The Last Refuge: Duke Center for Smoking Cessation Still Accepting Funding from Philip Morris, and Not Prominently Disclosing It

For more than a decade, tobacco control advocates have understood that it is unethical for universities - especially medical and public health schools - to take tobacco industry funding for research because the support of university research has long been a centerpiece of the tobacco industry's public relations strategy: a part of its attempts to undermine the public's appreciation of the hazards of smoking and the industry's role in the epidemic and to gain legitimacy by allying itself with prominent research institutions.

More than a decade ago, Joanna Cohen wrote that: "by accepting money from the tobacco industry recipients not only benefit directly from the sale of cigarettes but also promote the interests of tobacco companies by facilitating their ability to sell cigarettes. The acceptance of funding provides these companies with respectability by association; recipients may also act as de facto spokespersons for the industry, defending its interests, or, more subtly, remaining silent on issues that may impact negatively on the industry. This helps maintain the “legitimacy” of this industry and its products. ... Moreover, some maintain that by taking tobacco money, universities are shirking their responsibility as moral institutions entrusted with contributing to a healthy, productive, and just society."

"The arguments against accepting tobacco money are compelling, particularly to members of the health community, who are acutely aware of the enormous health toll caused by tobacco and the even greater number of tobacco related casualties that await us. Many are also aware of the unethical conduct of the tobacco industry and its long campaign of denial, obfuscation, and deceit over the harmful effects of its products. This group may be best positioned to understand that, even if a particular university may come out ahead by accepting tobacco money and even if there is some advancement of knowledge, there is still a net loss for society through the support of this industry's interests."

This was written prior to Judge Kessler's decision noting a long history of the industry using the funding of research at universities as part of a coordinated plan to defraud the American public.

Since that decision, it has become very difficult to find an academic medical or public health institution that is willing to accept tobacco funding.

The Rest of the Story

There is still, however, a last refuge for tobacco industry-sponsored research. There is a last bastion of acquiescence in the historical tobacco industry scheme to gain a public relations victory by allying itself with academia and pretending to be an objective, scientific voice in the smoking debate. There is still one academic center that is allowing itself to be used as a pawn in the marketing of cigarettes.

That last bastion is the Duke Center for Smoking Cessation.

To my surprise, I just found out that the Duke Center for Smoking Cessation will be funded by Philip Morris - on a no-cost extension basis - through May 31, 2014. This means that contrary to my previous understanding, the Duke Center for Smoking Cessation is still funded by Philip Morris.

The rest of the story is that since 2004, Duke has continuously served as a public relations arm for Philip Morris, accepting $37 million in funding from Big Tobacco to help the nation's leading tobacco company achieve its marketing goal of legitimizing itself as a corporation sincerely interested in helping smokers to quit. And Duke continues to serve that role today.

Note that according to the agreement between Duke and Philip Morris, the director of Duke's nicotine research center (or a designee) became a formal part of Philip Morris' public relations efforts, by virtue of appointment to the Advisory Board of the company's "smoker cessation support initiative."

The rest of the story is that rather than being a model for tobacco control for the nation, Duke is instead an example of exactly the opposite. It is perhaps a model, but a model for the most egregious violation of medical ethics. Duke allowed itself and its reputation and good name to be used as a public relations ploy for a tobacco company. Duke allowed itself to be used as a pawn in the public relations and marketing strategy of Philip Morris.

By associating its name with that of Duke University, Philip Morris used Duke to gain public relations marketing value from that association. This is public relations 101. Using corporate funding to secure public credibility and respect. It was part of Philip Morris' (and the other tobacco companies') playbook for decades.

The rest of the story is that Duke continues to undermine its own scientific integrity and that of academia as a whole by allowing itself to serve as a pawn in the tobacco industry's public relations and marketing strategy. A university - and especially a medical center - should not play a role in marketing the most deadly consumer product. But that is exactly what Duke will continue to do, well into the year 2014.

Rather than being recognized as a model for tobacco control, Duke should instead be entered into the Hall of Shame as a medical center that puts money over ethical integrity. 

And to make matters worse, the Center still does not prominently disclose its massive funding from Philip Morris - or the fact that this funding continues at the present time and will continue into next year. There is still no disclosure on the Center's home page, which is the appropriate place for such a disclosure.

The sole disclosure on the website is a new page called "Timeline" which graphs the historical funding for the Center. But readers are unlikely to navigate to this page unless they have a specific interest in the history of the Center. Even on this page, the link to the document which reveals the continuation of the funding into 2014 is so small that you almost literally need a magnifying glass to see it. (Even with my new $400 "progressive" lenses, I didn't even notice this link until my fourth viewing of the page.)

Moreover, members of the public who are being recruited to be human subjects in Center research are not readily informed of the current Philip Morris funding. You can go through the entire online screening process and still not have any idea that you are being asked to participate in a smoking cessation study by an academic center that is funded by Big Tobacco! I would think that if many members of the public found this out, they would be outraged. Particularly those who have lost loved ones to cancer or other diseases caused by Big Tobacco products. 

Even if they are informed later in the enrollment process, I find the failure to disclose the Big Tobacco funding up front to be a travesty, as well as an ethical breach. The same holds for the failure to disclose the Big Tobacco funding for the Center on its home page.