Nicotine and Covid: an undeclared conflict of interest invalidates a study

An article from the European Respiratory Journal, published in July 2020, has just been withdrawn from publication after the revelation of its authors' links to the tobacco industry.

In general, smoking tobacco impairs respiratory function and makes smokers more likely to develop severe symptoms in the event of a respiratory infection. Coronaviruses are precisely viruses that attack the lungs and respiratory function. Despite some contradictory studies on this topic, a majority of studies show that smokers tend to develop more severe forms of COVID-19 than non-smokers.

Undeclared conflicts of interest

A study published in July 2020 in the European Respiratory Journal indicated that smokers would be 23% less likely to contract COVID-19. This study was withdrawn from publication on April 22, 2021, following the revelation by the World Health Organization (WHO) of the financial links between the authors of the study and the tobacco industry. These authors had nevertheless indicated that they had no conflict of interest, otherwise the editors of the scientific journal "would not have given their agreement for the publication of this article" [1].

Two authors of the study are being questioned: José M. Mier, who continues to serve as a consultant to the tobacco industry on harm reduction, and Konstantinos Poulas, a leading researcher at the Greek NOSMOKE Institute, which has received funding from the Philip Morris International-funded Foundation for a Smoke-Free World. In a article from Le Monde published in December 2020, journalist Stéphane Horel pointed out the affiliation of Konstantinos Poulas with the molecular biology laboratory, having benefited from funding from the company Nobacco, which became the sole distributor of Vype and Glo in 2018 following an agreement with British American Tobacco.

Beyond these links with the tobacco industry, the relevance of the results of this study has been assessed. Many biases surround the samples of patients studied: the status of smokers and ex-smokers was not always reported, as was the intensity and duration of their smoking, suggesting that they were less present among cases of severe forms of the disease [2]. The hypothesis of a "smoker's paradox" in the face of COVID-19 is thus maintained.

Tobacco industry on the lookout

Since March 2020, the COVID-19 health crisis has given rise to intense activity in the tobacco industry. For example, it has been an opportunity for the industry to deploy significant efforts in many countries to perpetuate tobacco sales and supplies, to promote its new products and to counter tobacco sales restriction measures (in South Africa in particular). The tobacco industry has also taken advantage of this crisis to develop its social responsibility strategy, intended to improve its image in Europe as well as in emerging and developing countries [3].

The health crisis has also given rise to a battle of scientific studies, allowing the tobacco industry to fuel its strategy of doubt. The few studies attributing protective virtues to nicotine have been widely relayed by the media but are still awaiting confirmation and the "smoker's paradox" seems most often linked to a lack of medical data on the smoking history of intubated people [4]. If this "paradox" therefore remains to be demonstrated, many observations seem to indicate that smoking is indeed "a factor in the severity and unfavorable evolution of COVID-19" [5]. The consequences of smoking in terms of mortality and morbidity are abundantly documented and lead to a reminder of the urgency of quitting smoking as quickly as possible.

Keywords: COVID-19, Conflicts of interest, Nicotine, CSR, Interference

©Tobacco Free Generation

[1] Bogart N, Scientific paper claiming smokers less likely to contract COVID-19 retracted over tobacco industry links, CTVNews. Published on April 22, 2021, accessed on April 26, 2021.

[2] Davey M, Scientific paper claiming smokers less likely to acquire Covid retracted over tobacco industry links, The Guardian. Published April 22, 2021, accessed April 26, 2021.

[3] Tobacco Free Generation. Europe, the tobacco industry is exploiting the Covid19 pandemic. Published October 15, 2020, accessed April 26, 2021.

[4] Thomas D, Berlin I, Covid-19 and smoking, Archives of Diseases of the Heart and Vessels - Practice. 2021 Jan; 2021(294): 26–29. Published online December 2, 2020, accessed April 26, 2020.

[5] High Council of Public Health, Advice on the link between smoking and Covid-19. Accessed April 26, 2021.

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