Tobacco Industry Influence Weakened Marketing of Smoking Cessation Products, JAMA Study Finds
Tobacco companies in the 1980s and 1990s asserted their influence over pharmaceutical companies to "tone down" marketing of nicotine gum and nicotine skin patches, according to a new analysis of internal industry documents, the San Francisco Chronicle reports (Perlman, San Francisco Chronicle, 8/14). For the report, published in today's Journal of the American Medical Association, University of California-San Francisco researchers reviewed internal documents from Philip Morris, RJ Reynolds, Lorillard and Tobacco Institute Web sites between February 2001 and June 2001 that were made public as the result of the 1998 national tobacco settlement (Shamasunder/Bero, JAMA, 8/14). In one case, researchers found evidence that Dow Chemical's pharmaceutical division, maker of Nicorette chewing gum, "scaled back" its marketing campaign urging physicians to encourage their patients to quit smoking after tobacco company Philip Morris "objected to the materials' anti-smoking tone" (Tanner, AP/Boston Globe, 8/14). According to the report, Dow in the early 1980s canceled its physician newsletter after only one issue in response to pressure from Philip Morris executives, who wanted Nicorette marketed only to those patients who needed to quit smoking for health reasons, the New York Times reports (Chang, New York Times, 8/14). Philip Morris continued its pressure, and by 1986, Dow's educational materials only contained one sentence, "If you want to stop smoking for good, see your doctor," according to researchers (San Francisco Chronicle, 8/14).
The study also demonstrates how drug maker Ciba-Geigy set "ground rules" to market its Habitrol nicotine patch after Philip Morris said Ciba-Geigy's ads had an "anti-tobacco theme" (Vergano, USA Today, 8/14). The company was urged to change its marketing to reflect that Ciba-Geigy did "not endorse positions which would take away the freedom of choice for smokers" (New York Times, 8/14). According to internal Philip Morris documents, Ciba-Geigy was persuaded to halt its "Smokebusters" Habitrol campaign and to "devise more appropriate advertising for this product in the future" (San Francisco Chronicle, 8/14). Dr. Lisa Bero, co-author of the study, said that what would be considered "hardball business tactics" in another situation are considered "unethical in this case" because Philip Morris knew the health risks linked to smoking, the Times reports (New York Times, 8/14). Bero said, "This study shows how the tobacco industry has used its financial might to thwart public health. We should ask if a company should be able to profit from both selling an addictive product and a drug to treat the addiction" (San Francisco Chronicle, 8/14). She added, "These cases are historical, but there is no reason to believe these financial ties have gone away. I don't see any evidence corporate responsibility has improved lately."
Pharmaceutical companies took issue with the analysis. Lori Kraut of Aventis Pharmaceuticals, formerly Marion Merrell Dow, the Dow subsidiary that marketed Nicorette, said, "I think the report is misleading. The aggressive nature of our marketing shows a serious effort was made to reach patients." John Kelly of the Pharmaceutical Research and Manufacturers of America said the study is "really poorly written medical history," adding that irrespective of "contacts ... between companies," drug companies made a "great effort to market both Nicorette and Habitrol" to physicians, USA Today reports (USA Today, 8/14).
Nicorette is now marketed by drug company GlaxoSmithKline, and Steve Burton, vice president for smoking control at GSK, said, "We have absolutely no conflicts of interest [with the tobacco companies]." He added, "Our commitment is unconditional." He said that the company targets the gum at smokers who have already decided to quit because it is most effective in "those who are motivated," according to the Times. In addition, Novartis, which was formed when Ciba-Geigy merged with Sandoz in 1996, said the drug maker is now "free of outside pressures," the Times reports. Brendan McCormick, a spokesperson for Philip Morris, said, "Basically, the actions that are described in the study do not reflect the actions we are taking on issues like this today," adding, "Certainly we acknowledge smoking causes serious disease in smokers and is addictive" (New York Times, 8/14).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.