PLOS Medicine just published an article I wrote with Jesse Elias and Pam Ling at UCSF on “Public versus internal conceptions of addiction: An analysis of internal Philip Morris documents.” This article discusses previously secret industry documents pointing at the disconnect between the Philip Morris’s public statements of addiction as reduced to nicotine, and their secret unpublished research showing that nicotine is a minor overall component of smoking addiction.
Public health researchers interested in helping smokers would do well to critically appraise the public statements, policies, and actions of tobacco and nicotine dealers, especially as these are strictly for-profit companies beholden to their lexical priority of fiduciary responsibility increasing shareholder value at all costs.
Rather than bandwagoning on nicotine determinism, addiction is a biopsychosocial disease with lobbying and advertising as disease vectors.
News media on the paper appears in The Outline and other interviews.
The Outline writes:
Publicly, Philip Morris has been willing to admit that cigarettes are addictive since 1998—but would only cop to the role of nicotine in forming an addiction. Yet privately, the company knew that social, psychological, and environmental factors are also central to addiction and how difficult it is to quit smoking. In other words, addiction was never just about nicotine, and Philip Morris knew it.
the researchers hope to remind public health officials that tobacco addiction is about more than just nicotine, and that there isn’t enough long-term data to show whether “reduced harm products” actually benefit public health. Even Philip Morris recognized this.
In other words, they said, PM’s ‘opportunistic’ shift from denying to affirming nicotine’s addictiveness was driven not by a substantive change in scientific understanding but by public, regulatory, and legal pressures.
While Philip Morris publicly acknowledged nicotine’s addictiveness in 2000, the study’s authors suggest that the company scapegoated the chemical as the solitary driver of addiction. By placing the blame on nicotine, company scientists drew attention away from a potential public health focus on biological, social, psychological, and environmental factors that could help people quit smoking….
For addiction researchers, public health researchers, and smokers, it’s clear that smoking is about so much more than the nicotine. But this analysis suggests that a major tobacco company attempted to steer the focus toward only nicotine, decreasing the effectiveness of interventions that could help people quit.
Susan Mayor writes in the the British Journal of Medicine writes that while PM’s “Addiction Consensus Group”:
Sounds very virtuous
More like a cover up. An analysis funded by the US National Cancer Institute compared the company’s public position on addiction with what was being discussed within company walls. It found that throughout the 2000s Philip Morris reinforced the idea that nicotine’s pharmacology was the main driver of smoking addiction. But internally, company scientists were saying there was bit more to it than that. Addiction was the result of “interconnected biological, social, psychological, and environmental determinants,” with nicotine just one component.