More Conflicts of Interest Being Hid by Electronic Cigarette Opponents: Funding of their Organization by Big Pharma Not Disclosed

Two days ago, I pointed out a strong bias against electronic cigarettes in the response of Drs. Nathan Cobb and David Abrams to a commentary I co-authored with Drs. Ted Wagener and Belinda Borrelli in the September issue of Addiction. After pointing out the bias, I posed the question of whether there may be a potential explanation for this strong apparent bias against a potentially effective new smoking cessation product that might compete with the mainstays of current treatment: smoking cessation drugs and cessation quitlines and web sites.

Yesterday, I revealed that there is indeed a possible explanation: financial conflicts of interest of both authors with companies which produce products used in smoking cessation treatment (cessation web sites and cessation drugs).

Specifically, I revealed that:

• Dr. Cobb is a paid consultant to a company that makes its profits based on an internet smoking cessation site which heavily promotes smoking cessation drugs: "Dr Cobb is a consultant to Healthways Inc, the current owner of the QuitNet system." Thus, he is conflicted because to the extent that the use of electronic cigarettes presents a different pathway to cessation than the traditional one - the use of a smoking cessation internet site, medication, online support, etc. - e-cigarettes may represent a threat to the profits of Healthways. 


• Dr. Abrams has received grant funding from multiple pharmaceutical companies that have investigated or manufactured smoking cessation drugs, including Eli Lilly, Dupont Merck, Glaxo-Wellcome, SmithKline Beecham, Sano Corporation, Bristol-Myers Squibb, Knoll Pharmaceuticals, and Pfizer. Dr. Abrams also reports having served as a senior scientific advisor for Johnson & Johnson. It is difficult to find a pharmaceutical company involved in smoking cessation drugs that Dr. Abrams has not had an association with over the years. 

None of these conflicts were disclosed in the article, which reported that the authors had nothing to disclose.

The Rest of the Story

The conflicts of interest with Big Pharma go far deeper than I revealed yesterday. The conflicts I revealed yesterday relate to personal conflicts of the co-authors. But there is also an institutional conflict of interest.

Both authors are with the Schroeder Institute for Tobacco Research and Policy Studies at the American Legacy Foundation.

What these authors did not disclose in the article is that the American Legacy Foundation receives funding from Big Pharma - specifically, from Pfizer, which is the maker of Chantix, a smoking cessation drug which stands to lose severely if electronic cigarettes become more and more popular. Thus, the Foundation's receipt of funding from Pfizer is a conflict of interest that I believe should have been revealed in the article.

What is the evidence for a financial connection between Pfizer and the American Legacy Foundation? Although you won't easily find any disclosure of this connection on the Legacy web site, Pfizer is transparent in reporting its donations to the American Legacy Foundation:

• In the first quarter of 2011, Legacy received $150,000 from Pfizer for a "Quitting Smoking Public Opinion Initiative."


• In the third quarter of 2011, Legacy received $150,000 from Pfizer for a "Quitting Smoking Public Opinion Initiative."


• In the first quarter of 2009, Legacy received $260,500 from Pfizer for a "Smoking Cessation Awareness and Benefit Survey."


• In addition, Pfizer is listed as a contributor to the 2009 American Legacy Foundation Honors event.


• Pfizer is not the only pharmaceutical company from which Legacy has taken money. The Foundation also admits to receiving funding from GlaxoSmithKline, Novartis Consumer Health, and Schering-Plough between 2008 and 2010.

The rest of the story is that these substantial conflicts of interest were not revealed in the article, thus hiding from readers the fact that these authors work at an organization which receives substantial funding from multiple companies that manufacture smoking cessation drugs and stand to lose tremendously if electronic cigarettes become more popular. I think that readers deserve to have this information and I therefore think these conflicts, along with the personal conflicts of interest I revealed yesterday, should have been disclosed.