22 February 2022
By: Jodie Briggs MPP, MA, and Donna Vallone PhD, MPH – Source: AJPH
Corporate deception in public health is nothing new. From the fossil fuel industry hiding the environmental impact of fracking to the pharmaceutical industry misleading the medical community about the dangers of opioid use, for-profit industries have often misrepresented scientific findings to obscure negative evidence related to the public’s health and well-being to protect their bottom line.
Among the worst offenders is the tobacco industry, who knowingly hid the truth about the impact of cigarette smoking for decades. Tobacco industry executives spun a narrative of doubt around the health risks of smoking, donated to politicians who would oppose greater regulations, and funded research designed to undercut objective scientific findings to protect profits.1 Not until the landmark 1998 Master Settlement Agreement did such actions receive greater attention and tobacco companies were forbidden to engage in practices that conceal health risks.
Unfortunately, history has begun to repeat itself. The tobacco industry is once again infiltrating scientific spaces and presenting a direct threat to the vital work of unbiased tobacco control scientists. With the popular introduction of e-cigarettes and other new nicotine products, the tobacco industry has remade itself into a self-proclaimed concerned corporate entity—and one that will go to great lengths to prop up their new products while opposing credible scientific findings. Both JUUL and Philip Morris have injected their narrative into scientific circles by publishing sponsored research in scientific journals. Other tactics include academic conference participation, where they introduce questionable findings, muddle earnest research efforts, and stifle honest debates among legitimate experts.
Although the Master Settlement Agreement ended tobacco industry–funded “research” groups such as the Tobacco Institute, which were designed to discredit the evidence between smoking and cancer, the Foundation for a Smoke-Free World (FSFW), founded in 2017 and funded by Philip Morris International, has worked to infiltrate scientific spaces and shape public discourse.2 FSFW recently published articles in established journals, including the International Journal of Environmental Research and Public Health and Drugs and Alcohol Today, by evading conflict-of-interest documentation and policies or by obscuring their role in funding.2
Most egregiously, JUUL recently sponsored an entire special issue of the American Journal of Health Behavior to showcase its industry-funded research.3 JUUL’s success in buying a complete issue was sufficiently concerning to garner a response from US Senators Elizabeth Warren and Richard Blumenthal, who called on acting Food and Drug Administration (FDA) Commissioner Janet Woodcock to more carefully examine industry-funded research, particularly with respect to conflict-of-interest documentation and the mechanisms through which the FDA evaluates the rigor of such studies.4
Scientific conferences are another venue where comprehensive policies must guard against industry influence. For example, the Society of Research on Nicotine and Tobacco (SRNT) previously allowed industry researchers to attend and present at their annual scientific conferences but recently banned tobacco industry employees from attending. SRNT made these changes in response to an outcry by many researchers who were disturbed by the overwhelming participation of industry researchers.
Allowing tobacco industry research in scientific publications and conferences has significant consequences. First, it lends the industry legitimacy and status—giving industry-sponsored research a false equivalence with independent, credible, public health research. Second, industry participation at academic conferences and other scientific arenas provides critical insight into tobacco control evidence and strategy, which the industry can then use to counter science-based policy initiatives. Third, legitimizing tobacco industry findings allows them to showcase their work to federal regulators. JUUL, for example, presented findings at the 2021 SRNT conference and then cited its own press release as evidence in their FDA Premarket Tobacco Product Application process.5 Lastly, younger researchers may not be aware of the tobacco industry’s long history of dishonesty and therefore may be less likely to appreciate the consequences of industry participation in scientific forums. By appropriating the language of harm reduction, the tobacco industry cynically claims to care about users’ health. But an industry whose financial success depends on the continuous generation of profits will never be in a position to authentically support the elimination of the disease and death caused by tobacco.
By participating in legitimate scientific activities, the tobacco industry gains the imprimatur of integrity—a veil that is increasingly being taken at face value. Recent media appearances by Philip Morris International’s former and current CEOs on CNBC and Bloomberg and in the Harvard Business Review as well as paid media placements in the Wall Street Journal and the Washington Post have given Philip Morris International platforms to stake claims of harm reduction to improve public health while continuing to sell deadly products. These efforts can all serve to shift public perceptions of the tobacco industry, subtly directing the general public into believing the industry’s pretense that it can be part of the public health solution to end smoking. This may be particularly true among America’s youth or those who have simply forgotten the industry’s egregious reputation and their ongoing unethical practices.6,7
The consequences of allowing any corporate industry an equivalent seat at the table are obvious: for-profit entities have an inherent conflict with regulatory actions that should be informed by unbiased scientific findings.
Unfortunately, some evidence indicates that the guardrails preventing industry influence have eroded.2 To help thwart this insidious process, the scientific community must renew its commitment to strict implementation of conflict-of-interest policies and reject offers of paid placement in special journal editions. Specific recommendations for doing this have been proposed, including standardized reporting of conflicts of interests and funding in journals and the adoption of author databases of financial interests.2 Tobacco researchers must also embrace policies to keep conferences free from industry participation and refuse to participate in forums with industry personnel. Finally, regulatory agencies must rely on independent, rather than industry-sponsored, study findings in assessing the population-level health impacts of novel tobacco products. If empirical findings support a population-level benefit, industry should follow established regulatory pathways for approvals prior to marketing.
Lessons learned from decades of deception by the tobacco industry should not have to be repeated. Holding the tobacco industry accountable required more than 40 years of comprehensive, collaborative efforts. There is no indication that their motivations have changed—their goal remains the expansion of their market share for nicotine addiction regardless of the public health consequences. The public, the scientific community, the media, and decision-makers alike must maintain a skeptical view of any efforts by the tobacco industry that seek to influence scientific and regulatory efforts, particularly those that could serve to reduce their profits. We cannot afford to permit the makers of the world’s deadliest products to distract us from a united, science-based effort to improve public health. Other corporations will doubtless seek to meddle in science; let’s make sure our public health response is united, tested, and successful. Our future depends on it.
J. Briggs conceptualized the editorial in conjunction with D. Vallone. J. Briggs led the writing with editorial oversight by D. Vallone.