Duke University and the Tobacco Industry

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Duke University in Durham, North Carolina provides an example of Tobacco Industry involvement in scientific research via funding.

History of Tobacco Money

Extending the accomplishments of Trinty College whose origins can be traced back to the 1800s, Duke University was founded in 1924, with a multi-million dollar gift from the Duke Endowment, a philanthropy fund set up by the wealthy Duke dynasty. According the University's website, there was a 19 million dollar gift from the 40 million dollar trust to improve the old Trinty College campus and build the new university campus around it. The Trinity College was subsequently renamed Duke University in memory of the family.[1] On his death a year after Duke University was established, James Buchanan 'Buck' Duke left approximately half of his estate to The Duke Endowment, which gave another 67 million dollars to the trust fund.[2]

The Duke family fortune was made in the tobacco trade. In 1885 James Buchanan Duke acquired a license to use the first automated cigarette making machine. By 1890, Duke consolidated control of his four major competitors under one corporate entity, the American Tobacco Company, which then held the monopoly in the American cigarette market.[3] [4] His attempts to conquer the British market at the start of the 1900s, eventually forced the then divided British manufacturers to merge into Imperial Tobacco in 1901.[5] Later, in 1902, a third cooperative venture named the British American Tobacco Company was set up between Imperial Tobacco in the UK and the American Tobacco Company to trade in Africa, Asia, Latin America and continental Europe.[6]

University Funding in Exchange for Tobacco PR

More recently, Duke University accepted multi-million dollar funding from Philip Morris (PM) to establish the Duke Center for Nicotine and Smoking Cessation Research (CNSCR). According to the letter of agreement between PM and Duke, the tobacco company agreed to give an initial award of $15 million to establish the Center in 2004, agreeing to pay $5 million annually for the first three years.[7] In October 2006, PM extended the grant for an additional $15 million over the three-year period June 2007 – May 2010.[8] In 2012, the company's website said "PM USA expects to provide a total of $37 million to the center through June 2012 to develop, evaluate and disseminate improved methods for quitting smoking."[9] This webpage mentions QuitAssist as PM's support for people who have decided to quit. The company also emphasises it does not have any control or influence how the research is conducted or published. As stipulated in the agreement, the University acknowledges the funding on its website[10] and in journal papers.[11]

In return for the funding, the director of Duke's nicotine research centre sits on the Advisory Board of PM's "smoker cessation support initiative". The agreement stipulated that one of the centre's academic scientists was to become a formal part of PM's public relations efforts. As a result the director of Duke's CNSCR, Jed E. Rose Ph.D. became one of the four Review Board Members of QuitAssist® along with Jonathan Bloomberg from University of Illinois College of Medicine, Rafael Art. Javier, from St. John's University and Robert L. Sokolove from Boston University School of Medicine.[12] In the second half of 2011, two more members were added to the renewed QuitAssist website: Caroline S. Clauss-Ehlers from Rutgers University and Cheryl K. Olson a health behavior researcher and consultant.[12]

Evaluating QuitAssist

In 2010, funded by PM, the Duke CNSCR set up a study to evaluate the QuitAssist website, with Jed Rose as the principal investigator. The University paid 8-10 consultants $1,000, to compare this website to two others.

The initial email to recruited consultants started with a section addressing the issue:

Funding for the study is provided by Philip Morris USA. I know that some scholars have decided not to take funding from tobacco companies, so, before providing complete details on what the consultation would involve, I wanted to determine whether you would be willing to receive compensation from a grant to Duke University from Philip Morris USA.[13]

PM develops nicotine inhaler

In 2010 PM was working on the development of a tobacco-free device to inhale one molecule of nicotine pyruvate, which dissolves into nicotine and pyruvate (normally found in the blood) on reaching the lungs. The product is expected to reach the market by 2013 or 2015. The announcement of a paper presenting the first results in 2010 stated "this product is now ready for commercialization as a smoking substitute or as a stop smoking medicine."[14] In his paper, Jed E. Rose said: "Further trials of this promising nicotine inhalation technology are warranted to assess its safety and efficacy in smoking cessation treatment or harm reduction approaches."[15]

In May 2011, PMI bought the global patent rights of a new technology employing, according to the press release:

a unique method for delivering a nicotine-containing aerosol that has the potential to reduce the harm of smoking. The technology has been acquired from its inventors, including Professor Jed Rose, Ph.D., a leading expert in the field of nicotine addiction research.[16]

Cessation Support as CSR Strategy

When the San Francisco Chronicle wrote a critical editorial about the University of California accepting tobacco money in 2007, PM's Senior Director, Communications sent this letter to the editor:

We agree with the overwhelming medical and scientific consensus that cigarette smoking causes lung cancer, heart disease, emphysema and other serious diseases in smokers and that smoking is addictive. We believe -- as do many in public health -- that working to reduce the risk of tobacco use for adults who continue to smoke is an important objective.
Our External Research Program supports independent research that contributes to fundamental scientific knowledge, helps address the concerns of the public-health community regarding cigarette smoking and enables the company to continue its pursuit of products that might reduce the health risks of smoking.[17]

Funding cessation research and producing cessation tools such as QuitAssist® can be considered examples of CSR Strategy, whereby a company that has been criticised for unethical practices attempts to regain respect by presenting a socially responsible image.

In the case of PM and QuitAssist® there is a gap between the company's history of denying that smoking is addictive and its recent efforts to help people to give up. Professor Michael Siegel is cynical about PM's venture into nicotine based cessation products:

When was the last time you heard Philip Morris acknowledge in a courtroom that smoking is extremely addictive? Have you ever heard Philip Morris admit in court that a particular smoker was addicted to nicotine? Has Philip Morris ever acknowledged to the public that the company used ammonia and other ingredients to alter the pH of tobacco smoke in order to enhance the delivery of nicotine?[18]

RJ Reynolds Professor of Medicine Chair

Duke University holds a chair in medicine paid for and named after a tobacco company, RJ Reynolds. Since April 2011 the chair has been held by Mary E. Klotman, M.D. Professor of Medicine. Klotman is described by Duke as "the only female department of medicine chair at a top-five U.S. medical school. She joined Duke in 2010 after spending 13 years as chief of the Division of Infectious Diseases at Mount Sinai Medical Center." Her research focuses on the origins of the HIV-1 virus.[19]

In the archives of Duke University Medical Center and the Duke University School of Medicine there is a file concerning all correspondence about the "R.J. Reynolds Professorship in Medical Education, 1967-1987"[20]

Revolving Door

Testimony to the close relations between Duke and Reynolds are the careers of those who change jobs between the University and the tobacco company. Sometimes positions overlap.

For example, Dr A. Wallace Hayes (1939). His CV shows that he had several positions with RJ Reynolds' Biochemical and Biobehavioural Research, Bowman Gray Technical Center. He started as Corporate Toxicologist and Director in 1984, became Group Director in 1986, and Vice President a year later until 1992. While working for RJ Reynolds, he was appointed as Research Professor, Department of Medicine and Toxicology Program at Duke University in 1986 and got a similar post at the Medical College of Virginia, Richmond, VA a year later. In 1988, the School of Veterinary Medicine, VPI, Blacksburg, VA appointed him as a Research Professor too.[21]

More recent is the example of Dr David J. Doolittle, he was listed on the Advisory Committee of the 10th International Conference of the International Dose-response Society in 2011. At this time he was listed as the Principal Scientist and Manager of the Laboratory of Environmental and Molecular Toxicology at RJ Reynolds. He simultaneously held appointments as Adjunct Assistant Professor of Toxicology at Duke University Medical Center, as well as Adjunct Associate Professor of Physiology and Pharmacology at Bowman Gray School of Medicine of Wake Forest University, another University close to Reynolds' headquarters in Winston-Salem in North Carolina.[22]

Notes

  1. William E. King, Duke University, A Brief Narrative History, No date, accessed 29 July 2011.
  2. The Duke Endowment,Our History, accessed 29 July 2011
  3. North Carolina Historic Sites, Duke Homestead: Cultivation of a Tobacco Empire, 3 December 2010, accessed 25 May 2012
  4. Gale Encyclopedia of US Economic History, James Buchanan Duke, 1999, accessed 25 May 2012
  5. Imperial Tobacco, History: Formation (1901-1980) accessed 25 May 2012
  6. BAT, Our history accessed 25 May 2012
  7. Howard A. Willard, Philip Morris Letter of Agreement, 1 June 2004, accessed 25 May 2012
  8. Phililp Morris, Supporting Cessation - Grants, PM website, August 2010, accessed through archive.org, May 2012
  9. Phililp Morris, Supporting Cessation - Grants, PM website, 2012, accessed May 2012
  10. Center for Nicotine and Smoking Cessation Research, CNSCR Research, accessed 3 August 2011
  11. See for instance: Jed E. Rose, Joseph E. Herskovic, Frederique M. Behm and Eric C. Westman, Precessation treatment with nicotine patch significantly increases abstinence rates relative to conventional treatment, Nicotine and Tobacco Research, Oxford Journals, Volume 11, Issue 9, pp. 1067-1075, 30 June 2009; also see list of the Centre's publications at CNSCR Recent Journal Articles, accessed February 2012
  12. 12.0 12.1 Phillip Morris, ADD TITLE, accessed February 2012
  13. Duke University, Request for Protocol Approval For the Use of Human Subjects in Non-Medical Research, no date, but listed on DukeSmoking website, under CNSCR news, late 2009 - early 2010, accessed February 2013
  14. Health New Zealand News 2010, New nicotine cigarette gives rapid lung delivery of nicotine, 1 March 2010, accessed February 2012
  15. Jed E Rose, James E. Turner, Thangaraju Murugesan, Frederique M. Behm and Murray Laugesen Pulmonary delivery of nicotine pyruvate: sensory and pharmacokinetic characteristics, Experimental and Clinical Psychopharmacology, 2010, Vol 18(5), pages 385–94, accessed May 2012
  16. PMI International Philip Morris International Enters into a Patent Purchase Agreement of New Technology with the Potential to Reduce the Harm of Smoking, Press Release, 26 May 2011, accessed February 2012
  17. Brendan McCormick Philip Morris responds, San Francisco Chronicle, 24 May 2007, accessed February 2012
  18. Michael Siegel, Duke University Sends Message that Philip Morris is Serious About Getting Smokers to Quit; Becomes Public Relations Arm for Big Tobacco, 21 July 2009, accessed 29 July 2011; Dr Siegel is a Professor in the Department of Community Health Sciences, Boston University School of Public Health and has 25 years of experience in the field of tobacco control. He previously spent two years working at the Office on Smoking and Health at the Denters for Disease Control and Prevention, where he conducted research on second-hand smoke and cigarette advertising. He has published nearly 70 papers related to tobacco. His explicit and well-sourced comments on the tobacco industry can be read at his (non-university) blog, The Rest of the Story: Tobacco News Analysis and Commentary.
  19. Inside Duke Medicine Thanks to generous donor support, 13 SoM and SoN faculty become endowed professors 9 May 2011
  20. Duke University Medical Center Archives,William G. Anlyan Papers accessed 1 August 2011 The file is part of the administration of William G. Anlyan, chancellor emeritus of Duke University Medical Center and a trustee of The Duke Endowment. He has served as dean of the Duke University School of Medicine (1964-1969), vice president for health affairs (1969-1983), and chancellor for health affairs (1983-1989).
  21. Belle Online Dr. A. Wallace Hayes, accessed 1 August 2011
  22. Belle Online Dr. David J. Doolittle, Advisory Committee of the 10th International Conference of the International Dose-response Society April 26-27 2011, accessed 1 August 2011