Experts condemn US tobacco companies’ sponsorship of medical training as ‘grotesque’

The tobacco company Philip Morris has sponsored courses for doctors in several countries, in what critics call a “grotesque” strategy.

Medical education programs on smoking cessation and harm reduction in South Africa, the Middle East and the US have been supported by Philip Morris International (PMI) or its regional subsidiaries, advertising material obtained by The Guardian shows.

The World Health Organization (WHO) said there was a risk of undermining public health efforts and called for these types of partnerships to be banned.

Dr. Tess Legg, from the Tobacco Control Research Group at the University of Bath, said the sponsorship of medical education was part of a “strategy to influence how science is used in medical practice and an attempt to boost the industry’s credibility among health professionals.” to rebuild.”

Nicholas Hopkinson, professor of respiratory medicine at Imperial College London, said: “Based on its market share (about 15%) and the global death toll from smoking (more than 8 million per year), Philip Morris kills at least a million people. every year. The idea that it should play a role in medical education is grotesque.”

The sponsored courses allow participants to accumulate credits that demonstrate they are engaged in post-qualification education. Typically, physicians must accumulate a certain amount of this “continuing medical education” (CME) or “continuing professional development” (CPD) points annually to continue practicing.

Hopkinson called on bodies that provide or regulate medical education to “enforce explicit statements and policies that tobacco industry involvement is completely prohibited.”

Dr. Rüdiger Krech, director of health promotion at WHO, called on certification authorities to ban partnerships with tobacco and related industries in medical education. “There is a clear commercial interest that could spread disinformation and undermine public health efforts,” he said.

“Health professionals must be supported by education that is evidence-based, transparent and meets the highest ethical standards.”

A medical organization in South Africa, the Alliance of South African Independent Practitioners Associations (Asaipa), has offered webinars on harm reduction in public health “sponsored by Philip Morris South Africa”.

Sharon Nyatsanza, deputy director of the South African National Council Against Tobacco, said the sponsorship may conflict local laws designed to reduce the influence of the tobacco industry.

She said: “We hope public health professionals know who PMI really is. PMI – the largest (global) cigarette manufacturer – has a history of funding research, medical professionals and creating front groups in ways designed to advance its own interests and contrary to public health.

She, along with many South African public health organizations and professionals, have written a letter to the Health Professions Council of South Africa, urging it to set a clear policy that tobacco industry financing and sponsorship is not allowed. They have also asked for CPD credits for tobacco company-sponsored events to be withdrawn.

In a statement, Asaipa said the content of all CPD webinars was reviewed “to ensure that no products from any partner are promoted during the educational sessions, and that all statements made during these sessions are based on clinical data and evidence”.

The statement added that Asaipa was “committed to maintaining the highest standards of integrity, transparency and ethical conduct in all our endeavors” and would “conduct a thorough review of our sponsorship and involvement with PMI to ensure that our actions are in line with our mission and values” .

A number of online courses from training provider Middle East Medical have been sponsored by Philip Morris, including a seminar for healthcare professionals and researchers in the region on April 26 last year “sponsored by Philip Morris Management Services (Middle East) Ltd”. The content included “barriers to implementing harm reduction” and “what is the scientific basis for smoking harm reduction”. A spokesperson said the company would “stop working with PMI in 2023.”

PMI has also sponsored sessions and speakers at conferences in Jordan and Egypt, among others.

Dr. Ahmad Abbadi, the regional coordinator for the Eastern Mediterranean at the Global Alliance for Tobacco Control, said he feared tobacco companies were targeting countries with weaker laws and regulations, especially around conflicts of interest.

“It is a great opportunity to advocate (…) in favor of the industry,” Abbadi said, adding that many of his contemporaries had gone to work abroad as Jordanian medical students. “I’m in Sweden, many of my classmates are in the US, Canada and Britain, all over the world,” he said. “You influence the region itself, but also the entire world because the world is more connected.”

Abbadi said the idea of ​​harm reduction is crucial to public health, citing examples such as seat belts, but that the term has been co-opted as a marketing tool for tobacco companies launching new products including heated tobacco.

The WHO has pointed out one lack of independent research to support claims that they are less harmful than cigarettes.

Medscape, a US website for healthcare professionals, has withdrawn a planned series educational courses around smoking cessation “supported by an independent educational grant from Philip Morris International”. criticism of doctors and academics. It said the use of PMI funding was “a misjudgment that was out of character” and that it would not accept funding from the tobacco industry in the future.

A spokesperson for Philip Morris International said the company “believed that evidence-based education on the topic of tobacco harm reduction was essential to improving public health.

PMI provides education grants for science-based programs that are conducted independently of PMI and follow accredited standards, including further independent third-party academic assessment, he said.

“The funding is clearly labeled and supports support from PMI. We have no control over the content and it is unfounded to claim that the programs are intended to promote PMI products. Our activities comply with all applicable laws.”