Students attending colleges across the United States have created TOMS campus clubs. As of March 20, 2014, 281 campus clubs existed in the United States with another dozen located in Canada. By comparison, another nonprofit organization known as Lions Club International was established in 1917 and is known for working to ending the cause of blindness, reports 400 Lions’ campus clubs in 42 countries.
The major mission of Toms is that a business, rather than a charity, would help their impact last longer. In his speech at the Second Annual Clinton Global Initiative Mycoskie states that his initial motivation was a disease called podoconiosis—a debilitating and disfiguring disease which causes one's feet to swell along with many other health implications. Also known as "Mossy Foot", podoconiosis is a form of elephantiasis that affects the lymphatic system of the lower legs. The disease is a soil-transmitted disease caused by walking in silica-rich soil. Toms currently works with factories nearby where they perform some of their shoe drops.
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A story by LA Weekly priced the manufacturing cost of a pair of Toms Shoes at $3.50-$5.00 in U.S. dollars, and noted that the children's shoes given out by the company were among the cheapest to make, which is not necessarily apparent to consumers. According to garment-industry author Kelsey Timmerman, many people he spoke to in Ethiopia were critical of the company, saying that they felt it exploited the idea of Ethiopian poverty as a marketing tool. An Argentina-based shoemaker agreed, saying that the imagery used by the company was manipulative.