American Academy of Pediatrics Calls for Ban on Electronic Cigarettes, But Fails to Disclose Its Huge Conflict of Interest with Big Pharma

In a previous post, I pointed out that every national anti-smoking organization which has called for the prohibition of electronic cigarettes has been found to have financial ties to Big Pharma. I thought this pattern had been broken when I saw a press release from the American Academy of Pediatrics calling for electronic cigarettes to be banned. I assumed that if the Academy had a financial conflict of interest with pharmaceutical companies, it would disclose it in the press release, as would be ethical behavior for a public health organization. Thus, I assumed that the pattern had been broken. What I didn't know was the rest of the story.

The Story

On October 20, the American Academy of Pediatrics issued a press release calling for a ban on electronic cigarettes.

According to the press release: "The AAP's work to eliminate children's exposure to tobacco and secondhand smoke is spearheaded at the AAP Julius B. Richmond Center, which was established in 2006. The AAP recommends bans on tobacco advertising in all media, and restrictions on the depiction of tobacco in movies and television. In addition to laws banning the sale of tobacco products to children, the AAP calls for bans on candy cigarettes, cigars, and other products that imitate smoking or tobacco use. E-cigarettes (electronic cigarettes) should also be banned. The sale of tobacco products on the same premises as pharmacies should be eliminated, including pharmacies located in supermarkets."

The Rest of the Story

It turns out that the American Academy of Pediatrics has a massive conflict of interest by virtue of substantial financial sponsorships by Big Pharma. A large number of pharmaceutical companies are major sponsors of the Academy's upcoming 2009 annual conference.

According to the conference web site, pharmaceutical company sponsors of the conference at the "gold" level include:

• GlaxoSmithKline
• Johnson & Johnson
• McNeil Pediatrics
• Merck
• Wyeth
• Pfizer
• Sciele

Many of these pharmaceutical companies produce nicotine replacement products or other smoking cessation drugs for which electronic cigarettes pose a huge threat. While FDA-approved smoking cessation medications are highly ineffective, with long-term success rates of only about 8-10%, electronic cigarettes appear to be much more effective, probably because they simulate the act of smoking, thus addressing both the behavioral and pharmacologic aspects of the smoking addiction.

To make a national recommendation that electronic cigarettes be banned without disclosing its severe financial conflict of interest with Big Pharma is, in my view, unethical. The financial conflict of interest could be perceived as influencing the Academy's policy on electronic cigarettes, since a ban on these apparently very effective smoking cessation devices is a move that protects pharmaceutical company profits from what would otherwise be a severe threat to their business.

Unfortunately, a ban on electronic cigarettes would also be a public health tragedy, as it would force hundreds of thousands of ex-smokers to return to cigarette smoking, and it would therefore do massive harm - causing disease and death among people who otherwise would have continued to regain their health.

It is a shame that while the American Academy of Pediatrics cares about children, it does not seem to care about those kids' parents, many of whom are going to become very ill or die if the Academy's policy recommendation on electronic cigarettes is heeded.

But regardless of the inappropriateness of the policy recommendation itself, the rest of the story is that the American Academy of Pediatrics has violated basic ethical principles of conduct by making a national policy recommendation on electronic cigarettes without disclosing its massive financial conflict of interest with a host of pharmaceutical companies whose products are being severely threatened by the increasingly popularity of electronic cigarettes.