UCSF report says Philip Morris influenced scientific article
Firm suggested to writer that link between SIDS, secondhand smoke be downplayed
– Alex Barnum, Chronicle Staff Writer
Monday, March 7, 2005
Researchers at UCSF reviewing once-secret industry documents have detailed an elaborate effort by a leading tobacco company to raise doubts among doctors and public health officials about the well-established link between secondhand smoke and sudden infant death syndrome.
The UCSF analysis shows how, in one case, executives at Philip Morris International hired a consultant to write a scientific article on the causes of SIDS, and persuaded him to change his original conclusions so the article called into question the connection to secondhand smoke.
The article, published in 2001 in a respected medical journal, has been cited at least 19 times by other scientific papers, which meant it was taken seriously by medical researchers and, ultimately, the UCSF researchers say, was used to mislead doctors and public health officials about the risks of secondhand smoke.
The tobacco companies “have this strategy to exert a subtle but very important influence over the research. It is designed to get the whole medical literature off in the wrong direction,” said Stanton Glantz, a UCSF professor of medicine and senior author of the analysis.
The analysis is based on once- confidential tobacco industry documents that were made public as a result of a landmark 1998 settlement of lawsuits brought by 46 states to pay for the costs of smoking-related health care. The settlement also makes public industry documents that are disclosed as part of ongoing litigation.
The new analysis by researchers at UCSF and the Centers for Disease Control and Prevention is being published today in the journal Pediatrics.
Glantz said it is the latest to contradict tobacco company claims that they have become better corporate citizens. As part of the 1998 federal court settlement, the companies agreed to stop inciting confusion about the evidence linking smoking and disease. “What this shows is that it’s just the same old, same old,” Glantz said.
A spokeswoman for Philip Morris USA said she couldn’t comment on the UCSF report because company officials had not had a chance to review it. She said consumers “should be guided by the conclusions of public health officials on the effects of secondhand smoke.”
Studies have shown that repeatedly exposing infants and children to secondhand smoke can cause a variety of ills, including asthma, respiratory infections and sudden infant death syndrome, or SIDS. Although most of the public health efforts to reduce SIDS have focused on getting parents to position sleeping infants on their backs, instead of their stomachs, Glantz said that secondhand smoke exposure is comparable to stomach-sleeping as a risk factor for SIDS.
A number of government agencies have noted the link with secondhand smoke, including the federal Environmental Protection Agency, the California EPA and the National Cancer Institute. Last year the U.S. surgeon general concluded that there is “a causal relationship between SIDS and maternal smoking during and after pregnancy.”
Meanwhile, the UCSF report says, the tobacco industry has waged a long campaign to undermine research linking second- hand smoke with a variety of diseases, starting in the 1980s when the industry was fighting a proposal to ban smoking on commercial airlines.
The first industry effort to undermine the link between smoking and SIDS failed. In the early 1990s, a longtime tobacco industry consultant, Peter Lee, was hired by Philip Morris to write a review of the scientific literature. His article concluded that “a causal relationship for parental smoking in SIDS remains unproven.”
But the article was rejected by a public health journal as biased. It was later published in a journal, Indoor and Built Environment, which has been shown to be a front for the tobacco industry, created by tobacco industry lawyers and consultants, according to the UCSF report.
Then, in 1997, Philip Morris hired Frank Sullivan to write a review of all known risk factors for SIDS. Sullivan, who had no previous experience in SIDS research, had participated in tobacco industry efforts to downplay the health effects of secondhand smoke, the UCSF researchers show.
The company budgeted $50,000 to $100,000 for completion of the article.
The UCSF report says the article was part of an overall scientific assault on evidence linking secondhand smoke and childhood health problems. A 1998 “impact assessment” written by Philip Morris’ worldwide scientific affairs department describes how efforts like Sullivan’s would “provide the necessary scientific background for a policy on the acceptability of smoking around children.”
Sullivan’s first draft concluded that both prenatal and postnatal exposure were risk factors for sudden infant death. In other words, an infant had a higher risk of dying from SIDS if the mother smoked during pregnancy or if the infant was exposed to secondhand smoke after birth.
But after sharing his draft with Philip Morris science executives and receiving their comments, Sullivan accommodated their suggestions and changed his original conclusion to focus more on the role of smoking during pregnancy as a risk for SIDS, and downplaying the risks of secondhand smoke.
To support this conclusion, Sullivan cited Lee’s literature review.
In 2001, the Sullivan article was published in the British journal “Paediatric and Perinatal Epidemiology,” which is published by Blackwell Publishing Inc. and is associated with the Society for Pediatric and Perinatal Epidemiological Research, a professional group.
Accompanying the article was a statement disclosing that Sullivan had received funding from Philip Morris, but the UCSF report points out that the disclosure failed to mention how the company had initiated the study or the extent to which company executives had shaped its conclusions.
A U.S. spokeswoman for Blackwell Publishing said she could not comment on the editorial policies of individual journals. She referred questions to the journal’s editor in London, who could not be reached.
The Sullivan article illustrates how disclosure guidelines adopted by medical journals have repeatedly failed to reveal the motivations and involvement of the tobacco industry, the UCSF report argues, and how simply accepting tobacco industry funding can compromise scientific integrity.
E-mail Alex Barnum at firstname.lastname@example.org.
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