Politics and incentives thwart science and harm reduction initiatives

By Kushlani De Silva 

Politics and money are getting in the way of science and public policy, and this often leads to conflict as opposed to conversation, remarked a panel of scientists and industry experts at the Global Nicotine Forum, held in Liverpool UK recently. 

The forum conducted live and to a global online audience discussed harm reduction products and policies for smokers the world over, and the challenges faced by the industry despite the compelling evidence presented for nicotine-based products. 

Nicotine-based products such as vape and e-cigarettes have become popular as reduced harm alternatives to tobacco-based cigarettes and smoking, which cause significant harm to human health. Countries such as the UK and New Zealand have adopted vape as a safer alternative based on scientific findings, and is actively promoting vaping over tobacco consumption. However, e-cigarettes and vaping remain banned in countries such as Australia and India. 

‘Science meets policy’ was the mission statement espoused by the forum, which was critical of how incentives have drowned out evidence-based actions. Roberto Sussman, Associate Professor at the University of Mexico, noted previously health policies in nations was determined by science and physicians, but now it is a matter often before politicians which has led to the degradation of associated laws and practices. 

“Tobacco and nicotine science was put in back seat, because science has become full of contradictions. There are many deviations and doubts published. What happens is that you have a political movement, that delays or promotes the implementation of a political plan,” Sussman said.  His views were endorsed by Professor Brad Rodu, Professor of Medicine at the University of Louisville Kentucky, who remarked that research universities have become businesses, seeking funding to continue doing business. These institutions and individuals are competing for research money, and will propagate the ideologies and findings of funding arms to achieve their end, which ultimately defeats science. 

“The tone is set on top. In 1994, I suggested that smokeless tobacco might be a safer substitute, I was blasted by the National Institute of Health and the Cancer Institute and investigated for two years. The tone was set there, and you can’t go up against that tone,” Rodu stressed. The forum discussed at length how researchers clamour for funding. So-much-so when Michael Bloomberg announced in January 2020 he prefers the prohibition of e-cigarettes, considering the amount of funding Bloomberg Philanthropies dishes out, recipients of this funding are found reporting in favour of banning e-cigarettes for the purpose of receiving more funding. 

Recipients of that money work in favour of banning e-cigarettes in low and middle-income countries. There isn’t a lot of funding available for research and training, so there is huge competition. Consequently, the number of reports against tobacco harm reduction will continue. There’s an astonishing number of people working in this respect and if there isn’t a huge problem to go after, there’s nothing for them to do. They are finding reasons to pursue their academic purpose and livelihoods. Much of these researchers have a very minute area of expertise, and it is very easy to connect that to tobacco because there is money involved. A lot of really poor science gets published as a result and universities are falling into that trap. Incentives are at the heart and core of the issues the nicotine industry is facing, it was said. Prof. Konstantinos Farsalinos, of the University of Patras, Greece, said: “The main incentive is money, funding for research groups and universities. I have been attacked for my research, despite there being no criticism of anyone. What is particularly concerning is the level of escalation these attacks take, with organised groups funded by Bloomberg Philanthropies. They go even further and deny the accused the chance to respond. That is very worrisome. They actively harm millions of smokers by doing this false reporting. They are hiding what can be done to reduce harm. They make lots of false allegations, and no response is allowed to be published. It’s more politics and less science. By doing so they are actively casing harm to public health and policy.” Participants at the forum also identified the lack of knowledge on the medical usage of nicotine as seen with autism, ADHD and other neurological diseases, which remains a largely untapped area of research and information. Nicotine is widely used by patients in such cases, and was viewed by some as a human right under health and well-being. “What’s the problem of being addicted to something that is not harmful? People say they are addicted to chocolate, but no one seems to make a fuss about that,” asked one participant at the sessions in Liverpool.

Science and innovation are key to driving change and enhancement in public health and society and it is not desirable to be changing ideals in this manner to benefit the political ambitions of a few. Tobacco harm reduction is a key discussion point over the past five decades, and it is ironic the anti-tobacco lobby is spearheading the drive against the very products that have come to reduce smoking and smoking related harm. We must hope that science holds out in the end.