Tuesday, July 21, 2009

Duke University Sends Message that Philip Morris is Serious About Getting Smokers to Quit; Becomes Public Relations Arm for Big Tobacco

Philip Morris has a new public relations arm and it has been brilliantly placed in as reputable an institution as the company could have dreamed about: a major research institution -- Duke University.

Duke University accepted multi-million dollar funding from Philip Morris to establish the Duke Center for Nicotine and Smoking Cessation Research (CNSCR). According to the letter of agreement between Philip Morris and Duke which is posted on the Center's web site, the tobacco company agreed to provide an initial award of $15 million to establish the Center in 2004, agreeing to pay $5 million annually for the first three years. It is not clear whether the Center continues to receive Philip Morris funding, but the letter of agreement with Philip Morris is still posted on the web site and the Center acknowledges that it is receiving tobacco industry funding for a 2009 scientific conference. Also, a recent article written by researchers at the Center acknowledges support from Philip Morris.

According to the agreement, the director of Duke's nicotine research center (or a designee) becomes a formal part of Philip Morris' public relations efforts, by virtue of appointment to the Advisory Board of the company's "smoker cessation support initiative."

According to an article written by the Center: "The CNSCR, originally established at UCLA as the Nicotine Research Program, became a part of Duke in 1989. In 2004, with financial support from Philip Morris, USA, it was expanded into the CNSCR. The main goal of the expansion has been to allow for the development of more advanced research. Over the years, the Nicotine Research Program's work led to several smoking cessation treatments, including the nicotine skin patch."

The Center is sponsoring a research conference (The 15th Annual Duke Nicotine Research Conference) on September 10, entitled "Personalized & Adaptive Treatment Strategies for Smoking Cessation." The premise for the conference is described as follows: "It is widely recognized that current smoking cessation treatments do not yield success for the majority of smokers. Even with the growing armamentarium of pharmacologic treatments, which include five forms of nicotine replacement therapy (NRT) as well as the prescription pharmaceuticals bupropion SR and verenicline (Chantix), less than 25% of smokers remain abstinent one year after attempting to quit smoking. A promising strategy for improving the effectiveness of smoking cessation treatments is to personalize treatment according to smokers' genotypic and phenotypic characteristics, and to modify the treatment adaptively over time based on early indicators of therapeutic response. This conference will review the rationale underlying personalized and adaptive approaches to smoking cessation treatment as well as clinical findings supporting the utility of this strategy. Data will be presented from animal models as well as clinical trials and clinical practice. The attendees will gain an in-depth understanding of the research directions being pursued to promote the development of more effective personalized smoking cessation treatment algorithms."

According to the conference description, it is being funded in part by "donations from pharmaceutical and tobacco companies."

The Rest of the Story

This Philip Morris-funded Center is a complete and utter joke. You mean to tell me that we are to now believe that Philip Morris is so concerned about getting its customers off of cigarettes that it has a legitimate research interest in finding the most effective methods for smoking cessation? You mean to tell me that Philip Morris really wants to help smokers quit?

If Philip Morris is really so concerned about getting smokers to quit, then why does it continue to use menthol flavoring and addictive nicotine at high levels in cigarettes, why does it continue to use ammonia to enhance the delivery of nicotine, and why has the company spent no money on advertising to help smokers quit? When was the last time you saw a Philip Morris communication to its customers urging them to quit smoking due to the severe health effects? When was the last time you heard Philip Morris acknowledge in a courtroom that smoking is extremely addictive? Have you ever heard Philip Morris admit in court that a particular smoker was addicted to nicotine? Has Philip Morris ever acknowledged to the public that the company used ammonia and other ingredients to alter the pH of tobacco smoke in order to enhance the delivery of nicotine?

And this is the company that Duke apparently wants us to believe is now deeply committed to finding a way to get smokers off of cigarettes?

I'm sorry, but Duke can't be taken seriously if they are going to try to convince us that Philip Morris is a reformed company that now is dead serious about helping its smoking customers to get off of cigarettes entirely.

You see, Duke is in a catch-22 situation here. They are between a rock and a hard place. Either they have to argue that Philip Morris is serious about getting smokers to quit (which is untenable, essentially a complete joke) or they have to admit that the true company-based purpose of the funding they are accepting is different from its stated purpose of helping find the most effective ways to help smokers quit.

And if the research funding is being given without the actual intention of achieving its stated purpose, then it is not a legitimate scientific research operation after all. Instead, it is simply an extension of the public relations branch of Philip Morris.

The mistake Duke has made is that it is allowing itself and its reputation and good name to be used as a public relations ploy for a tobacco company. Duke is allowing itself to be used as a pawn in the public relations and marketing strategy of Philip Morris.

Clearly, since the purpose of this research funding is demonstrably not to dramatically reduce the number of smokers, its purpose is therefore to serve as a public relations ploy - by which Philip Morris can improve its public image by being able to argue that it really cares and that it is a responsible corporate citizen which is trying to help its customers break their addiction to its products. By associating its name with that of Duke University, Philip Morris is using Duke to gain public relations marketing value from that association.

Clearly, there is no sincere research interest operating here on the part of Philip Morris. This is public relations 101. Using corporate funding to secure public credibility and respect. It has been a part of Philip Morris' (and the other tobacco companies') playbook for decades.

In United States of America v. Philip Morris USA, Inc., et al. (Civil Action No. 99-2496 [GK]), the United States District Court for the District of Columbia found that tobacco industry funding of university research has long been part of an illegal enterprise that violates federal anti-racketeering law. The Court found that tobacco industry funding of university research was essentially a public relations ploy to undermine the public’s appreciation of the harms of smoking while making it appear that the tobacco companies were concerned corporate citizens interested in advancing objective scientific research.

The Court’s opinion is that “the Defendants established a sophisticated public relations vehicle – based on the premise of conducting independent scientific research – to deny the harms of smoking and reassure the public. That essential strand of their long-range strategy was developed and implemented in 1953-54, and guided their activities for more than forty years.” (page 26)

The most important role of industry funding of research has been to refurbish the public image – especially the scientific image – of the tobacco companies: “Robert Seligman, Vice President of R&D of Philip Morris, described how Defendants used institutional grants to refurbish their scientific image. Seligman reported that … Shook, Hardy & Bacon attorney William Shinn had stated: “CTR began to lose their luster in the mid-60’s and the tobacco industry looked around for more beneficial ways to spend their research dollars on smoking and health. It was at this time that special projects were instituted at Washington University, Harvard University, and UCLA. … The industry received a major public relation ‘plus’ when monies were given to Harvard Medical school.” (page 148)

In fact, the chief public relations advantage gained by the industry granting money to an institution is the good will associated with the university’s name: “Arnold Henson of American [Brands Tobacco Company] acknowledged that one of the main reasons for the Harvard project was the ‘PR value of the Harvard name.’” (page 148)

In the opinion of the Court, the external research funding of the tobacco companies served as a way for the tobacco companies to coordinate their fraudulent activities, in violation of federal law (page 1541).

Brown & Williamson was quite explicit in acknowledging that the Council for Tobacco Research - the major research funding arm of the tobacco industry for many years - was essentially a public relations ploy, saying that “CTR was organized as a public relations effort” (page 50).

Remember, it was just two months ago that the D.C. Court of Appeals upheld the finding that Philip Morris and other tobacco companies were guilty of racketeering, including hiding the addictiveness of nicotine from the public. At the same time that Philip Morris was being found to be guilty of racketeering and fraud by virtue of its denial that nicotine is even addictive, Duke was accepting money from the same company under the pretense that Philip Morris now wants to help smokers quit?

The supposedly scientific conference on smoking cessation has also prostituted itself by apparently taking money from pharmaceutical companies. How can you have an objective discussion of smoking cessation when your conference is funded by Big Pharma?

The bias in the conference is readily apparent from the conference description. The description acknowledges that "current smoking cessation treatments do not yield success for the majority of smokers." If current treatments are dismal in their effectiveness, then why not seek new treatments? Why not, for example, consider ways of increasing smokers' motivation to quit? Why not put resources into mass media campaigns that have been documented to enhance smoking cessation at a level never seen in nicotine replacement therapy? Why not, for example, consider the use of cold turkey quitting, which has time and again proven to be the most effective cessation method?

But no - instead, the conference is committed to finding a way to keep pharmaceutical products the centerpiece of smoking cessation. But what else would you expect from a conference that is apparently being funded by pharmaceutical and tobacco companies?

The funding of the conference by "tobacco companies" is yet another public relations opportunity for these companies. Obviously, they have no sincere interest in helping smokers to stop using their products.

The rest of the story is that Duke is undermining its own scientific integrity and that of academia as a whole by allowing itself to serve as a pawn in the tobacco industry's public relations and marketing strategy. A university - and especially a medical center - should not play a role in marketing the most deadly consumer product. But that is exactly what this Duke center is doing.

CLARIFICATION: I want readers to understand that there is no "sinister plot" that I am accusing the Center or any Duke researchers of crafting. The "sinister plot," if there is one, is on the part of Philip Morris and what this tobacco company is doing to make the public believe that it is a changed company that has a sincere interest in finding ways of getting smokers to quit more effectively. I am not maligning the Duke researchers' intentions or those of the university, or those of the research itself. It is specifically Philip Morris' intentions which I am maligning. The only role that I am arguing Duke has played is serving as a pawn by which Philip Morris can achieve its aim of legitimizing itself in the discussion over smoking cessation. So when I say that the research money has no intention of accomplishing its stated purpose, I do NOT mean that the researchers or the Center have no intention of accomplishing the stated purpose, I mean that PHILIP MORRIS has no intention of accomplishing its stated purpose in funding the research.

This is why I argue that Duke is between a rock and a hard place. It either has to argue that Philip Morris is suddenly a changed company that truly cares about getting smokers to quit, or it has to admit that Philip Morris' purpose in funding the research is not a sincere one: that the company's true intent is different from its stated intent. The former argument would be untenable based on everything we know about the company and its current actions. The latter argument is problematic because it means that the research funding is essentially illegitimate (i.e., the funding entity is disguising the real purpose behind the funding, which seems inappropriate).

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