Progress in Tobacco Control Demands Open Science and Respectful Debate—Not Boycotts and Bans - Foundation for a Smoke-Free World

OPEN LETTER // SHARED Friday, April 30, 2021

Progress in Tobacco Control Demands Open Science and Respectful Debate—Not Boycotts and Bans

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On April 30, 2021, Tobacco Control published a paper titled “Paying lip service to publication ethics: scientific publishing practices and the Foundation for Smoke-Free World.” Penned by representatives of the Tobacco Control Research Group (TCRG) at the University of Bath, the piece condemns the Foundation and its grantees, apparently, for the sin of publishing research. Outraged at the Foundation’s mere existence, the authors call to suppress our work.

At the Foundation for a Smoke-Free World (FSFW), we reserve our outrage for the millions of lives lost due to tobacco each year. Though smoking rates continue to decline in some regions, they remain unacceptably high in low- and middle-income countries, and among marginalized communities. Where TCRG could devote its time to strategies that curb these disturbing trends, it instead chooses to question the integrity of groups, like the Foundation, that engage in this difficult work.

FSFW seeks to finally end the smoking epidemic via innovative approaches to cessation and harm reduction. And, in a 2020 paper, published in Drugs and Alcohol Today, I outlined reasonable strategies by which to achieve this goal. Therein, I show how the adoption of novel technologies and cessation support strategies could cause global smoking mortality to drop by three to four million deaths annually over the next forty years. If, by contrast, we maintain the status quo, one billion people are set to die this century as a result of tobacco use.

My 2020 article joined eight others to comprise a special issue, titled “Framework Convention on Tobacco Control: lessons learned on harm reduction and public health.” Through a series of reviews and original research, they collectively called for a reevaluation and revamping of the World Health Organization’s Framework Convention on Tobacco Control. The issue successfully synopsized topics in tobacco control requiring new attention in light of advances made since the FCTC was adopted fifteen years ago. The issue also served as the apparent impetus for TCRG’s ire.

I gladly welcome genuine academic critique of my paper, and of tobacco harm reduction (THR) more broadly. In fact, the special issue was intended to spark informed academic debate and elevate conversations in the field. Yet, rather than engage with any of these urgent matters—for example, barriers to cessation treatment, the need for tobacco control solutions in the Global South, or the troubling rates of tobacco-related deaths among women—TCRG attempts to argue that the entire issue doesn’t warrant publication.

While the authors raise grievances over particular publication protocols, the bulk of their argument seems to derive from the view that Foundation staff and grantees have no right to be published anywhere, ever. They justify this stance by pointing to the Foundation’s funder, Philip Morris International Global Services, Inc. (PMI), arguing that industry funding inherently taints research from the Foundation and those it supports.

For starters, I should note that the Foundation readily and regularly discloses its funding source; and we just as regularly remind that the Foundation is an independent nonprofit organization, free of influence from any outside funders. A thorough examination of our bylaws—and our track record—corroborates our independence. Given as much, there exists no reason why Drugs and Alcohol Today, or any journal, should reject publications from Foundation staff or grantees on the basis of “industry influence.”

Troublingly, TCRG joins a larger cohort of detractors seeking to silence, and even harass, scholars associated with harm reduction research. Brilliant scientists have been depicted as shills for Big Tobacco, merely because they recognize the potential of THR to reduce global deaths from smoking. In addition to generating unacceptable personal attacks, these boycotts and bans impede much-needed scientific progress and technological innovation. Though ideological blinders prevent groups like TCRG from recognizing these innovations, hard data points to an uncomfortable truth: as mainstream public health efforts stagnate, industry scientists are rapidly developing solutions that could reduce death and disease from tobacco.

Currently, industry leads patents and research output in this space, with PMI, BAT, Smoore, JUUL and Swedish Match all contributing research that has the potential to catalyze a transition away from combustible cigarettes and other toxic tobacco products. The Foundation, like everyone else, acknowledges the dirty legacy of the tobacco industry. However, we also recognize that the sector is now developing an off-ramp to the disaster that it created. While outright bans of industry and those they fund might offer moral high ground, they also rob smokers of urgently needed solutions. After all, deteriorating lungs don’t care whether their salvation arrives from industry-funded research.

After years of slow progress in tobacco control, emerging THR research offers a rare glimpse of hope—a chance to finally reduce smoking rates and associated deaths.  Unfortunately, ongoing biases against the Foundation, industry, and others involved with THR could impede adoption of these life-saving technologies.

Sadly, BMJ journals, including Tobacco Control, have contributed to the routine sidelining of critical THR research. For fifteen years, these publications have led boycotts of industry-funded science, thus widening the gap between THR researchers and those with biases against the field. This gap generates confusion among clinicians seeking to help their patients quit, and among policy makers who seek to develop policies based on sound science.

Admittedly, BMJ and others first introduced boycotts at a time when THR science, technology and, innovation were rudimentary. Yet, that is no longer the case. Toxicological, epidemiological and clinical research is advancing at a tremendous pace; and patent filings for the last five years reveal that we are in the midst of an explosion of knowledge that could end the use of toxic tobacco products. Readers of BMJ Journals and likeminded publications may not fully appreciate these incredible advances because antiquated policies preclude their publication.

A strong proponent of publication ethics, FSFW endorses transparency in research, equitable dissemination of scientific findings, and merit-based publication. Which is to say, we strongly support and uphold the principles of Open Science. Indeed, our publication practices adhere to ideals recently outlined by UNESCO in their Recommendations on Open Science. Nowhere in this document does UNESCO suggest banning industry publication. To the contrary, they suggest “[e]ngaging the private sector in the discussion about the ways in which the scope of Open Science principles and priorities can be enlarged and mutually shared.”

Furthermore, UNESCO highlights several critical guiding principles toward open science, including: “equal opportunities and access,” “respect, responsibility and accountability,” and “collaboration, participation and inclusion.” We enthusiastically endorse and enact these principles. By contrast, TCRG’s piece reveals an attitude of disrespect, runs contrary to a spirit of collaboration, and impedes opportunities for equal access to science.

Like all respectable scientists, Foundation staff and grantees welcome a critical evaluation of their research. After all, scholarly publication should serve spark debate with the larger research community, with the ultimate goal of forwarding science. We cannot engage in such debates, however, if we lack the opportunity to publish.

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