Author: Franklin Apfel [including interview transcript from Derek Yach] February 3 2018 – This blog, one of four, is part of series in which Apfel analyses and McKee comments on Yach’s interview responses on the tobacco industry and his involvement in the Foundation for a Smoke-Free World. The series is intended to identify new ways in which the industry is attempting to (re)frame conversations on tobacco and health and tobacco industry behaviours as demonstrated by their adherence to or circumvention of article 5.3 of the WHO Framework Convention on Tobacco Control (FCTC). Article 5.3 of the WHO Framework Convention on Tobacco Control states: "In setting and implementing their public health policies with respect to tobacco control, Parties shall act to protect these policies from commercial and other vested interests of the tobacco industry in accordance with national law."
A four part interview and commentary series
Interviewer: Franklin Apfel, World Health Communication Associates (WHCA)
Interviewee: Derek Yach, Founder and Director Phillip Morris International (PMI) Foundation for a Smoke- Free World
Commentary: Professor Martin McKee, London School of Hygiene and Tropical Medicine (LSHTM)
Public Health research incompetence frame
Apfel: In this frame, Yach casts a negative light on current peer-reviewed journal policies of excluding tobacco-sponsored research as representing a conflict of interest and goes on to claim that current public health research capacities are so underfunded and weak that they cannot even evaluate the sophisticated work being done by the industry.
Q. How would research carried out in conjunction with your Foundation find its way into peer-reviewed journals, which exclude tobacco company research based on conflicts of interest?
DY. Actually the BMJ have asked me to write an article for them. The Lancet did the same and I know that while some journals will ban Foundation work-and that by industry scientists-many leading and most cited ones tend to judge what they select on the basis of the methods and quality of the science and not on the source of the funding. Of course they require that be reported.
I think that's highly irresponsible and in fact frankly unethical to actually ban an article on the basis of who funded it as opposed to looking at the integrity of the methods and the scientific quality of it because what we’re basically doing is then having two classes of science: class A science would be those produced by people who have one type of money and type two by another; the methods may be substantially higher on the tobacco industry funded research.
[What I have found] is that the level of technical competence in some current tobacco industry sponsored research has gone beyond anything that we have seen in tobacco control for many years and only a relatively small group of experts on the public sector side are actually able to judge its quality these days and that is a problem. It is a problem because I would say that the science has gone faster in the tobacco industry laboratories particular related to new products, [not surprisingly] given the size of investments. Who is to judge that science? My view is that [our] Foundation needs to make sure that we've got a much larger cadre of public health competent scientists to understand why it is that the areas of systems biology, molecular biology, genomic and metabolomic science are today as important to understanding the future of the product in tobacco control as epidemiology and economics were in the past.
Q10. Some would say that all Tobacco sponsored research should be excluded because conflicts of interest will always be there when you are dealing with companies like Philip Morris whose core product continues to be promoting smoking to young people (e.g., like in the “Be Marlboro” campaign).
DY. Well, I think that [all authors] should declare the conflict, declare from where the source of funding is, be completely transparent about that and lay out their methods. The reality is from what I've seen from some of the emerging tobacco industry science, they are not only putting out the methods in greater detail than often public sector scientists do, but they are also going to very interesting lengths to run simulations on the data using third-party people [whenever they can to review data].
The Foundation is very interested in how we can have a high level of scientific integrity in tobacco control [research], particularly around products where there are going to be conflicts [whether they are produced] with the tobacco industry or the pharmaceutical industry (both [are currently] approaching the nicotine market from slightly different directions). We want to be assured of the quality of the science and [we think] there are many ways of doing that. One of them is independent peer review. Another [and perhaps even more interesting] is actually placing the data in a facility where third-party analysts can rerun the data or funding replication studies to see whether the same methods, the same approach can come up with the same results. I think those higher levels of science will benefit the entire field and should give the assurance of whether the industry is trying to bias the research in one way or another.
[To] simply start from the beginning and say because it's funded by an industry it shouldn’t be accepted I think is really unacceptable. I faced it directly when I joined PepsiCo. After I joined PepsiCo, journals who had been invited often to write articles started turning down my submissions without peer review simply because they said it was going to be biased coming from industry. I think that really begs the question of what actually these journals are trying to do. Are they trying to advance science, are they afraid that they will be unable to get reviewers to judge the quality of methods? So my view is that there is no case for banning anybody submitting an article and not getting a decent peer-review. If it fails on the grounds of methods, and that [I believe should be] the main criteria, than that should never make it into a journal. [Of course] the question of the conflict should be made clear, transparent, put upfront even in the front headline and then people can judge. This is how science has been evolving in many areas of bio-and agricultural science, advanced material science, electronics, etc. This isn't a unique problem with tobacco control research. In many other areas industry actually has a large pool of scientists doing high-quality work that has to get into the public domain. I can't see why we can't control the quality in tobacco control.
Let me add that it is interesting to reflect on how many top academics in the UK today had part of the research funded by the old tobacco industry research groups. Few could question their integrity or independence. They include Sir Michael Marmot, Sir Richard Peto and over 100 public health scientists.
Commentary – Professor Martin McKee
Derek Yach criticizes those journal editors who refuse to publish tobacco industry funded research, describing it as "frankly unethical", something that will cause a sharp intake of breath from many who have observed the longstanding disregard of basic ethical principles by the tobacco industry. He then calls on them to reconsider. This completely ignores how the tobacco industry has manipulated research in the past. Take an example that I was involved in as an editor. We accepted a paper from a Swedish researcher on differences in the diet of women whose partners were or were not smokers. On its own, the paper was fine, if unexciting. What we did not know until later was that it was part of an elaborate operation based in a German facility, so secret that knowledge of it was limited to a handful of people within Philip Morris, to undermine the evidence on the harm caused by second hand smoke. Painstaking research using the corporation’s internal documents revealed that what was published was only a fraction of the research being undertaken in Germany. What was published, perhaps unsurprisingly, served to confuse rather than illuminate the debate on the safety of second hand smoke. As Philip Morris staff noted, while the scientist directing the programme would not be able “to give environmental tobacco smoke a ‘clean bill of health’” he could “bring a healthy scepticism to … some of the claims being made about environmental tobacco smoke”. Not for the first time, it was apparent that the research that Big Tobacco undertook and what it published were quite different things, but without access to the overall picture, including the results that are withheld, it is impossible to know. Time and time again, reviews show that one of the strongest predictors of the findings from research on tobacco policy is whether the authors have a conflict of interest. Yet, Big Tobacco, often working with the food and alcohol industries, spare no effort to argue that conflicts of interest can easily be dealt with, with one notorious recent example being the recent Brussels Declaration, in which these industries played a prominent role. Yet the evidence is clear. They can’t be.
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