This is not just blowing smoke: The fight against Big Tobacco is far from over.

While new data from the National Health Interview Survey shows that cigarette use among U.S. adults has decreased from 20.9 percent in 2005 to 15.5 percent in 2016 (down from a peak of more than 40 percent in the 1960s), there are some important caveats:

  • Among 12 states in the U.S. (mostly the South and the Midwest), smoking rates are nearly seven percentage points higher than the national average, and that includes more youth smokers (ages 12-17).
  • Smoking still kills an estimated 480,000 Americans each year, despite it being the most preventable cause of death in the country.
  • Tobacco-related illnesses disproportionately affect poor people, minorities and those who are less educated than the rest of the population.

Indeed, the frontlines of this ongoing battle go beyond our borders. "The main challenge for any organization fighting tobacco use is that the tobacco industry continues to aggressively market its products to vulnerable populations around the world — children, teenagers, lower-income populations and others," says Dr. Kelly Henning, public health program lead at Bloomberg Philanthropies, an organization that has invested nearly $1 billion toward the fight against tobacco since 2007, focusing on low- and middle-income countries, where 80% of tobacco-related deaths occur. In that time, more than 70 of those nations have put a new strong anti-tobacco law into place.

But there's still a long way to go.

“It seems like the momentum to finish this journey among the public has slowed over the past 10 years,” says Phil Dearing, consultant for the Bridgespan Group, who researched and wrote this report about the long-term effects of anti-smoking efforts. “We could be making many more strides, whether it's with warning labels, higher state taxes or comprehensive smoke-free laws.”

Philanthropy Gives Us a Breath of Fresh Air

Earlier this year, Bloomberg Philanthropies announced a $20 million commitment to its Stopping Tobacco Organizations and Products program, helping orgs around the globe develop tools to combat the tactics of tobacco advocates. "STOP will divide resources between robust monitoring and reporting of industry behavior, and combating the false narratives so often created on the ground," says Dr. Henning.

Meanwhile, the WHO MPOWER framework (Monitor, Protect, Offer, Warn, Enforce, Raise) gives a baseline for action in many countries still catching up to the U.S. when it comes to prevention and intervention efforts. For example, a Global Adult Tobacco Survey helped build support for the government of Uganda to completely ban smoking in public places. In fact, comprehensive smoke-free legislation now affects more than 1.5 billion people around the world. And taxation on tobacco products is one of the more effective forms of control, as this study published in the Lancet found.

The efforts from both the public and private sectors (including significant investments from the Gates Foundation, the Robert Wood Johnson Foundation, the Annie E. Casey Foundation and other nonprofit leaders over the years, besides the orgs mentioned in this piece) have made an enormous, measurable impact — one that has saved millions of lives.

So why aren’t more joining the fray? Besides the major funders, overall donations to anti-tobacco efforts have been flat over the past decade. Below, we attempt to debunk some common misperceptions around anti-tobacco philanthropy — and how you can play a part.

Getting Real About Tobacco

The myth: Everybody knows smoking is bad and those who smoke can quit.
The reality: Public awareness is still an issue, and tobacco-related addiction continues to kill.
The action: Follow the data, wherever it leads. "Our most recent Annual Report shows that implementing data-driven solutions to the world’s biggest health challenges has resulted in nearly 35 million lives saved from tobacco and 370 billion fewer cigarettes sold in 2016 than 2012," says Dr. Henning.

Anti-smoking advocates can also borrow strategies from the Truth Initiative, which pushes back against the narrative that smoking is “cool”, while also reaching out to smokers looking for cessation methods.

The myth: Good anti-smoking policies are already in place and the science is settled.
The reality: E-cigarettes complicate the picture.
The action: It’s worth funding research that determines the true health impact of vaping, which remains unclear. While some studies have shown that the use of e-cigarettes is less harmful than combustible tobacco, “less harmful” isn’t the same as safe. As Dearing says, “The role of philanthropy is to understand it and fund more research, so that the messaging and the narrative aren’t controlled by e-cigarette companies.”

Adds Dr. Henning, "It’s also important to note that the tobacco industry has a very long history of funding new supposedly 'safer' products that have been a smokescreen for behavior that has led to worse outcomes for smokers."

The myth: Doing what’s worked for decades is enough.
The reality: Times have changed. The nonprofit sector must adapt.
The action: “A core piece of every successful social movement is continuing to measure what works and to change the strategy accordingly,” says Dearing, who cautions that we can’t go by past playbooks if we want to create a smoke-free future. Embrace course correction.


Original contribution by Gabe Guarente, Content Manager at Giving Compass