Wednesday, March 14, 2012

Society for Research on Nicotine and Tobacco (SRNT) Sacrifices Scientific Integrity for Money: Accepts Big Pharma Sponsorships for Annual Meeting

The Society for Research on Nicotine and Tobacco (SRNT) holds its annual meeting this week in Houston.

According to the program, major topic areas for paper sessions include:
  1. varenicline;
  2. dopamine;
  3. the process of quitting;
  4. genetics of nicotine addiction; and
  5. the biology of dependence and withdrawal.
One of the major theme lectures is entitled “Properties of Some Interesting Subtypes of Nicotinic Receptors: Expression, Structure, Function, Upregulation, Targets for Smoking Cessation Therapy.”

An entire session will be devoted to varenicline, with talks including:
  1. Extinction of smoking during response to varenicline: is one week long enough?;
  2. A double-blind, placebo-controlled study evaluating the safety and efficacy of varenicline for smoking cessation in schizophrenia and schizoaffective disorder;
  3. The effects of extended pre-quit varenicline treatment on smoking behavior and short-term abstinence: a randomized clinical trial;
  4. Real world effectiveness of varenicline and nicotine replacement therapy: findings from an outpatient smoking cessation clinic.
A sampling of additional papers on NRT and pharmaceutical smoking cessation treatment include:
  1. Using nicotine patches for the recommended duration helps smokers quit: a population-based cohort study;
  2. Effects of motivational interviewing and the nicotine patch for smoking cessation among homeless smokers;
  3. Medication adherence: who does, who doesn’t, and how to improve it;
  4. Effect of varenicline on individual nicotine withdrawal symptoms: a combined analysis of eight randomized placebo-controlled trials.

The Rest of the Story

According to the conference program, two of the major sponsors of the conference, which apparently provide financial support for SRNT that helps fund the annual conference, are:

  1. Pfizer; and
  2. GlaxoSmithKline

Pfizer, of course, is the manufacturer of varenicline (Chantix) and GlaxoSmithKline makes Zyban. both of these are smoking cessation drugs.

By accepting these sponsorships, SRNT is sacrificing the scientific integrity of the conference. There is no way that the conference can objectively consider the role of pharmaceutical smoking cessation products as part of a broad, national strategy for smoking cessation when the conference is being funded by the very manufacturers of many of those products.

The bias introduced by the Big Pharma sponsorship of the conference is readily apparent. While there are multiple talks about the role of pharmaceutical products in smoking cessation, especially the role of Chantix, noticeably absent from the conference program are the following talks:

  1. Suicidal ideation and completed suicide as adverse side effects of Chantix: should varenicline be taken off the market?;
  2. Case reports of varenicline-related deaths among patients with no prior history of depression;
  3. Population-based data show that smoking cessation drugs are not effective;
  4. Population-based data show that cold turkey quitting remains the most effective strategy;
  5. Problems of blinding in clinical trials of smoking cessation drugs; and
  6. Weaknesses of the transtheoretical model in explaining the process of smoking cessation: the need for anti-smoking media campaigns rather than smoking cessation drugs as the mainstay for a national smoking cessation strategy.

The rest of the story is that although its main purpose is presumably to foster objective scientific consideration of the issues regarding nicotine and tobacco control, SRNT is apparently heavily funded by the pharmaceutical industry. This funding, in my view, creates a substantial conflict of interest that precludes the objective consideration of many important scientific issues; in particular, the role of smoking cessation drugs as part of national or international tobacco control strategies.

This is in no way to fault the individual scientists who will present on these issues at the conference. Nor is it to suggest that any wrongdoing is occurring. It is merely to point out that the pharmaceutical sponsorship creates, by its very existence, an unavoidable bias that precludes a truly objective consideration of any scientific issue that may have significant implications for the profitability of smoking cessation drugs, and therefore, for their manufacturers who are conference sponsors.

It is also important to point out that bias does not necessarily have to be conscious. In fact, the most concerning bias is that which could arise subconsciously by virtue of the sponsorship of the conference by Big Pharma.

I should also note that SRNT is not unique in relying upon pharmaceutical company sponsorship. The 14th World Conference on Tobacco OR Health, which was held in Mumbai, India in March 2009, was sponsored by two of the largest representatives of Big Pharma: GlaxoSmithKline and Pfizer. The 2007 National Conference on Tobacco or Health was sponsored by Pfizer, as was at least one event at the 2009 Conference. And the Sixth National Conference on Tobacco or Health in Canada in 2009 was also sponsored by Pfizer.

I should once again highlight the International Society for the Prevention of Tobacco Induced Diseases (ISPTID) as one of the few national or international organizations that, despite past acceptance of sponsorships from Big Pharma, has changed and found other ways to support its annual meetings. I understand the difficulty of finding funding to support these large meetings. But it is possible to find alternative sources of funding. Failing to do so compromises the scientific integrity of these conferences.

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