Friday, December 11, 2020

How Federal Funding Influences Tobacco Research: GroupThink & Group Authorship


I recently critiqued a study by Dr. John Pierce and 35 co-authors of the FDA’s Population Assessment of Tobacco and Health (PATH) data that found, per their press release, “E-cigarettes Don’t Help Smokers Quit.”  My analysis showed their data supported a finding that e-cigarettes are as helpful as medicines and other aids promoted by anti-tobacco crusaders.

In my blog post, I advised that investigators at New York University, Ohio State, Georgetown and Columbia, led by Dr. Allison Glasser, concurrently co-authored another study finding that “…consistent and frequent e-cigarette use and increasing use over time, as well as flavors and device type, are associated with smoking cessation among adult smokers.”  Glasser was not a co-author of Pierce’s “Don’t Help” study, but two of Glasser’s colleagues were.

Pierce was not happy that Glasser’s findings were polar opposite to his.  In a letter to the editors of Nicotine & Tobacco Research, Pierce and three coauthors of the “Don’t Help” study asserted that Glasser’s results were invalid because the authors failed to adhere “to the best practices outlined in the National Academies of Science, Engineering and Medicine (NASEM) report on the public health consequences of e-cigarettes.”

In their reply, Glasser and co-authors wrote that Pierce et al. “are misguided.  Each study answers different questions…The two studies differ in a number of ways…we believe our study only adds to the range of studies available on this topic and offers a meaningful and more comprehensive perspective…To inform policy and interventions, we need evidence from studies of real-world use in addition to ideal, cessation-focused conditions.”

These letters, presenting radically different views on the impact of vaping on smoking, are based on conflicting methods of analyzing complex data.  They also raise other important issues.

 Given that Pierce’s “Don’t Help” study listed 35 co-authors, one may wonder how all of these people could have contributed to the final product.  The short answer is: They didn’t.

Why, then, did the study credit so many authors? A $243.6 million contract.

The U.S. Department of Health and Human Services (HHS) awarded that contract to Westat, a Rockville, Maryland, research corporation, to set up, manage and conduct research on the PATH survey.  Westat, in turn, awarded a total of $28.5 million to at least 18 universities and other contractors in support of the 36 coauthors.

Five years ago, I explained how NIH funding strongly influences some in the academic community to vigorously oppose – or ignore – tobacco harm reduction.  Government contracts like the one discussed here represent another source of funding that creates group authorship and groupthink about tobacco harm reduction.

In the present case, groupthink apparently broke down.  Pierce’s letter was signed by only three of his original 35 co-authors; Pierce added three new co-authors from his school, the University of California San Diego.  All signed on to the statement that Glasser’s study was invalid.

In his complaint letter, Pierce twice states that “the two senior authors [of the Glasser study] were also co-authors” of his study, implying that they had contradicted themselves.  Pierce has a point.

Also note how federal grants and contracts are intertwined in the tobacco research community.  The Glasser study was “funded in part by the National Cancer Institute (P01CA200512),” but this grant was to the Medical University of South Carolina, while Glasser and her co-authors were from New York University, Ohio State, Georgetown and Columbia.

Through convoluted funding programs, the U.S. Government continues to skew tobacco research to support prohibition rather than tobacco harm reduction, against the interests of inveterate smokers.


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