centers for Disease Control and Prevention. To succeed, Douglas will have to work through what he calls the “very fraught, polarized environment” that hampers the nonprofits, foundations, governments, and academics who work on tobacco control. They have fractured over tobacco harm reduction — the idea that people who cannot or will not quit smoking should be provided with alternatives, notably e-cigarettes, which deliver nicotine without burning tobacco.

Bloomberg Philanthropies and the nonprofits it supports — the Campaign for Tobacco-Free Kids and long-established groups like the American Cancer Society, the American Lung Association, and the American Heart Association — have campaigned relentlessly to limit access to e-cigarettes. The Campaign for Tobacco-Free Kids has focused on what it continues to describe as a “youth e-cigarette epidemic,” even though vaping by teens has fallen by more than 60% since its peak in 2019. They argue that e-cigarettes will lead to a new generation addicted to nicotine, even if they are not smoking.

Backed by $300 million in Bloomberg philanthropic money, along with political donations from Michael Bloomberg, the anti-vaping groups have helped convince five states – California, Massachusetts, New Jersey, New York, and Rhode Island – to ban the sale of flavored e-cigarettes. The nonprofit Truth Initiative goes further, saying it is “committed to making tobacco use and nicotine addiction a thing of the past,” which would require removing all e-cigarettes from the market. Some cities, including San Francisco, have already done so.

Douglas and his allies in the harm reduction camp say that’s been nothing short of disastrous. Bans on flavored e-cigarettes, which now cover nearly 40% of the United States, have been associated with increased sales of conventional cigarettes, according to several academic studies and financial analysts.

“These bans disincentivize the far safer product and move people back to a product that’s going to kill one in two of them,” Douglas says.

The argument threatens to derail progress on one of the most successful public health campaigns in history. The percentage of Americans who smoke has dropped from 42% in 1964 — when the first Surgeon General’s report warned of the dangers of smoking — to less than 12%. But the arrival of e-cigarettes fractured opponents of smoking, especially after startup company JUUL marketed its vapes with high nicotine levels to young people, infuriating activists and regulators.

“I can’t think of any other field of public health that has been so divided,” says Charles Gardner, a former program officer at the Foundation for a Smoke Free World and a global-health expert who previously worked at the Rockefeller and UBS Optimus foundations.

Tobacco money

The mission of the Foundation for a Smoke Free World, which Philip Morris started in 2017, is to reduce deaths and diseases caused by smoking. It focuses largely, but not entirely, on reduced-risk nicotine products, a category that includes e-cigarettes, oral tobacco, and “heat not burn” products that warm up tobacco without burning it.

This aligns with the goals of the company, which says that its future depends on replacing cigarettes with the smoke-free products that it sells. Philip Morris International promised that the foundation would be independent and said it would fund it with $80 million a year for 12 years.

Anti-smoking groups called the foundation a public relations stunt, noting that the tobacco industry has a long history of creating front groups to push its agenda. Joanna Cohen, a professor of disease prevention at the Bloomberg School of Public Health at Johns Hopkins University, and Ellen MacKenzie, the school’s dean, urged universities and nonprofits around the world to shun the foundation.

Douglas says the company has no influence over the foundation. All ties with Philip Morris were severed after accepting $122.5 million, which he characterized as a severance payment.

But some anti-tobacco advocates remain skeptical. Yolonda Richardson, president of the Campaign for Tobacco Free Kids, and Deborah Arnott, chief executive of a British health charity called Action on Smoking and Health, told Reuters that the foundation was tainted by accepting tobacco money and could not be seen as independent.

Douglas would like his critics to reserve judgment. “I’m asking those who feel doubt at this early stage to not merely rely on what I say but to watch what we do,” he says.

Vaping vs. Smoking

What, then, will the foundation do?

Douglas intends to correct widespread and dangerous misunderstandings about the relative risks of conventional cigarettes, e-cigarettes, and nicotine. There are no safe tobacco products; all fall along what’s called a continuum of risk. Nicotine pouches and gums are widely accepted because, unlike e-cigarettes, they have been approved as smoking-cessation medicines by the FDA.

That said, the vast majority of scientific experts and government agencies, including the Centers for Disease Control, say that vaping is safer than smoking, although its long-term effects remain unknown.

Public-opinion surveys, however, show that Americans mistakenly believe that e-cigarettes are as harmful or more harmful than conventional cigarettes. Misinformed smokers, therefore, have no reason to switch to the safer product.

Surprisingly, physicians are also misinformed. Surveys of doctors in the United States and around the world have found that most blame nicotine for many of the negative health consequences of smoking. Nicotine is addictive, but other chemicals and carcinogens, particularly those produced by combustion, are the primary causes of tobacco-related disease and death.

“Doctors understand that you shouldn’t be smoking,” says Michael Cummings, a tobacco-control expert at the Medical University of South Carolina. “Unfortunately, they’ve been sold a bill of goods on vaping.”

Misperceptions affect not only patients and the advice they get from doctors but also the beliefs and actions of elected officials who favor an abstinence-only approach to nicotine.

“Misunderstanding leads to poor policy,” Douglas says. While concerns about the long-term effects of vaping are valid, studies show that people who switch from conventional cigarettes to smoke-free nicotine products show immediate decreases in biomarkers associated with disease in their blood and urine.

More than anything else, Douglas would like to find common ground with the Bloomberg-funded groups around policies that would keep tobacco and nicotine products away from kids while helping adults kick their smoking habit.

______

Marc Gunther is a contributor at the Chronicle of Philanthropy, where you can read the full article. His report was provided to The Associated Press by the Chronicle of Philanthropy as part of a partnership to cover philanthropy and nonprofits supported by the Lilly Endowment. The AP and the Chronicle are solely responsible for all content. For all of AP’s philanthropy coverage, visit https://apnews.com/hub/philanthropy.

Leave a Reply

Your email address will not be published. Required fields are marked *

universo-virtual.com

buytrendz.net

thisforall.net

benchpressgains.com

qthzb.com

mindhunter9.com

dwjqp1.com

secure-signup.net

ahaayy.com

soxtry.com

tressesindia.com

puresybian.com

krpano-chs.com

cre8workshop.com

hdkino.org

peixun021.com

qz786.com

utahperformingartscenter.org

maw-pr.com

zaaksen.com

ypxsptbfd7.com

worldqrmconference.com

shangyuwh.com

eejssdfsdfdfjsd.com

playminecraftfreeonline.com

trekvietnamtour.com

your-business-articles.com

essaywritingservice10.com

hindusamaaj.com

joggingvideo.com

wandercoups.com

onlinenewsofindia.com

worldgraphic-team.com

bnsrz.com

wormblaster.net

tongchengchuyange0004.com

internetknowing.com

breachurch.com

peachesnginburlesque.com

dataarchitectoo.com

clientfunnelformula.com

30pps.com

cherylroll.com

ks2252.com

webmanicura.com

osostore.com

softsmob.com

sofietsshotel.com

facetorch.com

nylawyerreview.com

apapromotions.com

shareparelli.com

goeaglepointe.com

thegreenmanpubphuket.com

karotorossian.com

publicsensor.com

taiwandefence.com

epcsur.com

odskc.com

inzziln.info

leaiiln.info

cq-oa.com

dqtianshun.com

southstills.com

tvtv98.com

thewellington-hotel.com

bccaipiao.com

colectoresindustrialesgs.com

shenanddcg.com

capriartfilmfestival.com

replicabreitlingsale.com

thaiamarinnewtoncorner.com

gkmcww.com

mbnkbj.com

andrewbrennandesign.com

cod54.com

luobinzhang.com

bartoysdirect.com

taquerialoscompadresdc.com

aaoodln.info

amcckln.info

drvrnln.info

dwabmln.info

fcsjoln.info

hlonxln.info

kcmeiln.info

kplrrln.info

fatcatoons.com

91guoys.com

signupforfreehosting.com

faithfirst.net

zjyc28.com

tongchengjinyeyouyue0004.com

nhuan6.com

oldgardensflowers.com

lightupthefloor.com

bahamamamas-stjohns.com

ly2818.com

905onthebay.com

fonemenu.com

notanothermovie.com

ukrainehighclassescort.com

meincmagazine.com

av-5858.com

yallerdawg.com

donkeythemovie.com

corporatehospitalitygroup.com

boboyy88.com

miteinander-lernen.com

dannayconsulting.com

officialtomsshoesoutletstore.com

forsale-amoxil-amoxicillin.net

generictadalafil-canada.net

guitarlessonseastlondon.com

lesliesrestaurants.com

mattyno9.com

nri-homeloans.com

rtgvisas-qatar.com

salbutamolventolinonline.net

sportsinjuries.info

topsedu.xyz

xmxm7.com

x332.xyz

sportstrainingblog.com

autopartspares.com

readguy.net

soniasegreto.com

bobbygdavis.com

wedsna.com

rgkntk.com

bkkmarketplace.com

zxqcwx.com

breakupprogram.com

boxcardc.com

unblockyoutubeindonesia.com

fabulousbookmark.com

beat-the.com

guatemala-sailfishing-vacations-charters.com

magie-marketing.com

kingstonliteracy.com

guitaraffinity.com

eurelookinggoodapparel.com

howtolosecheekfat.net

marioncma.org

oliviadavismusic.com

shantelcampbellrealestate.com

shopleborn13.com

topindiafree.com

v-visitors.net

qazwsxedcokmijn.com

parabis.net

terriesandelin.com

luxuryhomme.com

studyexpanse.com

ronoom.com

djjky.com

053hh.com

originbluei.com

baucishotel.com

33kkn.com

intrinsiqresearch.com

mariaescort-kiev.com

mymaguk.com

sponsored4u.com

crimsonclass.com

bataillenavale.com

searchtile.com

ze-stribrnych-struh.com

zenithalhype.com

modalpkv.com

bouisset-lafforgue.com

useupload.com

37r.net

autoankauf-muenster.com

bantinbongda.net

bilgius.com

brabustermagazine.com

indigrow.org

miicrosofts.net

mysmiletravel.com

selinasims.com

spellcubesapp.com

usa-faction.com

snn01.com

hope-kelley.com

bancodeprofissionais.com

zjccp99.com

liturgycreator.com

weedsmj.com

majorelenco.com

colcollect.com

androidnews-jp.com

hypoallergenicdogsnames.com

dailyupdatez.com

foodphotographyreviews.com

cricutcom-setup.com

chprowebdesign.com

katyrealty-kanepa.com

tasramar.com

bilgipinari.org

four-am.com

indiarepublicday.com

inquick-enbooks.com

iracmpi.com

kakaschoenen.com

lsm99flash.com

nana1255.com

ngen-niagara.com

technwzs.com

virtualonlinecasino1345.com

wallpapertop.net

nova-click.com

abeautifulcrazylife.com

diggmobile.com

denochemexicana.com

eventhalfkg.com

medcon-taiwan.com

life-himawari.com

myriamshomes.com

nightmarevue.com

allstarsru.com

bestofthebuckeyestate.com

bestofthefirststate.com

bestwireless7.com

declarationintermittent.com

findhereall.com

jingyou888.com

lsm99deal.com

lsm99galaxy.com

moozatech.com

nuagh.com

patliyo.com

philomenamagikz.net

rckouba.net

saturnunipessoallda.com

tallahasseefrolics.com

thematurehardcore.net

totalenvironment-inthatquietearth.com

velislavakaymakanova.com

vermontenergetic.com

sizam-design.com

kakakpintar.com

begorgeouslady.com

1800birks4u.com

2wheelstogo.com

6strip4you.com

bigdata-world.net

emailandco.net

gacapal.com

jharpost.com

krishnaastro.com

lsm99credit.com

mascalzonicampani.com

sitemapxml.org

thecityslums.net

topagh.com

flairnetwebdesign.com

bangkaeair.com

beneventocoupon.com

noternet.org

oqtive.com

smilebrightrx.com

decollage-etiquette.com

1millionbestdownloads.com

7658.info

bidbass.com

devlopworldtech.com

digitalmarketingrajkot.com

fluginfo.net

naqlafshk.com

passion-decouverte.com

playsirius.com

spacceleratorintl.com

stikyballs.com

top10way.com

yokidsyogurt.com

zszyhl.com

16firthcrescent.com

abogadolaboralistamd.com

apk2wap.com

aromacremeria.com

banparacard.com

bosmanraws.com

businessproviderblog.com

caltonosa.com

calvaryrevivalchurch.org

chastenedsoulwithabrokenheart.com

cheminotsgardcevennes.com

cooksspot.com

cqxzpt.com

deesywig.com

deltacartoonmaps.com

despixelsetdeshommes.com

duocoracaobrasileiro.com

fareshopbd.com

goodpainspills.com

kobisitecdn.com

makaigoods.com

mgs1454.com

piccadillyresidences.com

radiolaondafresca.com

rubendorf.com

searchengineimprov.com

sellmyhrvahome.com

shugahouseessentials.com

sonihullquad.com

subtractkilos.com

valeriekelmansky.com

vipasdigitalmarketing.com

voolivrerj.com

zeelonggroup.com

1015southrockhill.com

10x10b.com

111-online-casinos.com

191cb.com

3665arpentunitd.com

aitesonics.com

bag-shokunin.com

brightotech.com

communication-digitale-services.com

covoakland.org

dariaprimapack.com

freefortniteaccountss.com

gatebizglobal.com

global1entertainmentnews.com

greatytene.com

hiroshiwakita.com

iktodaypk.com

jahatsakong.com

meadowbrookgolfgroup.com

newsbharati.net

platinumstudiosdesign.com

slotxogamesplay.com

strikestaruk.com

trucosdefortnite.com

ufabetrune.com

weddedtowhitmore.com

12940brycecanyonunitb.com

1311dietrichoaks.com

2monarchtraceunit303.com

601legendhill.com

850elaine.com

adieusolasomade.com

andora-ke.com

bestslotxogames.com

cannagomcallen.com

endlesslyhot.com

iestpjva.com

ouqprint.com

pwmaplefest.com

qtylmr.com

rb88betting.com

buscadogues.com

1007macfm.com

born-wild.com

growthinvests.com

promocode-casino.com

proyectogalgoargentina.com

wbthompson-art.com

whitemountainwheels.com

7thavehvl.com

developmethis.com

funkydogbowties.com

travelodgegrandjunction.com

gao-town.com

globalmarketsuite.com

blogshippo.com

hdbka.com

proboards67.com

outletonline-michaelkors.com

kalkis-research.com

thuthuatit.net

buckcash.com

hollistercanada.com

docterror.com

asadart.com

vmayke.org

erwincomputers.com

dirimart.org

okkii.com

loteriasdecehegin.com

mountanalog.com

healingtaobritain.com

ttxmonitor.com

bamthemes.com

nwordpress.com

11bolabonanza.com

avgo.top