TOBACCO INDUCED DISEASES Vol. 2, No. 4: 163-166 (2004) © PTID Society

EDITORIAL

There is No Scope for Tobacco Funded Research in our Society

The following position statement has been endorsed by the Executive Committee of the International Society for the Prevention of Tobacco Induced Diseases.

The International Society for the Prevention of behaviour can be swept under even large carpets? Tobacco Induced Diseases is a Multidisciplinary group As reported in the November issue of Academic of advocates comprising laboratory Medicine [1], journal of the American Medical Col- scientists, clinicians, health care researchers and public leges, the industry has recently “exploited institutional health workers. Their common aim is the prevention of fears of losing research funding as part of its strategy recruitment of any individual to nicotine addiction and to avoid tobacco stock divestment by US medical tobacco dependency, the promotion of smoking cessa- schools.” As stated by Ruth Malone RN, PhD, senior tion and elucidation of the mechanisms and outcomes author of the report and associate professor of nursing of injury caused by smoking. in University of California, San Francisco, School of A major objective of global tobacco control is to Nursing, “Funding research is a way the industry tries restrict the ability of transnational tobacco companies to to buy legitimacy. There are contradictions in selling promote their products, glamorize smoking in the eyes off tobacco stocks while continuing to take money de- of young people, propagate misleading information rived from tobacco profits.” [1] about the harm of active and and delay There are contradictions too for ISPTID. If we al- or dilute legislation. low the presentation of tobacco funded research at our In the third Annual Scientific Meeting of the So- meetings we would have to pretend that the entire his- ciety in Louisville Kentucky, U.S., in October 2004, tory of the corruption of science by big tobacco did not two of the posters gave acknowledgement to funding matter any longer. by the Philip Morris External Research Programme In 1988 Philip Morris, Lorillard and RJ Reynolds (PMERP). Although these are the only two such cases formed the “Centre for Indoor Air Research” (CIAR) to in the Society’s three-year history, the Executive Com- support research on “indoor air quality.” The aim was mittee regrets that this happened and wishes to reaffirm to distance the new organization of CIAR from the US that there is no scope whatsoever for any tobacco spon- Tobacco Institute and encourage scientists outside the sored or influenced activities within the Society. Al- industry to participate. The CIAR was wholly funded though the Society’s rules and intentions may not have and controlled by the industry. Professor Richard Day- been sufficiently clear, the Executive Committee has nard of Northeastern University School of Law, Boston, now resolved to never again accept tobacco funded Massachusetts, U.S., is quoted as saying, “Their true research for presentation or publication. purpose was to generate disformation.” [2] While authors of tobacco funded research may As part of the 1998 US Attorneys General Master deny any influence of their paymasters on their outputs, Settlement (Minnesota) with the industry, it was agreed this is not the point. The is currently that the US Tobacco Institute and the CIAR would be seeking to reposition itself, acquire new legitimacy, disbanded. Following this Philip Morris established the ingratiate itself with lawmakers and desperately avoid PMERP, in place of CIAR, in the same offices of the the impacts of both legislation and litigation which will same town in Maryland, under the same director, Dr. damage their sales and budgets. The industry’s defence Max Eisenberg. [3] lawyers state in the current trial in Washington, D.C., The aims of PMERP are apparently in large (under the Racketeering Influenced and Corrupt Or- measure to counter public health advocacy for tighter ganization Act-RICO), that the tobacco industry should tobacco control by being seen to be doing good. History be judged on its present behaviour, not its past history. suggests that ISPTID should not allow itself to be en- The question is how much mendacity and anti-social snared in this process.

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In the late 1970s and 1980s the concealment and and frequent squamous cell metaplasia in obfuscation of the harmful effects of both mainstream the ciliated epithelium of the nasal cavity. and sidestream (second-hand) smoke became a major • In terms of equal TPM concentration, project within the transnational tobacco companies. As sidestream smoke showed higher toxicity in described recently in The Lancet of November 11, terms of body weight development, food 2004, Pascal Diethelm, Jean-Charles Rielle and Martin consumption, rectal temperature and respi- Mckee [4] used previously secret industry documents to ratory frequency, than mainstream smoke. dissect the covert operations of Philip Morris (PM). They describe how PM sought to inform themselves of Diethelm and colleagues state that these findings the hazards of their products but deny or misrepresent were discussed in a letter to Dr. Thomas Osdene, chief their laboratory findings to others. PM even carefully scientist at Philip Morris, by Professor Ragnar Ry- hid the research operations from most of their staff. One lander, formerly chair of Environmental Medicine at former employee is quoted as stating in 1996 “I subse- Gothenberg University, who also held an adjunct pro- quently found out (by asking around) that hardly any- fessorial position at Geneva University. Rylander was a one [at Philip Morris] knew anything about INBIFO”. longstanding consultant to Philip Morris receiving, INBIFO was the Institute für Industrielle und Biol- from the 1980s, $150,000 a year in fees and other com- gische Forschung GMbH which Philip Morris bought pensation. [2] Rylander stated to Osdene, “The histol- as part of its offshore research operation. A PM execu- ogy demonstrates more advanced lesions in the nasal tive said its purchase would create “a locale where we epithelium and hyper- and metaplasia in areas which might do some of the things which we are reluctant to are not affected by mainstream smoke. The extent of do in this country” (i.e., the U.S.). Another senior PM cornification observed in these animals has never been executive said that research “on a contractual basis seen before.” If the industry had published these find- in Europe…presents an opportunity that is relatively ings 22 years ago, public health measures to protect lacking in risk and unattractive repercussions in this children, workers and the general public from second- country.” hand smoke might be well advanced and institutional- Some of the unpublished research findings in ized world-wide. Instead the industry has spent hun- INBIFO reports are staggering in terms of their clarity dreds of millions of dollars to block and disable even and implications. For example, as described by Di- the most protective measures against passive ethelm and colleagues [4], the rat experiments involv- smoking. The consequences can be counted in illness ing exposures to either mainstream or sidestream smoke episodes, hospital admissions, premature deaths and a clearly delineate the biological toxicity of the different massive cost to communities. chemical profiles of these agents: As stated in the conflict of interest statement in the Lancet article, Professor Rylander took legal action “All rats showed general signs of exhaus- against two of the authors of the Lancet paper after they tion after the end of the daily exposure. In publicly exposed his covert activities for the tobacco contrast to the rats of the mainstream group, industry. After three court cases including two appeals, which recovered by morning, the rats judgment was given in favour of the defendants, Di- of the sidestream groups continued to show ethelm and Rielle. The court considered that Rylander shaggy fur and some pronounced respira- had perpetrated “unprecedented scientific fraud.” In a tory symptoms characterized by whistling recent review by a special ethics committee in Geneva and rattling sounds.” University, chaired by Professor Alex Mauron, its con- clusion was: The report also concluded that: “Considering his close association with the • The mainstream total particulate matter tobacco industry and the duplicity of his at- (TPM) would have to be increased three titude throughout his professional career, it fold to produce similar reactions to those appears that Ragnar Rylander was not able seen with sidestream exposure. to preserve his intellectual independence in • Sidestream smoke (“puffed or non- the face of specific commercial interests. puffed”) caused more severe atrophic and Documentary evidence leads one to believe necrotic lesions of the olfactory epithelium that the attitude he adopted in his profes-

No Scope for Tobacco Funded Research 165

sional life consisted in unilaterally defend- cussed. The Workshop also explored the ing the interests of the tobacco industry in theoretical possibility of creating an inde- the conflict pitting the latter against scien- pendent institution to distribute funds for tists convinced of the harmful effects of research, including funds received from the passive smoking. He helped to elaborate the tobacco industry. This independent institu- industry’s strategy and in his agreements tion would, of course, need to be free of in- with the industry accepted a secrecy clause fluence from the tobacco industry in its op- that led him to suppress information known eration in order to be credible and effective. to him regarding the toxic effects of smok- However, no consensus was reached on the ing. The Commission considers it legiti- feasibility or desirability of this idea. mate to doubt the validity of the body of Ragnar Rylander’s work directly or indi- The Planning Committee believes that the rectly concerned with tobacco smoke.” Workshop objectives were met. Different viewpoints on this controversial topic were Professor Rylander of course rejects these find- aired in a civil and respectful manner. Par- ings. The Geneva court judgement and Geneva Univer- ticipants hopefully came away better in- sity enquiry report are now on the ISPTID website so formed as a result of their attendance at the that members may their own views. Workshop. We firmly believe it is worth- While we are not suggesting that any colleagues while to promote open discussion of the who have taken PMERP funds are intellectually dis- ethical, legal and policy issues of tobacco honest, the history of tobacco funding of research industry funding of tobacco research. Opin- shows such a large systematic bias in some of the out- ions across the entire spectrum are a wel- puts that we cannot, at this stage, have any confidence come part of that dialogue and we are quite in tobacco funded activities. satisfied that our forum was a success in Questions remain as to the extent to which to- meeting that goal.” bacco control advocates should in the future participate in engagements with any arm of the industry or those In the meantime and in the absence of an alterna- who are funded by them. A group of about 75 people tive formal approach, ISPTID will take all possible from tobacco sectors, together with eight from the steps to distance itself from tobacco sponsorship in any industry met recently in New Orleans to address the form. It is a clearly stated rule of the Society that all questions: conflicts of interest must be declared and tobacco 1. What are the potential risks and benefits of to- funded projects will not be accepted for presentation or bacco industry sponsorship of scientific research? publication in any form. 2. Are there procedures or mechanisms that could The future of the prevention of tobacco induced help protect against the types of research abuse that disease critically depends on the prevention of the have occurred in the past and that some believe are con- industry usurping any new and bogus role in tobacco tinuing to occur? control. Whether any alternative and safe model based A report by Mitchell Zeller [5] on Globalink on tobacco funding can be developed remains to be States: seen.

“A number of issues and ideas were dis- Anthony J. Hedley cussed by the group. The need for far Department of Community Medicine greater transparency by the tobacco indus- University of Hong Kong try in the area of research funding was dis- Hong Kong, China

REFERENCES 79:1017-26. 2. Thomas H, Gagliardi J. Tobacco smoking guns. 1. Wander N, Malone RE. Selling off or selling out? Hong Kong: South China Morning Post, Monday Medical schools and ethical leadership in tobacco January 18, 1999 Monday focus, pp 17. stock divestment. Academic Medicine 2004; 3. Max Eisenberg, Ph.D., Philip Morris External

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Research Program, Research Management Group, Philip Morris did not want you to see. Lancet pub- 1099 Winterson Road, Suite 280, Linthicum lished online November 11, 2004 (http:// Heights, Maryland, 21090-2216, USA. Tel: +1 image.thelancet.com/extras/03art7306web.pdf). (410) 684-3782; Fax: +1 (410) 684-3729; e-mail: 5. Zeller M. Issues raised by the offer and acceptance [email protected] of tobacco industry funds for research. Globalink, 4. Diethelm PA, Rielle J-C, McKee M. The whole 19 November 2004 (http://member.globalink.org/ truth and nothing but the truth? The research that 50789).