Healthy Skepticism Library item: 7798

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: news

Weeks C.
Red flags raised over anti-smoking guide
The Ottawa Citizen 2007 Jan 22
http://www.canada.com/topics/bodyandhealth/story.html?id=c59ba41e-772e-470a-a94e-130644177b38&k=56556

Full text:

The Canadian Cancer Society is about to publish an update to its guide that helps smokers who want to quit.
It cost $75,000 to redevelop the popular book, One Step at a Time, but the national charity didn’t have to worry about the price. That’s because it asked Pfizer Canada, the country’s largest maker of nicotine replacement therapy products, to pay the cost.

Pharmaceutical giants are some of the top financial contributors to groups such as the Canadian Lung Association, the Canadian Cancer Society, the Toronto-based Centre for Addiction and Mental Health, and others.

Those anti-smoking charities, non-profit groups and other organizations have close ties to pharmaceutical companies that make smoking-cessation products. However, they rarely disclose those relationships or the fact that they receive large donations, research grants and sponsorships from the makers of drugs they often promote.

The cancer society guide’s inside cover will thank Pfizer for its “generous support” and the back cover will thank individual donors and Pfizer for making the publication possible, but the varying disclosure practices are raising concerns among health experts regarding a lack of transparency and a potential conflict of interest in organizations throughout the country.

“When it comes to characterizing a disease or talking about a treatment, many times it sounds like they’re speaking with the voice of their funder,” said Alan Cassels, a drug-policy researcher at the University of Victoria.

Charities say financial contributions from pharmaceutical companies are only accepted with a strict “no-strings-attached” policy, but, with limited disclosure and unclear rules, it’s difficult for consumers to know how drug companies are involved with such groups and what influence they may have

For Dr. Jerome Kassirer, professor at the Tufts University School of Medicine and editor-in-chief emeritus of the New England Journal of Medicine, the issue is simple: consumers have no way of knowing if they’re listening to a sales pitch from a drug company that’s disguised as advice from a charity.

“Would the pharmaceutical companies spend billions of dollars a year if they didn’t think it was valuable?” he said. “Of course not.”

Louis Brisson, executive director of the Lung Association’s Quebec branch, said he has a “problem” releasing the amount of money received from drug companies.

“All my files are confidential,” he said.

The Canadian Council for Tobacco Control, a national advocacy group, provides a list of donors on its website that says it is funded by the government and non-governmental organizations such as the Canadian Cancer Society. But about 10 per cent of the group’s funding actually comes from Pfizer, according to executive director Bob Walsh.

Pfizer Consumer Healthcare, a branch of the parent company, controls about 30 per cent of the country’s nicotine replacement therapy market, making it Canada’s biggest supplier of the products. Johnson & Johnson recently purchased the company and said it plans to maintain relationships with charities.

“Often times, the groups come to us seeking funding for their projects and we look at them on a one-by-one basis,” said Johnson & Johnson spokeswoman Krista Scaldwell. “Relative to the amount they raise each year, it’s such a small amount.”

Those charities that accept money from drug companies say the pharmaceutical industry has no influence on their public messages and that they don’t promote medication in exchange for funding. Many say the donations are necessary for their survival, since they operate on a non-profit basis and receive limited government funding.

“We do reference nicotine replacement therapy — we just talk to Canadians about what the products are and that they can receive further information,” said Lesley Ring, director of corporate development at the Canadian Cancer Society.

“We’re transparent in what the relationship is. We’re not mentioning their products by name. We’re not endorsing their products.”

But the organization, along with others, promotes the benefits of such products and the difficult of quitting without medical help.

The Canadian Cancer Society’s One Step at a Time guide to quitting smoking puts a heavy emphasis on the importance of medication. It mentions medication about a dozen times throughout the book, including a description of available products. It doesn’t mention specific brands.

A Pfizer-funded study, released by the Canadian Council for Tobacco Control last year, cites the advantages offered by the drug company’s nicotine-replacement products and discourages smokers from quitting on their own.

Other statistics and studies cast doubt on the effectiveness of smoking cessation pharmaceutical aids, as well as the notion the majority of smokers are doomed to fail if they quit on their own.

More than 90 per cent of former smokers in the U.S. quit “cold turkey” or by slowly weaning themselves off cigarettes, as opposed to about seven per cent who used drugs and/or counselling, according to the American Cancer Society’s 2003 statistics.

Researchers in Switzerland found smokers involved in a study who were on placebo, but believed they received nicotine replacement therapy, had similar quit rates to those on medication.

“Regardless of actual treatment, smokers who believed they had received nicotine had significantly better outcomes than those who believed they had received placebo,” says the study, published in the Journal of Consulting and Clinical Psychology in 2005.

“It’s not true to say it’s next to impossible to do it on your own. Lots of people do it on their own,” said Roberta Ferrence, executive director of the Ontario Tobacco Research Unit at the University of Toronto.

“The majority of people do it on their own.”

“To be perfectly frank, first of all, we know that while nicotine replacement therapy can increase a given person’s odds of quitting, in fact, the largest majority of people who’ve quit smoking in the country have done so likely without the assistance of medication, including nicotine replacement therapy,” said Paul McDonald, professor of health at the University of Waterloo.

Tom Brandstetter is one of them.

The 32-year-old Sault Ste. Marie resident had smoked for 12 years when he decided to quit last year — without medication. He chalks up success to something you can’t buy at a drugstore.

“You really have to have that decision and willingness to want to,” he said. “You can’t just say: ‘I’m going to chew this gum and it’s going to make me quit.’ You have to really want to.”

Yet, a smoking-cessation guide published by the Quebec branch of the Lung Association encourages people to review available medication before they do anything else in preparation to quit. The guide offers a detailed description of name-brand smoking cessation products sold by Pfizer and other companies.

“I don’t have a clue why it’s there. It probably shouldn’t be there,” Mr. Brisson said when asked about the emphasis on medication. “I guess it’s a shot in the dark.”