The American Heart Association and four other leading health organizations on Wednesday urged members of the U.S. Chamber of Commerce’s Board of Directors to resign unless the chamber stops fighting anti-tobacco measures around the world.

The move follows a recent investigative series in The New York Times that exposed how the chamber has systematically opposed public health measures that reduce tobacco use. The chamber’s strategies included directly opposing countries’ tobacco control policies, pitting countries against each other in trade disputes and influencing international trade agreements to benefit tobacco companies, according to The New York Times’ report.

“The U.S. Chamber’s pro-tobacco work harms health around the world and does not serve the interests of the American business community,” the health groups wrote in letters to the more than 100 companies and organizations on the U.S. Chamber’s Board of Directors. The letter was co-written by the Campaign for Tobacco-Free Kids, American Cancer Society Cancer Action Network, the American Heart Association, the American Lung Association and Legacy.

The organizations oppose tobacco use because of its proven dangers: According to the World Health Organization, tobacco kills about 6 million people worldwide each year and is projected to kill 1 billion people this century unless current trends are reversed.

“The American Heart Association has worked very closely with companies in an effort to provide healthy workplaces for all employees, and avoiding tobacco has been proven to be critical to the public health,” American Heart Association CEO Nancy Brown said. “That is why the reports about the U.S. Chamber of Commerce are so disappointing. You cannot promote business at the expense of public health. And that is why we are calling upon the chamber to address this disconnect.”

The U.S. Chamber of Commerce describes itself as the world’s largest business organization, representing the interests of more than 3 million businesses across the nation. The letter is the latest response opposing the chamber following the report. On July 7, CVS Health resigned from the U.S. Chamber.

The letter from the health organizations points out that tobacco is different from other products in that it kills when used as intended, there is a global treaty ratified by 180 nations that is designed to reduce the use of tobacco products, and the tobacco industry has a long history of deception and marketing to children.

Here is full text of the letter sent to the U.S. Chamber of Commerce:

“We are writing to you as a member of the board of the U.S. Chamber of Commerce.  On June 30, 2015, and July 1, 2015, The New York Times published lengthy, well-researched stories exposing how the U.S. Chamber of Commerce has been and is still engaged in systematic efforts in countries around the world to oppose public health measures designed to reduce tobacco use. Tobacco kills nearly six million people every year worldwide and is projected to kill a billion people this century unless current trends are reversed.

The Times’ reporting and associated documentation provided online shows that the U.S. Chamber’s campaign to oppose non-discriminatory, evidence-based measures like smoke-free indoor public places and graphic warning labels on tobacco products includes:

Opposing countries’ health policies: In letters to officials of countries trying to pass policies to reduce tobacco use, the U.S. Chamber has voiced strong “concerns” about such laws, even suggesting in some instances that opposing tobacco companies’ wishes could cause instability and economic harm to the countries.

Pitting countries against each other: The Times reported that, at the request of the U.S. Chamber’s local affiliate, Ukraine filed an action against Australia before the WTO, initiating a lengthy, expensive international trade dispute.

Advocating for pro-tobacco provisions in international trade agreements: The U.S. Chamber has staunchly opposed measures in the Trans-Pacific Partnership (TPP) that would protect countries’ sovereign rights to implement life-saving public health policies.

Claiming that countries’ legitimate interest in protecting the health of their citizens could threaten foreign investment.

Tobacco is different from other products.  It is the only consumer product that kills when used exactly as intended and it is the only consumer product that is the subject of a global treaty ratified by 180 nations designed to reduce the use of and harm caused by that product.  There is a global consensus that governments should take strong action to reduce the use of tobacco.  Not only is tobacco different as a product, the tobacco industry’s behavior does not represent the values one expects from American business.  The tobacco industry consistently has opposed efforts by governments to protect their citizens from the harms of tobacco, has not been open or honest about the harms of its products, and has marketed its products in ways that appeal to youth.

By using the heavy-handed tactics described in the New York Times stories to threaten and intimidate countries and to portray the tobacco industry as representative of American business, the Chamber undermines the credibility and reputations of American businesses whose products deserve to be promoted and who play by the rules.

Demonstrating true corporate leadership, last week CVS Health became the first company to resign from the U.S. Chamber in protest over the Chamber’s activities acting as a tobacco industry front group. CVS Health officials told the New York Times that the company’s purpose is to help people lead healthier lives, and that the company’s leaders recognize that tobacco use conflicts with this mission.  CVS Health’s decision to leave the U.S. Chamber sets an example for every member who does not support the Chamber’s campaign of opposition to countries’ efforts to pass and implement policies to reduce tobacco use.

As United States-based health organizations, we strongly believe the U.S. Chamber’s pro-tobacco work harms health around the world and does not serve the interests of the American business community. We call on you to:

Urge the Chamber to stop all lobbying and other activities opposing non-discriminatory measures to reduce tobacco use anywhere in the world; and

If the Chamber fails to do so, follow the lead of CVS Health by withdrawing from membership in the Chamber.

The U.S. Chamber of Commerce harms all American businesses when it fails to recognize the uniqueness of tobacco products that cause death and disease when used as intended and the difference between the harmful behavior of the tobacco industry and American businesses that are good global corporate citizens.

Thank you for considering this urgent appeal.”