Pharmaceutical and tobacco industry ties hampered smoking cessation efforts, researchers charge

San Francisco, CA - Confidential tobacco industry documents made available to the public in 1998 show that the symbiotic financial interests of cigarette manufacturers and pharmaceutical companies likely dampened smoking cessation initiatives during the 1980s and 1990s, a new study shows. According to researchers Bhavna Shamasunder and Dr Lisa Bero (UCSF), the public deserves to know about financial stakes linking companies with ostensibly opposing aims and how these ties may have fostered both "competition and collaboration" between them.

"Our findings suggest that financial ties between tobacco and pharmaceutical companies have resulted in the weakening of smoking cessation efforts and the sharing of technology to develop nicotine products that are profitable to both industries," they observe.

What's more, Bero told heartwire , there's no way of gauging just how much interaction is still taking place between tobacco product manufacturers and pharmaceutical companies or their parent corporations. The latter, she says, have not been particularly forthcoming.

"That's one reason we use the previously secret tobacco industry documents to find out this information; they offer a unique source of data for the internal goings on of these companies. There really are no other sources that I know of where you can find this information."

That's one reason why Shamasunder and Bero wanted to publish their findings, Bero explains. "We wanted to draw attention to the fact that even though this is historical, we don't really know what's going on nowadays, because it's hard to get that information."

Their study appears in the August 14, 2002 issue of JAMA.

The Master Settlement Agreement of 1998 was drawn up by US attorneys general and 7 major tobacco companies to settle ongoing or future litigation being brought against the companies by 46 US states and 5 US territories. As part of the settlement, the companies were required to pay the states an estimated US $206 billion, as well as pay US $1.5 billion for an antismoking campaign. In addition, the companies agreed to changes to marketing policies and made previously secret documents available on the Internet.

Bero doubts that the material, while enlightening, is complete. "Certainly some documents have been destroyed, but it's hard to know how many because nobody knows what the baseline is," she told heartwire . "There's also evidence that if you're using just the tobacco industry websites, as we did for this paper, documents sometimes disappear from those websites."

Shamasunder and Bero scrutinized the posted documents using a combination of 49 terms to search for material that discussed various smoking cessation therapies or pharmaceutical company names. From their findings, they choose for publication 3 case studies focusing on types of nicotine gums and patches to illustrate the influence of the tobacco industry on pharmaceutical company decisions.

One case study showed that Marion Merrell Dow, a subsidiary of Dow Chemical Company and manufacturer of Nicorette® gum, canceled its Smoking Cessation Newsletter to physicians after tobacco giant Phillip Morris threatened to cancel its regular purchase of humectants from Dow Chemical. In 1982 alone, the authors note, Phillip Morris bought US $8 million worth of the chemicals, used to help tobacco retain moisture. After discovering that Dow was helping fund a public health council examining the effects of smoking on health, Phillip Morris threatened to suspend purchases once again, whereupon Dow canceled its support of the council.

A second case study documents exchanges between CIBA-Geigy (now Novartis) and Phillip Morris. CIBA-Geigy had been a "major supplier" of pesticides to Phillip Morris via its agricultural division, but when CIBA-Geigy released its nicotine patch in 1991, the tobacco company was moved to "help" CIBA-Geigy "devise more appropriate advertising" for the product. After discussions between the companies, CIBA-Geigy changed its marketing strategy, removing any "antismoking" messages.

The third case showed Procorida AB to be the holding company for Pharmacia AB, the Swedish Tobacco Company, and the Pinkerton Tobacco Company, holding more than 80% of the latter 2 companies. "By collaborating and sharing technology among its pharmaceutical and tobacco holdings, Procordia AB had the potential to benefit financially from creating an addiction through tobacco sales that could then be treated with its nicotine replacement therapies," Shamasunder and Bero write.

Corporate diversification has ethical ramifications, the authors conclude. "Corporate diversification of companies such as Procordia AB has allowed well-hidden financial ties between pharmaceutical companies and the tobacco industry to foster collaboration among companies. . . . We argue that it is not an acceptable conflict of interest for a company to profit both from selling addictive tobacco products and the drugs to treat the addiction."

Bero believes that the study may surprise some pharmaceutical company executives, but not at all levels of certain organizations. "With mergers and acquisitions, I'm sure there are new companies that don't know what their predecessor companies had been doing," she states. That said, she adds, megacorporations and corporate diversification are only becoming more common. "We don't think these financial ties are going away," she says.

Bero hopes to delve deeper into the available documents seeking other examples and more current information of pharmaceutical and tobacco industry ties. The authors also believe that physicians and other healthcare professionals could do more to question and put pressure on pharmaceutical companies bowing under the influence of the tobacco industry.

"I think that physicians did not know what was going on in the past and they probably wouldn't have been questioning it," Bero said. One place where physicians can have an influence today is on the boards of pharmaceutical companies, where they might hear of other companies that are within the same holding company, she suggests. "For example, although they might assume that these boards are operating completely independently, they could question and find out if they are."

Heartwire from Medscape © 2002 

Cite this: Pharmaceutical and tobacco industry ties hampered smoking cessation efforts, researchers charge - Medscape - Aug 13, 2002.