Tobacco smoking in three “left behind” subgroups: indigenous, the rainbow community and people with mental health conditions

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.

Pharmaceuticalisation as the tobacco industry's endgame

CONTEXT

Declining smoking prevalence and denormalisation of tobacco in developed countries reduced transnational tobacco company (TTC) profit during 1990s and 2000s. As these companies faced increasingly restrictive policies and lawsuits, they planned to shift their business to socially acceptable reduced-harm products. We describe the internal motivations and strategies to achieve this goal.

METHODS

We analysed previously secret tobacco industry documents available through the Truth Tobacco Documents Library. These documents were triangulated with TTCs' investor and other professional reports, websites and public statements.

FINDINGS

Mimicking pharmaceutical business models, tobacco companies sought to refurbish their image and ensure long-term profitability by creating and selling pharmaceutical-like products as smoking declined. These products included snus, heated tobacco products, e-cigarettes, nicotine gums and inhalers. Tobacco companies created separate divisions to develop and roll out these products, and the majority developed medical research programmes to steer these products through regulatory agencies, seeking certification as reduced-harm or pharmaceutical products. These products were regarded as key to the survival of the tobacco industry in an unfriendly political and social climate.

CONCLUSIONS

Pharmaceuticalisation was pursued to perpetuate the profitability of tobacco and nicotine for tobacco companies, not as a sincere search to mitigate the harms of smoking in society. Promotion of new pharmaceuticalised products has split the tobacco control community, with some public health professionals and institutions advocating for the use of 'clean' reduced-harm nicotine and tobacco products, essentially carrying out tobacco industry objectives.

Tobacco use among Kola Sámi, the indigenous people of the Murmansk region, Russia: A cross-sectional study

Russia is among the top ten nations in terms of smoking prevalence. Little is known about smoking rates among Indigenous Peoples in Russia. Our aim was to assess the prevalence of tobacco and nicotine product use among Kola peninsula Sámi. An exploratory cross-sectional survey was conducted to determine tobacco or nicotine product use among 505 Sámi people (about 30% of the whole Sámi population of Russia). Over 60% of participants had tried tobacco or nicotine products. Median age of first use was 15 years, with cigarettes being the most frequent first product tried and the most common type of product used currently. About a third of participants used a tobacco or nicotine product at least occasionally; 25% (predominantly males) smoked at least occasionally with 23.8% smoking daily. Of participants who smoked, 52.5% scored medium and 44.2% scored high on the Heaviness of Smoking Index. Seventeen percent of participants smoked formerly but not currently. Like some other Indigenous Peoples, Kola Sámi in Russia have a higher smoking prevalence than the average among the Russian population. Interest in a smoking cessation mobile app designed for the Sámi population suggests that such an intervention could help to reduce this inequity.

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.

Trends in tobacco smoking and smoking cessation in Russia with a focus on Indigenous populations: A narrative review

Introduction

Tobacco smoking is one of the main preventable causes of illness and premature death. Globally, more than 7 million people die annually from diseases associated with smoking, and this number is projected to increase to 8 million per year by 2030. Wide disparities in smoking prevalence exist by gender, age, socioeconomic status, rurality and ethnicity. In several countries, smoking is disproportionately high among the Indigenous populations.

Objective

This review assesses the prevalence and harm of smoking and current trends in smoking cessation among the diverse multi-ethnic populations of Russia, with a particular emphasis on Indigenous populations.

Data sources

We systematically searched health, nursing, social science and grey literature databases and bibliographies for relevant studies. Search strings combined keywords related to smoking prevalence and smoking cessation with keywords related to Russia and the Indigenous populations of Russia.

Study selection

Studies were included if they were published between 1 January 2005 and 14 October 2020, and if they reported prevalence of tobacco smoking and/or activities and outcomes of a smoking cessation programme or ban in the Russian Federation.

Conclusions

Tobacco smoking is significant in the entire Russian population, a higher prevalence of smoking in Indigenous populations compared to the dominant Russian (Slavic) ethnic group is common. Smoking prevalence data for most of the Indigenous ethnic groups of Russia remains unclear. Tobacco control interventions for Indigenous groups are underdeveloped even though they have the potential to deliver proportionately greater reduction in smoking harm.

Essential and non-essential elements in biological samples of inhabitants residing in Nenets Autonomous Okrug of the Russian Arctic

Exposure of Arctic residents to environmental pollutants is an emerging public health problem receiving little global attention. The objective of this study was to assess whole blood concentrations of nine selected essential (Co, Cu, Mn, Se, Zn) and non-essential (As, Cd, Hg, Pb) elements among Nenets and non-Nenets adult residents of the Nenets Autonomous Okrug (NAO) living in seven coastal and inland settlements. Urine was collected in two settlements for assessment of iodine status. Altogether 297 whole blood and 68 urine samples were analysed by inductively coupled mass spectrometry and the accuracy of the measurements was assessed by use of human whole blood and urine quality control materials. Several essential and non-essential showed significant variations in whole blood concentrations characterized by gender, population group and locality. Cd levels among non-Nenets non-smokers (0.19 µg/L) indicated a dietary intake at a natural global background level. Hg concentrations in whole blood show that not more than 10% of women in the fertile age had a Hg intake above the EFAS's recommendation. The Pb concentrations were in the range of, or partly exceeding reference values for increased risk of nephrotoxicity, and there is a need for a continued effort to reduce Pb exposure among the population groups in NAO. With high prevalence of obesity among the Nenets and non-Nenets population, a high prevalence of Fe-deficiency among menstruating women (<50 years) (37.2%) and a lower I status than recommended by WHO, these nutritional dependent components deserve further attention.

Addressing Major Health Disparities Related to Coronavirus for People With Behavioral Health Conditions Requires Strength-Based Capacity Building and Intentional Community Partnership

Far from being an equalizer, as some have claimed, the COVID‐19 pandemic has exposed just how vulnerable many of our social, health, and political systems are in the face of major public health shocks. Rapid responses by health systems to meet increased demand for hospital beds while continuing to provide health services, largely via a shift to telehealth services, are critical adaptations. However, these actions are not sufficient to mitigate the impact of coronavirus for people from marginalized communities, particularly those with behavioral health conditions, who are experiencing disproportional health, economic, and social impacts from the evolving pandemic. Helping these communities weather this storm requires partnering with existing community‐based organizations and local governments to rapidly and flexibly meet the needs of vulnerable populations.