Declaration of Interest and Confidentiality Undertaking Form.
I understand that:
"Interests" refer to any financial or non-financial links with the tobacco industry,
including through employment, consultancy, research, business, professional or personal
interests, contributions or gifts, family's or spouse/partner's interests, relationships up
to the fourth degree of consanguinity and affinity, and frequent or regular social
relationships.
"Tobacco industry" refers to (a) any tobacco or tobacco product manufacturer, processor,
wholesale distributor, importer; (b) any parent, affiliate, branch, or subsidiary of a
tobacco or tobacco product manufacturer, wholesale distributor, importer, retailer; or (c)
any individual or entity that represents or works to promote the interests of the tobacco
industry.
I declare that, other than the interests declared in the form below, I do not have interests,
currently or in the past five (5) years, related to the tobacco industry, and I am not knowingly
representing or receiving any contribution or compensation, directly or indirectly, whether
financial or otherwise, from the tobacco industry.
I certify that the information given above is, to the best of my knowledge, true, accurate, and
complete.
I agree to continually update my knowledge about the persons or entities that are considered
"tobacco industry." Should there be any change to the above information before, during, or within
one month after the meeting, I will promptly notify the organizers of such changes.
