Influencing Science: Commissioning Research and Reviews

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The tobacco industry has a history of funding research that is intended to undermine evidence that smoking causes harm, or which is intended to divert the issue away from health.

As far back as 1953, public relations (PR) firm Hill & Knowlton advised tobacco companies that the best way to fight against the emerging evidence of the link between smoking and cancer was not to deny the research outright but to say more research is warranted, thereby creating doubt. It is under Hill & Knowlton’s advice that the Tobacco Industry Research Committee was established. Rather than explore the relationship between smoking and cancer this group sought alternative explanations for the causes of cancer, thereby meeting the PR objective of creating doubt over existing evidence.1

Sometimes research is commissioned by the tobacco industry itself, and sometimes it is done by a third party, such as, for example, the European Science and Environment Forum or the Institute of Economic Affairs on the risks of second-hand smoke (SHS).

Research into the previously secret internal tobacco documents shows that the tobacco industry has both commissioned research to compliament its agenda and, in some cases, altered that research should the outcomes not fit with their requirements.

Phillip Morris Changing the Conclusions of Industry Funded Research

The University of California examined the industry’s strategies to contest the evidence on the impact of SHS exposure on maternal and child health and found that industry executives pressured the author of a review funded by the tobacco industry into changing his scientific conclusions.2

A review on sudden infant death syndrome (SIDS) was published in 20013 which acknowledged funding from Philip Morris (PM). The University of California found that tobacco industry documents related to this review showed the extent of company influence on the content and conclusions of this review.

Background: Prenatal and postnatal exposure to tobacco smoke adversely affects maternal and child health. SHS has been linked causally with SIDS in major health reports. In 1992, the US Environmental Protection Agency (EPA) first noted an association between SHS and SIDS, and both prenatal exposure and postnatal SHS exposure were listed as independent risk factors for SIDS in a 1997 California EPA report (republished in 1999 by the National Cancer Institute) and a 2004 US Surgeon General report. The tobacco industry has used scientific consultants to attack the evidence that SHS causes disease, most often lung cancer.2

PM executives feared that SHS and maternal and child health issues would create a powerful and emotional impetus for smoke-free areas in the home, public places, and the workplace. PM executives responded by commissioning “independent” consultants to write review articles for publication in the medical literature.

The first industry-funded article born of PM’s funding was a literature review focusing on smoking and SIDS, conducted by consultant Peter Lee and co-author Allison Thornton, which stated that the association between parental smoking and SIDS could have been attributable to failures in the research procedures.

In 1997, PM commissioned a consultant, Frank Sullivan, to write a review, with co-author Susan Barlow, of all possible risk factors for SIDS. The first draft concluded that prenatal and postnatal SHS exposure were both independent risk factors for SIDS. After receiving comments and meeting with PM scientific executives, Sullivan changed his original conclusions. Sullivan’s final review concluded that there was an impact for infants whose mothers smoked during pregnancy, but that postnatal effects of SHS were “less well established”.4
In April 2001 the Sullivan review was published in the British journal Paediatric and Perinatal Epidemiology, with a disclosure statement that acknowledged financial support from PM.3 The disclosure, however, did not reveal the full extent of PM’s involvement in shaping the content of the article. By 2004, the Sullivan SIDS review had been cited at least 19 times in the medical literature.
According to the University of California, these findings suggest that, accepting tobacco industry funds can disrupt the integrity of the scientific process.

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  1. A. M. Brandt, Inventing Conflicts of Interest: A history of tobacco industry tactics. American Journal of Public Health, 102(1), 63-71
  2. abTong EK, England L, Glantz SA. Changing conclusions on secondhand smoke in a sudden infant death syndrome review funded by the tobacco industry, Pediatrics, 2005 Mar;115(3):e356-66, accessed April 2012
  3. abSullivan FM, Barlow SM. Review of risk factors for sudden infant death syndrome, Paediatric and Perinatal Epidemiology, 2001;15 :144– 200
  4. Changes in the draft to support this new conclusion included descriptions of Peter Lee’s industry-funded review, a 1999 negative but underpowered study of SIDS risk and urinary cotinine levels, and criticisms of the conclusions of the National Cancer Institute report that SHS was causally associated with SIDS.