Neil McKeganey, Christopher Russell | 27 September 2016
In the past few days, several pro-tobacco harm reduction academics and scientists who are registered to attend the Global Tobacco and Nicotine Forum (GTNF) in Brussels, Belgium this week (27-29 September), received a letter signed by two major anti-smoking organisations – the European Network for Smoking and Tobacco Prevention (ENSP) and the U.S.-based Campaign for Tobacco-Free Kids (CTFK). This letter expressed to the recipients, including one of the authors of this blog (CR), the signatories’ ‘strong concern over the participation of renowned academics’ at a conference that is largely funded by the tobacco industry.
The signatories’ concern is that the academics mere attendance, let alone participation, at this conference ‘could be detrimental to their own reputation and to the reputation of their affiliated institution’. The letter concludes with the signatories’ expectation that, having now had the source of funding clarified, and attending companies named, the recipient will do ‘the right thing’ and withdraw from the event, thereby rectifying what must have been a ‘misunderstanding’ in accepting the initial invitation. To our knowledge, only one recipient of this letter has withdrawn from the GTNF.
So why do public health academics attend conferences that are heavily funded by and attended by tobacco companies? Each of the academics and medics who will be speaking at this year’s GTNF – Jack Henningfield, David Sweanor, Riccardo Polosa, David Levy, Ray Niaura, Karl Fagerstrom, Christopher Russell and others – are doing so not because they dispute the harms of smoking (a quick Google search will show that most of those named have spent the past 10-20 years of their academic career studying and reporting on the harmful effects of smoking tobacco and ways to encourage and assist smokers to quit), nor because they are being paid to do so by the tobacco industry – again, they are not.
No, their reason for speaking at this particular industry-heavy event is because they, like us, believe that major progress in reducing the global prevalence of tobacco smoking, and associated health harms, can be made by engaging in debate and discussion with the tobacco industry. The goal of this engagement is to encourage the tobacco industry to commit to a future of innovating reduced-risk nicotine consumer products that are substantially less harmful than combustible tobacco products and ultimately lead to the end of tobacco smoking.
Of course, many large tobacco companies have long since begun to manufacture and market a range of nicotine products, such as e-cigarettes, that have been shown in scientific studies to substantially reduce the user’s exposure to the harmful and potentially harmful toxins found in tobacco smoke. The GTNF provides a valuable opportunity to discuss with tobacco industry scientists and directors their plans to develop, steward, and market these products to smokers as an alternative to combustible tobacco products. Academics should rightly make up their own mind as to whether they feel they can valuably contribute to these meetings, and whether they are likely to take anything of value from these meetings. What is unacceptable is for any organisation to attempt to prevent any person from engaging in debate and discussion about the potential public health impact of tobacco harm reduction policies and products. Indeed, no side is served by attempts to create a cordon sanitaire between the scientific community and the tobacco industry, in which both parties suffer as a result of the non-exchange of ideas, of evidence, and of intellectual challenge.
It is truly ironic that organisations that have dedicated themselves to reducing smoking in society should see progress in excluding the industry from engaging with external public health and medical scientists, given the fact that the tobacco industry itself has been rightly challenged in the past for refusing to fully share its own internal data on the health effects of smoking. A refusal to speak with those who are regarded as one’s opponents may create a certain intellectual purity, but very few, if any, of society’s problems have ever been solved by disengagement from the views and activities of one’s opponents. Conferences like the GTNF present a valuable opportunity to learn about the novel products that the tobacco industry are developing with the aim of encouraging smokers to use non-combustible nicotine devices. Understanding the toxicity and appeal of those devices and their potential impact on smoking rates should be of interest to all who are seeking to reduce the prevalence of tobacco smoking and tobacco-related harm.
Whether one likes it or not, the tobacco industry will continue to sell, even if at lower volumes annually, a product that causes 100,000 deaths per year in the UK, and smoking-related disease in 2 million others. The deadly effects of smoking tobacco are now, and have been for some time, publicly acknowledged by every major tobacco company. In response, those working in public health have a responsibility to encourage and assist all smokers to quit fully and as soon as possible, and to encourage and assist those who are not currently willing or able to quit smoking fully to cut down their smoking or switch to using products that deliver nicotine in a form that is substantially less toxic than inhaled tobacco smoke.
The development of a range of reduced-risk nicotine products that confer a significantly lower risk to the health of the user and bystanders, and are used primarily to support attempts to quit smoking, underscores why it is now so important that scientists working externally to tobacco companies engage with these companies to critically assess their product-specific data and the methods by which these data were obtained. Far from avoiding interaction with the industry, critical scrutiny of the industry’s products and research, needs to be at the core of academics’ relationships with the industry.
The signatories of the aforementioned letter may believe that, in seeking to dissuade academics from participating in the GTNF, they are serving the interests of tobacco control. However, if the recipients of the letter were to be dissuaded from attending this and similar conferences, the opposite effect would be more likely; a generation of public health academics with little or no insights into what the tobacco industry is doing, or planning, and so fewer opportunities to encourage the industry to move their Research & Development activities in directions that would gradually migrate millions of smokers to use reduced-risk nicotine alternatives to smoking.
The letter recently sent to the various of public health and medical academics planning on attending the GTNF meeting engenders a climate of accusation, suspicion and of threatened reputational damage that is anathema to the freedom of thought, expression and engagement that is at the very heart of scientific investigation. These are dangerous times in which scientists need to resist the pressures of those who may be driven by the best of intentions, but in whose actions the very best of scientific enquiry may suffer.
Neil McKeganey Ph.D. Christopher Russell Ph.D.
Centre for Substance Use Research
Glasgow, United Kingdom.