Tuesday, March 12, 2013

If There Were 2,700 Lawsuits Against Electronic Cigarette Manufacturers, Would E-Cigs Stay on the Market? Anti-Smoking Groups Continue to Recommend Chantix Despite 2,700 Lawsuits and in Absence of Determining Validity of Claims

If there were 2,700 filed in the U.S. against electronic cigarette manufacturers for alleged severe consequences including suicide and attempted suicide, e-cigs wouldn't remain on the market for 24 hours. Even the possibility that e-cigs may have caused 2,700 deaths would be enough to force these products off the market.

Yet despite the more than 3,000 lawsuits filed against Pfizer for alleged fatal or near fatal consequences of its smoking cessation drug Chantix, anti-smoking groups continue to recommend this drug for widespread use.

Even worse, the anti-smoking groups are encouraging the use of Chantix in the absence of any definitive studies to determine whether these thousands of deaths were indeed attributable to Chantix.

According to an article at Thomson Reuters, Pfizer has agreed to settle 2,700 lawsuits related to fatal or near-fatal consequences of Chantix, meaning that there will be no further discovery in these cases, and we will come no closer to understanding the potential role of Chantix in these tragedies.

According to the article: "The United States' largest drugmaker has entered into agreements to settle around 80 percent of the more than 2,700 lawsuits over Chantix, costing the company around $273 million in 2012, according to the report filed on Feb. 28. Pfizer also said it has set aside $15 million to resolve all of the remaining claims in the United States."

The Rest of the Story

It's difficult to understand the logic of anti-smoking groups. They are promoting Chantix, which has been alleged to cause more than 3,000 deaths. At the same time, they supported a ban on electronic cigarettes, which have been alleged to cause zero deaths.

What makes matters worse - and in my view, unacceptable - is that in a number of cases, anti-smoking advocates or groups that continue to push Chantix are failing to prominently disclose their financial conflicts of interest. These groups have taken money from Pfizer, creating a severe conflict of interest, yet they hide or obscure this information.
For example, here is the page where the University of Wisconsin Center for Tobacco Research and Intervention (UW-CTRI) recommends the use of Chantix. Nothing on this page discloses that the Center or any of its faculty members have a conflict of interest by virtue of having taken money from Pfizer.

However, in a 2008 article in JAMA, the Center's director made this disclosure: "In the past 5 years, Dr Fiore reports that he has lectured and consulted for Pfizer and has served as an investigator on research studies at the University of Wisconsin (UW) that were supported by GlaxoSmithKline, Nabi, Pfizer, and sanofi-aventis."

So we find out that not only did the Center take money from Pfizer, but its director had a personal financial conflict of interest by having consulted for Pfizer. None of this is disclosed on the page where the Center recommends the use of Chantix, despite the more than 3,000 lawsuits filed against Pfizer for fatal or near-fatal alleged adverse events related to the drug.

There is certainly room for disagreement about the role of Chantix compared to electronic cigarettes in smoking cessation (and my own opinion is that NRT, other smoking cessation drugs, and electronic cigarettes all play an important role). However, when public opinions are offered about drugs in an effort to promote the use of the drugs, then any financial conflicts of interest must be disclosed. I do not believe that UW-CTRI is adhering to this basic ethical principle.

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