American Legacy Foundation Called for Removal of E-Cigarettes from Market Without Disclosing its Financial Ties to Big Pharma

The American Legacy Foundation released a policy statement on electronic cigarettes, in which it called for the removal of these products from the market. The statement was entitled "The FDA Should Take Electronic Cigarettes Off The Market Until It Is Satisfied That They Are Safe and Effective."

According to the statement: "While we remain open to promising products that can help smokers quit smoking, a consideration of all of the available evidence combined with important unanswered questions strongly supports our call on the FDA to prohibit the marketing and sale of e-cigarettes unless and until the FDA is satisfied that they are safe and effective."

I have already explained why this is an inappropriate policy suggestion that would result in severe public health harm. There is little doubt that these products are helping literally thousands of people to remain smoke-free and that removing them from the market would result in thousands of ex-smokers returning to cigarette smoking because e-cigarettes are no longer available. I have also explained how this policy statement misrepresents the scientific evidence, as it suggests that electronic cigarettes present a carcinogenic risk, although the actual laboratory findings show that only trace levels of carcinogens are present in these products, comparable to the levels of carcinogens present in nicotine gum and nicotine patches -- products which the American Legacy Foundation has no concerns regarding safety. Moreover, the levels of carcinogens in electronic cigarettes are more than 1000 times lower than in Marlboros, meaning that these products can dramatically reduce a smoker's cancer risk.

This commentary, however, focuses on another issue: the question of the objectivity of the policy statement and whether or not Legacy appropriate revealed conflicts of interest that may be perceived as affecting Legacy's position and its reporting of the scientific evidence.

The Rest of the Story

The rest of the story is that the American Legacy Foundation has taken money from Big Pharma. In 2009-2011, it acknowledges having accepted donations from the following pharmaceutical companies, many of which manufacture smoking cessation products:

• GlaxoSmithKline
• Pfizer
• Novartis
• Schering-Plough  

The receipt of this money represents a conflict of interest that I believe must be disclosed in any statement in which Legacy is making recommendations for national policy regarding electronic cigarettes. However, I cannot find any financial disclosure in the policy statement which informs the public that Legacy receives significant funding from the pharmaceutical industry.

This funding is highly relevant because electronic cigarettes represent a major potential threat to pharmaceutical company profits. If electronic cigarettes prove to be effective and continue to increase in popularity, they could put a huge dent in pharmaceutical smoking cessation drug sales, causing billion dollar losses for the pharmaceutical companies. This could threaten Legacy's future funding. Thus, by accepting this funding, Legacy has a vested financial interest in the stability of these pharmaceutical companies, and therefore, in the continued high rates of sale of their smoking cessation drugs. Electronic cigarettes threaten those high rates of sale, especially because preliminary evidence suggests that they may actually be far more effective than traditional pharmaceutical approaches to smoking cessation.

I believe that the American Legacy Foundation should have disclosed its financial conflict of interest.