Monday, July 22, 2013

American Legacy Foundation Still Failing to Disclose Conflict of Interest in Commenting on Electronic Cigarettes

In a June 26 press release, the American Legacy Foundation downplayed the results of a new clinical trial showing that electronic cigarettes can surprisingly enhance smoking cessation among smokers with little motivation to quit.

According to the press release: "The researchers reported that e-cigarettes decreased some smokers’ cigarette consumption and that 8.7% quit smoking 40 weeks after the intervention ended. Unfortunately, they also found that smokers quit rates were not statistically different whether given e-cigarettes with or without nicotine –thereby causing a placebo effect. ... We cannot conclude from this study that e-cigarettes promote cessation. While the study showed that some smokers quit, it does not show that the product itself had any role in the behavior change. In fact, the results merely show that sucking on an empty cigarette holder (a placebo) would likely accomplish the same thing."

This press release misses the whole point. And in doing so, it ends up misleading the public.

There is no true "placebo" effect involved with electronic cigarettes because the mimicking of smoking with the use of a cigarette-like device is the main point of the product. We do not want research to control for this effect. We want research to measure this effect.

Unfortunately, the misinterpretation and misrepresentation of this scientific evidence by the American Legacy Foundation appears not to be simply a mistake, but it has the appearance of being a result of a financial conflict of interest that Legacy once again fails to disclose.

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 press release which informs the public that Legacy has received 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.

The rest of the story is that not only is Legacy misrepresenting the scientific evidence on electronic cigarettes, but this misrepresentation has the appearance of being influenced by the foundation's financial conflict of interest with Big Pharma.

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