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Foundation for a Smoke-Free World and Healthy Indigenous Futures

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Foundation for a Smoke-Free World and Healthy Indigenous Futures Commentary Tob Control: first published as 10.1136/tobaccocontrol-2018-054792 on 10 May 2019. Downloaded from Foundation for a Smoke- Free World and healthy Indigenous futures: an oxymoron? Andrew Waa,1,2 Bridget Robson,3,4 Heather Gifford,5,6 Janet Smylie,7,8,9 Jeff Reading,10,11 Jeffrey A Henderson,12,13 Patricia Nez Henderson,13,14 Raglan Maddox ,8,15,16 Raymond Lovett,17,18 Sandra Eades,19,20 Summer Finlay,21,22,23,24 Tom Calma,25,26 Hāpai Te Hauora Māori Public Health For numbered affiliations see Indigenous peoples represent a diversity of targeted cessation interventions (eg, the Auakati end of article. cultures, perspectives and experiences that brings Kai Paipa Smoking cessation services), smoking tremendous vibrancy to our world. Within this among New Zealand Māori remains unacceptably Correspondence to diversity, many Indigenous peoples share a high.8 9 It was Māori in Aotearoa (New Zealand) Dr Raglan Maddox, Centre for Research and Action in Public common history of colonisation that continues who first advocated for a Tupeka Kore (tobacco- 10 Health, University of Canberra, today.1 We humbly acknowledge and respect free) country and emphasised the need to shift Canberra, ACT 2617, Australia; that Indigenous people are diverse and consti- attention away from individuals to the true source raglan. maddox@ canberra. tute many nations, language groups and cultures. of the problem: commercial tobacco and the edu. au 10 For the purposes of this commentary, Indigenous companies that sell and promote it. Received 15 October 2018 peoples include self-identified individuals and Improving physical health is a priority for Indig- Revised 4 February 2019 communities who have historical continuity with enous peoples, but this is usually set within the Accepted 15 February 2019 pre-colonial/pre- settler societies; are strongly broader context of Indigenous health and well- Published Online First linked to their natural environments; and often being that connects physical, psychological, social 10 May 2019 11 maintain their own distinct language(s), belief and and spiritual health. The proliferation of alter- social systems. native nicotine devices (ANDs) and the potential In 2017, Philip Morris International (PMI) they may hold for improving Indigenous health 12 13 provided US$1 billion funding for 12 years to is a hotly debated topic, and the control of copyright. establish the Foundation for a Smoke-F ree World this debate needs to be led by Indigenous peoples (the Foundation). The stated purpose of the Foun- and not influenced by external pressures, partic- 2 ularly from organisations that are linked to the dation is to help achieve a ‘smoke free world’. 3 According to the Foundation’s Strategic Plan, tobacco industry. The prevalence of commercial ‘ending smoking’ means eliminating use of the tobacco use in the general population of Australia, Canada, New Zealand and the USA is 16%, cigarette and other forms of combustible tobacco, 14–18 while ensuring populations affected by this trans- 18%, 16% and 16%, respectively. This is in http://tobaccocontrol.bmj.com/ formation are supported to find sustainable alter- contrast to the high rates of commercial tobacco native activities and products.3 The research use among Aboriginal and Torres Strait Islander agenda includes a focus on an alternative nicotine peoples in Australia (41%), First Nations (40%), Inuit (49%) and Métis (37%) peoples in Canada, product version of ‘harm reduction’. In August M ori in Aotearoa (35%) and American Indian or 2018, the Foundation provided a US$1 million ā Alaska Native in the USA (32%)14–16 18 19 which is grant that created a New Zealand-based Centre in each case substantially higher than their non- for Research Excellence: Indigenous Sovereignty Indigenous counterparts. and Smoking (the Centre) whose stated aim is to As others have detailed,20 21 the Founda- focus on reducing smoking- related harms among tion cannot be regarded as independent from Indigenous peoples.4 5 its tobacco industry funder, and its work serves on September 27, 2021 by guest. Protected Are the interests of Indigenous peoples truly to advance the industry’s goals. While PMI has being served by promoting the research agenda claimed it wants to ‘end smoking’, it continues to of a tobacco industry-funded Foundation? We do promote use of cigarettes. By serving the interests not think so, for several reasons. While improving of PMI, the Foundation is complicit in commer- help for people to cease commercial tobacco use cial tobacco use and the associated absolute and does have potential to reduce the harm from disproportionate tobacco- related harms to Indig- smoked tobacco use, evidence suggests that indi- enous peoples.9 22 vidually targeted interventions that are essentially © Author(s) (or their palliative and require a significant level of indi- employer(s)) 2020. Re-use permitted under CC BY-NC . No vidual agency do not actually address the root MODERN COLONISATION 6 7 commercial re-use . See rights cause of the problem. As such, they do little Colonisation is not a historical artefact and it and permissions. Published to address smoking disparities between Indige- continues contemporaneously at both country by BMJ. nous and non- Indigenous peoples. This is demon- and global levels. Indigenous knowledge, values, To cite: Waa A, Robson B, strated in papers that have found that despite behaviours and protocols have been suppressed Gifford H, et al. Tob Control decades of high- quality population- level (eg, the (or sometimes appropriated) through colonisation 2020;29:237–240. New Zealand Quitline and media campaigns) and processes, implemented by governments, churches Waa A, et al. Tob Control 2020;29:237–240. doi:10.1136/tobaccocontrol-2018-054792 237 Commentary Tob Control: first published as 10.1136/tobaccocontrol-2018-054792 on 10 May 2019. Downloaded from and other institutions.23–26 However, Indigenous peoples marketing, lobbying and litigation. The tobacco industry remain steadfastly resistant and resilient in the face of colonisa- has a long history of deliberately colluding in covering up, tion in its many forms.24 The global promotion of commercial denying, confusing and questioning the science on smoking- tobacco and the subsequent addiction of Indigenous peoples to related morbidity and mortality.35 As a business, PMI’s goal is nicotine products is a modern form of colonisation. Colonial to safeguard and extend shareholder profits, thus it is rapidly forms of oppression include, but are not limited to, forced expanding into the lucrative AND markets. PMI has never removal and relocation of Indigenous peoples from their demonstrated genuine concern for the health and well-being of land, removal of Indigenous children and using commercial Indigenous peoples, and has a history of ignoring and under- tobacco as a form of payment prior to engagement with the mining scientific evidence.36 The tobacco industry’s interest cash economy.24 27 For example, tobacco was issued as rations in Indigenous peoples has been to appropriate our names and on missions in Australia.27 Further, among some Indigenous imagery31 37 along with the tobacco plant itself, with the sole peoples, the modification, transformation and commercialisa- intent of furthering tobacco sales and profits. Despite this tion of the nicotiana tobacco plant belittles and disrespects history, the Foundation continues to claim that their agenda something which is held sacred.25 28–31 Thus, commercial is not influenced by PMI.2 38 The Foundation states that it tobacco and any of its derivatives represent a threat to physical “cannot engage in activities designed to support PMI’s inter- health, as well as spiritual health and well-being. In fact, given ests”,2 and is apparently seeking to associate with Indigenous this understanding regarding the modification, transformation organisations, researchers and peoples worldwide.4 But simply and commercialisation of the nicotiana tobacco plant25 30 and by existing and being embedded within PMI’s funding strate- the strong evidence base of commercial tobacco- related addic- gies, the Foundation is supporting PMI’s interests.21 tion and ill- health, tobacco industry–funded research activities Arguably, PMI funds the Foundation to create divisions 9 29 32 can be seen as a form of contemporary colonisation. This among those who are working towards a smoke- free world.20 21 form of contemporary colonisation can be seen as a result of For example, tobacco industry documents proved that the using culturally inappropriate protocols, assimilative practices industry has long known about the health effects of smoking, and a raft of colonisation tools and processes, distorting Indig- the danger of secondhand smoke and the addictiveness of enous realities and creating an inaccurate Indigenous narra- nicotine but deliberately colluded in covering up, denying, tive that promotes Indigenous health harms and perpetuates confusing and questioning the science demonstrating smoking- oppression. related morbidity and mortality.35 The arguments about who The tobacco industry’s role in purporting to support to trust and who researchers should accept funding from can health research, while also profiting from selling commercial dilute the health sectors’ efforts, create confusion, throw doubt tobacco products, creates a conflict of interest. Therefore, on who should be believed and create further opportunities copyright. tobacco industry funding of ‘health’ research either directly to promote the tobacco industry agenda.3 34 This replicates a or indirectly, including via third parties, should be vigorously common tool of colonisation: divide and conquer.39 resisted. This is underscored by the Framework Convention on Tobacco Control, which states the Parties are “deeply concerned about the high levels of smoking and other forms HIS TORY OF EXPLOITATION AND APPROPRIATION of tobacco consumption by indigenous peoples” (FCTC, PMI has a history of exploiting and appropriating Indigenous 22 Preamble), page 2 and urges that tobacco industry influence names and imagery to sell its products, including selling ‘Māori http://tobaccocontrol.bmj.com/ be resisted.
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