Why universities and scientific world should stay away from the tobacco industry. Journey in Big Tobacco deception

Vincenzo Zagà, M. Sofia Cattaruzza, Francisco Rodriguez Lozano, Antigona Trofor, Marco Mura, Giacomo Mangiaracina, Biagio Tinghino

University scientific research should never accept funding from companies operating in the same sector in which it is applied, due to evident conflicts of interest that could influ-ence or undermine the results of the research itself. This applies even more to industries whose production methods or products, such as tobacco, damage human health(1).

Universities that turn a blind eye to this mar-ket, accepting the advantages offered by grants and donations, become accomplices in spreading the “tobacco epidemic”(2), because the funding comes directly from the sale of tobacco products! This is “dirty” money, causes illness, suffering and death(3).

Researchers who accept such funding risk wel-coming the “Trojan horse” of the tobacco indus-try, and should remember Virgil in the Aeneid (Virgil, Eneide, lib. II, v. 49): “I fear the Greeks when they bring gifts” (lat.: “Timeo Danaos et dona ferentes”). It is the unheard cry with which the poor Laocoon tries in vain to convince the Trojans not to welcome the fatal horse within the walls. The ending is known.

University scientific research, due to the link that binds it to the younger generations who are educated, has an even greater duty not to cooper-ate with the tobacco industry, taking into account the commercial policies that enlist young people and transform them, through dependence, into “loyal customers” for many years(4).

In no way should the academic world endorse the frantic search to whitewash the tobacco giants, which has never succeeded, but has been recently revived with the introduction of the “reduced risk” products, the so-called “cold smoke”. The tobacco industry is a wolf in sheep’s clothing trying to re-present itself, from death factory to health company(5), even to the extent of changing its name: goodbye Philip Morris and welcome to Altria Group Inc.(6)! Today is Mondelēz International.

The social responsibility of the universities

By their “raison d’être”, universities are insti-tutions dedicated to improving life through the research and dissemination of knowledge. The university context facilitates “peer to peer” com-munication among young people and the acquisi-tion of knowledge and skills that lead to action to improve their health, and that of the commu-nity, and the propagation of healthy lifestyles through the emulation of behavior.

Universities are invested with an important ethical responsibility to help the world reduce and eliminate the tobacco epidemic, via research, training and information. For this reason they must be protected, with stringent regulations, from any maneuver that could undermine the indispensable freedoms for the pursuit of scien-tific truth, even at the cost of giving up rich fund-ing that could accelerate the pursuit of its scientific objectives. Otherwise, universities might lose all credibility by throwing years of tradition and rigorous research into the air.

The need to protect academic moral authority requires universities to renounce all forms of cooperation with the tobacco industry(7).

The nature of the problem

Although tobacco has been used in the West for at least 500 years, the damage to human health began in the late 1800s when, thanks to the mechanized production of cigarettes with what would become known as the “Bonsack machine”, cigarette manufacturing passed from a cottage industry to huge industrial mass pro-duction. This has allowed it to flood the planet with cigarettes arriving today at what the World Health Organization (WHO) calls the Tobacco Epidemic. The tobacco epidemic has inexorably led the planet to the so-called “Golden Holocaust”, due to the 7 million smoking-related deaths which occur each year(8,9).

Despite the fact that nowadays there are numerous and established proofs of causality between tobacco smoke and smoking-related diseases, more than a billion people in the world continue to smoke. The prevalence and incidence of smoking have increased every time that, over the past 150 years, there have been contro-versies among researchers on the real causality between tobacco consumption and related diseases. For over half a century, the tobacco industry has used these contro-versies by promoting the strategy of doubt(5,10).

Today, however, thanks to tobacco control policies implemented in Western countries, the tobacco industry has a desperate need to involve universities in the decep-tion of non-causality between tobacco smoke and smok-ing-related diseases(11,12).

The behavior of the tobacco industry

The contemporary tobacco industry was born practi-cally in 1882 thanks to the encounter between the com-mercial genius of James Buchanan Duke with the mechanic Bonsack, inventor of the machine which pro-duced a kind of infinitely long cigarette that was divided into the right size using mechanical cuts. Accompanying the mechanized production of cigarettes with effective marketing action, Buchanan Duke invented the tobacco industry and became, unwittingly, responsible for one of the worst massacres the world has ever known.

This interpretation, mostly promoted by the tobacco industry, was acceptable until the end of the 1940s, but since then the dangerous properties of tobacco products have been identified and well studied, and the tobacco industry has become increasingly irresponsible and criminal(8).

Big Tobacco – the term used to identify the largest companies in the global tobacco industry – has proven to be totally indifferent to the pain and suffering inflict-ed on humanity by its products, and has adopted a busi-ness model that puts the exponential growth of profit before the value of consumers’ lives.

Since the scientific community established that tobacco use is causally associated with premature death and pre-ventable chronic diseases, the tobacco industry has faced the threat to its profits by resorting to deception and lies(13) instead of investing to make its products less dangerous. Only recently, under the pressure of a more widespread societal sensitivity of the damage to public health arising from tobacco products, the industry has entered the “harm reduction” perspective, developing less toxic products (e-cigarettes, IQOS or “cold smoke”), of which, however, little is known, in particular about their long-term effects.

These products make sense as a substitute for traditional cigarettes for smokers who do not want or cannot quit, but they pose a great danger to non-smokers because, being advertised as less harmful, they can also lure non-smokers closer to tobacco. Paradoxically, these less toxic products could lead to greater tobacco damage to public health.

Once again, the tobacco industry casts doubt on the consequences of tobacco smoke, proved by the scientific research, and try to buy time in order to acquire new market shares.

The new products deriving from the industrial strat-egies of so-called “harm reduction” could have a similar role to what Bonsack’s machine had at the end of the nineteenth century: to increase the consumption of tobacco.

Returning to the relationship between this industry and research, it must never be forgotten that the response strategy of Big Tobacco was to launch a massive and systematic attack to subvert the veracity of acquired scientific knowledge(14,15), to misinform public opinion and decision makers, and to delay any form of control over the manufacture and use of its products. The famous “Frank Statement” is an excellent example of how the industry made the public believe that it was interested in the damage to health caused by tobacco, when instead its intentions were only to legally protect itself and cover up the truth for as long as possible in order to continue selling and making profits(15,16).

This attack on scientific knowledge, often labeled as “junk science” depending on the circumstances, still continues today, in subtle or blatantly clear forms, depending on the national contexts in which it operates.

The omnipresent benefit of the doubt on diseases caused by tobacco, sown by tobacco multinational cor-porations, is a scam designed specifically to prevent the translation of knowledge into health policies which can lead to reduced consumption and profits. The strategy of Big Tobacco has always been to generate doubt in the minds of judges, juries and public opinion, which lack the technical-scientific background necessary to criti-cally analyze the causal relationship between smoking and health-related harm. As shown in some confidential documents such as “We are the factory of doubt...”, creat-ing what is called agnotology, or the study of “construct-ed” ignorance. This strategy has been used to paralyze the efforts of the scientific community to better under-stand the natural history of diseases associated with tobacco consumption.

In implementing this strategy, the tobacco industry has started parallel research, appropriately manipu-lated, hiring and bribing various researchers all over the world, with the explicit intention to insinuate doubt and to contain the sense of resentment of public opinion towards the tobacco sector. The industry has always acted with indifference and insensitivity to the suffer-ing caused and with the aim of postponing any social control that could in any way affect its unscrupulous commercial strategies(11,16).

For over six decades, the tobacco “cartel” has tried in every way to actively challenge the scientific evidence in the media and courtrooms which has proved it to be responsible: a strategy that has, with some success, dis-guised its deception and diverted the attention and judg-ment of public opinion and political authorities(11,12).

For these actions of sabotage of scientific research, the tobacco industry has also resorted to the corruption of leading figures in the medical-scientific field, such as Ragnar Raylander in Switzerland (Professor of the

University of Geneva, paid to produce research aimed at denying the harmful effects of tobacco smoke, con-demned in 2003 by the Court of Justice of Geneva, for “unprecedented scientific fraud in the field of passive smoking”), Gaston Vettorazzi in USA (ex-toxicologist of the WHO, hired to hinder the entry in force of regula-tions to protect human health that would have limited the use of dangerous pesticides in the cultivation of tobacco) and Giuseppe Lojacono in Italy (former Professor of Health Economics at University of Perugia, Director of the Epidemiology & Prevention Magazine and of the Scientific Society with the same name; he was the “secret anti-IARC [International Agency for Research on Cancer] informant” paid to discredit the results of a major study on passive smoking and incriminate, instead, pollution as a cause of lung cancer)(17-21).

Likewise, the tobacco industry has bribed politicians and journalists to misrepresent research results when-ever they were perceived as threatening to their profits. Even today, Big Tobacco acquires indulgence and influ-ence through electoral contributions to politicians, spon-sorship of sporting and cultural events, financial support for charitable community initiatives, philanthropic insti-tutions (such as the Red Cross, the Movement of Italian Parents – Moige), up to the promotion, through associ-ated holding companies, of scientific conferences on issues of pollution, ecology and environment, relegating the tobacco problem to an ancillary role(17, 22-25).

The industry has even created opinion groups to sabotage WHO actions for tobacco control and to mis-represent the reports on the harmfulness of passive smoking(26), including the conclusions of the International Agency for Research on Cancer (IARC) on the causal relationship between passive smoking and lung cancer.

As if this were not enough, it has put pressure on the pharmaceutical companies that promoted campaigns and therapies for smoking cessation and has threatened airlines against the adoption of smoke restrictions on board aircraft(27).

All these practices are those of a corrupt industry that are obviously incompatible with any kind of col-laboration with health institutions in general and aca-demics in particular(28). Rather, they have the task of transmitting to future health professionals the ability to treat and prevent smoking(29) and should have a policy statement that specifically prohibits academic bodies from accepting tobacco industry funding including grant funding.

In the USA there are already several examples of this practice, and it is to be hoped that this will soon spread all over the world. Indeed, the European Journal of Public Health will no longer publish tobacco industry-support-ed research, a practice already adopted by many other medical journals such as BMJ, Heart, Thorax, PLOS One and many others(30).



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