Thursday, August 27, 2009

Anti-Smoking Groups' Suggested Questions for Smokers to Ask Their Doctor Includes Asking for Cessation Drugs Even if They Want to Quit on Their Own

The "Become an Ex" web site features a document which lists questions that smokers who want to quit smoking should ask their doctor.

"Becoming an Ex" is a quit smoking web site sponsored by a large number of health and anti-smoking groups, headed by the American Legacy Foundation and including several state health departments, the American Heart Association, American Cancer Society, and the Mayo Clinic. The complete list of groups can be found here.

The document instructs smokers who feel like they should quit on their own (cold turkey) not to do so, but instead to ask their physician for smoking cessation drugs.

Question 4 (which they are instructed to write down on a paper and bring to their doctor) is:

"I feel like I should quit on my own, but I am wondering about medicines. How could a medicine, over-the-counter or prescription, help me stop smoking?"

Question 5 is:

"Which medication do you recommend for me, and how do I use it?"

Notice that the question is not: "Do you recommend a medication for me, or do you recommend that I quit cold turkey?"

This is very curious (and unwarranted) advice, since we know that on a population basis, cold turkey quit attempts are the most successful. Moreover, if the patient has already expressed a desire to quit on his or her own - cold turkey - then putting them on drugs is probably the last thing you want to do as a physician.

Nevertheless, this document tells every smoker to ask their doctor which medication to take, not whether or not to use medication.

The Rest of the Story

At the bottom of the document, in the fine print, is a most interesting disclosure: "The development of this document was supported by a sponsorship from Pfizer Inc."

In other words, the rest of the story is that the advice to seek medication use even if your inclination is to attempt to quit cold turkey is biased advice which has the appearance of resulting from a financial conflict of interest: the fact that Pfizer - a pharmaceutical company which manufactures one of the major smoking cessation medications - is a sponsor of the development of the document.

Interestingly, the publication on the site which discusses medications mentions the benefits of Chantix, but does not mention the black box warning: the serious, life-threatening potential side effects of Chantix.

While it is up to private organizations to decide whether to accept corporate funding for their campaigns, it seems troubling to me that a number of state health departments (taxpayer-funded) would be involved in an effort that apparently takes pharmaceutical money to develop its materials. But for any of these organizations to be disseminating a document that was supported by Pfizer and is clearly not appropriate because of that conflict of interest is severely problematic as well.

This story demonstrates the extent to which the entire anti-smoking movement has sold itself out to Big Pharma, the extent to which the pharmaceutical funding is destroying the objectivity of these groups, and ultimately, the extent to which the protection of the public's health is suffering because of the prostitution of objective science and policy to the desire for funding.

(Thanks to PicassoIII for the tip).

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