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Why we work with the tobacco industry

2018; Wiley; Volume: 114; Issue: 2 Linguagem: Inglês

10.1111/add.14461

1360-0443

John R. Hughes, Karl Fagerström, Jack E. Henningfield, Brad Rodu, Jed E. Rose, Saul Shiffman,

Smoking Behavior and Cessation

AddictionVolume 114, Issue 2 p. 374-375 Letter to the EditorFree Access Why we work with the tobacco industry John R. Hughes, John R. Hughes john.hughes@uvm.edu orcid.org/0000-0001-9893-7843 Departments of Psychiatry and Psychological Science, University of Vermont, Burlington, VT, USASearch for more papers by this authorKarl O. Fagerstrom, Karl O. Fagerstrom Fagerstrom Consulting, Vaxholm, SwedenSearch for more papers by this authorJack E. Henningfield, Jack E. Henningfield Pinney Associates and Department of Psychiatry and Behavioral Science, The Johns Hopkins University School of Medicine, Bethesda, MD, USASearch for more papers by this authorBrad Rodu, Brad Rodu orcid.org/0000-0002-8213-4816 Department of Medicine and James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USASearch for more papers by this authorJed E. Rose, Jed E. Rose Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Baltimore, MD, USASearch for more papers by this authorSaul Shiffman, Saul Shiffman Departments of Psychology, Psychiatry, Pharmaceutical Sciences, and Clinical Translational Science, University of Pittsburgh and Pinney Associates, Pittsburgh, PA, USASearch for more papers by this author John R. Hughes, John R. Hughes john.hughes@uvm.edu orcid.org/0000-0001-9893-7843 Departments of Psychiatry and Psychological Science, University of Vermont, Burlington, VT, USASearch for more papers by this authorKarl O. Fagerstrom, Karl O. Fagerstrom Fagerstrom Consulting, Vaxholm, SwedenSearch for more papers by this authorJack E. Henningfield, Jack E. Henningfield Pinney Associates and Department of Psychiatry and Behavioral Science, The Johns Hopkins University School of Medicine, Bethesda, MD, USASearch for more papers by this authorBrad Rodu, Brad Rodu orcid.org/0000-0002-8213-4816 Department of Medicine and James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USASearch for more papers by this authorJed E. Rose, Jed E. Rose Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Baltimore, MD, USASearch for more papers by this authorSaul Shiffman, Saul Shiffman Departments of Psychology, Psychiatry, Pharmaceutical Sciences, and Clinical Translational Science, University of Pittsburgh and Pinney Associates, Pittsburgh, PA, USASearch for more papers by this author First published: 15 October 2018 https://doi.org/10.1111/add.14461Citations: 5AboutSectionsPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat This letter discusses the ethical issues when scientists work with the tobacco industry on less-risky tobacco products. The authors have consulted with or received research grants from tobacco companies related to less-risky tobacco products. We do this because the goal of tobacco/nicotine science should be a reduction in tobacco-related morbidity and mortality, and that harm reduction products can play a major role in achieving this goal. Given this focus, we limit our work with the industry to projects involving reduced-risk products. Even with taxation, smoking restrictions, mass media, stigmatization, etc. the prevalence of smoking is decreasing by less than 1% per year 1. Attempts to eradicate drugs well established in a culture have rarely been successful 2; e.g. despite all our efforts, only half of US smokers have quit 1. Given this, we believe it necessary to accept intermediate goals, such as use of reduced risk products, for some smokers. We believe the weight of the evidence indicates that the availability of harm reduction products does not undermine motivation for tobacco cessation and may improve public health 3. If the tobacco industry seeks to make money by marketing reduced risk products instead of more risky products, we fail to see this as a menace to public health. We believe industries' investment in less-risky products is a clear sign that they recognize their survival depends on such products. This shift is actually a tobacco control success story. Some will argue that the tobacco industry cannot be trusted, and thus the primary goal should be its extermination. Many tobacco companies have clearly been unethical; however, we believe the recent greater oversight by regulatory agencies in many countries has radically changed the situation. In the United States, the tobacco industry must obtain approval for their less risky products and their claims about risk reduction from the Food and Drug Administration (FDA). This approval involves an extensive review process by FDA staff, advisory boards and public comments. We would note that the level of accountability and transparency by the FDA is similar to or greater than that for pharmaceuticals, and exceeds that expected of academic scientists. It also means that, under current conditions, the FDA considers the tobacco industry legitimate. Why should we not do so? In the current climate, the industry is in a classic Catch-22 situation. If they perform their own research many journals will not believe it, no matter its scientific merit 2. However, if the industry attempts to sponsor independent research on a reduced risk product, this is hampered by the fact that independent scientists who undertake such research are stigmatized. For example, several of us have had to withdraw from presenting at meetings, serving on tobacco control boards, etc. due to working with the tobacco industry. Given that 7 million smokers die each year due to the use of combustible tobacco products (www.who.int), there is an under-appreciated urgency to decrease this toll and that all approaches should be considered. Furthermore, we believe that scientists should assist the development and testing of reduced risk products, regardless of who makes a profit from such products. Declaration of interests The Johns Hopkins University or Reynolds American. K.O.F. has received consulting and speaking fees from many companies that develop or market pharmacological and behavioral treatments for smoking cessation. He currently receives consulting fees from Swedish Match and has received fees in the past from Philip Morris International and British American Tobacco to assist their efforts to develop less-risky tobacco products. J.E.H. is Vice President of Research, Health Policy, and Abuse Liability at Pinney Associates, a consulting firm through which he consults to Niconovum USA, Inc., R.J. Reynolds Vapor Company and RAI Service Company, all subsidiaries of Reynolds American Inc. (now owned by British American Tobacco) on smoking cessation and harm reduction, with consultation on combusting cigarettes explicitly excluded from the scope of consultation. Within the past 5 years, he has served as an expert witness against the tobacco industry, and his written and videoed testimony may still serve in ongoing and future litigation against the tobacco industry. The views expressed in this editorial are his own, and not necessarily those of the Pinney Associates, B.R. authored a series of peer-reviewed publications investigating and endorsing less harmful smokeless tobacco products as alternatives for inveterate smokers from 1994 to 1999. These activities were supported solely by intra-university departmental funds. From 1999 to 2005 B.R.'s research was supported by an unrestricted grant from the US Tobacco Company to the University of Alabama at Birmingham. In 2005, B.R. became the first recipient of an endowed chair in tobacco harm reduction research in the James Graham Brown Cancer Center at the University of Louisville, which was supported by the US Smokeless Tobacco Company, Swedish Match and the Kentucky Research Challenge Trust Fund. From 2005 to the present his research has also been supported by unrestricted grants from Swedish Match, Altria Client Services, British American Tobacco and Reynolds American Inc. Services Company to the University of Louisville. B.R. has no personal or financial conflict of interest with respect to these sponsors or other stakeholders in the tobacco or vapor industries. J.E.R. has accepted research funding from the tobacco industry, including Philip Morris USA and Philip Morris International, supporting smoking cessation and harm reduction projects. He currently consults for Philip Morris International on reduced-harm products. J.E.R. is also an inventor and party to a patent purchase agreement with Philip Morris International pertaining to a pulmonary nicotine delivery system. S.S. serves as Senior Scientific Advisor at Pinney Associates, a consulting firm through which he consult to Niconovum USA, Inc., R.J. Reynolds Vapor Company and RAI Service Company, all subsidiaries of Reynolds American Inc. (now owned by British American Tobacco) on smoking cessation and harm reduction, with consultation on combusting cigarettes explicitly excluded from the scope of consultation. The views expressed in this editorial are his own, and not necessarily those of the University of Pittsburgh, Pinney Associates or Reynolds American. References 1Jamal A., King B., Neff L., Whitmill J., Babb S., Graffunder C. M. Current cigarette smoking among adults—United States, 2005–2015. Morb Mortal Wkly Rep 2016; 65: 1205– 1211. 2Fagerstrom K.-O., Hughes J. R. Why not publish all research that passes review? Addiction 2016; 111: 939– 940. 3 National Academies of Sciences, Engineering, and Medicine In: K. Stratton, L. Y. Kwan, D. L. Eaton, editors. Public Health Consequences of E-Cigarettes. Washington, DC: The National Academies Press; 2018, 541– 589. Citing Literature Volume114, Issue2February 2019Pages 374-375 ReferencesRelatedInformation