Tobacco Industry's Infiltration into the Medical World

In 2024, Philip Morris International (PMI) made headlines by funding continuing medical education (CME) courses focused on harm reduction. The courses, aimed at healthcare professionals, presented alternatives such as e-cigarettes and heated tobacco products as safer options to traditional smoking.

While PMI claims this type of initiative is intended to educate and combat misconceptions about risk reduction, experts say it is a calculated strategy to advance the company's commercial interests under the guise of scientific education.

A story of influence and strategic change

This move by the manufacturer is not an isolated case, but rather the culmination of decades of tobacco industry efforts to shape scientific and regulatory discourse. For decades, PMI and other tobacco companies have sought to influence public opinion, public policymaking, and even scientific research. From sponsoring scientific symposia and medical conferences to targeting journalists and policymakers with tailored messages, the industry has long used misinformation as a tool to maintain its dominant market position.

In the United States, the introduction of the Family Smoking Prevention and Tobacco Control Act in 2009 was a watershed, giving the FDA authority over tobacco products and creating a regulatory framework for “modified risk” products. Manufacturer PMI has used this framework to launch new products, claiming they are less harmful while evading strict regulation. However, these claims often rely on comparisons with traditional cigarettes and overlook emerging evidence of risks associated with e-cigarettes and heated tobacco.

The Medscape Controversy

In March 2024, Medscape[1], a major for-profit medical education platform, offered PMI-sponsored continuing medical education courses in the United States. The courses, which focused on harm reduction, represented the first instance of direct tobacco industry sponsorship of continuing medical education in the country. The tobacco company justified its participation by stating on its website that many healthcare professionals are “misinformed” about the potential benefits of new tobacco and nicotine products. However, the content of these courses closely mirrored the tobacco company’s marketing narrative, often presenting their products (heated tobacco, e-cigarettes, and oral products such as snus and nicotine pouches) as safe alternatives while omitting the importance of smoking cessation.

One notable example of the course materials instructed health professionals to recommend e-cigarettes to smoking patients concerned about lung cancer, without suggesting they quit smoking altogether. Such omissions have drawn sharp criticism from public health experts, who see them as a deliberate attempt to normalize the use of nicotine products under the guise of harm reduction.

Following strong criticism from these experts and medical professionals, Medscape withdrew the courses and pledged not to accept tobacco industry funding in the future. However, PMI’s efforts are not limited to the United States. Similar courses have been offered in South Africa, Saudi Arabia, and other Gulf countries through local providers. The tobacco industry’s use of intermediaries, such as the Foundation for a Smoke-Free World (renamed Global Action to End Smoking in 2024), further complicates efforts to prevent these incursions. The organizations, funded by the manufacturer, often present themselves as independent entities while promoting industry messages.

The role of accreditation bodies and the absence of specific exclusion rules

PMI's foray into medical education has highlighted a major vulnerability and flaw in professional education in the area of tobacco control.

The Accreditation Council for Continuing Medical Education (ACCME), which certified Medscape’s courses, failed to adopt internal rules prohibiting tobacco and nicotine industry-funded courses. This loophole allowed Philip Morris to exploit professional education systems to legitimize its discourse and influence clinical practice. Public health advocates are now calling for stricter regulations to prevent industry-funded courses from being accredited.[2].

Overall, as the industry continues to adapt its strategies to promote new products, it is imperative, according to health stakeholders, that policymakers, educators and health professionals remain vigilant. Banning tobacco industry funding in medical education and strengthening control mechanisms are essential measures to ensure that public health interests are not undermined.

New tobacco and nicotine products are not an effective solution to reducing smoking

Experts also point out that independent studies increasingly call into question the safety and effectiveness of the “alternatives” promoted by the tobacco industry. Studies have shown that heated tobacco products, despite being marketed as “smokeless,” still release harmful toxins. E-cigarettes, often touted as a safer alternative, have been linked to respiratory problems, cardiovascular problems, and an increased risk of addiction among young users. Oral tobacco products, such as snus, have been linked to increased risks of oral cancer.

Finally, public health experts stress that true risk reduction must first include stopping smoking as a priority.

AE

[1] Generation without tobacco, Philip Morris funds smoking cessation courses on medical site Medscape, published on April 12, 2024, consulted on January 7, 2025

[2] Ling PM, Glantz SA Historical and political context for Philip Morris International's continuing medical education courses on harm reduction Tobacco Control Published Online First: 03 January 2025. doi: 10.1136/tc-2024-059015

National Committee Against Smoking |