Politicians and Their Attitude to Smoking
14.3 Scientists and the Tobacco Industry
Oneperennialimportantissueiswhetherscientistsshouldacceptmoneyfromthetobacco industryfortheirwork.IgnazSemmelweis,directoroftheGynaecologyClinicinBudapest inthemid-nineteenthcentury,oncemadethefamousstatement,onbeingaskedwhether hehadacceptedmoneyfromacondomirm,whichwasafterallimmoral:“Thisisno causeforreproach:IhaveamachineintowhichIputdirtymoneyatthetopandtakeout cleanmoneyatthebottom.”Butitissurelyevidentthatascientistcannottaketheview thatitisnotwheremoneycomesfromthatcounts,butonlywhatitisusedfor. In1954,theUStobaccoindustryfoundedtheCouncilforTobaccoResearchCTR, whichprovideslargesumsofmoneyforresearchwork:US83millionfor865research projects in 279 medical facilities at universities, hospitals and research institutes [29] . Whileinitiallythefundingwasgivenforworkonthesubjectof“smokingandhealth,”a researchgroupwasformedwhichwasdevotedtobiomedicalresearchwithoutanyrefer- ence to smoking. The inluence of the CTR on research projects has been variously assessed,withnobiasbeingfoundinmanyinstances.Inthesecases,theaimoftheCTR wastoappearasadonorofequalstandingwiththeAmericanCancerSociety,theNational ScienceFoundation,theNationalInstitutesofHealthandotherleadingresearchbodies [29] ,andinthiswaytoacquireequalstatuswiththembyriding“piggy-back,”asitwere. Itisultimatelyaquestionofconsciencewhethermoneycanbeacceptedfromanindustry whichisresponsiblefor1,000smoking-relateddeathsadayintheUSAalone. InGermany,the“SmokingandHealth”researchcouncil,the“RauchenundGesundheit mbH” research company in Hamburg and the “Verum” Behaviour and Environment foundationinMunich,advisedbythephysiologistK.Thurauandortheclinicalmedical specialistF.Adlkofer,havesoughttodoscientiicworkinthisield [30,31] .Theirresults havebeenthesubjectofveryseverecriticism [30] .TheDanishphysicianT.Vosswaspaid US3,500–6,500amonthbyPhilipMorrisforspeakingpubliclyagainstanti-smoking groups.TheSwedishphysicianT.MalmforsoftheKarolinskaInstitutealsoworkedfor PhilipMorris,presentingtherisksofpassivesmokingasunproven,forwhichtheyreceived theequivalentofDEM60,000 [32] . Aroundtheyear1990,INFOTAB,athinktanksupportedbythetobaccoindustry,pub- lished“Aguidefordealingwithanti-tobaccopressuregroups” [33] ,inwhichanearly warningsystemwasestablishedforsettingupWHObureauxandforholdingregional workshopsofanti-smokinggroupsandnon-smokerorganisationsandcoalitions.These initiativeswereaccompaniedbyactivitiesaimedatdelayingtheestablishmentofanti- tobaccoprogrammes.AfterBATCohadstudiedtheWHOprogrammes,scientistswere enlistedandpaidbyBATCowho,actingasprivatepersons,castdoubtontheWHOpro- grammes.Thesescientistsincluded,forinstance,PaulDietrich,atthattimepresidentof theInstituteforInternationalHealthandDevelopment,andBobTollisonfromtheCentre forStudyofPublicChoice.Theformerplayeddownthetobaccoissuesinapublication plannedfortheNewYorkAcademyofSciences,andthelatterwrotesimilararticlesfor theInternationalHeraldTribune.TheessenceofthesearticleswasthattheWHOshould concernitselfmorewithcombatinginfectiousdiseasesmalariaandcholeraintheThird World,ratherthanwithissuessuchassafetybeltsorcigarettesandalcohol [34] .Ifthese misrepresentationsoftheWHOarerepeatedinternationallyoftenenough,theycometobe acceptedasfacts. Thequestionablesponsoringofresearchersatuniversitiesforstudiessympatheticto thetobaccoindustryshouldbereconsidered.AlsointheUSA,readers’lettersonthelow ornon-existentrisksofpassivesmokinghave,accordingtothejournalScience,beenpaid forwithsumsuptoUS10,000andevidencedonthepayrollsofthetobaccoindustry [35] . TheMunichmedicaljournalMünchnerMedizinischeWochenschriftcarried,inasupple- ment, a study on passive smoking by the well-known statistician K. Überla, entitled “Libertyandresponsibility–discussedwithspecialreferencetopassivesmoking,”which wasfundedbythePeutinger-Collegium,abodycloselyafiliatedtothetobaccoindustry [35] .Thisinstitutehas,sinceitsfoundation,beenrunbyG.B.Gori,anadvisertothe tobacco industry, who also acts as its adviser in public. In the years 19921993, Gori receivedoverUS20,000foriveletterstoscientiicjournalsJNatlCancerInstand dailynewspapersWallStreetJournal [36–39] . CriticalnoticehasalsobeendrawntotheUniversityofNottingham,whichopenedan InternationalCentreforCorporateSocialResponsibilitywithinancialsupportfromBAT [40] .Thisdecisionbytheuniversityarousedconsiderableprotestandcontroversialdiscus- sioninscientiicquartersandraisedthequestionastowhetheranactionofthiskindwas ethically and morally justiiable in view of the major damage to health caused by the tobaccoindustry’sproducts [41,42] .Itoughttobeimpossibleforphysicianstoconduct researchworkwiththeaidofsubsidiesfromthetobaccoindustryseeSect. 14.114.4 “Subsidised” Tobacco Growing
The cultivation of tobacco as a lucrative business for farmers is shown by a US list ofincomethatcanbeobtainedbythecultivationofvariousagriculturalproductssee Fig. 14.1 [12] . Theworld’sbesttobaccosaregrownoutsideofEurope;intheEuropeanUnion,only Greece3shareisabletoproducetobaccoofsuperiorquality [43] .TheEUsubsidises the tobacco industry to the tune of 1 billion annually, including 25.6 million for the Germantobaccogrowers [44] .In1997,Europeantobaccofarmersearnedapproximately 4,090 per hectare, a price which is below the average income for European farmers. However,asthisproductionissubsidised,itneverthelesscontinues.IntheGreekpartof Macedonia,thefarmersusedtogrowwheat,butbecauseofthesubsidiestheyswitchedto tobacco,especiallyastheannualsubsidiesinGreecerose,between1986and1995,to409 million [43] ,i.e.approximatelyivetimesthemarketvalue.Thecostsofsmokingtothe nationaleconomyhealthcare,socialsecurity,illness-relatedlossofproduction,onthe otherhand,areaboutthreetimeshigherthantheproitearnedfromtobaccogrowing [43] . Altogether,thetobaccoindustryemployssome200,000peopleintheEU,wherebythe tobaccoprocessingplantsarealsolocatedinruralregionsandsupporttheeconomythere.Parts
» Tobacco Plants and Their Origin Use of Tobacco for Religious Purposes
» The Appropriation of Tobacco by Europeans
» Development of the Cigarette
» Objections to Smoking on Health Grounds
» Women Won Over by the Cigarette
» The Medical Use of Tobacco in the Nineteenth Century
» Tobacco Research in the Twentieth Century
» Tobacco Consumption in the Twentieth Century
» Cigarette Smoking in the USA Since 1965
» Cigarette-Related Mortality in Different Countries
» Smokers and Other Risk Factors
» Smoking Behaviour and Educational Level in the EU
» Non-Disclosure of Findings by the Tobacco Industry
» The Cigarette as a Vehicle for Nicotine Release
» Modifications of Nicotine Release
» Maintaining Nicotine Dependence Nicotine and Dependence
» Marketing of Cigarettes with a “Reduced” Health Risk
» Compensatory Behaviour by Smokers
» Optimising Nicotine Release Nicotine and Dependence
» Importance of Absorption Rate
» Ammonium and pH Manipulation
» Cigarettes with Reduced Tar Yield
» Agonists and Antagonists of the nAChR and its Subtypes
» Effects of Nicotine on Receptors in Different Organs
» Metabolic and Hormonal Effects of Nicotine
» Central Nervous System Effects of Nicotine
» Types of Dependence Nicotine Dependence
» Molecular Biological Aspects of Dependence
» Genetic Aspects Nicotine Dependence
» Withdrawal Symptoms Nicotine Dependence
» Immunological Reactions Caused by Cigarette Smoking
» Association Between Smoking and Lung Cancer
» Tobacco-Specific Carcinogens Genetic Factors That Increase the Risk for Bronchial Carcinoma
» The Cytochrome P450 and GST System and Carcinogenesis
» Peptide Receptors, Genetic Factors That Increase the Risk for Bronchial Carcinoma
» Exogenous Factors and Lung Cancer
» Pathophysiology of COPD Cigarette Smoking and COPD
» Genetic Factors Important Risk Factors for COPD
» Occupational and Environmental Factors
» Caveats Concerning the Informative Value of Studies
» Cigarette Smoking and Bronchial Asthma in Adults
» Bronchial Asthma in Children
» Other Lung Diseases Influenced by Cigarette Smoking
» Coronary Artery Disease and Myocardial Infarction
» Changes in Endothelial Function and Microcirculation
» Microcirculation and O Systemic Vascular Changes
» Arteriosclerotic and Inflammatory Vascular Reactions
» Genetic Factors Blood Coagulation and Fibrinolysis
» Nicotine and Ischaemic Heart Disease
» Cognitive Impairment Central Nervous System
» Influence on Cognitive Performance
» Intellectual Impairment in Childhood
» Smoker Personality Profiles and Genetic Inheritance of Smoking
» Peculiarities of the Smoker’s Personality
» Reasons for Increased Cigarette Consumption
» Comorbidity Between Depression and Smoking
» Extent of Cigarette Consumption
» Effects of Smoking in Forms of Dementia
» Smoking and Parkinson’s Disease
» Diabetic Retinopathy Ocular Diseases
» Graves’ Ophthalmopathy Ocular Diseases
» Macular Degeneration Ocular Diseases
» Ocular Tumours Ocular Diseases
» Retinal Detachment Ocular Diseases
» Lipid and Cholesterol Metabolism
» Insulin Resistance Diabetic Nephropathy
» Oesophageal Cancer Gastrointestinal Tract
» Gastrointestinal Ulcers Gastrointestinal Tract
» Cancers of the Gastrointestinal Tract
» Pancreatic Cancer Gastrointestinal Tract
» Toxic Substances and Inducers
» Kidney Cancer Urinary Tract Diseases
» Bladder Cancer Urinary Tract Diseases
» Prostatic Hyperplasia and Prostatic Cancer
» Fertility Disorders Urinary Tract Diseases
» Vitamin D and Oestrogen Metabolism
» Osteoporosis Disorders of Mineral Metabolism and Bone
» Hip Fractures Disorders of Mineral Metabolism and Bone
» Skin Changes Skin and Mucosa
» Skin Tumours Skin and Mucosa
» Breast Cancer Skin and Mucosa
» Effects of Smoking on the Placenta
» Malformations Possibly Caused by Smoking
» Smoking and Sudden Infant Death Syndrome SIDS
» Effects of Nicotine on the Foetus
» Medical Care Costs Attributable to Smoking During Pregnancy
» ETS in the Workplace and at Home
» Fibrinogen Cholesterol Endothelium and Platelets
» Markers of Inflammation Changes at the Molecular and Cellular Level
» Passive Smoking During and After Pregnancy
» Coronary Heart Disease Cardiovascular Disease
» Stroke and Subarachnoid Haemorrhage
» Respiratory Tract in Children and Teenagers
» Bronchial Carcinoma Respiratory Tract
» Indications and Diagnostic Considerations
» Self-Help Interventions by the Smoker
» Physician Advice for Smoking Cessation
» Group Behaviour Therapy Programmes
» Mass Media Communication Strategies
» E-Learning, Email and Internet for Smoking Cessation
» Evaluation of Nicotine Products
» Nicotine Chewing Gum Nicotine
» Nicotine Sublingual Tablet Nicotine Nasal Spray
» Treatment and Dosage Nicotine
» Nicotine Chewing Gum Adverse Events Associated with NRT
» Nicotine Patch Adverse Events Associated with NRT
» Nicotine Nasal Spray Adverse Events Associated with NRT
» Nicotine Inhaler Adverse Events Associated with NRT
» Nicotine Sublingual Tablet Adverse Events Associated with NRT
» Nicotine Lozenge Adverse Events Associated with NRT
» Drug Interactions During Smoking Cessation
» Contraindications for the Use of Nicotine Products
» Nicotine Formulations as OTC Products
» Contraindications and Drug Interactions
» Tranquillisers and Buspirone Other Pharmacotherapies
» Various Antidepressants Other Pharmacotherapies
» Opioid Antagonists Other Pharmacotherapies
» Silver Acetate Other Pharmacotherapies
» Therapeutic Monitoring in Smoking Cessation
» Ischaemic Heart Disease Special Therapeutic Situations
» Pregnancy Special Therapeutic Situations
» Weight Gain Special Therapeutic Situations
» Alcohol Consumption Special Therapeutic Situations
» Organic Depression Organic Depression and Schizophrenia
» Schizophrenic Patients Organic Depression and Schizophrenia
» Interactions Between Cigarette Smoking and Administration of Psychopharmaceuticals
» Pre-operative Smoking Cessation Special Therapeutic Situations
» Social Influence Inoculation Strategy
» Life Skills Strategy Prevention Programmes for Schools
» Class 2000 Health Promotion Programme
» Trier University Health Programme Long-Term Studies
» Role of Teachers in Primary Prevention
» Prevention by Restricting Sales of Tobacco Products to Minors
» Role of the Mass Media in Sales of Tobacco Products to Adolescents
» Role of Government and Community in Primary Prevention
» Effect of Tobacco Industry Advertising Messages
» Tobacco Advertising and Adolescent Smoking Initiation
» Advertising with “Light” Cigarettes
» Smoking Bans in Public Buildings and Public Spaces
» Tobacco Industry, Governmental and Non-governmental Organisations
» Politicians and Their Attitude to Smoking
» Scientists and the Tobacco Industry
» Governmental Control of Toxic Tobacco Constituents
» Bans on Advertising in Various Countries
» Tobacco Industry: Playing Down the Risks of Smoking and Passive Smoking
» Smoking and Non-smoking: Weighing the Benefits
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