Overcoming barriers to disseminate effective smoking cessation treatments globally

Document analysis of the Foundation for a Smoke-Free World's scientific outputs and activities: a case study in contemporary tobacco industry agnogenesis

BACKGROUND

Tobacco corporation Philip Morris International launched the Foundation for a Smoke-Free World (FSFW), a purportedly independent scientific organisation, in 2017. We aimed to systematically investigate FSFW's activities and outputs, comparing these with previous industry attempts to influence science, as identified in the recently developed typology of corporate influence on science, the Science for Profit Model (SPM).

DESIGN

We prospectively collected data on FSFW over a 4-year period, 2017-2021, and used document analysis to assess whether FSFW's activities mirror practices tobacco and other industries have historically used to shape science in their own interests. We used the SPM as an analytical framework, working deductively to search for use of the strategies it identifies, and inductively to search for any additional strategies.

RESULTS

Marked similarities between FSFW's practices and previous corporate attempts to influence science were observed, including: producing tobacco industry-friendly research and opinion; obscuring industry involvement in science; funding third parties which denigrate science and scientists that may threaten industry profitability; and promoting tobacco industry credibility.

CONCLUSIONS

Our paper identifies FSFW as a new vehicle for agnogenesis, indicating that, over 70 years since the tobacco industry began to manipulate science, efforts to protect science from its interference remain inadequate. This, combined with growing evidence that other industries are engaging in similar practices, illustrates the urgent need to develop more robust systems to protect scientific integrity.

A smoking quitline integrated with clinician counselling at outpatient health facilities in Vietnam: a single-arm prospective cohort study

BACKGROUND

Limited evidence is available about the combination of multiple smoking cessation modalities in low- and middle-income countries. The study aimed to assess the feasibility of a smoking cessation intervention that integrates follow-up counselling phone calls and scheduled text messages with brief advice from physicians in Vietnam.

METHODS

This was a single-arm intervention study. Smokers were referred to the study Quitline after brief advice by physicians at three rural district hospitals in Hanoi, Vietnam. Following referral, participants received nine counselling phone calls in 12 months and a scheduled text message service that lasted for three months. Participants who reported smoking cessation for at least 30 days at the 12-month follow-up were invited for a urinary cotinine test to confirm cessation.

RESULTS

The Quitline centre had 431 referrals from participating hospitals. Among them, 221 (51.3%) were enrolled. After the baseline phone call, 141 (63.8%) participated in all 4 follow-up calls within the first month and 117 (52.9%) participated in all phone calls in 12 months. The median number of successful phone calls was 8 (interquartile range: 6 - 8). At the end of the study, 90 (40.7%) self-reported abstinence from smoking over the previous 30 days. Among them, 22 (24.4%) submitted a sample for cotinine test, of which 13 (59.1% of those tested) returned a negative result. The proportion of biochemically-verified quitters was 5.9%.

CONCLUSIONS

The integration of brief advice and referral from healthcare facilities, Quitline counselling phone calls, and scheduled text messaging was feasible in rural health facilities in northern Vietnam.

TRIAL REGISTRATION

ACTRN12619000554167 .

The New Nicotine Pouch Category: A Tobacco Harm Reduction Tool?

Nicotine pouches to be put under the upper lip are a new category of products that are being rapidly developed and marketed as consumer goods with little research or regulatory oversight. We have identified research gaps in assessing their harm and benefit potential, and possible regulatory science approaches to inform the policies that can allow a maximization of the category's public health potential while minimizing unintended consequences. Implications: This commentary presents a potential blueprint for a comprehensive assessment of the nicotine pouches category. Data from the proposed research areas can better inform the regulatory policy decisions around the category, with the aim to maximize the category's tobacco harm reduction potential while minimizing unintended harms.

Paying lip service to publication ethics: scientific publishing practices and the Foundation for a Smoke-Free World

Litigation forced the dissolution of three major tobacco industry-funded organisations because of their egregious role in spreading scientific misinformation. Yet in 2017, a new scientific organisation-the Foundation for a Smoke-Free World (FSFW)-was launched, funded entirely by tobacco corporation Philip Morris International (PMI). Experts fear FSFW similarly serves to benefit its funder's scientific and political agenda. We present three case studies of FSFW's publishing practices to explore: whether FSFW and its affiliates are acting with scientific integrity in their attempts to publish research; how conflicts of interest (COI) are governed in the journals FSFW targets; whether scientific publishing needs to be better protected from the tobacco industry in light of this, and if so, how. FSFW and its grantees have resorted to repeated obfuscation when publishing their science. FSFW staff have failed to act transparently and arguably have sought control over editorial processes (at times facilitated by PR firm, Ruder Finn). FSFW-funded organisations (including its Italian 'Centre of Excellence') and researchers affiliated with FSFW (including those working as editors and peer-reviewers) have failed to disclose their links to FSFW and PMI. While journals also failed to apply their COI policies, including on tobacco industry-funded research, the findings highlight that such policies are almost entirely dependent on researchers fully declaring all potential COIs. The paper explores ways to address these problems, including via standardised reporting of COI and funding in journals; journal policies prohibiting publication of tobacco industry-funded science; development of an author-centric database of financial interests; and legally mandated tobacco industry financial contributions to fund science on new tobacco and nicotine products.

Accelerating an end to smoking: a call to action on the eve of the FCTC’s COP9

Purpose

The World Health Organization Framework Convention on Tobacco Control (WHO FCTC) is the first treaty negotiated under the auspices of the WHO. This study aims to describe progress toward the framework’s goals, setbacks and strategies to update its articles to optimize outcomes.

Design/methodology/approach

A review of relevant literature, including papers in this special issue, forms the basis for identifying steps necessary to amplify the impact of the FCTC.

Findings

The WHO suggests that there are 1.3 billion users of tobacco globally. The expected deaths associated with tobacco use could be dramatically reduced by hundreds of millions between now and 2060 through measures that improve cessation and harm reduction support among adults. Additional steps needed to achieve the goals of the FCTC include developing new initiatives to address areas of profound neglect (for example, women); investing in global research and innovation; addressing the needs of vulnerable populations; and establishing a mechanism to fund priority actions required by low- and middle-income countries, including support for alternative livelihoods for smallholder farmers.

Practical implications

In November 2020, the WHO FCTC Parties will host their next Conference of the Parties (COP9) in the Netherlands. This paper aims to contribute to the needed policy decisions related to this meeting. Since acceptance of this article, the WHO FCTC team announced that doe to the COVID-19 pandemic COP9 has been rescheduled till November 2021.

Originality/value

There exists a need to prioritize the goals of tobacco control and offer clear strategies for its execution. This paper fills this niche via a thorough and up-to-date analysis of how to amend and enforce the FCTC.