Big Tobacco, Big Pharma, Big Vape

About a decade ago, the “American Vaping Association” railed against RJReynolds (later RAI, now part of British American Tobacco (BAT)) for attempting to persuade the FDA to “ban the sale of open-system e-cigarettes, including all component parts.” Now that pretty much all of the e-cigarette companies are tobacco companies, from Altria’s 35% stake in JUUL to RAI’s Vuse being #2 in the US, the question is moot. Big Tobacco won. Open systems are on the fringe, for people like Leonardo di Caprio.

Reynolds’ play to racism and prejudice by equating Chinese manufacture with poor quality is telling. Their own products are manufactured in China. But in order to try to dissuade the FDA from allowing open tank vape systems, it plays the China card. We need to educate people to stop doing this, as 99% of the time they are being hypocritical anyways (their own products are being made in China); and also, American manufacture now is mainly robot-run anyhow. Few quality American manufacturing jobs exist, compared to the 1970’s, for example.

What remains to be seen in the indefinite postponement of the E-cigarette regulations by the FDA is whether Big Tobacco got their way; or if public health will see their day.

New Publication: Financial Conflicts of Interest and Stance on Tobacco Harm Reduction: A Systematic Review

My colleagues Manali Vora, Jesse Elias, and Pam Ling and I at the Center for Tobacco Control Research and Education at the University of California, San Francisco just Financial Conflicts of Interest and Stance on Tobacco Harm Reduction: A Systematic Review. (Also available at PubMed).

Here are some sources that have blogged about the paper:

https://www.apha.org/news-and-media/news-releases/ajph-news-releases/2019/2019-july-issue

https://tobacco.ucsf.edu/scientific-articles-supporting-tobacco-harm-reduction-more-likely-be-industry-funded-and-lack-empirical-data

Abstract

Background. Tobacco companies have actively promoted the substitution of cigarettes with purportedly safer tobacco products (e.g., smokeless tobacco, e-cigarettes) as tobacco harm reduction (THR). Given the tobacco, e-cigarette, and pharmaceutical industries’ substantial financial interests, we quantified industry influence on support for THR.

Objectives. To analyze a comprehensive set of articles published in peer-reviewed journals assessing funding sources and support for or opposition to substitution of tobacco or nicotine products as harm reduction.

Search Methods. We searched PubMed, Embase, Web of Science, and PsycINFO with a comprehensive search string including all articles, comments, and editorials published between January 1, 1992 and July 26, 2016.

Selection Criteria. We included English-language publications published in peer-reviewed journals addressing THR in humans and excluded studies on modified cigarettes, on South Asian smokeless tobacco variants, on pregnant women, on animals, not mentioning a tobacco or nicotine product, on US Food and Drug Administration–approved nicotine replacement therapies, and on nicotine vaccines.

Data Collection and Analysis. We double-coded all articles for article type; primary product type (e.g., snus, e-cigarettes); themes for and against THR; stance on THR; THR concepts; funding or affiliation with tobacco, e-cigarette, pharmaceutical industry, or multiple industries; and each author’s country. We fit exact logistic regression models with stance on THR as the outcome (pro- vs anti-THR) and source of funding or industry affiliation as the predictor taking into account sparse data. Additional models included article type as the outcome (nonempirical or empirical) and industry funding or affiliation as predictor, and stratified analyses for empirical and nonempirical studies with stance on THR as outcome and funding source as predictor.

Main Results. Searches retrieved 826 articles, including nonempirical articles (21%), letters or commentaries (34%), editorials (5%), cross-sectional studies (15%), systematic reviews and meta-analyses (3%), and randomized controlled trials (2%). Overall, 23.9% disclosed support by industry; 49% of articles endorsed THR, 42% opposed it, and 9% took neutral or mixed positions. Support from the e-cigarette industry (odds ratio [OR] = 20.9; 95% confidence interval [CI] = 5.3, 180.7), tobacco industry (OR = 59.4; 95% CI = 10.1, +infinity), or pharmaceutical industry (OR = 2.18; 95% CI = 1.3, 3.7) was significantly associated with supportive stance on THR in analyses accounting for sparse data.

Authors’ Conclusions. Non–industry-funded articles were evenly divided in stance, while industry-funded articles favored THR. Because of their quantity, letters and comments may influence perceptions of THR when empirical studies lack consensus.

Public Health Implications. Public health practitioners and researchers need to account for industry funding when interpreting the evidence in THR debates. (Am J Public Health. Published online ahead of print May 16, 2019: e1–e8. doi:10.2105/AJPH.2019.305106)

E-cigarette e-waste litter is an environmental health harm that can be stopped before it metastasizes

My op-ed in the American Journal of Public Health that appeared this week discusses the new tobacco waste stream of electronic cigarette waste. Electronic waste is already the fastest growing waste stream globally. Creating a new product that has no current responsible recycling infrastructure, and that may be littered widely, contributing to plastic sinks such as the Great Pacific Gyre (garbage patch) in the Pacific Ocean, is a mistake. This op-ed discusses the problem and some of the solutions that can be taken to avoid a possible environmental health and ecological disaster.

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Photo of a dropped Juul vape on SF MUNI by Julia McQuoid, used with permission

Regarding this article and other research I am conducting, I also wrote a piece in the online academic blog/forum The Conversation on e-cigarettes as the Nespresso of tobacco products, environmentally speaking.

This article was republished by the University of California, Salon, Phys.org, The Houston Chron, the Connecticut Post, The Fresh Toast, Business Insider, EcoWatch, The Chicago Tribune, and many other news sources.

Reuters also interviewed me for a piece titled “E-cigarette policy should consider environmental effects, expert says.”

For my other writing on e-waste, please see my interview with Eric Lundgren in Nautilus.

 

New PLOS Medicine Article on Addiction

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.

Gizmodo writes:

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.

OnMedica writes:

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.

Inverse writes:

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 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.

Euphemisms and Dysphemisms

Here I will attempt to gather and decode euphemisms (saccharine words covering up the dismal reality, e.g., climate change for global warming) and dysphemisms (derogatory terms for neutral ones, e.g., warmist for people who acknowledge the facts of global warming) of corporate-speak.

 

“Crop Protection Agents” = pesticides

Example: Philip Morris attempting to use the natural anti-pest properties of tobacco to make the claim that tobacco is better for the environment than food crops (remember the neonicotinoid pesticides that are decimating bee and butterfly populations? They come from tobacco)

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Database of Industry Documents Databases

In an ongoing effort to compile the corruption of science and politics by short-sighted, manipulative industries, I am beginning to list the sites that document industrial epidemics. Enjoy!

CLIMATE

http://climateinvestigations.org

http://www.climatefiles.com

MONSANTO

https://usrtk.org

(Glyphosate) https://www.baumhedlundlaw.com/toxic-tort-law/monsanto-roundup-lawsuit/monsanto-secret-documents/

TOBACCO

https://www.industrydocumentslibrary.ucsf.edu

CHEMICAL

https://www.toxicdocs.org

https://www.industrydocumentslibrary.ucsf.edu

https://www.poisonpapers.org

https://www.publicintegrity.org/2014/12/04/16319/exposed-decades-denial-poisons

FOOD

http://sugarscience.ucsf.edu

GENERAL CORPORATE CRIME

https://www.corporatecrimereporter.com/

SOLUTIONS

http://productbio.com

 

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Upcoming UCSF Cancer Center talk

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CANCER CENTER TOBACCO CONTROL PROGRAM SEMINAR

 

Does the Tobacco Industry have its own Endgame?

The pharmaceuticalization of the tobacco industry and implications for public health

 

Yogi Hale Hendlin, PhD

Tuesday, September 26, 2017, 3:00 – 4:30 pm

CTCRE, Kalmanovitz Library, Room 366

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Yogi Hale Hendlin, PhD, is a Postdoctoral Research Fellow at the Center for Tobacco Control Research and Education working on inter-industry epidemics and industry subversion of science. His recent first-authored publication in the Annals of Internal Medicine titled “The Pharmaceuticalization of the Tobacco Industry” (reviewed by Reuters) demonstrates that in the face of declining cigarette volumes, the tobacco industry has been actively pursuing alternative forms of “medicinal” nicotine delivery to maintain profits. Hendlin is also currently working on a systematic review of tobacco harm reduction, analyzing the role of industry-funded scientists on the prominence of product substitution rather than cessation and public health measures in the tobacco harm reduction debate. At the intersection of environmental politics, the social determinants of health, and critical public health, Hendlin’s research addresses corporate harms to the health of society and the environment.

 

UCSF Kalmanovitz Library

530 Parnassus Ave., #366

San Francisco, CA 94143-1390