What Medscape Subscribers Really Thought About Its Tobacco Harm Reduction Programs

 

Earlier this year, Medscape, which describes itself as “the leading online global destination for physicians and healthcare professionals worldwide,” invited me to participate in a series of short continuing medical education (CME) programs on tobacco harm reduction (THR).  Medscape clearly disclosed that the series was sponsored by Philip Morris International, but the programs were firewalled; faculty were not in contact with or influenced by the sponsor.

Topics included, among others, an examination of nicotine, and the differential risks of combusted versus smoke-free tobacco/nicotine products.

I recorded two programs.  The first, “Nicotine Misperceptions: What Does the Evidence Say,” was published online by Medscape around March 1.  The second, in collaboration with Dr. Sally Satel, “Harm Reduction From Tobacco: An Evidence-Based Discussion,” was published April 1.  Dr. Satel also recorded a third program.

Following publication, a few anti-tobacco crusaders objected, threatening “a rapid global boycott by healthcare professionals disgusted by [Medscape’s] behaviour” in two British Medical Journal articles and one in The Examination.  I will not provide links to these, as they include ad hominem attacks on me.  Dr. Satel recounts the sorry tale in this article (here).    

As Dr. Satel notes, Medscape buckled, whining that “use of this funder was a misjudgment that was out of character for Medscape Education and that doing so may have disappointed our members.”

But were Medscape members truly offended by the PM sponsorship?  Evidence from an email I received from a Medscape manager says “NO.”  Shortly after my nicotine program aired, I received an unsolicited email from the manager titled, “One of the best CME programs I have seen in a long time…” Following is the text of that email, with some passages highlighted by me.

“We have the preliminary results from your program that was posted less than a month ago, and I am personally flabbergasted by the participation - over 6000 learners and over 2200 test takers!

“The comments from participants have been incredible as well:

• I can better educate and motivate pts on how to cut down their use of nicotine products. I am also more cognizant now that those who use cigarettes may have a more difficult time quitting. Will refer these pts to our clinical pharmacist who can also help advise and prescribe the appropriate tobacco cessation products.
  

• This was fantastic! This down to earth harm reduction approach is absolutely key to help meet people where they are, as nicotine addiction is so strong! Much better outcomes can be achieved as these presenters described, using less harmful forms of nicotine. As the doctors stated, there is a great need to educate providers, and clarify misconceptions about nicotine vs various methods of ingesting nicotine. I hope this presentation reaches a wide audience! One of the best continuing eds I have done in a while.
  

• Dispelled many myths I previously held about nicotine that I will no longer propagate.

• Thank you for bringing up such an important topic that can bring down the costs of healthcare and truly improve the public health. I am a psychiatric provider and have had a large number of patients successfully quit smoking with harm reduction measures!”

It is tragic that Medscape capitulated to rabid tobacco prohibitionists and stopped providing vital, life-saving information to health professionals.