Thursday, July 15, 2021

How NIH Funding Undermines Tobacco Harm Reduction


Have you ever considered the recent years’ tsunami of research that emphasizes the dangers of e-cigarette and vaping products?  Was this work spontaneously generated?  How was it funded? 

Philip Cole, Elizabeth Delzell and I answered these questions in a manuscript published in 2000 in the journal Epidemiology (available here).  We described how after World War II, universities “changed their mission and became research arms of the federal government…But, with considerable money comes influence and eventually some control. The funds had been flowing for little more than a decade when President Eisenhower, in his 1961 farewell address to the nation, warned universities against accepting encumbered federal funds. He saw that the giving hand already had become the heavy hand. One by one, ever more onerous conditions were attached to federal awards. This has continued to the point that many universities now harbor research programs, sometimes entire institutes, that function essentially as satellites of the federal government.”

The U.S. National Institutes of Health is the primary funding source for researchers at universities countrywide.  In 2018, NIH provided 54,000 awards to 2,900 institutions -- nearly $40 billion in all. 

Research awards have two components.  The first is “direct costs,” which covers actual research.  These funds are managed by the researchers and include salaries for faculty and staff, equipment and other necessary expenses. 

The second component is “indirect costs,” covering things not directly related to the research – items like buildings, utilities and administrative expenses.  These items are managed by university administrators.  For every $100 in direct costs that a researcher gets from the NIH for their project, university administrators take $55-70 for indirect costs.  That is why we wrote that “…the need [for indirect costs] is so great that, perversely, Moneychangers [i.e., administrators] now prefer encumbered research grants, which offset overhead costs, to unencumbered gifts which do not but which do give faculty members freedom to pursue their interests.”

When Uncle Sam gives universities money, there’s always a catch, which we described in our article: “Federal bureaucrats fuel the fires of growth by urging academics to do research consistent with their agency’s mission. Through master agreements, cooperative agreements, requests for proposals and inducements of every sort, professors are led into doing the government’s research.”

It gets worse.  Money is so scarce that “Many universities now are over committed to…the aggrandizement of research, and some have gone so far that research fundraising has become more important than research itself.”


This brings us to tobacco research.  As I have noted, the government’s stated mission is “to create a world free of tobacco use.”  In fiscal year 2020, the NIH disbursed 1,489 awards identifying the key word “tobacco” to 303 unique organizations.  The grants totaled $693 million.  Over one-quarter of this money ($186 million) was devoted to research on e-cigarettes and vaping products.  Note in the following chart how increases in this funding have driven the number of research publications.


In summary, NIH is the most critical source of support for all American researchers, universities and other academic institutions.  Researchers and administrators recognize the value, if not imperative, of comporting with the government’s tobacco-termination mission.  Despite this oppressive influence, researchers routinely declare that they have no conflicts of interest or bias.

The steady flow of research reports demonizing e-cigarettes and vapor products provides “scientific” evidence to support harsh regulation.  The Tobacco Products Scientific Advisory Committee (TPSAC) that advises the FDA on regulations is currently comprised of seven members who together received $25 million from NIH in fiscal year 2020, and $54 million in other years.  

This blog post was developed from a presentation I gave on “How Institutional Funding in the U.S. Works Against Tobacco Harm Reduction” at the 2010 Global Forum on Nicotine Conference.  The recorded video is available here.  

Note added July 16, 2021

I was notified by @phil_w888 via Twitter that the Canadian equivalent of the NIH, the Canadian Institutes of Health Research, announced funding for a project last year on the Health Effects of Vaping.  Incredibly, the description contained the following: 

"Research projects exploring the use of vaping as a smoking cessation tool or as a harm reduction strategy are not eligible for this funding opportunity." 


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