COD OKs One-time Endowment Option to Fund Tar Wars, Tobacco Cessation Efforts

Members of the Reference Committee on Health of the Public and Science heard impassioned testimony during the 2008 Congress of Delegates about a public health issue that's near and dear to AAFP members: tobacco cessation. The testimony came in response to a recommendation in a report from the AAFP Board of Directors to the Congress on the Board's work with the AAFP Foundation Board of Trustees to secure long-term financial support for the Academy's Tar Wars program, as well as its efforts in the areas of tobacco cessation, education and research.

In 2007, the AAFP Congress of Delegates adopted a resolution calling on the Academy to ensure "adequate funding" for Tar Wars "consistent with the intent of the adopted 2002 AAFP Congress of Delegates’ Resolution 210."

That 2002 resolution directed the Academy to "commit to seeking funding partners to continue the growth of the Tar Wars program on a national level." The resolution further called for the AAFP to "continue to fully support the Tar Wars program until such sponsorship is found."

In its role as the philanthropic arm of the Academy, the AAFP Foundation took on the task of securing the needed funding.

After considering the objectives set by the 2007 Congress, the foundation trustees decided that meeting the dual goals of guaranteeing ongoing funding for Tar Wars and expanding the program would best be accomplished through a large, one-time grant that would enable the foundation to set up an endowment program.

The sticking point: The funding sources most likely to commit the amount of support the foundation trustees deemed necessary would be corporate giving programs funded by tobacco monies.

Realizing that approaching such programs could run afoul of current Academy funding guidelines, the foundation trustees consulted the AAFP Board, which, in turn, put the funding question to this year's Congress. Two options were laid out in the Board's report:

Tar Wars founder and Colorado delegate Jeffrey Cain, M.D., of Aurora, began his comments at the Sept. 15 reference committee hearing with a quote he attributed to William Booth, founder of the Salvation Army: "I would take money from the devil if it helped me do the Lord's work." He urged those at the hearing to look at all possible options to continue funding the work of Tar Wars.

Mark Belfer, D.O., of Fairlawn, Ohio, president of the AAFP Foundation, strongly supported the option of approaching tobacco-funded giving programs in his testimony. "We want a one-time chance to talk to tobacco companies to say we want $10 to $15 million, so no more children's lungs are choked with smoke," he said.

AAFP Past President Michael Fleming, M.D., of Shreveport, La., also spoke in favor of considering even the more extreme option, pointing out that the state tobacco settlement funds slated to have been used for tobacco education and prevention programs have all too often gone to fund other endeavors.

"In my state, we use these funds to build roads," Fleming testified. "I'm just afraid that if we don't do this (consider the second funding option), we lose our ability to help kids."

Others testified ardently against the notion of dealing directly with the tobacco industry, fearing it could severely compromise the Academy's credibility.

"We own the trust of our patients; we worked hard to get it," said Georgia delegate George Shannon, M.D., of Columbus, adding that the risk of tarnishing family medicine's public image by seeming to collaborate, in any fashion, with tobacco companies was too great.

Idaho delegate William Woodhouse, M.D., of Pocatello, told the reference committee, "I really don't want to be watching 'Monday Night Football' when the ad comes on that says 'Philip Morris is working with the American Academy of Family Physicians to stop tobacco use.'"

Maryland delegate William Hakkarinen, M.D., of Cockeysville, also made clear his opposition to the second option, telling those at the hearing, "I speak vehemently and with passion against taking money from the devil, whatever the purpose."

Erica Swegler, M.D., an alternate delegate from Keller, Texas, suggested a compromise: Try the first, less controversial option for three to five years before considering moving to the second option.

Tennessee alternate delegate Timothy Linder, M.D., of Selmer, testified to committee members that he and other family physicians from his state had decided to show their support for Tar Wars by presenting the foundation with a $1,000 check to be used for the program. He challenged others at the hearing to do likewise and to encourage their colleagues back home to contribute, as well. If enough FPs respond to the challenge, Linder noted, their combined efforts could mitigate the need for "tobacco money."

In the end, the Congress of Delegates adopted a substitute option crafted by the reference committee that directs the AAFP to support the foundation's efforts "to seek funding for tobacco cessation, education, research and Tar Wars by contacting private foundations and corporate foundations in a manner consistent with current policy to create a one-time endowment."

The resolution further asks the AAFP Board to report back to the 2009 and 2010 Congresses on the status of the "tobacco control endowment" funding. It also calls for the Academy to inform members of the "acute, short-term need for bridging funds to continue Tar Wars until the tobacco control endowment is funded."