Why journals should not publish articles funded by the tobacco industry

British Medical Journal, Oct 28, 2000 by Gavin Yamey, Richard Savage, Jean King

That the tobacco industry is allowed a platform through scientific journals is a controversial issue. The Cancer Research Campaign already withholds research grants from academic departments closely linked with the tobacco industry; here it argues that respected journals should not publish articles funded by the industry. Such a notion is challenged by two editors, who prefer a policy of transparency and disclosure rather than prohibition.

FOR

The arguments for scientists refusing to accept funding from the tobacco industry and, by extension, journals refusing to accept publications arising from such funding, fall into three main categories (box 1).

Harm to health

The health risks associated with tobacco use have been detailed in many reports and were the basis of the justification for the Cancer Research Campaign's code of practice, which prohibits research groups in receipt of money from the tobacco industry from applying to it for funds (box 2).[1-7]

Distortion and "distraction" of scientific research

The tobacco industry has a long track record of seeking to cast doubt on good research, as shown in its own documents, now available on the internet owing to litigation cases in the United States. One tactic is to commission studies aimed at discrediting accepted findings: examples include studies that cast doubt on epidemiological findings, especially in relation to passive smoking, or which purport to identify other risk factors for ill health in active and passive smokers, such as a low intake of vegetables.[8 9] These studies are often open to criticism on methodological grounds: use of selective arguments and literature, inconsistency in the inclusion or omission of potentially biasing factors, playing with statistical inference rather than considering overall plausibility and weight of evidence, and drawing conclusions that are unwarranted by the evidence.[10-12] Such concerns may not prevent these studies from being published in international journals, where the peer review process has failed to address their methodological weaknesses. Often studies are funded through bodies that sound credible, such as the Centre for Indoor Air Research or the European Working Group on Environmental Tobacco Smoke, which have been set up by the tobacco industry. Editors and readers will be unaware of the source of their support.

Frequently, studies that conflict with orthodox health messages receive prominence in the media far beyond what might be expected, given the relative lack of evidence to support their case or their relatively unknown source.[13] This is often owing to public relations activities that have been carefully orchestrated by the tobacco industry. Once a story has appeared in a Western broadsheet, it is almost inevitably picked up in media around the world, again assisted by the efforts of the industry's public relations. The harm to efforts at tobacco control that such stories cause should not be underestimated, especially in developing countries, where the ability of health professionals to respond effectively is hampered by a lack of resources.

Project "Whitecoat," a plan to recruit scientists who would express views favourable to the tobacco industry, was also revealed in the industry's own documents.[14] Cohen et al detailed further examples of how the tobacco industry has sought to use scientists and institutions to gain credibility and prestige, has supported "distracting" research, and has tried to censor the tobacco control activities of institutions in receipt of funds from the tobacco industry. The authors argue that independent research and internal papers from the tobacco companies both point to an industry that has systematically "suppressed, manipulated and distorted the scientific record" and continues to do so.[15] Chapter and verse from the tobacco companies' papers are provided by Ong and Glantz for a multimillion dollar campaign to subvert science, which included: manipulating the media, commissioning "confounder" studies, using third parties to recruit scientists and infiltrate institutions, and, ironically, promoting their notion of "good epidemiological practice."[16]

Other disreputable activities

Numerous activities by the tobacco industry, and important knowledge it has not acted on, have come to light from within the industry's documents.[17] These range from concealing the growing evidence of the association between cancer and the addictiveness of cigarettes, concealing findings that so called "light" cigarettes deliver as much or more tar than ordinary strength brands, employing marketing strategies that specifically target minors, and being aware that a major proportion of their cigarette brands reaching the market, especially in developing countries, have been smuggled (see www.ash.org.uk).

The tobacco industry has also been active in promoting messages contrary to the health evidence in countries where tobacco control is currently poorly organised. "Hit squads" of so called experts paid by the tobacco industry can do untold harm, especially in developing countries, by delivering misinformation and creating confusion among government ministers and members of the public.[18] This can set back legislation and undermine individuals' determination to quit; in other words, it costs lives.