American vapers are familiar with Michael Bloomberg and his support for bans of flavored vaping products. But Bloomberg and the tobacco control organizations he funds are even more active in other parts of the world, especially in countries willing to sacrifice their own autonomy in exchange for public health funding.
The Bloomberg model, as explained last year by Pro-Vapeo Mexico president Dr. Roberto Sussman, is to offer funding for tobacco control and other public health projects to cash-strapped low- and middle-income countries (LMICs), while insisting their governments adopt the kinds of restrictive policies the philanthropist and his minions desire. In the case of low-risk nicotine alternatives like vaping, that means top-down control, taxes and—preferably—bans.
Bloomberg Philanthropies funds a number of organizations that work internationally to restrict access to low-risk nicotine products. They include the Campaign for Tobacco-Free Kids, the Johns Hopkins University Bloomberg School of Public Health, the CDC Foundation, the Bloomberg Initiative to Reduce Tobacco Use, Vital Strategies, Stopping Tobacco Organizations and Products (STOP), the Anti-Tobacco Trade Litigation Fund, the University of Bath (U.K.) Tobacco Control Research Group, the Global Centre for Good Governance in Tobacco Control (GGTC), the South-East Asia Tobacco Control Alliance (SEATCA), and The Union. The World Health Organization (WHO) and its tobacco control arm, the Framework Convention on Tobacco Control (FCTC), are also recipients of Bloomberg largesse (and influence).
Last year, The Union—a century-old lung health organization based in Paris—called for outright bans on e-cigarettes and heated tobacco products in LMICs. The Bloomberg-funded group essentially said that these countries are too corrupt and too lacking in resources to competently regulate low-risk nicotine products. Therefore, they said, bans are necessary.
Today, the International Network of Nicotine Consumer Organisations (INNCO) responded to Bloomberg and The Union, publishing a position paper listing 10 reasons why imposing blanket bans in LMICs is the wrong approach and won’t work.
INNCO is an umbrella group for almost 40 nicotine consumer-rights organizations in countries around the world, including CASAA in the United States. INNCO was formed in 2016 to advocate for tobacco harm reduction (THR) and proportionate regulation of low-risk alternative nicotine products like vapor and snus. (Disclosure: I am on the CASAA board of directors, and was a member of the steering group that ran INNCO during its first year.)
The 10 reasons INNCO lists for opposing bans are:
“The hundreds of millions of people who smoke in these countries should have the ability to make decisions about safer nicotine products, particularly when their own health is on the line,” said INNCO board president Samrat Chowdhery in a press release. “Overly simplistic policy solutions, such as proposed bans on all ENDS and THR products by the Bloomberg Philanthropies-funded The Union, are being offered as a blunt and impractical tool for a situation that requires pragmatism and nuance, making meaningful and sustainable change more difficult.”
Bans are discriminatory and patronizing, says INNCO. They also don’t work. Countries that can’t afford to manage regulation can’t afford to enforce prohibition either. The result is usually thriving black markets, as currently exist in India, Mexico, and much of Latin America and Asia where bans are in place. Product quality and safety is uncertain in black markets, and there are no age restrictions.
“Lack of regulation also makes it impossible for governments to track epidemiological data around the use of such products,” says INNCO. “The Union states that prohibition of ENDS and HTPs will aid tobacco control, yet in Mexico for example, the illicit market in cigarettes remains rampant, with around 50% of Mexican smokers purchasing cigarettes illegally.”
The Union and other Bloomberg-funded groups don’t advocate for cigarette bans, because they’re well aware that banning a major source of tax revenue would be a non-starter. Many LMICs depend on cigarette and other tobacco sales, and are more than happy to eliminate vaping products that compete with cigarettes. Getting big grants from an American billionaire may just be icing on the cake—especially when the government is part-owner of a tobacco company, like India or Thailand.
Aside from the health and human rights arguments against Bloomberg-backed bans, there is something uniquely distasteful about turning over your country’s health policy to rich foreigners. It harkens back to the colonial era, when wealthy European invaders occupied poorer countries and made the laws and rules for the (usually black or brown) natives—always for their own good, of course.
“A blanket ban in LMICs is a form of philanthropic colonialism, suggesting that these countries and their citizens cannot be trusted with any level of self-determination,” says Nancy Loucas of the Coalition of Asia Pacific Tobacco Harm Reduction Advocates (CAPHRA), an INNCO affiliate organization. “Inhabitants are treated as second-class citizens, which is offensive.”
The Campaign for Tobacco-Free Kids, for example, knows that banning flavored vaping products in the U.S. first requires them to spend tens of millions of Michael Bloomberg’s dollars to convince the public that a ban is necessary, and then to lobby Congress. Changing public policy or regulations in a democratic country is a time-consuming and expensive task.
But in many LMICs, Bloomberg-backed tobacco control groups only have to convince one autocratic leader, or a few people in the health ministry. They do this by promising to fund public health initiatives or other government programs. These programs provide jobs for people and earn plaudits for the leaders.
“Global organisations such as the WHO, Bloomberg Philanthropies and The Union wield great influence in LMICs through sponsorship of healthcare programs and public initiatives,” says the INNCO paper. “This influence manifests itself through top-down policymaking approaches, telling LMICs what is best for them.”
Meanwhile, smokers in LMICs are not quitting. While cigarette sales are declining in North American and European countries, many nations elsewhere are seeing tobacco sales growth. More than 80 percent of the world’s 1.3 billion tobacco users live in LMICs, and they deserve the same right to choose harm reduction their wealthier neighbors have.
“It is wrong to deny more than a billion tobacco users, most of those in LMICs, a voice and a choice,” says the INNCO paper. “Consumers have the right to be heard.”
Photo courtesy Bloomberg Philanthropies.