The tobacco industry is investing massively in scientific journals and the medical world

Tobacco companies invest billions in pharmaceutical and medical product subsidiaries and affiliates. These ties complicate efforts by researchers, scientific organizations and journals to distance themselves from the industry, find The Investigative Desk and the British Medical Association.[1] Journal (BMJ). 876 medical studies involving one or more scientists who received some form of funding from a tobacco manufacturer were identified in the PubMed database since 1996.

Although the tobacco industry has a long history of subverting science, most major medical journals do not have policies prohibiting research that is fully or partially funded by the industry. Even when publishers, authors, and universities are willing to restrict industry ties, evidence suggests that they have difficulty identifying funding sources, as tobacco companies have funded front groups and diversified into pharmaceuticals and health technologies.

Codes of ethics addressing tobacco sector financing are still too rarely found in medical journals

The Investigative Desk and The BMJ searched the PubMed database and found hundreds of publications showing links between the medical and pharmaceutical subsidiaries of major tobacco companies and medical research. A total of 876 studies found a relationship between at least one of the researchers and a medical company with financial ties to the tobacco industry. At least 13 journals with policies to prevent tobacco conflicts of interest published studies (27 in total) that may be linked to companies with investments in the tobacco industry.

The Swiss scientific publisher Multidisciplinary Digital Publishing Institute includes a strong statement in its tobacco policy: “ MDPI does not publish studies funded in whole or in part by the tobacco industry.

However, the analysis by Investigative Desk and the BMJ shows that 12 journals published by MDPI include studies with financial ties to the tobacco industry. For example, in a 2024 publication on tetrahydrocannabinol in the Journal of Clinical Medicine, two of the seven researchers were employees of Philip Morris’s Vectura subsidiary, according to their declarations of interest. And five of the authors are scientific advisors or paid consultants.

In 2021, the MDPI journal Vaccines published a study written by employees of Kentucky BioProcessing, a subsidiary of British American Tobacco (BAT). Vaccines editor Ralph Tripp of the Department of Infectious Diseases at the University of Georgia College of Veterinary Medicine said that was no reason to dismiss the study. "We were then (and still are) facing a SARS-CoV-2 pandemic, and it was therefore our duty to evaluate stable, effective and easy-to-manufacture vaccines needed to stop the covid-19 pandemic. The manuscript in question was reviewed and accepted on the basis of its scientific merits alone. The publication did not promote anything ".

The Investigative Desk and The BMJ also audited the editorial policies toward the tobacco industry of 40 leading medical journals, ranked by their Clarivate Impact Factor: the top 10 journals in general medicine and the top 10 in each of three therapeutic areas particularly affected by smoking (oncology, cardiac and cardiovascular medicine, and respiratory medicine). Of these 40 journals, only eight (20 %) had a policy prohibiting studies funded in whole or in part by the tobacco industry. Those that did were mainly journals in lung diseases. Six of the ten journals in respiratory medicine have a policy on publications funded by the tobacco industry. In contrast, of the top ten journals in oncology, only one has such a policy, and in cardiology, none have. Of the top ten journals in general medicine, only The BMJ has such a policy. Despite these provisions in principle, their application can be difficult when it involves subsidiaries or organisations associated with tobacco manufacturers. Last year, BMJ Open retracted an article after it emerged that ECLAT SRL (the funder mentioned) received support from the Foundation for a Smoke-Free World, a group supported and fully funded by the tobacco manufacturer PMI.

Helen Macdonald, head of research ethics at the BMJ, acknowledges the difficulties of complying with established rules: "These rules are difficult to implement for journals that rely heavily on the accuracy of authors' disclosures. The situation is further complicated by the definition of the tobacco industry, which is also evolving, as recent takeover attempts by pharmaceutical companies have shown."

Massive investments in medical treatments

Tobacco manufacturers have invested heavily in the pharmaceutical sector in recent years. Through its holding company Philip Morris Investments BV (PMIBV), PMI acquired Fertin Pharma laboratories in 2021[2], OtiTopic and Vectura[3], and announced that it is positioning itself as a player in the health and wellness sector. BAT is also present in the biotechnology sector through its subsidiary KBio Holdings and has launched into the development of plant-based treatments and vaccines against rare diseases.

The four major tobacco companies, PMI, BAT, Imperial Brands and Japan Tobacco International (JTI), have invested billions in companies that produce drugs or other medical products. These investments include treatments for diseases caused or aggravated by smoking. For example, Vectura, a subsidiary of PMI since 2021, produces an inhaler used by patients suffering from chronic obstructive pulmonary disease (COPD) or asthma. Fertin Pharma, a Danish subsidiary of PMI, produces nicotine gum. Fertin Pharma has developed numerous patents inspired by oral nicotine treatments and adapted some of them for other pathologies; it has also developed oral cannabis-based products, for both medical and recreational uses. JTI's pharmaceutical branch produces treatments for lung cancer, skin conditions such as psoriasis and atopic dermatitis, and heart disease. Imperial Brands invests in medical cannabis for people suffering from severe chronic pain and cancer.

An image and development strategy for cigarette manufacturers

These acquisitions confirm the diversification objectives of tobacco manufacturers, particularly Philip Morris and British American Tobacco, and aim to strengthen their image strategy. The latter is based on a discourse highlighting the notion of risk reduction presented in support of the development of new tobacco and nicotine products. Appearing as a "health company" also contributes to a strategy of dividing health players while reassuring decision-makers.

This diversification is therefore part of an overall strategy designed to enable manufacturers to return to the public decision-making table from which they have been ousted.

Last May[4], BMJ had revealed a multimillion-dollar deal between PMI and Medscape, one of the largest providers of medical education in the United States. Philip Morris was to pay $2.9 million to provide a one-year “PMI program” of smoking cessation training that would be sent to Medscape’s vast network of healthcare professionals. The program highlighted the use of the tobacco company’s nicotine products, particularly its vaping products.

Medical research could even help tobacco companies develop new nicotine products. According to paediatrician Harm Tiddens, emeritus professor of paediatric pulmonology at the Erasmus MC, studies on asthma inhalers could, for example, prove valuable for the production of cigarettes and vapes. "It is very difficult to get inhaled medications to exactly the right place in the lungs," explains Harm Tiddens. "This could be interesting for a tobacco manufacturer who wants to know how to absorb nicotine as quickly as possible into the lungs."

©Generation Without Tobacco

AE

[1] Van den Berg I, de Jeu M, Boytchev H. Tobacco funded research: how even journals with bans find it hard to stem the tide of publications BMJ 2024; 385:q1153 doi:10.1136/bmj.q1153

[2] Tobacco-free generation, Philip Morris acquires nicotine replacement specialist Fertin Pharma, published July 5, 2021, accessed June 4, 2024

[3] Tobacco-free generation, Philip Morris completes highly contested acquisition of Vectura, published on September 21, 2021, consulted on June 4, 2024

[4] Tobacco-free generation, Medscape Ends Partnership With Philip Morris Following Civil Society Outcry, published on May 8, 2024, consulted on June 4, 2024