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Accepting tobacco cash clouds U of A's ethics policy, credibility: Medical school has no business taking $1.5M grant from U.S.company

Sheila Pratt
The Edmonton Journal

Sunday, November 20, 2005

The big bosses in tobacco company boardrooms must be cheering these days. They scored a major victory right here in Edmonton, recruiting our world-class research institution, the University of Alberta, to look into their products.

The United States Smokeless Tobacco Company, makers of chewing tobacco, such as Skoal and Bandit, managed to get $1.5 million into the U of A medical school, of all places. It will fund a study comparing smokeless tobacco and cigarettes. The stamp of scholarly research on their product will be handy for the company. But this grant also buys the company long-sought legitimacy which comes with a university partnership.

While we would rather not bother with minor technicalities, it is difficult to take seriously a writer who does not even understand the subject well enough to know that products like Skoal are not chewed, "Bandit" is not a USSTC product name (there are products called "Skoal Bandits"), the name of the company is "U.S. Smokeless Tobacco Company" not "United States...",the grant is to a researcher in the Department of Public Health Sciences (in the Faculty of Medicine and Dentistry, but not the medical school), and most important, the grant is not earmarked to fund any particular study - it is completely unrestricted.

Researcher Carl Phillips, the grant recipient, makes no secret of his belief that chewing tobacco is a safer alternative to cigarettes, so it's no surprise he got the money. But it's hard to see how this combination will produce objective research.

Regarding the notion of "objective research", see the overview (coming soon). We also have to wonder if Ms. Pratt thinks that Dr. Phillips or any other researcher might keep secret his scientific beliefs.

The university says tobacco company money is just like any other funding from a private company. But such naivete is appalling. The administrators should apply their usual intellectual vigour to their ethics policy; if they did they'd come to a different conclusion.

What is naive is the assumption that the university administrators did not rigorously consider this, not to mention the presumption about what they would decide.

Tobacco companies are very different. They sell a product that kills thousands of people

As do automobile companies, food companies, pharmaceutical companies, and others also sell products that kill thousands of people. This is not to suggest that all these products are the same (indeed, our main interest is in steering people away from cigarettes),but it does show the illogic of the claim. More important, the author is clearly talking about cigarette companies, and either did not bother to learn that USSTC does not make cigarettes or is intentionally trying to confuse people about the different products.

and for the past decade, public policy has rightly aimed at undermining their product and the companies' previously prominent place in Canadian society. That's been done with a ban on tobacco advertising and with no-smoking bylaws. So tobacco companies can't sponsor car racing or a jazz festival anymore.

But, by golly, they can fund university research in Alberta.
Thankfully, not all universities take such a Pollyanna-ish view.

Notice that the cutesy language is used to cover up the complete lack of argument as to what might be wrong with the funding or what exactly the university might have been overly optimistic about.

The medical school at the University of Minnesota is the site of a premier America tobacco research institute, Transdisciplinary Tobacco Use Research Center. The centre, which unveiled a new study on smokeless tobacco, doesn't take tobacco money for the obvious reasons.

"We want to avoid the appearance of conflict of interest at all costs," says Dr. Dorothy Hatsukami, professor in cancer prevention.

The centre is concerned its research would not be seen as credible in the scientific community if it was funded by tobacco companies, says Hatsukami.

Also, it's most important the public get an independent evaluation of tobacco product so consumers have reliable data on the health hazards of tobacco.

We want to avoid blaming Dr. Hatsukami for misquotes and misrepresentations, so the following comments should be considered in response to what is written, without the presumption that she actually said it.

Setting aside substantive debates about what the Minnesota research really shows about ST as being too complicated for this forum (we will take it up in the FAQ), here we have yet another unsubstantiated assertion about conflict of interest and credibility (see the overview (coming soon)). As far as we can tell, the reason someone might find research that is financially supported by the ST industry to not be credible is because certain people are making every effort to tell people to believe that, presumably because they want to censor the results. If Hatsukami is really concerned that their research would not be seen as credible if funded by industry (and is not just trying to score debating points), it must be that she is either convinced that members of this scientific community cannot distinguish good research from bad on its merits, and so just resort to naive judgments based on funding, or that her group's research would not stand up to scientific scrutiny if they faced it. If these quotes are accurate, we would be curious to learn which of these she meant.

Reliable is exactly what tobacco companies have not been. As recently as the mid-1990s, they were saying cigarettes were not addictive and had no adverse health effects, though their research told them differently.

The author is apparently confusing cigarettes and smokeless tobacco (or is intentionally trying to confuse her readers).

There is some evidence that chewing tobacco is less harmful than cigarettes, says Hatsukami. But saying it is less harmful is not the same as saying it is safe, she says.

Saying there is "some evidence" that smokeless tobacco is less harmful than cigarettes is like saying that there is some evidence that smoking is bad for you. In both cases, the evidence is overwhelming, and the gross understatement is not much different from lying (though, again, we recognize that the author probably skewed Hatsukami's position, and grant her the professional respect to assume that the lie was not hers.)

And again, we get tired of saying it, but the "is not safe" argument is still a straw man. We are not aware if anyone claims that ST is perfectly safe.

"People have to become aware conventional smokeless tobaccos have high levels of toxins," she said.

It is clear that almost every literate North American grossly overestimates the risk from ST use; they actually need to become aware that whatever the level of "toxins" (the exact meaning of which is not well defined), the risk is quite low.

Researchers are aware tobacco companies want to use their results for marketing reasons, says Hatsukami, all the more reason to make sure the studies are independently funded.

It is hardly surprising that ST companies would want people to learn that their products are much less harmful than cigarettes. What is more interesting is why Hatsukami (or the editorial author) would find this to be bothersome. What better way to help people avoid the risks of smoking than to enlist the impressive marketing resources of a competing industry? This seems to be a great example of Rodu's point that anti-tobacco advocates seem to have lost touch with their goal - helping decrease the health impacts of smoking - and are pursuing a campaign of being anti-tobacco for its own sake.

Apart from that, Hatsukami undoubtedly knows that most of the research that shows that ST is much less harmful than cigarettes has been funded by non-industry sources. Finally, we suspect that the industry would get more mileage out of quoting research that they did not fund (because of the naive obsession with funding that is perpetuated here). So are we to assume that Hatsukami prefers studies that better aid ST marketing (or,perhaps did the author lose track of what whe was trying to argue.

The centre's latest study shows that smokeless tobacco contains significant levels of carcinogens and is addictive. It is not an effective product to help people quit smoking...

Finding carcinogens is a reason to think something might cause cancer if we have no other data. After we study the effect of the actual exposure on actual people, we should no longer worry much about finding carcinogens. Consider this analogy: before the hockey season starts (or basketball or football, for non-Canadians), you might look at a team's players, coaching, history, etc. and make a guess that they are going to have a poor season. That is perfectly reasonable to do at that time. If, however, the season progresses and the team is on their way to the championship, it does not make any sense to look at those pre-season statistics and conclude they are going to have a poor season. Similarly, it makes no sense to worry about ST being very carcinogenic when we already have that the data that shows it is not. The chemistry is a lot like looking at the pre-season data well into a winning season.

... especially when more benign alternatives, such as the nicotine patch or gum, are available.

As for the patch and gum being benign, as we have pointed out in detail elsewhere (e.g., Dr. Phillips' Letter that there is no evidence that they can further lower the already very low risk from ST use.

That speaks to the research proposed by U of A's Phillips. He says smokeless tobacco is an effective harm-reduction strategy. It will be interesting to compare Phillips' conclusions with that independently funded U.S.study.

It is more accurate to characterize Dr. Phillips' research as being based on the observation that ST ought to offer an effective harm reduction strategy, but it remains to be seen if we can implement it outside of Sweden. As for comparing the research, it might be a bit easier if the research the author proposes to compare to Phillips' research actually addressed the same point.

And to compare it with a new epidemiological study that showed U.S. adolescents were more likely to switch from smokeless tobacco to cigarettes than the other way around. That's hardly harm reduction. This represents one of the most perverse claims of the anti-ST activists. After all, if people really are switching from ST to cigarettes (which is probably the case, though the data to support the claim is actually somewhat weak, as see in FAQ (coming soon)), we should do everything we can to stop them. The most obvious course of action: Tell them that ST is much less harmful than smoking. Activists who try to hide that information are telling ST users, "you might as well smoke" (a title Dr. Phillips used for one of his papers to emphasize how important that misinformation is). Thus it is people like Pratt who are causing such unfortunate switching, and it is time they stopped doing it.

Tobacco companies have had a few victories on Canadian campuses recently.

Almost two years ago, Imperial Tobacco gave St. Michael's College at the University of Toronto $150,000 to fund a course in business ethics and social responsibility. That's almost laughable, given the abysmal ethical behaviour of tobacco companies. Like the U of A, St. Michael's argued at the time that Imperial Tobacco had no influence over the content of the course. So what's the problem?

Apparently Pratt is arguing that tobacco companies have contributed negatively to ethics and social responsibility, so they should not be allowed to contribute positively toward the same. The same argument would forbid funding from the agricultural industry to research food safety.

But at St. Mike's, there was at least some public outcry, unlike the silence on the big campus on the south side of Edmonton.

This is admittedly a trivial point, but Pratt seems to have a strange definition of "silence", given that hers was the 17th editorial or letter published on the subject that month.

Laurent Leduc, the business leader who set up the ethics course, was appalled when he discovered the source of the funding. "All of us understand the financial constraints that universities face," said Leduc at the time.

"But what any institution of higher learning must appreciate is that ethical considerations are not optional extras ... No financial need is sufficiently compelling to justify accepting funding from this source."

 It is impossible to learn from reading Pratt's editorial what ethical considerations might have been neglected in the University of Toronto case, but even if there was a problem, it is difficult to understand what that has to do with the U of A funding.
Whatever the niceties of university ethics policies, allowing tobacco companies onto campus takes a toll on the credibility of these institutions of higher learning. It raises questions about the ethical standards of institutions that can't see that partnership with tobacco is not in the public good. We again refer the readers to our overview (coming soon) about the complete vacuousness of these assertions.

Maybe the ethical waters have become so muddied by years of private-sector partnerships that universities can no longer see there's one exception out there to the public-private partnership. Five years ago, the board of governors turned down Imperial Tobacco's proposal to give $500,000 to the student union. Why doesn't it apply the same wisdom to a tobacco grant right inside its medical school?

One exception? Apparently Pratt would favour accepting a grant from a munitions manufacturer for designing deadlier landmines or from the Chinese government for figuring out better ways to censor the internet.The trouble with breathless over-the-top attacks is that they seem pretty silly when you take a close look.
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