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BMJ joins top medical journals in shunning misinformation propagated by tobacco-funded research

The British Medical Journal has announced that they “will no longer consider for publication any study that is partly or wholly funded by the tobacco industry. Our new policy is consistent with those of other journals including PLoS Medicine, PLoS One, PLoS Biology; Journal of Health Psychology; journals published by the American Thoracic Society; and BMJ’s own Tobacco Control.”

Misinformation is dangerous. Spreading false news and beliefs has always been common, and studies in methodologies of critical thinking and judgment has advanced rather drastically to train minds in discerning proper, credible works from the ranks of unreliable and biased writings.

Where techniques in security advance, techniques in breaking security will always be haunting, breaking a step or two ahead. Likewise with knowledge, even as critical thinking has improved, there will be charlatans taking advantage of weaknesses in methods of thought; posing the credibility of academic studies, they write convincing pieces of studies that are either worthless or, worse, intended to mislead readers into false believes and judgments.

The latter is what is happening with tobacco-funded ‘research’. Commissioned by research foundations created by tobacco firms and writing in the format of academic journals, tobacco-funded studies throw readers off-guard by using very analytical and scientifically-toned writing to ‘prove’ theories such as ‘No definite link between menthol flavours and youth smoking’ or ‘High tariffs linked to increased smuggling, which in turn funds criminal activity’. And in unfortunate moments, media agencies and journals sometimes get taken in and publish these writings to lend their reports a flavour of ‘balance’, adding false weight to the credibility of these writings and making it even harder for readers to make proper judgments on the truth of the matter.

The ban that BMJ and other medical journals impose on such tobacco-funded research is thus by no means ‘shutting out’ different opinions. Rather, the editorial boards are now much more aware of the ‘knowledge trap’ that such articles present; that by publishing such work alongside real scientific research, they unintentionally help tobacco fronts set such traps for their readers.

Journal policy on research funded by the tobacco industry

Jointly written by Fiona Godlee, editor in chief; Ruth Malone, editor, Tobacco Control; Adam Timmis, current/outgoing editor, Heart; Catherine Otto, incoming editor, Heart; Andy Bush, coeditor, Thorax; Ian Pavord, coeditor, Thorax; Trish Groves, editor in chief, BMJ Open

As editors of the BMJ, Heart, Thorax, and BMJ Open we have decided that the journals will no longer consider for publication any study that is partly or wholly funded by the tobacco industry. Our new policy is consistent with those of other journals including PLoS Medicine, PLoS One, PLoS Biology[1]; Journal of Health Psychology[2]; journals published by the American Thoracic Society[3]; and BMJ’s own Tobacco Control.[4]

Critics may argue—as many did when journals stopped publishing cigarette adverts—that publishing such research does not constitute endorsing its findings and that, as long as funding sources are fully disclosed, readers can consider that information and make up their own minds about the quality of the work. Peer review should prevail, goes this line of thinking: it’s not the editor’s job to make these kinds of judgments. However, this view ignores the growing body of evidence that biases and research misconduct are often impossible to detect,[5] and that the source of funding can influence the outcomes of studies in invisible ways.[6, 7]

Underlying all the activity of peer review, editing, and publishing is the assumption that medical journals exist for the purpose of advancing knowledge that can be used to promote health and reduce disease. But the deputy editor of JAMA, Drummond Rennie, who has perhaps studied the process of scientific publishing longer than anyone, has written about what he calls “little murders.” These are deceptive publication practices that are “destructive of the delicate web of trust between colleagues that keeps the whole enterprise functioning and afloat.”[8] The editor’s job, observes Rennie, is to “try to separate the insufferable behaviors of mere jerks from the illegal actions of bona fide crooks.”

The tobacco industry, far from advancing knowledge, has used research to deliberately produce ignorance and to advance its ultimate goal of selling its deadly products while shoring up its damaged legitimacy.[9] We now know, from extensive research drawing on the tobacco industry’s own internal documents, that for decades the industry sought to create both scientific and popular ignorance or “doubt.” At first this doubt related to the fact that smoking caused lung cancer; later, it related to the harmful effects of secondhand smoke on non-smokers and the true effects of using so called light or reduced tar cigarettes on smokers’ health.[9-12] Journals unwittingly played a role in producing and sustaining this ignorance.9

Some who work within public health and who buy the notion of “harm reduction” argue that the companies that now produce modified cigarette products and non-cigarette tobacco products, including electronic nicotine delivery devices (e-cigarettes), are different from the tobacco industry of old, or that the tobacco industry has changed. For “hardened” cigarette smokers who can’t or won’t quit cigarettes,[13] the argument goes, new tobacco products could represent potential public health gains, and company sponsored research may be the first to identify those gains.

But one fact remains unassailably true: the same few multinational tobacco companies continue to dominate the market globally and, as smaller companies develop promising products, they are quickly acquired by the larger ones. However promising any other products might be, tobacco companies are still in the business of marketing cigarettes. As US federal court judge Gladys Kessler pointed out in her judgment in the case of US Department of Justice versus Philip Morris et al, the egregious behaviour of these companies is continuing and is likely to continue into the future.[14] And just this summer documents leaked from one company showed a concerted campaign to “ensure that PP [plain packaging of tobacco products, bearing health warnings but only minimal branding] is not adopted in the UK.”[15] The tobacco industry has not changed in any fundamental way, and the cigarette—the single most deadly consumer product ever made—remains widely available and aggressively marketed.

Editors of BMJ journals are committed to integrity in scientific publishing and to ensuring that—as far as possible—their journals publish honest work that advances knowledge about health and disease. Back in 2003, the editor of the BMJ defended publication of a study with tobacco industry funding saying “The BMJ is passionately antitobacco, but we are also passionately prodebate and proscience. A ban would be antiscience.”[16] But it is time to cease supporting the now discredited notion that tobacco industry funded research is just like any other research. Refusing to publish research funded by the tobacco industry affirms our fundamental commitment not to allow our journals to be used in the service of an industry that continues to perpetuate the most deadly disease epidemic of our times.

15 Oct 2013

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