Tuesday, 22 May 2012

Swedish anti-snus/pro-Chantix experts have links to Pfizer

The Swedish press is reporting that several prominent public health spokespeople who have attacked snus and recommended Chamtix have undisclosed ties to the pharmaceutical industry.

Swedish tobacco experts in the double seats

Doctor helps to lobby against snus - and for Pfizer's drug

The Swedish National Institute of Public Health are experts on tobacco. They advise against snus but for the anti-nicotine drug Champix while they are working for Pfizer - which lobbies against snus and manufactures Champix.

- This could damage the authority's credibility, says Thomas Bull, a professor of constitutional law, told Aftonbladet.

These academics include Gunilla Bolinder and Hans Gilljam, both of the Karolinska Institute. Their work has been highly influential in maintaining the EU-wide ban on snus (see The Art of Suppression). While most scientific studies find no link between snus and any serious diseases, the Karolinska Institute has published a number of epidemiological studies in the past decade which found links with cancer and heart attack mortality. The Institute has repeatedly refused to allow other researchers to see the raw data of the Swedish Construction Workers Cohort, which has been used and reused by Karolinska researchers for these studies.

Bolinder and Gilljam have both recommended the use of Pfizer's stop-smoking drug Champix, despite reports of adverse effects on mental and cardiovascular health. Gilljam has even published a study claiming that Champix is an effective drug for helping people give up snus. The study was paid for by Pfizer and he is listed as a contact on the company's press releases.

Bolinder sits on Pfizer's advisory council and is quoted on one of the company's press releases singing the praises of Champix. It also appears that Pfizer's response to the EU's consultation on tobacco control—which says: "It is a top priority to maintain the sales ban on snus"—was copied verbatim by several anti-smoking groups that are funded by the Swedish National Institute of Public Health.

Full story (in Swedish) here.

Also, do read Clive Bates' (Deborah Arnott's predecessor at ASH) new blog post about the EU ban. Very thorough, with many useful graphics. Death by regulation: the EU ban on low-risk oral tobacco

Here’s what I think should happen:

  • The ban on smokeless oral tobacco is unjustified, illegal, harmful to health and represents a denial of consumer and human rights. It should be lifted without delay. 
  • The Commission, member states and elements of the public health community should not misuse the science of smokeless tobacco and harm reduction or use the SCENIHR report to justify a ban on a sub-category of smokeless tobacco. The science does not justify any ban on these products while cigarettes remain widely available and while more hazardous forms of smokeless tobacco is sold freely. 
  • Smokeless tobacco forms part of a ‘harm reduction’ market for lower risk alternatives to smoking – this could be an important market commercially in future, and if it does become sizeable, it will have considerable health benefits by reducing smoking. The EU could facilitate development of this market by setting standards for toxins present in smokeless tobacco placed on the market in the EU. 
  • To balance the market in favour of reduced risk products, governments should consider favourable excise tax treatment, relative to smoked tobacco, for nicotine products with greatly reduced risk, and allow meaningful risk communication through product marketing. 
  • The public health community should be honest about the relative risks of smokeless tobacco and smoking, take an evidence-based approach to policy, and adjust its posture towards harm reduction strategies accordingly. It is lethally irresponsible to mislead smokers about less hazardous alternatives to smoking.

I concur with all that, and I concur with this...

If you want a more complete account of the misleading and, frankly, bent scientific advice used to support the crusade against smokeless tobacco, I recommend a book: The Art of Suppression: Pleasure, Panic and Prohibition since 1800 by Chris Snowdon – an excellent account of the tactics of prohibitionists, featuring a chapter on snus.

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