Monday, August 17, 2009

Action on Smoking and Health Continues Push for Electronic Cigarette Ban, But Fails to Disclose Major Financial Conflict of Interest

In its continued push for the prohibition of the sale of electronic cigarettes in the United States and abroad, Action on Smoking and Health (ASH) is cautioning the public not to trust the facts or opinions expressed by anyone with connections to the electronic cigarette companies because those groups are biased by virtue of their financial conflict of interest.

In a press release that responds to an E Cigarette Direct letter regarding an article published in The Peninsula, which erroneously reported that electronic cigarettes have been found to be more harmful than regular cigarettes, ASH writes:

"In summary, in evaluating e-cigarettes, we respectfully suggest that both your publication and your readers not rely upon the largely unsubstantiated representations of sellers (who have an obvious bias and usually no medical training or credibility), some allegedly supported by studies which have not been published in reputable medical journals and which may have been financed by the industry itself (thereby creating a clear conflict of interest)."

"Instead, we would urge your publication and your readers to rely upon the impartial governmental body charged by U.S. law with evaluating such products [FDA], major U.S. national health organizations which are impartial and have the necessary scientific authority and credibility to address these issues, and decisions by impartial and unbiased entities such as the Attorney General of Oregon, Facebook, etc."

"In this regard you should find the links [URLs] set forth in this communication, as well as the many URLs contained in the linked documents, helpful. We urge you and your readers to consult them for the truth. The simple truth is that no reputable scientific study, much less one published in a major scientific or medical journal, has ever shown that e-cigarettes are any less dangerous than conventional tobacco cigarettes."

The Rest of the Story

The rest of the story is that it was discovered this weekend that ASH has a financial conflict of interest of its own, which it has failed to disclose, which has the appearance of leading to bias and partiality in its presentation of the facts and its opinions on the issue of electronic cigarettes.

It turns out that ASH is a major recipient of money from Big Pharma, which stands to lose huge amounts of profits if smokers start turning to electronic cigarettes rather than to existing pharmaceutical products in their attempts to quit smoking.

Specifically, ASH received $100,000 from Pfizer, according to the company's civic organization funding report for the 2nd quarter of 2009. Interestingly, that same report reveals that other recipients of major funding from Pfizer include three of the other major national anti-smoking organizations that are pushing for the removal of e-cigarettes from the market: the American Cancer Society, American Lung Association, and American Heart Association.

Is it merely a coincidence that each of the five major national organizations (the ACS, ALA, AHA, ASH and Campaign for Tobacco-Free Kids) that are lobbying for the removal of e-cigarettes from the market have been heavily funded by Big Pharma, which stands to lose substantial profits if smokers use e-cigarettes in their quit attempts rather than the traditional pharmaceutical products, such as nicotine replacement therapy and Chantix (which is - coincidentally or not - manufactured by Pfizer)?

It certainly has the appearance that these organizations are being influenced by virtue of their own conflicts of interest. It is nice for ASH to call on the public to be skeptical of information they receive from groups with financial ties to electronic cigarette companies, but ASH should have been forthcoming in disclosing its own financial conflict of interest: financial support from Big Pharma. That is every bit as important a conflict and it has every bit of the same appearance of biasing ASH's presentation of information and its opinion on this issue.

However, I frankly find ASH's failure to disclose its own conflict of interest more unethical and unscrupulous precisely because it has gone to great lengths to try to discredit the statements of others because of their conflicts of interest. To me, that makes it even more inexcusable for ASH to then hide its own conflict of interest, which is every bit as substantial, since the pharmaceutical companies (and Pfizer in particular) stand to lose so much money if electronic cigarettes remain on the market.

By the way, since when does an organization (ASH) which maintains that 30 minutes of secondhand smoke exposure raises a nonsmoker's risk of a fatal heart attack to the same level as an active smoker's have "the necessary scientific authority and credibility to address these issues."

And also, since when did Facebook become an authority on the relative health risks of various type of cigarettes? I trust Facebook for a lot of things, but toxicological risk assessments are not one of them.

Now to some brief comments on the substantive scientific issue to which ASH is responding. The original article in The Peninsula stated that: "the “e-cigarette” harms human health far more than the normal cigarette" and that "it contains 40 times as much nicotine as a regular cigarette."

Neither of these statements is true. There is absolutely no evidence that e-cigarettes are more harmful than regular cigarettes, and there is abundant evidence to support the contention that e-cigarettes are much safer than conventional ones. In fact, it doesn't take a rocket scientist to figure out that a product which delivers propylene glycol and nicotine is going to be safer than one which delivers the nicotine along with 10,000+ chemicals, including 57 carcinogens and numerous toxins.

It is also untrue that e-cigarettes deliver 40 times as much nicotine as regular cigarettes. They actually deliver less nicotine than most conventional cigarettes.

So it seems completely reasonable that E Cigarette Direct wrote to the Peninsula to point out its errors. That letter to the editor was entirely appropriate and accurate in pointing out first that electronic cigarettes are safer than conventional ones because they do not contain tobacco and thus are free of the more than 10,000 chemicals delivered by cigarettes. It also correctly pointed out that the FDA's alarmist claim that e-cigs contain carcinogens was meaningless because they were present only at trace levels comparable to those found in nicotine replacement products. Second, the letter correctly pointed out the evidence that e-cigarettes deliver less nicotine than conventional cigarettes.

Nevertheless, ASH took issue with this response and its press release asks the public to assume that electronic cigarettes are as dangerous as regular cigarettes, but without any scientific evidence. ASH writes that "the simple truth is that no reputable scientific study, much less one published in a major scientific or medical journal, has ever shown that e-cigarettes are any less dangerous than conventional tobacco cigarettes."

Well, the simple truth is also that no reputable scientific study, much less one published in a major scientific or medical journal, has ever shown that e-cigarettes are anywhere near as dangerous as conventional tobacco cigarettes.

E Cigarette Direct has now challenged ASH to actually address the substantive scientific issues at hand: is there evidence that electronic cigarettes deliver more nicotine than conventional cigarettes and is there evidence that these devices are more hazardous than conventional cigarettes? That press release concludes: "In a response to Ash published on the E Cigarette Direct website, the company alleged that ASH had not replied directly to any of the points raised by E Cigarette Direct, stating: "We believe that ASH did not deal with the issues we raised simply because there is no logical response." Managing Director Jean Rasbridge said: "We challenge them to re-read our letter, to read our response to ASH, and to actually address the points raised. We believe a dialogue on whether the electronic cigarette is better or worse than real cigarettes will be of more benefit than side-stepping the real issue - is the electronic cigarette safer than conventional cigarettes?"

Of course, ASH will not respond directly to the scientific substance of the issue, just as ASH never responded to the scientific substance of the issue of whether 30 minutes of secondhand smoke exposure increases the risk of a fatal heart attack among a nonsmoker to the same level as that of an active smoker. ASH is hardly an impartial and unbiased source of medical risk inforamation. In fact, its funding by Big Pharma has the appearance of creating a substantial bias in its presentation of scientific information regarding the relative danger of cigarette vs. e-cigarette smoking.

Unfortunately, while complaining about the conflicts of interest of others, ASH failed to disclose its own conflict of interest. Now, instead of merely acting unscientifically, it is acting unethically as well.


(Thanks to Ladyraj for the tip).

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