Philip Morris Funds Smoking Cessation Courses on Medscape Medical Site

Medscape[1], a leading medical information company, has been asked to cancel a series of new smoking cessation training courses funded by tobacco giant Philip Morris International (PMI). For healthcare professionals, Medscape has lost all credibility[2].

Five courses launched online in February and March, funded by PMI, discussed smoking cessation through the use of other nicotine-containing products, including nicotine pouches, snus, and vaping products. Medscape temporarily removed some of the courses while it conducted a review, but it told the BMJ that it had not until now " found no evidence of deviation from Medscape's strict standards of quality and integrity ".

Courses to promote new nicotine products as less harmful

The five courses in question are titled “Nicotine Misperceptions: What Does the Evidence Say?”; “Smoking Cessation: Conversations in the Clinic”; “The Health Impact of Tobacco Products: What Do We Know in 2024?”; “Tobacco Harm Reduction: An Evidence-Based Discussion”; and “Smoking Cessation: What Works? What Doesn’t?”

The content of the courses tended to present nicotine products other than cigarettes as relatively harmless, thereby aligning with the commercial interests of PMI, which also sells vaping products, nicotine pouches and snus.

Some courses did not even suggest quitting smoking altogether as an option to reduce health risks. For example, one course presented the case of a 41-year-old man who smokes a pack of cigarettes a day and wants to reduce his risk of cancer because his father smoked and recently died of lung cancer. Possible responses for advice to give this man are to consider switching to a pipe or e-cigarettes or to reduce his consumption to half a pack a day. This advice is scientifically inaccurate because the risk of cancer is primarily linked to the duration of exposure, and the health hazard is present regardless of the tobacco product.

Outcry among health professionals

In addition to the content of these courses, it is the visibility and comprehensiveness of the disclosure of financial ties that also raises concerns among the scientific community. On the Medscape website, all courses are marked with the words " Supported by an independent educational grant from Philip Morris International » – but this support is not mentioned in the course slides and transcripts which can be distributed independently.

Medscape defended its reputation, saying through a spokesperson that its top priority is to provide "accurate and unbiased information to healthcare professionals." Medscape said all training programs follow standards set by the Accreditation Council for Continuing Medical Education (ACCME). Note that authors are required to declare their interests, but only with the pharmaceutical industry.

« Medscape, LLC requires anyone in a position to control educational content to disclose all financial relationships with ineligible companies who had place in the last 24 months. Ineligible businesses are organizations whose primary business is the production, marketing, sale, resale or distribution of health products used by or on patients. " However, many of the files on the Medscape site are sponsored by Pfizer or Moderna.

There are also concerns about the financial ties to the tobacco industry of one of the speakers in several courses, Brad Rodu, a professor of medicine and chair funded by the US Smokeless Tobacco Company and Swedish Match North America (now owned by PMI). In an article published in October 2023, Rodu stated that his “research is supported by unrestricted grants from tobacco companies to the University of Louisville.” The website Tobacco Tactics documents numerous past ties to the tobacco industry, with Rodu reporting receiving funding from British American Tobacco from 2010 to 2015, andAltria from 2010 to 2012.

However, the disclosure fields on Medscape's website state that " Brad Rodu has no relevant financial relationships. " Medscape said that under ACCME standards, financial relationships do not need to be disclosed if they do not involve a healthcare company or are more than two years old. ACCME President and CEO Graham McMahon told the BMJ that the accreditation board did not prohibit educational content funded by the tobacco industry, provided that providers " comply with rules to ensure content is protected from bias and influence, and that the provider discloses support for learners, among other requirements ".

While health professionals welcome the withdrawal of the courses, they are likely to be republished on the site, as indicated by a spokesperson for Mescape: In accordance with Medscape's standard operating procedures, if inquiries are received about educational content, it is temporarily removed from public access so that it can undergo a thorough review. This secondary review is nearly complete and has found no evidence of deviation from Medscape's high standards of quality and integrity, consistent with the ACCME Standards for Integrity and Independence in Accredited Continuing Education ".

Attempts to rehabilitate the tobacco industry

Tess Legg, a research associate at the University of Bath, said funding for training health professionals was part of a wider plan to restore the credibility of the tobacco industry, which has suffered a reputation for decades of manipulating science. The courses are a " worrying precedent that will undoubtedly be increasingly exploited by PMI and other tobacco manufacturers. ", according to Robert Jackler, Sewall Professor Emeritus at Stanford University School of Medicine in California, with the sole aim of restoring their reputation and influencing regulators.

A recent study[3] by researchers at the University of Bath shows that the tobacco industry actively participates in scientific events to improve its image. Over the period from 2012 to 2021, the study recorded British American Tobacco's participation in 176 scientific events (resulting in 50 presentations and 210 posters) and PMI's participation in 199 events (resulting in 27 presentations and 146 posters). More recently, a survey[4] The Swiss Association for the Prevention of Smoking had brought to light that Philip Morris International's involvement in the publication of a study on benzopyrene by the Zurich Polytechnic had been concealed from the Swiss Science Fund.

©Generation Without Tobacco

AE

[1] Medscape is a website providing access to medical information for clinicians. It also offers continuing education for physicians and health care professionals.

[2] Boytchev H. Exclusive: Outcry as Philip Morris International funds smoking cessation courses on Medscape BMJ 2024; 385:q830 doi:10.1136/bmj.q830

[3] Matthes BK, Fabbri A, Dance S, et al. Seeking to be seen as legitimate members of the scientific community? An analysis of British American Tobacco and Philip Morris International's involvement in scientific events. Tobacco Control, Published Online First: 03 February 2023. doi: 10.1136/tc-2022-057809

[4] Tobacco-free generation, Philip Morris International's Hidden Funding of Swiss Research, published on February 22, 2024, consulted on April 11, 2024