If you attach the word Big to any multi-national industry, it immediately takes on a threatening and evil connotation: Big Pharma, Big Food, Big Alcohol, Big Energy and of course, Big Tobacco. And often this is for very good reasons: their prime directive is to make profits for shareholders, often at the expense of customers’ health and wellbeing (eg fast food, cheap alcohol and cigarettes) and have used their extreme wealth at best to try and thwart legislative controls on their business and at worst, engaged in rampant bribery and corruption.
The unwholesome reputation of these global enterprises means it is axiomatic that any research or charitable activity funded or underwritten wholly or partly by a relevant commercial interest is regarded as in the thrall of that interest and so disregarded or attacked. Academic conference presenters and writers are at pains to make it clear they have no funding from Big [Insert the industry here] and a certain moral high tone is used to condemn anybody who it is believed to be thus tainted. Engagement at any level is actively discouraged and taken to extremes in Article 5.3 of the FCTC, which might just be unique in international treaty provisions. I overheard a tobacco policy analyst saying recently that he couldn’t even accept a cup of coffee from a tobacco executive and had to pay for it himself in case it got back to his bosses.
There is a degree of hypocrisy at work when those doing the attacking are themselves often in receipt of funding from organisations and agencies who, while not commercial, certainly have covert (or not so covert) political or moral agendas. Such views dictate which bids are successful.
But when it comes to the Big Bad Wolves, I wonder if we shouldn’t be a little more grown up about this issue, a little more confident in our own judgements and exercise of due diligence, and I have come across some interesting corroborative views.
From a charity point of view, in my previous role as Director of Communications and Information at DrugScope, some of our publications and events were underwritten by pharmaceutical companies who were, in my view, providing ethical products helping in the treatment of our client groups, whether that was methadone or hepatitis treatments. So what if they got their name on a leaflet or a conference banner? If that was what it took to get some funding unavailable elsewhere, it was hardly much of a price to pay and certainly did not undermine the value of the information which was independently written by reputable authors. This approach did not sit easy with some of my colleagues, but I made the case and won the day. I spoke recently to the head of an alcohol charity who takes a similar position and also faces a garlic and crosses view of Big Booze.
The Washington Post conducted an interview with Michael Jacobson, who recently stepped down as head of the Center for Science and Public Interest and coined the phrase ‘junk food’.
Here is a brief extract:
Does the food industry have a role to play in promoting good nutrition? And have your views on that changed? There was a time when you were Public Enemy No. 1, as far as some food companies were concerned.
Yes, we’ve loosened up on that. You know, now I talk routinely with some of the big companies and trade associations, even if we disagree with them violently on certain things.
So you’ve made your peace with “Big Food”?
Well — I’m certainly wary about applauding a company across the board. We support them on some specific things. We’ve applauded Mars for committing to get rid of food dyes in candies, for instance. But we still say the candies are junk. Just a little less junkie”
Now as the article goes on to point out, there is a world of difference between Big Food (and Big Pharma) and Big Tobacco. The food and pharmaceutical industries are far more diversified providing life sustaining and life saving products, neither of which can be said of Big Tobacco. Then again, the tobacco industries are not only becoming more diversified, but moving into areas that are healthier for their customers, by several orders of magnitude and that I feel demands a rather more considered and nuanced approach.
This seems to be a view shared by Richard Smith, former editor of the British Medical Journal who wrote an opinion piece about the reaction to Derek Yach’s appointment as head of the Foundation for a Smoke Free World under the headline, ‘A public health witch hunt - bad for everybody’.
In replying to a request from a journalist, Smith wrote,
“I think that the public health sector is showing a knee-jerk reaction in objecting to the foundation Derek is leading”.
“The appearance of e-cigarettes has changed the picture radically….I don’t think that it will be possible to achieve a nicotine-free world—because people with severe mental health problems are given relief from nicotine. But it may be possible to achieve a tobacco-free world by moving from tobacco to e-cigarettes. Philip Morris seems to think that this will happen, and so there is business logic in funding a foundation to promote a tobacco-free world”
“I think too that it is possible for the foundation to achieve a form of governance that will guarantee its freedom—at least until more funding is needed”
“I think that WHO and other public health bodies should think more deeply before reacting so quickly and negatively”.
“Finally, I hope that you are not being used to conduct a witch hunt when there are no witches. Or perhaps I’m one.”
Smith goes to explain some background for his readers, in particular, that Derek Yach had already blotted his public health copybook by moving to PepsiCo.
“But there was a logic: Indra Nui, the chief executive, recognised that increasing health consciousness among consumers meant that there was money to be made from healthy products and that the future of unhealthy products—like sugary drinks—might be short. Yach could have impact on a huge scale by facilitating the move to healthier products. It’s also the case that once a publicly-listed business commits itself to something, it has to deliver. This is in contrast to many public organisations, including governments and UN organisations, that make commitments and then fail to deliver on them. It’s much harder to deliver than to promise.”
“David Sweanor, a Canadian lawyer who has many times successfully sued the tobacco industry, [says] it’s a mistake to regard the industry as a monolithic empire of evil. Different companies and people within the companies have different views. He argues that it’s important for public health people to engage with the industry”. Smith point out an editorial in The Lancet which while believing the Foundation was just another Big Tobacco smokescreen which will fail, at least recommended that it be given a chance."
“Nobody will benefit from creating further division among public health people and organisations. People, I believe, should not only be talking to the tobacco industry, but to each other with mutual respect”
I would say we need a smoke-free rather than a tobacco-free world, but I would concur with Richard Smith’s sentiments. There should to be rules of engagement. But call me naïve, or whatever you want, surely a combination of openness and transparency, of due diligence, of robust corporate governance and oversight, and a trust that somebody won’t sell their soul for a double expresso and a croissant, might result in a confluence rather than a conflict of interest for the ultimate benefit of all people trying to quit smoking?